NL2032972B1

NL2032972B1 - Mandibular repositioning appliance

Info

Publication number: NL2032972B1
Application number: NL2032972A
Authority: NL
Inventors: Jeroen Allessie Michiel
Original assignee: Michiel Allessie Holding B V
Priority date: 2022-09-07
Filing date: 2022-09-07
Publication date: 2024-03-21

Abstract

A mandibular repositioning appliance (MRA) comprises an upper splint to be worn over the teeth of the upper jaw of 5 a patient, which upper splint is provided with a pair of down— wardly extending upper fins, and a lower splint to be worn over the teeth of the lower jaw of a patient, which lower splint is provided with a pair of upwardly extending lower fins. Each of the upper fins and lower fins is attached to the 10 respective splint for a rotation around a substantially hori— zontally and transversally extending axis, in such a manner that an inclination of the fins can be changed.

Description

Mandibular repositioning appliance

The invention relates to a mandibular repositioning appliance (MRA) comprising an upper splint to be worn over the teeth of the upper jaw of a patient, which upper splint is provided with a pair of downwardly extending upper fins, and a lower splint to be worn over the teeth of the lower jaw of a patient, which lower splint is provided with a pair of up- wardly extending lower fins, wherein each of the upper fins is provided with an upper fin engagement surface and each of the lower fins is provided with a lower fin engagement surface and wherein, when the splints are fitted to the teeth of the jaws, an upper fin engagement surface of an upper fin is intended for cooperation with a lower fin engagement surface of a cor- responding lower fin such as to initiate a forward movement of the lower jaw relative to the upper jaw, and wherein at least some fins are adjustable in different positions.

The initiated forward movement of the lower jaw causes the tongue of the patient to move forward, thereby re- ducing the occurrence of snoring and mild sleep apnea when the patient is sleeping.

During prolonged use of the MRA it may be desirable to carry out an adjustment of the position of the lower jaw as caused by the MRA. Such an adjustment may be achieved, for ex- ample, by making at least some of the fins adjustable. Docu- ment US 6 604 527 Bl (which defines the state of the art as defined in the preamble of the main claim) in one embodiment shows an MRA in which the fins of the lower splint are embod- ied as blocks which can slide along recesses in the lower splint. The position of each block can be set by a turnbuckle mechanism which can be operated by a turnbuckle key.

It is an object of the present invention to provide an MRA in which the adjustment of the fins can be carried out in an alternative manner.

In accordance with the present invention, each of the upper fins and lower fins is attached to the respective splint for a rotation around a substantially horizontally and trans- versally extending axis, in such a manner that an inclination of the fins can be changed.

A change of the inclination of the fins (and conse- quently a corresponding change of the inclination of the coop- erating upper fin and lower fin engagement surfaces) results in a change of the degree of forward movement of the lower jaw (for example, changing the inclination such that the engage- ment surfaces of the fins extend more steeply, that means closer to extending vertically, will result in an increase of the forward movement of the lower jaw, whereas changing the inclination such that the engagement surfaces of the fins ex- tend less steeply, that means closer to extending horizon- tally, will result in a decrease of the forward movement of the lower jaw).

Although it is possible to change the inclination of the upper fins and of the lower fins in a different degree, it is preferred to change both in a similar manner, such that an optimized engagement between the upper fin engagement surfaces and the lower fin engagement surfaces may be guaranteed and maintained (generally, among others for avoiding high local pressures and damages resulting therefrom, an optimized en- gagement means an engagement over a large area).

In a preferred embodiment of the MRA the fins are in- tegrally connected to the splint at an interface region and the interface region is made of a material which is capable of allowing said rotation.

Thus, in such an embodiment a rotation and change of inclination of the fins is made possible by a deformation of the material from which the interface region is made. As such, mechanical devices (among which a physical rotation axis) for allowing the rotation are missing, which makes the MRA less complicated, more reliable, and more comfortable to wear by the patient.

In one embodiment of the MRA, the material is a ther- moplastic material, for example polyamide 11 or 12 (also re- ferred to as “Nylon 11% or “Nylon 12%, respectively). For al- lowing the desired rotation the material can be heated and, after the desired rotation has occurred, can be allowed to cool down again such that the new rotational position (amended inclination) is maintained.

Stated otherwise, the material during heating softens such that the fins can be reshaped into the new, desired rota- tional position, after which this new position is fixed when the material again cools down. Thus, the indication ‘defor- mation’ means that the fins are brought into a new shape (thus are ‘reshaped’).

In one embodiment of the MRA the interface region is part of the fins and/or of the splint. This means that a re- spective fin closely joins a corresponding splint, and that the deformation of material occurs in at least one of the fin and splint. It may be desirable to concentrate most, if not all, of the material deformation in the fin such as not to de- teriorate the retention of the splint by the teeth (which might result from a deformation of the splint).

In an alternative embodiment of the MRA, the inter- face region is defined by a member which is substantially po- sitioned between a respective fin and the splint. In such an embodiment, therefore, the material deformation is concen- trated (or for a major part concentrated) in said member, such that the shape of the fins and of the splints may be main- tained as designed originally notwithstanding the rotation and change of inclination of the fins.

As an example, an embodiment is conceivable in which the member defining the interface region is made of a number of separate spaced columns extending between the respective fin and the splint. Such spaced columns combine an enhanced deformability (for example when heated) with sufficient rigid- ity to keep the fins in the required relative positions with respect to the splints.

In the above, embodiments have been mentioned in which the rotation and change of inclination of the fins is based upon a material deformation (which causes a virtual ro- tation axis), but it is also possible that the fins and the flint are separate parts which are connected by a (physical) rotation axis and wherein fixating means are provided intended for fixating (keeping) the respective fin and splint in a de- sired mutual rotational position.

For example, the fixating means may comprise screws, bolts or similar means on one of the respective fin or splint cooperating with a curved slot in the other of the respective fin or splint.

Hereinafter the invention will be elucidated while referring to the drawing in which embodiments of the invention are illustrated. Herein:

Figure 1 is a schematical representation of an embod- iment of an MRA fitted to the teeth of a patient, in a side elevational view and in a first operative position;

Figure 2 is a view similar to figure 1, but with the

MRA in a second operational position;

Figure 3 is a schematical view according to arrow V in figure 2;

Figure 4 is a schematical view according to arrow V in figure 2, but of a different embodiment, and

Figure 5 is a schematical and partial side eleva- tional view of yet another embodiment.

The mandibular repositioning appliance (MRA) illus- trated in figure 1 comprises an upper splint 1 to be worn over the teeth 2 of the upper jaw of a patient, which upper splint 1 is provided with a pair of downwardly extending upper fins 3 (of which only one is visible in this side elevaticnal view, in which the left-hand side corresponds with the frontal (fa- cial) side of the head of the patient/person using the MRA).

The MRA further comprises a lower splint 4 to be worn over the teeth 5 of the lower jaw of the patient, which lower splint is provided with a pair of upwardly extending lower fins 6 (again only one of which is visible). Each of the upper fins 3 is provided with an upper fin engagement surface 7 and each of 5 the lower fins 6 is provided with a lower fin engagement sur- face 8.

When the splints 1 and 4, as illustrated in figure 1, are fitted to the teeth 2,5 of the upper and lower jaws, re- spectively, the upper fin engagement surface 7 of an upper fin 3 cooperates with the lower fin engagement surface 8 of a cor- responding lower fin 6 such as to initiate (cause) a desired forward movement Fi; of the lower jaw relative to the upper jaw.

In figure 1 the fins 3 and 6 are positioned at an in- clination angle oi with respect to a vertical direction. It is noted that in the illustrated embodiment the inclination of the upper and lower fins is similar. However, this is not strictly necessary.

In figure 2 the inclination of the fins 3 and 6 has been changed (by a rotation around a substantially horizon- tally and transversally extending virtual rotation axis, as illustrated schematically by the curved arrows) to the incli- nation angle co» which in this embodiment is smaller than oy. As a result of this changed inclination of the fins 3,6 and, thus, of the cooperating upper and lower fin engagement sur- faces 7,8 the lower jaw is moved forward according to Fg, wherein the lower jaw assumes a more forward position compared to the position in figure 1. By choosing the angle over which the fins are rotated, the additional amount of forward move- ment of the lower jaw can be set.

In the embodiments illustrated in figures 3 and 4, the fin 3 (and 6, not illustrated here) is integrally con- nected to the respective splint 1 (and 4, not illustrated here) at an interface region, wherein said interface region is made of a deformable material which is capable of allowing said rotation, for example because the material is a thermo- plastic material (such as, for example, polyamide 12).

In the embodiment according to figure 3, the inter- face region 9 is part of the fin 3 and of the splint 1. It is possible too, however, that the interface region 9 is com- pletely located in the fin 3, or completely in the stint 1.

In the embodiment according to figure 4, the inter- face region is defined by three separate spaced columns 10 ex- tending between the respective fin 3 and the splint 1. Of course, the number, position, and shape of the columns 10 may vary as desired.

Finally referring to figure 5, part of an embodiment is illustrated in which the fins and the flints (for example fin 3 and splint 1) are separate parts which are connected by a physical rotation axis 11 and wherein fixating means are provided intended for fixating (keeping) the respective fin and splint in a desired mutual rotational position. In this specific embodiment the fixating means are defined by a screw 12 threaded in the splint 1 and cooperating with a curved slot 13 in the fin 3.

The invention is not limited to the embodiments de- scribed which may be varied widely within the scope of the in- vention as defined by the appending claims. For example, the teachings of the present invention in an equivalent manner ap- ply to an MRA which is capable of moving the lower jaw in a backward direction rather than a forward direction (as may be used to counteract disadvantage effects of a prolonged use of the MRA with a forward displacement of the lower jaw).

Claims

: Conclusions

1. Mandibular reduction appliance (MRA) comprising an upper splint to be worn over the teeth of the upper jaw of a patient, the upper splint having a pair of downwardly extending upper bosses, and a lower splint to be worn over the teeth of the lower jaw of a patient, said lower splint having a pair of upwardly extending lower lugs, each of the upper ridges having an upper ridge engagement surface and each of the lower ridges having a lower ridge engagement surface and wherein, when the splints are mounted on the teeth of the jaws, an upper cam engaging surface of an upper cam is intended for engagement with a lower cam engaging surface of a corresponding lower cam, such that forward movement of the lower jaw relative to the upper jaw is initiated, and at least some of the cams be adjustable in different positions, characterized in that each upper cam and lower cam is attached to the respective splint for rotation about an axis extending essentially horizontally and transversely, such that an inclination of the cams can be changed .

2. MRA according to claim 1, wherein the cams are integrally connected to the splint at an interface area and wherein the interface area is made of a material capable of allowing said rotation.

The MRA of claim 2, wherein the material is a thermoplastic material.

The MRA according to claim 3, wherein the material is polyamide 11 or 12.

5. MRA according to any one of claims 2-4, wherein the interface area is part of the cams and/or the splint.

6. MRA according to any one of claims 2-4, wherein the interface area is defined by a part placed essentially between a respective ridge and the splint.

The MRA of claim 6, wherein the part defining the interface area is made of a number of separate spaced columns extending between the respective ridge and the splint.

8. MRA according to claim 1, wherein the cams and splint are separate parts connected by a rotation axis and wherein fixing means are provided intended for fixing the respective cam and splint in a desired mutual rotational position.

An MRA according to claim 8, wherein the fastening means are screws, bolts or similar means on one of the respective ridge or splint which cooperate with a curved slot in the other of the respective ridge or splint.