AU2021106195A4

AU2021106195A4 - An intra-oral appliance for use with a fixed retainer

Info

Publication number: AU2021106195A4
Application number: AU2021106195A
Authority: AU
Inventors: Christopher John Farrell
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-08-20
Filing date: 2021-08-20
Publication date: 2021-10-28
Anticipated expiration: 2029-08-20

Abstract

: An intra-oral appliance for a patient having a fixed retainer mounted on a lingual surface of their upper or lower arch teeth is disclosed. The appliance comprises inner and outer 5 walls joined by a web and defining upper and lower arch channels, and the inner wall has a channel surface facing towards the channels and an opposing lingual surface. The channel surface of the inner wall has a lower recess facing into the lower arch channel, and/or an upper recess facing into the upper arch channel. The upper and the lower recesses are configured to receive a permanent retainer mounted on the patient therein 10 to allow the inner wall to fit over an associated arch and teeth of the patient fitted with the fixed retainer. The recesses are elongated in a direction of length of the upper and lower arch channels and extends across the incisor teeth and the canine teeth. Figure 6 for publication 4/5 Figure 6 \gr Figure 7

Description

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AN INTRA-ORAL APPLIANCE FOR USE WITH A FIXED RETAINER FIELD

This invention relates to an intra-oral appliance suitable for use by a patient wearing a fixed retainer. It also extends to a method of treating a patient having a fixed retainer using the appliance.

The invention relates particularly but not exclusively to an intra-oral appliance that can be worn by a patient who is fitted with a permanent fixed retainer that is mounted on the lingual surface of their upper and/or lower arch teeth.

DEFINITIONS

In the present disclosure and claims, the term "comprising" shall be understood to have a broad meaning similar to the term including" and will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps. This definition also applies to variations on the term "comprising" such as "comprise" and comprises".

In the present disclosure and claims, the term "fixed retainer" shall be understood to mean an appliance that remains in a patient's mouth all the time and is not removed each day. Typically, these retainers are bonded to the patient's teeth.

BACKGROUND

A fixed or bonded permanent retainer is used on a patient after orthodontic treatment to stabilize the arch structure and retain the alignment of teeth and to resist post treatment relapse. A bonded retainer comprises a metal wire mounted on the lingual side or surface of the lower arch teeth and/or the upper arch teeth. Typically, it is bonded to the left and right cuspids or canine teeth and extends across the incisors. The ends of the wire are bonded to the teeth by means of a bonding agent. An illustration of a bonded retainer on a lower arch of a user is provided in Figure 1.

A permanent retainer typically remains in place on a patient for years and sometimes even decades. Some people have been able to wear their permanent retainers for up to 20 years.

The permanent retainer aims to hold the teeth in their position after orthodontic treatment to resist them from relapsing back or moving back into their original position. Applicant is aware of some limitations of these retainers. For example, they only extend across the front teeth and do not apply a retaining force to all the teeth. Because the retainer does not extend across the full row of teeth, its influence is necessarily limited.

Another limitation is that the permanent retainer does not exert a myofunctional influence on the arch structures and tongue of a patient. That is, the fixed retainer does not exert any positive effect on muscles that are associated with the patient's arches, and muscles positioned around the patient's teeth sockets. Further, it also does not exert any positive influence on the tongue and help to position the tongue which is important for developing and maintaining correct dental occlusion.

In addition to permanent retainers, some removable retainers are also known that are worn by patients on a daily basis at night-time. These removable retainers are single arch appliances that are custom moulded to suit the dentition of the patient and are typically mounted over the teeth of the patient. They help with the alignment of teeth along an arch but do not have any influence on developing the arch form or correctly positioning the upper and lower arches for correct dental occlusion. Another disadvantage with removable retainers is that there can be difficulties in achieving patient compliance.

SUMMARY OF THE DISCLOSURE

Applicant recognises that some patients having a bonded permanent retainer on their upper or lower arches may also desire to use an intra-oral appliance having upper and lower channels for receiving their upper and lower arches. These appliances can be worn for a variety of reasons including the following:

0 promoting myofunctional habits that promote correct dental occlusion; * correctly positioning the upper arch relative to the lower arch; * promoting alignment of teeth along an arch form; • TMJ support; and * Treatment of SDB.

However, if a patient has a permanent retainer fitted onto the lingual surface of the dentition on their upper or lower arches, they will not be easily fitted with an intra-oral appliance having upper and lower channels. This is because the permanent retainer mounted on the lingual surface of the teeth interferes with and/or obstructs the lingual wall or inner wall of the appliance. Put another way, the permanent retainer obstructs the appliance and stops it from fitting properly.

Applicant recognises it would be beneficial if an appliance could be devised that could be comfortably and effectively worn by a patient when they have a permanent retainer on the lingual surfaces of their upper and/or lower teeth. This would avoid the situation where the retainer interferes with the close and comfortable fit of an appliance over the arches of a patient.

In a broad aspect of the invention there is provided an intra-oral appliance for a patient having a fixed retainer, e.g., a permanent retainer, mounted on the lingual surface of their upper or lower arch teeth, the appliance comprising: inner and outer walls joined by a web and defining upper and lower arch channels, the inner wall having a channel surface and a lingual surface, wherein the channel surface of the inner wall has at least one recess formed therein that is configured to receive a fixed retainer mounted on the patient therein to allow the inner wall to fit over an associated arch and teeth of the patient fitted with the fixed retainer.

That is, the fixed, e.g., permanent, retainer is received in the at least one recess in the inner wall and a remainder of the inner wall of the appliance (outside of the recess) is able to lie flat against, and bear up against, a lingual surface of the associated arch and teeth of the patient.

The at least one recess may comprise a lower recess facing into the lower arch channel.

The at least one recess may comprise an upper recess facing into the upper arch channel.

Yet further, the at least one recess may comprise a lower recess facing into the lower arch channel and an upper recess facing into the upper arch channel.

The recess may extend across the incisor teeth and the bicuspid teeth (canine teeth).

The recess may be elongated in the direction of length of the upper and lower arch channels and have opposed ends.

The opposed ends of each recess may be curved.

Each recess may have a cross sectional profile that is configured to receive a retainer therein, that can be seen when the appliance is viewed in cross section.

The cross-sectional profile of the recess may be curved, e.g., it may have a concave curvature. In one form the profile of the recess may be semi-circular.

Further, each recess may have a depth of at least 2mm, e.g., at least 3mm relative to the surrounding inner wall which can be viewed in the cross-sectional profile.

The outer wall may include an outer or buccal surface facing outward and an inner or channel surface facing towards the arch channels.

The appliance may further include a tongue tag on the inner wall.

The tongue tag may include a tongue positioning formation on the lingual surface of the inner wall which receives a tip of the tongue of a patient for assisting them to correctly position their tongue. The tongue tag may be a passive tongue tag that correctly positions the tongue (in contrast to a functional tongue tag that actively exercises the tongue).

The tongue tag may include a tongue positioning formation and the tongue positioning formation may comprise a shallow recess in the lingual surface of the inner wall to which the tongue tip is drawn.

According to another aspect of the invention there is provided an intra-oral appliance for a patient having a fixed retainer mounted on the lingual surface of their upper or lower teeth, the appliance comprising: inner and outer walls joined by a web and defining upper and lower arch channels, the inner wall having a channel surface and a lingual surface, wherein the channel surface of the inner wall has a lower recess formed therein facing into the lower channel, and an upper recess formed therein facing into the upper channel, each recess is configured to extend across the incisor and canine teeth of the patient and receive the fixed retainer therein.

The intra-oral appliance may include any one or more of the optional or preferred features of the appliance defined in a preceding aspect of the invention. Further, the intra-oral appliance may include any combination of these features.

According to yet another aspect of the invention there is provided a method of treating a patient who has a permanent retainer fitted over a lingual surface of their upper or lower arch, including: providing an appliance comprising an inner wall and an outer wall joined by a web and defining upper and lower arch channels, the inner wall having a channel surface and a lingual surface, and the channel surface of the inner wall has at least one recess formed therein, mounting the appliance over the upper and lower arches of the patient with the permanent retainer received within the at least one recess so that the appliance fits the patient fitted with the retainer.

The appliance may have an upper recess formed facing into the upper arch channel and a lower recess facing into the lower arch channel and the patient may have a fixed retainer fitted over the lingual surface of their upper arch and another fixed retainer fitted over the lingual surface of their lower arch, and mounting the appliance over their upper and lower arches may comprise receiving said one and other retainers in the upper and lower recesses respectively.

Instead the patient may only have a fixed retainer fitted over the lingual surface of their upper arch and mounting the appliance over their upper and lower arches may comprise receiving said retainer in the upper recess.

Further instead the patient may only have a fixed retainer fitted over the lingual surface of their lower arch, and mounting the appliance over their upper and lower arches may comprise receiving said retainer in the lower recess.

The appliance may function to improve the myofunctional habits of the patient and thereby help maintain the arch form and the alignment of teeth post orthodontic treatment.

The appliance may include any one or more of the optional or preferred features of the appliance defined in a preceding aspect of the invention. Further, the intra-oral appliance may include any combination of these features.

BRIEF DESCRIPTION OF THE DRAWINGS

An intra-oral appliance suitable for use by a person having a permanent retainer fitted on their lower or upper arches in accordance with the invention may manifest itself in a variety of forms. It will be convenient to hereinafter describe in detail an embodiment of the invention with reference to accompanying drawings. The purpose of providing this detailed description is to instruct persons having an interest in the subject matter of the invention how to carry the invention into practical effect. However, it is to be clearly understood that the specific nature of this detailed description does not supersede the generality of the preceding summary section. The Detailed Description makes reference to the accompanying drawings in which:

Figure 1 is a schematic drawing of a lower arch of a patient fitted with a bonded or fixed permanent retainer;

Figure 2 is an upper perspective view of an intra-oral appliance in accordance with the invention for use by a patient fitted with a fixed retainer;

Figure 3 is a lower perspective view of the intra-oral appliance of Figure 2 when viewed from the rear;

Figure 4 is a top plan view of the intra-oral appliance of Figure 2;

Figure 5 is a bottom plan view of the intra-oral appliance of Figure 2;

Figure 6 is a cross-sectional view through a centre line of the appliance of Figure 2;

Figure 7 is a rear view of the appliance in Figure 2;

Figure 8 is a front view of the appliance in Figure 2; and

Figure 9 is a schematic cross-sectional drawing of the intra-oral appliance fitted on a patient having fixed retainers on their upper and lower arches.

DETAILED DESCRIPTION OF AN EXAMPLE EMBODIMENT

Figure 1 illustrates a prior art retainer mounted on the lower arch of a patient.

The retainer comprises a length of wire that extends across the lingual surface of the front six teeth on the lower arch, i.e., the four incisors and the bicuspids on the lower arch. Each end of the wire is fixed to the associated bicuspid (canine teeth) by bonding or other technique. The function of the retainer is to hold the teeth of the associated arch namely the lower arch in the position and aligned with each other to prevent relapse after orthodontic treatment. For example, the curved shape of the wire helps to preserves the shape of the arch particularly in an anterior region of the arch. As the retainer forms part of the prior art and has been discussed above in the background section, it will not be described further in the detailed description.

In Figures 2 to 9, reference numeral 10 illustrates an intra-oral appliance in accordance with one embodiment of the invention.

The appliance 10 comprises an outer wall 12 and an inner wall 14 that are interconnected by a web 16 and together form upper and lower channels 20 and 22 within which respectively the upper and lower arches and associated dentition of a patient can be received. The outer wall 12 has an outward facing buccal surface and an inner or channel facing surface. Correspondingly, the inner wall 14 has an outer or channel facing surface and a lingual inner surface. The web 16 in turn has upper and lower surfaces.

Overall, the appliance 10 has a has catenary shape that mimics the form of the dental arch. That is, it has a frontal region indicated generally by numeral 24 with arms 26 extending back from each side of the frontal region 24.

The upper channel 20 is formed by the inner or channel surface of the outer wall 12, the outer or channel surface of the inner wall 14 and the upper surface of the web 16. The lower channel 22, in turn, is formed by the inner or channel surface of the outer wall 12, the outer or channel surface of the inner wall 14, and the lower surface of the web 16.

The appliance 10 has a recess 30 formed in or defined in the outer surface of the inner wall 14 facing into the upper channel 20. The appliance 10 also has a similar recess 34 formed in the outer surface of the inner wall 14 facing into the lower channel 22. The recesses 30, 34 may also be referred to as cut-outs.

Each recess 30, 34 has a length extending across the four incisor teeth and the adjacent canine teeth on left and right sides of the incisor teeth. Further, the ends of each recess 30, 34 may be rounded or curved as shown in the drawings.

Each recess 30, 34 has a depth that is sufficient to receive a retainer on a patient or a user fully therein. The cross-sectional configuration of the recesses 30, 34 which are shown in Figure 6 which gives an indication of the depth of the recesses 30, 34. Each recess 30, 34 has a curved, e.g., semi-circular cross-sectional configuration, and this provides some tolerance for fitting the appliance to patients having different sized teeth and also differently sizes of retainers.

The appliance also has a tongue tag 50 on the upper portion of the inner wall 14. The tongue tag 50 assists a user to correctly position their tongue in their oral cavity to achieve an optimal myofunctional effect. In the illustrated embodiment, the tongue tag 50 has a tongue positioning formation in the form of a shallow recess on the lingual surface of the inner wall 14 to which the tongue tip is drawn. The tongue tag 50 is a passive myofunctional feature that is designed to correctly position the tongue rather than actively exercise the tongue.

In use, the intra-oral appliance 10 can be fitted to a user or patient who desires to use a myofunctional appliance to improve for example their myofunctional health, but who it fitted with a permanent retainer on their upper or lower arches. The reasons why a patient who is fitted with a permanent retainer would have reason to wear a myofunctional appliance have been discussed at some length in the background section of the specification.

To fit the intra-oral appliance to a patient, as shown in Figure 9 the appliance 10 is inserted into the oral cavity and mounted over the upper and lower arches in the same way that a TRAINERTM or MYOBRACE© appliance is mounted over the arches of a user. As shown, the patient has a permanent retainer indicated by numeral 60 on the lingual surface of each of their upper and lower arches 62 and 64. The retainers 60 are received within the recess 30 or 34 in the inner wall 14. The recesses 30, 34 are sized such that the permanent retainer 60, e.g., wire, can be fully received within the recess 30, 34 and does not project out from the recess 30, 34. Thus, the retainer 60 does not interfere with fitting of the appliance 10 to the patient and this enables the remainder of the channel or outer surface of the inner wall 14 to lie flat up against the arches 62 and 64 of the patient and abut the arches and their associated teeth. This enables the appliance 10 to exert a treatment force on the arches and teeth of the patient.

The intra-oral appliance 10 described above with reference to the drawings may conveniently be injection moulded from a suitable material, e.g., medical grade silicon. The material provides comfortable cushioning against the arches of the patient while still exerting a myofunctional effect. The appliance is typically pre-manufactured in a plurality of different sizes which enables the appliance to be fitted to and used by a large percentage of the population.

The recesses 30, 34 are dimensioned to receive a retainer therein with some clearance in both a direction of length and width. This provides a tolerance that enables the pre- manufactured appliance 10 to be satisfactorily fitted to different users and function properly.

The intra-oral appliance 10 is also dimensioned to provide some clearance in a direction of depth when the retainer 60 is received therein. Once again, this helps the appliance 10 to be fitted to and be used by a range of users or patients having different arch sizes and teeth sizes.

In another embodiment of the appliance, that is similar to the embodiment above but is not illustrated, the appliance only has a recess defined in the inner wall facing into the lower channel receiving the lower arch teeth. This appliance would be suitable for being fitted to a patient wearing a permanent retainer on their lower arch teeth.

In yet another embodiment of the appliance, similar to the embodiment above but not illustrated, the appliance only has a recess defined in the inner wall facing into the upper channel receiving the upper arch teeth. This appliance would be suitable for being fitted to a patient wearing a permanent retainer on their upper arch teeth.

One advantage of the intra-oral appliance described above with reference to Figures 3 to 8 of the drawings is that it is designed with a recess or cut out that is specially configured to receive the wire of a fixed retainer without distorting the appliance. This therefore allows the appliance to fit snugly over the lower or upper arch of a user and exert its full myofunctional effect.

Another advantage of the appliance described above is that it enables a patient fitted with a permanent retainer on their lower and/or upper arches to additionally wear an appliance promoting good myofunctional habits and thereby enjoy the further benefits of treatment with an appliance. Thus, it enables a patient to receive the cumulative benefits of a permanent fitted retainer an intra-oral appliance promoting correct myofunctional habits. Yet another advantage of the intra-oral appliance in Figures 3 to 8 of the drawings is that it helps to correctly position a user's upper arch relative to their lower arch which confers orthodontic benefits.

Yet another advantage of the intra-oral appliance described above with reference to the drawings is that wearing the intra-oral appliance contributes to the retention of the arch form and teeth alignment obtained by orthodontic treatment. That is, the intra-oral appliance works in combination with or in tandem with the retainer to retain the patient's arch form and teeth alignment, e.g., an expanded arch form, in their post treatment positions without relapse. Applicant believes that a patient will be less likely to suffer relapse if they wear an appliance like that in Figures 3 to 8 in addition to their permanent retainer. Further, applicant believes that the retention provided by the appliance will be more sustainable and therefore more durable because it encourages good myofunctional habits. By contrast, the permanent retainer only provides a basic retention of the teeth rand does not promote good myofunctional habits.

Yet another advantage of the intra-oral appliance described above with reference to the drawings is that it has a tongue tag that promotes correct tongue position which in turn encourages improved dental occlusion.

A yet further advantage of the intra-oral appliance described above with reference to the drawings is that it can be pre-manufactured in a plurality of sizes by injection moulding and is capable of being fitted to most patients even though they have different arch sizes and different sizes of teeth. That is, it is not custom manufactured for each patient.

It is intended that all matter contained in the above detailed description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. All such modifications and variations thereto, as would be apparent to persons skilled in the art, are deemed to fall within the broad scope and ambit of the invention as is set forth herein. Changes in detail or structure may be made without departing from the basic elements of the invention as defined in the following claims.

Claims

CLAIMS:

1. An intra-oral appliance for a patient having a fixed retainer mounted on a lingual surface of their upper or lower arch teeth, the appliance comprising: inner and outer walls joined by a web and defining upper and lower arch channels, the inner wall having a channel surface and a lingual surface, wherein the channel surface of the inner wall has at least one recess formed therein that is configured to receive a fixed retainer mounted on the patient therein to allow the inner wall to fit over an associated arch and teeth of the patient fitted with the fixed retainer.

2. An intra-oral appliance according to claim 1, wherein the at least one recess comprises a lower recess facing into the lower arch channel, and/or an upper recess facing into the upper arch channel.

3. An intra-oral appliance according to claim 1 or claim 2, wherein the at least one recess is elongated in a direction of length of the upper and lower arch channels and extends across the incisor teeth and the canine teeth.

4. An intra-oral appliance according to any one of claims 1 to 3, wherein each recess has a cross-sectional profile transverse to its direction of elongation having a concave curved configuration.

5. A method of treating a patient who has a fixed retainer fitted over a lingual surface of their upper or lower arch, including: providing an appliance comprising, an inner wall and an outer wall joined by a web and defining upper and lower arch channels, the inner wall having a channel surface and a lingual surface, and the channel surface of the inner wall has at least one recess formed therein, mounting the appliance over the upper and lower arches of the patient with the fixed retainer received within the at least one recess, so that the appliance fits the patient fitted with the fixed retainer.