Patent Grant
8696352
1. Field of the Invention
The invention relates generally to an article for correcting facial features and oral function, and more specifically to an intra oral maxillofacial prosthesis and methods for treating the symptoms of facial nerve paralysis using the same.
2. Background Information
In today's society, youth is a highly prized asset. The human face is an important element in projecting a youthful appearance, but it is always eventually subject to the effects of aging, which sagging cheeks, lines, wrinkles, folds, and depressions. Similarly, these effects may occur after extreme, rapid weight loss, or as a consequence of facial paralysis from health problems such as Bell's palsy or stroke.
Bell's Palsy is a form of facial paralysis resulting from dysfunction cranial nerve VII (the facial nerve) that results in the inability to control facial muscles on the affected side. The annual incidence of Bell's palsy is about 20 per 100,000 population, and the incidence increases with age. Bell's palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. The hallmark of this condition is a rapid onset of partial or complete palsy (paralysis) that often occurs overnight. In rare cases, it can occur bilaterally resulting in total facial paralysis. Symptoms vary from person to person and can range in severity from mild weakness to total paralysis. These symptoms include twitching, weakness, or paralysis, drooping eyelid or corner of the mouth, drooling, dry eye or mouth, impairment of taste, and excessive tearing in the eye. For most people, Bell's palsy symptoms improve within a few weeks, with complete recovery in three to six months. About 10 percent will experience a recurrence of Bell's palsy, sometimes on the other side of the face. A small number of people continue to have some Bell's palsy signs and symptoms for life.
The resultant effects of facial paralysis include, but are not limited to, facial distortion/disfigurement, psychological trauma, problems with mastication and eating, and the inability to smile and/or talk normally. Because oral tissues are highly sensitized, they often become irritated due to food being trapped in the cheek of a person afflicted with facial paralysis. In addition, air bubbles accumulate in the oral vestibule on the affected side of the mouth when speaking.
Various forms of paralysis or weakness of the unilateral or bilateral facial muscles have been caused by injury to the facial nerve, viral infection, bacterial infection, nerve trauma, vascular etiologies, parotidectomy, stroke, brain surgery, aging, and trauma etiologies. Because facial paralysis affects each individual differently, afflicted subjects must seek treatments tailored to the specific symptoms that occur. Drugs are commonly used to treat the condition chemically, while various forms of surgery attempt to transplant nerves from other areas of the face and body and/or attempt to lift drooping skin/cheeks. In addition, subjects afflicted with facial palsy often seek speech therapy to correct basic communication skills.
Thus, a need exists for a system that addresses the physical appearance, oral discomfort and psychological distress from the victims' physical affect of the traumatic neuropathy.
The present invention is based on the finding that an intra-oral prosthesis can be used to correct facial features and/or oral function of a subject suffering from facial palsy. Provided herein are a system and method for correcting facial features and oral function of a subject. Using accurate models of both upper and lower arches of a subject's teeth, including the full vestibular areas, the appliances discussed herein are custom designed and built with regard to the individual subject's unique dentition and oral structure. Accordingly, the systems and methods provided herein include one or more intra-oral prosthesis for the relief of symptoms and physical, psychological and social affect of the subject's palsy or defect.
As such, in one aspect, the invention provides an intra-oral appliance for correcting facial features of a subject. The appliance includes an appliance body configured for engagement with a subject's upper teeth and anterior palate, wherein the appliance body has one or more extensions for engaging one or more of the gingival-buccal area and the vestibular area of the subject's mouth, thereby at least partly defining a cavity in the vestibule of the subject's mouth. In one embodiment, the appliance body has one extension for defining the vestibule at either side of the subject's mouth. In another embodiment, the appliance body has two extensions for defining the vestibule at both sides of the subject's mouth.
In another aspect, the invention provides a system for correcting facial features of a subject. The system includes an upper intra-oral appliance comprising a first appliance body configured for engaging one or more of the upper gingival-buccal area, the upper gingivolabial area, and the upper vestibular area of the subject's mouth, and a lower intra-oral appliance comprising a second appliance body configured for engaging one or more of the lower gingival-buccal area, the lower gingivolabial area, and the lower vestibular area of the afflicted side the subject's face. In one embodiment, the first appliance body is configured for engagement with the subject's upper teeth and anterior palate, wherein the first appliance body has one or more extensions for engaging one or more of the upper gingival-buccal area, the upper gingivolabial area, and the upper vestibular area of the subject's mouth. In another embodiment, the first appliance body is configured for engagement with the subject's upper gingiva on the afflicted side the subject's face, wherein the first appliance body is positioned from the maxillary midline of the subject's upper gingiva to the farthest upper posterior tooth or edentulous buccal portion. In yet another embodiment, the first appliance body is configured for engaging the upper gingiva where the tooth crown meets the gum line. In yet another embodiment, the first appliance body further comprises one or more posterior lingual/palatal claps for engaging one or more teeth of the subject. In yet another embodiment, the second appliance body is configured for positioning from the mandibular midline of the subject's lower gingival to the farthest lower posterior tooth or edentulous buccal portion. In yet another embodiment, the second appliance body further comprises one or more posterior lingual/palatal claps for engaging one or more teeth of the subject.
In another embodiment, the system further includes a third intra-oral appliance comprising a third appliance body configured for engagement with the subject's upper gingiva on the afflicted side the subject's face, wherein when used, the third appliance body is positioned from the maxillary midline of the subject's upper gingiva to the farthest upper posterior tooth or edentulous buccal portion, and wherein the first and third intra-oral appliances are not used simultaneously.
In another aspect, the invention provides a system for correcting facial features of a subject. The system includes a first upper intra-oral appliance comprising a first appliance body configured for engagement with the subject's upper teeth and anterior palate, wherein the first appliance body has one or more extensions for engaging one or more of the upper gingival-buccal area, the upper gingivolabial area, and the upper vestibular area of the subject's mouth, a second upper intra-oral appliance comprising a second appliance body configured for engagement with the subject's upper gingiva on the afflicted side the subject's face, wherein the second appliance body is positioned from the maxillary midline of the subject's upper gingiva to the farthest upper posterior tooth or edentulous buccal portion, and a lower intra-oral appliance comprising a third appliance body configured for engaging one or more of the lower gingival-buccal area, the lower gingivolabial area, and the lower vestibular area of the afflicted side the subject's face, wherein the first upper intra-oral appliance and the second upper intra-oral appliances are not used simultaneously. In one embodiment, any of the first appliance body, the second appliance body, and the third appliance body independently further comprise one or more posterior lingual/palatal clasps for engaging one or more teeth of the subject.
In another aspect, the invention provides a method for correcting facial features and oral function of a subject. The method includes fitting a subject in need thereof with an intra-oral appliance, which includes an appliance body configured for engagement with a subject's upper teeth and anterior palate, wherein the appliance body has one or more extensions for engaging one or more of the gingival-buccal area, the gingivolabial area, and the vestibular area of the subject's mouth, thereby at least partly defining the cavity in the vestibule of the subject's mouth.
In another aspect, the invention provides a method for correcting facial features and oral function of a subject. The method includes fitting a subject in need thereof with an upper intra-oral appliance comprising a first appliance body configured for engaging one or more of the upper gingival-buccal area, the upper gingivolabial area, and the upper vestibular area of the subject's mouth, and a lower intra-oral appliance comprising a second appliance body configured for engaging one or more of the lower gingival-buccal area, the lower gingivolabial area, and the lower vestibular area of the afflicted side the subject's face, thereby at least partly defining the cavity in the vestibule of the subject's mouth.
In one embodiment, the first appliance body is configured for engagement with the subject's upper teeth and anterior palate, wherein the first appliance body has one or more extensions for engaging one or more of the upper gingival-buccal area, the upper gingivolabial area and the upper vestibular area of the subject's mouth. In another embodiment, the first appliance body is configured for engagement with the subject's upper gingiva on the afflicted side the subject's face, wherein the first appliance body is positioned from the maxillary midline of the subject's upper gingiva to the farthest upper posterior tooth or edentulous buccal portion. In yet another embodiment, the first appliance body is configured for engaging the upper gingiva where the tooth crown meets the gum line. In yet another embodiment, the first appliance body further comprises one or more posterior lingual/palatal clasps for engaging one or more teeth of the subject. In yet another embodiment, the second appliance body is configured for positioning from the mandibular midline of the subject's lower gingival to the farthest lower posterior tooth or edentulous buccal portion. In yet another embodiment, the second appliance body further comprises one or more posterior lingual clasps for engaging one or more teeth of the subject.
In certain embodiments, the subject suffers from facial paralysis or defect. In those embodiments, the facial paralysis or defect is a result of brain surgery, glioma, brain injury, facial or dental surgery, Bell's Palsy, neuro-injuries, aging, stroke or disease.
Before the present systems, devices, and methods are described, it is to be understood that this invention is not limited to particular devices, methods, and experimental conditions described, as such devices, methods, and conditions may vary. It is also to be understood that the terminology used herein is for purposes of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only in the appended claims.
As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural references unless the context clearly dictates otherwise. Thus, for example, references to “the method” includes one or more methods, and/or steps of the type described herein which will become apparent to those persons skilled in the art upon reading this disclosure and so forth.
The term “comprising,” which is used interchangeably with “including,” “containing,” or “characterized by,” is inclusive or open-ended language and does not exclude additional, unrecited elements or method steps. The phrase “consisting of” excludes any element, step, or ingredient not specified in the claim. The phrase “consisting essentially of” limits the scope of a claim to the specified materials or steps and those that do not materially affect the basic and novel characteristics of the claimed invention. The present disclosure contemplates embodiments of the invention devices and methods corresponding to the scope of each of these phrases. Thus, a device or method comprising recited elements or steps contemplates particular embodiments in which the device or method consists essentially of or consists of those elements or steps.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the invention, the preferred methods and materials are now described.
The present invention is based on the finding that an intra-oral prosthesis can be used to correct facial features and/or oral function of a subject suffering from facial palsy. Thus, provided herein is a system for correcting facial features of a subject. The system includes one or more intra-oral appliances, which can be used simultaneously or individually by a subject to at least partially define the cavity in the vestibule of the subject's mouth. In one embodiment, the system includes two or more intra-oral appliances. In another embodiment, the system includes three or more intra-oral appliances, which hereinafter will be referred to as Appliance A, Appliance B, and Appliance C, as discussed below.
Each of Appliances A-C are custom fit to each subject by making a mold or dental impression of the upper and lower teeth and palate. The appliances are then made using any of commonly used biocompatible dental materials such as, but not limited to, polyurethane, polycarbonate, heat- or cold-cured acrylics, fibered acrylic plastic, thermoplastic polyurethane, flexible polymers, any suitable chemically activated or light activated materials that cure to solid form, or any combination thereof. Thus, suitable biocompatible dental plastics from which Appliances A-C may be made include, but are not limited to, thermoplastics, polyethylene, polystyrene, polyvinyl chloride, polytetrafluoroethylene, acrylics, polyesters, silicones, polyurethanes, and/or halogenated plastics or the like. In various embodiments, Appliances A-C may molded or laminated from multiple layers of one or more of the biocompatible dental materials, depending on the needs of the user. In other embodiments, Appliances A-C may have a solid core, such as a biocompatible metal, surrounded by the one or more biocompatible dental materials. In yet other embodiments, the materials from which Appliances A-C may be made, can be clear or colored, depending on the needs of the user. In one embodiment, any or all of Appliances A-C are made from ethylene vinyl acetate, either alone or in combination with any other biocompatible dental material.
Referring now to
As used herein, the term “gingiva” refers to the gums of a subject. As used herein, the term “buccal” is used to refer to the cheek or sides of the mouth. Thus, the term “gingival-buccal area” of a subject refers to the area within a subject's mouth that is defined by the gums and the cheek.
As used herein, the term “labium” refers to the lip of a subject. Thus, the term “gingivolabial area” refers to the area within a subject's mouth that is defined by the gums and the inner surface of the lips.
As used herein, the term “vestibule” refers any of various cavities or hollows within the mouth of subject. Thus, the term “vestibular area” is used to refer to any cavity or hollow within the subject's mouth that is located within the gingival-buccal areas and/or the gingivolabial areas of the mouth.
Referring now to
In most instances, body 22 is held in place by engagement with the upper teeth and anterior palate of the subject. However, in certain embodiments, body 22 can have one or more posterior lingual/palatal clasps (not shown), which are usually made of stainless steel, for engaging one or more of the subject's teeth. It should be understood that any of the intra-oral clasps known in the art for dental appliances may be integrated into body 22 for additional security of the device when worn by the subject. Exemplary clasps include, but are not limited to c-clasps, which are placed over and surround a molar, ball clasps, which are placed between teeth and have a ball on the gingival side for securing the appliance in place, and Adams' clasps, which are formed wire clasps of modified arrowhead design using the buccomesial and distoproximal undercuts of a tooth for retention.
Referring now to
In various embodiments, body 32 is held in place by one or more posterior lingual/palatal clasps 36 and 38 (as shown in
It should be understood that Appliance A and Appliance B are not intended to be worn simultaneously by the subject. When a subject is prescribed or otherwise obtains a system in which both Appliance A and Appliance B are provided, the subject may select the Appliance that best suit's the needs of the user. For example, the subject may find that Appliance A is more comfortable for daily usage, but Appliance B is preferable for social occasions because it is less noticeable and more natural looking when worn.
Referring now to
In various embodiments, body 42 is held in place by one or more posterior lingual clasps 46 and 48 (shown in
When a subject is prescribed or otherwise obtains a system in which Appliances A, B and C are provided, the subject may select any combination of Appliances that best suit's the needs of the user. For example, the subject may find that Appliance A in combination with Appliance C sufficiently corrects facial features and oral function for daily usage, but Appliance B in combination with Appliance C is preferable for social occasions because, as indicated above, Appliance B is less noticeable and more natural looking when worn than Appliance A.
Accordingly, in another aspect, the invention provides a method for correcting facial features and oral function of a subject. The method includes fitting a subject in need thereof with one or more of the intra-oral appliance defined above. As used herein, the term “subject” refers to any individual or patient to which the subject methods are performed. Generally the subject is human, although as will be appreciated by those in the art, the subject may be an animal that is used as a model for facial palsy. Thus other animals, including mammals such as rodents (including mice, rats, hamsters and guinea pigs), cats, dogs, rabbits, farm animals including cows, horses, goats, sheep, pigs, etc., and primates (including monkeys, chimpanzees, orangutans and gorillas) are included within the definition of subject.
Various forms of paralysis or weakness of the unilateral or bilateral facial muscles have been caused by injury to the facial nerve, viral infection, bacterial infection, nerve trauma, vascular etiologies, parotidectomy, stroke, brain surgery, aging, and trauma etiologies. Thus, subjects upon which the methods of the invention may be performed include, but are not limited to, those suffering from facial paralysis or defect. Such facial paralysis or defect may result from any one or more of brain surgery, glioma, brain injury, facial or dental surgery, Bell's Palsy, neuro-injuries, aging, stroke or disease.
In addition, as humans age, the natural facial muscle tone and/or skin tension lessens, thereby resulting in a slight (or in some cases severe) drooping of the cheek. Thus, the methods provided herein find use in correcting facial features of older subjects who do not have facial palsy.
In all instances, the definition of the upper and/or lower vestibule by the one or more extensions of the appliance bodies described herein, serve to plump or otherwise lift and/or stretch the cheek tissue along the mandibular jaw and gingival ridge. This results in a straightening of the lip line, balancing of a slacked facial aspect, and improving oral function of the subject. Thus, the systems and intra-oral appliances described herein serve to treat oral dysfunction, physical affect, and psychological perception of self in a subject having facial palsy. Abnormal speech, if present, is aided in that any air that is trapped and/or bubbling within the upper and/or lower vestibules between the cheek and the gingiva on the afflicted side of the face is reduced by filling the void from lost muscle tension and allowing the air to flow over the tongue instead of being redirected to the collapsed vestibule. In addition, mastication of food is improved by preventing the pocketing of food particles in the vestibule of the cheek. A more natural contour of the vestibule aids in the downward drainage of saliva to the occlusal surface of the mandibular arch, aiding the elimination of oral fluids from the mouth. In certain subjects, the pooling of saliva can cause irritation of the gingival firm tissue, thereby causing sores on the lips and corners of the mouth.
Although the invention has been described with reference to the above appliances, it will be understood that modifications and variations are encompassed within the spirit and scope of the invention. Accordingly, the invention is limited only by the following claims.
| Number | Name | Date | Kind |
|---|---|---|---|
| 7861724 | Keropian | Jan 2011 | B2 |
| 7878802 | Hagelganz et al. | Feb 2011 | B2 |
| 7890193 | Tingey | Feb 2011 | B2 |
| 7905724 | Kuo et al. | Mar 2011 | B2 |
| 7971591 | Jansheski | Jul 2011 | B2 |
| 8444412 | Baughman et al. | May 2013 | B2 |
| 20030023313 | Byers | Jan 2003 | A1 |
| 20030207224 | Lotte | Nov 2003 | A1 |
| 20050126579 | Benja-Athon | Jun 2005 | A1 |
| 20060018844 | Katz | Jan 2006 | A1 |
| 20060172262 | Bruce | Aug 2006 | A1 |
| 20070037120 | Ritter | Feb 2007 | A1 |
| 20100075268 | Duran Von Arx | Mar 2010 | A1 |
| 20120270173 | Pumphrey et al. | Oct 2012 | A1 |
| Number | Date | Country | |
|---|---|---|---|
| 20130071801 A1 | Mar 2013 | US |
