Multi-Axis Dental Orthotic Strut for Adjustable Jaw Advancement
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Solution Overview
Problem
Existing dental orthotics, such as the Herbst appliance, are semi-permanently bonded to teeth, making adjustments to strut length cumbersome and uncomfortable for the wearer, and often cause lateral and medial stresses leading to wear and discomfort due to limited jaw movement capabilities.
Innovation Solution
A dental orthotic with a maxillary and mandibular retainer system featuring a variable-length rigid strut with an internal adjuster, elastic closure, and fenestrations for comfort, along with resilient struts that apply forward force for jaw advancement, and multi-axis rotatable joints for non-sagittal jaw movement, allowing for adjustable and comfortable jaw displacement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Force
If the Herbst appliance is semi-permanently bonded to teeth with spring-loaded struts, then continuous pressure can be applied to advance the jaw, but the device cannot be easily removed or adjusted by the wearer and causes lateral and medial stresses leading to wear and discomfort
Solution Approach 1:
The orthotic device is divided into separate maxillary and mandibular portions that can be independently removed from the teeth. The strut connecting these portions is segmented with an internal adjuster mechanism, allowing the length to be divided into adjustable increments. This segmentation enables the wearer to remove and adjust the device without requiring professional intervention, while still maintaining the ability to apply continuous pressure through the resilient nature of the strut material.
Solution Approach 2:
The strut transitions from a fixed-length rigid component to a dynamic, adjustable-length resilient component. The internal adjuster mechanism allows the strut length to be changed in increments, enabling the device to adapt to changing jaw positions over time. The resilient material allows the strut to dynamically respond to jaw movements while maintaining continuous forward pressure, resolving the contradiction between fixed force application and adjustable geometry.
2Force
If the Herbst appliance uses spring-loaded struts for continuous pressure, then jaw advancement is achieved, but adjustments to strut length require removal from the patient's mouth which is cumbersome
Solution Approach 1:
The internal adjuster mechanism is designed to be operable by the wearer themselves without requiring removal from the mouth or professional assistance. The adjustment process is simplified to allow the wearer to modify the strut length in increments independently, enabling self-service adjustments that save time and improve convenience while maintaining the necessary jaw advancement force.
3Device complexity
If the orthotic has limited jaw movement capabilities, then the structure remains simple, but lateral and medial stresses cause wear and discomfort
Solution Approach 1:
The strut's ability to change length in increments allows the device to adapt to the jaw's natural movement parameters. As the jaw moves laterally and medially during function, the adjustable length accommodates these parameter changes, reducing stress on the device structure and the teeth. This dynamic parameter adjustment maintains structural simplicity while eliminating the harmful stresses caused by rigid, fixed-geometry designs.
4Ease of manufacture
If the strut length is fixed, then manufacturing is simpler, but the orthotic cannot be adjusted after delivery to the patient
Solution Approach 1:
The internal adjuster mechanism is nested within the strut structure, with the adjustment mechanism contained inside the strut body. This nested design allows the strut to be manufactured as a complete unit with integrated adjustment capability, simplifying the manufacturing process while enabling post-delivery adjustments. The adjuster is housed within the strut's internal geometry, allowing length changes without requiring disassembly or complex external mechanisms.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables adjustable jaw advancement without removing the device, improves wearer comfort, and extends the orthotic's lifespan by reducing stress and discomfort, while allowing precise measurement and adjustment of jaw displacement for effective airway clearance.
Implementation Method 1
Another class of orthotic, and in particular that described by Robson (U.S. Pat. No. 5,752,822) relies on positioning the tongue on an extension that elevates the tongue and causes the tongue to move forward to an upward position resting on the extension. These devices are designed to manipulate the airway by changing the position of the tongue.
Implementation Method 2
The Herbst appliance, or Herbst-type orthotics, often suffer from a number of practical problems. Generally, these devices are semi-permanently bonded to the teeth, and while they can be removed by a practitioner, they are not generally amenable to removal by the wearer. These appliances generally utilize spring-loaded struts, in order that a continuous pressure may be applied to advance the jaw.
Data Source
AI summary
A dental orthotic strut having at least one multi-axis rotable joint connecting the strut to either a maxillary and/or mandibular retainer attached to the teeth. Jaw advancement may be accomplished by periodically replacing the strut with a new strut having a slightly longer minimum length, thereby advancing the resting position of the closed jaw. The rotable joint or joints allow greater freedom of movement and comfort when the jaw is opened in a non-sagittal plane. A plurality of strut pairs having a same length, but with progressively longer sets of strut pairs is generally supplied, so that left and right struts can be progressively replaced with longer struts over time.