CN113143523A - Oral disposable gothic arch-type penograph and method for determining positive relation position - Google Patents
Oral disposable gothic arch-type penograph and method for determining positive relation position Download PDFInfo
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- CN113143523A CN113143523A CN202110429044.6A CN202110429044A CN113143523A CN 113143523 A CN113143523 A CN 113143523A CN 202110429044 A CN202110429044 A CN 202110429044A CN 113143523 A CN113143523 A CN 113143523A
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Abstract
The disposable gothic arch-type recorder in the mouth has simple structure and low cost, reduces the clinical cross infection probability by one-time use, and is convenient for popularization and use in a large-scale oral outpatient service; the arch tracer is used for determining the clinical operation flow of the central relation position of a patient without a dental jaw, the vertical height is adjusted in a modularized mode, the accuracy is 0.5mm, the clinical requirement is completely met, the clinical operation is convenient, 3 contour tracing needles which are arranged in a triangular mode guarantee the balance and stability of a tracing plate, the stability of the central relation is finally guaranteed, the possible upper and lower jaw small deviation of fixation of a conventional oral Golde type arch single tracing needle is overcome, and the upper jaw completes the wax levee in advance to facilitate the accurate position of the upper closing frame and the artificial tooth arrangement of the facial arch transfer.
Description
Technical Field
The invention relates to an intraoral disposable gothic arch recorder and a method for determining the central relation position of an edentulous jaw patient by using the intraoral gothic arch recorder.
Background
China already enters an aging society, the proportion of old people is increased year by year, and more edentulous patients exist. Whether a conventional complete denture is manufactured or a denture is implanted for repair, the determination of the correct position of the lower jaw relative to the upper jaw of the patient, namely the median relationship, is the key to whether the physiological functions of the mouth and jaw, such as chewing, of the patient can be finally recovered.
In the clinical routine determination of the medial relation, a physician usually determines the medial relation by empirically determining the vertical distance and then guiding the mandibular condyle of the patient to the most anterior position of the temporomandibular joint to determine the horizontal position, and then using the wax levee to record: it is difficult to ensure that the position of the clinical record is consistent with the true median relationship of the patient, simply depending on the physician's empirical judgment.
To determine the accuracy of the median relationship, a recording method of tracing the trajectory of the movements of the lower jaw inside and outside the oral cavity, i.e. the Goldstrophe method; the principle is that the center relation position is the only position of the mandible retreating, and any jaw position of the mandible when the mandible is stretched forwards and moved laterally is positioned in front of the center relation; generally, a recording plate is fixedly arranged on a maxilla base support, a recording needle is fixedly arranged on a mandible base support, and the recording tracks of jaw position in all directions in the horizontal plane can obtain a V-shaped graph on the maxilla recording plate, wherein the tip end of the V-shaped graph points to the back end and points to the top roof of a European gothic building due to the shape of the V-shaped graph, and the V-shaped graph is called a gothic bow. The tip of the gothic arch represents the centric relationship, and when the needle is at this tip, the lower jaw is in its only position in which it is set back.
The common gothic arch is complex in structure, firstly, an upper closing frame in the center relation of upper and lower jaws is preliminarily determined, resin upper and lower closing supports are manufactured, an occlusion plane is determined, self-setting resin is used for fixing the upper and lower jaw occlusal plates and the upper and lower closing supports on the occlusion plane, a metal tracing plate is fixed on a metal sliding rail of the upper jaw occlusal plate, the metal tracing plate can slide back and forth within a certain range and is adjusted to a proper position, a tracing coating is sprayed on the surface of the metal tracing plate, and a lower jaw fixing plate of a spiral tracing needle is fixed on the metal sliding rail of the lower jaw biting plate and is adjusted to a proper position. The fixed upper jaw closing support is placed into a mouth of a patient, a screwdriver is used for adjusting the height of a lower jaw tracing needle so as to adjust a proper vertical distance, the patient is ordered to move forwards and leftwards and rightwards, a V-shaped figure with the pointed end pointing to the rear end is left on a tracing coating on an upper jaw metal tracing plate, the upper jaw closing support and the lower jaw closing support in the mouth are taken out, a V-shaped fixed point is found, and a fixing piece hole with a hole is matched with the tracing needle of the lower jaw for fixing. After the patient uses up, still need to close each subassembly of the U.S. Goldder's bow in the mouth from upper and lower and hold in the palm and demolish, ensure not to lose each part, then clean, disinfect for next use. The oral Goldder bow has more mechanical accessories, needs experienced clinicians and longer clinical operation when in use, and is inconvenient for clinical popularization and use. The scholars propose to manufacture the integrated upper jaw closing support and the tracing plate by a 3D printing method, although the operation is simplified, the manufacturing cost is higher, the difficulty of single-point fixation can not be fundamentally solved, and the method is not suitable for popularization to beginners and primary hospitals; some students add mechanical devices in the aspect of adjustment to ensure the fine and accurate adjustment, but the additional mechanical devices have limited installation and debugging space, which brings the complexity and the complexity of clinical operation and overhigh cost.
Disclosure of Invention
Aiming at the difficulties of determining the median relationship of the existing clinical edentulous jaw and deficient teeth patients, the defects that the original Goldy bow has complex structure, high cost, complicated clinical using procedures and sensitive single-point fixing technology, cannot be used for primary hospitals and young doctors and the like are overcome, the invention provides the intraoral disposable Goldy bow recorder which has simple structure, multi-point tracing, stability, low manufacturing cost, convenient use and low technical sensitivity, avoids cross infection, is beneficial to the primary hospitals and the clinical doctors, accurately determines the median relationship of the patients and manufactures the false teeth with high quality.
The disposable gothic arch tracer in the mouth consists of the following parts:
1. the mandibular tracing needle fixing plate 1 and the mandibular tracing needle 2 are made of high-strength polymethyl methacrylate (PMMA) or stainless steel materials, the thickness of the mandibular tracing needle fixing plate 1 is about 1.0mm, the mandibular tracing needle fixing plate is in an equilateral trapezoid shape, the width of the bottom side is 50.0mm, the height of the mandibular tracing needle is 25.0mm, the width of the top side is 35.0mm, the mandibular tracing needle fixing plate 1 is made of cylindrical stainless steel materials with the diameter of 1.0mm, the height of the mandibular tracing needle is 10.0mm, the tip of the mandibular tracing needle 1 is in a conical shape, the first mandibular tracing needle is positioned at the position 5.0mm away from the center of the bottom side, the other two mandibular tracing needles are far away from the bottom side and are positioned on the vertex of an equilateral triangle with the side length of 10.0mm together with the first tracing needle (figures 2-1 and 2-2);
2. the upper jaw tracing plate 5 is made of high-strength polymethyl methacrylate (PMMA), is 1.0mm thick, is in an approximately equilateral trapezoid with a semi-arc-shaped top side, 40.0mm wide bottom side, 30.0mm high and 30.0mm long top side chord length (figures 2-3);
3. the heightening trace plate 4 is made of high-strength polymethyl methacrylate (PMMA) with the same size as the upper jaw trace plate 5 and has the thickness of 0.5mm and 1.0 mm;
4. the needle fixing piece 3 is used for fixing the positions of the needle 2 and the maxillofacial tracing plate 5, is high-strength polymethyl methacrylate (PMMA), has a 15.0mm long round-angle equilateral triangle shape and a thickness of 1.0mm, has 3 fixing round holes with a diameter of 1.0mm in the center, is positioned at 3 fixed points of the 10.0mm long equilateral triangle shape, and is parallel to the mandible needle fixing plate 1 after the round holes are buckled and jointed with the tip of the needle 2. (FIGS. 2 to 4)
Drawings
FIGS. 1-1: a solid view of the disposable Goldder-type mandibular trace needle fixing plate, the trace needle fixing plate and the maxillary trace plate after being fixed in the mouth;
FIGS. 1-2: a sector-shaped exploded view of a disposable Goldder-type mandibular tracing needle fixing plate, a tracing needle fixing plate and a maxillary tracing plate in the mouth;
FIG. 2-1: horizontal view of mandible tracing needle fixing plate;
FIGS. 2-2: the front view of a mandible tracing needle fixing plate;
FIGS. 2-3: a maxillary tracing plate;
FIGS. 2-4: a needle fixing sheet;
FIG. 3-1: complete denture upper and lower base supports;
FIGS. 3-2: the complete denture upper jaw wax dike looks sideways;
FIGS. 3-3: the complete denture upper jaw wax levee is in a frontal view;
FIGS. 3-4: the fixing plate with the needle is fixed on the lower jaw base;
FIGS. 3-5: the maxillary tracing plate is fixed on the maxillary base;
FIGS. 3-6: preliminarily determining the vertical distance between the upper jaw and the lower jaw;
FIGS. 3-7: adjusting the vertical distance to be proper by using an adding and tracing plate;
FIGS. 3-8: the lower jaw repeatedly makes forward extension and lateral movement;
FIGS. 3-9: a needle motion trail obtained on the maxillary tracing plate;
figures 3-10: the needle fixing sheet is fixed on the maxillary tracing plate according to the tracing vertex position;
FIGS. 3-11: the mandibular tracing needle is positioned in the small hole of the tracing needle fixing piece, and the central relation is verified;
FIGS. 3-12: the intraoral median relationship was confirmed and the silicone rubber was fixed.
Reference numerals:
1. a mandibular needle fixing plate;
2. a tracing needle;
3. a needle fixing sheet;
4. heightening the tracing board;
5. maxillary tracing board
6. Lower jaw temporary base
7. Upper jaw base and wax levee;
the specific implementation mode is as follows:
referring to fig. 1-1 through 2-4, the intraoral disposable gothic arch recorder of the present invention is comprised of the following parts: a mandible tracing needle fixing plate 1, a tracing needle 2, a tracing needle fixing plate 3, a heightened tracing plate 4 and a maxilla tracing plate 5.
1. Referring to the attached drawings 2-1 and 2-2, the mandibular needle fixing plate 1 is made of high-strength polymethyl methacrylate (PMMA) or stainless steel, is 1.0mm thick, is in the shape of an isosceles trapezoid, has a bottom side 50.0mm wide, a height 25.0mm and a top side 35.0mm wide; three tracing needles 2, each of which is a cylindrical stainless steel needle with the diameter of 1.0mm and is 10.0mm high, the first tracing needle is positioned at the position 5.0mm from the center of the bottom edge, the other two tracing needles are far away from the bottom edge and are positioned on the vertex of an equilateral triangle with the side length of 10.0mm together with the first tracing needle;
2. referring to the attached drawings 2-4, the needle fixing plate 3 is used for fixing the positions of the needle and the maxilla needle, and is made of high-strength polymethyl methacrylate (PMMA), a round-corner equilateral triangle with the side length of 15.0mm and the thickness of 1.0mm, 3 fixing round holes with the diameter of 1.0mm are arranged in the center, 3 fixed points are arranged on the equilateral triangle with the side length of 10.0mm, and the needle fixing plate is parallel to the mandible fixing plate after the round holes are buckled and jointed with the tip of the needle.
3. The heightening trace plate 4 is made of high-strength polymethyl methacrylate (PMMA) with the same size as the upper jaw trace plate, and the thickness is divided into 0.5mm and 1.0 mm;
4. referring to the attached drawings 2-3, the maxillary tracing plate 5 is made of high-strength polymethyl methacrylate (PMMA), is 1.0mm thick, and is in an arc shape capable of inscribing an isosceles trapezoid, wherein the bottom side of the inscribing isosceles trapezoid is 40.0mm wide and 30.0mm high, and the chord length of the top side is about 30.0 mm;
referring to FIGS. 1-1, 1-2, 3-1 through 3-12, the present invention utilizes the intraoral Gothic arch recorder to determine the neutral relationship of an edentulous patient as follows:
1. preparing a complete denture functional final impression, pouring a non-dentognathic final impression superhard gypsum model, manufacturing upper and lower jaw resin bases by using a light-cured resin plate or a 3D printing method, wherein the thickness of the bases is about 1.0mm, and fitting the bases in the mouth without interfering the lip and tongue movement (figure 3-1);
2. making a wax dike on the maxillary resin base, determining an occlusion plane on the wax dike, cutting the edge within 2.0mm below the lip, and determining the fullness and the convexity of the upper lip (fig. 3-2 and 3-3) in parallel with the tragus line of the nasal wing;
3. fixing a mandibular tracing needle fixing plate with self-setting resin or a baked soft red wax sheet in the area between the lateral canine teeth and the first molar teeth on the mandibular resin base to ensure that it is substantially parallel to the occlusal plane (fig. 3-4);
4. heating and baking appropriate amount of red wax sheet with alcohol lamp, filling and fixing in front palate region of outer surface of base support in upper jaw wax dike by hand, primarily fixing upper jaw tracing plate, making it substantially flat with wax dike, immediately placing upper jaw resin base support into mouth, and fitting with upper jaw alveolar ridge (fig. 3-5);
5. the lower jaw base with the tracing needle is placed into the mouth to be kept stable, the patient is ordered to slowly occlude the upper jaw and the lower jaw, and the vertical relation of the patient is preliminarily determined according to the jaw position (figures 3-6);
6. then taking out the upper and lower jaw base supports, cooling, putting into the mouth again, checking whether the vertical distance is accurate, if the vertical distance is too high, repeating the step 1-5, if the vertical distance is too low, adhering a heightened tracing plate on the surface of the tracing plate until the perpendicular distance is proper (fig. 3-7);
7. spraying the tracing powder on the surface of the maxillary tracing board, stabilizing the upper and lower jaw base supports on the upper and lower jaw alveolar ridges, ordering the patient to bite and extend forwards, and moving left and right (fig. 3-8);
8. the maxillary base support is taken out, 3 "↓" shaped patterns (figures 3-9) appear on the trace board,
9. determining the location of the apex of the mouth, drilling a spot with a small ball, coloring the mark, cleaning the powder, fixing the needle anchor in accordance with the determined spot location (FIGS. 3-10),
10. when the patient is placed into the mouth again to confirm the central relationship, the lower jaw tracing needle is just positioned in 3 round holes of the upper jaw tracing needle fixing piece, the upper jaw and the lower jaw relationship are stable, and the central relationship of the patient is determined (fig. 3-11);
11. after the medial relation is determined in the mouth without error, the upper and lower jaw base supports (figures 3-12) are fixed by the silicon rubber, the upper closing frame can be transferred by the face arch, and the medial relation is determined.
To summarize:
the disposable oral Golde type arch recorder has simple structure and low manufacturing cost, reduces the clinical cross infection probability and is convenient for popularization and use in a large-scale oral outpatient service. When the median relationship is determined, the clinical operation process is simple, the vertical height is adjusted in a modularized mode, the accuracy is 0.5mm, the clinical requirement is completely met, and the clinical operation is convenient; the 3 contour trace needles which are arranged in a triangle shape ensure the balance and stability of the trace board, finally ensure the stability of the center relation, and overcome the possible micro deviation of the upper jaw position and the lower jaw position of the fixation of the conventional oral Copender type bow single trace needle. The upper jaw completes the wax bank in advance, so that the face arch is transferred to the upper frame and the artificial teeth are arranged at the accurate position.
Claims (4)
1. An intraoral disposable gothic arch recorder is characterized in that: comprises a mandibular tracing needle fixing plate (1), three tracing needles (2), a tracing needle fixing plate (3), a heightened tracing plate (4) and a maxillary tracing plate (5); the lower jaw tracing needle fixing plate (1) is in an isosceles trapezoid shape, and the three tracing needles (2) are arranged on the lower jaw tracing needle fixing plate (1) in an equilateral triangle shape; the tracing needle fixing piece (3) is used for fixing the positions of the tracing needle and the maxillofacial tracing plate, the tracing needle fixing piece (3) comprises three retention round holes, the three retention round holes are buckled and jointed with the tips of the three tracing needles (2), and the tracing needle fixing piece (3) is parallel to the mandible tracing needle fixing plate (1); the heightened tracing plate (4) has the same size as the upper jaw tracing plate (5); the maxillary tracing plate (5) is an arc which can inscribe an isosceles trapezoid.
2. An intraoral disposable gothic arch recorder according to claim 1, the mandibular trace needle fixation plate (1), the trace needle fixation plate (3), the heightened trace plate (4) and the maxillary trace plate (5) being of high strength Polymethylmethacrylate (PMMA) or stainless steel material.
3. An intraoral disposable gothic arch recorder according to claim 1, the mandibular stylus retaining plate (1) being 1.0mm thick, 50.0mm wide at the base, 25.0mm high and 35.0mm wide at the top; the three tracing needles (2) are all cylindrical stainless steel needles with the diameter of 1.0mm, the height of the three tracing needles is 10.0mm, the first tracing needle is positioned at the position 5.0mm away from the center of the bottom edge, the other two tracing needles are far away from the bottom edge and are positioned on the vertex of an equilateral triangle with the side length of 10.0mm together with the first tracing needle; the needle tracing fixing piece (3) is a rounded equilateral triangle with the side length of 15.0mm and the thickness of 1.0mm, three fixing round holes with the diameter of 1.0mm are arranged in the center and are positioned at three fixed points of the equilateral triangle with the side length of 10.0 mm; the thickness of the heightened tracing plate (4) is 0.5mm or 1.0 mm; the width of the bottom edge of the inscribed isosceles trapezoid of the maxillary tracing plate (5) is 40.0mm, the height of the inscribed isosceles trapezoid is 30.0mm, and the chord length of the top edge of the inscribed isosceles trapezoid is about 30.0 mm.
4. Use of an intraoral disposable gothic arch register according to claim 1 for determining the neutral relation of an edentulous patient, the method comprising the steps of:
(1) preparing a complete denture functional final impression, pouring a non-dentognathic final impression superhard gypsum model, and manufacturing upper and lower jaw resin bases by using a light-cured resin plate or a 3D printing method, wherein the thickness of the bases is about 1.0 mm;
(2) making a wax dike on the upper jaw resin base, determining an occlusion plane on the wax dike, wherein the cutting edge is within 2.0mm below the lip and is parallel to the tragus line of the nasal wing, and determining the fullness and the convexity of the upper lip;
(3) fixing a mandibular tracing needle fixing plate by using self-setting resin or a heated red wax sheet in the area between canine teeth on two sides and the first molar on the mandibular resin base to ensure that the mandibular tracing needle fixing plate is basically parallel to an occlusal plane;
(4) filling and fixing a red wax sheet in a front palate area on the outer surface of a base support in the upper jaw wax dike, preliminarily fixing an upper jaw tracing plate which is basically level with the wax dike, putting an upper jaw resin base support into a mouth, and fitting an upper jaw alveolar ridge;
(5) the mandible base with the tracing needle is placed into the mouth to keep stable, and the vertical relation of the patient is determined;
(6) taking out the upper and lower jaw base supports, cooling, putting into the mouth again, checking whether the vertical distance is accurate, if the vertical distance is too high, repeating the steps (1) to (5), and if the vertical distance is too low, adhering a heightened tracing plate on the surface of the tracing plate;
(7) the surface of the maxillary tracing plate is sprayed with tracing powder, the upper and lower jaw base supports are stabilized at the alveolar ridges of the upper and lower jaws, and 3 "↓" shaped patterns can appear on the tracing plate through the occlusion protrusion and the left and right side movement of a patient;
(8) determining the position of the vertex outside the mouth, drilling a fixed point by using a small ball, coloring and marking, cleaning the trace powder, and fixing a trace needle fixing piece according to the determined fixed point position;
(9) when the lower jaw tracing needle is placed into the mouth again to confirm the central relation, the lower jaw tracing needle is just positioned in 3 round holes of the upper jaw tracing needle fixing piece, the upper jaw and the lower jaw relation is stable, and the central relation of a patient is determined;
(10) after the centering relation is determined in the mouth, the upper and lower jaw base supports are fixed by the silicon rubber, the face bow is transferred to the upper closing frame, and the centering relation is determined.
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Cited By (1)
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| CN114224547A (en) * | 2021-12-17 | 2022-03-25 | 四川大学 | Digital Gothic bow device and manufacturing method thereof |
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