Mandibular Advancement Device with Lingual Strap
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Solution Overview
Problem
Existing mandibular advancement devices for treating snoring and obstructive sleep apnea are cumbersome, complex, and often cause side effects like GERD due to their requirement of multiple engagement members and limited tongue depression, which can lead to airway obstruction during deep sleep.
Innovation Solution
A mandibular advancement device with a maxillary tray and a mandibular tray featuring at least two advancement members that protrude over the maxillary tray to advance the mandible, combined with a lingual strap to retain the tongue in a non-obstructive position, reducing the need for multiple engagement members and minimizing GERD risks.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple engagement members (bite pads, flanges) are used on both maxillary and mandibular trays to advance the mandible, then the mandible can be advanced to the desired position, but the device becomes cumbersome, complex, and increases the likelihood of failure
Solution Approach 1:
The invention extracts and eliminates the maxillary tray and its engagement members from the device. Only the mandibular tray with advancement members remains, which protrude upward to contact the maxillary tray's outer surface. This reduces the number of engaging members from four to two, simplifying the device while maintaining mandible advancement capability
Solution Approach 2:
The device is segmented into independent functional components: the mandibular tray with advancement members that protrude upward, and the maxillary tray with an open anterior region. This segmentation allows the advancement members to contact the maxillary tray surface without requiring engagement members on both trays
2Reliability
If the device requires four or more engaging members to advance the mandible, then mandible advancement is achieved, but the device causes dental, muscle, and TMJ pain when the patient bruxes or clenches teeth
Solution Approach 1:
By removing the maxillary tray and its engagement members, the invention eliminates the sources of dental and muscle pain that occur during bruxing or clenching. The mandibular tray's advancement members contact only the outer surface of the maxillary tray, not the teeth directly, reducing harmful forces on dental structures and muscles
3Duration of action of moving object
If the mouth drops open during deep sleep stages, then the patient enters normal sleep cycles, but the bite pads or guide members disengage and allow the mandible and tongue to fall back, obstructing the airway
Solution Approach 1:
The advancement members on the mandibular tray protrude upward to contact the outer surface of the maxillary tray in advance, establishing a mechanical linkage that prevents the mandible from falling back. This preliminary positioning ensures that even when the mouth opens during deep sleep, the mandible remains advanced and the airway stays patent
Solution Approach 2:
The invention changes the dimension of engagement from horizontal (bite pads on both trays) to vertical (mandibular advancement members protruding upward to contact maxillary tray surface). This vertical engagement maintains mandible position even when the mouth opens, preventing airway obstruction
4Reliability
If a transpalatal bar is extended down the posterior aspect of the tongue to hold it forward, then airway opening is improved, but the gag reflex is activated and the design is not well tolerated by patients
Solution Approach 1:
The invention removes the transpalatal bar entirely and replaces it with advancement members on the mandibular tray that protrude upward to contact the maxillary tray. This eliminates the gag reflex activation while maintaining airway opening through mandible advancement and tongue space creation
Solution Approach 2:
The outer surface of the maxillary tray acts as an intermediary surface that the advancement members contact. This indirect contact mechanism advances the mandible and creates tongue space without directly depressing the tongue or activating the gag reflex, as would occur with a transpalatal bar
Data Source
AI summary
A mandibular advancement device used in the management of snoring, obstructive sleep apnea, TMD and bruxism, comprises a maxillary tray for receiving/retaining maxillary teeth, a mandibular tray for receiving/retaining mandibular teeth, and at least two advancement members/prongs located on the mandibular tray at the anterior-lateral regions thereof. The advancement members/prongs, when in use, contact the outer surface of the maxillary tray in an anterior-lateral region thereof, thereby advancing/retaining the mandible and tongue in a protrusive position. Raised occlusal surfaces/bite pads in a region contiguous and posterior to the advancement prongs allow a passive tongue retaining gap or space to be formed in the anterior and posterior regions of the device. A lingual retaining strap may be provided between opposite posterior portions of the mandibular tray to passively retain the tongue in a protruded, non-obstructive position.