Craniofacial exoskeleton: cyborg realm or new age reality?

From the science fiction movies of the 80s to getting an FDA approval in 2018, exoskeletons have sure come a long way from being merely a subject of fantasy and wonder. Exoskeletons are electromechanical devices worn by a human operator and designed to increase physical performance of the wearer. Within the last few years, exoskeletons have been found to be of immense use in multiple aspects of healthcare. The most common being musculoskeletal rehabilitation post stroke/paresis/degenerative muscular diseases [1]. Static exoskeletons have also found use in form of 3D casts and stabilization splints in orthopaedics [2]. As the understanding and technological support is increasing, the niche for exoskeleton use increases manifold, every passing day.

Encountering an article recently on APOSEMA [3], a soft robotic mask that uses biometric sensors and an augmented reality digital layer to exaggerate and translate human expressions, our curiosity took a few leaps ahead to wonder how exoskeletons could turn abound the application of augmented physical power in craniofacial region.

The potential areas that could benefit from craniofacial exoskeleton are static/3D exoskeletons for jaw immobilization in cases of fractures. Another area of interest could be powered exoskeleton for jaw exercises and mobilization. Many patients lack compliance with these exercises despite adequate pain control. A powered exoskeleton with an inbuilt automated exercise protocol could obviate the need of compliance and avoid jerky painful mouth opening by existing devices. The assisted opening could be continuous and calibrated much more finely for patients requiring exercises like post-surgery oral submucous fibrosis, temporomandibular joint ankylosis, radiation fibrosis or paediatric patients. Selectively restrictive exoskeleton assisted opening devices could be used for non-surgical candidates of recurrent condylar dislocation. Similar exoskeleton devices with digital interface could be a boon for maxillofacial prosthetics requiring bionic eye/lip/nasal prosthesis. Another possible area could be powered exoskeleton assisted dentofacial orthopaedics, orthodontic tooth movements, palatal expansions and distraction osteogenesis.

The feasibility and application of exoskeletons in the unexplored niche of craniofacial region, whether static or powered, cannot be comprehended at present, but it is definitely much ahead of being a meagre cyborg realm fantasy.

Disclosure statement

No potential conflict of interest was reported by the author(s).