Patent Publication Number: US-11642238-B2

Title: Mandibular protrusion device

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a continuation of U.S. application Ser. No. 16/509,538 filed Jul. 12, 2019, which is a continuation of U.S. application Ser. No. 14/430,568, which is the U.S. national phase of PCT/CA2013/050726 filed Sep. 24, 2013, which claims the benefit under 35 U.S.C. § 119 of Canadian patent application Serial No. 2,791,139, filed Sep. 24, 2012, the entire respective disclosures of which are incorporated herein by reference. 
    
    
     TECHNICAL FIELD OF THE INVENTION 
     The technical field relates to mandibular protrusion devices. More particularly, it relates to a mandibular protrusion device having a maxillary dental tray connected to a mandibular dental tray by lateral links providing an articulation therebetween. 
     BACKGROUND 
     It is known in the art to use dental appliances for the treatment of snoring and sleep apnea. For example and without being limitative, the dental appliances can be intraoral orthoses which prevent the mandible from moving posteriorly during sleep. 
     One type of known intraoral orthosis includes two dental trays (or bite forms) joined together so that the user&#39;s mandible projects forwardly from its normal position and thereby helps reducing snoring and sleep apnea. In such an orthosis, the dental trays are connected to one another through two lateral links which are configured to advance the user&#39;s mandible during a vertical movement between the maxilla and the mandible. In some embodiments, for connection to the dental trays corresponding to the maxilla or the mandible, the lateral links have a protrusion inserted in a through hole of the dental trays. 
     One of the common drawbacks of known intraoral orthoses is that the lateral links often disconnect from the dental tray to which they are engaged, when the intraoral orthosis is being manipulated. In such cases, the user must spend time to reconnect the disconnected lateral link to its respective dental tray. 
     In view of the above, there is a need for an improved mandibular protrusion device which, by virtue of its design and components, would be able to overcome or at least minimize some of the above-discussed prior art concerns. 
     BRIEF SUMMARY OF THE INVENTION 
     According to a first general aspect, there is provided a mandibular protrusion device which comprises a maxillary dental tray, a mandibular dental tray and at least two lateral links. Each one of the lateral links has a first end removably engageable with the maxillary dental tray and a second end removably engageable with the mandibular dental tray. The maxillary dental tray, mandibular dental tray and the lateral links have complementary male and female members configured to be engageable and disengageable from one another in at least one engagement/disengagement configuration that is not reached when the device is worn or in normal use. 
     In an embodiment, the engagement/disengagement configuration is a single configuration for each one of the at least two lateral links. 
     In an embodiment, each one of the complementary male and female members of the maxillary dental tray, mandibular dental tray and the at least two lateral links has a particular predetermined shape. The engagement/disengagement configuration is reached when the predetermined shape of the corresponding ones of the male and female members of the maxillary dental tray, mandibular dental tray and the at least two lateral links are aligned. 
     In an embodiment, the at least two lateral links include a right side lateral link and a left side lateral link. The engagement/disengagement configuration is different for the right side lateral link and the left side lateral link. 
     In an embodiment, the engagement/disengagement configuration of one of the right side lateral link and the left side lateral link is at about 200° and the engagement/disengagement configuration of the other one of the right side lateral link and the left side lateral link is at about 170° with respect to a configuration where the maxillary dental tray and the mandibular dental tray are superposed. 
     In an embodiment, the complementary male and female members of the maxillary dental tray, mandibular dental tray and the at least two lateral links are substantially L-shaped. 
     In an embodiment, each one of the male members includes a pivot portion rotatable into a corresponding complementary female member and connected to a substantially L-shaped enlarged head. 
     In an embodiment, the at least two lateral links include the male members and the maxillary dental tray and mandibular dental tray include the complementary female members. 
     In an embodiment, a first one of the male members protrude on a first side of the lateral links and a second one of the male members protrude on a second side of the lateral links. 
     In an embodiment, each one of the at least two lateral links is engageable with the mandibular dental tray by engaging the mandibular dental tray from an inner side towards an outer side of the mandibular dental tray and each one of the at least two lateral links is engageable with the maxillary dental tray by engaging the maxillary dental tray from an outer side towards an inner side of the maxillary dental tray. 
     In an embodiment, each one of the at least two lateral links has an elongated portion extending between the first end and the second end, the elongated portion having a curvature defined therein. 
     In an embodiment, each one of the at least two lateral links is thicker along sections of the elongated portion and towards the first end and the second end. 
     In an embodiment, each one of the at least two lateral links is narrower in a central section of the elongated portion than close to the first end and the second end. 
     In an embodiment, the mandibular dental tray is configured for engagement between the complementary male and female members of the at least two lateral links and the mandibular dental tray to occur above a contact plan between sections of the maxillary dental tray and the mandibular dental tray. 
     In an embodiment, the mandibular dental tray is configured for engagement between the complementary male and female members of the at least two lateral links and the mandibular dental tray to occur above an upper section of a wall of the mandibular dental tray. 
     In an embodiment, the lateral links are engageable with the mandibular dental tray in posterior sections thereof and forwardly thereof with the maxillary dental tray. 
     According to another general aspect, there is also provided a mandibular protrusion device comprising a maxillary dental tray, a mandibular dental tray and at least two lateral links removably engageable to the maxillary dental tray and the mandibular dental tray. The mandibular protrusion device is configurable between a plurality of operative configurations reached when the device is worn or in normal use and a non-operative configuration distinct from the plurality of operative configurations. The at least two lateral links are engageable and disengageable from the maxillary dental tray and the mandibular dental tray only when the mandibular protrusion device is configured in the non-operative configuration. 
     In an embodiment, the non-operative configuration ranges between 90° and 270° with respect to a configuration where the maxillary dental tray and the mandibular dental tray are superposed. 
     In an embodiment, the non-operative configuration comprises a single engagement/disengagement configuration for each one of the at least two lateral links. Each one of the at least two lateral links is engageable and disengageable from the maxillary dental tray and the mandibular dental tray only in its engagement/disengagement configuration. 
     In an embodiment, the at least two lateral links, the maxillary dental tray and mandibular dental tray include removably engageable complementary male and female members having a particular predetermined shape, the engagement/disengagement configuration being reached when the predetermined shape of the corresponding ones of the male and female members of the maxillary dental tray, mandibular dental tray and the at least two lateral links are aligned. 
     In an embodiment, the complementary male and female members of the maxillary dental tray, mandibular dental tray and the at least two lateral links are substantially L-shaped. 
     In an embodiment, each one of the male members includes a pivot portion rotatable into a corresponding complementary female member and connected to a substantially L-shaped enlarged head. 
     In an embodiment, the at least two lateral links include the male members and the maxillary dental tray and mandibular dental tray include the complementary female members. 
     In an embodiment, a first one of the male members protrude on a first side of the lateral links and a second one of the male members protrude on a second side of the lateral links. 
     In an embodiment, the at least two lateral links include a right side lateral link and a left side lateral link. The engagement/disengagement configuration is different for the right side lateral link and the left side lateral link. 
     In an embodiment, the engagement/disengagement configuration of one of the right side lateral link and the left side lateral link is at about 200° and the engagement/disengagement configuration of the other one of the right side lateral link and the left side lateral link is at about 170° with respect to a configuration wherein the maxillary dental tray and the mandibular dental tray are superposed. 
     In an embodiment, each one of the at least two lateral links is engageable with the mandibular dental tray by engaging the mandibular dental tray from an inner side towards an outer side of the mandibular dental tray and each one of the at least two lateral links is engageable with the maxillary dental tray by engaging the maxillary dental tray from an outer side towards an inner side of the maxillary dental tray. 
     In an embodiment, each one of the at least two lateral links has an elongated portion extending between a first end and a second end, the elongated portion having a curvature defined therein. 
     In an embodiment, each one of the at least two lateral links is thicker along sections of the elongated portion and towards the first end and the second end. 
     In an embodiment, each one of the at least two lateral links is narrower in a central section of the elongated portion than close to the first end and the second end. 
     In an embodiment, the mandibular dental tray is configured for the engagement between the at least two lateral links and the mandibular dental tray to occur above a contact plan between sections of the maxillary dental tray and the mandibular dental tray. 
     In an embodiment, the mandibular dental tray is configured for the engagement between the at least two lateral links and the mandibular dental tray to occur above an upper section of a wall of the mandibular dental tray. 
     In an embodiment, the lateral links are engageable with the mandibular dental tray in posterior sections thereof and forwardly thereof with the maxillary dental tray. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Other objects, advantages and features will become more apparent upon reading the following non-restrictive description of embodiments thereof, given for the purpose of exemplification only, with reference to the accompanying drawings in which: 
         FIG.  1    is a front perspective view of a mandibular protrusion device in accordance with an embodiment; 
         FIG.  2    is a front elevation view of the mandibular protrusion device shown in  FIG.  1   ; 
         FIG.  3    is a top plan view of the mandibular protrusion device shown in  FIG.  1   ; 
         FIG.  4    is a rear perspective view of the mandibular protrusion device shown in  FIG.  1   ; 
         FIG.  5    is a perspective view of a lateral link of the mandibular protrusion device shown in  FIG.  1   ; 
         FIG.  6    is a perspective view of a lateral link of a mandibular protrusion device according to an embodiment where the lateral link is thicker along sections of the elongated portion and towards ends thereof; 
         FIG.  7    is a perspective view of a lateral link of a mandibular protrusion device according to an embodiment where the lateral link is narrower in the central section of the elongated portion; 
         FIG.  8    is a front perspective view of the mandibular protrusion device shown in  FIG.  1   , wherein the mandibular protrusion device is in an inoperative configuration and one of the lateral links is detached from the dental trays; 
         FIG.  9    is a side elevation view of the mandibular protrusion device shown in  FIG.  1   , wherein the mandibular protrusion device is in an inoperative configuration and one of the lateral links is configured to be engaged with the dental trays; 
         FIG.  10    is a perspective view, enlarged, of a rear end of the lateral link shown in  FIG.  5   , engaged with the mandibular dental tray; 
         FIG.  11    is a perspective view of the mandibular protrusion device shown in  FIG.  1   , wherein the mandibular dental tray and the maxillary dental tray are configured in an engagement/disengagement configuration for a right side lateral link; 
         FIG.  12    is a perspective view, enlarged, of the mandibular protrusion device showing the lateral link when the mandibular dental tray and the maxillary dental tray are configured in the engagement/disengagement configuration for the right side lateral link; 
         FIG.  13    is a perspective view of the mandibular protrusion device shown in  FIG.  1   , wherein the mandibular dental tray and the maxillary dental tray are configured in an engagement/disengagement configuration and the left side lateral link is positioned in its engagement/disengagement configuration; 
         FIG.  14    is a perspective view, enlarged, of a right side of the mandibular protrusion device shown in  FIG.  1   , without the lateral links; and 
         FIG.  15    is a perspective view, enlarged, of a left side of the mandibular protrusion device shown in  FIG.  1   , without the lateral links. 
     
    
    
     DETAILED DESCRIPTION 
     In the following description, the same numerical references refer to similar elements. The embodiments, geometrical configurations, materials mentioned and/or dimensions shown in the figures or described in the present description are embodiments only, given solely for exemplification purposes. 
     Moreover, although the embodiments of the mandibular protrusion device and corresponding parts thereof consist of certain geometrical configurations as explained and illustrated herein, not all of these components and geometries are essential to the invention and thus should not be taken in their restrictive sense. It is to be understood, as also apparent to a person skilled in the art, that other suitable components and cooperation thereinbetween, as well as other suitable geometrical configurations, may be used for the mandibular protrusion device, as will be briefly explained herein and as can be easily inferred herefrom by a person skilled in the art. Moreover, it will be appreciated that positional descriptions such as “above”, “below”, “left”, “right” and the like should, unless otherwise indicated, be taken in the context of the figures and should not be considered limiting. 
     Referring now to the drawings and, more particularly referring to  FIGS.  1  to  4   , there is shown a mandibular protrusion device (or intraoral orthosis)  20  in accordance with an embodiment. The mandibular protrusion device  20  includes two dental trays (or bite forms) and, more particularly a maxillary dental tray  22  (or upper dental tray) to be placed onto the user&#39;s maxilla and a mandibular dental tray  24  (or lower dental tray) to be placed onto the user&#39;s mandible. Each one of the dental trays  22 ,  24  has a wall  26  and defines a U-shaped dentition receiving cavity  28 , which, in an embodiment, reflects the dentition of the intended user of the device  20 . Each one of the dental trays is substantially U-shaped and has an anterior section  25  and two posterior sections  27  extending from opposite ends of the anterior section  25 . 
     In an embodiment, the mandibular dental tray  24  has two flanges  30  extending upwardly from an outer side  31  of the wall  26  and located on opposite sides of the mandibular dental tray  24  in the posterior sections  27 , i.e. at a rear end thereof. Each one of the flanges  30  has a mandibular dental tray aperture  32  defined therethrough. In an embodiment, the mandibular dental tray aperture  32  is defined in a section of the flanges  30  which extends above an upper section  29  of the wall  26  in the posterior sections  27 . In an embodiment, the mandibular dental tray apertures  32  can be respectively located between teeth  34  to  38  and teeth  44  to  48  according to the FDI World Dental Federation notation. The mandibular dental tray apertures  32  are characterized by a predetermined shape, as will be described in more details below. 
     The maxillary dental tray  22  also has two maxillary dental tray apertures  34  defined therethrough. The maxillary dental tray apertures  34  are located on opposite sides of the maxillary dental tray  22  and extend through the outer side  31  of the wall  26 . The maxillary dental tray apertures  34  are located anteriorly of the mandibular dental tray apertures  32 , when the maxillary dental tray  22  and the mandibular dental tray  24  are superposed, in an operative configuration as will be described below. In an embodiment, the maxillary dental tray apertures  34  can be respectively located between teeth  12  to  16  and teeth  22  to  26  according to the FDI World Dental Federation notation. Similarly to the mandibular dental tray apertures  32 , the maxillary dental tray apertures  34  are characterized by a predetermined shape, as will also be described in more details below. 
     Referring to  FIGS.  1  to  7   , the mandibular protrusion device  20  also includes two lateral links  36  configured to pivotally connect the maxillary dental tray  22  and the mandibular dental tray  24  to one another. As shown in  FIGS.  5  to  7   , each one of the lateral links  36  has two ends  38 , defined at opposite ends of an elongated portion  39 . The ends  38  of the lateral links  36  also are engageable with a respective one of the maxillary dental tray  22  and the mandibular dental tray  24 . The maxillary dental tray  22 , the mandibular dental tray, and the lateral links  36  are configured such that when the lateral links  36  are connected to the dental trays  22 ,  24 , the user&#39;s mandible is moved forward. 
     The lateral links  36  are flexible members. As can be seen in  FIGS.  5  to  7   , the lateral links  36  could present different configurations. In the embodiment shown in  FIG.  5   , the lateral link  36  has a substantially uniform width and thickness. In the embodiment shown in  FIG.  6   , the lateral link  36  is characterized by an overall thicker profile than in the embodiment shown in  FIG.  5   , including thicker sections of the elongated portion  39  and thicker ends  38 . For instance, this lateral link  36  can be suitable for users experimenting high levels of bruxism. In the embodiment shown in  FIG.  7   , the lateral link  36  is narrower in a central portion of the elongated portion  39  than at the ends  38 . For instance, this lateral link  36  can be suitable for users having a weak jaw musculature. In all of the illustrated embodiments, the elongated portion  39  has a curvature defined therein, i.e. it is slightly curved, such as to better adapt to the morphology of the user and provide some resilience when stretched. However, it is appreciated that, in an alternative embodiment, the shape of the lateral links  36 , including their elongated portion  39  and their ends  38 , can vary from the embodiments shown. 
     Each one of the ends  38  of the lateral links  36  includes a pivot member  40  engageable with the mandibular dental tray apertures  32  and the maxillary dental tray apertures  34 . In the illustrated embodiment, a first pivot member  40   a  protrudes on a first side  36   a  and a second pivot member  40   b  protrudes on a second side  36   b  of each lateral link  36 . More particularly, the pivot members  40  have a pivot portion  42  and an enlarged head  44 . The shape of the enlarged heads  44  corresponds to the shape of the mandibular dental tray apertures  32  and the maxillary dental tray apertures  34  such as to be insertable therein. The pivot portion  42  is smaller in cross-section than the apertures  32 ,  34  in order to pivot freely therein. 
     In the embodiment shown, the mandibular dental tray apertures  32 , the maxillary dental tray apertures  34  and the enlarged heads  44  are substantially L-shaped. The pivot portions  42  are connected to their respective enlarged head  44  at the junction of the two arms of the L-shaped enlarged heads  44 . In the embodiment shown, the pivot portions  42  are cylindrical members with a substantially circular cross-section. One skilled in the art would understand that the mandibular dental tray apertures  32 , the maxillary dental tray apertures  34  and the enlarged heads  44  could also have other particular predetermined shape. 
     Thus, as shown in  FIGS.  8  and  9   , the enlarged heads  44  can be inserted into or disengaged from the dental tray apertures  32  and/or the maxillary dental tray apertures  34  in a single configuration, i.e. only in a configuration wherein the two arms of the “L” of the enlarged heads  44  are aligned (or “substantially in register”) with the two arms of the “L” of the mandibular dental tray apertures  32  and/or the maxillary dental tray apertures  34 . When the enlarged heads  44  are inserted in the mandibular dental tray apertures  32  and/or the maxillary dental tray apertures  34  and extend past the flanges  30  and/or the wall  26 , the lateral links  36  can freely pivot in the apertures  32 ,  34 . 
     Furthermore, in the embodiment shown, a first one of the arms of the L-shaped enlarged heads  44  extends substantially parallel to the elongated portion  39  of the lateral links  36 . Thus, the first arms of the L-shaped enlarged heads  44  of the lateral links  36  are oriented towards one another. The second ones of the arms of the L-shaped enlarged heads  44  of the lateral links  36  extends in the same direction and substantially perpendicularly to the first arms. 
     In the embodiment shown, the two lateral links  36  of the mandibular protrusion device  20  are identical. However, in an alternative embodiment, the two lateral links  36  of a device  20  could be different from one another. Moreover, the shape of the pivot portions  42  and/or the enlarged heads  44  can vary from the embodiment shown, provided that the shape of the enlarged heads  44  and the shape of the corresponding mandibular dental tray apertures  32  and/or maxillary dental tray apertures  34  are selected in a manner such that the enlarged heads  44  can be inserted into or disengaged from the apertures  32 ,  34  in a non-operative configuration. In an embodiment, the non-operative configuration in which the enlarged heads  44  can be inserted into or disengaged from the apertures  32 ,  34  is a single configuration. 
     Furthermore, in the embodiment shown, the pivot members  40  and the corresponding mandibular dental tray apertures  32  and maxillary dental tray apertures  34  all have the same shape. However, in an alternative embodiment, the pivot members  40  for the maxillary dental tray  22  could differ from the pivot members  40  for the mandibular dental tray  24 . Similarly, the pivot members  40  and the corresponding mandibular dental tray apertures  32  and maxillary dental tray apertures  34  of a left side of the mandibular protrusion device  20  could differ from the pivot members  40  and the corresponding mandibular dental tray apertures  32  and maxillary dental tray apertures  34  of a right side of the mandibular protrusion device  20 . 
     Still referring to the embodiment shown, and more particularly to  FIGS.  14  and  15   , when the maxillary dental tray  22  and the mandibular dental tray  24  are superposed the right side L-shaped mandibular dental tray aperture  32  is configured with a first one of the arms extending substantially downwardly and rearwardly and a second one of the arms extending substantially upwardly and rearwardly. The left side L-shaped mandibular dental tray aperture  32  is configured with a first one of the arms extending substantially downwardly and rearwardly and a second one of the arms extending substantially rearwardly and upwardly. The right side L-shaped maxillary dental tray aperture  34  is configured with a first one of the arms extending substantially upwardly and forwardly and a second one of the arms substantially extending downwardly and forwardly. The left side L-shaped maxillary dental tray aperture  34  is configured with a first one of the arms extending substantially forwardly and upwardly and a second one of the arms extending substantially downwardly and forwardly. 
     In the embodiment shown, the pivot members  40  of the lateral links  36  are engaged with the mandibular dental tray  24  by inserting the pivot members  40  from an inner side  46  towards an outer side  48  of the tray  24 . On the opposite, the pivot members  40  of the lateral links  36  are engaged with the maxillary dental tray  22  by inserting the pivot members  40  from the outer side  48  towards the inner side  46  of the tray  22 . It is appreciated that, in an alternative embodiment, the pivot members  40  of the lateral links  36  could be engaged with the mandibular dental tray  24  by inserting the pivot members  40  from the outer side  48  towards the inner side  46  of the tray  22 . For instance and without being limitative, this configuration could occur if the mandibular dental tray  24  is free of flanges  30  and the lateral links  36  are engaged directly with the mandibular dental tray  24 , as it is shown in the accompanying figures for the maxillary dental tray  22 . 
     Furthermore, in an implementation, the maxillary dental tray  22  can include flanges extending downwardly and the maxillary dental tray apertures  34  could be defined in the flanges. The pivot members  40  of the lateral links  36  could be engaged with the maxillary dental tray  22  by inserting the pivot members  40  from the inner side  46  towards the outer side  48  of the tray  22 . 
     In the embodiment shown, the mandibular dental tray apertures  32  and maxillary dental tray apertures  34  are positioned in a manner such that the elongated portion  39  of the lateral links  36  extend substantially horizontally when the maxillary dental tray  22  rests (or abuts) the mandibular dental tray  24 , i.e. the mandibular protrusion device is in the operative configuration, as shown in  FIGS.  1  to  4   . In an embodiment, the orientation of the lateral links  36  when the maxillary dental tray  22  rests (or abuts) the mandibular dental tray  24  is substantially parallel to a contact plan between the maxillary dental tray  22  and the mandibular dental tray  24  in the posterior sections  27 . 
     Referring to  FIGS.  8  to  13   , the mandibular dental tray apertures  32  and maxillary dental tray apertures  34  are also configured in a manner such that, in order to engage and disengage the lateral links  36  from the apertures  32 ,  34 , the maxillary dental tray  22  must be pivoted rearwardly from its operative position into an engagement/disengagement configuration. In the illustrated embodiment, the engagement/disengagement configuration for the left side lateral link is different than the engagement/disengagement configuration for the right side lateral link. As can be seen in  FIG.  13   , in the illustrated embodiment there is approximately a 30° offset between the engagement/disengagement configurations of the two lateral links  36 . The left side lateral link has an engagement/disengagement configuration at about 200° and the right side lateral link has an engagement/disengagement configuration at about 170°, with respect to the normal and operative configuration wherein the two trays  22 ,  24  are superposed. One skilled in the art will appreciate that, in an alternative embodiment, the engagement/disengagement configuration of the left side lateral link and the right side lateral link could be inverted. 
     Moreover, in an alternative embodiment the offset between the engagement/disengagement configurations of the two lateral links  36  could be smaller or greater than 30° and could range between 0° and 90°. For example and without being limitative, in an embodiment, the left side lateral link can have an engagement/disengagement configuration at about 225° and the right side lateral link can have an engagement/disengagement configuration at about 135°, with respect to the normal and operative configuration wherein the two trays  22 ,  24  are superposed. 
     It will be understood that, in another alternative embodiment, the engagement/disengagement configuration could be the same for the left side lateral link and the right side lateral link, i.e. there could be no offset between the engagement/disengagement configurations of the two lateral links  36 . For example and without being limitative, the maxillary dental tray  22  could be configured in a configuration wherein it is positioned behind and at the same height than the mandibular dental tray  24 , i.e. it is rotated rearwardly about 180° from the operative configuration, to be configured in the engagement/disengagement configuration. 
     The engagement/disengagement configuration wherein the enlarged heads  44  can be inserted into or disengaged from the mandibular dental tray apertures  32  and maxillary dental tray apertures  34  corresponds to a non-operative configuration, i.e. a configuration that is not reached when the device is worn or in normal use. As mentioned above, in the embodiment shown, the engagement/disengagement configuration corresponds to a configuration wherein the maxillary dental tray  22  is rotated rearwardly with respect to the mandibular dental tray  24 . For instance, the maxillary dental tray  22  can be rotated rearwardly between 90°, wherein the lateral links extend substantially vertically and upwardly from the mandibular dental tray  24 , and 270°, wherein the lateral links extend substantially vertically and downwardly from the mandibular dental tray  24 , from the operative configuration to be configured in the engagement/disengagement configuration. Furthermore, it corresponds to a configuration that cannot be reached during conventional washing operation of the mandibular protrusion device  20 . 
     In the operative configuration wherein the maxillary dental tray  22  and the mandibular dental tray  24  are superposed, the lateral links  36  are prevented from disengagement from the dental trays  22 ,  24  since the enlarged heads  44  are not aligned (or substantially in register) with their apertures  32 ,  34  as shown in  FIG.  10   . 
     In an alternative embodiment (not shown), the device  20  can have more than one engagement/disengagement configuration, i.e. the enlarged heads  44  can be inserted into or disengaged from the apertures  32 ,  34  in more than one configuration, provided that the configurations correspond to non-operative configurations, i.e. configurations that are not reached when the device is worn or in normal use. 
     In the embodiment shown, the dental trays  22 ,  24  include the female members, i.e. the mandibular dental tray apertures  32  and maxillary dental tray apertures  34 , in which the male members of the lateral links  36  are engageable, i.e. the pivot members  40 . In an alternative embodiment (not shown), the dental trays  22 ,  24  can include the male members, i.e. the pivot members which protrude outwardly therefrom, and the lateral links  36  can include the complementary female members, i.e. apertures defined therethrough. In this embodiment, the shape of the apertures can be a predetermined shape which corresponds to the predetermined shape of the pivot members and, more particularly, to the shape of an enlarged head thereof. The complementary male and female members can be configured and positioned in a manner such that they are engageable and disengageable from one another in one or several non-operative configurations, i.e. configurations that are not reached when the device is worn or in normal use. In an embodiment, the complementary male and female members can be engageable and disengageable from one another in a single configuration, which can be a configuration that is not reached when the device is worn or in normal use. 
     Several alternative embodiments and examples have been described and illustrated herein. The embodiments of the invention described above are intended to be exemplary only. A person of ordinary skill in the art would appreciate the features of the individual embodiments, and the possible combinations and variations of the components. A person of ordinary skill in the art would further appreciate that any of the embodiments could be provided in any combination with the other embodiments disclosed herein. It is understood that the invention may be embodied in other specific forms without departing from the spirit or central characteristics thereof. The present examples and embodiments, therefore, are to be considered in all respects as illustrative and not restrictive, and the invention is not to be limited to the details given herein. Accordingly, while the specific embodiments have been illustrated and described, numerous modifications come to mind without significantly departing from the spirit of the invention. The scope of the invention is therefore intended to be limited solely by the scope of the appended claims.