RU2628064C2 - Method for diagnosis of lower jaw mobility and device for its implementation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions includes a device for diagnosis of movements and forces of the lower jaw dentition relative to the upper jaw dentition and a method of diagnosis using the device, refers to the field of medicine and can be used in dental practice. The device for diagnosis of movements and forces of the lower jaw dentition relative to the upper jaw dentition contains a carrier fastened to the dentition or on the tooth or on a dental structure or inside a dental structure or on the gum, and on which at least one sensor is located for real-time registration of the investigated parameter associated with lower jaw functioning, as well as an electronic unit with the function of obtaining measurement data and their processing, a power unit and unit for measurement data transmission to the external receiving computerized means. The carrier is made in the form of a flexible or rigid plate, on which the electronic unit in the form of a microprocessor, a measurement data transmission unit made in the form of a process connector for wire communication or a wireless communication module, and a sensor or sensors made with different functions for measurement of the investigated parameters are fixed, and a power supply made in the form of at least one battery, or a wired power module or a wireless power module, is located next to the carrier, mechanically associated with it and electrically connected to the components on the carrier. The method for diagnosis of movements and forces of the lower jaw dentition relative to the upper jaw dentition is performed by the device.

EFFECT: possibility of obtaining a reliable picture of movements and efforts of the lower jaw dentition relative to the upper jaw dentition to obtain a diagnosis and choose a method of treatment.

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Description

The invention relates to dental medicine, in particular, considers a method for diagnosing the presence of mobility of the lower jaw and a device for its implementation. In this case, we are talking about the diagnosis of bruxism (as an example of a disease) and, in the general case, about the comprehensive diagnosis of movements and efforts made by the dentition of the lower jaw in relation to the dentition of the upper jaw in order to increase the reliability of the staged diagnosis and the choice of treatment method.

Stress accumulated during the working day, increased prolonged physical activity, the presence of birth injuries to the head in children, all of the above problems can lead to strong closure of the dentition and uncontrolled movements of the lower jaw at night, during sleep. Dental interventions can also lead to bruxism. Nightly uncontrolled movements of the jaw in most cases lead to wear and tear of tooth tissues. Processes that are not diagnosed for a long time can lead to total tooth decay and difficulties in their restoration. Also, this process leads to changes in the muscular system involved in the movements of the lower jaw (n / h).

Bruxism refers to an unconscious habit characterized by the rhythmic activity of the facial and jaw muscles, which causes contact between the dental surfaces, accompanied by grinding and gritting of the teeth. Bruxism can occur during the day, in which case it is called daytime, but it usually occurs when a person is sleeping. This is called nocturnal bruxism and represents the third most common sleep disorder, being the most serious and difficult to treat, since the patient is not aware of his gnashing of teeth. All forms of bruxism include strong contact between the cutting surfaces of the upper and lower teeth, which can cause serious tooth damage or jaw muscle discomfort. Teeth contact during grinding and tapping includes movement of the lower jaw and audible sounds. Squeezing, on the other hand, involves inaudible, steady and strong contact of the teeth, but is not accompanied by movements of the lower jaw.

Timely diagnosis will reveal the presence of uncontrolled movements of the lower jaw. To date, special mouthguards are used to diagnose the presence of uncontrolled movements of the lower jaw during the day or during sleep. This mouthguard is made of a thin plastic plate, followed by applying paint to the mouthguard surface.

Methods of making mouthguards:

1. The patient is taken an impression from the dentition, depending on which jaw will be made kappa.

2. A cast model is cast according to the cast.

3. The gypsum model is fitted with a special plastic plate (usually a plastic plate with a thickness of 0.5-1 mm is used). The plate is heated in a special apparatus, a vacuumformer.

4. The resulting kappa is stained with food-grade paint.

The patient dresses this plate for the night, and removes it in the morning. According to the amount of ink erased on the chewing surface of the plate, it is analyzed whether the patient moved his lower jaw during sleep.

This technique is aimed at detecting the presence of uncontrolled movements of the lower jaw and has significant disadvantages. It is uninformative, because only shows the result, i.e. there were movements n / h or there were none.

The use of these mouthguards makes it impossible to analyze:

1. In what phase of sleep, uncontrolled movements of the lower jaw occurred or at what time.

2. It is impossible to determine the duration of movements, how much time the patient moved his lower jaw and with what frequency.

3. On what trajectory did the lower jaw move and what were the movements in character (intermittent or smooth), how long did the movements occur, and at what time did the movements occur. It is also not known whether squeezed (strongly closed) while a person has dentition.

4. Also, the use of mouthguards distorts the usual closure of the dentition, completely overlapping the dentition and thereby overestimating the height of the closure.

Currently, several different treatments for bruxism are offered: relaxation therapy and psychotherapeutic approaches, such as mass negative practice (for example, clenching your teeth while awake for fatigue of the jaw muscles), occlusal contact (for example, grinding of some teeth and artificial restoration of others), the use of drugs such as local anesthesia or tranquilizers (US 6,632,843), development of a conditioned disgust reflex (US 6,164,278), the use of interocclusive orthopedic appliances th (US 6,302,110) and biofeedback therapy. Biofeedback approaches aim at creating knowledge signals for treating bruxism and using devices that are placed in the mouth or placed on the patient’s head or face. Such devices include various types of sensors that report a particular bruxism event and give a signal, either causing a natural reflex to stop gnashing or warning a patient. WO 03/059160 discloses, for example, a device mounted on a patient’s head, temple, forehead or jaw, which has biosensors that measure the activity of nerves or muscles associated with bruxism, and a drug delivery module that releases a sedative drug that acts on specific nerves or muscles. However, one of the main problems of this device is the lack of a controller that could distinguish normal muscle or nerve activity from activity associated with bruxism. In addition, the use of drugs or painkillers, which are expensive and can have side effects, is not recommended, in particular, with such treatment. The dosage of drugs should be personalized to avoid improper use, which can either be ineffective or may cause unwanted drowsiness.

So, from US 20100036286, A61B 5/11, publ. 02/11/2010, there is a device for diagnosing the presence of mobility of the lower jaw, which is a dental splint for measuring occlusal forces in case of occlusion of teeth, which is designed to dress with a contact on the surface of the teeth and which is a carrier with a supporting surface located between opposite two teeth upper and lower jaw, which has flank walls perpendicular to the supporting surface, located along the teeth outside and inside, as well as at it least one sensor for determining the measurement of occlusal forces, which is positioned inside one of the flank walls and outside the area of occlusion.

In this device, at least one sensor may be located on the external surface of the tooth, or on the external side of the fillings, in the fillings, crowns or inserts of the tooth, or on the external surface of the dental implant, artificial tooth or denture. And a sensor is understood to mean at least one sensor selected from the group consisting of a distance measurement sensor, a bending sensor for bending load, a vibration sensor, a voltage sensor, a displacement sensor, or a pressure and force sensor. At least one sensor is a piezoelectric sensor or strain gauge. A plurality of sensors can be mounted on the toothbrush, differing in structure or differing in function.

In addition, there is an electronic unit for accepting and / or evaluating measured variables recorded by at least one sensor. The device may comprise a transmission module operably connected to at least one sensor for transmitting the measured variables to the electronic unit.

The disadvantage of this device is its size, due to the presence of a tooth splint, which is inserted between two abutting teeth or between rows of teeth and which must be constantly worn or for some time in the oral cavity. This creates inconvenience to the patient, even in a dream.

Dental splint belongs to the category of devices that are made individually for the patient, taking into account the peculiarities of the structure of his teeth and the position of the lower jaw. This requires an individual approach, time and knowledge of the technology of production (manufacture) of a dental tire. If we consider that it is necessary to install electronic components on such a bus, ensure their connection, adjust the algorithm and connect it to a computer, it becomes clear that such a device can only be manufactured at the factory. And this increases the time for diagnosis and, accordingly, for the treatment of the patient.

In addition, the known device is fully aimed at diagnosing and measuring occlusal forces and does not give a general picture of the behavior (movement) of the lower jaw relative to the upper jaw for such manifestations as bruxism, apnea, TMJ dysfunctions, etc.

The present invention is aimed at achieving a technical result, which consists in simplifying the design by eliminating the tooth splint inserted between the teeth and expanding the diagnosed parameters by providing a reliable picture of the movements and efforts of the dentition of the lower jaw relative to the dentition of the upper jaw in order to increase the reliability of the diagnosis and the choice of treatment.

The specified technical result for the device is achieved by the fact that in the device for diagnosing the presence of mobility of the lower jaw containing a carrier mounted on the dentition or on the tooth, or on the dental structure, or inside the dental structure, or on the gum and on which at least one a sensor for real-time recording of the studied parameter associated with the functioning of the lower jaw, as well as an electronic unit configured to receive measurement data and their image doors, a power supply unit and a module for transmitting measurement data to an external receiving computerized means, the carrier is made in the form of a flexible or rigid plate on which an electronic unit is fixed in the form of a microprocessor, a module for transmitting measurement data made in the form of a technological connector for wired communication or in the form of a module wireless communication, and a sensor or sensors with different from each other measurement functions of the studied parameters, and the power supply unit, made in the form of at least one battery element, or in the form of wire Foot power module, or a wireless power supply is located nearby the carrier is mechanically connected with it and is connected electrically with the components on this carrier.

For the device, a magnetic field sensor and / or magnetic element and / or accelerometer and / or temperature sensor and / or gyroscope and / or force recorder are used as a sensor.

The specified technical result for the method is achieved in that the method for diagnosing the presence of mobility of the lower jaw is characterized in that they are placed on the dentition or on the tooth, or on the dental structure, or inside the dental structure, or on the gum, at least two sensors mounted on a common movable media or installed on separate media and made with the registration function of the investigated parameter, carry out the registration of signals from the sensors, and the mobility of the tooth or tooth row or dental construction of the lower jaw relative to the upper jaw or relative to each other or the presence of contact, its strength and direction between the teeth, or dentitions, or dental designs is determined by the change in the values of the recorded signals, depending on the displacement of the sensors relative to each other on a common mobile carrier or sensors on separate media.

These features are significant and are interconnected with the formation of a stable set of essential features sufficient to obtain the desired technical result.

The present invention is illustrated by specific examples of execution, which, however, are not the only possible, but clearly demonstrate the ability to achieve the desired technical result.

In FIG. 1 shows one device mounted on the teeth and a second device mounted inside the dental structure (crown);

FIG. 2 - the first example of the device;

FIG. 3 - the second example of the device;

FIG. 4 - the third example of the device.

According to the present invention, there is considered the design of a device for diagnosing the presence of mobility of the lower jaw and based on the use of this device or several such devices, a new method for the comprehensive diagnosis of all movements made by the lower jaw for a given period of time. In this case, we are talking about the diagnosis of bruxism (as an example of a disease) and, in the general case, about the comprehensive diagnosis of movements and efforts made by the dentition of the lower jaw in relation to the dentition of the upper jaw in order to increase the reliability of the staged diagnosis and the choice of treatment method.

In the new method, the miniature device 1 records the movements of the lower jaw 2 relative to the upper jaw 3 in space, speed, closing force, periodicity, closing time, head position, etc. The device 1 allows you to measure the distance, determine the presence of movement, direction, speed, position in space and position relative to each other, temperature, compression force (TMF, teeth, dentitions, dental structures and the person himself, his head, etc.) depending from tasks to be solved.

This device is mounted on the dentition or inside the dental structure (Fig. 1). The device can be mounted on the external, internal sides of the tooth (an example is shown in Fig. 1, mounting the device on the teeth of the lower jaw), on the side surfaces, the device can also be attached to dental structures, as well as mounted inside dental structures (an example is shown in Fig. 1 , fixing the device inside the crown on the upper jaw).

Its size and shape do not interfere with the usual movements of the lower jaw and do not cause discomfort. The device is able to work autonomously for several days, recording measurements. Also, the device can independently process and interpret the received data, transfer it to an external receiver 4 of the type of computerized means (computer, phone, tablet, other electronic device). In the future, information from the sensor can be viewed on a computer, phone, tablet, and other electronic devices.

This device for diagnosing the presence of mobility of the lower jaw (Fig. 2-4) contains a carrier 5, mounted on the dentition or on the tooth, or on the dental structure, or inside the dental structure, or on the gum. The carrier is provided with attachment elements or is fixed by adhesive. Attachment issues are not considered due to the presence on the market of a large number of various means from mechanical to adhesive.

The carrier is made in the form of a flexible or rigid plate on which an electronic unit is fixed in the form of a microprocessor 6 (made with the function of receiving measurement data and processing them — a microcontroller, a computer), a measurement data transmission module made in the form of a process connector 7 (for examples, by . 2 and 3) for wired communication or in the form of a wireless communication module 8 (for example, Bluetooth radio), and a sensor or sensors 9 with different measurement functions of the parameters under study. A sensor or at least one sensor is used to record in real time the parameter under study associated with the functioning of the lower jaw. For the device, a magnetic field sensor and / or magnetic element and / or accelerometer and / or temperature sensor and / or gyroscope and / or force recorder are used as a sensor. Sensors can be combined into modules, for each of which a set of sensors is selected depending on the type of study or the task.

The power supply 10 is made in the form of at least one battery (battery, miniature battery), or in the form of a wired power module, or a wireless power module. The power supply 10 is located next to the carrier 5, is mechanically connected to it and electrically connected to the components on this carrier.

The main elements of the device are:

1. Microprocessor 6. The main tasks of the microcontroller are: collection, processing, storage of information received from sensors, and communication with a computer (phone, tablet, etc.).

2. Sensors 9. Record various indicators: temperature, displacement of the dentition, etc. The main types of sensors of the device:

- magnetic field sensor: during movement of dentitions (teeth, dental structures) with a fixed magnetic element, the magnetic field around the sensor changes, which makes it possible to determine the presence of movement, its direction, speed, frequency, etc .;

- strain gauge: registers pressing (compression, curvature, twisting, etc.), serves to record the efforts on the teeth, dentitions, dental structures;

- an accelerometer, serves to determine the position of the device (and therefore the patient’s head) in space, also serves to determine acceleration, speed, movement;

- temperature sensor.

3. Media 5 in the form of a printed circuit board. It serves as a fastener connecting the microcontroller, sensors and other modules. It can be made rigid or flexible.

3. Power module 10. Provides energy to all consumers. It can be made in the form of a power element (s), or in the form of a wired power module, or in the form of a wireless power module (bluetooth).

4. Data transmission module (communication module). Serves for the exchange of information and programming of the device (for connecting to a computer, phone, tablet, etc.). It can be made in the form of a technological connector 7 or in the form of a module 8 for wireless communication.

In FIG. 2-4 illustrate several possible arrangements of the device. In FIG. 2 shows a first embodiment, according to which the carrier is made in the form of a square or rectangular board (flexible or rigid), and the battery is placed outside the board's dimensions and is connected mechanically and electrically with it. On the board there is a technological connector for connecting a cable from an external computerized means for taking measured parameters recorded in the microprocessor memory during the diagnosis (battery life of the device (in the patient’s mouth). The minimized dimensions of the device allow it to be fixed on the external surface of the tooth and do not interfere jaw movements.

In FIG. 3 shows an embodiment of the example of FIG. 2. The difference is that the board is made in the form of a narrow, long, flexible loop, which allows you to place more sensors and fasten the board to the dentition.

In FIG. Figure 3 shows an example of execution, according to which the board is made in the form of a circle repeating the size of a flat disk battery. The round printed circuit board lies on the battery, there is no technological connector, and a wireless module is installed for transmitting measurement data to an external computerized device in the current time mode.

For all examples, the scale is approximate.

Other device configurations are possible depending on the required end characteristics, for example, a set of necessary sensors.

For sterility requirements, the device can be placed by the user in a casing before being mounted on a patient.

Procedure for using the device:

1. The user turns on the device by pressing the power switch or inserting batteries, or by connecting the device to a computer (tablet, phone, other electronic device, etc.). A combination of these actions is also possible.

2. The user connects the device to a computer (phone, tablet, other electronic device, etc.). (If not already connected.)

3. The user with the help of special software programs (sets up) the device - enters the parameters of future diagnostics into the device, for example: diagnostic time, recording frequency, recording order, their number, recording content, sleep, wake, meal, other activity etc. The introduced parameters (settings) depend, for example, on the type of future diagnostics.

4. The user attaches the device or devices and / or its elements to the patient.

5. The user can ask the patient to move his teeth to calibrate the initial data of the device. If necessary for installed sensors.

6. For a certain / appointed time, the patient is with the device.

7. The user removes the device from the patient.

8. The user connects the device to a computer (phone, tablet, other electronic device, etc.). (If not connected. The device may not be disconnected from the computer (phone, tablet, other electronic device, etc.) for the duration of the diagnosis if a wireless or vice versa wired connection is used, or both at once).

9. The user can use special software to view, and / or analyze, and / or process, and / or save, and / or transfer device data and / or diagnostics.

This device or devices allow you to implement a method for diagnosing the mobility of the lower jaw, including the registration of movements and contacts between the dentition. The method for diagnosing the mobility of the lower jaw is based on the following actions, the set of which from the following list is made depending on the choice of the target diagnosis:

- register efforts on the dentition,

- register efforts on the teeth,

- register efforts on dental structures,

- register the movement of the dentition,

- register tooth movements,

- register the movement of dental structures,

- register the movement of the bass,

- register the position of the head,

- register the activity of the patient,

- record the temperature,

- the mobility of the teeth (dentition, dental structures, lower jaw) relative to each other is determined by the displacement of the components of the device (or devices) attached to the teeth (dentition, structure) relative to each other, while the sensor signals change,

- the presence of contact, its strength and direction between the teeth, dentitions, dental structures is determined by the displacement of the components of the device (or devices) relative to each other, while the sensor signals change.

- the measured data can be processed by the device itself or the measured and / or processed data can be transferred to a computer, phone, tablet, other electronic computerized device.

The device allows you to measure any mobility of the jaw, teeth, dental structures, etc. (for example, the doctor can record the uncontrolled movements of the jaws at night, during sleep, or the doctor can measure how two adjacent teeth move relative to each other when clenching the dentition, etc.). The size allows you to fix the device even inside the crown (the doctor of his choice can fix the device: inside the crown or on the tooth, etc.) - depending on what parameter needs to be measured.

It is also important that a magnetic element is used to work with a magnetic sensor. The magnetic sensor is fixed on one object (tooth, dental structure, etc.), and the magnetic element on another. Thus, the sensor can detect the movement of the magnetic element.

For example, if it is necessary to diagnose the presence of movements of one jaw relative to the other, then a device with at least a magnetic sensor is attached to one, and a magnetic element is attached to the other jaw. In the presence of movements of one jaw relative to the other, the device containing the sensor and the magnetic element will move relative to each other, which will allow the sensor to register a change in the magnetic field.

In a similar way, if necessary, measure the movement of one tooth relative to another (for example, in a pair of two adjacent teeth on the same jaw).

If necessary, measure the load on the dental structure (for example, a crown), it is possible to use a device that at least contains a force recorder. In this case, the device can be located inside the dental structure (this is only one of the possible options for location and use). When the load on the dental structure, the recorder efforts of the device will allow to diagnose this.

Thus, we can formulate a method for diagnosing the presence of mobility of the lower jaw as a sequence of the following actions:

- place on the dentition or on the tooth, or on the dental structure, or inside the dental structure, or on the gum at least two sensors mounted on a common movable carrier or installed on separate carriers and made with the registration function of the studied parameter;

- carry out the registration of signals from sensors, this registration is considered as a basic level of reference movement;

- determine by changing the values of the recorded signals, depending on the displacement of the sensors relative to each other on a common movable carrier or sensors on separate carriers, the mobility of the tooth or dentition, or dental construction of the lower jaw relative to the upper jaw or relative to each other or the presence of contact, its strength and the direction between the teeth, or dentitions, or dental structures.

Claims (8)

1. A device for diagnosing the movements and efforts of the dentition of the lower jaw relative to the dentition of the upper jaw, containing a carrier mounted on the dentition, or on the tooth, or on the dental structure, or inside the dental structure, or on the gum and on which is located at least one sensor for real-time recording of the studied parameter associated with the functioning of the lower jaw, as well as an electronic unit configured to receive measurement data and their processing, a pit block and a module for transmitting measurement data to an external receiving computerized device, characterized in that the carrier is made in the form of a flexible or rigid plate on which an electronic unit is fixed in the form of a microprocessor, a module for transmitting measurement data made in the form of a technological connector for wired communication or in the form wireless communication module, and a sensor or sensors with different from each other measurement functions of the studied parameters, and the power supply unit, made in the form of at least one battery element, or in the form a wired power module, or wireless power module, is located next to the carrier, mechanically connected to it and electrically connected to components on this carrier. 2. The device according to claim 1, characterized in that a magnetic field sensor is used as a sensor. 3. The device according to p. 2, characterized in that it contains a magnetic element for collaboration with a magnetic field sensor. 4. The device according to claim 1, characterized in that an accelerometer is used as a sensor. 5. The device according to claim 1, characterized in that a temperature sensor is used as a sensor. 6. The device according to claim 1, characterized in that a gyroscope is used as a sensor. 7. The device according to claim 1, characterized in that the force logger is used as a sensor. 8. A method for diagnosing movements and efforts of the dentition of the lower jaw relative to the dentition of the upper jaw by the device according to any one of paragraphs. 1-7, characterized in that they are placed on the dentition or on the tooth, or on the dental structure, or inside the dental structure, or on the gum, at least two sensors mounted on a common movable carrier or installed on separate carriers and made with registration function of the studied parameter, the signals from the sensors are recorded, and the mobility of the tooth or dentition or dental construction of the lower jaw relative to the upper jaw or relative to each other or and the presence of contact, its strength and direction between the teeth, or dentitions, or dental designs is determined by the change in the values of the recorded signals, depending on the offset relative to each other of sensors on a common movable carrier or sensors on separate carriers.

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