CN112274277A - Novel upper jaw arch expander for patient with bilateral cleft lip and palate and correction method - Google Patents
Novel upper jaw arch expander for patient with bilateral cleft lip and palate and correction method Download PDFInfo
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- 206010009260 Cleft lip and palate Diseases 0.000 title claims abstract description 37
- 208000016653 cleft lip/palate Diseases 0.000 title claims abstract description 37
- 230000002146 bilateral effect Effects 0.000 title claims abstract description 27
- 238000000034 method Methods 0.000 title claims abstract description 15
- 238000012937 correction Methods 0.000 title abstract description 12
- 238000011282 treatment Methods 0.000 claims abstract description 20
- 210000003254 palate Anatomy 0.000 claims abstract description 9
- 210000004513 dentition Anatomy 0.000 claims abstract description 5
- 230000036346 tooth eruption Effects 0.000 claims abstract description 5
- 235000013290 Sagittaria latifolia Nutrition 0.000 claims abstract description 4
- 235000015246 common arrowhead Nutrition 0.000 claims abstract description 4
- 210000002455 dental arch Anatomy 0.000 claims description 37
- 210000001909 alveolar process Anatomy 0.000 claims description 32
- 239000011347 resin Substances 0.000 claims description 13
- 229920005989 resin Polymers 0.000 claims description 13
- 210000000988 bone and bone Anatomy 0.000 claims description 10
- 230000007547 defect Effects 0.000 claims description 9
- 230000014759 maintenance of location Effects 0.000 claims description 9
- 210000002050 maxilla Anatomy 0.000 claims description 8
- 238000004458 analytical method Methods 0.000 claims description 7
- 238000005452 bending Methods 0.000 claims description 6
- 210000001847 jaw Anatomy 0.000 claims description 6
- 238000004519 manufacturing process Methods 0.000 claims description 6
- 229910001220 stainless steel Inorganic materials 0.000 claims description 6
- 238000011161 development Methods 0.000 claims description 5
- 230000018109 developmental process Effects 0.000 claims description 5
- 208000006820 Arthralgia Diseases 0.000 claims description 3
- 238000007408 cone-beam computed tomography Methods 0.000 claims description 3
- 238000003745 diagnosis Methods 0.000 claims description 3
- 210000004283 incisor Anatomy 0.000 claims description 3
- 238000005498 polishing Methods 0.000 claims description 3
- 239000010935 stainless steel Substances 0.000 claims description 3
- 238000009966 trimming Methods 0.000 claims description 3
- 101150097977 arch-1 gene Proteins 0.000 abstract description 6
- 208000032170 Congenital Abnormalities Diseases 0.000 description 3
- 206010010356 Congenital anomaly Diseases 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 230000007698 birth defect Effects 0.000 description 2
- 206010009259 cleft lip Diseases 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 206010009269 Cleft palate Diseases 0.000 description 1
- 240000004282 Grewia occidentalis Species 0.000 description 1
- 208000031481 Pathologic Constriction Diseases 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
- A61C7/08—Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
- A61C7/10—Devices having means to apply outwardly directed force, e.g. expanders
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- Veterinary Medicine (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
The invention discloses a novel upper jaw arch expander and a correction method for a patient with bilateral cleft lip and palate.A upper jaw arch expander comprises a hyperbolic labial arch 1, an adjacent hook 3, an arrow snap ring 4, a first spiral arch expander 5, a second spiral arch expander 6, a third spiral arch expander 7 and a Y-shaped splitting base; the Y-shaped split base comprises a front base 81, a left base 82 and a right base 83 which are connected by a spiral bow expander; the Y-shaped split base plate covers the palate and the palatal side of the dentition; two adjacent hooks 3 are respectively positioned between the left second front molar and the right second front molar and the first molar and fixedly connected with the Y-shaped split base; two arrow head snap rings 4 are respectively positioned on the left first molar and the right first molar and fixedly connected with the Y-shaped split base; the hyperbolic labial arch 1 is positioned in the middle-proximal anterior area of the fissure and is fixedly connected with the Y-shaped split base. The invention solves the problems that the maxillary arch expansion of a patient with bilateral cleft lip and palate cannot control the anterior maxillary protrusion and the gap is too wide at the same time, simplifies the correction procedure and shortens the treatment time.
Description
Technical Field
The invention belongs to the technical field of oral medicine, and particularly relates to a novel upper jaw arch expander for a patient with bilateral cleft lip and palate and a correction method.
Background
Cleft lip and palate is the most common congenital birth defect of the oral face, the prevalence rate in China is 0.082-0.16%, and the median of all birth defects is the first. The sequential treatment of cleft lip and palate patients becomes a consensus of experts and scholars at home and abroad, namely, the patients carry out different treatments in different growth and development stages according to self conditions, including cleft lip operation, cleft palate operation, orthodontic treatment, bone grafting operation, voice training and the like. The incidence of misfit deformity in such patients is very high, about 97%, due to the effects of congenital development and surgery. Orthodontic treatment plays an important role in the sequential treatment of cleft lip and palate, and throughout the sequential treatment.
The problems of dental arch width matching and fissure region width of cleft lip and palate patients are key points and difficulties in orthodontic treatment of cleft lip and palate. For a patient with bilateral cleft labialis and palate, the continuity of the maxilla is interrupted, the anterior maxilla and the alveolar process are broken, the anterior process is obvious, the muscle force is abnormal, so that the posterior segments of the maxilla on the two sides rotate to the midline and collapse, which is often expressed as the anterior process of the anterior segment of the dental arch of the maxilla, the gap of the two-side fracture areas is wide, the alveolar processes on the two sides of the fracture are badly aligned to form a step, the teeth in the fracture areas are lost, the posterior dental areas of the maxilla collapse and are reversely closed, and the patient with. Regardless of preoperative orthodontic treatment, permanent tooth simple orthodontic treatment or orthodontic maxillomandibular joint treatment of alveolar process bone grafting, a patient with cleft lip and palate needs to match widths and forms of upper and lower dental arches to adjust the size of a cleft area at the alveolar process, particularly, before bone grafting, preoperative orthodontic treatment widens the upper dental arch, adjusts the width of cleft area of the alveolar process, restores the normal form of the dental arch, is beneficial to the operation and improves the success rate of bone grafting. Therefore, the correct treatment of the problems of the width of the upper and lower dental arches and the width of the fissure area of the cleft lip and palate patient is of great significance to the orthodontic treatment effect and the long-term stability.
At present, the clinical orthodontic appliance aiming at the width abnormity of cleft lip and palate dental arch is mainly an upper jaw arch expander, the upper jaw arch expander can be divided into an active arch expander and a fixed arch expander according to whether a patient can take or wear the appliance, and can be divided into a rapid arch expander and a slow arch expander according to an arch expanding mode. The arch expander which is commonly used by a patient with bilateral cleft lip and palate comprises a four-corner coil spring arch expander, a split base support arch expander, an arch expander auxiliary arch expander and the like. Such appliances can solve the problem of narrow maxillary arch, but generally can not solve the problems of anterior maxillary protrusion and too wide gap, and the expansion of the posterior dental arch can further cause the width of the gap area to increase, which is not favorable for the success of bone grafting operation. Therefore, for cleft lip and palate patients, the upper jaw arch expansion appliance is generally needed to be used firstly to solve the problem of dental arch stenosis, and then the fixed appliance is used to solve the problems of the alignment and the width of two ends of the cleft, so that the correction procedure is troublesome and the time is long.
Disclosure of Invention
The invention aims to solve the technical problem that the existing maxillary expander cannot control the anterior maxillary protrusion and the gap of a patient with bilateral cleft lip and palate to be too wide, and provides a novel maxillary expander which is used for the patient with bilateral cleft lip and palate and simultaneously solves the problems of narrow maxillary width and the anterior maxillary protrusion. Namely, a novel maxillary expander for a patient with bilateral cleft lip and palate, which comprises: the double-curved labial arch, the adjacent hook, the arrow snap ring, the first spiral arch expander, the second spiral arch expander, the third spiral arch expander and the Y-shaped split base;
the Y-shaped split base comprises a front base, a left base and a right base;
the Y-shaped split base support covers the palate part and the palatal side of the dentition, the front base support is positioned in front of the alveolar process fracture areas on the two sides, the left base support is positioned behind the left alveolar process fracture area and the left alveolar process fracture area in the middle of the palate, and the right base support is positioned behind the right alveolar process fracture area and the right alveolar process fracture area in the middle of the palate;
the left base support and the right base support are connected through a first spiral bow expander;
the front base support and the left base support are connected through a second spiral bow expander;
the front base support and the right base support are connected through a third spiral bow expander;
two adjacent hooks are respectively positioned between the left second front molar and the right second front molar and the first molar and fixedly connected with the Y-shaped split base;
the two arrow-head snap rings are respectively positioned on the left first molar and the right first molar and fixedly connected with the Y-shaped split base;
the hyperbolic labial arch is positioned in the near-middle anterior tooth area of the fissure and is fixedly connected with the Y-shaped split base.
Further, the front base, the left base and the right base are respectively integrally molded by using self-setting base resin.
Further, the first helical expander is in an initial minimum width position;
and the second spiral bow expander and the third spiral bow expander expand the second spiral bow expander and/or the third spiral bow expander through the spiral spring adjusting holes according to the preset width.
Furthermore, the legs of the first spiral bow expander, the second spiral bow expander and the third spiral bow expander are embedded in resin;
and the spiral spring adjusting holes of the first spiral bow expander, the second spiral bow expander and the third spiral bow expander are not embedded by resin.
Furthermore, the hyperbolic labial arch, the adjacent hooks and the arrow snap rings are all formed by bending stainless steel wires with the thickness of 0.8 mm.
The invention also designs a correction method for a patient with bilateral cleft lip and palate,
the method comprises the following steps:
1) preparing a dental model;
2) clinical examination and model analysis:
analyzing the width and the shape of the upper and lower jaw dental arches, and analyzing the position of the anterior jaw bone and the width of the crack;
CBCT analyzes the position and the defect amount of alveolar process defect, the condition of maxillary lateral incisor defect, the anterior labial-lingual position, lip inclination and the amount of labial-lingual bone plate, the buccal-lingual position of posterior teeth and the amount of buccal bone plate;
determining the expansion amount of the maxillary dental arch and the amount of the maxillary bone required to move backwards according to the analysis data, finally determining the final width of the alveolar process fracture, and calculating the preset widths of the second spiral arch expander and the third spiral arch expander according to the width;
3) preparing a maxillary arch expander for bilateral cleft lip and palate: trimming a dental model, bending a double-curved labial arch, an adjacent hook and an arrow snap ring by adopting a stainless steel wire of 0.8mm, placing a first spiral arch expander in the middle of a palate, widening a second spiral arch expander and a third spiral arch expander to a preset size through a spiral spring adjusting hole according to a preset width, placing the second spiral arch expander and the third spiral arch expander in crack areas on the left side and the right side, paving wax for fixation, and manufacturing a Y-shaped split base by using self-setting base resin; grinding and polishing to manufacture the appliance;
4) correcting: putting the prepared maxillary arch expander for the bilateral cleft lip and palate into the mouth of a patient, and checking the retention and fitting conditions; determining the development amount of the dental arch according to the contra-occlusion condition of the dental arch, rotating the spiral spring adjusting hole of the first spiral arch expander twice a week, and increasing the distance between the left base and the right base by 0.25mm after each rotation until the back teeth are covered normally; determining the amount of reducing the width of the fracture according to the width of the fracture on the left side and the right side and the position of the anterior jaw bone, reversely rotating spiral spring adjusting holes of a second spiral arch expander and a third spiral arch expander in the left fracture area and the right fracture area twice a week, and reducing the distance between a front base and a left base as well as the distance between the front base and a right base by 0.25mm after each rotation until the width of the fracture is proper; checking and inquiring the arthralgia condition in each time of the re-diagnosis, observing the retention condition of the appliance, checking the improvement condition of the dental arch width of the patient and the reduction condition of the fracture width; after the width of the dental arch and the width of the fissure are improved to the treatment target, the appliance is continuously worn for three months, the existing dental arch is maintained, and the recurrence is prevented.
The invention designs a novel upper jaw expander for a patient with bilateral cleft lip and palate, solves the problems that the upper jaw expander for the patient with bilateral cleft lip and palate cannot control the anterior maxillary protrusion and too wide fracture at the same time, simplifies the correction procedure and shortens the treatment time.
Drawings
FIG. 1 is a schematic representation of a normal human dental arch configuration in accordance with an embodiment of the present invention;
FIG. 2 is a schematic representation of a cleft lip and palate patient arch morphology according to an embodiment of the present invention;
FIG. 3 is a schematic diagram showing the occlusal surface structure of the maxillary expander according to the embodiment of the present invention;
FIG. 4 shows a schematic front view of a cleft lip patient wearing a maxillary expander according to an embodiment of the present invention;
fig. 5 shows a schematic view of the posterior occlusal surface of a maxillary expander carried by a cleft lip and palate patient according to an embodiment of the present invention.
In the figure: 1. a hyperbolic labial arch; 2. alveolar process fissure region; 3. an adjacent hook; 4. an arrow snap ring; 5. a first spiral bow expander; 6. a second spiral bow expander; 7. a third spiral bow expander; 81. a front base support; 82. a left base support; 83. and a right base support.
Detailed Description
Exemplary embodiments of the present disclosure will be described in more detail below with reference to the accompanying drawings. While exemplary embodiments of the present disclosure are shown in the drawings, it should be understood that the present disclosure may be embodied in various forms and should not be limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the disclosure to those skilled in the art.
The invention is used for correcting bilateral cleft lip and palate, the shape of a dental arch of a normal person is shown in figure 1, the shape of a dental arch of a patient with bilateral cleft lip and palate is shown in figure 2, the invention provides a novel maxillary expander for the patient with bilateral cleft lip and palate, and the maxillary expander comprises: the double-curved labial arch support comprises a double-curved labial arch 1, an adjacent hook 3, an arrow snap ring 4, a first spiral arch expander 5, a second spiral arch expander 6, a third spiral arch expander 7 and a Y-shaped split base.
Specifically, the Y-shaped split base comprises a front base 81, a left base 82 and a right base 83; the Y-shaped split base plate covers the palatal part and the palatal side of the dentition, the front base plate 81 is positioned in front of the fracture zone of the alveolar process on the two sides, the left base plate 82 is positioned behind the fracture zone of the left alveolar process and the left alveolar process in the middle of the palatal part, and the right base plate 83 is positioned behind the fracture zone of the right alveolar process and the right alveolar process in the middle of the palatal part; the left base support 82 and the right base support 83 are connected through a first spiral bow expander 5; the front base support 81 and the left base support 82 are connected through a second spiral bow expander 6; the front base support 81 and the right base support 83 are connected through a third spiral bow expander 7; two adjacent hooks 3 are respectively positioned between the left second front molar and the right second front molar and the first molar and fixedly connected with the Y-shaped split base; the two arrow-head snap rings 4 are respectively positioned on the left first molar and the right first molar and are fixedly connected with the Y-shaped split base; the hyperbolic labial arch 1 is positioned in the near-middle anterior tooth area of the fissure and is fixedly connected with the Y-shaped split base.
Illustratively, as shown in fig. 3, the reference 2 is the position corresponding to the alveolar process fissure area of the patient, and there is one on the left and right, and fig. 3 is divided into the left and right of the patient. The invention is changed into a Y-shaped split base on the basis of the conventional left and right split base, and the Y-shaped split base comprises a front base 81, a left base 82 and a right base 83; the Y-shaped split base plate covers the palatal part and the palatal side of the dentition, the front base plate 81 is positioned in front of the bilateral alveolar process fracture area, the left base plate 82 is positioned behind the left and left alveolar process fracture areas in the middle of the palatal part, and the right base plate 83 is positioned behind the right and right alveolar process fractures in the middle of the palatal part. The left side, the right side and the front part of the dental arch are separately controlled through the Y-shaped split base support, so that the control on the front dental arch is increased while the dental arches on the left side and the right side are widened. The front base support 81, the left base support 82 and the right base support 83 are respectively connected by using a spiral bow expander, wherein the left base support 82 and the right base support 83 are connected by a first spiral bow expander 5; the front base support 81 and the left base support 82 are connected through a second spiral bow expander 6; the front base 81 and the right base 83 are connected by a third spiral bow expander 7. Two adjacent hooks 3 are respectively positioned between the left second front molar and the right second front molar and the first molar and fixedly connected with the Y-shaped split base, and the adjacent hooks 3 on the two sides are respectively connected to the left base 82 and the right base 83; the two arrow-shaped snap rings 4 are respectively positioned on the left first molar and the right first molar and fixedly connected with the Y-shaped split base, and the arrow-shaped snap rings 4 on the two sides are respectively connected to the left base 82 and the right base 83; the hyperbolic labial arch 1 is positioned in the near-middle anterior tooth area of the fissure, is fixedly connected with the Y-shaped split base and is connected on the anterior base 81. After the patient has taken the maxillary expander, the positive visual effect is shown in figure 4. The upper jaw arch expander designed by the invention needs to expand dental arches and narrow gaps, and has higher retention requirement on the upper jaw arch expander, so that the upper jaw arch expander is designed by adding an arrow snap ring 4 to the first upper jaw molar, and adding an adjacent hook 3 between the second front upper molar and the first upper jaw molar on the left side and the right side respectively, so that the upper jaw arch expander has a good retention effect during correction and increases the correction efficiency.
Specifically, the front base 81, the left base 82, and the right base 83 are integrally molded with a self-setting base resin. The first spiral expander 5 is in an initial minimum width position; the second spiral bow expander 6 and the third spiral bow expander 7 expand the second spiral bow expander 6 and/or the third spiral bow expander 7 through spiral spring adjusting holes according to preset widths. The legs of the first spiral bow expander 5, the second spiral bow expander 6 and the third spiral bow expander 7 are embedded in resin; the spiral spring adjusting holes of the first spiral bow expander 5, the second spiral bow expander 6 and the third spiral bow expander 7 are not embedded by resin. The double-curved lip bow 1, the adjacent hook 3 and the arrow snap ring 4 are all made of 0.8mm stainless steel wires by bending.
Illustratively, the front base 81, the left base 82, and the right base 83 are each integrally molded using a self-setting base resin. The invention adopts the spiral arch expander to reduce the crack, wherein the spiral arch expander which is connected with the split bases at the front part and the left and right sides is used for determining the width of the final alveolar process crack according to the inspection and analysis result, calculating the preset width of the second spiral arch expander 6 and the third spiral arch expander 7 according to the width, and expanding the arch expander according to the preset width. During treatment, the spiral spring is rotated reversely to adjust the hole to reduce the width of the arch expander, so that the purpose of reducing the size of the crack is achieved, and meanwhile, the hyperbolic labial arch is used in the near-middle anterior tooth area of the crack to ensure the retention and force transmission of the anterior base. The backward moving force generated by the spiral arch expander is transmitted to the anterior jawbone through the anterior base support and the hyperbolic labial arch, so as to achieve the purpose of reducing the width of the fracture of the anterior jawbone. The first spiral expander 5 is in an initial minimum width position; the second spiral bow expander 6 and the third spiral bow expander 7 expand the second spiral bow expander 6 and/or the third spiral bow expander 7 through spiral spring adjusting holes according to preset widths. Wherein the preset width is determined according to the degree of narrowing the gap. FIG. 5 shows the maxillary occlusal aspect of a patient with cleft lip and palate after simulating the upper arch expander, wherein the second and third spiral arch expanders 6 and 7 are widened spiral expanders; the first spiral bow expander 5 is a normal non-widened spiral bow expander.
The invention also designs a correction method for the patient with bilateral cleft lip and palate, which comprises the following steps:
1) preparing a dental model;
2) clinical examination and model analysis: analyzing the width and the shape of the upper and lower jaw dental arches, and analyzing the position of the anterior jaw bone and the width of the crack; CBCT analyzes the position and the defect amount of alveolar process defect, the condition of maxillary lateral incisor defect, the anterior labial-lingual position, lip inclination and the amount of labial-lingual bone plate, the buccal-lingual position of posterior teeth and the amount of buccal bone plate; determining the expansion amount of the maxillary dental arch and the amount of the maxillary bone required to move backwards according to the analysis data, finally determining the final width of the alveolar process fracture, and calculating the preset widths of the second spiral arch expander 6 and the third spiral arch expander 7 according to the width;
3) preparing a maxillary arch expander for bilateral cleft lip and palate: trimming a dental model, bending a double-curved labial arch 1, an adjacent hook 3 and an arrow snap ring 4 by adopting a stainless steel wire of 0.8mm, placing 1 spiral arch expander in the middle of a palate, placing the middle of the palate as a first spiral arch expander 5, additionally pre-expanding the width of the spiral arch expander by 2 spiral arch expanders according to the amount of reducing the gap required from left to right, placing the spiral arch expanders in the crack areas at the left and right sides, respectively placing a second spiral arch expander 6 and a third spiral arch expander 7, paving wax for fixation, and manufacturing a Y-shaped split base by using self-setting base resin; grinding and polishing to manufacture the appliance;
4) correcting: putting the prepared maxillary arch expander for the bilateral cleft lip and palate into the mouth of a patient, and checking the retention and fitting conditions; determining the development amount of the dental arch according to the condition of the reverse occlusion of the dental arch, rotating the spiral spring adjusting hole of the first spiral arch expander 5 twice a week, and increasing the distance between the left base support 82 and the right base support 83 by 0.25mm after each rotation until the back teeth are covered normally; determining the amount of reducing the width of the fracture according to the width of the fracture on the left side and the right side and the position of the anterior jawbone, reversely rotating the spiral spring adjusting holes of the second spiral arch expander 6 and the third spiral arch expander 7 in the left and right fracture areas twice a week, and reducing the distance between the front base 81 and the left base 82, and the distance between the front base 81 and the right base 83 by 0.25mm after each rotation until the width of the fracture is proper; checking and inquiring the arthralgia condition in each time of the re-diagnosis, observing the retention condition of the appliance, checking the improvement condition of the dental arch width of the patient and the reduction condition of the fracture width; after the width of the dental arch and the width of the fissure are improved to the treatment target, the appliance is continuously worn for three months, the existing dental arch is maintained, and the recurrence is prevented.
The upper jaw arch expander designed by the invention solves the problems that the upper jaw arch expansion of a patient with bilateral cleft lip and palate cannot control the protrusion of the anterior jaw and the gap is too wide at the same time, simplifies the correction procedure and shortens the treatment time.
The above are merely examples of the present application and are not intended to limit the present application. Various modifications and changes may occur to those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the scope of the claims of the present application.
Claims (6)
1. A novel maxillary expander for a patient with bilateral cleft lip and palate, the maxillary expander comprising: the double-curved labial arch expanding device comprises a double-curved labial arch (1), an adjacent hook (3), an arrow snap ring (4), a first spiral arch expanding device (5), a second spiral arch expanding device (6), a third spiral arch expanding device (7) and a Y-shaped split base;
the Y-shaped split base comprises a front base (81), a left base (82) and a right base (83);
the Y-shaped split base support covers the palatal part and the palatal side of the dentition, the front base support (81) is positioned in front of the fracture zone of the alveolar process on the two sides, the left base support (82) is positioned behind the fracture zone of the left alveolar process and the left alveolar process in the middle of the palatal part, and the right base support (83) is positioned behind the fracture zone of the right alveolar process and the right alveolar process in the middle of the palatal part;
the left base support (82) and the right base support (83) are connected through a first spiral bow expander (5);
the front base support (81) is connected with the left base support (82) through a second spiral bow expander (6);
the front base support (81) is connected with the right base support (83) through a third spiral bow expander (7);
two adjacent hooks (3) are respectively positioned between the left second front molar and the right second front molar and the first molar and fixedly connected with the Y-shaped split base;
the two arrow-shaped snap rings (4) are respectively positioned on the left first molar and the right first molar and are fixedly connected with the Y-shaped split base;
the hyperbolic labial arch (1) is positioned in the near-middle anterior tooth area of the fissure and is fixedly connected with the Y-shaped split base.
2. The maxillary expander of claim 1 wherein the front base (81), the left base (82) and the right base (83) are each integrally molded using a self-setting base resin.
3. The maxillary expander of claim 1,
the first spiral bow expander (5) is in an initial minimum width position;
the second spiral bow expander (6) and the third spiral bow expander (7) expand the second spiral bow expander (6) and/or the third spiral bow expander (7) through spiral spring adjusting holes according to preset widths.
4. The maxillary expander of claim 3 wherein,
the legs of the first spiral bow expander (5), the second spiral bow expander (6) and the third spiral bow expander (7) are embedded in resin;
the spiral spring adjusting holes of the first spiral bow expander (5), the second spiral bow expander (6) and the third spiral bow expander (7) are not embedded by resin.
5. The maxillary expander of claim 1,
the double-curved lip arch (1), the adjacent hook (3) and the arrow snap ring (4) are all made of 0.8mm stainless steel wires by bending.
6. A method of correcting a patient with bilateral cleft lip and palate using the maxillary expander of any one of claims 1 to 5,
the method comprises the following steps:
1) preparing a dental model;
2) clinical examination and model analysis:
analyzing the width and the shape of the upper and lower jaw dental arches, and analyzing the position of the anterior jaw bone and the width of the crack;
CBCT analyzes the position and the defect amount of alveolar process defect, the condition of maxillary lateral incisor defect, the anterior labial-lingual position, lip inclination and the amount of labial-lingual bone plate, the buccal-lingual position of posterior teeth and the amount of buccal bone plate;
determining the expansion amount of the maxillary dental arch and the amount of the maxillary bone required to move backwards according to the analysis data, finally determining the final width of the alveolar process fracture, and calculating the preset widths of a second spiral arch expander (6) and a third spiral arch expander (7) according to the width;
3) preparing a maxillary arch expander for bilateral cleft lip and palate: trimming a dental model, bending a double-curved labial arch (1), an adjacent hook (3) and an arrow head snap ring (4) by adopting a stainless steel wire of 0.8mm, placing a first spiral arch expander (5) in the middle of a palate, widening a second spiral arch expander (6) and a third spiral arch expander (7) to a preset size through spiral spring adjusting holes according to a preset width, placing the second spiral arch expander and the third spiral arch expander in crack areas on the left side and the right side, paving wax for fixation, and manufacturing a Y-shaped split base by using self-setting base resin; grinding and polishing to manufacture the appliance;
4) correcting: putting the prepared maxillary arch expander for the bilateral cleft lip and palate into the mouth of a patient, and checking the retention and fitting conditions; determining the development amount of the dental arch according to the condition of the retrozygosis of the dental arch, rotating the spiral spring adjusting hole of the first spiral arch expander (5) twice a week, and increasing the distance between the left base (82) and the right base (83) by 0.25mm after each rotation until the posterior teeth are covered normally; determining the amount of reducing the width of the fracture according to the width of the fracture on the left side and the right side and the position of the anterior jaw, reversely rotating the spiral spring adjusting holes of the second spiral arch expander (6) and the third spiral arch expander (7) in the left fracture area and the right fracture area twice a week, and reducing the distance between the front base (81) and the left base (82), and the distance between the front base (81) and the right base (83) by 0.25mm after each rotation until the width of the fracture is proper; checking and inquiring the arthralgia condition in each time of the re-diagnosis, observing the retention condition of the appliance, checking the improvement condition of the dental arch width of the patient and the reduction condition of the fracture width; after the width of the dental arch and the width of the fissure are improved to the treatment target, the appliance is continuously worn for three months, the existing dental arch is maintained, and the recurrence is prevented.
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Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2530565C1 (en) * | 2013-08-06 | 2014-10-10 | Михаил Александрович Постников | M.a. postnikov's method of treating anterior occlusion complicated by cleft lip, alveolar process and hard and soft palate |
| CN209884379U (en) * | 2019-03-21 | 2020-01-03 | 北京大学口腔医学院 | Dental arch width regulator for cleft lip and palate patient |
| CN213697276U (en) * | 2020-11-05 | 2021-07-16 | 北京大学口腔医学院 | A novel upper jaw expands bow ware for bilateral lip cleft palate patient |
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2020
- 2020-11-05 CN CN202011224826.8A patent/CN112274277B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2530565C1 (en) * | 2013-08-06 | 2014-10-10 | Михаил Александрович Постников | M.a. postnikov's method of treating anterior occlusion complicated by cleft lip, alveolar process and hard and soft palate |
| CN209884379U (en) * | 2019-03-21 | 2020-01-03 | 北京大学口腔医学院 | Dental arch width regulator for cleft lip and palate patient |
| CN213697276U (en) * | 2020-11-05 | 2021-07-16 | 北京大学口腔医学院 | A novel upper jaw expands bow ware for bilateral lip cleft palate patient |
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