Introduction: In patients with maxillary deficiency, facemask treatment for growing patients has been used throughout much of history to move the maxilla both forwards and downwards. The recommended wearing time of a face mask is usually longer than 14 h in a day.

Objective: Patient's cooperation and 300-400 gm. consistent force are essential for the treatment outcome. However, no attempt has been made to measure the force applied against the reverse full headgear in real time. The objective of this study is how to analyze patients wearing time and the amount of force in real time, utilizing the internet of things (IOT).

Materials & Methods: “Real time facemask” composes of Load Cell Weight Sensor (AD Module ESU) connected to the facemask, Arduino Force Sensor Circuit, MIT App Inventor, Google Firebase. The doctor and the patients can assess the cloud-based wearing time and analytics.

Results: Utilizing face masks and IOT technology, we were able to detect whether and how much weight (0 to 1000 g) was being applied to a face mask in real time with thirty seconds interval.

Conclusion: We suggested an IOT based tractable system for a facemask. This workflow can be widely applicable to any removable appliances in the future. Collected data will provide a comprehensive understanding of optimal force and timing for the treatment.

Keywords: Maxillary deficiency, Facemask, Real time, The internet of things, MIT App Inventor

Abbreviations: IOT: Internet of things; MIT: Massachusetts Institute of Technology; App: Application

INTRODUCTION

The maxilla articulates with nine other bones, these being the frontal cranial and the ethnocide, as well as the “nasal, zygomatic, lacrimal, inferior nasal concha, palatine, vomer, and the adjacent fused maxilla.” It is connected to other bones above through sutures (Figure 1).

In growing children, the maxilla departs from circummaxillary sutures when facemask treatment is applied [1]. Facemasks, also called reverse-pull headgear, have been used throughout much of history to move the maxilla both forwards and downwards in patients with midfacial deficiencies [2]. The clinical application of a facemask is depicted in Figure 2.

The best treatment timing for growing patients is still controversial, and the correlation between cooperation and age is one of the most confounding variables [3-5].

The recommended wearing time of a facemask is usually longer than 14 h in a day [6,7], but this is completely dependent on the cooperation of the patient. It has been reported that received compliance is insufficient [8,9]. A previous study suggested to measure the wearing time using TheraMon chip technology used sensors that collected the data of wearing time and temperature. It was placed on the forehead of the patient [10].

However, to our knowledge, no attempt has been made to measure the force applied against the reverse full headgear in real time. Since the suggested force for facemasks lies around 300 to 400 g, to keep the force consistent, especially during sleep, seems critical for the outcome, yet difficult to do so. To overcome the complications in this process, we used Internet of Things (IOT) technology and transferred the collected data onto their own phone in real time to be used as an asset. This data could be used to create an entirely new system to analzye the data procured by facemasks to personalize assistance for each patient.

We suggested an IOT based tractable system for a facemask. This workflow can be widely applicable to any removable appliances in the future. Collected data will provide a comprehensive understanding of optimal force and timing for the treatment.

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