RU2554332C1 - Method of reducing weight by means of intra-oral devices - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine and can be used in case if it is necessary to reduce excessive weight in patients. For this purpose, passive fixation of upper and lower jaws to each other, completely excluding possibility of chewing food, is performed by means of intraoral devices. Passive fixation of jaws is provided due to levelling and connection of intra-oral devices with respect to each other without taking into account direction of growth and shape of teeth. For the period from 1 to 3 weeks feeding is performed only with liquid food. After 1-3 weeks fixation of jaws is removed and feeding with individually selected diet in combination with individually selected physical exercise is realised. Procedure of fixation is repeated until result is obtained. Method ensures effective and comfortable reduction f body weight in patients with obesity due to reduction of nutrition caloric intake by application of jaws fixation, completely preventing possibility of chewing solid food, without producing any effect on teeth, eliminating necessity of "correct" orthodontic fixation of applied devices, as well as due to application of additional complex of procedures.

EFFECT: increase of method efficiency.

7 cl, 24 dwg

Description

The invention relates to methods for reducing excess weight.

A variety of surgical methods for reducing obesity are known, which are mainly based on restricting the passage of food and / or absorption of nutrients.

However, surgical methods are quite traumatic and carry a certain risk to health and life.

Known methods of psychotherapeutic effects in conditions of asthenization, failure of biorhythms and behavioral stereotypes that alter the eating behavior of suggested persons (patent No. 2244569, IPC A61M 21/00).

Known methods of weight correction using, including reducing the calorie content of food. For example, prescribe a low-calorie diet with a reduced calorie content of 1000 kcal in the first month, 1200 kcal in the second month, followed by bringing it to a value that corresponds to the norm of the body’s needs (patent No. 2264233, IPC A61M 21/00). Or, at the stage of dynamic observation, a hypocaloric diet with a low calorie content of 800 kcal is used for one month, in the second month - 1200 kcal, followed by bringing the calorie content to a value corresponding to the body’s need rate - 1800 kcal (patent No. 2427394, IPC A61M 21/00). Low-calorie diets are known: for example, Pevzner’s diet No. 8 (V. A. Oleneva. Clinical Nutrition for Obesity. A Guide to Clinical Nutrition edited by M. A. Samsonov and A. A. Pokrovsky. M .: Med., 1992. S.175-178), including a balanced amount of protein, vitamins and dietary fiber. There are also known methods of weight loss using the so-called "zero" or liquid diet in the form of liquid and jelly-like dishes that reduce the calorie intake of food and, accordingly, aimed at weight loss.

However, most of the known methods of weight correction and reducing excess body weight through diets and dietary restrictions are focused on people with strong motivation and will, which is not always the case.

Dental methods and devices are also known for correcting weight and reducing the oral cavity by reducing the volume of the oral cavity, and, consequently, reducing the amount of food taken and reducing calories consumed.

These include weight loss methods using resilient devices that attach to the mouth to inhibit but not completely prevent food intake, as described in U.S. Pat. Pat. Nos. 4,825,881 and 4,883,072.

There is also known a solution aimed at reducing chewing activity, thereby reducing food intake with a device installed next to one or more teeth, U.S. Pat. Nos. 4,727,867 (Knoderer).

A solution is known (US 4,344,424 Anti-eatingfacemask), according to which the user prevents food intake to reduce overweight by means of a face mask worn on the outer region of the mouth and chin. The mask is designed in such a way that prevents food from entering the mouth and swallowing it, but does not interfere with the user's speech and breathing, and is fixed on the user's head using a strap system.

A device for limiting the opening of the mouth (RF patent No. 2212207, IPC A61C 7/36, A61F 5/00) containing fixing elements that are made in the form of metal orthodontic crowns on the first molars of the upper and lower jaws. To the vestibular surface of the locking elements are soldered elements for mounting the limiter movement. The fastening elements are made in the form of loops of steel wire and are bent in the form of locks for snapping the motion limiter in the direction of the transitional fold. The movement limiter is in the form of a ring of elastic material reinforced with a metal cable.

There is a method of reducing and controlling weight using an intraoral device (Oralapplianceandmethodforuseinweightlossandcontrol), adopted for the prototype of the proposed method, proposed in patent US 2003075186. This solution is intended to slow down the process of food absorption and, thereby, accelerate the sensation of satiety. To this end, a device consisting of lower and upper parts is fixed on the upper and lower teeth, and the two parts are connected by a flexible element, with the help of which the width of the mouth opening and the movement of the lower jaw are limited. Thus, they slow down the chewing process, reduce the amount of food consumed, while maintaining the possibility of speech activity.

However, when using this method and device, forces arise, aimed at the extraction (pulling) of the tooth.

Known methods for tooth splinting wire, preventing the opening of the upper and lower jaws, but designed to treat injuries of the maxillofacial region and used in surgical dentistry.

Thus, the tire for the treatment of fractures of the lower jaw according to patent No. 108953 (IPC A61C 7/36), contains a basis made in the form of a mandibular plate with fixation means, with immobilizing wire hook loops, with plastic, vertical, occlusal planes and ion-plasma nitride titanium coating which is installed on the lower jaw. A standard Vasiliev bus with hook loops with ion-plasma nitride-titanium-hafnium coating is fixed to the upper jaw. When closing the mouth, plastic vertical occlusal planes create compression immobilization of the broken lower jaw. Wire hook loops on the mandibular plate and hook loops on Vasiliev’s splint fixed on the upper jaw are connected by rubber rings.

The disadvantage of these solutions is the complexity of the method and the bulkiness of the devices used, their lack of aesthetics, the complexity of installation, removal and use. In addition, these methods and devices do not allow the user to maintain the usual quality of life, as they interfere with speech activity, create constant discomfort, irritating the oral mucosa, and affect teeth and soft tissues.

The inventive method solves the problem of reducing excess weight, ensuring the achievement of a technical result, which consists in reducing the calorie intake. The technical result consists in the complete exclusion of the possibility of taking solid food by fixing the upper and lower jaws in a closed position, while maintaining a comfortable quality of human life due to the passive way of fixing the device to the teeth, eliminating the active effect on the teeth and soft tissues.

The problem is solved in that in the method of weight loss, including reducing calorie intake, according to the claimed solution, only liquid food is fed for a period of 1 to 3 weeks, for which passive fixation of the upper and lower jaws is carried out by means of intraoral fixation devices, eliminating the possibility chewing food, and passive fixation of the jaws is ensured by alignment and connection of intraoral devices relative to each other without taking into account the direction of growth and shape teeth then, after 1-3 weeks, the jaws are removed, the diet is individually adjusted in combination with individually selected physical activities, if necessary, the fixation procedure is repeated until the result is achieved.

In this case, the intraoral devices are connected and aligned with each other using the power wire and intermaxillary fixation elements, and the power wire is attached to the intraoral devices through openings made either directly in the intraoral devices or in fastening elements made in the form of plastic attached to them or metal tubes. As elements of intermaxillary fixation, a metallized thread and / or wire lock made in the form of a U-shaped wire bracket are used. Intraoral devices are connected by intermaxillary fixation elements in pairs, or crosswise, or zigzag, or in a circular pattern. As intraoral passive fixation devices, dental devices made on the basis of buccal tubes, or braces, or mouthguards are selected. Before fixing the jaws, a preliminary diagnosis of the patient is carried out to select the type of passive fixation device and the method of intermaxillary attachment, as well as to determine the fixation time of the lower and upper jaws and exclude solid food. In urgent cases, the jaw fixation is removed by cutting a metallized thread or opening a wire lock.

The claimed solution is illustrated by the drawings, which show: in Fig. 1, a fixing device based on buccal tubes with a circular pattern of fastening the intermaxillary filament along the internal openings of the buccal tubes; figure 2 - fixing device on the basis of buccal tubes with a circular pattern of fastening of the intermaxillary filament along the external holes of the buccal tubes; figure 3 is a fixing device based on buccal tubes with a pairwise scheme of fastening of the intermaxillary thread; figure 4 is a fixing device based on buccal tubes with a cross-shaped fastening scheme of the intermaxillary thread; figure 5 - fixing device on the basis of buccal tubes with a zigzag attachment pattern of the intermaxillary thread; Fig.6 is a fixing device based on buccal tubes with a pairwise mounting scheme of a wire lock; Fig.7 is a fixing device based on buccal tubes with a cross mounting scheme of a wire lock; on Fig - fixing device based on braces with a circular pattern of fastening of the intermaxillary thread; figure 9 is a fixing device based on braces with a pairwise scheme for fastening the intermaxillary thread; figure 10 - fixing device based on braces with a cross pattern of fastening of the intermaxillary thread; figure 11 - fixing device based on braces with a zigzag pattern for fastening the intermaxillary thread; on Fig - fixing device based on brackets with a pairwise scheme for attaching a wire lock; in Fig.13 - a fixing device based on brackets with a cross mounting scheme of a wire lock; on Fig - a locking device based on buccal tubes and braces with a combined scheme for fastening the intermaxillary thread and wire lock; on Fig - view of the bracket side and top; Fig.16 is a side view of the buccal tube and top; on Fig - locking device based on the mouthguard with intermaxillary locking in the form of wire locks; on Fig - fixing device based on mouthguards with intermaxillary locking in the form of a combination of wire lock and plastic tube; on Fig - fixing device based on the mouthguard with the intermaxillary fixation in the form of a combination of intermaxillary thread with a plastic tube; on Fig - fixing device based on the mouthguard with an intermaxillary lock in the form of an intermaxillary thread; Fig.21 is a view of the mouthguard with a tooth retainer.

The positions in the figures indicated:

1 - buccal tube with holes 1A, 1B, 1B and 1G,

1a, 1b - the outer holes of the buccal tube 1,

1c, 1d - internal holes of the buccal tube 1,

2 - power wire for load distribution between the teeth,

3 - intermaxillary fixation thread (ligature),

4 - the node of the thread of the maxillary fixation (ligature),

5 - bracket

6 - wire lock,

7 - groove in the bracket 5,

8 - wings of the bracket 5,

9 - the base of the bracket 5,

10 - the base of the buccal tube 1,

11 - holes of the buccal tube 1 on the upper jaw,

12 - holes of the buccal tube 1 on the lower jaw,

13 - kappa,

14 - a plastic tube on the tray 13,

15 - tooth retainer for mouthguards 13.

The claimed solution is also illustrated by photographs, which show: in Photo 1 - kappa in profile with a wire lock in plastic tubes; Photo 2 - kappa in profile with a thread of maxillary fixation; Photo 3 - buccal tube in profile with power wire and intermaxillary fixation thread.

The inventive method performs the task of reducing weight by passively fixing the jaws — without exerting any influence (traction, pressure) on the teeth — using intraoral devices based on various dental devices, such as buccal tubes, braces or mouth guards or other fasteners. A feature of the proposed method is that the passive fixation of the jaws eliminates the need for "correct" orthodontic fixation of the devices used (buccal tubes or braces), providing for their installation in accordance with the long axis of the tooth, since such an installation leads to an active effect on the tooth and a change in tooth position that does not match the purpose of the proposed decision. On the contrary, the inventive method provides for the alignment of the devices used (buccal tubes or braces, etc.) only with respect to each other for the unimpeded introduction of the power wire, while excluding any effect (especially traumatic) or pressure on the tooth or the possibility of extraction ( pulling out) a tooth. In this regard, the inventive method allows the use of devices such as buccal tubes, without bending (torques) of the groove and without hooks.

In contrast to the known methods of weight correction using dental devices, the claimed method provides not partial, but complete exclusion of opening the mouth and chewing movements and, consequently, the penetration of any solid food, except liquid. Moreover, the inventive method aims to reduce caloric intake using intraoral biologically safe and aesthetically acceptable dental devices that do not have a violent effect on the dento-jaw system, but completely prevent chewing movement of the jaws and chewing solid food, as a result of which calorie intake into the body is limited, which contributes to a gradual decrease in the patient’s nutritional dependence and the exclusion of an increase in the calorie intake of food, and the volume food creates a feeling of fullness due to the stretching of the stomach wall.

The method consists in the fact that in order to reduce calorie intake, they provide only liquid food for 1-3 weeks, excluding chewing solid food, for which they use passive food (that is, without using elastic, rubber modules, springs, etc. means for active influence on the teeth and dentitions), but tight fixation of the upper and lower jaws, then after 1-3 weeks remove the fixation of the jaws, provide nutrition with an individually selected diet in combination with individually selected physical activity, if necessary The fixation procedure is repeated until the result is achieved. Passive fixation of the jaws is carried out using an intraoral fixation device. Dental devices made on the basis of standard braces, or on the basis of standard or specially made cheek tubes, or on the basis of standard designs of mouth guards or other (specially made) devices, are chosen as an intraoral passive fixing device. The alignment inside the oral devices (for example, such as a bracket or buccal tube) relative to each other is carried out using a power wire that provides load distribution between the teeth, as well as using elements of the intermaxillary fixation, which use either a metallized thread (ligature), or wire lock made in the form of a U-shaped wire staple of different thicknesses. The power wire is fixed to the intraoral devices through openings made either directly in the intraoral devices (in the case of buccal tubes and braces) or in the fastening elements (in the case of mouthguards or braces) in the form of plastic or metal tubes. For attaching intraoral devices to the tooth, bases with a grooved sole are used. The fixation of the jaws is carried out by removing wire locks or cutting the threads of the intermaxillary fixation. In this case, the buccal tubes and braces are left on the teeth for subsequent repetition of the fixation of the jaws, while the mouthguard is removed. Before the passive fixation of the jaws, a preliminary diagnosis of the patient is carried out to select the type of device and method of intermaxillary attachment, as well as to determine the fixation time of the lower and upper jaws and exclude solid food.

An intraoral device made on the basis of buccal tubes contains at least four pairs of buccal tubes with openings for the power wire and openings for the intermaxillary fixation element. As an element of intermaxillary fixation, an intermaxillary fixation thread or a wire lock in the form of a U-shaped curved wire is used. Holes (external) are located along the upper side of the buccal tubes fixed on the upper row of teeth, as well as along the lower side of the buccal tubes fixed on the lower row of teeth. Holes (internal) are located along the lower side of the buccal tubes fixed on the teeth of the upper jaw, as well as along the upper side of the buccal tubes fixed on the teeth of the lower jaw.

The buccal tubes are mounted using composite material on the outer sides of the posterior teeth on each side of the upper and lower jaws, observing the alignment of the holes.

Power wires are designed to support and distribute the load between the teeth. The power wire is a common support for the buccal tubes located on one (upper or lower) row of teeth. Power wires are inserted into the holes on the buccal tubes of the upper and lower jaws.

Thus, by means of power wires, mutual fastening and interaction of the buccal tubes on the upper row of teeth and, accordingly, the buccal tubes on the lower row of teeth is ensured.

An intermaxillary fixation thread may be used as an element of intermaxillary fixation.

The intermaxillary fixation thread is inserted into the openings of the buccal tubes. The intermaxillary fixation thread can be inserted into the openings of the buccal tubes in different directions and in different ways, as shown in Figs. 1-5: with a circular diagram of the fastening of the maxillary filament along the internal openings of the buccal tubes; with a circular pattern of fastening of the intermaxillary filament along the external holes of the buccal tubes; with a pair-wise fastening scheme of the intermaxillary thread; with a cruciform pattern of fastening of the intermaxillary thread; with a zigzag pattern for fastening the intermaxillary thread.

As an element of intermaxillary fixation, a wire lock can be used. The wire lock can be made in the form of a U-shaped curved wire (staples) of different thicknesses depending on the method of attachment with the formation of the central section and side parts. The central - U-shaped - wire section fixes the position of the upper and lower buccal tubes and enhances the closure strength of the upper and lower jaws. The fastening of the wire lock can also be performed in different directions and in different ways, some of which are shown in Fig.6-7: for example, with a pairwise mounting scheme of a wire lock, with a cross mounting scheme of a wire lock. The implementation of the wire lock can be carried out in the form of a single design with the buccal tube, when the U-shaped wire is pre-soldered to the buccal tube, and then the whole structure is passively fixed on the teeth.

In the intraoral device made on the basis of the bracket, braces of any prescription are selected, having a groove caliber of at least 22 (approximately 0.22 mm) and not having an inclination at its base. The device based on the bracket contains at least four pairs of braces with a groove for installing the power wire and wings for fixing the ligature, or with a soldered metal tube under the wire lock. As an element of intermaxillary fixation, an intermaxillary fixation thread or a wire lock in the form of a U-shaped curved wire is used. The location and fastening of braces on the teeth and intermaxillary fixation with their help can be performed according to different schemes, reflected in Figs. 8-13: with a circular pattern of fastening of the intermaxillary floss; with a pair-wise fastening scheme of the intermaxillary thread; with a cross scheme of fastening of the intermaxillary thread; with a zigzag pattern for fastening the intermaxillary thread; with a pairwise wire lock fastening scheme; with a cross mounting scheme of a wire lock.

The intraoral device for implementing the method of weight reduction can be performed using both the buccal tubes and the bracket with the combined fastening scheme of the intermaxillary thread and wire lock, as, for example, as shown in Fig. 14.

In the device based on the mouthguard, the standard mouthguard design is supplemented by a tooth fixation system (for a stronger attachment to the teeth), an intermaxillary lock, and fasteners soldered into the mouthguard in the area of the outer sides of the lateral teeth for locking the intermaxillary fixation or fixing thread. An important role in attaching the mouthguard is the natural retention, physiological inclinations of the teeth and their shape (in particular, the vestibular or anterior inclination (more often) of the front teeth and the shape (undercut) of the crowns of the posterior teeth).

The tooth fixation system includes a tooth retainer made in the form of sagging on the outer and inner surfaces of the lateral teeth of the upper and lower jaws, as well as recesses in the mouthguard, the shape and size of which are made corresponding to the shape and size of the tooth retainers. Thus, with the help of tooth retainers and recesses on the mouthguard, its fastening to the teeth is carried out according to the principle of the snap mechanism. Nodules are made of composite material.

The intermaxillary fixation lock contains at least four fasteners (two on the upper jaw and two on the lower jaw) for the fixation element. An intermaxillary fixation thread or a wire lock in the form of a U-shaped curved wire can be used as a fixation element. The fasteners are soldered to the mouthguard in the area of the outer side of the lateral teeth on the upper and lower jaws, forming a single structure with the mouthguard. The fastening element is made in the form of a transparent plastic tube (or specially made devices like buccal tubes or braces made of plastic or metal) with a hole diameter corresponding to the size and shape of the intermaxillary fixation thread or a U-shaped curved wire of a wire lock. (Fig. 17-20).

The intermaxillary fixation thread is inserted into the holes of one of the sides of the plastic tube and stretched along it with access to the opposite side and the formation of the attachment site.

The wire lock can be made in the form of a curved wire with the formation of a central - straight or slightly rounded - section and side parts. The central section of the wire fixes the position of the fastener and enhances the closure of the upper and lower jaws. The ends of the side parts of the wire are inserted into the holes of the fasteners, forming a wire lock.

With a larger number of fasteners, the stroke of the thread or wire is similar to that described above.

An important feature of the claimed technical solution is that the intraoral dental device (based on braces, cheek tubes, mouthguards or other specially made devices) is fixed in such a way that there is no forced effect from the device on the teeth and surrounding tissues. That is, passive fixation of intraoral devices eliminates the active influence on the teeth and dentition, on the position of the teeth and occlusion in general, on the possibility of changing the direction of tooth growth, thereby ensuring maximum comfort of the use of the claimed devices. Passive fixation is carried out through the use of a metallized intermaxillary fixation thread or a thick metal wire, which, unlike elastic bands, or springs, or elastics, do not affect the teeth and ensure tight tooth closure. A dense passive fixation of the device (both on the basis of the buccal tubes, and braces or mouth guards) to the teeth implies compliance with the coaxial location of the holes in the buccal tubes, or in the grooves of the braces, or in the fasteners of the mouth guard. That is, a passive way of fixing intraoral devices is provided both by the material of the connecting elements, and by orienting the devices relative to each other, and not relative to the direction of growth and shape of the teeth.

Thus, in contrast to the known methods designed to reduce the calorie intake of food using dental devices and, consequently, to control and manage eating behavior, the inventive method through dental devices provides maximum comfort of their use without making aesthetically unusual changes in the appearance of the user. A transparent kappa with a fastener made of a transparent plastic tube is invisible to others. A device based on buccal tubes is also hidden from prying eyes. At the same time, reliable intermaxillary fixation completely prevents the opening of the mouth and chewing activity, thereby preventing solid food from entering the mouth and reducing the total caloric intake. This ensures that the user maintains a normal lifestyle with the ability to conduct speech activity and take liquid food, as well as provide both hygienic care of the oral cavity by rinsing and cleaning the outer surface of the teeth with a toothbrush. The exclusion of solid foods from the diet automatically reduces the calorie intake, the use of food as an anti-stress factor, which results in a decrease in mental dependence on food, the ability to change eating behavior and, ultimately, weight loss. This method helps people with a lack of willpower and motivation to withstand the calorie restriction regime and adjust to reduce the amount of food eaten. It is very important that when using the proposed method, it is possible to independently open the jaws by the patient or a medical professional: in emergency cases, the jaws are removed by cutting the metallized thread or opening the wire lock, which ensures the safety of the proposed method.

Claims (7)

1. A method of reducing weight, including reducing caloric intake, for which, by means of intraoral devices, the upper and lower jaws are fixed between each other, characterized in that passive fixation is carried out, completely eliminating the possibility of chewing food, moreover, passive fixation of the jaws is ensured by alignment and connection of intraoral devices relative to each other without regard to the direction of growth and shape of the teeth; nutrition is carried out only with liquid food for a period of 1 to 3 weeks; then, after 1-3 weeks, the jaws are removed, the diet is individually adjusted in combination with individually selected physical activities, the fixation procedure is repeated until the result is achieved. 2. The method of weight reduction according to claim 1, characterized in that the intraoral devices are connected and aligned with each other using the power wire and intermaxillary fixation elements, and the power wire is attached to the intraoral devices through openings made either directly in the intraoral devices or in fasteners attached to them, made in the form of plastic or metal tubes. 3. A method of reducing weight according to claim 2, characterized in that metallized thread and / or wire lock made in the form of a U-shaped wire bracket are used as intermaxillary fixation elements. 4. The method of weight reduction according to claim 2, characterized in that the intraoral devices are connected by intermaxillary fixation elements in pairs, or crosswise, or in a zigzag manner, or in a circular pattern. 5. The method of weight reduction according to claim 1, characterized in that dental devices made on the basis of buccal tubes, or braces, or mouthguards are selected as intraoral passive fixative devices. 6. The method of weight reduction according to claim 1, characterized in that prior to installing the device, a preliminary diagnosis of the patient is carried out to select the type of device and method of maxillary attachment, as well as to determine the fixation time of the lower and upper jaws and exclude solid food. 7. The method of reducing weight according to claim 1, characterized in that in urgent cases, the fixation of the jaws is removed by cutting the metallized thread or opening the wire lock.

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