EP1871313A1 - Orthese dentaire - Google Patents
Orthese dentaireInfo
- Publication number
- EP1871313A1 EP1871313A1 EP06726038A EP06726038A EP1871313A1 EP 1871313 A1 EP1871313 A1 EP 1871313A1 EP 06726038 A EP06726038 A EP 06726038A EP 06726038 A EP06726038 A EP 06726038A EP 1871313 A1 EP1871313 A1 EP 1871313A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- orthosis
- orthosis according
- jaw
- cooperation
- mandibular
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 230000001939 inductive effect Effects 0.000 claims abstract description 3
- 230000002009 allergenic effect Effects 0.000 claims description 6
- 239000000126 substance Substances 0.000 claims description 6
- 229910000831 Steel Inorganic materials 0.000 claims description 5
- 239000010959 steel Substances 0.000 claims description 5
- 239000004925 Acrylic resin Substances 0.000 claims description 4
- 229920000178 Acrylic resin Polymers 0.000 claims description 4
- 210000000988 bone and bone Anatomy 0.000 abstract description 2
- 208000001797 obstructive sleep apnea Diseases 0.000 description 9
- 201000002859 sleep apnea Diseases 0.000 description 9
- 210000001847 jaw Anatomy 0.000 description 8
- 210000003205 muscle Anatomy 0.000 description 7
- 238000001356 surgical procedure Methods 0.000 description 6
- 238000011282 treatment Methods 0.000 description 6
- 210000004763 bicuspid Anatomy 0.000 description 5
- 206010021079 Hypopnoea Diseases 0.000 description 4
- 238000006243 chemical reaction Methods 0.000 description 4
- 210000002455 dental arch Anatomy 0.000 description 4
- 208000008784 apnea Diseases 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
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- 238000012986 modification Methods 0.000 description 3
- 230000011514 reflex Effects 0.000 description 3
- 230000000638 stimulation Effects 0.000 description 3
- 230000036346 tooth eruption Effects 0.000 description 3
- 230000005856 abnormality Effects 0.000 description 2
- 210000004513 dentition Anatomy 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 210000004392 genitalia Anatomy 0.000 description 2
- 230000006698 induction Effects 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 210000002050 maxilla Anatomy 0.000 description 2
- 230000003387 muscular Effects 0.000 description 2
- 230000036961 partial effect Effects 0.000 description 2
- 230000029058 respiratory gaseous exchange Effects 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 241000282465 Canis Species 0.000 description 1
- 201000006306 Cor pulmonale Diseases 0.000 description 1
- 208000020401 Depressive disease Diseases 0.000 description 1
- 208000007590 Disorders of Excessive Somnolence Diseases 0.000 description 1
- 206010020751 Hypersensitivity Diseases 0.000 description 1
- 206010021143 Hypoxia Diseases 0.000 description 1
- 206010024119 Left ventricular failure Diseases 0.000 description 1
- 208000030663 Libido disease Diseases 0.000 description 1
- 206010061876 Obstruction Diseases 0.000 description 1
- 208000004186 Pulmonary Heart Disease Diseases 0.000 description 1
- 206010038687 Respiratory distress Diseases 0.000 description 1
- 206010039163 Right ventricular failure Diseases 0.000 description 1
- 206010039203 Road traffic accident Diseases 0.000 description 1
- 208000006011 Stroke Diseases 0.000 description 1
- 206010043183 Teething Diseases 0.000 description 1
- 230000003213 activating effect Effects 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 206010003119 arrhythmia Diseases 0.000 description 1
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- 230000001174 ascending effect Effects 0.000 description 1
- 235000004251 balanced diet Nutrition 0.000 description 1
- 230000006399 behavior Effects 0.000 description 1
- 230000003542 behavioural effect Effects 0.000 description 1
- 238000005266 casting Methods 0.000 description 1
- 210000003169 central nervous system Anatomy 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
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- 235000005911 diet Nutrition 0.000 description 1
- 230000000378 dietary effect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 238000005530 etching Methods 0.000 description 1
- 238000013467 fragmentation Methods 0.000 description 1
- 238000006062 fragmentation reaction Methods 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 210000004195 gingiva Anatomy 0.000 description 1
- 208000018875 hypoxemia Diseases 0.000 description 1
- 210000004283 incisor Anatomy 0.000 description 1
- 230000000670 limiting effect Effects 0.000 description 1
- 208000020442 loss of weight Diseases 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 210000004373 mandible Anatomy 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 208000031225 myocardial ischemia Diseases 0.000 description 1
- 231100000957 no side effect Toxicity 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 210000002741 palatine tonsil Anatomy 0.000 description 1
- 230000007310 pathophysiology Effects 0.000 description 1
- 238000011458 pharmacological treatment Methods 0.000 description 1
- 210000003800 pharynx Anatomy 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000002685 pulmonary effect Effects 0.000 description 1
- 239000011347 resin Substances 0.000 description 1
- 229920005989 resin Polymers 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 230000000284 resting effect Effects 0.000 description 1
- 210000003625 skull Anatomy 0.000 description 1
- 210000001584 soft palate Anatomy 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 230000009885 systemic effect Effects 0.000 description 1
- 230000002123 temporal effect Effects 0.000 description 1
- 210000001738 temporomandibular joint Anatomy 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 238000007483 tonsillectomy Methods 0.000 description 1
- 230000001052 transient effect Effects 0.000 description 1
- 230000017105 transposition Effects 0.000 description 1
- 238000009423 ventilation Methods 0.000 description 1
- 210000001260 vocal cord Anatomy 0.000 description 1
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 a dental orthosis, particularly for the therapeutic treatment of Obstructive Sleep Apnea Syndrome (OSAS).
- OSAS Obstructive Sleep Apnea Syndrome
- OSA is a disease defined by a series of episodes of obstructions, total or partial, leading to the total or partial cessation of breathing during sleep, and more specifically to either hypopnea, that is to say a decrease in airflow, ie apnea, ie the cessation of airflow or ventilation.
- Apnea is usually defined by a stop of 10 seconds or more of airflow and hypopnea by at least a 50% decrease in airflow for at least 10 seconds.
- the main symptoms related to OSA and therefore to apnea and / or hypopnea are hypersomnolence, memory problems, difficulty concentrating, behavioral disorders, depressive syndromes, libido disorders, automatic behaviors and the risk of traffic accidents.
- OSAS is associated with cardiovascular excess mortality as it is likely to lead to left and / or right ventricular failure, cardiac arrhythmias, cerebrovascular accidents and systemic arterial hypertension and / or pulmonary and ischemic heart disease.
- the hypopneas are also accompanied by microreveils, disorganizing all the sleep of the individual and leading to a fragmentation of sleep, which is no longer restorative because of these interruptions in airflow and episodes of hypoxemia that result hence a feeling of fatigue in the patient.
- this device is relatively bulky, expensive and noisy, resulting in noise that is difficult to manage for the immediate surroundings of the user.
- Surgical procedures to correct organic defects that may lead to OSA may also be considered, such as nasal surgery, soft tissue surgery (tonsillectomy, uvulopalatopharyngoplasty, pharyngotomy, basiglossectomy), or bone surgery, such as bimaxillary surgery, hyoid surgery, or genital transposition.
- This modification also affects the craniofacial skeleton.
- OSA anatomical abnormality
- craniomaxillofacial abnormalities and retromandibulia for example the position of the maxillary, the angulation of the base of the skull and the height of the face.
- OSA The pathophysiology of OSA is unclear and involves several factors such as changes in upper airway anatomy and resistance as well as control of pharyngeal dilator muscle tone during sleep.
- dental prostheses have been proposed propelling the mandible in the context of the treatment of OSAS, these prostheses being intended to be worn at night.
- These dental prostheses are intended to prevent the patient from exerting muscle forces on the soft tissues of the airways superior, including tongue, pharynx, velum and vocal cords.
- Prostheses according to the prior art generate a visco-elastic muscle reaction of the mandibual retropulsors.
- the present invention proposes to solve the problems related to the prior art with the aid of an easily usable prosthesis, inexpensive, easily adaptable, easy to manufacture with simple elements, having no side effects associated with prostheses according to the prior art (dental pain for example), to effectively treat patients with OSAS with high success rates and favoring muscular involvement in mandibular advancement.
- the present invention relates to a dental orthosis comprising upper cooperation means adapted to cooperate with the upper jaw and lower cooperation means adapted to cooperate with the lower jaw, characterized in that said orthosis present means capable of inducing a mandibular advancement and more specifically the lower cooperation means comprise means able to exert pressure on the chin spines of said lower jaw.
- the pressure means are in the form of at least one bracket with a rounded end covered by a plate in a non-allergenic substance and made of a steel wire.
- the lower cooperation means have means for adjusting the mandibular propulsion consisting of a cylinder of adjustable length.
- the upper cooperation means comprise fastening means on the upper jaw constituted by fastening means on at least one molar in the form of a Adams-type hook.
- FIG. 1 shows a front view of the orthosis according to the invention placed in a jaw of a patient
- FIG. 2 shows a side view of the orthosis according to the invention placed in a jaw of the patient
- FIG. 3 shows a perspective view of the inside of a jaw of a patient with the orthosis according to the invention
- FIG. 4 shows a front perspective view of the orthosis according to the invention fixed on the upper jaw
- FIG. 5 shows a side perspective view of the orthosis according to the invention fixed on the upper jaw
- - Figure 6 shows a perspective view of three-quarters of the orthosis according to the invention fixed on the upper jaw.
- Figure 1 shows a front view in perspective of the orthosis according to the invention placed in a jaw of a patient.
- the orthosis according to the invention 1 has upper and lower cooperation means 2 3 capable of cooperating with the maxillary, respectively upper 4 and lower 5 of a patient.
- the upper and lower cooperation means (2, 3) are in the form of a gutter 6 in which the dentition, respectively, of the maxillary upper 2 and lower 3 is able to support and cooperate.
- the cooperation means (2, 3) are in a generally semicircular or horseshoe shape.
- FIG. 1 shows cooperation means (2, 3) with an open outer face, that is to say that once the teeth have been resting on the channel 6, then the outer face of the teeth is not covered by the cooperation means (2, 3) or only partially.
- the upper and lower cooperation means (2, 3) have digs or internal engravings of complementary shape to the dental crown of the teething respectively of the upper maxillary 4 and lower 5, these digs or etchings being advantageously made from of maxillary castings 4 and lower 5.
- the dental crown can fit totally or partially into the gutter 6, thus allowing fixed retention of the cooperation means (2, 3) on the dental arches.
- the cooperation means (2, 3) are made of a non-allergenic material, in particular an acrylic resin.
- Figure 2 shows a side view of the orthosis according to the invention placed in a jaw of a patient.
- fixing means 7 of the orthosis 1 on the upper maxillary 4 are provided in the upper cooperation means 2.
- the fixing means 7 are in the form of hooks 8 cooperating with the patient's upper dental arch.
- the dentition of each individual is composed of a double pair of incisors (9a, 9b, 9c, 9d), a pair of canines (10a, 10b), a double pair of premolars (11 a, 11b, 11c, 11d) and then molars (12a, 12b), this dental distribution being found both for the upper maxilla 4 than for the lower jaw 5.
- the fastening means 7 shown in FIG. 2 consist of fastening means using at least one premolar 13 and fixing means on at least one molar 14
- the fixing means on at least one molar 14 are in the form of a hook 8 commonly known as Adar's hook.
- the so-called Adams hook 8 is thus advantageously made of a hard steel wire surrounding a molar (12a, 12b) and whose two ends are encompassed in the upper cooperation means 2 and more precisely in the constituent resin mass of these means of cooperation 2.
- the fixing means of the orthosis 1 with the aid of at least one premolar 13 is in the form of an arm 15 advantageously made of an ascending steel wire and able to be inserted between the two premolars (11). a, 11 c) of the maxilla 4.
- the free end of the arm 15 has a ball or bulge material so as not to notch or irritate the gingiva at the free space between the two premolars (11a, 11b, 11c, 11d).
- Figure 3 shows a perspective view of the inside of a jaw with the orthosis according to the invention.
- the pressure means 16 are in the form of two brackets 17 with a rounded end 18 covered with a plate 19 made of a non-allergenic substance, for example an acrylic resin.
- the plates 19 of the pressure means 16 are advantageously placed opposite the mucous area covering the chin spines.
- the plates 19 are designed and shaped in such a way as to exert pressure on the genital processes.
- the brackets 17 are advantageously made of a steel wire commonly used in the field of the invention and of sufficient strength and rigidity to exert pressure on the mucosal area.
- Figures 4 and 5 show respectively a front and side perspective view of the orthosis according to the invention attached to the upper jaw 4. From Figures 4 and 5, it can be seen that the rounded end 18 of the brackets 17 is shaped in the form of a closed loop or hook.
- the stimulation resulting from the pressure exerted on the chin spines is transmitted to the central nervous system which transforms it into efferent motor messages.
- FIG. 6 represents a third perspective view of the orthosis according to the invention fixed on the upper jaw 4.
- the lower cooperation means 5 are made in such a way that the digs or engravings in the gutter 6 for the dental crowns of the lower jaw 5 are placed in such a way that there is a mandibular advancement relative to the occlusion position of at least a few millimeters, this mandibular advance being adjusted by the mandibular propulsion adjustment means 20.
- the adjustment means of the mandibular propulsion 20 are in the form of a jack 21 of adjustable length thus making it possible to adjust the mandibular advance.
- the means for adjusting mandibular propulsion 20 are provided symmetrically in the lower cooperation means 3 at the level of the premolars or molars respectively right and left of the lower jaw 5.
- the adjustment means of the mandibular propulsion 20 are thus in the form of a recess of material 22 in the lower cooperation means 3, and consequently in the gutter 6.
- the mandibular adjustment means 20 make it possible to progressively adjust the mandibular advance as a function of the response muscle induced by the patient and thus to cause a progression of the tongue and consequently a greater release of the upper airways.
- the orthosis thus obtained allows the induction of a mandibular advancement that is no longer forced over the prostheses known from the prior art, but only induced, the pressure exerted at the level of the chin spines leading to reflex mandibular advancement.
- the mandibular advancement is therefore induced by the pressure means 16.
- the orthosis according to the invention is particularly adapted to the treatment of Obstructive Sleep Apnea Syndrome.
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)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR0502346A FR2882923B1 (enrdf_load_stackoverflow) | 2005-03-09 | 2005-03-09 | |
| PCT/FR2006/000506 WO2006095083A1 (fr) | 2005-03-09 | 2006-03-07 | Orthese dentaire |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| EP1871313A1 true EP1871313A1 (fr) | 2008-01-02 |
Family
ID=35169719
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP06726038A Withdrawn EP1871313A1 (fr) | 2005-03-09 | 2006-03-07 | Orthese dentaire |
Country Status (6)
| Country | Link |
|---|---|
| US (1) | US20080190437A1 (enrdf_load_stackoverflow) |
| EP (1) | EP1871313A1 (enrdf_load_stackoverflow) |
| JP (1) | JP2008532603A (enrdf_load_stackoverflow) |
| CA (1) | CA2598779A1 (enrdf_load_stackoverflow) |
| FR (1) | FR2882923B1 (enrdf_load_stackoverflow) |
| WO (1) | WO2006095083A1 (enrdf_load_stackoverflow) |
Families Citing this family (12)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102123686B (zh) * | 2008-05-21 | 2014-11-19 | C·潘廷 | 用于缓解打鼾和睡眠呼吸暂停的装置 |
| US20100104998A1 (en) * | 2008-10-25 | 2010-04-29 | Stanley Edward Farrell | Dental Splint |
| JP5635525B2 (ja) * | 2009-10-20 | 2014-12-03 | 国立大学法人 岡山大学 | 口腔用具 |
| KR101154618B1 (ko) | 2011-03-16 | 2012-06-08 | 동국대학교 산학협력단 | 교정용 하악 유도 악기능 장치 |
| US9730831B2 (en) | 2012-06-19 | 2017-08-15 | Duane C. Keller | Method of manufacturing an oral tray for stabilizing jaw joint relationships for treatment of sleep apnea |
| EP2695589A1 (en) * | 2012-08-10 | 2014-02-12 | Michèle Hervy | Intraoral functional device for relieving obstructive sleep apnea syndrom, snoring and/or other airway disorders |
| US20140076332A1 (en) * | 2012-09-15 | 2014-03-20 | Kenneth Luco | Dental Appliance for Treatment of Obstructive Sleep Apnea (OSA) and Sleep Bruxism |
| GB2537399A (en) * | 2015-04-16 | 2016-10-19 | C Basson Johannes | Device for retaining in a user's mouth |
| US10010313B2 (en) | 2015-05-18 | 2018-07-03 | Richard L. Arden | Mandibular subluxation device and method |
| US10258319B2 (en) | 2015-05-18 | 2019-04-16 | Richard L. Arden | Airway assist device and method |
| US10342526B2 (en) | 2015-07-01 | 2019-07-09 | Richard L. Arden | Airway assist device and method |
| WO2020123592A1 (en) | 2018-12-11 | 2020-06-18 | Wiele Gary B | An assembly and method of treatment providing non-invasive controlled positioning and movement of a patient's jaw |
Family Cites Families (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4669459A (en) * | 1985-11-29 | 1987-06-02 | Spiewak Martin H | Anti-snoring device |
| US4969822A (en) * | 1988-10-27 | 1990-11-13 | Summer John D | Oral orthopedic appliance for correcting mandibular retrusion |
| US6055986A (en) * | 1992-11-16 | 2000-05-02 | Meade; Thomas E. | Apparatus and method for the reduction of snoring |
| US5365945A (en) * | 1993-04-13 | 1994-11-22 | Halstrom Leonard W | Adjustable dental applicance for treatment of snoring and obstructive sleep apnea |
| US5570704A (en) * | 1993-10-28 | 1996-11-05 | Snoreless Corp | Universal, user-adjustable oral cavity appliance to control snoring and reduce episodes of obstructive sleep apnea |
| US5409017A (en) * | 1994-01-19 | 1995-04-25 | The University Of British Columbia | Mandible repositioning appliance |
| US6109265A (en) * | 1995-06-23 | 2000-08-29 | Frantz; Don E. | Elastic mandibular advancement appliance |
| US5829441A (en) * | 1997-06-24 | 1998-11-03 | Nellcor Puritan Bennett | Customizable dental device for snoring and sleep apnea treatment |
| CA2455589C (en) * | 2001-07-25 | 2010-01-05 | Charles D. Kownacki | Nocturnal oral airway dilator |
| US7328705B2 (en) * | 2003-03-10 | 2008-02-12 | Mark Abramson | Dental appliance for improving airflow through nasal-pharyngeal airway |
| US6983752B2 (en) * | 2004-03-11 | 2006-01-10 | Sleep Sound Services Zzz | Dental appliance for the treatment of sleep disorders |
-
2005
- 2005-03-09 FR FR0502346A patent/FR2882923B1/fr not_active Expired - Fee Related
-
2006
- 2006-03-07 US US11/908,171 patent/US20080190437A1/en not_active Abandoned
- 2006-03-07 EP EP06726038A patent/EP1871313A1/fr not_active Withdrawn
- 2006-03-07 JP JP2008500230A patent/JP2008532603A/ja active Pending
- 2006-03-07 WO PCT/FR2006/000506 patent/WO2006095083A1/fr not_active Application Discontinuation
- 2006-03-07 CA CA002598779A patent/CA2598779A1/fr not_active Abandoned
Non-Patent Citations (1)
| Title |
|---|
| See references of WO2006095083A1 * |
Also Published As
| Publication number | Publication date |
|---|---|
| FR2882923B1 (enrdf_load_stackoverflow) | 2008-03-14 |
| WO2006095083A1 (fr) | 2006-09-14 |
| CA2598779A1 (fr) | 2006-09-14 |
| JP2008532603A (ja) | 2008-08-21 |
| US20080190437A1 (en) | 2008-08-14 |
| FR2882923A1 (enrdf_load_stackoverflow) | 2006-09-15 |
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| PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
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| 17P | Request for examination filed |
Effective date: 20070831 |
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| DAX | Request for extension of the european patent (deleted) | ||
| 17Q | First examination report despatched |
Effective date: 20090506 |
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| STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN |
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| 18D | Application deemed to be withdrawn |
Effective date: 20091001 |