Dentistry – Orthodontics – Including extra-oral force transmitting means
Patent
1998-03-24
1999-11-09
Lewis, Ralph A.
Dentistry
Orthodontics
Including extra-oral force transmitting means
G04F 700
Patent
active
059802464
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
This application describes an electronic device that will both measure and enhance the compliance of young orthodontic patients with wearing an orthodontic headgear which is a common removable orthodontic appliance. Furthermore, this device will measure the duration and amount of force applied during headgear use which is information of clinical and scientific importance.
BACKGROUND
There are approximately 8,856 orthodontic specialists in the United States, as well as an unknown number of dentists who provide orthodontic services. A survey of the members of the American Association of Orthodontists (more than 90% of U.S. orthodontists are members of the AAO) indicated that 1,358,000 patients began orthodontic treatment in 1992. The mean cost of orthodontic treatment is estimated to be $3200 per child patient in the permanent dentition and $3500 per adult patient. Approximately, 77% of the new patients started in 1992 were under the age of 18. Few orthodontists would disagree that patient nonadherence is a challenging problem. In addition to its economic cost, nonadherence can result in protracted treatment and failure to achieve orthodontic correction. Complicating the task of the orthodontist is a lack of objective information about the degree to which patients are actually complying with the prescribed regimen (e.g., headgear use). One recent survey of orthodontists found that 80% of the respondents said that they had no particular method for assessing adherence.
In broad terms, orthodontic treatment goals are to provide patients with properly aligned teeth, a functional occlusion, and optimal facial aesthetics. An Angle Class II malocclusion occurs in 15 to 20% of U.S. children. This common condition occurs in both genders, is not related to socioeconomic status, and is rarely self-correcting. This type of malocclusion is diagnosed in the antero-posterior plane of space as a discrepancy between the positioning of the maxillary and mandibular dentitions. Specifically, the mandibular dentition is located more posteriorly than would be ideal relative to the maxillary dentition. Patients with this malocclusion (Angle Class II, division I) are typically described as having proclined or protrusive upper incisors, a retrusive lower jaw, and excess overjet. In all but the mild Class II patients, an underlying skeletal disharmony is present and is at least partially responsible for the spatial malrelations between the teeth. Consequently, a common treatment for this malocclusion involves the application of orthopedic forces in growing children to alter the relative growth pattern between the jaws, thus bringing them into proper alignment. This is most commonly accomplished by means of a headgear appliance which restrains the forward growth of the maxilla while allowing the forward growth of the mandible to continue unimpeded. A recent national survey reported that nine out of ten orthodontists use headgear appliances "routinely" or "occasionally" in the treatment of Class II malocclusions.
Orthodontic treatment frequently relies on the use of removable appliances to provide forces to teeth and bones in order to correct spatial malrelations between the teeth and/or jawbones. The removable nature of these appliances requires that patients (typically growing children) comply with the orthodontist's request to wear the device. Unfortunately, poor compliance is the rule rather than the exception with wearing removable orthodontic appliances. This generic problem is also pervasive in medicine (e.g., taking medications as prescribed).
Headgear appliances have been used since the nineteenth century. They are a removable type of orthodontic appliance that patients are typically advised to wear for 12-14 hours a day. A headgear consists of an inner metal bow that enters the mouth and attaches to the upper jaw by means of the maxillary first molars. Two arms extend from this inner bow to the outside of the mouth and then curve back along the outside of the cheeks and point toward the back of the head. A
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Barrett George A.
Prall Chris
Ramsay Douglas S.
Soma Mani
Lewis Ralph A.
The University of Washington
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