FR2641964A1 - Cast activators for dentofacial orthopaedic treatment and periodontics - Google Patents

Abstract

The invention consists in a prefabrication of the various types, of ideal elliptical shape, in several sizes corresponding to the various ages, state, dimension of the dentition. This prefabrication is made of "food grade" rubberised or plastic mixtures. The dental arches and the teeth are placed in normalised relationships inside a "dental corridor" consisting of the outer bar 1, the inner bar 2 (both vertical) and the horizontal plane 7 of superelevation, of which all the walls are smooth. The action of these activators results from their inherent tonicity and the polymicrostimulations of the facial and buccal muscles during the various movements of the natural functions of the dento-maxillo-facial apparatus. The use of the device according to the invention is intended for odontologists.

Description

 The present invention relates to a device belonging to the category of means put into action for simplified treatment in orthopedic functional dentofacial therapy.

 The applicant's specialization and his professional functions in social and liberal university practice led him to study the needs in infant dental care, in particular with regard to the treatments set out in title, or, to put it more simply, "recovery" of teeth ", that is to say, to correct malformations of the maxillae, anomalies in their relations, malpositions of the teeth. There are also their consequences on facial aesthetics and harmony and the various functions: chewing, breathing, phonation, to the various pledges of Life.

The percentage of children eligible for such treatment is estimated at around 25%. Average figure established by numerous statistics, notably those of the Official School Dental Inspection. The average birth rate of 800,000 per year means that 200,000 children need treatment each year. The average duration of these treatments being around 2 years, it is easy to realize the importance of the needs and their repercussions on Health
Public, social and ... family expenses, improving the "Quality of
Life".

 This led the applicant to design an apparently simple device (although requiring an etiopathogenic investigation), efficient, multifunctional; limiting the number of visits, therefore the movement of patients and accompanying persons, especially for those far from a Practitioner, specialized or not.

 In short, as reliable as possible, whatever the age: child, adult, old man, and the dental formula.

 Technically, the design is based on the comparative study of the countless devices used, yesterday and today; After having analyzed the mechanism of their action, we have synthesized the effects produced: favorable, null or harmful, and this, logically, in the 3 directions of space. Classifications, already old but still valid, define in particular the anteroposterior and transverse relationships of skin, bone (maxilla) and teeth tissues.

For simplicity, we have retained the ANGLE classification, which for being imperfect is, however, known to all Odonto
Stomatologists. 3 classes: - Class I corresponds to normal, or para-normal skeletal relationships, in the sagittal (or anteroposterior) direction. Our "Gutter Activator
Conformateur "responds to this clinical form. Superior dental arch and
Lower dental arch are placed in these same normal sagittal relationships.

-Class ll corresponds to abnormal skeletal relationships in this same sagittal direction. In its subdivision 1, the upper arch is moved forward; the mandible is moved backwards. There are also anomalies in the vertical and transverse directions. In its subdivision 2, the upper arch is less prominent, the mandible is moved backwards. Abnormal vertical and transverse directions are very marked. Our "Gutter Activator for
Retromorphosis "was the subject of Patent No. 1,101,897 issued on June 22, 1955, therefore now out of date.

- Class III corresponds to an advanced position of the mandible (by progression or hyperdevelopment) with, most often, maxillary retroposition and anomalies in the vertical and transverse directions.

 Our "Gutter Activator for Anemorphosis" retropulses the mandible and vestibule the Maxillary Incisivo-Canine arch.

These 3 ANGLE classes therefore correspond to 3 types of Activators
Gutters A 4th type is added to it, called "Activator for Expansion
Transversale "whose essential action is the enlargement of the maxillae, alveoli and dental arches. It also does not act, like the other types, in the other directions of space.

 The description of the 3 types for which we are asking for protection is specified by the following texts, to which are added diagrams objectifying their differences in form, structure, efficiency. Classification and identification are facilitated by distinctive signs: vertical points, horizontal points, horizontal lines (internal or lingual face).

Additions are easily added to these various types of Activators
Gutters. For example, transpalatal wires in the form of handles, positioning the tongue forward or backward according to the opening of their curve, according to the technique of
Teacher. BALTERS. We then speak of the "Baltization" of the "SB" (SOULET BESOMBES); or the addition of rubber cords (SANDOW type), according to the technique of Prof. MACARY. We then speak of the "Macarysation" of "SB" (SOULET-BESOMBES).

 "S.B." Gutter Activators (SOULET-BESOMBES) are prefabricated in flexible (food-based or rubber-based) materials.

A renewed interest in this truly multifunctional therapy manifesting itself so much in France (Theses, Memoirs,
Communications) that Abroad (the USA "rediscover" this therapy of European and, above all, French origin), leads us to seek national protection.

 Indeed, American and other firms offer devices that have the same external appearance but that cannot act, at least currently. It is to be feared that the reasons for this inactivity compared to ours appear to them ...

 Conforming Gutter Activator. Consisting of 2 vertical bands (one external, the other internal) connected by a horizontal plane.

The double Gutter includes more particularly the maxillary arch and slightly less completely, the mandibular arch. She acts:
- on individual dental movements.

 - the upper proalveoli.

- open bite (open bite) consequences of habits
annoying: sucking fingers, various objects, lingual interposition
(RIX Syndrome).

 - malpositions with mild endoalveoli and incisal overbite.

- mandibular deviations (lateral sliding) of occlusal origin,
muscle or neuro-muscle. Hence the normalization of the midline.

 - on bruxism and snoring.

 The Activator of this type ensures a state of aesthetic and functional harmony in the 3 directions. The restraint, passive or active, is ensured, as well as obtaining an occluso-articulated balance as perfect as possible, so difficult to achieve by other means. The removal of traumatic occlusions is obtained, polymicrotrauma being eliminated at all ages. Which is essential.

 Corresponding to the ANGLE Class I, this Conforming Activator is manufactured in several nt intended for lacteal dentition, mixed dentition, adult dentition and according to dental volume. This type is identified by vertical dots 5 in the middle part of the lingual surface. For classification, a green disc is glued to the transparent box containing it.

 Figure 1 shows: in A: the general view of the Conforming Activator front (1), rear (2), elevation (3).

in B: the anteroposterior median section of the vestibular band (4) and the internal or retro-incisal relief (6).

in C: the cross section at the premolars, its interdental thickness (7), the vestibular strip (4) and the internal (or lingual) strip (5).

 Figure 2 shows: in D: an example of anomaly of the premolar reports (reversed on the right).

in F: an example of lingual interposition projecting the incisors forward, separating them and propelling the upper lip.

 Figure 3 shows: at E: the effect produced by the Activator and its thickness (7) (C in Figure 1).

in G: the effects produced by the Activator: the thickness (7) raises the molar and premolar relationships while the external strip (4) will verticalize the incisors, allow their approximation, and normalize the labial profile. It is in front of the internal relief in retro-incisor (6) that the teeth, incisors and canines are guided, which will be displaced according to the arrows, thus returning to their normal relationships.

 Gutter Activator for Antemorphosis.

 The double groove will exert very differentiated actions on the jaws and on the mandible.

On the jawbones: the vestibular band is very thin in its anterior part (corresponding to the Incisivo-Canin arch). Infinitely thicker is the posterior bulwark, or lingual: the aim being to vestibulate said arch
Incisivo-Canin. In its posterior part the vestibular band is less and less thick while the lingual band is very powerful in order to produce the desired transverse expansion of the premolar and molar regions.

 On the mandible: the vestibular band is extremely powerful in its incisor-canine part to exert strong pressure from front to back. In the premolar and molar region it is not very high.

 Calculated to be at a distance from these teeth on the outside, it will not exert any action. The lingual band is not very high and also at a distance from the mandibular premolars and molars.

 The thickness of the horizontal part is quite considerable in order to remove the abnormal criss-crossing of the incisors and canines, to facilitate their correction and to allow maxillary transverse expansion.

 Let us summarize the actions of this model (also prefabricated in several dimensions addressing, as for the other models, to the different age and dental volume): -Vestibulisation of the maxillary incisor-canine arch and transverse expansion by liberation of the maxillary arch which is trapped by the mandibular arch. The lack of development (hypotrophy of the maxillae) is, most often noted, from where the utility of these actions of "stimulation-development".

- mandibular retropulsion due to the strong pressure of the vestibular band. In orthodontic age, an "anatomical reserve" of the temporomandibular joint allows the mandibular condyle to recede into the glenoid cavity.

 This type of Gutter Activator is identified by horizontal dots - and a red patch stuck on the box containing it.

 Figure 4 shows: in A: the anteroposterior median section of the vestibular band (4) and internal relief of the lingual band (6).

in B: the cross section at the premolars (7).

in C: the cross section at the molars (8).

in D: the general view of the Activator in elevation (3) with the level of the aforementioned cuts (D)
Figure 5 shows: in E: the effect sought in the lateral parts of the maxillary arch (expansion) in F: the labial, incisor and molar relationships before treatment.

in G: the effect produced on these various ratios, the Activator being in place in the mouth, in particular in the sagittal direction, effect objectified by the arrows (4) vestibular strip, (6) internal relief, (7) horizontal thickness .

 Gutter Activator for Expansion.

 More semi-circular in shape than the Conforming Activator (variation of the axes of the ellipse), it differs from it by a greater tone, increasing its efficiency in the transverse direction.

 Because of the embryological independence of the maxillae and the mandible, and of the teeth with the bones, very frequent are the cases of large teeth and bones of insufficient size to accommodate them in good order. Increasing the alveolar and bone dimensions can correct what is classically called "dento-maxillary disharmony". The space thus obtained will allow normalization of the implantation of the teeth, an essential factor for good occlusion and a correct dental joint.

 On the other hand, like the Conforming Activator, the expansion model places the maxillae and the mandible in normal vertical and sagittal relationships.

These various actions are obtained by:
- a more marked thickness of the vestibular strip
- a much greater thickness of the internal strip, which is also much more extended downwards than in the conforming model.

 - a wider width of the "dental corridor" between the 2 bands above allows the centrifugal movement of the teeth.

 Figure 6 shows: in A: the anteroposterior median section, the vestibular strip (4) and the internal relief (6).

in B: the cross section at the level of the 1st molar and the different dimensions.

in C: the general view (3) in elevation of the vestibular strip (4), of the lingual strip (5), of the horizontal thickness (7) of the Activator for Expansion.

 Figure 7 shows: in D: the centrifugal action of the Expansion Activator. Thanks to the thickness of the horizontal plane, the displacement of the teeth will be parallel to their vertical axis.

The movements will be of "gression" and not of "version". The downward extension of the internal strip (8) is necessary because the mandibular enlargement (compact bone in the shape of a horseshoe) is much slower to obtain than the enlargement of the maxillary stage (thin bones, pneumatized by the maxillary sinuses) and that normal physiological inocclusion slows this enlargement.

Claims (6)

 1) Prefabricated Gutter Activators, in several sizes in flexible rubber or plastic material, characterized by a double gutter of semi elliptical shape; an upper (1) including the upper alveolo-dental arch; a lower one, encompassing the mandibular alveolo-dental arch, separated by a horizontal thickness (7). The vestibular band (external) (4), the lingual band (internal) (5) as the horizontal thickness (7) are smooth on all their faces.  2) Gutter Activators according to claim 1 characterized in that the general elliptical shape, the parts: anterior and posterior and their thickness are variable according to the 3 types described: Conforming, for Antemorphosis, for Expansion.  3) Gutter Activator according to claims 1) and 2) of tvne Conformator characterized in that to obtain an occluso-articulated balance as perfect as possible, the maxilla and mandible are left in normal anteroposterior relationships. Only the dental malpositions will be corrected by the relief (6), the reports of the "bases" being preserved in their correct primitive state.  4) Gutter Activator according to claims 1) and 2) tvoe For Anemoryhosis characterized in that it must correct the maxillary / mandible reverse relationships. It will therefore propel by relief (6) the incisivocanin and lateral regions of the maxilla and retropulse the mandible, thanks to the anteroposterior action exerted and to the "anatomical reserve" of the temporomandibular joint. The very thin vestibular band (4) in its upper part is much thicker in its antero-lower part. The internal relief (6) of the lingual strip is also much thicker in its upper part to vestibulate the incisor-canine group.  5) Gutter Activator according to claims 1) and 2) tvne for Expansion. It is characterized by the fact that its shape is more semi-circular than those of other types (variations of the axes of the general shape ellipse). The thickness, more considerable, of its vestibular (4) and lingual (5) bands, the downward extension of the lingual band, give it a tone such that it produces an expansion of the alveolo-dental arches by centrifugal action.  6) Use of the Prefabricated Gutter Activators, described in the set of claims 1) to 5), for dentofacial orthopedic and periodontology treatments.