U.S. patent application number 17/179791 was filed with the patent office on 2021-08-05 for custom-formable night grinding appliance and method of use.
The applicant listed for this patent is Akervall Tehcnologies, Inc.. Invention is credited to Charlotte Akervall, Jan Akervall, Johann W. Schwank.
Application Number | 20210236325 17/179791 |
Document ID | / |
Family ID | 1000005534965 |
Filed Date | 2021-08-05 |
United States Patent
Application |
20210236325 |
Kind Code |
A1 |
Akervall; Jan ; et
al. |
August 5, 2021 |
CUSTOM-FORMABLE NIGHT GRINDING APPLIANCE AND METHOD OF USE
Abstract
Disclosed is a dental appliance composed of a thermo-plastic
polymer with low compressibility, high toughness, and high tensile
strength, with a low softening point. The appliance has
perforations that enable it to be easily custom-fitted by the user
or a health professional. The appliance begins as an unformed
dental tray that is significantly thinner than existing dental
appliances. Once fitted, the dental appliance provides superior
protection against damage to the enamel of the teeth and abrasion
of the teeth due to bruxism or other mechanism leading to
biomechanical wear of dental surfaces. The perforations facilitate
the custom-fitting process by allowing the user to suck air through
the perforations, thus applying a negative pressure between the
material and the teeth while the material is still soft and
pliable. This enables a user or health professional to within
minutes create a final product that rivals the quality and fit of
an appliance made by dental laboratories using dentist made
impressions.
Inventors: |
Akervall; Jan; (Saline,
MI) ; Akervall; Charlotte; (Saline, MI) ;
Schwank; Johann W.; (Saline, MI) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Akervall Tehcnologies, Inc. |
Saline |
MI |
US |
|
|
Family ID: |
1000005534965 |
Appl. No.: |
17/179791 |
Filed: |
February 19, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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13894469 |
May 15, 2013 |
10945874 |
|
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17179791 |
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61647093 |
May 15, 2012 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F 5/566 20130101;
A61F 2005/563 20130101 |
International
Class: |
A61F 5/56 20060101
A61F005/56 |
Claims
1. A mouth guard, comprising: a first surface and an opposite
second surface, said surfaces being substantially planar and
defining a substantially constant thickness between them; a first
plurality of perforations extending entirely through said first
surface to said second surface, said first plurality of
perforations having a first row and a second row, wherein
perforations in said first and second rows are laterally offset; a
second plurality of perforations extending entirely through said
first surface to said second surface, said second plurality of
perforations having a first row and a second row, wherein
perforations in said first and second rows are laterally offset, a
bite line separates said first and second rows of said first
plurality of perforations from said first and second rows of said
second plurality of perforations, wherein said bite line is solid
with no perforations, said bite line is located between said first
and second pluralities of perforations, wherein individual
perforations of said first and second plurality of perforations
extend spaced from one another continuously from a rear portion on
said first surface, across a line of symmetry, to a rear portion on
said second surface, wherein said bite line is adapted to receive
lateral shearing forces from teeth, wherein said perforations are
adapted to dissipate the shearing forces.
2. The mouth guard of claim 1, wherein said first and second rows
of perforations in said first and second plurality of perforations
are the only perforations.
3. The mouth guard of claim 1, further comprising at least one cusp
on an outer edge portion of a perimeter and at least one lobe on
said outer edge portion, wherein said at least one cusp is adapted
to dissipate the shearing forces.
4. The mouth guard of claim 1, wherein said mouth guard is
constructed of randomly distributed, randomly oriented interwoven
strands of polycaprolactone molecules of random shapes and sizes to
increase abrasion resistance of said mouth guard.
5. The mouth guard of claim 1, wherein individual perforations said
first and second pluralities of perforations have a circular cross
section.
6. The mouth guard of claim 4, wherein said first and second rows
of said first plurality of perforations are arranged in two
parallel rows adjacent said outer edge portion.
7. The mouth guard of claim 1, wherein individual perforations are
spaced from one another by a distance of approximately a
perforation diameter away from an adjacent perforation.
8. The mouth guard of claim 1, wherein said mouth guard is formed
of a substantially incompressible, constant volume material.
9. The mouth guard of claim 1, wherein there are a greater number
of perforations in said first plurality of perforations compared
with said second plurality of perforations.
10. A mouth guard, comprising: a first surface and an opposite
second surface, said surfaces being substantially planar and
defining a substantially constant thickness between them; a first
plurality of perforations extending entirely through said first
surface to said second surface, said first plurality of
perforations having a first row and a second row, wherein
perforations in said first and second rows are laterally offset; a
second plurality of perforations extending entirely through said
first surface to said second surface, said second plurality of
perforations having a first row and a second row, wherein
perforations in said first and second rows are laterally offset, a
bite line at least partially separates said first and second rows
of said first plurality of perforations from said first and second
rows of said second plurality of perforations, wherein a line of
symmetry extends across said bite line and divides said first
surface in half wherein an equal number of perforations is on each
side of the line of symmetry, wherein said bite line is adapted to
receive lateral shearing forces from teeth, wherein said
perforations are adapted to dissipate the shearing forces.
11. The mouth guard of claim 1, further comprising at least one
cusp on an outer edge portion of a perimeter and at least one lobe
on said outer edge portion, wherein said at least one cusp is
adapted to dissipate the shearing forces.
12. The mouth guard of claim 1, wherein said mouth guard is
constructed of randomly distributed, randomly oriented interwoven
strands of polycaprolactone molecules of random shapes and sizes to
increase abrasion resistance of said mouth guard.
13. The mouth guard of claim 11, wherein said first and second rows
of said first plurality of perforations are arranged in two
parallel rows adjacent said outer edge portion, and wherein said
first and second rows of said second plurality of perforations are
arranged in two parallel rows adjacent an inner edge portion.
14. The mouth guard of claim 11, wherein individual perforations
are spaced from one another by a distance of approximately a
perforation diameter away from an adjacent perforation.
15. The mouth guard of claim 11, wherein said mouth guard is formed
of a substantially incompressible, constant volume material.
16. The mouth guard of claim 11, wherein there are a greater number
of perforations in said first plurality of perforations compared
with said second plurality of perforations.
17. The mouth guard of claim 11, wherein along a portion of said
bite line adapted to receive molars, there are no perforations.
18. The mouth guard of claim 11, wherein said first and second rows
of said first plurality of perforations have a terminus adjacent a
terminus of said first and second rows of said second plurality of
perforations.
19. The mouth guard of claim 19, wherein said first and second rows
of said first plurality of perforations extend at a substantially
constant distance from said first and second rows of said second
plurality of perforations.
20. A mouth guard, comprising: a first surface and an opposite
second surface, said surfaces being substantially planar; a first
plurality of perforations with circular cross-sections, said first
plurality of perforations having a first row and a second row,
wherein perforations in said first and second rows are laterally
offset; a second plurality of perforations with circular
cross-sections, said second plurality of perforations having a
first row and a second row, wherein perforations in said first and
second rows are laterally offset, a bite line at least partially
separates said first plurality of perforations from said second
plurality of perforations, at least one cusp on a perimeter portion
and at least one lobe on said perimeter portion, wherein said bite
line is adapted to receive lateral shearing forces from teeth,
wherein said perforations and said at least one cusp are adapted to
dissipate the shearing forces.
Description
FIELD
[0001] The present invention relates generally to night grinding
appliances. More particularly, the invention relates to
custom-formable night-grinding dental appliances that are thin and
have a multiplicity of strategically placed perforations. The
perforations facilitate breathing and the flow of saliva while
maximizing the protection of teeth with regard to bruxism or other
mechanisms leading to biomechanical wear of dental surfaces.
BACKGROUND
[0002] Many dental patients suffer from temporomandibular joint
disorder (TMD), a condition involving the improper functioning of
the jaw and the temporomandibular joint. One of the conditions
leading to TMD is bruxism, the subconscious clenching and grinding
of teeth that typically occurs during sleep, but that may also
occur while the patient is awake. In some cases of bruxism, the
forces from jaw movements lead to tooth enamel damage, and over
time the exerted excessive pressure can cause damage to the TMJ's
articulating surfaces and lead to abrasion of the teeth surfaces.
One of the treatments for bruxism is to insert custom-formed dental
appliances, also known as "night grinding appliances", or "bruxism
protective device" or "mouth guards" to prevent direct contact of
the occlusal surfaces of the teeth.
[0003] Night grinding appliances or fitted mouth guards are
typically prescribed by dentists and custom formed. Typically, the
dentist first takes an impression of the patient's teeth, and a
cast of the maxillary upper arch is fabricated. Then, a polymeric
material, usually an acrylic material is molded over the cast while
applying a vacuum. The resulting fitted mouth guard is then trimmed
and polished. Alternatively, multiple layers of polymer are
laminated together under pressure in an attempt to improve the
physical properties of the protective layers. These custom-made
fitted mouth guards tend to be very expensive, and require a visit
to the dentist, and, in some cases, fabrication in a dental
laboratory.
[0004] Mouth guards for other uses, such as sports, do not provide
protection against shear forces created by bruxism. Sports guards
are developed to accommodate single, quick, large forces that are
acting substantially normal to the tooth outer surface. Sports
guards have no mechanism to contend with constant, low level shear
forces from the user's own teeth.
SUMMARY
[0005] Described herein is a generally U-shaped dental appliance
made of polycaprolactone or other thermoplastic polymer with a low
softening point. The appliance is substantially thinner than
conventional dental trays and has strategically located
perforations. The majority of the perforations are disposed
primarily outside of an arc-shaped region associated with a user's
bite line. The perforations facilitate breathing and unrestricted
flow of saliva. The appliance can easily be heated to its softening
point and custom-fitted by a dentist, other health professional, or
even by the patient conforming exactly to the contours of the
user's dentitions.
[0006] The fitted dental appliance provides superior protection
against damage to the enamel of the teeth and abrasion of the teeth
due to bruxism or other mechanisms leading to biomechanical wear of
dental surfaces.
[0007] The appliance facilitates the custom-fitting process by
allowing the user to suck air and saliva through the perforations,
thus applying a negative pressure between the material and the
teeth while the material is still soft and pliable. The result is
within a short time a conformal fit around every tooth as the
material hardens, thus enabling a user or health professional to
create a final product that rivals the quality and fit of an
appliance made by dental laboratories using dentist made
impressions.
[0008] The appliance has a periphery including a plurality of lobes
and cusps to enhance custom fitting by allowing the softened
material to envelop the teeth without buckling.
[0009] After fitting to the patient's dentitions, the fitted
appliance cools to ambient temperature and contracts slightly, thus
conforming even better to the contours of the user's dentitions,
and thereby preventing the appliance from getting dislodged or
falling out during sleep.
[0010] The appliance covers only the teeth and not the gum line on
the labial side and the palate on the lingual side, in order to not
cause discomfort, irritation of the gums, gagging, or inhibited
breathing and saliva flow.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] The features of the subject appliance will be better
understood in the context of the detailed description, in
conjunction with the drawings.
[0012] FIG. 1 is a scanning electron micrograph of an unformed tray
taken at 8,000.times. magnification, showing the interwoven strands
of the polymer imparting high abrasion resistance.
[0013] FIG. 2 is a schematic illustration of an unformed tray with
strategically placed perforations.
[0014] FIG. 3A is a schematic cross section of two adjacent
perforations before the application of grinding forces and FIG. 3B
is a schematic cross section of the same two adjacent perforations
during the application of grinding forces, illustrating how the
shape of the perforations changes during application of grinding
forces.
[0015] FIG. 4 shows a frontal view of the fitted appliance.
[0016] FIG. 5 shows a bottom view of the fitted appliance depicting
a lower surface of the appliance that is in contact with the dental
surfaces.
[0017] FIG. 6 shows another bottom view of the formed
appliance.
[0018] FIG. 7a depicts one embodiment of a formed appliance with
circular perforations.
[0019] FIG. 7b depicts another embodiment of a formed appliance
with circular and teardrop perforations.
[0020] FIG. 7c depicts another embodiment of a formed appliance
with half moon and teardrop perforations.
[0021] FIG. 7d depicts another embodiment of a formed appliance
with half moon perforations.
[0022] FIG. 8 shows one embodiment of the formed appliance on the
dentitions of a user.
DETAILED DESCRIPTION
[0023] It is to be understood that the device may assume various
alternative orientations and step sequences, except where expressly
specified to the contrary. It is also to be understood that the
specific devices and processes illustrated in the attached
drawings, and described in the following specification are simply
exemplary embodiments of the concepts defined in the appended
claims. Hence, specific dimensions, directions or other physical
characteristics relating to the embodiments mentioned herein are
not limited unless required in the claims.
[0024] Turning now to FIG. 4-6, one embodiment of a mouth guard 10
is depicted. The mouth guard 10 has an inner upstanding wall 12
with an inner surface 14 and an outer surface 16. The two surfaces
14, 16 are generally parallel one another. The guard 10 also has an
outer upstanding wall 18 with an inner surface 20 and an outer
surface 22. The two surfaces 20, 22 are generally parallel one
another. The inner upstanding wall 12 and the outer upstanding wall
18 are connected at their base portions with a U-shaped occlusal
line portion 24 to form a U-shaped cross section. The walls 12, 18
of the guard 10 and the occlusal line portion 24 are unitarily
formed as one piece. The occlusal line portion 24 is the part of
the device that covers the bite line--the surface of the protected
dentition that comes in contact with the surface of the dentition
on the other jaw when the individual bites down during grinding or
clenching. The occlusal line portion 24 can also be appreciated
from FIG. 8.
[0025] Although the guard 10 may have an upper edge portion 26 of
the outer upstanding wall 18 that is relatively straight, in the
preferred embodiment a number of small lobes and cusps are located
in the outer upstanding wall 18. The lobes and cusps are used to
enhance the custom fitting process of the guard 10 to the user's
teeth by allowing the softened guard material to adapt to any shape
of the user's dentitions during the fitting process. As shown in
FIG. 4, the upper edge portion 26 of the outer upstanding wall 18
is provided with at least one cusp. A first cusp 28 is provided
between a right half 30 and a left half 32 on a centerline 34 at a
forward portion 36 of the outer upstanding wall 18. The guard 10 is
symmetric about the centerline 34.
[0026] Preferably, a second cusp 38 is provided on the upper edge
portion 26 of the outer upstanding wall 18 as well. In the depicted
embodiment, the second cusp 38 is provided at a rearward portion 40
of the outer upstanding wall 18. The second cusp 38 is positioned
so that it is located between the user's incisors and molars (see
also FIG. 8). A lobe 42 formed between points 44 and 46. Lobes 42
and cusps 28, 38 are not depicted on the inner upstanding wall 12
but they may be used on this wall 12 as well.
[0027] A cusp 28, 38 is defined as an indentation of the wall 18 of
the mouth guard 10, and a lobe 42 is defined as a protruding
portion of the wall 18 of the guard 10. Without such cusps 28, 38
and lobes 42, a guard 10 that has been softened to mold against a
user's teeth tends to fold or buckle when the guard 10 is wrapped
around teeth and gums during fitting. This is especially the case
if the curvature and shape of the dentitions are uneven. If such
folding occurs when the material hardens during the fitting
process, the fitted mouth guard 10 may become uncomfortable to
wear, irritating the inside of the lip, and compliance to wear it
may decrease. Thanks to these cusps 28, 38 and lobes 42 the final
result is a conformally fitted mouth guard 10 that has an outer
upstanding wall 18 and an inner upstanding wall 12 both without
folds and irregularities and that is extremely comfortable. Another
effect of such cusps 28, 38 and lobes 42 is that shear forces to
the fitted mouth guard 10, as applied from the lower jaw during
grinding, are dissipated away from the occlusal line portion 24,
and up towards these cusps 28, 38 and lobes 42, thereby decreasing
the negative effect of grinding on the dental surfaces.
[0028] Multiphysics computer simulation analysis has shown that the
cusps 28, 38, representing singular points on the curvature of the
fitted mouth guard 10, act as zones where stresses in the material
are concentrated and energy is dissipated, adsorbing and
dissipating forces from high impact areas, i.e. the occlusal line
portion 24. When shear forces are applied to the fitted mouth guard
10 during grinding or clenching of teeth, a deformation wave front
travels though the walls 12, 18 and crests at a cusp 28 and/or 38.
This directs the impact energy away from the dentition and
concentrates it harmlessly in the cusp 28 and/or 38.
[0029] As shown in FIGS. 3A, 4-6, a plurality of openings 48 are
located in the inner upstanding wall outer surface 16. The openings
48 connect with a plurality of perforations 50 extending through to
the inner upstanding wall 12. The perforations 50 connect with a
plurality of exits 52 in the inner upstanding wall inner surface
14.
[0030] As also shown in FIGS. 4-6, a plurality of openings 54 are
located in the outer upstanding wall outer surface 22. The openings
54 connect with a plurality of perforations 56 extending through
the outer upstanding wall 18. The perforations 56 connect with to a
plurality of exits 58 in the outer upstanding wall inner surface
20.
[0031] The strategically placed perforations 50, 56 in the guard 10
distribute the forces from clenched teeth more evenly and prevent
abrasion of the teeth. The perforations 50, 56 increase the ability
of the guard 10 to dissipate energy produced during grinding and
clenching of teeth by redirecting the forces generated when teeth
are clenched and dissipating the energy by temporarily distorting
their shape.
[0032] As shown in FIGS. 3a, and 4-6, the openings 48, 54 and exits
52, 58 maybe circular in shape and the perforations 50, 56 may be
cylindrical. The openings 48, 54, exits 52, 58, and perforations
50, 56 temporarily deform from circles into ovals in the region
where a grinding and/or clenching force is applied, as
schematically depicted in FIG. 3b.
[0033] FIGS. 3a and 3b, depict two openings 48, exits 52 and
corresponding perforations 50 in the inner upstanding wall 12. A
shear force 60, which is applied during grinding, travels along the
outer surface 16 (in this example) as a wave. The wave encounters a
first perforation 64, which becomes temporarily deformed by the
wave. The wave deforms the first perforation 64, which has a
circular cross-section, into a perforation with an oval
cross-section, which expends some of the energy of the wave. The
guard 10 in which the perforation 64 is located maintains a
constant volume. Thus, a second perforation 66, which is proximate
the first perforation 64, gets compressed to account for the
deformation of the first perforation 64. The combination of
perforation 64 deformation and the compression of an adjacent
perforation 66 acts to absorb the laterally moving shear force in
the guard 10. The amount of compression of an adjacent perforation
66 is a function of the amount of deformation caused by the first
perforation 64. It can be appreciated that the deformation and
compression occurs across many perforations simultaneously in the
guard 10.
[0034] Based on the foregoing, it can be appreciated that a shear
force generated at a rear portion 68 of the guard 10 can be
dissipated before it reaches a forward portion 70 of the guard 10
thus causing no distortion in the forward portion 70
perforations.
[0035] The perforations 50, 56 are placed in the walls 12, 18 to
maximize the tensile strength of the guard 10 without exposing any
of the protected dental surfaces to the unprotected teeth on the
opposite jaw. The location of the perforations 50, 56 also
optimizes saliva flow around the dentitions, which improves
comfort.
[0036] The perforations 50, 56 improve comfort, i.e. improve
breathing and decrease drooling, i.e. the flow of saliva outside
the mouth. Breathing is improved since the perforations 50, 56
allow the guard 10 to be thinner and thus take up less space in the
mouth. Drooling is decreased since saliva can be sucked straight
through the perforations 50, 56 in the guard 10. Drooling is a
common problem with conventional dental devices and a major reason
for poor compliance to use them. The optimized saliva flow in the
current invention that enables the user to suck saliva straight
through the guard 10, thus avoiding saliva accumulation around it,
mimics the natural sucking and swallowing of saliva an individual
does automatically during sleep.
[0037] The perforations 50, 56 also improve the fitting procedure.
The fitting procedure begins by taking the tray 72 depicted in FIG.
2. The tray 72 is heated, such as by hot water, microwave energy,
or the like. Upon application of heat, the tray 72 becomes
malleable. The heated tray 72 is put into the user's mouth and
against the occlusal line of one set of teeth, such as the top set
of teeth.
[0038] The perforations 50, 56 allow the user to suck saliva and
air through the perforations 50, 56 during the fitting process.
This creates a slight vacuum between the softened guard 10 and the
dentitions thus attracting the softened material to the dental
surfaces and molding it perfectly around the contours of every
tooth. The perforations 50, 56 allow the user to suck the softened
appliance down onto the dental surface without having to apply any
external mechanical pressure. The result is a perfect fit around
every individual tooth, no matter the shape or relative location of
an individual tooth. Upon cooling, the material retains the shape
obtained during the molding process. This overcomes a major problem
with conventional fitted mouth guards, where the user has to press
the fingers onto the lips from the outside to form the softened
fitted mouth guard to the teeth, with generally poor results.
[0039] The perforations 50, 56 can be manufactured in a variety of
shapes, sizes, and directions through the unformed tray 72, but are
typically in the range of 1-2 mm in diameter and shaped as
cylindrical, straight, horizontal channels penetrating the walls
12, 18 of the formed guard 10. The location, shape, and direction
of these perforations 50, 56 may vary depending on demands on
saliva flow, since saliva flow is not uniform throughout the oral
cavity. For instance, the saliva flow is higher close to the ducts
of the Parotid and submandibular saliva glands, located in the
buccal mucosa and in the floor of the mouth. The location of these
salivary glands ducts correspond to the rear portion 68 of the
fitted guard 10 (Parotid glands) and the inner wall in the midline
(Submandibular glands), and the perforations 50, 56 could be bigger
in these locations to compensate for greater saliva flow.
[0040] Since perforations 50, 56 have been proven to increase the
ability of the material to dissipate energy produced during
grinding and clenching of teeth by temporarily deforming the
cylindrical shape of the perforations 50, 56, a wide variety of the
number of perforations 50, 56 and of their exact locations and
directions in the material can be used. The present invention can
be used on upper as well as lower teeth to improve protection.
[0041] The location, size and shape of the perforations 50, 56 are
arranged in special patterns that are optimized to dissipate the
shear forces applied to the grinding guard by the teeth of the user
suffering from bruxism. Enhanced absorption and dissipation of
shear forces can be achieved by strategically placing perforations
50, 56 having complex shapes such as tear drop shapes or half-moon
shapes, as illustrated in FIG. 7a-d. In some cases, nonsymmetrical
perforations, whose shapes are not symmetrical to the laterally
traveling shear force wave, are preferable for their ability to
absorb and dissipate shear forces.
[0042] It is preferred that at least two perforations 50, 56 are
located adjacent one another and that the perforations 50, 56 have
different shapes. By way of example, a guard 10 might have a
circular perforation directly adjacent a teardrop perforation.
Preferably, adjacent means that the adjacent perforations are no
more than 1-2 perforation diameters away from one another with no
intervening structure. This close relationship of perforations is
preferred because it allows them to be in force transmitting
communication with one another. In one embodiment, the distance
between perforations is less than approximately 3 mm and preferably
between approximately 1-2 mm.
[0043] FIG. 7a depicts one embodiment where two rows of
perforations are provided. These perforations 56 are from the outer
upstanding wall 18. A first upper row 74 is above a second lower
row 76 wherein the perforations 56 in the respective rows are
laterally offset from one another and do not overlap. In this
embodiment, the perforations 56 in both rows are
circular/cylindrical.
[0044] FIG. 7b depicts another embodiment where two rows of
perforations are provided. A first upper row 74 is above a second
lower row 76 wherein the perforations 56 in the respective rows are
laterally offset from one another and do not overlap. The
perforations in the first row 74 are circular/cylindrical 78; the
perforations in the second row 76 are a teardrop shape 80.
[0045] FIG. 7c depicts another embodiment where two rows of
perforations are provided. A first upper row 74 is above a second
lower row 76 wherein the perforations 56 in the respective rows are
laterally offset from one another and do not overlap. The
perforations in the first row 74 are a combination of
circular/cylindrical 78 and tear dropped shaped 80; the
perforations in the second row 76 are a combination of half moon
shape 82 and circular/cylindrical 78.
[0046] FIG. 7d depicts another embodiment where two rows of
perforations are provided. A first upper row 74 is above a second
lower row 76 wherein the perforations in the respective rows are
laterally offset from one another and do not overlap. The
perforations in the first row 74 are circular/cylindrical 78; the
perforations in the second row 76 are a half moon shape 82.
[0047] Based on the foregoing, it can be appreciated that guards 10
can be highly customized to individual bruxism issues of a user.
The location, size and shape of perforations can be tailored to the
specific type and severity of bruxism experienced by a user.
[0048] The shapes, sizes, and exact location of these perforations
are determined by multiphysics computer simulations. These
multiphysics computer simulations allow to determine the optimum
pattern distribution and perforation shapes that allow the guard 10
to deform in such a way that the shear forces applied during
grinding are directed into distortions of the perforation shapes in
a lateral direction, thereby dissipating energy and protecting the
underlying teeth. This permits the appliance to dissipate shear
forces by deformation of selected perforations in grinding guard
regions that experience shear forces, while maintaining the
remaining perforations unaltered. This feature preserves the
excellent fit of the grinding guard 10 even under severe bruxism
conditions. It is important to note that this mechanism of energy
dissipation is fundamentally different than the principles of
operation of prior art mouth guards where cylindrical perforations
were used to dissipate vertically applied compressive forces. Here,
horizontal shear forces are redirected to change the shape of the
perforations, a fundamentally different energy absorption mechanism
made possible by the special shape of the perforations.
[0049] Dental appliances 10 according to this invention are made
from a material that is considerably tougher than conventional
stock boil and bite appliances, typically made of ethyl vinyl
acetate (EVA). The increased toughness of the material improves its
ability to absorb energy and its resistance to damage when stressed
during clenching and grinding of teeth.
[0050] The material used in this invention is substantially less
compressible than the materials used in conventional boil and bite
appliances. Preferably, the material is substantially
incompressible and substantially constant volume. By way of
example, the material may be such as polycaprolactone or other
thermoplastic polymers. According to a multiphysics computer
simulation, the material in the current invention deforms only 1.4%
under a static load of 2 MPa in comparison to 35% for EVA used in
conventional appliances. The less a dental device compresses under
impact the less it "caves in". This means that the impact forces
dissipate laterally over the device rather than being transferred
through the material to the underlying teeth. Better dissipation of
forces increases the protection of the dental surfaces. Since
compression of the current invention is only 1/25 of conventional
dental devices, the transferred forces to the teeth are just a
fraction of those in conventional devices, and the degree of
protection of the dental surfaces by the current invention is
significantly better. Furthermore, less compression results in less
permanent deformation of the material itself, which increases its
durability. The decreased deformation maintains the excellent
conformal fit of the appliance during clenching of teeth and
prevents dislodging of the appliance from the dentitions.
[0051] Conventional, EVA based appliances need to be about 4 mm
thick to provide adequate protection. Thanks to the superior
properties of the material in the current invention, a thickness of
on average 1.6 mm (range 1.0-2.5 mm) is sufficient to provide
adequate protection of the dentitions against abrasion during
grinding of teeth. The thinner a night grinding fitted mouth guard
10 is the more comfortable it is, which in turn is important for
compliance to use the guard. Bulkier dental device tend to cause
gagging. Furthermore, a thinner fitted mouth guard 10 is easier to
fit around individual teeth, especially when perforations and the
pliability of the current material allows custom fitting to any
surface.
[0052] The unformed tray 72 may have a uniform thickness, however,
when it is fitted the thickness of the appliance may vary. For
example, the thickness of the fitted guard 10 may vary in different
areas between 1.0 and 1.8 mm when the unformed tray thickness is
approximately 1.6 mm. The varying thickness may occur in different
areas of the unformed tray to provide increased comfort to the
user. Furthermore, the unformed tray 72 may be deliberately made
thicker in specific areas where dental abrasion is suspected to
occur. This can be accomplished by starting from an unformed tray
72 that has regions of different thickness. For example, the
material covering the bite line could be made thicker uniformly or
only in specific areas, such as the molar region.
[0053] In the preferred embodiments the appliance according to the
invention is based on a thermo-plastic polymer with low
compressibility. The polymer softens when heated to temperatures
above 50.degree. C., allowing it to be conformally fitted to the
dentitions. The physical properties of this thermo-plastic polymer,
such as compressibility, toughness, tensile strength, pliability,
and melting point can be adjusted by synthesizing the polymer with
different molecular weight distributions (with mean molecular
weight in the range of 20,000-80,000), or by incorporating
nano-particles and other materials like bentonite clay
nanoparticles modified by surfactants such as Stepantex SP-90, to
get additional benefits, e.g. increased tensile strength, lower
melting temperature, etc. In the preferred embodiment, the polymer
is highly abrasion resistant thanks to its structure that contains
interwoven strands 84 of polymer, as shown in a magnified scanning
electron microscope image (FIG. 1). Since these strands 84 are
interwoven and extend deep into the material, they will not easily
be pulled out or removed from the material during grinding of
teeth, thereby making the appliance more abrasion resistant.
[0054] The shape of the unformed tray 72 facilitates the fitting of
the softened material by being wide enough to cover all teeth and
wrap around them, and by being narrow enough not to cause pressure
on the teeth when the fitted mouth guard 10 cools off and contracts
around the teeth. In contrast to athletic fitted mouth guards,
night grinding fitted mouth guards are used for 6-10 hours
straight, and therefore need to be extremely comfortable to
guarantee compliance to use them during an entire night's sleep.
The carefully designed shape, with cusps 28, 38 and lobes 42
prevents the material from folding when the soft material is molded
up against the teeth. The width of the dental unformed tray has
also been carefully designed to cover the curved occlusal line
portion 24 with solid material without perforations and still allow
the user to mold the material up on the inside and outside of each
tooth. This design will make sure that the fitted device grips
around the teeth and does not fall out during sleep, and at the
same time not extend up to the gum line, which is uncomfortable,
nor to the hard palate on the inside, which can create gagging. It
extends back to the molars, just enough to avoid contact between
lower and upper dentitions, but it is short enough to avoid
unnecessary gagging. The thinness and the exact design of the
unformed dental tray 72 and the location of the perforations 50, 56
allow the material to mold conformally around any uneven surface of
the teeth. FIG. 3 shows an example of a fitted appliance.
[0055] Due to the ease with which the material can be formed and
manipulated, the user can fit the mouth guard 10 on site or at home
without assistance of health professionals. Fitting is superior due
to the distinct properties of the polymer (thin and pliable at
moderate temperatures), and to the design of the unformed dental
tray 72 with strategically placed perforations 50, 56, as described
above, and lobes 42 and cusps 28, 38 as described above. These
properties permit the user to place and fit the heated, softened
material over the dentition through a rapid process wherein the
material is sucked onto the teeth. In particular, the perforations
50, 56 enhance the effect of the suctioning by allowing the user to
create a negative pressure between the teeth and the material, thus
sucking the material down to every irregularity of the teeth.
Thanks to the perforations 50, 56 in the guard 10, the suctioning
maneuver creates a minimal dead space between the material and the
teeth, thus leading to a perfect, conformal fit. Without such
perforations 50, 56, conformal fitting cannot be done since not
enough negative pressure can be built up between a solid material
and the dentition. This is reflected in the instructions of
conventional fitted mouth guards, where the user is directed to
apply downward mechanical pressure on the material, from outside
with the fingers, to force the material to come closer to the
teeth.
[0056] Polymer-based guard 10 according to this invention are
inexpensive and disposable thereby improving oral hygiene. Users
can move their jaws in any way without risking the guard 10
becoming dislodged.
[0057] The guard 10 can be re-shaped to optimize fitting by
re-heating to the softening point and repeating the fitting. The
superior fit of the guard 10 also results in the need for less
material on the inside of the teeth, which in turn reduces gagging
and improves comfort.
[0058] Users of the inventive guard 10 can breathe more easily.
There is more room in the mouth since the guard 10 is considerably
thinner than prior art dental appliances, and air can also move
freely though the perforations.
[0059] In accordance with the provisions of the patent statutes,
the present device has been described in what is considered to
represent its preferred embodiments. However, it should be noted
that the device can be practiced otherwise than as specifically
illustrated and described without departing from its spirit or
scope.
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