WO2014197430A1 - Appareil buccal de traction élastique et procédés de traitement de l'apnée du sommeil et du ronflement tout en prévenant ou réduisant simultanément le risque de syndrome d'articulation temporo-mandibulaire. - Google Patents

Appareil buccal de traction élastique et procédés de traitement de l'apnée du sommeil et du ronflement tout en prévenant ou réduisant simultanément le risque de syndrome d'articulation temporo-mandibulaire. Download PDF

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Publication number
WO2014197430A1
WO2014197430A1 PCT/US2014/040613 US2014040613W WO2014197430A1 WO 2014197430 A1 WO2014197430 A1 WO 2014197430A1 US 2014040613 W US2014040613 W US 2014040613W WO 2014197430 A1 WO2014197430 A1 WO 2014197430A1
Authority
WO
WIPO (PCT)
Prior art keywords
mandibular
maxillary
appliance
pull
oral appliance
Prior art date
Application number
PCT/US2014/040613
Other languages
English (en)
Inventor
Donald FRANTZ
Michael Frantz
Joseph Frantz
Original Assignee
Frantz Donald
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 Frantz Donald filed Critical Frantz Donald
Publication of WO2014197430A1 publication Critical patent/WO2014197430A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/56—Devices for preventing snoring
    • A61F5/566—Intra-oral devices

Definitions

  • the technology herein generally relates to oral appliances for treating, preventing or alleviating snoring and sleep apnea while avoiding or reducing the risk of temporomandibular disorders (TMD) occurring in the temporomandibular joint (TMJ).
  • TMD temporomandibular disorders
  • TMJ temporomandibular joint
  • the technology herein relates to removable mandibular advancement appliances having structures adapted to move the jaw forward and to move the mandible away from the skull, thus opening the bite vertical.
  • One aspect of the invention is an pull oral appliance for treating sleep apnea and snoring while concurrently preventing or reducing the risk of TMJ disorder including an elastic bite pad providing therapeutic treatment, and an elastic elongate member integral to the bite pad.
  • the bite pad and elongate member have a durometer hardness in the range of 10 Shore A to 100 Shore A.
  • the pull oral appliance further includes a maxillary attachment member integral to the elongate member, and, a mandibular attachment member integral to the bite pad.
  • the bite pad, elongate member, maxillary attachment member and mandibular attachment member are constructed from an elastic material, and, wherein the maxillary attachment member and mandibular attachment member are constructed from a non-elastic material.
  • the bite pad, elongate member, maxillary attachment member and mandibular attachment member are constructed from either Dynaflex by GLS Corporation or Pellethane 2363 Polyurethane by Dow Chemical of various durometers.
  • the pull appliance further includes a maxillary anchor adapted to releasably attach to the maxillary attachment member, and a mandibular anchor adapted to releasably attach to the mandibular attachment member.
  • a maxillary anchor adapted to releasably attach to the maxillary attachment member
  • a mandibular anchor adapted to releasably attach to the mandibular attachment member.
  • it further includes maxillary and mandibular trays, the maxillary anchor is affixed to the maxillary tray, and the mandibular anchor is affixed to the mandibular tray.
  • the height of said bite pad is in the range of 3mm to 18mm.
  • the width of the elongate member is in the range of 3mm to 8mm.
  • the pull oral appliance further includes maxillary attachment means integral to the elongate member, and, mandibular attachment means integral to the bite pad.
  • the pull oral appliance further includes maxillary anchoring means affixed to an upper tray for releasable attachment to the maxillary attachment means, and, mandibular anchoring means affixed to a lower tray for releasable attachment to the mandibular attachment means.
  • Another aspect of the invention is a method of treating obstructive sleep apnea and snoring in a human using any of the pull oral appliances above using the steps or acts of (in any order) preventing a jaw from retracting, deflecting mandibular
  • the method further includes preventing or reducing the risk of side effects selected from discomfort, tooth soreness, and tooth movement.
  • it further includes vertically adjusting the jaw in the range of 3mm to 19mm in the anterior region as measured from an upper right central incisor where it meets an upper gingival tooth line to a lower right central gingival tooth line.
  • it further includes forward adjusting the jaw in the range of 2mm to 20 mm as measured from a predetermined centric occlusion.
  • it further includes a plurality of steps of vertically and forwardly adjusting the jaw various lengths for a duration of time.
  • repositioning the mandible with a removable oral appliance is an effective means of treating both snoring and sleep apnea.
  • the present invention enables a physician or dentist to select the desired amount of mandibular advancement and to select the desired amount of vertical opening to provide successful treatment.
  • Multiple appliances of varying durometer hardness and dimensions are employed to optimize therapeutic treatment (e.g., vertical displacement and mandibular advancement) for effective treatment. While in use, the appliance frees the mandibular forward as well as lateral excursion whereby one end of the appliance is removably attached to the maxillary tray in the anterior, and the other end of the appliance is removably attached the mandibular tray in the posterior.
  • the bite pad of the elastic component of the appliance is compressed between maxillary and mandibular teeth under muscular force.
  • the inelastic components effectively pulls the mandibular forward.
  • the elastic and inelastic components are interchangeable/replaceable with other elastic components having different hardness/durometer, dimensions, etc. to provide variable amounts of therapeutic mandibular advancement and vertical mandibular deflections.
  • the patient goes into REM sleep, they become essentially paralyzed.
  • the mandible jaw As the mandible jaw is advanced, the tongue is pulled forward as it is attached to the mandible, thus opening the airway.
  • Elastics while effectively advancing the mandible (and opening the bite), cushion the patients TMJ (and the appliance).
  • Figure 1 shows an upper side perspective view of one aspect of the invention depicting one embodiment of the pull dental appliance removably applied to plaster or stone dental fixtures for treating sleep apnea or snoring while concurrently preventing or reducing the risk of TM J.
  • Figure 2 shows a side perspective view of another embodiment of the pull dental appliance for treating sleep apnea or snoring while concurrently preventing or reducing the risk of TM J.
  • Figure 3 shows a side perspective view of the pull dental appliance depicted in Figure 2.
  • Fig. 1 Shown in Fig. 1 is one embodiment of the pull oral dental appliance 100 releasably applied to a maxillary (i.e., upper) and mandibular (i.e., lower) dental model architectures 12,14 preferably constructed from plaster or stone or another suitable material.
  • the appliance 100 includes maxillary (i.e., upper) and mandibular (i.e., lower) trays 16,18, preferably constructed from polyethylene terepthlate (PETB) or like material using thermo-pressure forming processes Eastman Eastar PETG Copolymer 6763.
  • PETB polyethylene terepthlate
  • FIG. 1 As shown in Figures 1, 2, and 3, another embodiment of a releasably attachable pull dental appliance 200 is releasably attached to the trays 16,18, which may be made from Eastman Eastar PETG Copolyester 6763.
  • the appliance includes anchors 26,32 (preferably constructed from PETG or a like material) affixed to the trays 16,18 using an adhesive material, such as acrylic adhesive (e.g., cold cure orthodontic acrylic) or another suitable adhesive.
  • Maxillary anchor 32,34 are affixed to upper tray 16 being located on each anterior labial portion of the upper tray near the upper cuspid teeth.
  • Mandibular anchors 26 are affixed to the posterior buccal portion on each side of the lower tray 18 on the occlusal surface of the lower molar teeth.
  • the maxillary 32,34 and mandibular anchors 22,26 are generally aligned with one another, and the maxillary anchor 32 is forward of the mandibular anchor 26.
  • anchors 22,26,32,34 are employed in the human patient's maxillary and mandibular jaws, i.e., one on the left side and one on the right side to therapeutically treat the human for sleep apnea and/or snoring while concurrently preventing TMJ.
  • the lower or mandibular anchor 26 is a curved catch element that releasably engages an elastic portion 24,27.
  • the upper or maxillary anchor 32 further includes a post or peg 34 (having a stay) for engaging an aperture in an upper attachment member 30.
  • the lower or mandibular anchor 26 also includes a post 22 that releasably engages an aperture in the elastic portion 24.
  • the embodiment includes elastic injection molded component 24,27,28,30 having a bite pad 27.
  • the anterior portion of the elastic strap has a tab 30 having an aperture therein for securing the elongate member to post 34.
  • bite pad 27 provides various bite openings being of various thicknesses attached to post 22.
  • An elongate member 28 may be of various lengths to provide different millimeters of advancements of the mandible and upper attachment member 30.
  • Post 30 may also have a hole to hook over post 34.
  • the hardness of the elastic injection molded component is preferably in the range of 10 Shore A to 100 Shore A and constructed from either Dynaflex available from GLS Corporation or Pellethane 2363 Polyurethane available from Dow Chemical.
  • the elongate member 28 may be various shapes, such as a rod or cord (i.e., cylindrical), a band, or other suitable shapes.
  • the maxillary attachment means includes anchor 32 and the post 34.
  • the mandibular attachment means includes the anchor 26 and the post 22.
  • Other suitable maxillary and mandibular attachment structures may be employed as is known in the art to releasably attach the elastic straps to the pull dental appliance 200 to the upper and lower trays 16,18.
  • Posterior occlusal right and left surfaces of lower tray 18 are provided.
  • Interchangeable bite pads 27 having a variety of thicknesses are provided to increase or decrease the vertical component of the appliance.
  • the bite planes are provided each having a top side providing a smooth surface engageable with the occlusal surface of the upper tray 16 to space the occlusal surfaces from one another while permitting sliding movement of these surfaces laterally as well as longitudinally relative to one another.
  • the bottom side of each bite plane rests on the right and left surfaces of lower tray being formed for releasable attachment to a side of the lower tray 18 being attached to peg 22.
  • the maxillary and mandibular anchors 22,26 on the right and on the left may be bonded to the outer sides of the upper and lower trays 16,18, respectively, with orthodontic acrylic.
  • the anchors 32,34 on the upper or maxillary tray and anchors 26,22 on the posterior part of the lower or mandibular trays are configured and adapted for releasable retention of the elastic members 24,27,28,30.
  • the anchors 32,34 may be disposed as follows: One on the right and one on the left of the anterior labial (check) portion of the maxillary or upper tray 16. One on the right and one on the left of the posterior buccal (cheek) portion of the mandibular or lower tray 18.
  • the length of the elastic member 24,27,28,30 may be about 15-30 mm.
  • the length and/or elasticity of the elastic components 24,27,28,30 being such that, when attached to the anchors 32,34 on the upper tray and anchors 26,22 on the lower tray, they are placed in tension or stretched as the appliance 100,200,300 is installed in a patient's mouth so as to urge the lower jaw forward and open the bite.
  • the elongate member 28 is about 3-4 mm thick.
  • the elastic member 24,27,28,30 is preferably made of injection molded thermoplastic elastomer, of different lengths, different durometers, and different bite pad thicknesses which may be provided to satisfy the patient's needs.
  • the elastic member 24,27,28,30 allows the patient's musculature to relax by the use of a low durometer strap. When treatment is started until the musculature accepts mandibular advancement when firmer straps can be placed without TMJ pain because there is less resistance and not to fight or resist the bias.
  • the elastic member 24,27,28,30 may be made from various hardness/durometer elastics and releasable attached to the anchors on the lower appliance and on the upper appliance.
  • the elongate member 28 and bite pad 27 provide elastic protection from TMJ.
  • the bite pad 27 may have various vertical heights and made of various durometers.
  • a plurality of bite pads 27 provide a wide range of vertical openings simply by inserting a different elastic strap having a different hardness (i.e., durometer) and/or bite pad thickness/height.
  • the bite pad 27 and elongate member 28 regulates and determines the length or amount of mandibular advancement.
  • the pull appliance 24,27,28,30 may be injection molded in various lengths and different durometers providing various lengths of mandibular advancement and firmness of bite pad and firmness of elastic pull.
  • the top surface is at an elevation below the occlusal surface of one side of the tray 16 to provide a vertical opening of anywhere from 3 millimeter to 18 millimeter.
  • the bite plane of the bite pad 27 is described in detail below.
  • the bite pad 27 may be made of injection molded plastic and has a generally smooth, curved, and convex top contact surface.
  • the bite plane of the bite pad 27 has a generally flat bottom surface.
  • the component parts 26,22 of the pull appliance 100,200 may be removably attached to the posterior buccal right and left surfaces of the mandibular lower tray 18.
  • a different elastic pull appliance having different dimensions is simply releasably attached to the anchors 26,22 on the lower and 32,34 on the upper.
  • bite pads 27 provide various therapeutic treatments. For example, a thicker bite pad 27 may be substituted in place of an original bite pad 27 to more efficaciously treat the sleep apnea and/or snoring and still provide for sufficient patient comfort, particularly respecting TMJ.
  • this elastic member may, at the discretion of the treating doctor, be replaced with a non-elastic member so the effective treatment mandible location may be guaranteed to remain. If TMJ pain develops, an elastic member may be reinserted.

Abstract

La présente invention concerne un appareil buccal de traction élastique pour traiter l'apnée du sommeil et le ronflement tout en prévenant ou réduisant simultanément le risque de syndrome temporo-mandibulaire. L'appareil comprend un coussinet dentaire qui assure un traitement thérapeutique. Le coussinet dentaire présente une dureté d'après duromètre allant de 10 Shore A à 100 Shore A. L'appareil comprend en outre un élément allongé élastique faisant partie intégrante du coussinet dentaire. L'élément allongé présente également une dureté d'après duromètre allant de 10 Shore A à 100 Shore A. L'appareil peut comprendre d'autres composants comme des organes d'ancrage et des structures de fixation pouvant se fixer de manière amovible sur des gouttières maxillaires et mandibulaires formées en fonction de la mâchoire et des dents du patient humain.
PCT/US2014/040613 2013-06-04 2014-06-03 Appareil buccal de traction élastique et procédés de traitement de l'apnée du sommeil et du ronflement tout en prévenant ou réduisant simultanément le risque de syndrome d'articulation temporo-mandibulaire. WO2014197430A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201361830755P 2013-06-04 2013-06-04
US61/830,755 2013-06-04

Publications (1)

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WO2014197430A1 true WO2014197430A1 (fr) 2014-12-11

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PCT/US2014/040613 WO2014197430A1 (fr) 2013-06-04 2014-06-03 Appareil buccal de traction élastique et procédés de traitement de l'apnée du sommeil et du ronflement tout en prévenant ou réduisant simultanément le risque de syndrome d'articulation temporo-mandibulaire.

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020039276A1 (fr) * 2018-08-23 2020-02-27 Bolzern Frank Appareil pour le traitement du ronflement et de l'apnée obstructive du sommeil
US11679023B2 (en) 2017-07-11 2023-06-20 Stewart Cullen Mandibular advancement splint

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5947724A (en) * 1995-06-23 1999-09-07 Frantz; Don E. Elastic mandibular advancement appliance with slide-in bite planes
US7712468B2 (en) * 2007-02-21 2010-05-11 Hargadon Paul K Magnetic dental appliance
US20120231932A1 (en) * 2011-03-11 2012-09-13 Power Balance Llc Oral appliance for improving strength and balance
US20130130190A1 (en) * 2010-08-05 2013-05-23 Ultradent Products, Inc. Orthodontic Force Module Including Elastomeric Member for Class II and Class III Correction

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5947724A (en) * 1995-06-23 1999-09-07 Frantz; Don E. Elastic mandibular advancement appliance with slide-in bite planes
US7712468B2 (en) * 2007-02-21 2010-05-11 Hargadon Paul K Magnetic dental appliance
US20130130190A1 (en) * 2010-08-05 2013-05-23 Ultradent Products, Inc. Orthodontic Force Module Including Elastomeric Member for Class II and Class III Correction
US20120231932A1 (en) * 2011-03-11 2012-09-13 Power Balance Llc Oral appliance for improving strength and balance

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11679023B2 (en) 2017-07-11 2023-06-20 Stewart Cullen Mandibular advancement splint
WO2020039276A1 (fr) * 2018-08-23 2020-02-27 Bolzern Frank Appareil pour le traitement du ronflement et de l'apnée obstructive du sommeil

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