WO2014012827A1 - Device for expansion of a palate in the transverse plane and frontal plane - Google Patents

Device for expansion of a palate in the transverse plane and frontal plane Download PDF

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Publication number
WO2014012827A1
WO2014012827A1 PCT/EP2013/064567 EP2013064567W WO2014012827A1 WO 2014012827 A1 WO2014012827 A1 WO 2014012827A1 EP 2013064567 W EP2013064567 W EP 2013064567W WO 2014012827 A1 WO2014012827 A1 WO 2014012827A1
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WO
WIPO (PCT)
Prior art keywords
maxillary
screen
zone
lingual
gutter
Prior art date
Application number
PCT/EP2013/064567
Other languages
French (fr)
Inventor
Michel Alglave
Original Assignee
Michel Alglave
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Michel Alglave filed Critical Michel Alglave
Publication of WO2014012827A1 publication Critical patent/WO2014012827A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/08—Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/10—Devices having means to apply outwardly directed force, e.g. expanders
    • 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 device for expanding a palate in the transverse and frontal direction.
  • This device can also correct defects in shape of the lower dental arch.
  • the invention is particularly applicable to the sector of orthodontic appliances to at least recontourner the shape of the upper dental arch and, advantageously, simultaneously correct the alignment of the teeth.
  • the invention overcomes, in whole or in part, the disadvantages or limitations of techniques known hitherto.
  • the present invention provides a device for expanding a palate advantageously in the transverse and frontal direction, comprising a gutter having a maxillary bearing surface, preferably having a curved surface preferably with a maximum height of 4 mm, opposite the first upper molars, and comprising two symmetrical half-arches on either side of a median direction and joining in a front zone of the gutter.
  • the device is characterized in that it comprises a lingual screen mounted movable with respect to the gutter in a reversible movement directed towards the front zone in the median direction and at least one lateral palatal portion comprising, on an anterior face , a bearing zone applicable to a sector of the upper dental arch at one of the half-arches, the lingual screen being configured to transmit at least partly a lingual thrust force, in the median direction, to the support zone during the reversible movement.
  • the lingual screen provides the device with a means for the support of the tongue to actuate the operation during the lingual movements of the patient.
  • the patient indeed produces a forward thrust of the dental arch and this dynamic thrust is used to exert support, very advantageously in a premolar area, on the dental arch.
  • No prior adjustment out of shape adaptation of the device) is necessary and it is the patient who himself generates the expansion forces of the dental arch. Note that this operation can simultaneously ensure the correction of muscular dysfunctions of the tongue and, possibly the upper and lower lip, as will be specified later.
  • the area of the upper dental arch is a premolar area.
  • the action of the device is thus concentrated on a specific area of the dental arch, an area where the potential mobility is high and which requires an enlargement, in the case of ogival-shaped palates in particular.
  • the lingual thrust force is advantageously transmitted to the sector of the dental arch by the support zone in an oblique orientation relative to the median direction.
  • the device acts as a force transmitting member by transforming a force in the median direction into a force having a component oriented transversely and advantageously obliquely to the median direction.
  • the device can be active as soon as the teeth are clamped by the patient
  • the invention is such that:
  • the lingual screen is connected to the gutter by an elastically deformable medial palatal portion;
  • the at least one lateral palatal portion is made of a material that is more flexible than the material of the lingual screen
  • the lingual screen comprises at least one wing applying to a face preferably anterior to the first molar, the lateral palatal portion vis-à-vis the bearing zone;
  • the lateral palatal portion is integral with the gutter by a junction line located outside the support zone;
  • the half-arc of the gutter at which the support zone is situated has a distal lateral zone having a thickness greater than that between the gutter front zone and the distal lateral zone.
  • the thickness of the half-arc is increasing in the distal lateral zone towards its distal end
  • the bearing zones each comprise a hemispherical bulge
  • the gutter comprises, in a distal lateral zone of the half-arc at which the support zone is situated, an internal distal section projecting from the maxillary support surface and bordering the maxillary support surface on the side of said support zone; maxillary support surface where the lingual screen is located, and an external distal panel protruding from the maxillary support surface and bordering the maxillary support surface on the side of said maxillary support face opposite to the lingual screen .
  • the distal inner side has on the side of the maxillary support surface a dental application surface which is retracting on the maxillary support surface in an increasing manner toward the front zone, and in which the external distal part comprises side of the maxillary support surface a tooth application surface which is retracting on the maxillary bearing surface decreasingly towards the front zone;
  • the device also comprises a labial screen mounted on a vestibular panel of the gutter, the vestibular panel and the at least one lateral pan palatin being located vis-à-vis on either side of the maxillary support surface;
  • the labial screen is connected to the vestibular panel at a single point arranged in a sagittal plane in the median direction, in elevation with respect to the maxillary support surface;
  • the labial screen is biconvex around the upper median direction and advantageously convex on the lower edge and can be configured to exert a counter-thrust to the lingual screen;
  • the labial screen comprises two upper extensions preferentially forming a gingivo-labial sulcus support zone, for example a V-shaped zone;
  • the vestibular panel is made of a material that is more flexible than the material of the labial screen
  • the gutter has a mandibular support face opposite to the maxillary support surface and its curved surface when provided with it;
  • the gutter comprises at least one flange protruding around the mandibular support face
  • the device is formed symmetrically along a sagittal plane passing through the median direction;
  • the maximum transverse dimension of the lingual screen is configured to be greater than the spacing between the palatal surfaces of the upper two premolar.
  • the invention thus combines a dynamic effect by the lingual thrust and possibly the labial counter-thrust, and a static pressure effect of the labial screen due to its transverse oversize.
  • Figure 1 shows a substantially front perspective of an embodiment of the invention.
  • FIG. 2 presents in perspective substantially rearward the device in the embodiment of FIG.
  • Figure 3 is a view at a slightly different angle, with a variant of lip screen with narinaire extensions.
  • FIG. 4 is a front view of the device of the invention corresponding to the embodiment of FIG.
  • Figure 5 shows part of the device in a preferred embodiment.
  • Figure 6 shows this part of the device in plan view in a preferred embodiment.
  • Figures 7 and 8 are respectively a top view and a bottom view of the device in an example with canine palatal bulges.
  • Figure 9b is a sectional view in a sagittal plane. That is to say along the line C-C of Figure 9a which is a reminder of the front view.
  • Figure 10 shows another perspective of the device.
  • Figures 1 1 to 13 schematize the expansion of arcade that can be obtained.
  • Figures 14 and 15 show respectively in perspective and in top view, an initial state of a palace.
  • Figures 16 and 17 are similar views after treatment by the invention.
  • Figure 18 shows schematically, in profile, the implantation in the mouth of the device of the invention.
  • symmetrical means that the device of the invention advantageously has a symmetry, or for certain parts along a median direction axis which will be explained later, either according to a sagittal plan.
  • the symmetrical term does not mean that slight dimensional or geometric variations are possible around a symmetry in the strict sense.
  • the device may have slight variations between the left and right side portions of the invention adapted to cooperate with the dental arches.
  • sagittal plane refers to its usual anatomical definition as a vertical plane and perpendicular to the plane seen from the front.
  • this plane is parallel to an anteroposterior axis of the head and passes through a point located midway between the two eyes.
  • the median direction is included in the sagittal plane, the sagittal plane may also be defined as the plane containing said median direction and substantially perpendicular to the maxillary support face which will be presented in more detail later.
  • the adjective "frontal” is used here to designate a direction of intersection between a frontal plane and the sagittal plane, that is to say still generally a vertical direction.
  • an anatomical portion of the patient may include a bone portion and / or a dental portion at which the device can be applied and / or perform a particular action of recontourrison or alignment.
  • a sector concerned by the invention is an upper premolar sector corresponding to the sector at which place the upper premolar teeth and, for their foundation, an alveolar bone portion.
  • the device according to the invention appears in different views in FIGS. 1 to 10.
  • It generally has a shape adapted to the contours of the upper dental arch of the patient intended to receive the device.
  • the device of the invention comprises a gutter 1 allowing at least one support of the upper jaw.
  • the trough 1 comprises a maxillary bearing surface 3, visible for example in perspective in FIG. 1 or in the top view of FIG. 7.
  • the maxillary bearing surface 3 is substantially planar except in a distal lateral zone 14a, 14b which will be explained later.
  • the maxillary bearing surface 3 and its curved surface 15 allows the application of the teeth of the upper dental arch of the patient.
  • the groove 1 preferably comprises a mandibular support surface 2 which may be of substantially identical configuration to the maxillary support surface 3 except that it is preferably flat whereas the maxillary face 3 is advantageously provided with curved surfaces 15 presented in detail later. It should be noted that according to the invention it is not absolutely necessary to have a mandibular orthodontic correction. Indeed, the device of the invention can be limited to a purely limited application to the upper dental arch.
  • the trough 1 comprises two half-arches 23a, 23b, each placed on one side of the trough 1 around a front area 22 realizing the junction between the two half-arches 23a, 23b symmetrical.
  • the axis of symmetry of the two half-arches 23a, 23b corresponds to a median direction of the gutter which cuts it in two equal parts. This direction "m" is visible in particular in the view from above and corresponds to the intersection between the sagittal plane and a substantially horizontal plane in which is located at least approximately the maxillary support surface 3.
  • the shape and the dimension of the trough 1 are adapted to the morphology of the patient and can therefore be variable. As a result, the invention is thus available in several sizes. There is also the possibility of adjusting the transverse dimension marked "d" in the figures and corresponding to the internal width of the gutter at the level of the first molars.
  • the gutter 1 is advantageously flexible and therefore elastically deformable as indicated above and can be made in different biocompatible materials and particularly polyvinyl chloride (PVC) or silicone.
  • the groove 1 is a bite plane interposed between the upper arch and the lower arch. Its typical thickness is of the order of 2 to 4 millimeters.
  • the device comprises means making it possible, on the basis of a thrust exerted by the tongue of the patient, to transfer the lingual forces to a given sector of the dental arch and particularly to a sector upper premolar.
  • the device comprises a lingual screen 4, embodiments of which are visible in Figures 1 to 9 and which may be in the case illustrated in the form of a substantially curved web whose convexity is directed towards the gutter 1
  • the lingual screen 4 is, according to a first option, connected to the trough 1 via a medial palatal portion 10 having an attachment zone for the lingual screen 4 and, at a lower end, a zone of connection to the trough 1 at the maxillary bearing surface 3.
  • the trough 1, the lingual screen 4 and the medial palatal portion 10 may be made in three separate parts. However, they can be joined at least two by two as one-piece pieces.
  • the lingual screen 4 is made of a material less flexible than the material of the rest of the gutter 1 and possibly of the medial palatal portion 10. It may be a thermosetting plastic for example and possibly has the ability to be shaped by exposure to heat (thermoforming).
  • the lingual screen 4 does not apply towards the middle of the device and focuses its support on the support zones 9a, 9b.
  • the median zone of the lingual screen 4 advantageously adopts a change in curvature so as to avoid its support on the medial palatal portion 10, as in FIG. 9b where the screen 4 does not bear on the portion 10. The latter may be deleted.
  • the lingual screen 4 is mounted on the channel 1 so as to preserve a mobility at least in the direction along the median direction in the form of sliding or translation from back to front in a reversible manner. Additional movements are not excluded, however, including a possibility of at least limited rotation of the lingual screen 4 relative to the gutter 1.
  • the lingual screen 4 preferably comprises a face by which the lingual thrust can be applied, this face being concave.
  • the other face, opposite and therefore convex, is constituted to apply to another portion of the device of the invention.
  • This portion, called lateral palatal portion 8a, 8b provides the interface between the lingual screen 4 and the dental sector at which the support is to be transferred.
  • the device of the invention being advantageously symmetrical, two lateral palatal portions 8a, 8b are present in the figures even if this case is absolutely not limiting of the invention.
  • each lateral palatal portion 8a, 8b has a bearing zone 9a, 9b which is applicable to the sector of the dental arch. greater than the level at which it is necessary to locate the exercise of the support and connected to the gutter 1 projecting from the anterior edge of the maxillary support face 3, movements forward or recessed vis-à-vis the face maxillary support 3.
  • the lateral palatal portions 8a, 8b are connected to the trough 1 only on a line outside the bearing zone 9a, 9b while the lateral palatal portion 8a, 8b extends at the level of said zone of support 9a, 9b.
  • the bearing zones 9a, 9b each comprise a bulge 8'a, 8'b preferably hemispherical which may have a diameter of the order of 8mm.
  • the bulges 8'a, 8'b are preferably symmetrical and may further be of a soft material such as silicone, or be filled with a liquid distributing the pressure points. They exert a lateral and symmetrical thrust in the palate opposite the space intended for the descent of the upper canines. This stimulating thrust is exerted each time the patient squeezes his teeth (to maintain the device) and the tongue pushes forward the lingual screen 5 because these two bulges 8'a, 8'b are located at the lateral junctions of the patient. the lingual arc and the inner hemi-arc portions 8a, 8b.
  • the lateral palatal portions 8a, 8b have an extension with freedom of movement at which the bearing zones 9a, 9b are located.
  • this entails a backward motion in the median direction of the assembly formed by the lingual screen 4 and the portion medial palate 10.
  • the lingual screen 4 exerts a force, by its wings 26a, 26b, on the lateral palatal portions 8a, 8b so that they are themselves caused to exert a support on a sector of the upper dental arch at the level of the support zones 9a, 9b.
  • the premolar dental sector and also preferably the canine sector are particularly well adapted for the localization of the support zones, since these are the privileged places to go back to treat ogival-shaped palaces.
  • the premolar dental sector is preferably at the side and palatal parts of the first upper molars where the support is exercised.
  • the lingual screen 4 advantageously comprises two wings, each capable of being applied to the posterior face of the lateral palatal portions 8a, 8b at a location opposite the support zones 9a, 9b.
  • the lingual screen contact 4 / lateral palatal portions 8a, 8b can be plane-to-plane. But these parts preferably have different concavities / convexities to limit friction and locate their contact with respect to the bearing areas 9a, 9b and 8'a, 8'b bulges.
  • the maxillary bearing surface 3 preferably has a curved profile at an application zone of at least one molar tooth. As seen for example in Figure 2 or Figure 7, this particular configuration is performed at two distal lateral zones 14a, 14b located substantially at the distal ends of each half-arc 23a, 23b.
  • the curved profile advantageously has a maximum height towards the middle of the width of the maxillary bearing surface 3. It can also be curved in the direction transverse to the length of the maxillary bearing surface 3 with an elevation which reaches a maximum of maximum towards the middle of the first upper molar, before the distal end of each half-arc 23a, 23b.
  • the thickness of the trough 1 may be variable and in particular increase towards the distal end of each half-arc 23a, 23b at the distal zones 14a, 14b.
  • the dental support area of the maxillary bearing surface 3 is slightly raised relative to the remainder of the groove 1 so as to form the curved surface 15 as shown in FIG. 5.
  • the molars will more quickly dock the maxillary bearing surface 3 that premolars, they may even remain elevated relative to said maxillary support surface 3 without coming into contact or at least without exerting strong pressures.
  • This freedom offered to the premolar sector promotes its mobility and its displacement under the impetus of the thrust exerted at the level of the support zones 9a, 9b.
  • FIGS. 2 and 6 show in greater detail another possibility of the invention according to which the distal lateral zones 14a, 14b have panels, respectively internal distal panels 16a, 16b and external distal panels 17a, 17b, preferentially for each half-arc 23a, 23b.
  • These sections 16a, 16b, 17a, 17b preferentially frame a molar tooth and particularly the first upper molar so as to exert a lateral support on the latter.
  • This configuration of sections makes it possible to push the cusp distal of the first upper molar into rotation in the horizontal plane.
  • This rotational mobility makes it possible to more effectively anchor the first upper molar and participate in the orthodontic effort.
  • the sections 16a, 16b, 17a, 17b are preferably provided with a particular profile along a sectional plane perpendicular to the sagittal plane.
  • the torque imposed on the tooth must be of the "toe in” type, that is to say, tend to follow the direction of rotation indicated by the arrow "t" in FIG.
  • the internal distal panel 16 has, starting from the end of the half arc considered, a more outgoing profile than towards the front end of the half -arc considered. A progression in this bulge towards the inside of the maxillary bearing surface 3 is advantageous, as represented in FIG. 6.
  • the profile of the bulge of the external distal panels 17 (that is to say situated on one side the maxillary support surface 3 opposite to that where the lingual screen 4) is substantially opposite.
  • This conjugation of two complementary profiles makes it possible to induce the first upper molar to the rotary displacement previously indicated.
  • the device preferably comprises, for optimum efficiency, a labial screen 5.
  • the labial screen 5 is located in the anterior area of the device of the invention and constitutes the front part of the assembly. Joined by a connecting zone 13 to a vestibular panel 6 protruding beyond the maxillary bearing surface 3, the labial screen 5 forms an intermediate element between the upper and lower lip of the patient and the complete device.
  • Figures 7 and 8 give more particularly a configuration. In these views, the lateral edges of the labial screen 5 are not in contact with the rest of the device, for the sake of clarity of the drawings. Nevertheless, in operation, the labial screen 5 is applied to the rest of the device.
  • the convexity is executed not only in planes parallel to the sagittal plane but also in perpendicular planes.
  • the connecting zone 13, represented for example in FIG. 1, is preferably a single connection zone so that all the forces exerted by the upper and lower lip and taken up by the lip screen 5 are concentrated at this point. .
  • the connecting zone 13 is configured to be positionable with respect to an anatomical point generally called "point A" practitioners and corresponding to a gingival area situated between the roots of the upper central incisors, in the sagittal plane.
  • the labial screen 5 advantageously has two upper extensions 5a, 5b extending to the upper gingivo-labial groove facing the nostrils.
  • the V-shape that is to say, producing a progressive separation of the extensions towards their distal ends, is intended to respect the upper labial brake.
  • the coast l 2 of Figure 4 is preferably 6 mm with a tolerance of roughly 1 to 2 mm.
  • a mandibular support surface 2 is however advantageously present with at least one rim and advantageously a plurality of projecting rims around said mandibular support face 2.
  • these flanges comprise a lower palatal rim 12 capable of forming below the lingual screen 4 and the lateral portions 8a, 8b, an area of the space in which the distal end of the tongue can be received and can guide the movement of the lower incisors during movements of the mandible.
  • the lower part of the trough 1 further comprises a lower vestibular rim January 1, intended substantially to be located on the anterior side of the incisors of the lower dental arch opposite, relative to the lower palatal rim 12.
  • a distal flange 24 may be formed and advantageously four flanges 24 each located respectively corresponding to an inner distal portion 16a, 16b and an outer distal portion 17a, 17b. This provides additional guidance at the molar sector of the lower dental arch.
  • the mandible of the patient who clamps the teeth is placed in the channel formed by the gutter at the maxillary support surface 3 in propulsion to obtain an end to end position of the upper and lower incisors.
  • the groove 1 enters the patient's mouth being contracted transversely between the thumb and forefinger.
  • the patient will contract his lips and allow the labial screen 5 to exert support on the point 13 corresponding to a midpoint between the upper central incisors.
  • the patient will exert a thrust by his tongue on the lingual screen 4 moving elastically in the median direction "m" from rear to front.
  • the lateral palatal portions 8a, 8b at the level of the dental sector to be reformed (preferably that of the upper premolars and advantageously also of the upper canines).
  • the support exerted by the labial screen 5 forms a counterpressure in the support exerted at the support zones so that the extension effect, contrary to the ogival tendency, is increased.
  • the labial screen 5 transfers the excessive lower labial and chin forces, harmonizes the pressure difference between the upper and lower lips. Its purpose is not only counter-support, but also to allow a better growth of the mandible and a decrease of the hyperpressure on the lower incisors. Space saving is achieved due to the premaxillary expansion which makes possible dental alignment.
  • the device thus acts essentially on the effect of the reflex contracture of the patient. Nevertheless, by simply clamping the teeth in the gutter 1, the patient activates the device simply by virtue of its elasticity. Thus, the dysfunction of the patient corresponding to a low position of the tongue and a tension of the lower lip, is used to correct the dysmorphosis (an ogival palate) and thus to round the upper dental arch and incidentally the lower one. Extended use of the device corrects initial oral muscle dysfunctions.
  • gutter portions have no material other than the thickness of the channel 1 between said faces 2, 3, for example between the panels 16a, 16b, 17a, 17b and the portions Lateral 8a, 8b and the vestibular panel 6. In this way, a large possibility of modification of elastic deformation is retained.
  • the lingual screen 4 advantageously comprises two wings and the palatal side portions 8a, 8b comprise two bearing zones 9a, 9b having no direct connection to the trough 1, so that these parts are capable of a deformation and in particular a deformation in the direction of the maxillary support surface 3 to best perform the localized expansion force on the dental arch.
  • the length of the free portion of the lateral palatal portions 8a, 8b is advantageously at least 5 millimeters and possibly about 8 millimeters, as illustrated in FIG. 10 with a tolerance of + or - 2 mm.
  • FIGS 1-1 to 13 illustrate the evolution of the shape of the palate during the treatment by means of the invention.
  • a medial lingual support causes posterointerior and advantageously anterolateral forces.
  • This induces, thanks to the invention, thrusts Pi, P 2 on two premolar dental sectors 25 and preferably also flares p1, p2 on the upper canine alveolar sectors.
  • a counter-thrust C is exerted on the gutter, so that, together with Pi and P 2 , the counter-thrust C promotes the expansion and preferably the rounding what reveal, so intentionally exaggerated, Figures 12 and 13.

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Abstract

The present invention relates to a device for expansion of a palate in the transverse plane and frontal plane, comprising a splint provided with a maxillary bearing surface and comprising two half-arcs (23a, 23b) which are symmetrical on each side of a median direction and join each other at a front region of the splint. Said device has a lingual screen (4) mounted so as to be movable with respect to the splint in a reversible movement directed towards the front region in the median direction, and at least one lateral palatine portion having, on an anterior surface, a bearing region that can be placed on a sector of the upper dental arch in the area of one of the half-arcs (23a, 23b), the lingual screen (4) being designed in such a way that a lingual thrust is at least partially transmitted by it to the bearing region during the reversible movement. A labial screen (5) is connected to the vestibular face (6) at a single point disposed in a sagittal plane in the median direction (m), in elevation with respect to the maxillary bearing surface (3) providing a median counter-thrust to the antero-lateral forces transmitted by the lingual screen (4).

Description

« Dispositif d'expansion d'un palais dans le plan transversal et frontal »  "Device for expansion of a palace in the transverse and frontal plane"
La présente invention est relative à un dispositif d'expansion d'un palais dans le sens transversal et frontal. Ce dispositif peut aussi corriger des défauts de forme de l'arcade dentaire inférieure. L'invention s'applique particulièrement au secteur des appareils d'orthodontie pour au moins recontourner la forme de l'arcade dentaire supérieure et, avantageusement, corriger simultanément l'alignement des dents. The present invention relates to a device for expanding a palate in the transverse and frontal direction. This device can also correct defects in shape of the lower dental arch. The invention is particularly applicable to the sector of orthodontic appliances to at least recontourner the shape of the upper dental arch and, advantageously, simultaneously correct the alignment of the teeth.
De nombreux dispositifs orthodontiques existent avec des niveaux d'efficacité thérapeutique très variables et parfois avec la mise en œuvre d'appareillages dentaires complexes et difficiles à tolérer pour le patient. Pour des pathologies liées à la forme et/ou la dimension des arcades dentaires, telles que la dysmorphose endognathie, dans laquelle le palais a une forme excessivement ogivale, bien peu de dispositifs efficients existent en pratique sans gêner la langue dans le palais.  Many orthodontic devices exist with very variable therapeutic efficacy levels and sometimes with the implementation of complex dental equipment and difficult to tolerate for the patient. For pathologies related to the shape and / or dimension of the dental arches, such as dysmorphosis endognathia, in which the palate has an excessively ogival shape, very few efficient devices exist in practice without disturbing the tongue in the palate.
Le document FR-A-2 959 931 du demandeur a vocation à s'appliquer à étendre l'arcade dentaire supérieure et donne des résultats intéressants. Le dispositif présenté dans cette publication prend la forme globale d'une gouttière orthodontique souple à laquelle sont associés deux arcs formés de lames métalliques couplées par des vis, l'ensemble étant réglable de sorte à pré-contraindre le système de lames et générer, sur l'arcade dentaire supérieure, un appui apte à évaser cette dernière. Ce dispositif nécessite néanmoins une mise en charge, par le patient ou mieux le praticien, pour le réglage des vis. Son usage n'est donc pas totalement simplifié. En outre, l'effet d'écartement de l'arcade dentaire qu'il produit repose seulement sur les forces statiques imposées par les lames métalliques inconfortables. Document FR-A-2 959 931 of the applicant is intended to apply to extend the upper dental arch and gives interesting results. The device presented in this publication takes the overall shape of a flexible orthodontic gutter to which are associated two arches formed of metal blades coupled by screws, the assembly being adjustable so as to pre-constrain the blade system and generate, on the upper dental arch, a support able to flare the latter. These measures However, it requires loading, by the patient or better the practitioner, for adjusting the screws. Its use is not totally simplified. In addition, the spacer effect of the dental arch that it produces relies only on the static forces imposed by the uncomfortable metal blades.
L'invention permet de remédier, en tout ou partie, aux inconvénients ou limitations des techniques connues jusqu'à présent.  The invention overcomes, in whole or in part, the disadvantages or limitations of techniques known hitherto.
A cet effet, la présente invention propose un dispositif d'expansion d'un palais avantageusement dans le sens transversal et frontal, comprenant une gouttière dotée d'une face d'appui maxillaire, ayant avantageusement une surface bombée de préférence avec une hauteur maximale de 4 mm , en regard des première molaires supérieures, et comprenant deux demi-arcs symétriques de part et d'autre d'une direction médiane et se rejoignant en une zone avant de la gouttière.  For this purpose, the present invention provides a device for expanding a palate advantageously in the transverse and frontal direction, comprising a gutter having a maxillary bearing surface, preferably having a curved surface preferably with a maximum height of 4 mm, opposite the first upper molars, and comprising two symmetrical half-arches on either side of a median direction and joining in a front zone of the gutter.
De manière avantageuse, le dispositif est caractérisé en ce qu'il comporte un écran lingual monté mobile par rapport à la gouttière dans un mouvement réversible dirigé vers la zone avant suivant la direction médiane et au moins une portion palatine latérale comportant, sur une face antérieure, une zone d'appui applicable sur un secteur de l'arcade dentaire supérieure au niveau de l'un des demi arcs, l'écran lingual étant configuré pour transmettre au moins en partie un effort de poussée linguale, suivant la direction médiane, à la zone d'appui lors du mouvement réversible.  Advantageously, the device is characterized in that it comprises a lingual screen mounted movable with respect to the gutter in a reversible movement directed towards the front zone in the median direction and at least one lateral palatal portion comprising, on an anterior face , a bearing zone applicable to a sector of the upper dental arch at one of the half-arches, the lingual screen being configured to transmit at least partly a lingual thrust force, in the median direction, to the support zone during the reversible movement.
L'écran lingual confère au dispositif un moyen pour l'appui de la langue pour actionner le fonctionnement lors des mouvements linguaux du patient. A chaque pression linguale, le patient produit en effet une poussée vers l'avant de l'arcade dentaire et cette poussée dynamique est exploitée pour exercer un appui, très avantageusement dans un secteur prémolaire, sur l'arcade dentaire. Aucun réglage préalable (hors adaptation de forme du dispositif) n'est nécessaire et c'est le patient qui génère lui-même les forces d'expansion de l'arcade dentaire. On notera que ce fonctionnement peut assurer simultanément la correction de dysfonctionnements musculaires de la langue et, possiblement de la lèvre supérieure et inférieure, comme il sera précisé ultérieurement.  The lingual screen provides the device with a means for the support of the tongue to actuate the operation during the lingual movements of the patient. At each lingual pressure, the patient indeed produces a forward thrust of the dental arch and this dynamic thrust is used to exert support, very advantageously in a premolar area, on the dental arch. No prior adjustment (out of shape adaptation of the device) is necessary and it is the patient who himself generates the expansion forces of the dental arch. Note that this operation can simultaneously ensure the correction of muscular dysfunctions of the tongue and, possibly the upper and lower lip, as will be specified later.
Suivant un cas préféré, le secteur de l'arcade dentaire supérieure est un secteur prémolaire. On concentre ainsi l'action du dispositif sur une zone précise de l'arcade dentaire, zone où la mobilité potentielle est élevée et qui nécessite un élargissement, dans les cas de palais de forme ogivale en particulier.  In a preferred case, the area of the upper dental arch is a premolar area. The action of the device is thus concentrated on a specific area of the dental arch, an area where the potential mobility is high and which requires an enlargement, in the case of ogival-shaped palates in particular.
Pour assurer cette expansion d'arcade, l'effort de poussée linguale est avantageusement transmis au secteur de l'arcade dentaire par la zone d'appui suivant une orientation oblique relativement à la direction médiane. On comprend que le dispositif agit comme un organe de transmission d'effort en transformant une force suivant la direction médiane en une force ayant une composante orientée transversalement et avantageusement obliquement à la direction médiane. To ensure this arch expansion, the lingual thrust force is advantageously transmitted to the sector of the dental arch by the support zone in an oblique orientation relative to the median direction. We understand that the device acts as a force transmitting member by transforming a force in the median direction into a force having a component oriented transversely and advantageously obliquely to the median direction.
Le dispositif peut être actif dès le serrage des dents par le patient  The device can be active as soon as the teeth are clamped by the patient
D'autres buts et avantages apparaîtront au cours de la description qui suit qui présente un mode de réalisation de l'invention illustratif mais non limitatif.  Other objects and advantages will become apparent from the following description which presents an illustrative but nonlimiting embodiment of the invention.
Suivant des variantes préférées mais non limitatives, l'invention est telle que : According to preferred but nonlimiting variants, the invention is such that:
- l'écran lingual est raccordé à la gouttière par une portion palatine médiane déformable élastiquement ; the lingual screen is connected to the gutter by an elastically deformable medial palatal portion;
- la au moins une portion palatine latérale est en un matériau plus flexible que le matériau de l'écran lingual ;  the at least one lateral palatal portion is made of a material that is more flexible than the material of the lingual screen;
- l'écran lingual comporte au moins une aile s'appliquant sur une face de préférence antérieure à la première molaire, de la portion palatine latérale en vis-à-vis de la zone d'appui ;  - The lingual screen comprises at least one wing applying to a face preferably anterior to the first molar, the lateral palatal portion vis-à-vis the bearing zone;
- la portion palatine latérale est solidaire de la gouttière par une ligne de jonction située hors de la zone d'appui ;  - The lateral palatal portion is integral with the gutter by a junction line located outside the support zone;
- le demi-arc de la gouttière au niveau duquel est située la zone d'appui comporte une zone latérale distale présentant une épaisseur supérieure à celle entre la zone avant de gouttière et la zone latérale distale.  the half-arc of the gutter at which the support zone is situated has a distal lateral zone having a thickness greater than that between the gutter front zone and the distal lateral zone.
- l'épaisseur du demi-arc est croissante dans la zone latérale distale vers son extrémité distale ;  the thickness of the half-arc is increasing in the distal lateral zone towards its distal end;
- les zones d'appui comportent chacune un renflement hémisphériques ;  the bearing zones each comprise a hemispherical bulge;
- la gouttière comporte, dans une zone latérale distale du demi-arc au niveau duquel est située la zone d'appui, un pan distal interne faisant saillie sur la face d'appui maxillaire et bordant la face d'appui maxillaire du côté de ladite face d'appui maxillaire où se situe l'écran lingual, et un pan distal externe faisant saillie sur la face d'appui maxillaire et bordant la face d'appui maxillaire du côté de ladite face d'appui maxillaire opposé à l'écran lingual.  the gutter comprises, in a distal lateral zone of the half-arc at which the support zone is situated, an internal distal section projecting from the maxillary support surface and bordering the maxillary support surface on the side of said support zone; maxillary support surface where the lingual screen is located, and an external distal panel protruding from the maxillary support surface and bordering the maxillary support surface on the side of said maxillary support face opposite to the lingual screen .
- le pan distal interne comporte du côté de la face d'appui maxillaire une surface d'application dentaire qui est rentrante sur la face d'appui maxillaire de manière croissante en direction de la zone avant, et dans lequel le pan distal externe comporte du côté de la face d'appui maxillaire une surface d'application dentaire qui est rentrante sur la face d'appui maxillaire de manière décroissante en direction de la zone avant ;  the distal inner side has on the side of the maxillary support surface a dental application surface which is retracting on the maxillary support surface in an increasing manner toward the front zone, and in which the external distal part comprises side of the maxillary support surface a tooth application surface which is retracting on the maxillary bearing surface decreasingly towards the front zone;
- la zone latérale distale est configurée pour s'appliquer sur un secteur molaire de l'arcade dentaire supérieure. - le dispositif comporte aussi un écran labial monté sur un pan vestibulaire de la gouttière, le pan vestibulaire et le au moins un pan palatin latéral étant situés en vis-à- vis de part et d'autre de la face d'appui maxillaire ; the distal lateral zone is configured to apply to a molar sector of the upper dental arch. - The device also comprises a labial screen mounted on a vestibular panel of the gutter, the vestibular panel and the at least one lateral pan palatin being located vis-à-vis on either side of the maxillary support surface;
- l'écran labial est raccordé au pan vestibulaire en un point unique disposé dans un plan sagittal suivant la direction médiane, en élévation par rapport à la face d'appui maxillaire ;  the labial screen is connected to the vestibular panel at a single point arranged in a sagittal plane in the median direction, in elevation with respect to the maxillary support surface;
- l'écran labial est biconvexe autour de la direction médiane supérieure et avantageusement convexe sur le bord inférieur et peut être configuré de sorte à exercer une contre-poussée à l'écran lingual;  - The labial screen is biconvex around the upper median direction and advantageously convex on the lower edge and can be configured to exert a counter-thrust to the lingual screen;
- l'écran labiale comporte deux extensions supérieures formant préférentiellement une zone d'appui de sillon gingivo-labial par exemple en V  the labial screen comprises two upper extensions preferentially forming a gingivo-labial sulcus support zone, for example a V-shaped zone;
- le pan vestibulaire est en un matériau plus flexible que le matériau de l'écran labial ;  the vestibular panel is made of a material that is more flexible than the material of the labial screen;
- la gouttière comporte une face d'appui mandibulaire opposée à la face d'appui maxillaire et sa surface bombée quand elle en est pourvue ;  - The gutter has a mandibular support face opposite to the maxillary support surface and its curved surface when provided with it;
- la gouttière comporte au moins un rebord en saillie autour de la face d'appui mandibulaire ;  the gutter comprises at least one flange protruding around the mandibular support face;
- le dispositif est formé de manière symétrique suivant un plan sagittal passant par la direction médiane ;  the device is formed symmetrically along a sagittal plane passing through the median direction;
- la dimension transversale maximale de l'écran lingual est configurée pour être supérieure à l'écartement entre les faces palatines des deux prémolaires supérieures.  - The maximum transverse dimension of the lingual screen is configured to be greater than the spacing between the palatal surfaces of the upper two premolar.
L'invention combine ainsi un effet dynamique par la poussée linguale et éventuellement la contre-poussée labiale, et un effet statique par pression de l'écran labiale du fait de sa surdimension transversale.  The invention thus combines a dynamic effect by the lingual thrust and possibly the labial counter-thrust, and a static pressure effect of the labial screen due to its transverse oversize.
Les dessins ci-joints sont donnés à titre d'exemples et ne sont pas limitatifs de l'invention. Ils représentent seulement un mode de réalisation de l'invention et permettront de la comprendre aisément.  The accompanying drawings are given by way of example and are not limiting of the invention. They represent only one embodiment of the invention and will make it easy to understand.
La figure 1 montre une perspective sensiblement de face d'un mode de réalisation de l'invention.  Figure 1 shows a substantially front perspective of an embodiment of the invention.
La figure 2 présente en perspective sensiblement arrière le dispositif dans le mode de réalisation de la figure 1.  FIG. 2 presents in perspective substantially rearward the device in the embodiment of FIG.
La figure 3 est une vue sous un angle légèrement différent, avec une variante d'écran labiale à extensions narinaires.  Figure 3 is a view at a slightly different angle, with a variant of lip screen with narinaire extensions.
La figure 4 est une vue de face du dispositif de l'invention correspondant au mode de réalisation de la figure 3.  FIG. 4 is a front view of the device of the invention corresponding to the embodiment of FIG.
La figure 5 présente une partie du dispositif dans un mode de réalisation préféré. La figure 6 présente cette partie du dispositif en vue de dessus dans un mode de réalisation préféré. Figure 5 shows part of the device in a preferred embodiment. Figure 6 shows this part of the device in plan view in a preferred embodiment.
Les figures 7 et 8 sont respectivement une vue de dessus et une vue de dessous du dispositif dans un exemple avec des renflements palatins canins.  Figures 7 and 8 are respectively a top view and a bottom view of the device in an example with canine palatal bulges.
La figure 9b est une vue en coupe dans un plan sagittal. C'est-à-dire suivant la ligne C-C de la figure 9a qui est un rappel de la vue de face.  Figure 9b is a sectional view in a sagittal plane. That is to say along the line C-C of Figure 9a which is a reminder of the front view.
La figure 10 présente une autre perspective du dispositif.  Figure 10 shows another perspective of the device.
Les figures 1 1 à 13 schématisent l'expansion d'arcade que l'on peut obtenir. Figures 1 1 to 13 schematize the expansion of arcade that can be obtained.
Les figures 14 et 15 montrent respectivement en perspective et en vue de dessus, un état initial d'un palais. Les figures 16 et 17 sont des vues similaires après traitement par l'invention. Figures 14 and 15 show respectively in perspective and in top view, an initial state of a palace. Figures 16 and 17 are similar views after treatment by the invention.
La figure 18 schématise, vue de profil, l'implantation en bouche du dispositif de l'invention.  Figure 18 shows schematically, in profile, the implantation in the mouth of the device of the invention.
Dans la description qui suit et à moins qu'il en soit indiqué autrement, on entend par symétrique le fait que le dispositif de l'invention présente avantageusement une symétrie, soit pour certaines parties suivant un axe de direction médiane qui sera explicité plus loin, soit suivant un plan du type sagittal. Le terme symétrique ne signifie pas que de légères variations dimensionnelles ou géométriques soient possibles autour d'une symétrie au sens strict. Notamment, suivant les corrections à apporter à la morphologie du patient, le dispositif peut présenter de légères variations entre les parties latérales gauche et droite de l'invention aptes à coopérer avec les arcades dentaires. Le terme « plan sagittal » s'entend de sa définition anatomique habituelle comme d'un plan vertical et perpendiculaire au plan vue de face. Typiquement, ce plan est parallèle à un axe antéropostérieur de la tête et passe par un point situé à mi- distance entre les deux yeux. Dans le cadre de l'invention, la direction médiane est incluse dans le plan sagittal, le plan sagittal pouvant être défini par ailleurs comme le plan contenant ladite direction médiane et sensiblement perpendiculaire à la face d'appui maxillaire qui sera présentée plus en détails ultérieurement. L'adjectif « frontal » est ici employé pour désigner une direction d'intersection entre un plan frontal et le plan sagittal, c'est-à-dire encore généralement une direction verticale.  In the description which follows and unless otherwise indicated, symmetrical means that the device of the invention advantageously has a symmetry, or for certain parts along a median direction axis which will be explained later, either according to a sagittal plan. The symmetrical term does not mean that slight dimensional or geometric variations are possible around a symmetry in the strict sense. In particular, according to the corrections to be made to the morphology of the patient, the device may have slight variations between the left and right side portions of the invention adapted to cooperate with the dental arches. The term "sagittal plane" refers to its usual anatomical definition as a vertical plane and perpendicular to the plane seen from the front. Typically, this plane is parallel to an anteroposterior axis of the head and passes through a point located midway between the two eyes. In the context of the invention, the median direction is included in the sagittal plane, the sagittal plane may also be defined as the plane containing said median direction and substantially perpendicular to the maxillary support face which will be presented in more detail later. . The adjective "frontal" is used here to designate a direction of intersection between a frontal plane and the sagittal plane, that is to say still generally a vertical direction.
On entend par secteur d'arcade dentaire, une portion anatomique du patient pouvant comprendre une partie osseuse et/ou une partie dentaire au niveau de laquelle le dispositif peut s'appliquer et/ou opérer une action notamment de recontournement ou d'alignement. En particulier, un secteur concerné par l'invention est un secteur prémolaire supérieur correspondant au secteur au niveau duquel se situent les dents prémolaires supérieures et, pour leur fondement, une portion osseuse alvéolaire. The term dental arcuate sector, an anatomical portion of the patient may include a bone portion and / or a dental portion at which the device can be applied and / or perform a particular action of recontournement or alignment. In particular, a sector concerned by the invention is an upper premolar sector corresponding to the sector at which place the upper premolar teeth and, for their foundation, an alveolar bone portion.
L'adjectif « maxillaire » est utilisé en référence à la mâchoire supérieure et l'adjectif « mandibulaire » en référence à la mâchoire inférieure.  The adjective "maxillary" is used with reference to the upper jaw and the adjective "mandibular" with reference to the lower jaw.
Le dispositif selon l'invention apparaît sous différentes vues aux figures 1 à 10. The device according to the invention appears in different views in FIGS. 1 to 10.
Il présente globalement une forme adaptée aux contours de l'arcade dentaire supérieure du patient destiné à recevoir le dispositif. It generally has a shape adapted to the contours of the upper dental arch of the patient intended to receive the device.
Comme pour d'autres dispositifs orthodontiques connus, le dispositif de l'invention comporte une gouttière 1 permettant au moins un appui de la mâchoire supérieure. A cet effet, la gouttière 1 comprend une face d'appui maxillaire 3, visible par exemple en perspective en figure 1 ou sur la vue de dessus de la figure 7. Avantageusement mais non exclusivement, la face d'appui maxillaire 3 est sensiblement plane hormis dans une zone latérale distale 14a, 14b qui sera explicitée plus loin. La face d'appui maxillaire 3 et sa surface bombée 15 permet l'application des dents de l'arcade dentaire supérieure du patient.  As for other known orthodontic devices, the device of the invention comprises a gutter 1 allowing at least one support of the upper jaw. For this purpose, the trough 1 comprises a maxillary bearing surface 3, visible for example in perspective in FIG. 1 or in the top view of FIG. 7. Advantageously but not exclusively, the maxillary bearing surface 3 is substantially planar except in a distal lateral zone 14a, 14b which will be explained later. The maxillary bearing surface 3 and its curved surface 15 allows the application of the teeth of the upper dental arch of the patient.
A l'opposé de la face d'appui maxillaire 3, la gouttière 1 comporte préférentiellement une face d'appui mandibulaire 2 qui peut être de configuration sensiblement identique à la face d'appui maxillaire 3 sauf qu'elle est préférentiellement plane alors que la face maxillaire 3 est avantageusement dotées de surfaces bombées 15 présentées en détail ultérieurement. Il faut noter que selon l'invention il n'est pas absolument nécessaire de disposer d'une correction orthodontique mandibulaire. En effet, le dispositif de l'invention peut se restreindre à une application purement limitée à l'arcade dentaire supérieure.  In contrast to the maxillary bearing surface 3, the groove 1 preferably comprises a mandibular support surface 2 which may be of substantially identical configuration to the maxillary support surface 3 except that it is preferably flat whereas the maxillary face 3 is advantageously provided with curved surfaces 15 presented in detail later. It should be noted that according to the invention it is not absolutely necessary to have a mandibular orthodontic correction. Indeed, the device of the invention can be limited to a purely limited application to the upper dental arch.
D'une manière générale, pour suivre le contour anatomique de l'arcade dentaire supérieure du patient, la gouttière 1 comporte deux demi-arcs 23a, 23b, chacun placé d'un côté de la gouttière 1 autour d'une zone avant 22 réalisant la jonction entre les deux demi-arcs 23a, 23b symétriques. L'axe de symétrie des deux demi-arcs 23a, 23b correspond à une direction médiane de la gouttière qui la coupe en deux parties égales. Cette direction « m » est visible notamment sur la vue de dessus et correspond à l'intersection entre le plan sagittal et un plan sensiblement horizontal dans lequel se situe au moins approximativement la face d'appui maxillaire 3.  In general, to follow the anatomical contour of the upper dental arch of the patient, the trough 1 comprises two half-arches 23a, 23b, each placed on one side of the trough 1 around a front area 22 realizing the junction between the two half-arches 23a, 23b symmetrical. The axis of symmetry of the two half-arches 23a, 23b corresponds to a median direction of the gutter which cuts it in two equal parts. This direction "m" is visible in particular in the view from above and corresponds to the intersection between the sagittal plane and a substantially horizontal plane in which is located at least approximately the maxillary support surface 3.
On comprend aisément que la forme et la dimension de la gouttière 1 sont adaptées à la morphologie du patient et peuvent donc être variables. En conséquence, l'invention est ainsi déclinable en plusieurs tailles. Il existe par ailleurs la possibilité d'ajuster la dimension transversale repérée « d » sur les figures et correspondant à la largeur intérieure de la gouttière au niveau des premières molaires. La gouttière 1 est avantageusement souple et donc déformable élastiquement comme indiqué précédemment et peut être réalisée dans différents matériaux biocompatibles et particulièrement du polychlorure de vinyle (PVC) ou encore du silicone. It is easy to understand that the shape and the dimension of the trough 1 are adapted to the morphology of the patient and can therefore be variable. As a result, the invention is thus available in several sizes. There is also the possibility of adjusting the transverse dimension marked "d" in the figures and corresponding to the internal width of the gutter at the level of the first molars. The gutter 1 is advantageously flexible and therefore elastically deformable as indicated above and can be made in different biocompatible materials and particularly polyvinyl chloride (PVC) or silicone.
Dans la partie présentant la face d'appui maxillaire 3 et la face d'appui mandibulaire 2, la gouttière 1 constitue un plan de morsure s'interposant entre l'arcade du haut et celle du bas. Son épaisseur typique est de l'ordre de 2 à 4 millimètres.  In the portion having the maxillary bearing surface 3 and the mandibular support face 2, the groove 1 is a bite plane interposed between the upper arch and the lower arch. Its typical thickness is of the order of 2 to 4 millimeters.
Selon l'invention, outre la gouttière 1 , le dispositif comprend des moyens permettant, sur la base d'une poussée exercée par la langue du patient, de transférer les efforts linguaux à un secteur déterminé de l'arcade dentaire et particulièrement à un secteur prémolaire supérieur. Pour y parvenir, le dispositif comprend un écran lingual 4 dont des modes de réalisation sont visibles aux figures 1 à 9 et qui peut se présenter dans le cas illustré sous la forme d'une nappe sensiblement incurvée dont la convexité est orientée vers la gouttière 1. L'écran lingual 4 est .suivant une première option, raccordé à la gouttière 1 par l'intermédiaire d'une portion palatine médiane 10 présentant une zone de fixation pour l'écran lingual 4 et, à une extrémité inférieure, une zone de raccordement à la gouttière 1 au niveau de la face d'appui maxillaire 3. La gouttière 1 , l'écran lingual 4 et la portion palatine médiane 10 peuvent être réalisées en trois pièces distinctes. Cependant, elles peuvent être réunies au moins deux par deux sous forme de pièces monoblocs. Avantageusement pour exercer un appui le plus efficace possible sur le reste du dispositif, l'écran lingual 4 est réalisé en une matière moins flexible que la matière du reste de la gouttière 1 et éventuellement de la portion palatine médiane 10. Il peut s'agir d'un plastique thermodurcissable par exemple et a éventuellement la faculté d'être conformé par exposition à la chaleur (thermoformage). Dans une autre option, l'écran linguale 4 ne s'applique pas vers le milieu du dispositif et concentre son appui sur les zones d'appui 9a, 9b. Dans ce cas, la zone médiane de l'écran lingual 4 adopte avantageusement un changement de courbure de sorte à éviter son appui sur la portion palatine médiane 10, comme en figure 9b où l'écran 4 n'appuie pas sur la portion 10. Cette dernière peut éventuellement être supprimée.  According to the invention, besides the gutter 1, the device comprises means making it possible, on the basis of a thrust exerted by the tongue of the patient, to transfer the lingual forces to a given sector of the dental arch and particularly to a sector upper premolar. To achieve this, the device comprises a lingual screen 4, embodiments of which are visible in Figures 1 to 9 and which may be in the case illustrated in the form of a substantially curved web whose convexity is directed towards the gutter 1 The lingual screen 4 is, according to a first option, connected to the trough 1 via a medial palatal portion 10 having an attachment zone for the lingual screen 4 and, at a lower end, a zone of connection to the trough 1 at the maxillary bearing surface 3. The trough 1, the lingual screen 4 and the medial palatal portion 10 may be made in three separate parts. However, they can be joined at least two by two as one-piece pieces. Advantageously, in order to exert as effective a support as possible on the rest of the device, the lingual screen 4 is made of a material less flexible than the material of the rest of the gutter 1 and possibly of the medial palatal portion 10. It may be a thermosetting plastic for example and possibly has the ability to be shaped by exposure to heat (thermoforming). In another option, the lingual screen 4 does not apply towards the middle of the device and focuses its support on the support zones 9a, 9b. In this case, the median zone of the lingual screen 4 advantageously adopts a change in curvature so as to avoid its support on the medial palatal portion 10, as in FIG. 9b where the screen 4 does not bear on the portion 10. The latter may be deleted.
L'écran lingual 4 est monté sur la gouttière 1 de sorte à préserver une mobilité au moins dans la direction suivant la direction médiane sous forme de coulissement ou de translation d'arrière en avant de manière réversible. Des mouvements additionnels ne sont cependant pas exclus et notamment une possibilité de rotation au moins limitée de l'écran lingual 4 relativement à la gouttière 1 .  The lingual screen 4 is mounted on the channel 1 so as to preserve a mobility at least in the direction along the median direction in the form of sliding or translation from back to front in a reversible manner. Additional movements are not excluded, however, including a possibility of at least limited rotation of the lingual screen 4 relative to the gutter 1.
Le caractère réversible du mouvement de l'écran lingual 4 peut être simplement obtenu du fait de la déformabilité élastique des matériaux envisagés précédemment. D'une manière générale, l'écran lingual 4 comprend préférentiellement une face par laquelle la poussée linguale peut être appliquée, cette face étant concave. L'autre face, opposée et donc convexe, est constituée pour s'appliquer sur une autre portion du dispositif de l'invention. Cette portion, dénommée portion palatine latérale 8a, 8b réalise l'interface entre l'écran lingual 4 et le secteur dentaire au niveau duquel l'appui doit être transféré. Le dispositif de l'invention étant avantageusement symétrique, deux portions palatines latérales 8a, 8b sont présentes sur les figures même si ce cas n'est absolument pas limitatif de l'invention. De sa face antérieure située à l'opposé de sa face sur laquelle s'appuie l'écran lingual 4, chaque portion palatine latérale 8a, 8b présente une zone d'appui 9a, 9b qui est applicable sur le secteur de l'arcade dentaire supérieure au niveau duquel il faut localiser l'exercice de l'appui et raccordée à la gouttière 1 en saillie sur le bord antérieur de la face d'appui maxillaire 3, de mouvements en avant ou en retrait vis-à-vis de la face d'appui maxillaire 3. The reversible nature of the movement of the lingual screen 4 can simply be obtained because of the elastic deformability of the materials envisaged above. In general, the lingual screen 4 preferably comprises a face by which the lingual thrust can be applied, this face being concave. The other face, opposite and therefore convex, is constituted to apply to another portion of the device of the invention. This portion, called lateral palatal portion 8a, 8b provides the interface between the lingual screen 4 and the dental sector at which the support is to be transferred. The device of the invention being advantageously symmetrical, two lateral palatal portions 8a, 8b are present in the figures even if this case is absolutely not limiting of the invention. From its anterior face situated opposite its face on which the lingual screen 4 is based, each lateral palatal portion 8a, 8b has a bearing zone 9a, 9b which is applicable to the sector of the dental arch. greater than the level at which it is necessary to locate the exercise of the support and connected to the gutter 1 projecting from the anterior edge of the maxillary support face 3, movements forward or recessed vis-à-vis the face maxillary support 3.
A cet effet, les portions palatines latérales 8a, 8b sont raccordées à la gouttière 1 uniquement sur une ligne hors de la zone d'appui 9a, 9b alors que la portion palatine latérale 8a, 8b s'étend au niveau de ladite zone d'appui 9a, 9b.  For this purpose, the lateral palatal portions 8a, 8b are connected to the trough 1 only on a line outside the bearing zone 9a, 9b while the lateral palatal portion 8a, 8b extends at the level of said zone of support 9a, 9b.
Dans les modes de réalisation représentés aux figures mais de manière non limitative, les zones d'appui 9a, 9b comportent chacune un renflement 8'a, 8'b préférentiellement hémisphérique qui peut présenter un diamètre de l'ordre de 8mm. Les renflements 8'a, 8'b sont à titre préféré symétriques et peuvent en outre être en un matériau mou tel du silicone, ou être rempli d'un liquide répartissant les points de pression. Ils exercent une poussée latérale et symétrique dans le palais en regard de l'espace destiné à la descente des canines supérieures. Cette poussée stimulante s'exerce chaque fois que le patient serre les dents (pour maintenir l'appareil) et que la langue pousse en avant l'écran lingual 5 car ces deux renflements 8'a, 8'b sont situés aux jonctions latérales de l'arc lingual et l'hémi arc interne des portions 8a, 8b.  In the embodiments shown in the figures but in a nonlimiting manner, the bearing zones 9a, 9b each comprise a bulge 8'a, 8'b preferably hemispherical which may have a diameter of the order of 8mm. The bulges 8'a, 8'b are preferably symmetrical and may further be of a soft material such as silicone, or be filled with a liquid distributing the pressure points. They exert a lateral and symmetrical thrust in the palate opposite the space intended for the descent of the upper canines. This stimulating thrust is exerted each time the patient squeezes his teeth (to maintain the device) and the tongue pushes forward the lingual screen 5 because these two bulges 8'a, 8'b are located at the lateral junctions of the patient. the lingual arc and the inner hemi-arc portions 8a, 8b.
Ainsi, les portions palatines latérales 8a, 8b présentent une extension dotée d'une liberté de mouvements au niveau de laquelle se situent les zones d'appui 9a, 9b. Cinématiquement, lorsque le patient déplace la langue et exerce un appui sur l'écran lingual 4, cela entraîne un mouvement d'arrière vers l'avant, suivant la direction médiane, de l'ensemble constitué par l'écran lingual 4 et la portion palatine médiane 10. Durant ce mouvement, l'écran lingual 4 exerce un effort, par ses ailes 26a, 26b, sur les portions palatines latérales 8a, 8b si bien qu'elles sont elles-mêmes amenées à exercer un appui sur un secteur de l'arcade dentaire supérieure au niveau des zones d'appui 9a, 9b. Cet appui est exercé de manière oblique relativement à la direction médiane si bien qu'il a tendance à produire un élargissement de l'arcade dentaire supérieure au niveau indiqué. Le secteur dentaire prémolaire et aussi préférentiellement le secteur canin sont particulièrement bien adaptés pour la localisation des zones d'appui, puisque ce sont les endroits privilégiés à recontourner pour traiter les palais de forme ogivale. En outre, le secteur dentaire prémolaire est préférentiellement au niveau des parties latérales et palatines des premières molaires supérieures où l'appui est exercé. Pour favoriser l'efficacité du système formé par l'écran lingual 4 et les portions palatines latérales 8a, 8b, l'écran lingual 4 comporte avantageusement deux ailes, chacune capable de s'appliquer sur la face postérieure des portions palatines latérales 8a, 8b à un endroit en vis à vis des zones d'appui 9a, 9b. Le contact écran lingual 4/portions palatines latérales 8a, 8b peut être plan sur plan. Mais ces parties présentent préférentiellement des concavités/convexités différentes pour limiter les frottements et localiser leur contact en regard des zones d'appui 9a, 9b et des renflements 8'a, 8'b. Thus, the lateral palatal portions 8a, 8b have an extension with freedom of movement at which the bearing zones 9a, 9b are located. Cinematically, when the patient moves the tongue and exerts a support on the lingual screen 4, this entails a backward motion in the median direction of the assembly formed by the lingual screen 4 and the portion medial palate 10. During this movement, the lingual screen 4 exerts a force, by its wings 26a, 26b, on the lateral palatal portions 8a, 8b so that they are themselves caused to exert a support on a sector of the upper dental arch at the level of the support zones 9a, 9b. This support is exerted obliquely relative to the median direction so that it tends to produce an enlargement of the dental arch greater than the indicated level. The premolar dental sector and also preferably the canine sector are particularly well adapted for the localization of the support zones, since these are the privileged places to go back to treat ogival-shaped palaces. In addition, the premolar dental sector is preferably at the side and palatal parts of the first upper molars where the support is exercised. To promote the efficiency of the system formed by the lingual screen 4 and the lateral palatal portions 8a, 8b, the lingual screen 4 advantageously comprises two wings, each capable of being applied to the posterior face of the lateral palatal portions 8a, 8b at a location opposite the support zones 9a, 9b. The lingual screen contact 4 / lateral palatal portions 8a, 8b can be plane-to-plane. But these parts preferably have different concavities / convexities to limit friction and locate their contact with respect to the bearing areas 9a, 9b and 8'a, 8'b bulges.
Pour compléter l'efficacité du dispositif de l'invention, il comporte avantageusement une configuration particulière pour la partie au niveau de laquelle les premières molaires supérieures sont destinées à s'appliquer. Plus précisément, la face d'appui maxillaire 3 présente préférentiellement un profil bombé au niveau d'une zone d'application d'au moins une dent molaire. Telle que visible par exemple à la figure 2 ou à la figure 7, cette configuration particulière est réalisée au niveau de deux zones latérales distales 14a, 14b situées sensiblement aux extrémités distales de chaque demi-arc 23a, 23b. Le profil bombé a avantageusement une hauteur maximale vers le milieu de la largeur de la face d'appui maxillaire 3. Il peut par ailleurs être bombé dans la direction transverse à la longueur de la face d'appui maxillaire 3 avec une élévation qui atteint un maximum vers le milieu de la première molaire supérieure, avant l'extrémité distale de chaque demi-arc 23a, 23b.  To complete the effectiveness of the device of the invention, it advantageously comprises a particular configuration for the part at which the first upper molars are intended to apply. More specifically, the maxillary bearing surface 3 preferably has a curved profile at an application zone of at least one molar tooth. As seen for example in Figure 2 or Figure 7, this particular configuration is performed at two distal lateral zones 14a, 14b located substantially at the distal ends of each half-arc 23a, 23b. The curved profile advantageously has a maximum height towards the middle of the width of the maxillary bearing surface 3. It can also be curved in the direction transverse to the length of the maxillary bearing surface 3 with an elevation which reaches a maximum of maximum towards the middle of the first upper molar, before the distal end of each half-arc 23a, 23b.
En complément ou de manière alternative, l'épaisseur de la gouttière 1 peut être variable et notamment croissante en direction de l'extrémité distale de chaque demi- arc 23a, 23b au niveau des zones distales 14a, 14b. En augmentant l'épaisseur référencée « e » en figure 5, la zone d'appui dentaire de la face d'appui maxillaire 3 est légèrement surélevée relativement au reste de la gouttière 1 de sorte à former la surface bombée 15 telle qu'en figure 5. Ainsi, les molaires vont plus rapidement accoster la face d'appui maxillaire 3 que les prémolaires, celles-ci pouvant même rester en surélévation relativement à ladite face d'appui maxillaire 3 sans rentrer en contact ou pour le moins sans exercer de fortes pressions. Cette liberté offerte au secteur prémolaire favorise sa mobilité et son déplacement sous l'impulsion de la poussée exercée au niveau des zones d'appui 9a, 9b. Les figures 2 et 6 présentent plus en détail une autre possibilité de l'invention selon laquelle les zones latérales distales 14a, 14b présentent des pans, respectivement pans distaux internes 16a, 16b et pans distaux externes 17a, 17b, préférentiellement pour chaque demi-arc 23a, 23b. Ces pans 16a, 16b, 17a, 17b encadrent préférentiellement une dent molaire et particulièrement la première molaire supérieure de sorte à exercer un appui latéral sur cette dernière. Cette configuration de pans permet de pousser la cuspide distale de la première molaire supérieure en rotation dans le plan horizontal. Cette mobilité en rotation permet d'ancrer plus efficacement la première molaire supérieure et participe à l'effort orthodontique. Pour favoriser ce déplacement de la première molaire, les pans 16a, 16b, 17a, 17b sont préférentiellement pourvus d'un profil particulier suivant un plan de coupe perpendiculaire au plan sagittal. En effet, le couple imposé à la dent doit être du type « toe in », c'est-à-dire avoir tendance à suivre le sens de rotation indiqué par la flèche « t » en figure 6. Les profils des pans présentant en conséquence des renflements rentrant progressivement au-dessus de la face d'appui maxillaire 3. En particulier, le pan distal interne 16 présente en partant de l'extrémité du demi-arc considéré, un profil plus sortant que vers l'extrémité avant du demi-arc considéré. Une progression dans ce renflement vers l'intérieur de la face d'appui maxillaire 3 est avantageuse, telle que représentée en figure 6. Avantageusement, le profil du renflement des pans distaux externes 17 (c'est-à-dire situé sur un côté de la face d'appui maxillaire 3 opposée à celui où se trouve l'écran lingual 4) est sensiblement inverse. Cette conjugaison de deux profils complémentaires permet d'inciter la première molaire supérieure au déplacement rotatif précédemment indiqué. In addition or alternatively, the thickness of the trough 1 may be variable and in particular increase towards the distal end of each half-arc 23a, 23b at the distal zones 14a, 14b. By increasing the thickness referenced "e" in FIG. 5, the dental support area of the maxillary bearing surface 3 is slightly raised relative to the remainder of the groove 1 so as to form the curved surface 15 as shown in FIG. 5. Thus, the molars will more quickly dock the maxillary bearing surface 3 that premolars, they may even remain elevated relative to said maxillary support surface 3 without coming into contact or at least without exerting strong pressures. This freedom offered to the premolar sector promotes its mobility and its displacement under the impetus of the thrust exerted at the level of the support zones 9a, 9b. FIGS. 2 and 6 show in greater detail another possibility of the invention according to which the distal lateral zones 14a, 14b have panels, respectively internal distal panels 16a, 16b and external distal panels 17a, 17b, preferentially for each half-arc 23a, 23b. These sections 16a, 16b, 17a, 17b preferentially frame a molar tooth and particularly the first upper molar so as to exert a lateral support on the latter. This configuration of sections makes it possible to push the cusp distal of the first upper molar into rotation in the horizontal plane. This rotational mobility makes it possible to more effectively anchor the first upper molar and participate in the orthodontic effort. To promote this displacement of the first molar, the sections 16a, 16b, 17a, 17b are preferably provided with a particular profile along a sectional plane perpendicular to the sagittal plane. In fact, the torque imposed on the tooth must be of the "toe in" type, that is to say, tend to follow the direction of rotation indicated by the arrow "t" in FIG. As a consequence of the bulges gradually returning above the maxillary bearing surface 3. In particular, the internal distal panel 16 has, starting from the end of the half arc considered, a more outgoing profile than towards the front end of the half -arc considered. A progression in this bulge towards the inside of the maxillary bearing surface 3 is advantageous, as represented in FIG. 6. Advantageously, the profile of the bulge of the external distal panels 17 (that is to say situated on one side the maxillary support surface 3 opposite to that where the lingual screen 4) is substantially opposite. This conjugation of two complementary profiles makes it possible to induce the first upper molar to the rotary displacement previously indicated.
Le dispositif comporte préférentiellement, pour une efficacité optimale, un écran labial 5. L'écran labial 5 est situé dans la zone antérieure du dispositif de l'invention et constitue la partie frontale de l'ensemble. Joint par une zone de liaison 13 à un pan vestibulaire 6 faisant saillie au-delà de la face d'appui maxillaire 3, l'écran labial 5 forme un élément intercalaire entre la lèvre supérieure et inférieure du patient et le dispositif complet. Les figures 7 et 8 en donnent plus particulièrement une configuration. Dans ces vues, les bords latéraux de l'écran labial 5 ne sont pas en contact avec le reste du dispositif, pour la clarté des dessins. Néanmoins en fonctionnement, l'écran labial 5 est amené à s'appliquer sur le reste du dispositif.  The device preferably comprises, for optimum efficiency, a labial screen 5. The labial screen 5 is located in the anterior area of the device of the invention and constitutes the front part of the assembly. Joined by a connecting zone 13 to a vestibular panel 6 protruding beyond the maxillary bearing surface 3, the labial screen 5 forms an intermediate element between the upper and lower lip of the patient and the complete device. Figures 7 and 8 give more particularly a configuration. In these views, the lateral edges of the labial screen 5 are not in contact with the rest of the device, for the sake of clarity of the drawings. Nevertheless, in operation, the labial screen 5 is applied to the rest of the device.
Sa forme est avantageusement biconvexe sur son bord supérieur et convexe sur son bord inférieur et légèrement aplatie dans sa partie médiane supérieure, partie dans laquelle il est solidarisé avec la gouttière 1 via le pan vestibulaire 6. Avantageusement, la convexité est exécutée non seulement suivant des plans parallèles au plan sagittal mais aussi suivant des plans perpendiculaires. Its shape is advantageously biconvex on its upper edge and convex on its lower edge and slightly flattened in its upper middle part, part in which it is secured to the channel 1 via the buccal pan 6. Advantageously, the convexity is executed not only in planes parallel to the sagittal plane but also in perpendicular planes.
La zone de liaison 13, représentée par exemple en figure 1 , est préférentiellement une zone de liaison unique de sorte que l'ensemble des efforts exercés par la lèvre supérieure et inférieure et repris par l'écran labial 5 sont concentrés au niveau de ce point. Préférentiellement la zone de liaison 13 est configurée pour être positionnable en regard d'un point anatomique dénommé généralement par les praticiens « point A » et qui correspond à une zone de gencive située entre les racines des incisives centrales supérieures, dans le plan sagittal. L'écran labial 5 présente avantageusement deux extension supérieures 5a, 5b se prolongeant jusqu'au sillon gingivo-labial supérieur en regard des narines. La forme en V, c'est-à-dire produisant un écartement progressif des extensions vers leurs extrémités distales, est destinée à respecter le frein labial supérieur. Lorsque le patient contracte les lèvres et/ou serre les dents, ces deux extensions vont dilater les narines. Le diamètre des orifices narinaires en est augmenté transversalement, permettant une meilleure ventilation nasale. Ceci est particulièrement intéressant car la majorité des patients présentant une arcade dentaire et un palais étroits ont un problème de respiration nasale déficiente.  The connecting zone 13, represented for example in FIG. 1, is preferably a single connection zone so that all the forces exerted by the upper and lower lip and taken up by the lip screen 5 are concentrated at this point. . Preferably, the connecting zone 13 is configured to be positionable with respect to an anatomical point generally called "point A" practitioners and corresponding to a gingival area situated between the roots of the upper central incisors, in the sagittal plane. The labial screen 5 advantageously has two upper extensions 5a, 5b extending to the upper gingivo-labial groove facing the nostrils. The V-shape, that is to say, producing a progressive separation of the extensions towards their distal ends, is intended to respect the upper labial brake. When the patient contracts the lips and / or squeezes the teeth, these two extensions will dilate the nostrils. The diameter of the nasal orifices is increased transversely, allowing better nasal ventilation. This is particularly interesting because the majority of patients with narrow dental arches and palates have deficient nasal breathing problems.
La côte l2 de la figure 4 est préférentiellement de 6 mm avec une tolérance de plus ou moins 1 à 2 mm. The coast l 2 of Figure 4 is preferably 6 mm with a tolerance of roughly 1 to 2 mm.
Les dispositions décrites précédemment ont essentiellement des vertus thérapeutiques pour la conformation de l'arcade dentaire supérieure et le repositionnement de la mandibule.  The arrangements described above have essentially therapeutic virtues for the conformation of the upper dental arch and the repositioning of the mandible.
Sur la face opposée à la face d'appui maxillaire 3, une face d'appui mandibulaire 2 est cependant avantageusement présente avec au moins un rebord et avantageusement une pluralité de rebords en saillie autour de ladite face d'appui mandibulaire 2. Telle que présentés plus en détails dans la vue de la figure 8, ces rebords comprennent un rebord palatin inférieur 12 apte à former en dessous de l'écran lingual 4 et les portions latérales 8a, 8b, une zone de l'espace dans laquelle l'extrémité distale de la langue peut être reçue et permet de guider le mouvement des incisives inférieures lors des mouvements de la mandibule.  On the face opposite to the maxillary bearing surface 3, a mandibular support surface 2 is however advantageously present with at least one rim and advantageously a plurality of projecting rims around said mandibular support face 2. As presented in more detail in the view of FIG. 8, these flanges comprise a lower palatal rim 12 capable of forming below the lingual screen 4 and the lateral portions 8a, 8b, an area of the space in which the distal end of the tongue can be received and can guide the movement of the lower incisors during movements of the mandible.
Avantageusement, la partie inférieure de la gouttière 1 comporte en outre un rebord vestibulaire inférieur 1 1 , à vocation sensiblement à se situer du côté antérieur des incisives de l'arcade dentaire inférieure à l'opposé, relativement au rebord palatin inférieur 12. Au niveau des zones latérales distales 14a, 14b, au moins un rebord distal 24 peut être formé et avantageusement quatre rebords 24 chacun situé en correspondance respectivement d'un pan distal interne 16a, 16b et d'un pan distal externe 17a, 17b. On effectue ainsi un guidage supplémentaire au niveau du secteur molaire de l'arcade dentaire inférieure. Advantageously, the lower part of the trough 1 further comprises a lower vestibular rim January 1, intended substantially to be located on the anterior side of the incisors of the lower dental arch opposite, relative to the lower palatal rim 12. At the distal lateral zones 14a, 14b, at least one distal flange 24 may be formed and advantageously four flanges 24 each located respectively corresponding to an inner distal portion 16a, 16b and an outer distal portion 17a, 17b. This provides additional guidance at the molar sector of the lower dental arch.
On décrit ci-après un mode opératoire de l'invention.  An embodiment of the invention is described below.
La mandibule du patient qui serre les dents se place dans le canal formé par la gouttière au niveau de la face d'appui maxillaire 3 en propulsion pour obtenir une position de bout à bout des incisives supérieures et inférieures. Avantageusement, la gouttière 1 rentre dans la bouche du patient en étant contractée transversalement entre le pouce et l'index.  The mandible of the patient who clamps the teeth is placed in the channel formed by the gutter at the maxillary support surface 3 in propulsion to obtain an end to end position of the upper and lower incisors. Advantageously, the groove 1 enters the patient's mouth being contracted transversely between the thumb and forefinger.
Au préalable, on aura pu régler les dimensions du dispositif à la morphologie du patient et en particulier thermoformer l'écran lingual 4 selon la dimension transversale souhaitée en fonction de la taille du palais du patient.  Beforehand, it was possible to adjust the dimensions of the device to the morphology of the patient and in particular thermoform the lingual screen 4 according to the desired transverse dimension according to the size of the patient's palate.
En avalant sa salive, le patient va contracter ses lèvres et permettre à l'écran labial 5 d'exercer un appui sur le point 13 correspondant à un point médian entre les incisives centrales supérieures. Dans le même temps, le patient va exercer une poussée par sa langue sur l'écran lingual 4 mobile élastiquement selon la direction médiane « m » d'arrière vers l'avant. De ce fait, il conduit à écarter les portions palatines latérales 8a, 8b au niveau du secteur dentaire à reformer (préférentiellement celui des prémolaires supérieures et avantageusement aussi des canines supérieures). On notera l'effet de synergie entre les deux mouvements opérés, l'un au niveau de l'écran lingual 4 et l'autre au niveau de l'écran labial 5 et qui permet d'arrondir : l'arcade dentaire supérieure triangulaire dans le plan horizontal simultanément à l'expansion latérale et le palais ogival dans le plan frontal par expansion. En effet, l'appui exercé par l'écran labial 5 forme une contre-poussée à l'appui exercé au niveau des zones d'appui si bien que l'effet d'extension, contraire à la tendance ogivale, est accru. L'écran labial 5 transfère les forces labiales inférieures et mentonnières excessives, harmonise la différence de pression entre les lèvres supérieures et inférieures. Son but n'est pas seulement le contre-appui, mais aussi de permettre une meilleure croissance de la mandibule et une diminution de l'hyperpression sur les incisives inférieures. On obtient un gain de place dû à l'expansion du prémaxillaire ce qui rend possible un alignement dentaire.  Swallowing his saliva, the patient will contract his lips and allow the labial screen 5 to exert support on the point 13 corresponding to a midpoint between the upper central incisors. At the same time, the patient will exert a thrust by his tongue on the lingual screen 4 moving elastically in the median direction "m" from rear to front. As a result, it leads to the removal of the lateral palatal portions 8a, 8b at the level of the dental sector to be reformed (preferably that of the upper premolars and advantageously also of the upper canines). Note the synergy effect between the two operated movements, one at the level of the lingual screen 4 and the other at the level of the labial screen 5 and which allows to round: the upper triangular dental arch in the horizontal plane simultaneously with the lateral expansion and the ogival palate in the frontal plane by expansion. Indeed, the support exerted by the labial screen 5 forms a counterpressure in the support exerted at the support zones so that the extension effect, contrary to the ogival tendency, is increased. The labial screen 5 transfers the excessive lower labial and chin forces, harmonizes the pressure difference between the upper and lower lips. Its purpose is not only counter-support, but also to allow a better growth of the mandible and a decrease of the hyperpressure on the lower incisors. Space saving is achieved due to the premaxillary expansion which makes possible dental alignment.
L'appareil agit ainsi essentiellement sur l'effet de la contracture réflexe du patient. Néanmoins, en serrant simplement les dents dans la gouttière 1 , le patient active le dispositif du simple fait de son élasticité. Ainsi, la dysfonction du patient correspondant à une position basse de la langue et une tension de la lèvre inférieure, est utilisée pour corriger la dysmorphose (un palais ogival) et donc arrondir l'arcade dentaire supérieure et accessoirement l'inférieure. Le port prolongé de l'appareil corrige les dysfonctions musculaires buccales initiales. The device thus acts essentially on the effect of the reflex contracture of the patient. Nevertheless, by simply clamping the teeth in the gutter 1, the patient activates the device simply by virtue of its elasticity. Thus, the dysfunction of the patient corresponding to a low position of the tongue and a tension of the lower lip, is used to correct the dysmorphosis (an ogival palate) and thus to round the upper dental arch and incidentally the lower one. Extended use of the device corrects initial oral muscle dysfunctions.
On notera l'intérêt dans le dispositif d'avoir des parties en saillie au-delà des faces d'appui maxillaire 3 et mandibulaire 2 qui ne soient pas en continuité le long des demi-arcs 23a, 23b. En particulier, dans l'exemple représenté, des portions de gouttière ne présentent pas d'autre matière que l'épaisseur de la gouttière 1 entre lesdites faces 2, 3, par exemple entre les pans 16a, 16b, 17a, 17b et les portions latérales 8a, 8b et le pan vestibulaire 6. De cette façon, on conserve une large possibilité de modification de déformation élastique.  Note the interest in the device to have projecting portions beyond the maxillary support surfaces 3 and mandibular 2 which are not in continuity along the half-arches 23a, 23b. In particular, in the example shown, gutter portions have no material other than the thickness of the channel 1 between said faces 2, 3, for example between the panels 16a, 16b, 17a, 17b and the portions Lateral 8a, 8b and the vestibular panel 6. In this way, a large possibility of modification of elastic deformation is retained.
Comme indiqué précédemment, l'écran lingual 4 comporte avantageusement deux ailes et les portions latérales palatines 8a, 8b comportent deux zones d'appui 9a, 9b ne présentant pas de jonction directe à la gouttière 1 , si bien que ces parties sont susceptibles d'une déformation et en particulier d'une déformation en direction de la face d'appui maxillaire 3 permettant d'exercer au mieux l'effort localisé d'expansion sur l'arcade dentaire. La longueur de la partie libre des portions palatines latérales 8a, 8b est avantageusement d'au moins de 5 millimètres et possiblement de 8 millimètres environ, comme illustrée en figure 10 avec une tolérance de + ou - 2 mm.  As indicated above, the lingual screen 4 advantageously comprises two wings and the palatal side portions 8a, 8b comprise two bearing zones 9a, 9b having no direct connection to the trough 1, so that these parts are capable of a deformation and in particular a deformation in the direction of the maxillary support surface 3 to best perform the localized expansion force on the dental arch. The length of the free portion of the lateral palatal portions 8a, 8b is advantageously at least 5 millimeters and possibly about 8 millimeters, as illustrated in FIG. 10 with a tolerance of + or - 2 mm.
Les figures 1 1 à 13 illustrent l'évolution de la forme du palais au cours du traitement au moyen de l'invention.  Figures 1-1 to 13 illustrate the evolution of the shape of the palate during the treatment by means of the invention.
En figures 1 1 et 12, un appui lingual médian provoque des forces postéro- antérieures et avantageusement antérolatérales. Cela induit, grâce à l'invention, des poussées P-i, P2 sur deux secteurs dentaires prémolaires 25 et avantageusement aussi des poussées p1 , p2 sur les secteurs alvéolaires canins supérieurs. Grâce à l'écran labial 5, une contre-poussée C est exercée sur la gouttière, si bien que, conjuguée à Pi et P2, la contre-poussée C favorise l'expansion et préférentiellement l'arrondissement ce que révèlent, de manière volontairement exagérée, les figures 12 et 13. In FIGS. 11 and 12, a medial lingual support causes posterointerior and advantageously anterolateral forces. This induces, thanks to the invention, thrusts Pi, P 2 on two premolar dental sectors 25 and preferably also flares p1, p2 on the upper canine alveolar sectors. Thanks to the labial screen 5, a counter-thrust C is exerted on the gutter, so that, together with Pi and P 2 , the counter-thrust C promotes the expansion and preferably the rounding what reveal, so intentionally exaggerated, Figures 12 and 13.
En fin de traitement, la dimension transversale des secteurs prémolaires supérieurs « d » de l'arcade est augmentée et l'arcade nettement plus arrondie.  At the end of treatment, the transverse dimension of the upper premolar sectors "d" of the arch is increased and the arcade much more rounded.
D'autres vues schématiques sont données en figure 14 à 17. L'évolution de la forme du palais est bien visible dans le plan transversal entre les figures 15 et 17. Dans le plan frontal, on note une convexité moins forte et une plus faible hauteur entre les figures 14 et 16. REFERENCES Further schematic views are given in Figure 14 to 17. The evolution of the shape of the palate is clearly visible in the transverse plane between Figures 15 and 17. In the frontal plane, we note a lower convexity and a weaker height between Figures 14 and 16. REFERENCES
1 . Gouttière 1. Gutter
2. Face d'appui mandibulaire  2. Mandibular support surface
3. Face d'appui maxillaire  3. Maxillary support surface
4. Ecran lingual  4. Lingual screen
5. Ecran labial, 5a, 5b. extension supérieure 5. Labial screen, 5a, 5b. superior extension
6. Pan vestibulaire 6. Buccal Pan
8a, 8b. Portion palatine latérale  8a, 8b. Side palatal portion
8'a, 8'b. Renflement  8'a, 8'b. Bulge
9a, 9b. Zone d'appui  9a, 9b. Support area
10. Portion palatine médiane  10. Medial palatal portion
1 1 . Rebord vestibulaire inférieur  1 1. Lower vestibular edge
12. Rebord palatin inférieur  12. Lower palatal edge
13. Zone de liaison  13. Link area
14a, 14b. Zone latérale distale  14a, 14b. Distal lateral area
15. Surface bombée  15. Curved surface
16a, 16b. Pan distal interne  16a, 16b. Internal distal pan
17a, 17b. Pan distal externe  17a, 17b. External distal pan
18. Surface convexe  18. Convex surface
19. Surface concave  19. Concave surface
20. Surface convexe  20. Convex surface
21 . Surface concave  21. Concave surface
22. Zone avant  22. Front area
23a, 23b. Demi-arcs 23a, 23b. Half arches
24. Rebord distal  24. Distal edge
25. Secteur d'arcade  25. Arcade sector
26a, 26b. Ailes 26a, 26b. wings
e. Epaisseur  e. Thickness
R. Résultante d'appui lingual  R. Resulting lingual support
Pi . Poussée  Pi. thrust
P2. Poussée P 2 . thrust
C. Contre-poussée  C. Counter-thrust
d. Dimension transversale  d. Cross dimension
m. Direction médiane  m. Median Direction
t. Mouvement « toe-in » L. Langue t. Toe-in movement L. Language
N. Narine N. Narine
pl . Poussée antérolatérale pl. Anterolateral thrust
p2. Poussée antérolatérale p2. Anterolateral thrust
d'. Dimension transversale inter canine of. Inter canine transversal dimension

Claims

REVENDICATIONS
1 . Dispositif d'expansion d'un palais dans le sens transversal et frontal, comprenant une gouttière (1 ) dotée d'une face d'appui maxillaire (3) et comprenant deux demi-arcs (23a, 23b) symétriques de part et d'autre d'une direction médiane (m) et se rejoignant en une zone avant (22) de la gouttière (1 ), 1. Device for expanding a palate in the transverse and frontal direction, comprising a gutter (1) having a maxillary bearing surface (3) and comprising two symmetrical half-arcs (23a, 23b) on each side and other of a median direction (m) and joining at a front area (22) of the gutter (1),
Caractérisé en ce qu'il comporte : Characterized in that it comprises:
- un écran lingual (4) monté mobile par rapport à la gouttière (1 ) dans un mouvement réversible dirigé vers la zone avant (22) suivant la direction médiane (m), - au moins une portion palatine latérale (8a, 8b) comportant, sur une face antérieure, une zone d'appui (9a, 9b) applicable sur un secteur de l'arcade dentaire supérieure au niveau de l'un des demi-arcs (23a, 23b), l'écran lingual (4) étant configuré pour s'appliquer sur la au moins une portion palatine latérales (8a, 8b) pour transmettre au moins en partie un effort de poussée linguale médiane à la zone d'appui (9a, 9b) lors du mouvement réversible.  a lingual screen (4) movably mounted relative to the gutter (1) in a reversible movement directed towards the front zone (22) in the median direction (m), - at least one lateral palatal portion (8a, 8b) comprising on an anterior surface, a bearing zone (9a, 9b) applicable to a sector of the upper dental arch at one of the half-arches (23a, 23b), the lingual screen (4) being configured to apply on the at least one lateral palatal portion (8a, 8b) to at least partially transmit a medial lingual thrust force to the bearing zone (9a, 9b) during the reversible movement.
2. Dispositif selon la revendication précédente comprenant deux portions palatines latérales (8a, 8b) déformables élastiquement.  2. Device according to the preceding claim comprising two lateral palatal portions (8a, 8b) elastically deformable.
3. Dispositif selon l'une des revendications précédentes dans lequel la au moins une portion palatine latérale (8a, 8b) est en un matériau plus flexible que le matériau de l'écran lingual (4).  3. Device according to one of the preceding claims wherein the at least one side palatal portion (8a, 8b) is a material more flexible than the material of the lingual screen (4).
4. Dispositif selon l'une des revendications précédentes dans lequel l'écran lingual (4) comporte au moins une aile s'appliquant sur une face postérieure de la portion palatine latérale (8a, 8b) en vis-à-vis de la zone d'appui (9a, 9b).  4. Device according to one of the preceding claims wherein the lingual screen (4) comprises at least one wing on a posterior side of the lateral palatal portion (8a, 8b) vis-à-vis the zone support (9a, 9b).
5. Dispositif selon la revendication précédente dans lequel la au moins une aile est configurée pour s'appliquer de manière oblique relativement à la direction médiane (m) sur la face postérieure de la portion palatine latérale (8a, 8b).  5. Device according to the preceding claim wherein the at least one wing is configured to apply obliquely relative to the median direction (m) on the rear face of the lateral palatal portion (8a, 8b).
6. Dispositif selon l'une des revendications précédentes dans lequel la portion palatine latérale (8a, 8b) est solidaire de la gouttière (1 ) par une ligne de jonction située hors de la zone d'appui (9a, 9b).  6. Device according to one of the preceding claims wherein the lateral palatal portion (8a, 8b) is integral with the gutter (1) by a junction line located outside the bearing zone (9a, 9b).
7. Dispositif selon l'une des revendications précédentes dans lequel le demi-arc (23a, 23b) de la gouttière (1 ) au niveau duquel est située la zone d'appui (9a, 9b) comporte une zone latérale distale (14a, 14b) présentant une épaisseur supérieure à celle entre la zone avant (22) de gouttière (1 ) et la zone latérale distale (14a, 14b).  7. Device according to one of the preceding claims wherein the half-arc (23a, 23b) of the gutter (1) at which is located the bearing zone (9a, 9b) comprises a distal lateral zone (14a, 14b) having a thickness greater than that between the front zone (22) of the gutter (1) and the distal lateral zone (14a, 14b).
8. Dispositif selon la revendication précédente dans lequel l'épaisseur du demi-arc (23a, 23b) est croissante dans la zone latérale distale (14a, 14b) vers son extrémité distale. 8. Device according to the preceding claim wherein the thickness of the half-arc (23a, 23b) is increasing in the distal lateral region (14a, 14b) towards its distal end.
9. Dispositif selon l'une des revendications précédentes dans lequel la gouttière (1 ) comporte, dans une zone latérale distale (14a, 14b) du demi-arc (23a, 23b) au niveau duquel est située la zone d'appui (9a, 9b), un pan distal interne faisant saillie sur la face d'appui maxillaire (3) et bordant la face d'appui maxillaire (3) du côté de ladite face d'appui maxillaire où se situe l'écran lingual (4), et un pan distal externe faisant saillie sur la face d'appui maxillaire (3) et bordant la face d'appui maxillaire du côté de ladite face d'appui maxillaire opposé à l'écran lingual (4). 9. Device according to one of the preceding claims wherein the gutter (1) comprises, in a distal side region (14a, 14b) of the half-arc (23a, 23b) at which is located the bearing zone (9a , 9b), an internal distal portion protruding from the maxillary bearing surface (3) and bordering the maxillary bearing face (3) on the side of said maxillary bearing face where the lingual screen (4) is located , and an outer distal portion protruding from the maxillary bearing surface (3) and bordering the maxillary bearing surface on the side of said maxillary support face opposite to the lingual screen (4).
10. Dispositif selon la revendication précédente dans lequel le pan distal interne (16a, 16b) comporte du côté de la face d'appui maxillaire (3) une surface d'application dentaire qui est rentrante sur la face d'appui maxillaire (3) de manière croissante en direction de la zone avant (22), et dans lequel le pan distal externe (17a, 17b) comporte du côté de la face d'appui maxillaire (3) une surface d'application dentaire qui est rentrante sur la face d'appui maxillaire (3) de manière décroissante en direction de la zone avant (22).  10. Device according to the preceding claim wherein the inner distal portion (16a, 16b) comprises on the side of the maxillary bearing surface (3) a dental application surface which is reentrant on the maxillary bearing surface (3). in an increasing manner towards the front zone (22), and in which the external distal part (17a, 17b) comprises on the side of the maxillary bearing surface (3) a dental application surface that is re-entrant on the face of maxillary support (3) decreasingly towards the front zone (22).
1 1 . Dispositif selon l'une des revendications précédentes dans lequel les zones d'appui (9a, 9b) comportent chacune un renflement (8'a, 8'b) hémisphériques.  1 1. Device according to one of the preceding claims wherein the bearing zones (9a, 9b) each comprise a hemispherical bulge (8'a, 8'b).
12. Dispositif selon l'une des revendications précédentes, comportant un écran labial (5) monté sur un pan vestibulaire (6) de la gouttière (1 ), le pan vestibulaire (6) et la au moins une portion palatine latérale (8a, 8b) étant situés en vis-à-vis de part et d'autre de la face d'appui maxillaire (3). Dispositif selon la revendication précédente dans lequel l'écran labial (5) est raccordé au pan vestibulaire (6) en un point unique disposé dans un plan sagittal suivant la direction médiane (m), en élévation par rapport à la face d'appui maxillaire (3).  12. Device according to one of the preceding claims, comprising a labial screen (5) mounted on a vestibular panel (6) of the gutter (1), the buccal pan (6) and the at least one lateral palatal portion (8a, 8b) being located vis-à-vis on either side of the maxillary support face (3). Device according to the preceding claim wherein the labial screen (5) is connected to the vestibular panel (6) at a single point arranged in a sagittal plane in the median direction (m), in elevation relative to the maxillary support surface. (3).
13. Dispositif selon l'une des deux revendications précédentes, dans lequel l'écran labial (5) est biconvexe autour de la direction médiane (m) sur son bord supérieur et convexe sur son bord inférieur et configuré de sorte à exercer une contre- poussée à l'écran lingual (4).  13. Device according to one of the two preceding claims, wherein the labial screen (5) is biconvex around the median direction (m) on its upper edge and convex on its lower edge and configured to exert a counter-effect. push to the lingual screen (4).
14. Dispositif selon l'une des trois revendications précédentes, dans lequel l'écran labiale (5) comporte deux extensions supérieures (5a, 5b) formant une zone d'appui de sillon gingivo-labial en V.  14. Device according to one of the three preceding claims, wherein the labial screen (5) comprises two upper extensions (5a, 5b) forming a V-shaped gingivo-labial sulcus support zone.
15. Dispositif selon l'une des quatre revendications précédentes dans lequel le pan vestibulaire (6) est en un matériau plus flexible que le matériau de l'écran labial (5).  15. Device according to one of the four preceding claims wherein the buccal pan (6) is a material more flexible than the material of the labial screen (5).
16. Dispositif selon l'une des revendications précédentes dans lequel la gouttière (1 ) comporte une face d'appui mandibulaire (2) plane opposée à la face d'appui maxillaire (3). 16. Device according to one of the preceding claims wherein the channel (1) comprises a flat mandibular bearing surface (2) opposite to the maxillary bearing surface (3).
17. Dispositif selon la revendication précédente, dans lequel la gouttière (1 ) comporte au moins un rebord en saillie autour de la face d'appui mandibulaire (2). 17. Device according to the preceding claim, wherein the gutter (1) comprises at least one flange projecting around the mandibular support surface (2).
18. Dispositif selon l'une des revendications précédentes, formé de manière symétrique suivant un plan sagittal passant par la direction médiane (m).  18. Device according to one of the preceding claims, formed symmetrically along a sagittal plane passing through the median direction (m).
19. Dispositif selon l'une des revendications précédentes dans lequel la face d'appui maxillaire (3) comporte, au niveau d'une zone latérale distale (14a, 14b) de chaque demi-arc (23a, 23b), une surface bombée (15).  19. Device according to one of the preceding claims wherein the maxillary bearing surface (3) comprises, at a distal side region (14a, 14b) of each half-arc (23a, 23b), a convex surface. (15).
PCT/EP2013/064567 2012-07-19 2013-07-10 Device for expansion of a palate in the transverse plane and frontal plane WO2014012827A1 (en)

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Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015110550A1 (en) * 2014-01-22 2015-07-30 Michel Alglave Device for facilitating nasal breathing for snorers
WO2015132649A1 (en) * 2014-03-04 2015-09-11 Lettieri Clelia Orthodontic orthopaedic functional appliance
WO2017046184A1 (en) * 2015-09-17 2017-03-23 Michel Alglave Intraoral device for the repositioning and rehabilitation of the tongue
EP3153136A1 (en) * 2015-10-05 2017-04-12 Christophe Otte Dynamic dental device
CN106725923A (en) * 2017-03-09 2017-05-31 黄家亮 Stealthy dental aligners with auxiliary distraction device
IT202000018034A1 (en) * 2020-07-24 2022-01-24 Biomax Spa ORTHODONTIC DEVICE FOR CRANIAL ADAPTATIONS.
IT202200008114A1 (en) * 2022-04-22 2023-10-22 Biomax S P A DEVICE TO PREVIEW THE AESTHETICS IN DENTAL PROSTHETIC REHABILITATION OR IN THE REALIGNMENT SURGERY OF THE DENTAL ARCHS WITH ALIGNERS.
CN117204965A (en) * 2023-11-09 2023-12-12 四川大学 Invisible appliance for asymmetric arch expansion

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2641964A1 (en) * 1989-01-26 1990-07-27 Besombes Andre Cast activators for dentofacial orthopaedic treatment and periodontics
WO2008113896A1 (en) * 2007-03-22 2008-09-25 Huu Tam Tran Intra maxillary suction device
US20100227289A1 (en) * 2007-08-29 2010-09-09 Christopher John Farrell Orthodontic appliance
FR2959931A1 (en) 2010-05-11 2011-11-18 Michel Paul Alain Alglave Removable device for increasing width of upper dental arch of patient, has activation screws connecting internal and external dental arcs, where screws are projected outside internal dental arc at end of activation of screw

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2641964A1 (en) * 1989-01-26 1990-07-27 Besombes Andre Cast activators for dentofacial orthopaedic treatment and periodontics
WO2008113896A1 (en) * 2007-03-22 2008-09-25 Huu Tam Tran Intra maxillary suction device
US20100227289A1 (en) * 2007-08-29 2010-09-09 Christopher John Farrell Orthodontic appliance
FR2959931A1 (en) 2010-05-11 2011-11-18 Michel Paul Alain Alglave Removable device for increasing width of upper dental arch of patient, has activation screws connecting internal and external dental arcs, where screws are projected outside internal dental arc at end of activation of screw

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015110550A1 (en) * 2014-01-22 2015-07-30 Michel Alglave Device for facilitating nasal breathing for snorers
WO2015132649A1 (en) * 2014-03-04 2015-09-11 Lettieri Clelia Orthodontic orthopaedic functional appliance
WO2017046184A1 (en) * 2015-09-17 2017-03-23 Michel Alglave Intraoral device for the repositioning and rehabilitation of the tongue
FR3041242A1 (en) * 2015-09-17 2017-03-24 Michel Alglave INTRABUCCAL DEVICE FOR REPOSITIONING AND REHABILITATION OF LANGUAGE
EP3153136A1 (en) * 2015-10-05 2017-04-12 Christophe Otte Dynamic dental device
CN106725923A (en) * 2017-03-09 2017-05-31 黄家亮 Stealthy dental aligners with auxiliary distraction device
IT202000018034A1 (en) * 2020-07-24 2022-01-24 Biomax Spa ORTHODONTIC DEVICE FOR CRANIAL ADAPTATIONS.
WO2022018773A1 (en) * 2020-07-24 2022-01-27 Biomax S.P.A. An orthodontic device for cranial adaptations
IT202200008114A1 (en) * 2022-04-22 2023-10-22 Biomax S P A DEVICE TO PREVIEW THE AESTHETICS IN DENTAL PROSTHETIC REHABILITATION OR IN THE REALIGNMENT SURGERY OF THE DENTAL ARCHS WITH ALIGNERS.
CN117204965A (en) * 2023-11-09 2023-12-12 四川大学 Invisible appliance for asymmetric arch expansion
CN117204965B (en) * 2023-11-09 2024-01-23 四川大学 Invisible appliance for asymmetric arch expansion

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