WO2015193316A1

WO2015193316A1 - Lip retractor, dental treatment assembly, and method for using same

Info

Publication number: WO2015193316A1
Application number: PCT/EP2015/063478
Authority: WO
Inventors: Jean-Yves Renard
Original assignee: Prophytec
Priority date: 2014-06-16
Filing date: 2015-06-16
Publication date: 2015-12-23
Also published as: FR3022135A1; FR3022135B1

Abstract

The present invention relates to a lip retractor for oro-dental operation, comprising: a frame (10) provided with a central opening (14) that allows access to the teeth of a patient; at least two hooks (40) for supporting the lips and cheeks of the patient; and means (50) for adjusting the position of the hooks (40) with respect to the frame (10), including non-return elements (64; 74; 94, 95; 109). The invention also relates to a dental treatment assembly comprising such a retractor (1), and also to a method for using such a retractor (1).

Description

LIP RETRACTOR, DENTAL TREATMENT SET

AND METHOD FOR IMPLEMENTING

The present invention relates to a lip retractor for use in oral surgery, that is, an intervention involving the mouth, teeth, and / or surrounding tissues of a patient. The invention also relates to a set of oral treatment comprising such a spacer, and a lamp holder and / or a lingual barrier. The invention finally relates to a method of implementing such a spacer. The field of the invention is that of oral treatment equipment.

During an oral operation, it is known to keep the lips and cheeks of a patient away from his teeth to facilitate the work of the dentist. For example, the dentist can put cotton stems between the patient's gums and cheeks. According to an advantageous alternative, the dentist may use a lip spacer, such as those known from FR-A-2 926 716, EP-A-1 844 728 and WO-A-96/29952.

FR-A-2 926 716 discloses a lip spacer, comprising an annular skirt for supporting the lips and one or more tongues for supporting the teeth. The skirt has an oval section adapted to the shape of the patient's lips. The skirt is intended to bear against the gums, so as to effectively isolate the lips of the patient's teeth. The tabs are intended to be immobilized between teeth of the patient by occlusal support. This ensures a stable and permanent positioning of the spacer as long as the patient does not loose the teeth, even if he moves his lips or swallows. The spreader is monobloc and disposable.

The object of the present invention is to provide a variant lip retractor, improved in terms of versatility.

For this purpose, the invention relates to a lip spacer for oral operation, comprising: a frame provided with a central opening for accessing the teeth of a patient; at least two support hooks of the patient's lips and cheeks; and means for adjusting the position of the hooks relative to the frame, including non-return elements.

Thus, the invention makes it possible to provide a versatile and ergonomic lip retractor. The configuration of the spacer can be adapted to the particular morphology of each patient, which avoids having to have a series of spacers having different dimensions. The anti-return elements prevent accidental loosening of the spacer during an oral operation. In addition, the materials of the spacer are chosen to allow its autoclave treatment, which avoid throwing the retractor after each oral operation. Particularly advantageously, the spacer according to the invention is universal, adjustable and autoclavable.

According to other advantageous features of the spacer according to the invention, taken separately or in combination:

- The lip spacer includes four support hooks of the patient's lips and cheeks, each hook being positioned in a quarter of the central opening.

- The adjustment means comprise an adjustment system which is specific to each hook, so that each hook is positionable independently of the other hooks.

- The adjustment means comprise transverse adjustment elements and vertical adjustment elements

- For each hook, at least the transverse adjustment elements include non-return elements.

- For each hook, the adjustment means comprise a groove formed on the frame, a first slider movable relative to the groove, and a second slider movable relative to the first slider.

The invention also relates to a set of oral-dental treatment, comprising a lip spacer as mentioned above, and at least one of: a lamp holder, adapted to support a lamp or a device for radiation; a soft lingual barrier, adapted to block the tongue of a patient during an oral operation; and a saliva suction device, such as suction tubes adapted to be connected to the lip spacer and the lingual barrier.

Preferably, the oral treatment assembly comprises a lip spacer, a lamp holder and a lingual barrier. Advantageously, the assembly also comprises a saliva suction device, in particular suction tubes connected to the spacer and to the lingual barrier.

According to particular embodiments of the constituent elements of the oral health treatment set:

- The lamp holder comprises: a body provided with a housing for receiving the lamp or the radiation device; and four brackets to the frame of the lip spacer.

- The lingual barrier comprises: a central portion provided to block the patient's tongue; side blocks intended to be clamped between the patient's teeth; elastic elements connecting the central portion and the side blocks; and a circuit saliva suction, including in particular at least one connection housing of a saliva suction device, such as suction tubes.

The invention also relates to a method of implementing a lip spacer as mentioned above. The method comprises the following steps:

a) pre-set the position of the hooks relative to the frame;

b) position the lip spacer on the patient's face;

c) move the lips and cheeks of the patient by adjusting the position of the hooks relative to the frame.

The invention will be better understood on reading the description which follows, given solely by way of nonlimiting example and with reference to the appended drawings in which:

- Figure 1 is a perspective view of a lip spacer according to the invention, shown from the front and provided with a lamp holder also according to the invention;

- Figure 2 is a front view along the arrow II in Figure 1;

- Figure 3 is a rear view along the arrow III in Figure 1;

FIG. 4 is another perspective view, showing the spacer and the support from the rear, at an angle different from FIG. 1;

FIGS. 5 to 8 are perspective views showing elements constituting the spacer of FIGS. 1 to 4;

- Figure 9 is another perspective view, showing the support at an angle different from Figures 1 and 4;

- Figure 10 is a view along the arrow X in Figure 9;

- Figure 1 1 is a view along the arrow XI in Figure 9;

- Figure 12 is a perspective view of a lingual barrier according to the invention;

- Figures 13 to 15 are views from below, according to the arrow XV in Figure 12, showing different configurations of the lingual barrier;

- Figure 16 is a section along the line XVI-XVI in Figure 15; and

- Figure 17 is a section along the line XVII-XVII in Figure 15.

In Figures 1 to 17 are shown the constituent elements 1, 2 and 3 of a set of oral treatment, according to the invention.

This set comprises a lip spacer 1, a lamp holder 2 and a lingual barrier 3, each according to the invention. During an oral operation performed on a patient, the spacer 1 is provided to separate the lips and the cheeks of the patient, the support 2 is provided to support a lamp, or any other device of radiation directed towards the teeth of the patient, while the lingual barrier 3 is provided to block the patient's tongue in his oral cavity. The spacer 1 is provided for joint use with the support 2 and / or the barrier 3, or for independent use.

The spacer 1 has a front side 4, a back side 5, an upper side 6 and a lower side 7. When the spacer 1 is installed on the patient, the front side 4 is facing the dentist, the back side 5 is oriented towards the patient's mouth, the upper side 6 is oriented towards the patient's nose and the lower side 7 is oriented towards the chin of the patient.

The spacer 1 comprises a frame 10 of generally rectangular shape, centered on a central axis X1. We also define a vertical axis Y1 and a horizontal axis Z1 perpendicular to the axis X1, as shown in Figures 2 and 3. The plane including the axes X1 and Y1 is a plane of symmetry of the frame 10. The frame 10 is half rigid, preferably made of plastic, by injection. The frame 10 has a convex front face 1 1 and a concave rear face 12. The four corners of the frame 10 have a rounded outer shape. The lower outer edge of the frame 10 is straight, while the upper and lateral outer edges of the frame 10 are rounded to a convex profile.

The frame 10 has a central opening 14, passing between the faces 1 1 and 12. The opening 14 has a generally rectangular shape and delimits the inner edges of the frame 10. The lower and lateral internal edges of the frame 10 are rounded according to a profile concave, while the upper inner edge of the frame 10 is rounded in a concave profile. The opening 14 allows access to the patient's teeth by the front side 4 of the spacer 1.

On the upper side 6, the frame 10 has a notch 15 for receiving the patient's nose. More specifically, the notch 15 is formed on the upper outer edge of the frame 10. The convex shape of the rear face 1 1 and the presence of the notch 15 facilitate the positioning of the spacer 1 on the patient's face. The frame 10 also comprises orifices 16 for fixing the support 2, as well as clamps 17 for fixing suction tubes for the saliva of the patient. The orifices 16 are formed through the sides of the frame 10. A pair of clamps 17 is formed protruding on the front face 1 1, in each of the lower corners of the frame 10. A through opening 18 is formed through the frame 10, The suction tubes can be clipped between the clamps 17, and then guided through the openings 18 to be connected to the lingual barrier 3, as detailed below.

The retractor 1 comprises hooks 40, or spacers, supporting the lips and cheeks of the patient. More specifically, the spacer 1 comprises an upper left hook 41, a right upper hook 42, a lower left hook 43 and a lower right hook 44. Each hook 40 is positioned in a quarter of the central opening 14, these quarters being delimited by the axes Y1 and Z1. Each hook 40 has an outer surface 45 of convex shape and an inner surface 46 of concave shape. Each hook 40 is bent so that its inner surface 46 can bear against the lip of the patient. The hooks 40 are rigid.

The spacer 1 comprises means 50 for adjusting the position of each hook 40. More specifically, the spacer 1 comprises four adjustment systems 51, 52, 53 and 54, respectively associated with the hooks 41, 42, 43 and 44. Spreader 1 comprises an adjustment system 50 which is specific to each hook 40. Thus, each hook 40 is positionable independently of the other hooks 40. Each system 50 comprises a groove 60 formed on the frame 10, a first slide 70 or 90 mounted movable in the groove 60 and a second slide 80 or 100 movably mounted relative to the first slide.

The upper systems 51 and 52 have some different structural, but similar operation, in comparison with the lower systems 53 and 54. The upper systems 51 and 52 each comprise a groove 60, a slider 70 and a slider 90, while the systems lower 53 and 54 each comprise a groove 60, a slider 80 and a slider 100. The hooks 41 and 42 are each integral with a slider 80, while the hooks 43 and 44 are each integral with a slider 100.

In projection in a vertical plane comprising the axes Y1 and Z1, as in Figures 2 and 3, the upper grooves 60 each extend along an axis A65 inclined by an angle β65 of the order of 80 degrees with respect to the Y1 axis, while the lower grooves 60 each extend along an axis A66 perpendicular to the axis Y1.

Each groove 60 has a through opening 61 formed between the faces 1 1 and 12. The groove 60 also has two internal edges 62 and 63 which extend parallel to each other along the opening 61, on the side of the inner face 12 One of the borders 62 and 63 comprises a rack 64 formed by a series of teeth.

Each slider 70 includes a front side 71 and a rear side 72. On the front side 71, the slider 70 is provided with a vertical groove 73 provided to receive the slider 80. On the rear side 72, the slider 70 is provided with a element 74 intended to be received in the groove 60. The slide 70 further comprises two tweezers 76 and 77 separated by an intermediate space 78. The slider 70 is mounted in sliding connection in the groove 60. When the tweezers 76 and 77 are at rest, the element 74 cooperates with the rack 64 by allowing the slider 70 to move in a direction opposite to the axis Y1 and the notch 15, but not in a direction directed towards the axis Y1 and the notch 15. In other words, the elements 64 and 74 constitute non-return elements, allowing the displacement of the hook 41 or 42 only to spread the lips and the patient's cheeks. When the tweezers 76 and 77 are tightened, the element 74 no longer cooperates with the rack 64 and the movement of the slider 70 is allowed in the two opposite directions.

Each slider 80 comprises a hook connection portion 81, as well as two tabs 82 and 83 which extend from the portion 81 opposite the hook 40 and which are spaced apart by an elongate groove 85. The slider 80 comprises in addition to a protuberance 84 formed projecting on the outer side of the tab 82. The slider 80 is mounted in sliding connection relative to the slider 70, more precisely in the groove 73. The protrusion 84 forms a stop adapted to abut against the slider 70, thus limiting the relative displacement between the sliders 70 and 80.

The slider 90 comprises a front side 91 and a rear side 92. On the front side 91, the slider 90 is provided with a vertical groove 93 provided to receive the slider 100. Also on the front side 91, the slider 90 comprises two racks 95 which are each formed by a series of teeth and which extend along the groove 93. On the rear side 92, the slider 90 is provided with a member 94 adapted to be received in the groove 60. The slider 90 comprises in addition to two tweezers 96 and 97 separated by an intermediate space 98.

The slider 90 is mounted in sliding connection in the groove 60. When the tweezers 96 and 97 are at rest, the element 94 cooperates with the rack 64 by allowing the slider 90 to move in a direction opposite to the axis Y1, but not in a direction directed to the Y1 axis. In other words, the elements 64 and 94 are non-return elements, allowing the movement of the hook 43 or 44 only to move the lips and cheeks of the patient. When the tweezers 96 and 97 are tightened, the element 94 no longer cooperates with the rack 64 and the movement of the slider 90 is allowed in the two opposite directions.

The slider 100 comprises a hook connection portion 101, as well as two tabs 102 and 103 which extend from the portion 101 opposite the hook 40 and which are spaced apart by an elongated groove 105. The slider 100 comprises in addition to a portion 104 secured to the portion 102 and separated from the portion 103 by a groove 105. The groove 105 forms an L between the portions 102, 103 and 104. The slide 100 comprises also two tweezers 106 and 107 separated by an intermediate space 108, and teeth 109 formed projecting on the side of the tweezers 106 and 107.

The slider 100 is mounted in sliding connection relative to the slider 90, more precisely in the groove 93. When the tweezers 106 and 107 are at rest, the teeth 109 cooperate with the racks 95 by allowing the slider 100 to move in an opposite direction. to the axis Z1, but not in a direction directed towards the axis Z1. In other words, the elements 95 and 109 constitute anti-return elements, allowing the movement of the hook 43 or 44 only to move the lips and cheeks of the patient. When the tweezers 106 and 107 are tightened, the teeth 109 no longer cooperate the racks 95 and the movement of the slider 100 is allowed in the two opposite directions.

Thus, the adjustment systems 50 make it possible to adjust the position of the hooks 40 with respect to the frame 10 in a simple and practical manner, on the one hand, depending on the morphology of the patient and, on the other hand, to remove the lips and the cheeks of the patient before performing an oral operation. Within each system 50, the groove 60 and the slider 70 or 90 form transverse adjustment elements of the position of the hook 40, while the slider 70 or 90 and the slider 80 or 100 form vertical adjustment elements of the hook position 40.

The systems 51 and 52 include non-return elements 64 and 74 formed by the groove 60 and the slider 70, while the slider 80 is simply provided with a stop 84. The systems 53 and 54 include non-return elements 64. , 94, 95 and 109 formed by the groove 60, the slider 90 and the slider 100. In other words, for each hook 40, at least the transverse adjustment elements 60, 70 and 90 include non-return elements 64, 74 and 94.

The elements 10, 40 and 50 constituting the spacer 1 are preferably made of polymeric materials suitable for oral or dental applications, by injection or any other molding process. These polymers are selected for their safety for the patient, as well as for their resistance to autoclave processing temperatures. In addition, these polymers are lighter and less expensive than metals.

The support 2 comprises a body 20 and four tabs 21 connected to the body 20.

The support 2 is semi-rigid, preferably made of plastic, by injection. The body 20 has an oval shape in the plane of Figures 2 and 3, arched forward in the plane of Figure 10 and arched rearwardly in the plane of Figure 1 1. The body 20 is provided with a through opening 22, which forms a housing for receiving the lamp or the radiation device during an oral-dental operation. As examples, the support 2 can receive a lighting lamp or a light source provided to react a gel or paste disposed on the teeth of the patient, which can be mounted and immobilized on the body 20 by cooperation of shapes or any other means. Each lug 21 has an elongated shape between an end 23 connected to the body 20 and an end 24 provided with a stud 26 for fixing to the frame 10 of the spacer 1. The pads 26 of the support 2 are provided to be received in the orifices 16 of the frame 10. The support 2 is symmetrical with respect to a central axis X2, which coincides with the central axis X1 of the spacer 1 in assembled configuration.

The lingual barrier 3 comprises a central cup 30, two end blocks 31, two elongate strands 32 and two connecting rods 33. The cup 30 has a convex front face 34 intended to face the incisors and a concave rear face 35 provided to obstruct the language. The blocks 31 are intended to be wedged between the jaws of the patient. Each strand 32 extends in a corrugated structure between the cup 30 and one of the rods 33. Each rod 33 extends along an axis A33 between one of the blocks 31 and one of the strands 32. Each block 31 has a peripheral outer groove 36 for receiving the teeth of the patient.

Each block 31 also includes an array of internal channels 37 and through-holes 38. In particular, each block 31 comprises a housing 39 for receiving a suction tube, for connecting the tubes to the barrier 3 and sucking the tube. saliva of the patient through the orifices 38 and channels 37. In other words, the barrier 3 comprises a saliva suction circuit constituted by the channels 37, the orifices 38 and the housing 39.

The barrier 3 is flexible, made of elastic material, for example by molding elastomeric material. Thus, the blocks 31, the strands 32 and the rods 33 are elastically deformable. The blocks 31 can be returned by torsion of the elastic rods 33 around the axes A33, while the elastic strands 32 can be stretched, so as to adapt the configuration of the barrier 3 to the morphology of the patient. For example, each strand 32 can measure 15 mm and be stretched up to 19 mm. Thus, the barrier 3 has an important versatility. In addition, the barrier 3 is disposable after use.

FIG. 13 shows the barrier 3 in a contracted configuration, while FIG. 14 shows the barrier 3 in an extended configuration, it being understood that the elasticity of the strands 32 makes it possible to compact or lengthen the barrier 3 even more than on the Figures 13 and 14. Figure 15 shows the barrier in an intermediate configuration, which corresponds to its molding configuration. When the barrier 3 is in place in the patient's mouth, his tongue pushes the cup 30 and the strands 32 are deformed in the shape of a circular arc. The method of implementation of the spacer 1 is detailed below.

The method comprises a step of presetting the position of the hooks 40 with respect to the frame 10. The presetting can consist in modifying the position of the hooks 40 or at least some hooks 40 to facilitate their subsequent placement relative to the lips of the patient. Alternatively, the presetting may be to leave the hooks 40 or at least some hooks 40 in their initial position if it is satisfactory. The presetting depends in particular on the morphology of the patient.

The method comprises a step of positioning the spacer 1 on the patient's face, while the latter has his mouth open. The rear face 12 is positioned against the face, the notch 15 is positioned at the nose, while the hooks 40 are positioned between the lips of the patient.

The method comprises a step of separating the lips and cheeks of the patient, performed by adjusting the position of the hooks 40 relative to the frame 10. The surfaces 46 of the hooks 40 press against the lips to separate them, then maintain this spacing during the oral operation. The anti-return elements 64, 74, 94, 95 and 109 belonging to the adjustment systems 50 prevent the pressure of the lips and cheeks from moving the hooks 40. Preferably, the spacer step comprises a sub-step of adjusting upper hooks 41 and 42, and a sub-step of adjusting the lower hooks 43 and 44.

The method may also comprise a step of positioning the support

2 on the frame 10 or disassembly of the support 2 relative to the frame 10. The method may also comprise a step of positioning the lingual barrier 3 in the patient's mouth. The method may also include a step of positioning the suction tubes.

Thanks to the invention, the teeth and the surrounding tissues of the patient are accessible during the entire oral operation. The spacer 1 can be used together with the lamp holder 2 and the lingual barrier 3, to further facilitate the work of the dentist. By way of examples, the invention can be used in orthodontics, for faceting or for taking a digital impression.

Furthermore, the spacer 1 may be shaped differently from Figures 1 to 17 without departing from the scope of the invention. In particular, the retractors 40 and the adjustment systems 50 may have different shapes, sizes and arrangements adapted to the intended applications. For example, the upper systems 51 and 52 may comprise sliders 90 and 100 instead of the sliders 70 and 80. In another example, the lower systems 53 and 54 may comprise sliders 70 and 80 instead of sliders 90 and 100. In another example, the spacer 1 may have two hooks 40, or six hooks 40. Other variants not shown can be implemented without departing from the scope of the invention.

In addition, the technical characteristics of the various embodiments and variants mentioned above may be, in whole or in part, combined with one another. Thus, the spacer 1 can be adapted in terms of cost, functionality and ergonomics.

Claims

1. Lip retractor (1) for oral surgery, comprising:

a frame (10) provided with a central opening (14) for accessing the teeth of a patient;

at least two hooks (40) for supporting the lips and cheeks of the patient; and means (50) for adjusting the position of the hooks (40) relative to the frame (10), including non-return elements (64; 74; 94; 95; 109).

2. Lip retractor (1) according to the preceding claim, characterized in that it comprises four hooks (40) for supporting the patient's lips and cheeks, each hook (40) being positioned in a quarter of the central opening (14).

3. Lip spacer (1) according to one of the preceding claims, characterized in that the adjusting means (50) comprise an adjustment system (51, 52, 53, 54) which is specific to each hook (40). , so that each hook (40) is positionable independently of the other hooks (40).

4. Lip spacer (1) according to one of the preceding claims, characterized in that the adjusting means (50) comprise transverse adjustment elements (60, 70; 60, 90) and vertical adjustment elements (70). , 80, 90, 100)

Lip retractor (1) according to claim 4, characterized in that for each hook (40), at least the transverse adjustment elements (60, 70; 60, 90) include non-return elements (64; 94).

6. Lip spacer (1) according to one of the preceding claims, characterized in that for each hook (40), the adjusting means (50) comprise a groove (60) formed on the frame (10), a first slider (70; 90) movable relative to the groove (60), and a second slider (80; 100) movable relative to the first slider (70; 90).

7. Oral treatment unit (1, 2, 3), characterized in that it comprises a lip spacer (1) according to one of claims 1 to 6, and at least one of:

a lamp holder (2) adapted to support a lamp or a radiation device;

a soft lingual barrier (3) adapted to block the tongue of a patient during a dental operation; and

a saliva suction device, such as suction tubes adapted to be connected to the lip spacer (1) and the lingual barrier (3).

8. oral treatment unit (1, 2, 3) according to claim 7, characterized in that the lamp holder (2) comprises:

a body (20) provided with a housing (22) for receiving the lamp or the radiation device; and

four tabs (21) for attaching to the frame (10) of the lip spacer (1).

9. Oral treatment unit (1, 2, 3) according to one of claims 7 or 8, characterized in that the lingual barrier (3) comprises:

a central portion (30) provided to block the patient's tongue;

side blocks (31) adapted to be clamped between the patient's teeth; elastic members (32, 33) connecting the central portion (30) and the side blocks (32); and

a saliva suction circuit (37, 38, 39), including in particular at least one housing (39) for connecting a saliva suction device, such as suction tubes.

10. A method of implementing a lip spacer (1) according to one of claims 1 to 6, characterized in that it comprises the following steps: a) pre-set the position of the hooks (40) relative the frame (10);

b) positioning the lip spacer (1) on the patient's face;

c) spreading the lips and cheeks of the patient by adjusting the position of the hooks (40) relative to the frame (10).