CN112274277B - Novel maxillary expander for patient with bilateral cleft lip and palate and correction method - Google Patents
Novel maxillary expander for patient with bilateral cleft lip and palate and correction method Download PDFInfo
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- CN112274277B CN112274277B CN202011224826.8A CN202011224826A CN112274277B CN 112274277 B CN112274277 B CN 112274277B CN 202011224826 A CN202011224826 A CN 202011224826A CN 112274277 B CN112274277 B CN 112274277B
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- 206010009260 Cleft lip and palate Diseases 0.000 title claims abstract description 32
- 230000002146 bilateral effect Effects 0.000 title claims abstract description 32
- 208000016653 cleft lip/palate Diseases 0.000 title claims abstract description 32
- 238000000034 method Methods 0.000 title claims abstract description 17
- 238000012937 correction Methods 0.000 title abstract description 11
- 210000003254 palate Anatomy 0.000 claims abstract description 23
- 210000001847 jaw Anatomy 0.000 claims abstract description 9
- 210000004763 bicuspid Anatomy 0.000 claims abstract description 7
- 210000004513 dentition Anatomy 0.000 claims abstract description 6
- 230000036346 tooth eruption Effects 0.000 claims abstract description 6
- 210000002455 dental arch Anatomy 0.000 claims description 38
- 210000001909 alveolar process Anatomy 0.000 claims description 21
- 239000011347 resin Substances 0.000 claims description 13
- 229920005989 resin Polymers 0.000 claims description 13
- 230000014759 maintenance of location Effects 0.000 claims description 9
- 210000000988 bone and bone Anatomy 0.000 claims description 8
- 206010009259 cleft lip Diseases 0.000 claims description 8
- 238000004458 analytical method Methods 0.000 claims description 6
- 230000007547 defect Effects 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
- 238000005452 bending Methods 0.000 claims description 4
- 208000006820 Arthralgia Diseases 0.000 claims description 3
- 238000007408 cone-beam computed tomography Methods 0.000 claims description 3
- 210000003823 hyoid bone Anatomy 0.000 claims description 3
- 210000004283 incisor Anatomy 0.000 claims description 3
- 210000004373 mandible 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 3
- 210000002050 maxilla Anatomy 0.000 description 6
- 208000032170 Congenital Abnormalities Diseases 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 206010010356 Congenital anomaly Diseases 0.000 description 3
- 230000007698 birth defect Effects 0.000 description 3
- 210000000214 mouth Anatomy 0.000 description 3
- 210000003781 tooth socket Anatomy 0.000 description 3
- 206010009269 Cleft palate Diseases 0.000 description 2
- 208000031481 Pathologic Constriction Diseases 0.000 description 2
- 230000005856 abnormality Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000036262 stenosis Effects 0.000 description 2
- 208000037804 stenosis Diseases 0.000 description 2
- 230000005540 biological transmission Effects 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 238000012549 training Methods 0.000 description 1
Classifications
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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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- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
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- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
The invention discloses a novel maxillary expander and a correction method for patients with bilateral cleft lip and palate, wherein the maxillary expander comprises a hyperbolic lip expander 1, an interproximal hook 3, an arrow clasp 4, a first spiral expander 5, a second spiral expander 6, a third spiral expander 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 which are connected by using a spiral bow expander; the Y-shaped split base covers the palate and the palate side of the dentition; two adjacent hooks 3 are respectively positioned between the left and right second premolars and the first molar and fixedly connected with the Y-shaped split base; the two arrow snap rings 4 are respectively positioned at the left and right first molar teeth and fixedly connected with the Y-shaped split base; the hyperbolic labial arch 1 is positioned in the anterior tooth area near the middle of the fissure and is fixedly connected with the Y-shaped split base. The invention solves the problems that the upper jaw of the existing patient with bilateral cleft lip and palate expands the arch and simultaneously cannot control the anterior process of the anterior jaw and the overwidth of the fissure, simplifies the correction procedure and shortens the treatment time.
Description
Technical Field
The invention belongs to the technical field of stomatology, and particularly relates to a novel maxillary arch expander and a correcting method for a patient with bilateral cleft lip and palate.
Background
Cleft lip and palate is the most common congenital birth defect of the face of the oral cavity, the prevalence rate in China is 0.082-0.16%, and the first birth defect is listed in all birth defects. The sequential treatment of cleft lip and palate patients is the consensus of specialists at home and abroad, namely, the patients are treated differently according to the conditions of the patients in different growth and development stages, including cleft lip operation, cleft palate operation, orthodontic treatment, bone grafting operation, voice training and the like. The incidence of mismatching deformities in such patients is very high, about 97%, due to congenital development and surgical effects. Orthodontic treatment plays an important role in cleft lip sequence treatment and throughout the sequence treatment.
The problem of the matching of the dental arch width and the width of the fissure area of the cleft lip and palate patient is the key point and the difficult point in the orthodontic treatment of the cleft lip and palate. In a patient with bilateral cleft lip and palate, as the continuity of the maxilla is interrupted, the anterior maxilla and the alveolar process are broken, the anterior process is obvious, the muscle force abnormality causes the posterior segment of the bilateral maxilla to rotate towards the midline and collapse, the anterior process of the maxilla is often represented by the anterior segment of the maxilla, the gap width of the bilateral fissure area is large, the alveolar processes on the two sides of the fissure are poorly aligned to form steps, the teeth in the fissure area are lost, the collapse and the inverse of the maxilla are locked, and no occlusion contact is caused. The cleft lip patients need to match the widths and the forms of the upper dental arch and the lower dental arch no matter the orthodontic treatment before the bone grafting of the dental alveolus, the permanent tooth period Shan Chunzheng orthodontic treatment or the orthodontic and orthognatic combined treatment, the size of a gap area at the dental alveolus is adjusted, especially before bone grafting, the orthodontic treatment expands the dental arch of the upper dental arch, adjusts the width of the dental alveolus gap, restores the normal form of the dental arch, is favorable for the operation and improves the success rate of bone grafting. Therefore, the problem of correctly treating the width of the upper dental arch, the lower dental arch and the width of the fissure area of the cleft lip and palate patient has important significance for orthodontic treatment effect and long-term stability.
The current orthodontic appliance for cleft lip dental arch width abnormality is mainly a maxillary arch expander, and the maxillary arch expander can be divided into an active arch expander and a fixed arch expander according to whether a patient can be taken off or put on the appliance or not, and can be divided into a rapid arch expander and a slow arch expander according to an arch expanding mode. The expander which is commonly used for patients with bilateral cleft lips and palates comprises a quadrangle ring spring expander, a split base expander, an expander auxiliary expander and the like. Such appliances can solve the problem of maxillary dental arch stenosis, but generally cannot solve the problem of anterior maxillary protrusion and excessive width of the fissure, and the expansion of the posterior dental segment can further cause the width of the fissure area to be increased, which is unfavorable for the success of bone grafting operation. Therefore, aiming at cleft lip and palate patients, the problem of dental arch stenosis is usually solved by using an upper jaw arch expanding appliance, and the problem of alignment and width of two ends of a crack is solved by using a fixed appliance, 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 can not control the anterior maxillary protrusion and the gap width of a patient with bilateral cleft lip and palate, and provides a novel expander for the patient with bilateral cleft lip and palate, which can simultaneously solve the problems of narrow maxillary width and anterior maxillary protrusion. Namely, a novel maxillary expander for a patient with bilateral cleft lip and palate, comprising: the device comprises a hyperbolic lip bow, an interproximal hook, an arrow clasp, a first spiral bow expander, a second spiral bow expander, a third spiral bow expander and a Y-shaped split base;
The Y-shaped split base comprises a front base, zuo Jituo and a right base;
The Y-shaped split base covers the palate and the palate side of the dentition, the front base is positioned at the front part of the bilateral alveolar process fissure area, zuo Jituo is positioned behind the left side and the left side alveolar process fissure area in the middle of the palate, and the right base is positioned behind the right side and the right side alveolar process fissure area in the middle of the palate;
The Zuo Jituo and the right base are connected through a first spiral bow expander;
The front base support is connected with Zuo Jituo through a second spiral bow expander;
The front base support and the right base support are connected through a third spiral bow expander;
The two adjacent hooks are respectively positioned between the left and right second premolars and the first molar and fixedly connected with the Y-shaped split base;
The two arrow clamping rings are respectively positioned at the left and right first molar teeth and fixedly connected with the Y-shaped split base;
the hyperbolic labial arch is positioned in the anterior tooth area near the middle of the fissure and is fixedly connected with the Y-shaped split base.
Further, the front base, zuo Jituo and the right base are integrally molded using self-setting base resins, respectively.
Further, the first helical expander is in an initial minimum width position;
The second spiral expander and the third spiral expander expand the hole to widen the second spiral expander and/or the third spiral expander according to the preset width through the spiral spring adjusting hole.
Further, the legs of the first spiral expander, the second spiral expander and the third spiral expander are embedded in resin;
the spiral spring adjusting holes of the first spiral expander, the second spiral expander and the third spiral expander are not embedded by resin.
Further, the hyperbolic lip bow, the adjacent hooks and the arrow clasp are all made of stainless steel wires with the thickness of 0.8 mm.
The invention also designs a correction method for the 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 dental arches of the upper jaw and the lower jaw, and analyzing the position of the front jaw and the width of a crack;
CBCT analyzes the position and the defect amount of the alveolar process defect, the condition of the missing of the maxillary incisors, the labial lingual position, the labial inclination and the amount of the labial lingual bone plate of the anterior teeth, the buccal lingual position and the amount of the buccal bone plate of the posterior teeth;
Determining the expansion amount of the maxillary dental arch and the amount of the mandible to be moved backwards according to the analysis data, finally determining the final width of the alveolar process fissure, and calculating the preset widths of the second spiral expander and the third spiral expander according to the width;
3) Preparing a bilateral cleft lip and palate maxillary arch expander: trimming a dental model, bending a hyperbolic lip bow, an interproximal hook and an arrow clasp by adopting a stainless steel wire with the thickness of 0.8mm, placing a first spiral expander in the middle of a palate, widening a second spiral expander and a third spiral expander to a preset size according to a preset width through spiral spring adjusting holes, placing the second spiral expander and the third spiral 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; polishing and finishing to manufacture an appliance;
4) Correcting: putting the prepared upper jaw expander for bilateral cleft lip and palate into the mouth of a patient, and checking retention and fitting conditions; determining the development quantity of dental arches according to the dental arch reverse situation, rotating the spiral spring adjusting hole of the first spiral arch expander twice per week, and increasing the distance between Zuo Jituo and the right base by 0.25mm after each rotation until the coverage of the rear teeth is normal; determining the amount of reducing the width of the crack according to the width of the crack on the left side and the right side and the position of the front jaw bone, reversely rotating the spiral spring adjusting holes of the second spiral expander and the third spiral expander in the left crack area and the right crack area twice per week, and reducing the distance between the front base and Zuo Jituo and the distance between the front base and the right base by 0.25mm after each rotation until the width of the crack is proper; each time the joint pain is checked and inquired, the retention condition of the appliance is observed, the improvement condition of the dental arch width of the patient is checked, and the reduction condition of the slit width is checked; after the width of the dental arch and the width of the fissure are improved to the treatment target, the appliance is worn for three months, the existing dental arch is maintained, and the recurrence is prevented.
The novel maxillary arch expander for the patient with bilateral cleft lip and palate solves the problem that the maxillary arch expansion of the patient with bilateral cleft lip and palate can not control the anterior jaw protrusion and the gap too wide at the same time, simplifies the correction procedure and shortens the treatment time.
Drawings
FIG. 1 shows a schematic representation of the arching of a normal human tooth in accordance with an embodiment of the present invention;
FIG. 2 shows a schematic view of the arching state of a cleft lip and palate patient according to an embodiment of the present invention;
FIG. 3 is a schematic view showing the occlusal surface view structure of the maxillary arch expander according to an embodiment of the present invention;
FIG. 4 is a schematic view of a cleft lip and palate patient with a maxillary expander in front view according to an embodiment of the present invention;
Fig. 5 shows a schematic view of the posterior occlusal view of a cleft lip patient with a maxillary expander according to an embodiment of the present invention.
In the figure: 1. hyperbolic labial arch; 2. alveolar process fissure area; 3. an inter-adjacent hook; 4. an arrow clasp; 5. a first helical bow expander; 6. a second helical bow expander; 7. a third helical bow expander; 81. a front base; 82. zuo Jituo; 83. and a right base.
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 provides a novel maxillary expander for a patient with bilateral cleft lip and palate, which is used for correcting the bilateral cleft lip and palate, wherein the dental arch state of a normal person is shown in figure 1, the dental arch state of the patient with bilateral cleft lip and palate is shown in figure 2, and the maxillary expander comprises: the device comprises a hyperbolic lip bow 1, an interproximal hook 3, an arrow clasp 4, a first spiral bow expander 5, a second spiral bow expander 6, a third spiral bow expander 7 and a Y-shaped split base.
Specifically, the Y-shaped split base includes a front base 81, a left base 82, and a right base 83; the Y-shaped split base covers the palate and the palate side of the dentition, the front base 81 is positioned at the front part of the bilateral alveolar process fissure area, the Zuo Jituo is positioned behind the left side and left side alveolar process fissure area in the middle of the palate, and the right base 83 is positioned behind the right side and right side alveolar fissure in the middle of the palate; the Zuo Jituo and the right base 83 are connected through a first spiral bow expander 5; the front base plates 81 and Zuo Jituo are connected through a second spiral bow expander 6; the front base 81 and the right base 83 are connected through a third spiral bow expander 7; two adjacent hooks 3 are respectively positioned between the left and right second premolars and the first molar and fixedly connected with the Y-shaped split base; the two arrow clamping rings 4 are respectively positioned at the left and right first molar teeth and fixedly connected with the Y-shaped split base; the hyperbolic labial arch 1 is positioned in the anterior tooth area near the middle of the fissure and is fixedly connected with the Y-shaped split base.
Illustratively, as shown in fig. 3, the reference numeral 2 is a position corresponding to the fissure region of the alveolar process of the patient, and the position is divided into left and right parts, and fig. 3 is divided into left and right parts of the patient. The invention is changed into a Y-shaped split base on the basis of a conventional left-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 covers the palate and the palate side of the dentition, the front base 81 is positioned in front of the bilateral alveolar process fissure area, zuo Jituo is positioned behind the left and left alveolar process fissure areas in the middle of the palate, and the right base 83 is positioned behind the right and right alveolar fissures in the middle of the palate. The left side, the right side and the front part of the dental arch are controlled separately through the Y-shaped split base, so that the control of the front dental arch is increased while the dental arches on the left side and the right side are widened. The front base 81, the left base 82 and the right base 83 are respectively connected by using a spiral bow expander, wherein the Zuo Jituo and the right base 83 are connected by a first spiral bow expander 5; the front base plates 81 and Zuo Jituo are connected through a second spiral bow expander 6; the front base 81 and the right base 83 are connected by a third screw expander 7. Two adjacent hooks 3 are respectively positioned between the left and right second premolars and the first molar and fixedly connected with the Y-shaped split base, and the adjacent hooks 3 on two sides are respectively connected with the left base 82 and the right base 83; the two arrow snap rings 4 are respectively positioned at the left and right first molar teeth and fixedly connected with the Y-shaped split base, and the arrow snap rings 4 at the two sides are respectively connected with the left base 82 and the right base 83; the hyperbolic labial arch 1 is positioned in the mesial anterior tooth area of the fissure, is fixedly connected with the Y-shaped split base and is connected to the anterior base 81. The frontal effect is shown in fig. 4 when the patient has carried the maxillary expander. The maxillary expander designed by the invention not only needs to expand dental arches, but also needs to narrow gaps, and has higher retention requirement on the maxillary expander, so that the maxillary expander designed by the invention is added with an arrow clasp 4 at the first molar of the maxillary, and an adjacent hook 3 is respectively added between the second premolars and the first molar at the left side and the right side, thereby having good retention effect during correction and increasing correction efficiency.
Specifically, the front base 81, the left base 82, and the right base 83 are integrally molded using self-setting base resins, respectively. The first spiral bow expander 5 is in an initial minimum width position; the second spiral expander 6 and the third spiral expander 7 expand the hole by adjusting the hole of the spiral spring according to the preset width, and the second spiral expander 6 and/or the third spiral expander 7 expand the hole. 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 expander 5, the second spiral expander 6 and the third spiral expander 7 are not embedded by resin. The hyperbolic lip bow 1, the adjacent hooks 3 and the arrow clasp 4 are all made of stainless steel wires with the thickness of 0.8 mm.
Illustratively, the front, left and right bases 81, 82, 83 are each integrally formed using a self-setting base resin. The invention adopts the spiral expander to shrink the crack, wherein the spiral expander which connects the front part with the split base at the left side and the right side is used for determining the width of the final alveolar process crack according to the checking and analyzing result, calculating the preset widths of the second spiral expander 6 and the third spiral expander 7 according to the width, and expanding the expander according to the preset widths. The spiral spring adjusting hole is reversely rotated in treatment to reduce the width of the arch expander, so that the aim of reducing the size of the fissure is fulfilled, and meanwhile, the hyperbolic lip arch is used in the near-middle anterior tooth area of the fissure to ensure the retention and the force transmission of the anterior base. The backward movement force generated by the spiral bow expander is transferred to the anterior jawbone through the anterior base and the hyperbolic lip bow, so as to achieve the purpose of reducing the width of the crack of the backward movement anterior jawbone. The first spiral bow expander 5 is in an initial minimum width position; the second spiral expander 6 and the third spiral expander 7 expand the hole by adjusting the hole of the spiral spring according to the preset width, and the second spiral expander 6 and/or the third spiral expander 7 expand the hole. Wherein the preset width is determined according to the degree of narrowing the gap. Fig. 5 shows a cleft lip patient simulated posterior maxillary dentition occlusal view with an upper expander, wherein the second spiral expander 6 and the third spiral expander 7 are expanded spiral expanders; the first spiral expander 5 is a normal, non-expanded spiral 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 dental arches of the upper jaw and the lower jaw, and analyzing the position of the front jaw and the width of a crack; CBCT analyzes the position and the defect amount of the alveolar process defect, the condition of the missing of the maxillary incisors, the labial lingual position, the labial inclination and the amount of the labial lingual bone plate of the anterior teeth, the buccal lingual position and the amount of the buccal bone plate of the posterior teeth; determining the expansion amount of the maxillary dental arch and the amount of the mandible to be moved backwards according to the analysis data, finally determining the final width of the alveolar process fissure, and calculating the preset widths of the second spiral expander 6 and the third spiral expander 7 according to the width;
3) Preparing a bilateral cleft lip and palate maxillary arch expander: trimming a dental model, namely bending a hyperbolic lip bow 1, an interproximal hook 3 and an arrow clasp 4 by adopting a stainless steel wire with the diameter of 0.8mm, placing 1 spiral expander in the middle of a palate, placing a first spiral expander 5 in the middle of the palate, pre-expanding the widths of the spiral expanders by 2 spiral expanders according to the amount of reducing gaps left and right and placing the spiral expanders in crack areas on the left and right sides, respectively placing a second spiral expander 6 and a third spiral expander 7, paving wax for fixation, and manufacturing a Y-shaped split base by using self-setting base resin; polishing and finishing to manufacture an appliance;
4) Correcting: putting the prepared upper jaw expander for bilateral cleft lip and palate into the mouth of a patient, and checking retention and fitting conditions; determining the development amount of dental arches according to the dental arch reverse situation, rotating the spiral spring adjusting hole of the first spiral arch expander 5 twice per week, and increasing the distance between Zuo Jituo and the right base 83 by 0.25mm after each rotation until the rear teeth are covered normally; determining the amount of reducing the width of the crack according to the width of the crack on the left side and the right side and the position of the front jaw bone, reversely rotating the spiral spring adjusting holes of the second spiral expander 6 and the third spiral expander 7 in the left and the right crack areas twice per week, and reducing the distance between the front base brackets 81 and Zuo Jituo 82 and the distance between the front base bracket 81 and the right base bracket 83 by 0.25mm after each rotation until the width of the crack is proper; each time the joint pain is checked and inquired, the retention condition of the appliance is observed, the improvement condition of the dental arch width of the patient is checked, and the reduction condition of the slit width is checked; after the width of the dental arch and the width of the fissure are improved to the treatment target, the appliance is worn for three months, the existing dental arch is maintained, and the recurrence is prevented.
The maxillary arch expander designed by the invention solves the problem that the maxillary arch expansion of the existing bilateral cleft lip and palate patient cannot control the anterior process of the anterior jaw and the excessive width of the fissure, simplifies the correction procedure and shortens the treatment time.
The foregoing is merely exemplary of the present application and is not intended to limit the present application. Various modifications and variations of the present application will be apparent to those skilled in the art. Any modification, equivalent replacement, improvement, etc. which come within the spirit and principles of the application are to be included in the scope of the claims of the present application.
Claims (3)
1. A novel maxillary expander for a bilateral cleft lip patient, the maxillary expander comprising: the device comprises a hyperbolic lip bow (1), an interproximal hook (3), an arrow clasp (4), a first spiral bow expander (5), a second spiral bow expander (6), a third spiral bow expander (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 covers the palate and the palate side of the dentition, the front base (81) is positioned at the front part of the bilateral alveolar process fissure area, the Zuo Jituo (82) is positioned behind the left side and the left side alveolar process fissure area in the middle of the palate, and the right base (83) is positioned behind the right side and the right side alveolar process fissure area in the middle of the palate;
The Zuo Jituo (82) and the right base (83) are connected through a first spiral bow expander (5);
The front base (81) and the Zuo Jituo (82) are connected through a second spiral bow expander (6);
the front base (81) and the right base (83) are connected through a third spiral bow expander (7);
two adjacent hooks (3) are respectively positioned between the left second premolars and the right second premolars and the first molar and are fixedly connected with the Y-shaped split base;
The two arrow clamping rings (4) are respectively positioned at the left and right first molar teeth and fixedly connected with the Y-shaped split base;
the hyperbolic labial arch (1) is positioned in the middle front tooth area near the fissure and is fixedly connected with the Y-shaped split base;
the first spiral bow expander (5) is in an initial minimum width position;
The second spiral expander (6) and the third spiral expander (7) expand the hole by a spiral spring adjusting hole according to the preset width, and the second spiral expander (6) and/or the third spiral expander (7) are/is expanded;
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 expander (5), the second spiral expander (6) and the third spiral expander (7) are not embedded by resin;
The hyperbolic lip bow (1), the adjacent hooks (3) and the arrow clasp (4) are all formed by bending stainless steel wires with the thickness of 0.8 mm.
2. The maxillary arch expander according to claim 1, wherein the front base (81), the left base (82) and the right base (83) are integrally molded respectively using self-solidifying base resins.
3. A method for correcting a patient suffering from bilateral cleft lip and palate by using the maxillary arch expander according to any one of claims 1 to 2,
The method comprises the following steps:
1) Preparing a dental model;
2) Clinical examination and model analysis:
Analyzing the width and the shape of dental arches of the upper jaw and the lower jaw, and analyzing the position of the front jaw and the width of a crack;
CBCT analyzes the position and the defect amount of the alveolar process defect, the condition of the missing of the maxillary incisors, the labial lingual position, the labial inclination and the amount of the labial lingual bone plate of the anterior teeth, the buccal lingual position and the amount of the buccal bone plate of the posterior teeth;
Determining the expansion amount of the maxillary dental arch and the amount of the mandible to be moved backwards according to the analysis data, finally determining the final width of the alveolar process fissure, and calculating the preset widths of the second spiral expander (6) and the third spiral expander (7) according to the width;
3) Preparing a bilateral cleft lip and palate maxillary arch expander: trimming a dental model, bending a hyperbolic lip bow (1), an interproximal hook (3) and an arrow clasp (4) by adopting a stainless steel wire with the thickness of 0.8mm, placing a first spiral expander (5) in the middle of a palate, expanding a second spiral expander (6) and a third spiral expander (7) to a preset size according to a preset width through spiral spring adjusting holes, placing the two parts at the left side and the right side of the dental model in crack areas, paving wax for fixation, and manufacturing a Y-shaped split base by using self-setting base resin; polishing and finishing to manufacture an appliance;
4) Correcting: putting the prepared upper jaw expander for bilateral cleft lip and palate into the mouth of a patient, and checking retention and fitting conditions; determining the development quantity of dental arches according to the dental arch reverse situation, rotating the spiral spring adjusting hole of the first spiral arch expander (5) twice per week, and increasing the distance between Zuo Jituo (82) and the right base (83) by 0.25mm after each rotation until the rear teeth are covered normally; determining the amount of reducing the width of the crack according to the width of the crack on the left side and the right side and the position of the front jaw bone, reversely rotating the spiral spring adjusting holes of the second spiral expander (6) and the third spiral expander (7) in the left and the right crack areas twice per week, and reducing the distance between the front base plates (81) and Zuo Jituo (82), the front base plates (81) and the right base plates (83) by 0.25mm after each rotation until the width of the crack is proper; each time the joint pain is checked and inquired, the retention condition of the appliance is observed, the improvement condition of the dental arch width of the patient is checked, and the reduction condition of the slit width is checked; after the width of the dental arch and the width of the fissure are improved to the treatment target, the appliance is worn for three months, the existing dental arch is maintained, and the recurrence is prevented.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
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| Publication number | Priority date | Publication date | Assignee | Title |
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| 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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| 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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