Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
  • A61F5/56—Devices for preventing snoring
  • A61F5/566—Intra-oral devices

Definitions

• the present invention relates to an intraoral orthosis intended for the treatment of snoring and more particularly for that of sleep apnea.
• Document WO 97/04716 discloses an intraoral device comprising two mandibles respectively maxillary and mandibular, connected by a connecting device intended to generate a mandibular propelling force oriented in the direction of the mandibular propulsion, so as to maintain an offset of the mandible towards the front of the maxilla, while allowing lateral movements.
• the connection device consists of a simple elastic band passed over hooks fixed to one and the other of the gutters. This device does not allow a fine adaptation to the problem of each patient.
• the connecting device consists of a fairly complex mechanical connection adjustable by means of a screw.
• a titratable orthosis is marketed under the name of EMA Titration® by the company Frantz Design and includes at the front of the gutters two rods which can be fixed one on the other by means of a plurality notches spaced 3 mm apart, in different adjustable longitudinal positions.
• EMA Titration® the company Frantz Design
• the adjustment of either of these devices is a long and complicated affair, since it requires removing the device, defining a first setting, testing the device one or more nights with this setting to see if it is satisfactory, if not, to modify this first setting and to repeat the trial and error testing operations until a satisfactory setting is obtained.
• the displacement of the patient's mandible is obtained by a special intraoral device in the laboratory or hospital, consisting of gutters linked to supports arranged at their front parts, a linear mechanical actuator (for example with screw) or hydraulic actuator (for example with piston) being provided between the two supports to cause the relative displacement of the mandible in one direction, its displacement in the other direction being caused by the muscular contraction.
• Documents DE 295 06 512 U or US 5 066 226 also know orthoses with connecting rods, possibly adjustable, but none of them makes it possible to carry out both the titration and then to constitute the definitive titrated orthosis. .
• the object of the invention is to propose a new intraoral orthosis, simple and easy to manufacture, which allows a perfect adaptation to the patient, and can be used both for determining the effective mandibular advancement and for maintaining it, once this determination obtained.
• an orthosis comprising two maxillary and mandibular grooves, connected together by at least one connecting element removably disposed between a remote point of one of the grooves and an advanced point of the other, characterized in that this connecting element is a rigid elongate element and hinged in a removable manner on the gutters, and in that it is chosen between, initially corresponding to the step of determining or titrating the effective mandibular advance, a jack capable of being connected to a control circuit and, in a second step corresponding to the final orthosis, a rod of fixed length determined according to the effective mandibular advance determined.
• the actuator and the associated control circuit can be of the hydraulic, electric or magnetic type.
• the connecting rod is chosen from a set of connecting rods of several lengths increasing by a fixed step to be compatible with the results of the measurements.
• the connecting rod comprises a set of fixing locations allowing several useful lengths of connecting rod, for example differing from each other by a given pitch.
• the actuator and the connecting rod comprise removable articulated fixing members to the gutters.
• the connection makes it possible to generate a propulsive force on the mandible, when the jack is used, or to block this advancement, when the connecting rod is used, while in both cases allowing the movements of diduction and d mouth opening.
• the fixing members are provided so that the piston is arranged so that the force generated is substantially in the plane between the two closed dental arches, that is to say the occlusal plane.
• the gutters are advantageously made up of a rigid plastic upper surface and a deformable lower surface ensuring good adaptation and fixity on the dental arches. It is possible to provide several sizes of gutters (for example five) to adapt to each individual case.
• the gutters can also be produced individually in a single material by thermoforming.
• gutters other devices adapting to dental arches and which can similarly serve as a support for the jacks and connecting rods of the invention, for example metal frames (advantageously made of titanium) of the type used in advanced orthoses, at least one of which is covered with a layer (for example resin) allowing the teeth of the opposing frame to slide.
• metal frames advantageousously made of titanium
• a layer for example resin
• the orthosis is advantageously equipped with a it includes a titration marking device, a part of which is connected to each of the gutters in a removable manner. It can be a removable graphic plate used only during the determination step, this plate being fixed in the anteromedial part of a gutter and cooperating with a stylet resiliently fixed from removably on the other gutter, or a sliding index device driven by a finger in a slide.
• FIG. 1 is a perspective view of an orthosis according to the invention
• FIGS. 2 and 3 are side views and of above the same orthosis
• FIG. 4 is a detail view of a jack that can be used in the orthosis of FIG. 1
• FIG. 5 is a section at the line VV of FIG. 4 showing a method of embodiment of the cylinder attachment zone
• FIGS. 6 to 9 show in section various possibilities for producing the detachable articulated attachment of the cylinder or of the connecting rod on the orthosis
• FIG. 10 is a view similar to FIG.
• Figures 1 1 and 12 show two possibilities for producing connecting rods
• Figure 13 shows an alternative embodiment of connecting rod
• Figures 14 and 15 shows in section and in perspective an alternative embodiment orthosis comprising a titration plate.
• Prosthesis 1 comprises two gutters respectively maxillary and mandibular, formed by a rigid part or upper surface 2, 2 'and a part 3, 3' or lower surface adaptable to the dental arch. At the rear of the maxillary rigid part
• plumb with the mesial face of the second molars are formed on one side and on the other of the locations 4 of detachable articulated attachment for the connecting elements of the jack 10 or connecting rod 20 type (cf. also figures 10 to 12).
• locations 4 ′ of removable articulated attachment are formed on the side of the rigid mandibular part 2 ′.
• the locations 4, 4 ′ allow the ends of the connecting elements to be attached in an articulated, simple and removable manner, which are shaped accordingly.
• the locations 4 and 4 ′ may, where appropriate, be provided for protruding downwards and upwards respectively (relative to the plane of the gutter on which they are formed) so as the connecting element 10 or 20 which connects them thirst arranged more in the occlusal plane.
• FIG. 1 to 3 there is shown as a connecting member a cylinder 10 (there are advantageously two, one on each side of the gutters) consisting of a fine syringe whose rod 1 1 of piston 12 is bent at its end 13 and cooperates with location 4.
• the syringe body 14 comprises a collar 15 (FIG. 1) or a projection 16 (FIGS. 4, 5) provided with a fixing end 17 cooperating with location 4 ' .
• the syringe is connected by a tube 5 to a hydraulic circuit for controlling the recoil of the piston in the syringe, which corresponds by reaction to an advance of the mandible.
• the control circuit can be produced simply and comprise a control jack produced in the form of a syringe 6, the piston 7 of which is moved by a threaded rod 8 with knurled head 9.
• the body of the syringe 6 is graduated in order to be able to monitor exactly the progression of the corresponding mandibular advancement.
• two jacks 14 are used on either side of the orthosis, it is possible to use only one control jack 6, the end of which is connected by a double tube to the two jacks 14.
• the ends 13 and 17 may be provided with male profiles cooperating with a female profile formed at location 4 or 4, in particular key profiles, that is to say male profiles of the elongated button type 18 cooperating with female profiles in the form of lights, so that they can be mttOduire in a position and be axially retained there after a rotation (Cf. Figures 5 and 6).
• the male profiles can alternatively comprise a mushroom-shaped button 19 which snaps elastically into an opening in the location 4 or 4 ′ (cf. FIG. 8) or else in the form of a ball joint 20 engaging elastically in a counter ball joint formed at location 4 '.
• the male profiles can be formed in the locations 4 or 4 'and cooperate with a female profile formed in the end of the connecting member, as shown in Figure 7, the left part of Figure 4 or the figure 12.
• the connecting rods 20 can be produced in the form of rods provided with ends 13 with a male profile similar to the end of the jack rod (cf. FIG. 11) or in the form of flat rods endowed with a female profile (cf. 12) cooperating with a suitable profile of the location 4 or 4 '. According to the variant shown in FIG.
• the connecting rods 13 are suitable for several different titrations, for example thanks to a plurality of fixing locations in the form of female profiles or simple holes 40, 40 ′ and 41 defining useful lengths of connecting rod varying by a step p between a minimum length L and a maximum length L + np, or n is an integer, for example 5.
• the step p can be 1 mm for example and the length L of 30 mm. It is advantageous to arrange the holes 40, on the side opposite to the side where the hole 41 is located, on two parallel lines, as shown. Instead of a single hole 41, several holes can be provided allowing, in combination with the several holes 40, 40 ′, a greater range of useful lengths.
• FIG. 2 schematically, a graphic plate 21 removably attached to the front of the lower gutter 2 ', on which points a stylet 22 held by an elastic stylus holder 23 (for example, a leaf spring) removably attached to the upper gutter 2.
• This tracing system makes it possible to mark the propulsion path.
• a tab 21 removably attached to the front of the lower gutter 2 ', on which points a stylet 22 held by an elastic stylus holder 23 (for example, a leaf spring) removably attached to the upper gutter 2.
• an elastic stylus holder 23 for example, a leaf spring
• the 30 fixes at the front of the lower gutter an arm 31 carrying a finger 32, capable of pj-xcourt a light 33 formed in a plate 34 fixed by a lug 35 and a fixing 36 to the upper gutter.
• the finger 32 can push a sliding index finger 37 in the lumen 33 and thus mark the position corresponding to the titration of the orthosis.
• the instructions for use of the orthosis of the invention are as follows.
• the deformable intrados 3, 3 'of the gutters are formed on the patient's dental arches.
• Gutters and jacks are put in place, which are connected to the hydraulic control circuit.
• Each turn of the control cylinder screw sends liquid into the lateral cylinders of the gutters and causes the mandible to advance.
• Each advanced mandible in turn leads to airway disobstraction.
• the connecting rod set is searched for the rod closest to the effective mandibular advancement thus determined and the lateral jacks are replaced in the orthosis by two connecting rods, so as to produce the final orthosis of the patient.

Landscapes

• Health & Medical Sciences (AREA)
• Otolaryngology (AREA)
• Pulmonology (AREA)
• Nursing (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Orthopedics, Nursing, And Contraception (AREA)

Applications Claiming Priority (3)

Publications (1)

Family

ID=8856199

Family Applications (1)

Country Status (4)

Families Citing this family (12)

Family Cites Families (8)

• 2000
  • 2000-11-08 FR FR0014339A patent/FR2816203B1/fr not_active Expired - Fee Related
• 2001
  • 2001-11-08 AU AU2002218341A patent/AU2002218341A1/en not_active Abandoned
  • 2001-11-08 EP EP01993440A patent/EP1335688A1/de not_active Withdrawn
  • 2001-11-08 WO PCT/FR2001/003471 patent/WO2002038090A1/fr not_active Application Discontinuation

Non-Patent Citations (1)

Also Published As

Similar Documents

Legal Events