Surgery – Body protecting or restraining devices for patients or infants – Head or face protector
Reexamination Certificate
2002-05-07
2004-09-21
Brown, Michael A. (Department: 3764)
Surgery
Body protecting or restraining devices for patients or infants
Head or face protector
C128S861000
Reexamination Certificate
active
06792952
ABSTRACT:
CROSS-REFERENCE TO RELATED APPLICATION
Not applicable.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
Not applicable.
Reference to a “Computer Listing Appendix Submitted on a Compact Disc”
Not applicable.
BACKGROUND OF THE INVENTION
(1) Field of the Invention
The present invention relates to a method for treating maxilla/cranial base to mandibular axis discrepancies in the temporomandibular joints (TMJs) of a patient such as is caused by mandibular, temporomandibular dysfunction syndrome (MTDS) or developmental facial/dental deformities without performing open jaw joint surgery. The method includes (1) repositioning the patient's mandible into a stable relationship with the cranial base using a craniomandibular orthopedic repositioning orthotic which over time deprograms the patient's jaw into the stable mandible to cranial base relationship; (2) constructing a model of the patient's mouth on an artificial jaw simulator which replicates the patient's jaw joint true hinge axis of rotation in the repositioned and stabilized mandible to cranial base relationship; (3) planning a surgical procedure comprising total maxillary osteotomy on the model which substantially treats the MTDS or developmental facial/dental deformities; and (4) performing the surgical procedure on the patient based on the surgical procedure planned on the model to treat the discrepancies.
(2) Description of Related Art
The surgical treatment of mandibular, temporomandibular dysfunction syndrome (MTDS) or developmental facial/dental deformities traditionally has centered on surgical manipulation of the jaw joint structural components: disc, ligaments, and tendons using open arthrotomy, arthroscopy, or partial or total jaw joint replacement. The fundamentals of oral and maxillofacial surgical procedures are standard and have been described in many texts on surgical techniques. For example, see
Atlas of Oral and Maxillofacial Surgery
(Keith ed., W. B. Saunders Company, Philadelphia, (1992) pp. 201-216). In general, these surgical procedures are performed with the jaw joints in an acquired bite or position of maximum intercuspation of the teeth without reference to the relationship of each mandibular condyle to its socket of the glenoid fossa and without any attempt to place each mandibular condyle in any stable, verifiable, and reproducible position in its socket of the glenoid fossa. Furthermore, the surgical procedures for treating MTDS or developmental facial/dental deformities are not generally planned on a model of the patient's jaw joint in which the model has replicated the patient's true hinge axis of rotation in the stable condylar position. Because the mandible condyles are not stably positioned within their sockets, the mandible to cranial base relationship remains unstable. Therefore, following a standard surgery for treating MTDS or developmental facial/dental deformities, the unstable relationship between the mandible and cranial base over time tends to develop into MTDS. As long as the relationship between the mandible and cranial base remains unaddressed in the standard surgical treatments for MTDS or developmental facial/dental deformities, the unstable relationship will remain and most likely render the surgical treatment merely temporary in effect.
Therefore, there is a need for a surgical method for treating MTDS or developmental facial/dental deformities in a patient wherein the method restores a functional bite to the patient while maintaining the patient's jaw joint in its stable condylar position. In particular, there is a need for a method wherein the surgery to treat the MTDS or the developmental facial/dental deformities is planned on a model which replicate's the patient's true hinge axis of rotation in which the mandibular condyles are in a stable condylar position.
SUMMARY OF THE INVENTION
The present invention provides a method for treating maxilla/cranial base to mandibular axis discrepancies in the temporomandibular joints (TMJs) of a patient such as is caused by mandibular, temporomandibular dysfunction syndrome (MTDS) or developmental facial/dental deformities without performing open jaw joint surgery. The method includes (1) repositioning the patient's mandible into a stable relationship with the cranial base using a craniomandibular orthopedic repositioning orthotic which over time deprograms the patient's jaw into the stable mandible to cranial base relationship; (2) constructing a model of the patient's mouth on an artificial jaw simulator which replicates the patient's jaw joint true hinge axis of rotation in the repositioned and stabilized mandible to cranial base relationship; (3) planning a surgical procedure comprising total maxillary osteotomy on the model which substantially treats the MTDS or developmental facial/dental deformities; and (4) performing the surgical procedure on the patient based on the surgical procedure planned on the model to treat the discrepancies.
Therefore, the present invention provides a method for treating maxilla/cranial base to mandibular axis discrepancies in the temporomandibular joints of a patient comprising (a) fitting an orthotic to the maxillary teeth of the patient so as to allow full coverage of all the maxillary teeth, wherein the orthotic has an anterior ramp to provide anterior guidance of the patient's mandible in excursive movements by contact of the superior surface of the anterior mandibular teeth of the patient with a posterior surface of the anterior ramp of the orthotic so as to allow for complete disclusion of the posterior mandibular teeth of the patient from the orthotic during eccentric jaw movements which over time deprograms the temporomandibular joints of the patient into a stable condylar position by stabilizing the condyles in their corresponding glenoid fossa sockets in the maxilla/cranial base;
(b) determining alignment of the mandible to the maxilla/cranial base in the temporomandibular joints of the patient after each condyle has been stabilized in its corresponding glenoid fossa socket by the orthotic;
(c) constructing a model of an upper dental arch of the patient with a base, which is parallel on all sides to the upper dental arch model and is delineated with horizontal and vertical reference lines, and a model of a lower dental arch of the patient with a base, which is parallel on all sides to the lower dental arch model and is delineated with horizontal and vertical reference lines;
(d) mounting the base of the upper dental arch to an upper plate with mounting stone of an artificial jaw simulator and mounting the base of the lower dental arch to a lower plate with mounting stone of the artificial jaw simulator such that the true axis of rotation of the temporomandibular joints of the patient with the temporomandibular joints in the stable condylar position has been maintained and wherein the sides of each base are parallel and confluent to the artificial jaw simulator mounting plates;
(e) determining on the artificial jaw simulator mounted with the upper and lower dental arch models an amount of maxillary bone to be removed from the patient's maxilla in a surgical procedure wherein the maxilla is cut along a transverse plane superior to the maxillary teeth to separate the maxilla into an upper and a lower part which is sufficient to allow a jaw position in the patient when the upper and lower parts are joined after the amount of maxillary bone has been removed wherein the maxillary and mandibular teeth of the patient are re-approximated into a position coincidental to the stabilized jaw joint position with a functional bite wherein the anterior maxillary teeth provide anterior guidance of the mandible in excursive movements by contact of the lingual surface of the anterior maxillary teeth with the superior surface of the mandibular anterior teeth while allowing complete disclusion of the posterior maxillary and mandibular teeth during eccentric jaw movements and which at the same time maintains the temporomand
Brown Michael A.
McLeod Ian C.
LandOfFree
Method and device for treatment of temporomandibular... does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Method and device for treatment of temporomandibular..., we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Method and device for treatment of temporomandibular... will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-3190523