JP6504992B2 - Method of manufacturing oral mouthpiece and oral mouthpiece - Google Patents

Description

  The present invention relates to a method for producing an oral mouthpiece and an oral mouthpiece. More specifically, the airway is secured by pulling up a portion of the pharynx such as the tongue base and the soft palate that may block the airway (hereinafter referred to as “tongue base”) to the inside of the oral cavity by the vacuum effect generated at the time of wearing. The present invention relates to an improvement in the symptoms of obstructive sleep apnea syndrome.

  For some time, obstructive sleep apnea syndrome has been pointed out as the cause in some car accidents and labor accidents. The main cause of obstructive sleep apnea syndrome is that the tongue base and the like are lowered and the airway is blocked due to muscle relaxation during sleep. One of the treatment tools is disclosed in, for example, Patent Document 1 below. The described mouthpiece has been proposed.

  As shown in FIG. 8 (a), in the mouthpiece 9 described in Patent Document 1, a tube 91 is provided on the front side of the main body 90 which is a portion held by upper and lower jaws, and the tube 91 is a mouthpiece An opening 92 is formed toward the front side of the mouth 9, and a hole 93 whose both ends are in communication with the inner side of the palate, which is the inner peripheral surface of the mouthpiece 9, is formed. It is made possible.

  According to this mouthpiece 9, as shown in FIG. 8 (b), breathing is possible even when the mouth is closed during sleep, and continuous positive pressure is currently the main treatment method for obstructive sleep apnea syndrome. Even if it does not use an insufflation device which is inconvenient to carry like respiratory therapy, it is said that the airway will be secured and the symptoms will be improved.

JP, 2010-142497, A

  However, although the mouthpiece 9 described in Patent Document 1 enables respiratory air to flow in and out of the oral cavity, it is possible that the tongue root and the soft palate are lowered by the muscle relaxation during sleep to occlude the airway. It was not of an essentially depressible structure.

  In addition, as a treatment method for obstructive sleep apnea syndrome performed using a mouthpiece, a mouthpiece configured to cause the lower jaw to project anterior to the upper jaw in order to secure an airway during sleep was used. There is a sleep splint therapy, but it is also an aid to mouth breathing, so it may cause side effects such as thirsty, salivary, painful teeth, painful jaws, changes in biting, etc. It has been reported.

  The present invention has been made in view of the above points, and the airway is secured by pulling up the tongue base to the inside of the oral cavity by the vacuum effect generated at the time of wearing, and the symptoms of obstructive sleep apnea syndrome are improved. It is an object of the present invention to provide an oral mouthpiece and a method of manufacturing the same.

  In order to achieve the above object, the method for producing an oral mouthpiece according to the present invention comprises upper and lower jaws of a mouthpiece part formed of a soft resin based on the prepared tooth model of the wearer. And forming each of the maxillary and mandibular tooth models on the guide pinted articulator in a central occlusion position, and attaching the respective tooth pieces to the same tooth model The process of attaching parts, heating the portions of the upper and lower jaw mouthpiece parts that come in contact with each other by bite to be able to weld, closing and pressing the guide pin attached articulator, and pressing the guide pins after pressing The upper and lower jaw mouthpieces so that the floats fall within a range of 0 mm to 2 mm and the contact area is airtight in the inward and outward directions of the oral cavity And a step of integrating.

  Here, based on the prepared tooth model of the wearer, by providing a step of individually forming a mouthpiece part made of soft resin corresponding to the upper jaw and the lower jaw, It is possible to create a flexible mouthpiece part that conforms to the shape of the tooth and makes it difficult for the wearer to feel uncomfortable.

  Each of the mouthpieces is provided with a step of attaching each of the upper jaw and lower jaw tooth molds to the articulator with guide pins in a central occlusal position, and attaching the respective mouthpiece parts to the mounted same tooth molds The parts can be adjusted to be in central occlusion. The central occlusion position is the position of the lower jaw where the maxillary and mandibular dentitions contact at most locations and are stably engaged with each other. The same meaning is used hereinafter.

  The jaws of the upper and lower jaws are heated until it is possible to weld parts that contact each other by engagement, closing and pressing the articulator with a guide pin, and the floating of the guide pin after pressing is within the range of 0 mm to 2 mm. And the step of integrating the upper and lower jaw mouthpiece parts so as to fit within the upper and lower mouths in an airtight manner in the inner and outer directions of the oral cavity, thereby meshing the upper and lower jaw mouthpiece parts A mouthpiece for oral cavity having a thickness of 0 mm to 2 mm or less where the portions in contact with each other can be made thin or thin and is airtight in the inside and outside of the oral cavity be able to.

  Further, the step of individually forming the mouthpiece parts corresponding to the upper and lower jaws is carried out by vacuum suction of the heated soft resin sheet along the contours of the teeth and gingival parts of the dental model. In this case, the process is easy because the soft resin sheet only needs to be cut away from the soft resin sheet so as to conform to the contours of the teeth and gingival parts of the dental model.

  In addition, when the maxillary and mandibular tooth models of the upper and lower jaws are attached to the articulator with guide pins in a central occlusion position, when the mandible is set to be in the resting position, the wearer can It is hard to feel discomfort about a position, and it can be set as an oral mouthpiece with a comfortable feeling of wear. The mandibular resting position is the position of the mandible in a state in which the mandible is naturally induced by relieving the power of the jaw, and is used hereinafter in the same sense. Also, the mandible resting position is usually a position 2 to 3 mm below the central occlusion position.

  In the case of providing a step of forming a tooth model of each of the upper and lower jaws of the wearer prior to the step of individually forming the mouthpiece parts correspondingly to the upper and lower jaws, a prototype of the oral cavity mouthpiece and For example, the in-house production of a tooth model improves the efficiency of a series of operations.

  In order to achieve the above object, the oral mouthpiece of the present invention comprises an upper mouthpiece part embellished with a soft resin based on a prefabricated upper jaw tooth model of the wearer and a prefabricated wear Based on the mold model of the lower jaw of the person, the patient is embellished with a soft resin, and the heat is integrated so that the wearer can hold the central occlusion position and the mandible resting position with the upper mouthpiece part. A lower mouthpiece part welded together and integrated with the upper mouthpiece part so that the thickness of the heat-welded portion is in the range of 0 to 2 mm and air tight in the inside and outside directions of the oral cavity.

  Here, the upper mouthpiece part has a good feeling of fit because it is based on the tooth model of the upper jaw of the wearer, and because it is embellished with a soft resin, it does not easily cause a feeling of pain when worn.

  The lower mouthpiece parts are also fitted based on the tooth model of the lower jaw of the wearer and fit well, and because they are embellished with a soft resin, they are less likely to cause a feeling of pain when worn. In addition, since the upper and lower mouthpiece parts after being united are placed in a position where the wearer can hold the central occlusion position and the mandible resting position, toothaches and jaws found in sleep splint therapy It reduces the possibility of side effects such as pain and changes in bite.

  In addition, since the thickness of the heat-welded portion between the upper mouthpiece part and the lower mouthpiece part is formed within the range of 0 to 2 mm, for example, side effects such as discomfort in the oral cavity and changes in bite may occur when worn. It reduces the possibility of occurrence.

  Furthermore, since the heat-welded portions of the upper mouthpiece part and the lower mouthpiece part are formed to be airtight in the inward and outward directions of the oral cavity, mouth breathing can not be performed, for example, thirst and saliva seen in sleep splint therapy The possibility of side effects such as the occurrence of many

  In addition, by wearing an oral mouthpiece mouthpiece that becomes airtight in the inward and outward directions of the oral cavity, the interior of the mouth of the nasal breathing wearer becomes repeatedly negative pressure each time it inhales during breathing, and this negative Under pressure, the tongue base is pulled to the inside of the oral cavity, and the airway is secured.

  More specifically, the inability to breathe in the mouth necessarily causes the wearer to breathe in the nose, and the air to be inhaled passes from the nasal cavity through the pharynx to the trachea, but each time the gas is inhaled, the wearer is sealed. Air is drawn to the trachea through the pharynx to create a negative pressure in the oral cavity. When the oral cavity is in negative pressure, a suction force is generated toward the back of the oral cavity (front teeth, oral vestibule, direction of the hard palate) viewed from the pharynx side, and the entire tongue is pulled up with this, the tongue base Is also pulled up inside the mouth. Obstructive sleep apnea is caused by blockage of the airway at the base of the tongue by muscle relaxation due to sleep, but by wearing the mouthpiece as described above, the tongue base is pulled to the inside of the oral cavity to secure the airway. Symptoms improve.

According to the manufacturing method of the mouthpiece for oral cavity according to the present invention, the airway is secured by pulling up the tongue base to the inside of the oral cavity by the vacuum effect which occurs at the time of wearing, and for the oral cavity the symptom of obstructive sleep apnea syndrome is improved A mouthpiece can be provided.
Further, according to the mouthpiece for oral cavity according to the present invention, the airway is secured by pulling up the tongue base to the inside of the oral cavity by the vacuum effect generated at the time of wearing, and the symptom of obstructive sleep apnea syndrome can be improved.

It is side view explanatory drawing of the mouthpiece for oral cavity of this invention. It is a perspective view which shows each tooth model of the upper jaw and the lower jaw produced in the manufacturing process of the mouthpiece for oral cavity of FIG. Fig. 3 shows a process of making a mouthpiece part from the tooth model shown in Fig. 2; (a) is a perspective view of a sheet-like mouthpiece part carved from the tooth model; (b) shows from the sheet It is perspective explanatory drawing of the mouthpiece part of the detached state. It is the explanatory view which expressed the state where each tooth model of upper jaw and lower jaw shown in Drawing 2 was attached to the articulator with a guide pin from the side, and expanding a part. It is explanatory drawing which represented the state which attached the mouthpiece parts so that it might be covered on each tooth model installed in the articulator with a guide pin shown in FIG. In the articulator with a guide pin shown in FIG. 4, a state in which the contact portions of upper and lower jaw mouthpiece parts are heat-welded is shown from the side, and a part thereof is enlarged. Fig. 2 shows the state of the pharynx and air flow during sleep of a patient with obstructive sleep apnea syndrome, (a) represents a patient not wearing an oral mouthpiece, (b) in Fig. 1 It is use condition explanatory drawing showing the patient who wore an oral mouthpiece shown. (A) is a perspective view of the mouthpiece of patent document 1, (b) is a use condition explanatory view of the mouthpiece of patent document 1. FIG.

  The embodiment of the present invention will be described in more detail with reference to FIGS. 1 to 7. In addition, the code | symbol in each figure is attached in the range which reduces complexity and makes an understanding easy. Further, “EVA” in the present embodiment is equivalent to the “soft resin” described above, and “EVA sheet” is equivalent to the “soft resin sheet” described above.

(Oral mouthpiece 1)
The oral cavity mouthpiece 1 will be described with reference to FIG.
The mouthpiece 1 is formed by heat-welding an upper jaw mouthpiece part 12 and a lower jaw mouthpiece part 13 formed of an EVA (ethylene-vinyl acetate copolymer) sheet by heat welding, The heat welding site is set at a position where the wearer can hold the central occlusion position and the mandible resting position, and is airtight in the inside and outside directions of the oral cavity.

(Method of manufacturing oral mouthpiece 1)
A method of manufacturing the oral cavity mouthpiece 1 will be described.

(1) Step of creating a dental model First, a dental model of each of the upper and lower jaws of the wearer H is created. This process is the same process as the process of creating a dental model performed in dental treatment and the like.

  Specifically, the impression material is put on a tray for taking a dental mold used in dentistry, the tray is put in the mouth of the wearer H, and the upper and lower jaws are taken, and so-called dental casts Create a female mold. Plaster or the like is poured into the prepared upper and lower jaw female molds, and after being hardened, the upper and lower jaw model T1 and the lower jaw model T2 are taken out (see FIG. 2).

(2) Step of producing mouthpiece parts Based on the upper and lower tooth model T1 and lower jaw and tooth model T2 created in the above-mentioned step (1), upper and lower jaw mouthpiece parts are separately created. In the present embodiment, each mouthpiece part is created using a vacuum former (not shown).

  The upper jaw tooth model T1, the lower jaw tooth model T2, and the EVA sheet S are set in a vacuum former, and heating and vacuum suction are performed. The upper jaw tooth model T1 and the lower jaw tooth model T2 are arranged such that the tips of the teeth face the EVA sheet S side.

  At this time, the heated EVA sheet S is vacuum-sucked to conform to the contours of the teeth and gingival parts of the upper and lower tooth model T1 and the lower and lower tooth model T2 (ie, the EVA sheet S is an upper tooth model). As a result, the upper and lower jaw mouthpiece parts are formed on a single EVA sheet S (see FIG. 3A). ).

  Then, by separating each of the mouthpiece part prototypes from the EVA sheet S, the portion in which the maxillary tooth model T1 is engraved is on the max. Mouthpiece part 12 and the portion in which the maxillary tooth model T2 is is is the lower jaw mouthpiece 13 (See FIG. 3 (b)).

(3) Bonding preparation step of mouthpiece parts Each of the upper and lower tooth model T1 and the lower and lower tooth model T2 is attached to the articulator M with a guide pin. The attached maxillary tooth model T1 and mandible tooth model T2 are adjusted to be in central occlusal position, and further, the arrangement of maxillary tooth model T1 and mandible model T2 is adjusted to be mandibular resting position (See FIG. 4). At this time, the lower end of the guide pin G generated when the upper jaw tooth model T1 and the lower jaw tooth model T2 are closed is adjusted to be 0 mm (see the enlarged portion in FIG. 4).

  Note that the articulator M with guide pins shown in FIGS. 4 to 6 is generally used in the dental technology industry, so the description of the operation is omitted, but the articulator with general guide pins has It is assumed that it has a position adjustment function and an engagement confirmation function using a guide pin.

  This step is performed as preparation for bonding the upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 created in the step (2), and this operation is performed after the bonding of the upper jaw mouthpiece part 12 and the lower jaw Adjust the position of each of the maxillary tooth model T1 and the mandible tooth model T2 as the mounting base for the guide pin with articulator M used during the bonding operation so that the arrangement with the mouthpiece part 13 is optimal for the wearer It is to do.

  Next, the upper jaw mouthpiece part 12 is attached to the upper jaw tooth model T1, and the lower jaw mouthpiece part 13 is attached to the lower jaw tooth model T2 (see FIG. 5). When the articulator M with a guide pin is closed so that the upper jaw tooth model T1 and the lower jaw tooth model T2 are engaged in this state, the height of the tooth tip of the upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 is high. (About 2 to 4 mm), floating of the guide pin G occurs (see the enlarged portion in FIG. 5).

(4) Finishing process to mouthpiece Open the articulator M with guide pin, and heat the parts of upper jaw mouthpiece part 12 and lower jaw mouthpiece part 13 that contact each other by engagement until welding becomes possible with handy gas burner etc. The guide pin attached articulator M is closed again, and the upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 are brought into contact with each other.

  Next, press the articulator M with a guide pin from above, and the upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 so that the lift of the lower end of the guide pin G becomes 2 mm or less (close to 0 mm as much as possible). Integrate (heat welding) so that the contact site of the air tight in the inward and outward directions of the oral cavity (see FIG. 6).

  Here, “to be 2 mm or less (close to 0 mm as much as possible)” means that each position of the upper and lower jaws of the wearer reproduce the central occlusion position and the mandible resting position at the time of wearing. Although it is described from the viewpoint that it is better to reduce the thickness of the contact portion of the mouthpiece part, it does not exclude the case where it exceeds 2 mm, but if it exceeds 2 mm, it may cause discomfort or bite in the oral cavity. It is not preferable because side effects such as changes may occur.

  Here, in order to bring the lower end of the guide pin G closer to 0 mm, for example, (a) a portion where the upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 are in contact can be heated by a handy gas burner etc. The tips of the maxillary tooth model T1 and the maxillary tooth model T2 bite into the melted part where the maxillary mouthpiece part 12 and the mandibular mouthpiece part 13 come in contact with each other and pierce it, and a hole is opened in a part of the maxillary tooth model Press until a portion of the model T1 and the lower jaw model T2 comes into contact (that is, a hole is opened at the portion of contact and the space inside the upper mouthpiece part 12 and the lower mouthpiece part 13 communicate) And the method of making it weld so that it may be airtight about the direction of the inside and outside of the oral cavity, or integrating them, or (a) upper jaw mouthpiece part 12 and lower jaw mouthpiece parts The contact part of one of the three contact parts is heated until welding becomes possible with a handy gas burner etc., and the contact part of the heated mouthpiece part is heated at the contact part of both mouthpiece parts. There is a method of pressing so as to bite the lower end of the guide pin G down to 0 mm by an uncompleted mouthpiece part and integrating so as to be airtight in the inside and outside directions of the oral cavity.

  The mouthpiece 1 for oral cavity is obtained by removing the integrated upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 from the articulator M with guide pins (in other words, the upper jaw tooth model T1 and the lower jaw tooth model T2).

  In the present embodiment, although an alginate impression material, an agar impression material, etc. are used as the impression material, it is not particularly limited as long as it is a material that can be used to form a dental model.

  In the present embodiment, gypsum is used as a material for forming a tooth model, but the present invention is not limited to this. For example, various synthetic resins etc. can be used to form a tooth model. It is more preferable that the material has a certain heat resistance (heat resistance that can withstand the temperature of the heated soft resin sheet).

  In the present embodiment, an EVA sheet which is a resin sheet having thermoplasticity and flexibility is used as a material for forming a mouthpiece part, but the present invention is not limited to this. For example, other types of synthetic resin It is a material, etc., has no toxicity to the human body, and has flexibility to deform according to the shape of the oral cavity so that the wearer feels no pain or hardly pain when placed in the oral cavity It may be one.

  In the present embodiment, a vacuum former is used to form a mouthpiece part, but the invention is not limited to this. For example, a heated soft resin sheet is pressed against the prepared tooth model It may be made to conform to the mold by hand, or may be adopted a known technique such as forming a model by spraying a liquid soft resin onto the mold.

  In the present embodiment, prior to the step of individually forming the respective mouthpiece parts corresponding to the upper and lower jaws, the step of preparing a dental model of each of the upper and lower jaws of the wearer is provided. For example, the step of creating a tooth model may be outsourced.

(Action)
The operation of the oral cavity mouthpiece 1 will be described with reference to FIG.

  FIG. 7 (a) shows the pharyngeal condition and air flow during sleep of a patient with obstructive sleep apnea syndrome (hereinafter referred to as "non-wearer N") who does not wear a mouthpiece for oral cavity. It represents. In the non-dresser N shown in FIG. 7A, the tongue base 2 and the soft palate 3 are lowered by muscle relaxation during sleep, and the airway 4 of the pharynx is obstructed, and obstructive sleep apnea occurs. .

  FIG. 7 (b) shows the state of pharynx and air flow during sleep of a patient with obstructive sleep apnea syndrome (hereinafter referred to as "wearer H") wearing the mouthpiece 1 for oral cavity. There is. In the wearer H shown in FIG. 7 (b), the tongue base 2 and the soft palate 3 are not lowered even if muscle relaxation occurs during sleep. It is presumed that this phenomenon is caused by the following action.

  (A) When the mouthpiece 1 for oral cavity is worn, the heat-welded portion of the upper jaw mouthpiece part 12 and the lower jaw mouthpiece part 13 is formed airtight in the inward and outward directions of the oral cavity. It becomes impossible to breathe and it becomes nasal breathing.

  (A) The inspiratory flow reaches the airway 4 including the pharynx through the nasal cavity and goes to the lungs, but at this time, the air in the closed oral cavity is drawn from the nasal cavity by the flow of inspiratory flow passing through the airway 4 to the pharynx side It flows out and as a result, the inside of the oral cavity is in a negative pressure state each time the air is inhaled.

  (C) In the oral cavity which has become negative pressure, a pulling force (suction force) is generated toward the back (from the front teeth, the oral vestibule, the direction of the hard palate) seen from the pharynx side The tongue base 2 and the soft palate 3 hanging down due to muscle relaxation are pulled up to the inside of the oral cavity, and the airway 4 is secured.

  (D) As mentioned above, although obstructive sleep apnea is caused by muscle relaxation due to sleep and the tongue base 2 etc. block the airway 4, the wearer H wears the mouthpiece 1 for oral cavity, A vacuum effect is generated inside, the tongue base 2 and the like are pulled to the inside of the oral cavity, the airway 4 is secured, and the symptom of obstructive sleep apnea syndrome is ameliorated.

  When the oral cavity mouthpiece 1 is worn, the possibility of the side effects such as the thirst seen in sleep splint and the occurrence of a large amount of saliva are reduced.

  In addition, since the heat-welded portion between upper jaw mouthpiece part 12 and lower jaw mouthpiece part 13 is formed to have a thickness of 0 to 2 mm, the central occlusion position and lower jaw resting position of the wearer are reproduced when worn. Reduce the possibility of side effects such as discomfort and changes in bite.

  According to the manufacturing method of the oral cavity mouthpiece 1 described above, the airway 4 is secured by pulling up the tongue base 2 and the like to the inside of the oral cavity by the vacuum effect generated at the time of wearing, and the symptom of obstructive sleep apnea syndrome is An oral mouthpiece 1 to be improved can be provided, and an oral mouthpiece 1 with high processing accuracy can be obtained without the hands of a skilled dental technician.

  In continuous positive breathing therapy, which is currently the mainstream treatment method, it is inconvenient to bear the burden of bringing in an air supply device even at travel destinations etc., but the mouthpiece for oral cavity 1 is a simple thing that only it is worn The convenience is good. In addition, wearing the mouthpiece 1 can prevent snoring and bruxism.

  The terms and expressions used in the present specification and claims are for descriptive purposes only and are not limiting in any way, and the features and characteristics described in the present specification and claims There is no intention to exclude terms or expressions that are equivalent to some. Further, it goes without saying that various modifications are possible within the scope of the technical idea of the present invention.

1 mouthpiece for mouth 12 upper jaw mouthpiece part 13 lower jaw mouthpiece part 2 tongue base 3 soft palate 4 airway H wearer N non-dresser T1 maxillary tooth model T2 mandibular tooth model M articulator with guide pin G guide pin 9 mouse Piece 90 body 91 tube 92 opening 93 hole

Claims (5)

A step of individually forming a mouthpiece part made of soft resin corresponding to the upper jaw and the lower jaw based on the prepared tooth model of the wearer;
Attaching each of the maxillary and mandibular dental casts to an articulator with guide pins in a central occlusal position, and attaching each of the mouthpiece parts to the attached dental casts;
The upper and lower jaw mouthpiece parts are heated until it is possible to weld parts that contact each other by meshing, closing and pressing the guide pin attached articulator, the part between the left back tooth and the right back tooth is and fused to a continuous method for producing an oral mouthpiece and a step of the inner and outer direction to integrate the respective mouthpiece part of the upper and lower jaws so that the airtight mouth cavity. The step of individually forming the mouthpiece parts corresponding to the upper and lower jaws is performed by vacuum suction of the heated soft resin sheet along the contours of the teeth and gingival parts of the dental model. The manufacturing method of the oral cavity mouthpiece as described in 1. The oral cavity mouthpiece according to claim 1 or 2, wherein, when the maxillary and mandibular tooth molds are mounted on the guide pinted articulator in a central occlusion position, the mandibular resting position is further set. Production method. The method according to claim 1, 2 or 3, further comprising the step of creating a tooth model of each of the upper and lower jaws of the wearer prior to the step of individually forming the mouthpiece parts correspondingly to the upper and lower jaws. Method for oral mouthpieces. An upper mouthpiece part and a lower mouthpiece part , which are made of a soft resin based on the prefabricated upper and lower tooth models of the wearer ,
The upper mouthpiece part and the lower mouthpiece part are arranged such that the wearer can hold the central occlusal position, and the heat welding portion in which the region from the left back tooth to the right back tooth is continuously heat welded The mouthpiece is an integrated structure that is airtight in the inward and outward directions of the mouth.

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