RU223512U1 - ORTHODONTIC MYOFUNCTIONAL DEVICE - Google Patents

Abstract

The utility model relates to orthodontics and can be used for the treatment and elimination of myofunctional disorders and dental anomalies. An orthodontic myofunctional device has been developed, which is a two-jaw removable device, which consists of lip pads, cheek shields and a platform for positioning the tongue, interconnected into a single frame with metal wire. The lip pads are made in pairs for the upper and lower lips, with the paired lip pads connected to each other by a V-shaped arch. The cheek shields are designed to be placed in the area of the masticatory muscles and are connected to the platform for positioning the tongue by arches with a bend. The positioning platform is designed to allow physiologically correct placement of the tongue on it. The technical result is to ensure a state of physiological rest; normalization of the position of the tongue and elimination of the possibility of its retraction and, as a result, restoration of proper swallowing; restoration of nasal breathing. 4 ill.

Description

The utility model relates to the field of medicine, in particular to orthodontics (dentistry) and can be used for the treatment and elimination of myofunctional disorders and dental anomalies.

State of the art

Myofunctional disorders are a decrease or increase in the normal tone of the masticatory and facial muscles that occur when the functions of the dental system (breathing, swallowing, chewing) are impaired.

The most important life-supporting functions of the body - breathing, swallowing and chewing - are associated with the human stomatognathic system.

For the proper functioning of the human stomatognathic system, we need physiological breathing through the nose. When breathing is carried out through the nose, the air passing through the nasal passages is moistened, purified, cooled or heated and supplied in sufficient volume. With the correct breathing pattern through the nose, our diaphragm always turns on, which helps create negative pressure in the lungs and increases the volume of inhalation. For proper nasal breathing, it is necessary for the lips to close (lip valve). At the same time, not tense, but relaxed lips guarantee the physiological state of subatmospheric pressure homeostasis, that is, our internal pressure in the chest and abdominal cavity is below atmospheric pressure, which is the physiological norm.

With this type of balanced physiological nasal breathing, when there is no breathing through the mouth, or its mixed type, simultaneously through the nose and through the mouth, the correct relationship of the jaws is formed, the tongue is able to be in the correct position on the palate and the relationship of the upper and lower jaws becomes physiological.

In childhood, correct positioning of the tongue and correct swallowing stimulates the correct growth of skeletal bones, skull bones and jaw bones. In adulthood, a correctly positioned tongue drains the nasal sinuses and maintains their healthy condition, and among other things, it affects intelligible, high-quality speech.

At the same time, a person has a state of rest, peace, when the action of the sympathetic system is replaced by the parasympathetic system during sleep. To do this, those sensors that exist in the ligament of the tooth and provide information to the brain with each closure should not work, that is, the teeth at rest, when a person is not chewing, should not close (the jaws are “suspended”). The distance between the teeth in this physiological position (normally) is up to 2 mm, which is achieved by the correct position of the tongue on the palate and correct breathing through the nose.

If nasal breathing is impaired, a person experiences either a mixed type of breathing through the mouth and through the nose, or an oral type of breathing. In this case, stimulation of the growth of the upper jaw is suspended, the tongue is located on the lower jaw, which leads to its posterior, most often, position in relation to the upper jaw, which affects the temporomandibular joint and posture. As a result, when breathing through the mouth, a person does not receive enough oxygen because the diaphragm does not work. When breathing through the mouth, a person often gets symptoms of sleep apnea, stopping breathing during sleep, which is associated, among other things, with the retraction of the lower jaw and the retraction of the tongue, blocking the airways, which is very dangerous.

People who sleep with their mouths open are more likely to snore, have trouble sleeping, and feel exhausted. In this case, the tongue tries to compensate for the labial valve, since the lips become hypertonic and the labial valve does not work properly, the tongue tries to compensate for the absence of the labial valve by inserting itself between the teeth, forming various dentofacial anomalies. Very often, patients with this type of breathing begin to clench their teeth excessively, trying to restore the unity of their internal environment, to compensate for the lack of a proper labial valve.

These processes involve the masticatory muscles, which are quite powerful muscles and are also stress muscles. During a stressful situation, a person’s primary reaction manifests itself, during which a person tenses and clenches the chewing muscles and fists, increasing the strength of the entire musculoskeletal system and, often, such people can sleep with their mouth open during sleep and snore with the risk of sleep apnea, and then they may clench their teeth tightly and grind these teeth (bruxism). In this case, sleep is of poor quality, the person wakes up exhausted, even if he slept all night.

Most often, as adults, we develop incorrect muscle patterns. The masticatory muscles are hypertonic, the orbicularis oris muscle, the depressor muscles and the muscles that lift the angle of the mouth are overstrained and hypertonic, the tongue is at the bottom, the lower jaw goes back, which also entails hypertonicity of the scalene muscles, sternoclavicular mastoid and trapezius muscles.

Various devices that eliminate myofunctional disorders and dentofacial anomalies are described in the specialized and patent literature.

For example, it is known (RU 2290126 C1, published December 27, 2006) that a two-jaw orthodontic apparatus for the treatment of distal deep bite contains a removable base made of two plates for the upper and lower jaws, fixing and power elements fixed to the base. On the upper and lower plates of the base, artificial chewing teeth are installed instead of missing ones or holes are made for the growth of new chewing teeth. On the upper base plate there are round clasps for the 6th teeth, M-shaped hooks soldered into the base for elastic traction in the area of the chewing teeth and Kalvelis arm-shaped springs to eliminate diastema. On the lower base plate there are two clasps for the 6th teeth, two circuit lip caps installed in bushings with locks welded into the base, and hooks for elastic rods. Technical result - the invention allows for optimal growth in the TMJ joints, prevents mesial displacement of permanent teeth, improves the shape and profile of the face, especially in patients aged 6-8 years with a distal deep bite, eliminates sagittal gaps of more than 10 mm and diastema in the area of the central incisors upper jaw.

Also known is RU 2279862 C1 (published on July 20, 2006) a shield device for eliminating myofunctional disorders. The device consists of two lingual shields and two vestibular shields with a template space, which are connected to each other by a wire arch with a central bend. The lingual shields are connected to each other by an omega-shaped loop, and to the vestibular shields by two wire extensions. The wire arch that connects the vestibular shields is made with two additional lateral bends. The bends have the physiological shape of the lateral segments of the upper dentition. As a result, the effectiveness of treatment of dentoalveolar anomalies increases by targeting the dentition, taking into account the use of the straight arc technique to normalize the position of the teeth in the transversal and sagittal planes. The harmful force action from the cheek and chewing muscles and the muscles of the tongue is eliminated.

From the patent RU154582U1 (published on August 27, 2015), an intraoral two-jaw device is known, which is intended to eliminate the symptoms of snoring and sleep apnea syndrome. The orthodontic device contains maxillary and mandibular aligners covering the dental arches, while on the maxillary aligner behind the incisors there is a platform for the tip of the tongue, and in the area of the lateral teeth a dental splint with soft occlusal pads is fixed, the maxillary and mandibular aligners are connected on the vestibular side by two orthodontic elastic with chains, fixed with buttons or with the help of mouth guard files on the upper and lower canines. The orthodontic device also differs in that the aligners are made of biocompatible thermoplastic. As a result of using the device, muscle activity improves in accordance with the position of the lower jaw and the temporomandibular joint.

It is known (RU 2123819 C1, Published: 12/27/1998) a device for orthodontic treatment. The device contains base plates for the upper and lower jaws, connected to each other in a constructive bite by means of a fixing device, pelots for the lower lip and buccal pelots. Additionally, the device is equipped with Adems clasps and orthodontic screws. The fixing device includes guide tubes fixed to the maxillary plate for the entry of L-shaped pins installed on the mandibular plate. The pelot for the lower lip is installed on the mandibular plate, and the cheek pelots are elastically connected to each other by an elastic rod. As a result, an increase in the effective treatment of distal occlusion is ensured; normalization of the size of the dentition and the position of the lower jaw is achieved.

The disadvantage of the known solutions is, first of all, that they do not ensure the correct position of the tongue and, as a result, do not contribute to the relaxation of the masticatory muscles, the orbicularis oris muscle, the orbicularis floor of the mouth muscle and the mentalis muscle.

Also known (RU 2797642 C1, published 06/07/2023) are dental devices and methods for fixing and correcting the position of the tongue. In accordance with the first aspect, a dental device is provided for limiting movement of the posterior region of the patient's tongue while allowing the anterior region and lateral edges of the tongue to perform movements necessary for speech and swallowing, comprising an attachment mechanism for securing the dental device to the teeth in the patient's oral cavity, including an open circular tape, connecting element. In other aspects, a dental device is provided comprising an attachment mechanism for securing the dental device to teeth in a patient's oral cavity and assemblies for use by the patient as part of a personalized tongue restriction plan, the assemblies including a restriction mechanism, an adjustment mechanism, and a locking mechanism. The inventions make it possible to eliminate breathing disorders during sleep associated with tongue dysfunction, while providing the possibility of movements of the posterior region, tip and lateral ribs of the tongue required for speech and swallowing.

A group of inventions known from patent RU 2607170 C1 (published on January 10, 2017) is intended for use in the prevention of snoring. A set of dental tongue detent devices includes a restraining means located above the patient's tongue, wherein the restraining means is shaped to restrict movement of the posterior region of the patient's tongue. The restraining means allows at least the anterior region and lateral edges of the patient's tongue to make movements necessary for speech and swallowing, and a method of treatment. These devices can be used as a set or individually. The treatment method involves the use of a dental appliance to reduce the volume of the patient's tongue and widen the airway and may be combined with the use of another dental appliance to correct other deficiencies of the patient's tongue.

Patent document US20090126742 (published May 21, 2009) discloses a tongue catch and hold device that securely holds the tongue during sleep to minimize the risk of the tongue slipping and blocking the pharynx, a condition known as obstructive sleep apnea. A plurality of tongue gripping projections are connected to the upper and lower supports. The ridges engage and hold the tongue. The upper and lower supports are offset towards each other in the tongue engagement position. The upper support is connected to the user's upper jaw, such as a denture, dental device, or upper tooth engagement mechanisms. The lower support may be hinged or otherwise connected to or separated from the upper support. In one embodiment, a tube and rod mechanism connects the upper and lower supports together. Exemplary methods for making tongue gripping projections are also described.

It is also known (WO2020/185350, published 02/01/2007) an oral care device adapted to be worn on the user's teeth, comprising an upper guard and a lower guard, which are configured to prevent or reduce the effects of tongue thrust and tongue mispositioning, in particularly during sleep.

In addition, it is known (WO2013/086586, published 06/20/2013) an oral treatment device for sleep apnea and snoring, including a pad adapted to rest under the user's tongue to support the tongue from below, and engage the undersurface of the tongue using reflex action relaxed tongue, tongue flow adaptation effect. Embodiments also include textured surfaces on the front of the device to stimulate the tongue and tongue reflex. The device is designed to be worn for relatively long periods of time and minimize any sleep disruption while ensuring effective tongue positioning.

The disadvantage of the known solutions is, first of all, that they show the effect on the body only at the structural level, without revealing the work at the functional level. In addition, the structural arrangement and interconnection of the elements of the known devices does not allow them to be worn for a long time, both during sleep (at night) and while awake (during the day).

The closest analogue is the patent document CA2735032C, (published on September 26, 2011), which describes a removable intraoral device for improving airway patency. Wearing the device changes the position, configuration and freedom of movement of the tongue, chewing muscles, as well as the pharyngeal and facial muscles. The device is suitable for the correction of snoring and/or obstructive sleep apnea by intermittent closures or partial obstructions occurring in the oropharynx during sleep. The device of the invention can improve various types of airway disorders and improve oral function by changing the position, configuration and freedom of movement of selected parts of the tongue and mouth, reducing resistance to air flow in the mouth and pharynx, reorienting and reprogramming the muscles of the mouth and tongue and maintaining proper systemic balance mouth

The disadvantage of the prototype method is that only wearing the device while sleeping (at night) is disclosed, i.e. the known solution can provide an effect on the human body only at the structural level, and, accordingly, does not allow maintaining the achieved therapeutic effect until the moment of complete morphological and functional restructuring.

The foregoing shows that there is a need to create a device in which the described disadvantages would be eliminated.

Disclosure of utility model

The technical result of the proposed utility model is to ensure a state of physiological rest and normalize the position of the tongue and, as a result, restore proper swallowing and nasal breathing.

For the purposes of this utility model, the term “state of physiological rest” refers to the natural position of the teeth when the muscles (muscles of mastication, orbicularis oris and mentalis) are relaxed and the teeth are not touching each other. Normally, the distance between the teeth at rest should not exceed 5 mm. With an underbite, the teeth at rest are too far apart from each other; with an overbite, on the contrary, they close tightly together. The state of physiological rest is the initial and final moment of all movements of the lower jaw. In a state of physiological rest, normalization of the position of the tongue is ensured. The “normal position of the tongue” (physiologically correct position of the tongue) means its neutral position, when the tip of the tongue is located behind the upper incisors, without touching them. Where the tongue is when we pronounce the sound “H” is the so-called “resting point”. During each swallowing movement, the back of the tongue is pressed against the palate, stimulating the growth of the upper jaw in width, improving blood supply to the nasal and oropharynx and thus increasing local immunity. The correct position of the tongue at rest and when swallowing is only possible with nasal breathing, while the mouth must be closed. Normalizing the position of the tongue eliminates the possibility of tongue retraction.

The technical result is achieved due to the fact that an orthodontic myofunctional device is proposed, which is a two-jaw removable device, which consists of lip pads, cheek shields and a platform for positioning the tongue, connected to each other into a single frame by metal wire, lip pads are made in pairs for the upper and lower lips, while the paired labial pads are connected to each other by a V-shaped arch, the cheek shields are designed to be placed in the area of the masticatory muscles and are connected to the platform for positioning the tongue by arches with a bend, while the platform for positioning the tongue is made with the possibility of a physiologically correct location on it language.

Brief description of drawings

In fig. Figure 1 shows a general view of the device in isometry.

In fig. Figure 2 shows a top view of the device.

In fig. Figure 3 shows a side view of the device.

In fig. Figure 4 shows a front view of the device with an axial section AA.

The drawings indicate the following items: double-jaw removable device (1), lip pads (2) for the upper lip, lip pads (3) for the lower lip, cheek shields (4), tongue positioning platform (5), metal wire (6) , arcs (7), arcs (8).

Essence of a utility model

The proposed orthodontic myofunctional device is a two-jaw removable device (1), which consists of lip pads (2, 3), cheek shields (4), and a platform for positioning the tongue (5), interconnected into a single frame by metal wire (6) (Fig. 1).

A single frame of metal wire (6) connects together all the elements of the two-jaw removable device (1) and ensures a state of physiological rest of the teeth and normalization of the position of the tongue without attaching the two-jaw removable device (1) to any jaw. This design also makes it possible to ensure that it is difficult to close the jaws, the patient feels every time that he is closing them and this causes nociceptive sensitivity and automatic opening, therefore the pattern associated with hypertonicity of the muscles (masticatory, orbicularis oris and mentalis) is gradually rebuilt. .

Lip pads (2, 3) are made in pairs: for the upper lip - paired lip pads (2), for the lower lip - paired lip pads (3). In this case, the paired labial pads are connected to each other by a V-shaped arch (7) (Fig. 1, 4).

Lip pads (2, 3) allow you to relax the orbicularis oris muscle in the area of the upper and lower jaws and eliminate its hypertonicity, thereby reducing pressure on the upper and lower jaws, ensuring a state of physiological rest of the teeth of both jaws and normalizing the position of the tongue. The V-shape of the arches (7) ensures the absence of jaw discomfort from the frenulum of the upper and lower lips, which in turn ensures a state of physiological rest of the teeth of both jaws and normalization of the position of the tongue. This allows you to restore proper swallowing and nasal breathing.

The cheek shields (4) are designed to be placed in the area of the masticatory muscles and are made uniform without division into the upper and lower jaws. The buccal shields (4) are connected on both (lateral) sides to the tongue positioning platform (5) by arcs (8). The arcs (8) are made with a bend (Fig. 4). The bending of the arches (8) provides the position of the platform for positioning the tongue (5), necessary to give the tongue a physiologically correct position, in which a state of physiological rest of the teeth of both jaws is achieved. The bend can be made V-shaped or U-shaped.

This design of the cheek shields (4) and arches (8) allows you to relax the masticatory muscles in the area of the upper and lower jaws and eliminate their hypertonicity, thereby reducing pressure on the lateral sides of the upper and lower jaws, as well as on the tongue, ensuring a state of physiological rest for both teeth jaws and normalization of tongue position. This allows you to restore proper swallowing and nasal breathing.

The platform for positioning the tongue (5) is a single element made with the possibility of physiologically correct positioning of the tongue on it (Fig. 1, section A-A of Fig. 4). When swallowing, the tongue presses on the tongue positioning platform (5), allowing all other muscles of the mouth to relax, ensuring a state of physiological rest for the teeth of both jaws and normalizing the position of the tongue. In addition, such a design of the platform for positioning the tongue (5) makes it possible to easily and conveniently install the inventive device in the mouth, ensure equal pressure of the tongue on the platform at all its points and weaken or prevent the effects of tongue thrust and incorrect positioning, as well as its retraction as in during sleep and during wakefulness.

The inventive device makes it possible to obtain a therapeutic effect both in a conscious state (awake), during the day, and during sleep, at night. At night, work is ensured at the structural level (obtaining structural changes: position of the tongue, reducing pressure on the muscles, etc.). In addition, during sleep, in order to further prevent unconscious air intake through the mouth, the patient’s mouth can be sealed with a plaster. During the daytime, in addition to work at the structural level (in particular, changing the position of the tongue), there is a conscious restructuring of the work of the muscles of the maxillofacial area by reducing their tonic tension, as well as restoration of the patient’s physiological muscle functioning skills (work at the functional level). At night, the results of the work are also consolidated at the functional level.

The described design of the orthodontic myofunctional apparatus allows you to form the correct breathing pattern through the nose and the position of physiological rest, the correct swallowing pattern and the correct position of the tongue, prevent the possibility of retraction of the tongue and lower jaw as a result of causing sleep apnea syndrome, and also prevent the possibility of clenching and grinding of teeth during bruxism .

In children, during a period of active growth, this apparatus, through the restructuring of the correct swallowing function, can affect the quality of speech, cognitive abilities and jaw growth, that is, transform the type of growth from vertical to horizontal.

Wearing the inventive device balances the upper and lower jaw, relaxes the trapezius muscles, scalene muscles, and the entire complex of muscles in the neck and shoulder girdle, which allows you to influence posture, while wearing the device can be supplemented with massage and/or sports, which additionally ensures the alignment of all muscle chains and eliminates overstrain of the maxillofacial region, which very often includes a pattern of tension along all Myers chains throughout the body.

This indicates that the described design of the orthodontic myofunctional apparatus provides a physiological restructuring of patterns associated with the predominance of the sympathetic nervous system over the parasympathetic, therefore, in general, the claimed apparatus balances the sympathetic and parasympathetic systems, helping to form a state of proper relaxation.

Implementation of a utility model

The proposed device works as follows.

For confirmation, 5 orthodontic myofunctional devices were manufactured according to the claimed utility model. All devices were double-jaw removable devices, consisting of paired lip pads for the upper and lower jaws, cheek shields and a platform for positioning the tongue, connected to each other into a single frame by metal wire. Paired labial pads were connected to each other by V-shaped arches. The buccal shields were designed to be placed in the area of the masticatory muscles and connected to the tongue positioning platform by curved arcs. The platform for positioning the tongue of each device was made with the possibility of physiologically correct positioning of the tongue on it.

Each device was used in the treatment of patients with various diagnoses: abnormal breathing, swallowing, apnea, bruxism, etc.

Treatment conditions are shown in Table 1.

Table 1 device 1 device 2 device 3 device 4 apparatus 5 Patient Woman,
49 years old Woman, 36 years old Woman,
37 years Male, 40 years old Woman, 28 years old Diagnosis Complaints of pain and tension in the neck, snoring, sleep apnea and poor sleep. Brokenness Bruxism. In my sleep I clenched my teeth very hard, which led to their abrasion. Pain in the chewing muscles and neck muscles. Hypertonicity of the orbicularis oris muscle, tension in the facial muscles and complaints of associated aesthetic defects. Depression, low mood. Complaints of difficulty swallowing, tension of the muscles of the floor of the mouth and clenching of teeth. Bruxism day and night. Headache. Bad dream. Hypertonicity of the orbicularis oris muscle, tension in the facial muscles, complaints of aesthetic defects, headaches. Arc bending shape(8) V-shaped V-shaped V-shaped U-shaped U-shaped Usage time during sleep
(with mouth taped) combined
(at night and 3-4 hours during the day) during sleep
(with mouth taped) combined
(at night and 4-5 hours during the day) daytime Additionally - - - swallowing exercises Pilates Duration of use 2 months 4 months 4 months 6 months 3 months Result Nasal breathing was restored and snoring stopped. Improved neck condition. Gets enough sleep in 6 hours. Feels cheerful. relaxation of the chewing muscles and neck muscles. No symptoms of bruxism and improved swallowing. muscle relaxation occurred, aesthetics improved and, as a result, mood improved Headaches went away, muscles relaxed, sleep and general psycho-emotional state improved. Improved physical condition and aesthetics, muscle relaxation, headaches gone.

The results of the study showed that the use of the claimed device in all patients, regardless of gender and age, provided a state of physiological rest (no teeth closing with relaxed muscles (masticatory muscles, orbicularis oris and mentalis muscles)). In patients, the position of the tongue was normalized and the possibility of its retraction was eliminated, and correct swallowing and nasal breathing were restored at the functional level. At the same time, testing studies (5-6 months after the end of use of the device) showed the preservation of the achieved results and the preservation of the therapeutic effect.

Thus, the results showed that the proposed utility model achieves all the stated technical results.

Claims (1)

An orthodontic myofunctional device, characterized by the fact that it is a two-jaw removable device, which consists of lip pads, cheek shields and a platform for positioning the tongue, connected to each other into a single frame by metal wire, the lip pads are made in pairs for the upper and lower lips, with paired the labial pads are connected to each other by a V-shaped arc, the cheek shields are designed to be placed in the area of the masticatory muscles and are connected to the platform for positioning the tongue by arcs with a bend, while the platform for positioning the tongue is a single element and is designed to be physiologically correctly positioned on it language.