JP2009504247A - Orthodontic apparatus and method - Google Patents

Abstract

The correction of the shape of the alveolar arch or maxilla and the stimulation of the growth and filling of the missing jaw tissue defect are described. The metal wire frame can be attached to the teeth of the anterior segment of the dentition, and the fastening elements are connected via a lingual arcing device or a lingual and vestibular power unit. Alternatively, the fastening elements can be fixed to the teeth of the outer section of the dentition, for example the metal wire frame grips the teeth of the outer section of the dentition. The fastening elements can be connected to two plates, which are located on either side of the midline palatal suture and are connected to each other by a metal wire palate power element. The outer section teeth and the fastening elements of one or more plates may be connected via a spring. The edge of the jaw defect can be stimulated by applying vibrations to the plate. By periodically correcting the working surface of the plate, space can be made available for tissue renewal. The shape of the alveolar arch can be corrected by the placement of the orthodontic device in the oral cavity, the periodic removal and biasing of the device, and the effects of forward and rotational forces on the teeth.

Description

  Embodiments of the invention relate to medicine, and in particular to orthodontics. More specifically, embodiments of the present invention provide corrections aimed at both expansion and contraction of the shape of the alveolar arch, correction of the upper jaw, ie, dental arch, alveolar arch and alveolar base arch, particularly cleft palate. And stimulation of the growth and filling of missing jaw tissue defects such as alveolar processes, and correction of the shape of the alveolar arch in the lingual and pre-lateral directions.

  Going back to 1880, Continuous designed a device that constitutes the vestibular and lingual arc devices connected to each other by cross members in the side tooth region (see Non-Patent Document 1).

  Further, there is known a device that is implemented in the form of a lingual spring and a vestibular spring that acts on the front teeth, and is fixed to a lingual arc device that connects the fixing elements of the wire frame on separate side teeth (Patent Document). 1).

  The device described above provides dental correction at the forehead, but considering that the archwire device is rigidly attached to the side tooth wire frame, the device laterally moves the side teeth. It is characterized by limited opportunities to move to.

  There are also known non-removable orthodontic devices that constitute an archwire device that is secured to a retainer that is firmly attached to the teeth. The aforementioned device makes it possible to provide correction of the shape of the dental arch and the position of the individual teeth by means of an anterior-rotational action on the teeth (see US Pat.

Such arcing devices do not stimulate intensive growth of alveolar processes and correction of the shape of the alveolar arch, thus extending the treatment period.
Furthermore, during tooth movement, the surface of the alveolar wall adjacent to the root is periodically subjected to intensive absorption at the point of compression.

  An orthodontic device for orthodontic correction (Patent Document 3) is closest in its technical essence to the examples of the device described in the claims. Said device consists of a fastening element which is connected to the biasing unit via the lingual and vestibular arch devices and is implemented in the form of a metal wire frame which grips the teeth of the outer section of the dentition. The metal wire frame is implemented from wire detail parts placed from the lingual side to the tooth neck, distributedly attached along the tooth height from the vestibular side and connected by a crosspiece placed in the tooth gap. The

  The structure of the device is such that the side teeth are driven by the anterior-rotational action on those teeth and the front teeth are driven by the actuation forces of the vestibular and lingual arc devices distributed along the incisor height. Provide movement relative to the body. Since the device is removable, it has the opportunity to periodically recover the time-reduced forces exerted by the wireframe and arcing devices by removing the device and energizing the elements of the device.

The actual use of the device makes it possible to carry out (on the body) movement of the tooth body and increase the transverse dimension of the alveolar process with an efficacy of 0.3-0.4 mm per month. However, a given device has a limited opportunity in achieving tooth sagittal-transverse movement and in fact stimulates alveolar process growth in the case of jaw constriction in the lingual direction Give no opportunity. Furthermore, the structure of the device does not provide a stable distribution of the arching device along the incisor height. This results in reduced therapeutic efficacy because it requires frequent correction of the archwire device.

  The device known as Derichsweiler's non-removable orthodontic device for rapid tearing of midline palatal sutures constitutes a plastic base with screws and metal reinforcement. The free end of the metal reinforcement is firmly fixed with a ring or crown in the region of the side teeth. (Non-patent document 2). However, the structure of the device provides stability of placement in the oral cavity but is not removable, which promotes the development of mucosal inflammatory diseases.

  Also known are orthodontic devices for rapid dehiscence of midline palatal sutures, including a non-removable foundation in the form of a ring or crown. The foundation parts are firmly arranged on the teeth of the outer section of the dentition and are connected to each other via a vestibular arc device. The device comprises a fixing unit embodied in an uprightly arranged tube joined on their lingual sides and a removable part constituting a plastic base with screws and metal reinforcement, The free end of the metal reinforcement is bent and attached to a tube placed upright. (Non-Patent Document 3).

  However, the apparatus described above is not convenient in use. Removal and installation of the device in the oral cavity is only possible with the direct involvement of a doctor, in particular an orthodontist.

  Another known orthodontic appliance for rapid tearing of the midline palatal stitch (US Pat. No. 6,099,056) differs advantageously from the similar in that it is removable. The device provides as simple as possible removal and installation conditions for the device, while at the same time providing device stability. The device comprises a removable part and a non-removable part. The non-removable part constitutes an orthodontic ring. The ring has a mounting unit and is firmly fixed to the teeth of the outer section of the dentition and connected to each other via a vestibular archwire device. The removable part has a vestibular arcuate device and includes a base plate located on both sides of the median palatal suture and a power element in the form of a combined spring connecting the base plates.

  The structure described above is selected as the closest analog to the device variant proposed for the correction of the upper jaw shape. Its closest analog and similar structures provide effective correction of the palate configuration (geometry), simultaneous movement (on the body) of the teeth and correction of the axial position of the teeth. Do not provide. Furthermore, the structure does not provide for correction of the shape of the alveolar arch at the forehead.

  In a known manner, the maxillary cleft palate can be closed by lowering the palate process by the nasal effect of the nose plate on the maxillary palate process. The method is realized by an obturator consisting of a dental gingival plate and a nasal plate with a fastening unit for elastic power elements. The closure device is effective in the active growth period of children before reaching 7-8 years of age. Known methods and closure devices lower the palate process and close it, but are not aimed at correcting the shape of the dental arch. (See Patent Document 5).

  Methods are also known for promoting the growth of missing maxillary tissue by stimulation of the cleft palate edge. The method is realized by a McNeill orthodontic device consisting of a maxillary plate with fastening elements and perots. The fastening elements and Perots are secured to the plate via buckles to stimulate the defect edges. (Non-Patent Document 3).

  Methods are also known for simultaneous closure of the cleft of the palate, stimulation and correction of the shape of the dental arch by the palatal plate. The method is realized by a device, that is, a closing device (see Non-Patent Document 4). This development is chosen as the closest analog to the proposed group of inventions.

  The device consists of a removable part and a fixed part. The fixed part is an orthodontic ring. The orthodontic rings are firmly fixed to the side teeth, connected to each other by a vestibular archwire device, and further comprise an attachment unit. The removable part that is the foundation of the device is realized in the form of a plate adjacent from the lingual side to the base of the side teeth. The plate closes the lingual-vestibular arcing device by means of a correction unit for engagement with a fixed part. The lingual arcing device is fixed to the plate via a spring, and the palate plate is fixed to the lingual arcing device via an orthodontic spring. The base of the device is fixed to the mounting unit of the fixed part via a lingual-vestibular arc device.

  The device described above closes the surface of the defect by means of a plate and, as a result of long-term use, promotes the reduction of the size of the dehiscence by stimulating the edges of the dehiscence and forming new tissue. The advantage of the closest analog is that it also provides orthodontic correction in the shape of the dental arch.

However, the closure devices and methods described above do not provide intensive stimulation of missing tissue growth and jaw defect filling based on their action.
Initially, tooth position correction was achieved by the action of the active details of a removable orthodontic appliance located on the tooth. The action was performed by periodic removal of the device, recovery of the reduced action of the device, and attachment of the device into the oral cavity.

  At the beginning of the 20th century, Mershon and Crozat developed a device that allows an anterior action to be applied simultaneously on the lingual sides of the side and front teeth (see Non-Patent Document 5). At about the same time, Ainsworth designed a device that exerts an anterior action on the lingual and vestibular sides of the side and anterior teeth, respectively (Non-Patent Document 6).

  Today, forward-acting highly removable devices, namely Crozat-Ricketts and Wilson orthodontic devices, are widely used (see Non-Patent Document 7 and Non-Patent Document 8).

  The above-described apparatus for performing a method of cyclically biasing and acting on a tooth with an anterior force (hereinafter referred to as "forward force") is capable of correcting the position of the teeth and the shape of the dental arch. To. However, expansion and extension of the dentition in the manner described above results in a buccal (vestibular) tilt of the teeth, i.e. no movement on the body of the teeth is provided.

  In 1886, Angle, the founder of modern non-removable orthodontic appliances, designed an anterior action device that was fixed so that it could not be removed on the side of the vestibule of the tooth. In 1916, for the first time, Angle presented a method of action by forward force-rotational force, performed by a stationary arc-wire device. The device provides movement (on the body) relative to the tooth body. Subsequently, Angle implemented the device in the form of an archwire device secured to a lock rigidly attached to the tooth through an improvement in the design of a non-removable orthodontic device for anterior-rotating action on the tooth. . The method and apparatus developed by Angle made it possible to perform (on the body) movement of the teeth and correct the shape of the dental arch (see Non-Patent Document 9).

  However, for advanced deformation of the alveolar arch, the achievement of movement (on the body) relative to the vestibular / lingual tooth body by the action of the anterior-rotational force on the teeth by the fixed arch device is the geometry of the dental arch. This can only be achieved after array pre-correction and tooth alignment.

Generally, the pre-correction is performed by a forward-acting removable or non-removable device that is attached to the mouth in the early stages of treatment. This means that the alveolar arch orthodontic process is multi-stage, and the anterior-rotating action on the teeth with a non-removable arc device is performed at a later stage of orthodontic treatment.

  As is well known, tooth movement in the alveolar process is possible through a coordinated process of alveolar bone resorption and regeneration (addition). In addition, the surface of the alveolar process facing the root at the compression and tension points of the wall of the bone marrow cavity is periodically absorbed and applied, respectively.

  Application of a large force in a non-removable arcing device can result in resorption of the root as well as alveolar bone. Thus, in practice, small forces are more often used. In summary, it can be said that a non-removable arcing device does not guarantee intensive correction of the shape of the alveolar process and requires long-term treatment.

  In order to eliminate step-by-step treatment in advanced deformation of the alveolar arch, a removable structure of the orthodontic appliance that provides anterior and rotational forces to the teeth has been presented. The device of a given structure constitutes a metal wire frame for the dentition section. The metal wire frame is distributed along the tooth height and is connected to each other by an orthodontic arching device and / or a spring (see Patent Document 3 and Patent Documents 6 to 8). The device described above was applied by the method attributed to the removable device, i.e. by periodic removal of the device, recovery of reduced action and installation of the device.

Such a treatment with a specific device is in that in a significant deformation of the alveolar arch, it eliminates the multi-step nature of the treatment and makes it possible to produce an anterior-rotational action on all teeth in the required direction. Are advantageously distinguished from known objects. During the use of these devices, the torque on the root apex of the teeth is a function of forward rotation, despite the fact that force values for individual crowns generally accepted in orthodontics of 50-150 gm apply. Some times exceeded similar values provided by other devices. It is a fastening metal wire frame with elements mounted distributed along the crown height, providing a large arm with the greatest force in the realization of the rotational action on the teeth, increasing the torque on the root Stipulated by promoting The aforementioned properties allow movement of the tooth axis of rotation to the apex and thus allow formation of alveolar bone tension and compression areas. These areas are adjacent to the lingual and vestibular sides of the root. Depending on the axial position of the tooth, the value, sequence, and combination of forward and rotational forces on the tooth are adjusted during tooth movement. The application of the method and apparatus described above results in the movement of the tooth body (on the body) and the simultaneous growth of alveolar process dimensions having an efficacy of about 0.3-0.4 mm / month. However, as a result of the long-term action of the elements that secure the metal wire frame attached to the tooth gap, the teeth are affected by the force that pushes them out of the socket of the alveoli. This results in loosening of the individual teeth.
U.S. Pat. No. 1,142,467 International Application No. 048868 Armenian Patent No. 512 Armenian invention patent 511 USSR Inventor Certificate No. 848020 Republic of Armenia, Application No. 20050147 for Inventor Republic of Armenia, Application No. 20050148 for inventor Republic of Armenia, Application No. 20050149 for inventor CONSUMMATE OCCLUSION, Robert Murray Ricketts, 1996, Figure 2-2 Korosilkina F. Wye. (Khoroshilkina FY), Marigin Yu. M. (Maligin Yu. M.), "Fundamentals of designing and technology of manufacturing of orthodontic devices", Publishing House "Medicine", 1997, Page 97, Figure 35 Korosilkina F. Wye. (Khoroshilkina FY), Marigin Yu. M. (Maligin Yu. M.), “Fundamentals of designing and technology of manufacturing of orthodontic devices”, Publishing House “Heaticine 肇, 1997, 98”. Page, Figure 36 Marylian P. Di. (Mailyan PD) "New means for orthodontic treatment", Kolomna, District of Moscow, page 58. “Directory on orthodontics”, Kishinev, 1990, page 180, FIGS. 27 and 188, FIG. Kolesov, “Stomatology of childhood”, Moscow, 1970, FIG. “CONSUMMATE OCCLUSION”, Earl. R. Ricketts, 1996, FIGS. 2-7 "Improved orthodontics (ENHANCED ORTHODONTICS)", R. Wilson, W. Wilson, p. 55 “CONSUMMATE OCCLUSION”, Earl. R. Ricketts, 1996, FIGS. 2-5B and 2-6A

  The problem of the claimed group of the invention is to design a device that can enhance the correction process of the shape of the alveolar process and the dental arch.

  According to a first variant of the device, the proposed problem is solved in a known device comprising a fastening element. The fastening elements are implemented in the form of a metal wire frame which is connected via a lingual and vestibular metal wire power unit and grips the teeth of the outer section of the dentition. The metal wire frame is placed on the tooth neck from one side and is implemented from a lingual detail and a vestibular detail. The lingual detail and the vestibular detail are attached distributed from the other side along the height of the tooth and are connected by a crosspiece. According to the invention, the device has a metal wire frame mounted on the teeth of the front section of the dentition, the coupling of the fastening elements via the front section of the metal wire frame and the lingual spring and the vestibule. This is done by at least one of the side springs.

  According to a second variant of the device, the proposed problem is solved in a known device comprising a fastening element. Said fastening element is connected to the power unit via a lingual arc device and is implemented in the form of a metal wire frame. The metal wire frame grips the teeth of the outer section of the dentition and is implemented from the lingual detail and the vestibular detail. The lingual detail and the vestibular detail are placed on the tooth neck from one side, distributed from the other side along the height of the tooth, and connected by a crosspiece. According to the invention, the device comprises a metal wire frame mounted on the teeth of the front section of the dentition and connected to the lingual arch device directly and / or via a spring. The one or more fastening elements are further connected to the lingual archwire device via a spring.

According to a third variant of the device, the proposed problem is solved in a known device comprising a fastening element. The fastening element is connected to the power unit via a lingual arc device and is implemented in the form of a metal wire frame. The metal wire frame grips the teeth of the outer section of the dentition and is implemented from the lingual detail and the vestibular detail. The lingual detail and the vestibular detail are placed on the tooth neck from one side, distributed from the other side along the height of the tooth, and connected by a crosspiece. According to the invention, the device comprises a metal wire frame mounted on the teeth of the front section of the dentition and connected via a spring to a lingual arc device, wherein one or more fastening elements are , Connected to the metal wire frame in the front section, and further connected to the lingual arc device via a spring.

  The essence of all variants of the claimed group of inventions is also that the lingual or vestibular details of the metal wire frame distributed along the height of the tooth face the tooth side facing the direction of movement. It is to be attached from.

  The essence of all variants of the claimed invention group is also that the metal wire frame is arranged on at least one of the individual teeth and groups of a section, and at least of the lingual and vestibular springs It is implemented from components connected to each other via either.

  The problem of the present invention group is to ensure an increased functionality of the device for correcting the shape of the maxilla, ie the alveolar arch, the alveolar base arch. According to a first variant of implementation of the device for correcting the shape of the upper jaw, the proposed problem is solved in a technical solution comprising a fastening element. The fastening element is fixed to the teeth of the outer section of the dentition and is connected to the two plates. The two plates are arranged on both sides of the median palate suture and are connected to each other by a metal wire palate power element. According to the invention, the fastening element is implemented in the form of a metal wire frame that grips the teeth of the outer section of the dentition, and the connection of the fastening element with the plate is effected via a spring.

  According to a second variant of implementation of the device for correcting the shape of the upper jaw, the proposed problem is solved in a technical solution comprising a fastening element. The fastening element is fixed to the teeth of the outer section of the dentition and is connected to two plates. The two plates are placed on either side of the midline palatal suture and are connected to each other by a metal wire palate power element. According to the invention, the structure additionally comprises a fastening element that is mounted on the teeth of the front section of the dentition. The fastening element is implemented in the form of a metal wire frame that grips the teeth of the outer section of the dentition, the plate being connected to the fastening elements of the outer section via springs. Further, the fastening element in the front section is connected to the metal wire palate power element by a spring.

  According to a third variant of implementation of the device for correcting the shape of the upper jaw, the proposed problem is solved in a technical solution comprising a fastening element. The fastening element is fixed to the teeth of the outer section of the dentition and is connected to two plates. The two plates are located on either side of the midline palatal suture and are connected to each other by a metal wire palate power element. According to the invention, the structure additionally includes fastening elements that are mounted on the teeth of the front section of the dentition. The fastening elements are implemented in the form of a metal wire frame that grips the teeth of each section of the dentition and are connected to each other and to the plate by means of a palatal arc device via springs.

  The challenge of the proposed method is to enhance stimulation of missing tissue growth and filling of the jaw defect. The challenge presented is that, in a known method in which the defect is closed by the plate and the edge of the defect is stimulated, according to the proposed method, the plate is given an oscillating motion and the working surface of the plate is periodic. The correction solves this by opening space for tissue renewal.

The problem with the proposed device is to form a device structure that provides enhanced stimulation of missing tissue growth and filling of the jaw defect. The challenge presented is solved by including an outer section tooth fastening element, one or more plates closing the missing tissue of the defect, and a lingual arcing device as compared to known technical solutions. The The lingual archwire device is connected to a fastening element and one or more plates via a spring. According to the invention, the fastening element is realized in the form of a metal wire frame, the detailed parts of said metal wire frame that grip the side tooth neck from the lingual and vestibular sides are the tooth gap, and the tooth nodules. The cross members are connected in the sagittal direction and / or the transverse direction by the cross member arranged in the inter-recess.

  Such a structure makes it possible to bring about vibrations of one or more plates by means of a periodic bias in the forward direction of the crosspiece arranged in the internodal recess. Furthermore, the structure allows for the movement of the alveoli both in the sagittal and transverse directions.

  Another proposed method challenge is enhanced orthodontic shape correction and increased convenience in using the device. The challenge presented is a known method for correcting the shape of the alveolar arch realized by the attachment, periodic removal and biasing of the orthodontic appliance and the action of forward and rotational forces on the teeth Is solved. In accordance with the present invention, teeth are affected by the power of the masticatory muscles by repeatedly removing the force generated by the device between periodic biases.

Embodiments of the present invention can be understood with reference to the drawings.
As shown in FIG. 1, the device for correcting the shape of the alveolar arch according to the first modified embodiment is in the form of a metal wire frame that holds the teeth of the outer section of the dentition. A fastening element (1) and a metal wire frame (2) mounted on the teeth of the front section of the dentition, said metal wire frame (2) being a lingual spring (3) and / or vestibule It is connected to the fastening element by a side spring (4).

  As shown in FIG. 2, the device for correcting the shape of the alveolar arch according to the second variant of embodiment is a fastening element (11) in the form of a metal wire frame that grips the teeth of the outer section of the dentition. And a metal wire frame (12) mounted on the teeth of the front section of the dentition. The metal wire frame (12) is connected to the lingual arc device (15) directly (13) and / or via a spring (14). Both ends of the lingual archwire device (15) are fixed on the fastening element (11). The lingual arc device (15) has a biasing unit (16) and is further connected to one or two fastening elements (11) via a spring (17). Implementation of the metal wire frame (see FIG. 4) in the form of separate components can be a kind of the proposed variant, in particular the second variant. In this case, the component wireframe (8) that holds the individual teeth and / or groups of teeth in a section is connected to each other by a lingual spring (9) and a vestibular spring (10).

  An apparatus for correcting the shape of an alveolar arch according to a third variant of implementation comprises a fastening element (21) in the form of a metal wire frame that grips the teeth of the outer section of the dentition, and a front of the dentition. And a metal wire frame (22) mounted on the section teeth. The metal wire frame (22) is connected to the lingual arching device (24) via a spring (23), and both ends of the lingual arching device (24) are fixed on the fastening element (21). Yes. The lingual archwire device (24) has a biasing unit (25) and is further connected to one or more fastening elements (21) via a spring (26). The metal wire frame (22) of the front section is connected to the fastening element or the element (21) via one or more springs (27) at the curved portion.

A feature of the present invention group is that the metal wire frame is implemented from the lingual detail part and the vestibular detail part, and the lingual detail part and the vestibular detail part are arranged on the tooth neck from one side, and the other side To be distributed along the tooth height and connected by a cross member placed in the tooth gap. At the same time, the lingual details (see FIG. 3) and vestibular details (see FIGS. 1, 2 and 4) of the metal wire frame distributed along the height of the tooth Mounted from the side. That is, in the first case, the device is aimed at tightening the alveolar arch, and in the second case, the device is aimed at expanding the alveolar arch.

  The apparatus for correcting the shape of the alveolar arch according to the first modification is used as follows. After mounting the device in the oral cavity, the patient is trained on the characteristics of treatment with the device. The device is energized every 15-20 days. The biasing of the lingual spring (3) and the vestibular spring (4) in the sagittal and / or transverse direction is further performed in the longitudinal direction of the fastening elements and the metal wire frames (1), (2) of the front section Alternation in the shape of the alveolar arch is accomplished by alternating rotations (from clinical indications) in combination with rotation about the axis.

  The apparatus for correcting the shape of the alveolar arch according to the second modification is used as follows. After mounting the device in the oral cavity, the patient is trained on the characteristics of treatment with the device. The device is energized every 15-20 days. The lingual arching device (15), its biasing unit (16), and consequently the spring (17), disposed between the lingual arching device (15) and the wire frames (11), (12), (14) sagittal and / or transverse biasing and further rotation of the fastening element and the preceding section of the metal wire frame (11), (12) around their longitudinal axis (clinical indications) By combining and alternating, the alveolar arch shape is corrected.

  The apparatus for correcting the shape of the alveolar arch according to the third modification is used as follows. After mounting the device in the oral cavity, the patient is trained on the characteristics of treatment with the device. The device is energized every 15-20 days. The lingual arcing device (24), its biasing unit (25), the spring (27) connecting the fastening element (21) and the wire frame (22) of the front section, and consequently the lingual arcing device (24) ) And the wire frame (21), (22), the sagittal and / or transverse biasing of the springs (26), (23), the fastening element and the metal wire frame of the front section ( Alternation of the shape of the alveolar arch is accomplished by alternating (with clinical indications) with rotations of 21), 22) about their longitudinal axis.

  Example: A 27-year-old woman complaining about aesthetic issues visited a clinic. Objectively, distal overbite (class II-1 malocclusion by angle), narrowing of both alveolar arches, irregular position and overcrowding of the teeth in the anterior segment.

According to the device of the first modification for the upper dentition and according to the device of the second modification for the lower dentition, two devices were manufactured and fitted into the oral cavity of the patient.
In the upper jaw, the biasing unit (6) of the lingual arch device (5) is applied to the lower jaw by the biasing of the lingual spring (3) and the vestibular spring (4) and the wire frames (1), (2). ) As a result, the springs (7) and (4) and the wire frames (1) and (2) disposed between the lingual arc device (5) and the wire frames (1) and (2) are attached. The force ensured the expansion of the alveolar arch. At 3.5 months after the start of treatment, measurements of alveolar arch transverse dimension in the fourth tooth region resulted in 5.0 mm and 6.5 mm maxillary and mandibular enlargement. The tooth position was considerably normalized and there was a gap between the teeth that was used to correct the tooth position in the next few months. Alveolar arch growth in the lateral segment of the lower jaw was also brought about. The occlusion was corrected after 6 months. The device was removed 3 months after the start of the maintenance period.

Example: A 19-year-old patient complaining about aesthetic issues and facial non-subjectivity after orthodontic treatment visited a clinic. Objectively, the asymmetry of the face, the left side was superior in size to the right side. Biometric investigations on the jaw model showed that the transverse altitude of the left alveolar arch was over 3-5 mm for palatal sutures. Compensatory displacement forced to the left side of the lower jaw. Wilson's occlusal plane slopes downward from right to left.

According to a third variant of the device for correcting the shape of the alveolar arch, two devices for the patient's upper and lower dentition were manufactured and fitted.
During the first two months, the biasing element (25) of the arcing device (24) and the biasing of only one side of the springs (23), (26) and the wire frame (21) resulted in an increase in the right side of both jaws. Achieved. At the same time, Wilson's correction of the occlusal curve, that is, reduction of the alveoli in the right ward of the lower jaw was realized. Due to the biasing of the springs (23), (26) and the wire frame (22), movement of the jaws to the right side of the anterior segment of the jaw was achieved in the third month of treatment. During the fourth month, the device was not energized. In the 5th and 6th months, the springs (23) and (26), the biasing unit (25) of the arcing device (24), and the wire frame (21) are biased to the left outer side of both jaws. Movement of the alveoli of the ward toward the tongue was achieved.

Facial asymmetry was significantly reduced after 6 months of treatment. The device was removed 3 months after the start of the maintenance period.
The actual use of the proposed variant of the device for correcting the shape of the alveolar arch showed the following.

-Guarantee the movement of the alveoli of the front section in the sagittal-transverse direction.
Achieve uniform and / or non-uniform expansion and contraction of the dentition.
-Guarantee the continuous movement of the outer ward or the previous ward in different directions.

Sagittal-transverse movement is enhanced separately and simultaneously in several sections of the dentition.
Correction of maxillary shape In clinical practice, maxillary hypoplasia and deformation are frequently encountered. Reasons for hypoplasia and deformity of the maxilla are disturbances of mineral metabolism in early childhood (rickets, dyspepsia), infectious and adult diseases, dysphagia, dysphagia, joint damage, early loss of milk or permanent teeth, masticatory muscles And facial muscle abnormalities (parafunctions).

In the case of severe stenosis of the dental arch, alveolar arch and alveolar base arch, mainly occurring in the case of severe rickets, the palate apex usually has a double base.
It is well known that bone tissue is a sticky elastic medium, and its elasticity increases considerably during its growth.

  In view of the foregoing, the device is designed to combine the action of the plate on the convex part of the palate's foramen with the tearing of the medial palatal suture and the growth of the alveolar process. That is, a bone tissue growth region (a region where the elasticity of the bone tissue is increased) is formed above and below the convex portion of the palate palate. The action of the plate on the convex part of the palate's palate and the presence of two areas with increased bone tissue elasticity make it possible to considerably increase the efficiency of correction of the shape of the top of the palate.

  As shown in FIGS. 5 and 6, the device for correcting the shape of the upper jaw according to the first variant comprises a fastening element (31). Said fastening element (31) is implemented in the form of a metal wire frame that grips the teeth of the outer section of the dentition. The plate (33) is fixed to an orthodontic spring (32) connected to the fastening element (31). The plates (33) are arranged on both sides of the median palate stitch, that is, on the convex surface of the palate's circular lid (see FIG. 6) and are connected to each other by metal wire palate power elements (34). Said power element (34) can be implemented in particular in the form of a coupled spring.

As shown in FIG. 7, the device for correcting the shape of the upper jaw according to the second variant results in the fastening elements (31) being attached to the teeth of the outer section (41) and the front section (42) of the dentition. ). The fastening element is implemented in the form of a metal wire frame that grips the teeth of the corresponding section of the dentition. The plate (44) is secured to an orthodontic spring (43) coupled to a side fastening element (41). The plates (44) are arranged on both sides of the median palate suture, that is, on the convex surface of the palate circle, and are connected to each other by a metal wire palate power element (45). The power element (45) is connected to the fastening element (42) in the front section through an orthodontic spring (46).

  As shown in FIG. 8, the device for correcting the shape of the upper jaw according to the third variant consists of fastening elements which are consequently attached to the teeth of the outer section (51) and the front section (52) of the dentition. . The fastening element is implemented in the form of a metal wire frame that grips the teeth of the corresponding section of the dentition. The palate arching device (54) is secured to an orthodontic spring (53) coupled to the fastening element (51). The plate (56) is fixed to the palate arching device (54) via the orthodontic spring (55), and is disposed on both sides of the median palate suture, that is, on the convex surface of the palate. The plates (56) can also be connected to each other, in particular by two metal wire palate power elements (57).

  In a third variant of implementation of the device, derived from clinical indication, the wire frame holding the teeth of the corresponding section of the dentition is placed on the individual teeth and / or teeth of the section. And component parts that are connected to each other via at least one of a lingual spring and a vestibular spring.

  In all variants of the proposed device, the fastening element is implemented in the form of a metal wire frame. The metal wire frame is arranged on the tooth neck from one side, distributedly attached along the tooth height from the other side, and connected by a cross member arranged in the tooth gap Implemented from parts and vestibule detail parts. At the same time, the discretely attached detail parts of the metal wire frame are attached from the side of individual teeth or groups of teeth facing the direction of movement.

  The device for correcting the shape of the upper jaw according to the first modification can be used as follows. After mounting the device in the oral cavity, the patient is trained on the characteristics of treatment with the device. The device is energized every 10-14 days. The midline palatal suture and the biasing of the metal wire palate power element (34) disposed between the plates (33) and the spring (32) connecting the plate (33) with the fastening elements (31) of the outer section. Alveolar process bone tissue growth is achieved.

  The device for correcting the shape of the upper jaw according to the second modification can be used as follows. After mounting the device in the oral cavity, the patient is trained on the characteristics of treatment with the device. The device is energized every 10-14 days. A palatal power element (45) disposed between the plates (44), a spring (43) disposed between the plate (44) and the fastening element (41) in the outer section, and a palatal power element (45) The sagittal and transverse biasing of the spring (46) disposed between the ligament and the anterior segment fastening element (42) achieves medial palatal suture and growth of alveolar bone tissue.

  The device for correcting the shape of the upper jaw according to the third modification is used as follows. After mounting the device in the oral cavity, the patient is trained on the characteristics of treatment with the device. The device is energized every 10-14 days. A spring (57) disposed between the plates (56), a spring (55) disposed between the plate (56) and the palatal arc device (54), and fastening elements (51), (52) comprising the palatal arc device A spring (53) coupled to (54) and a sagittal and transverse biasing of the palate arcing device (54) achieves medial palatal suture and bone tissue growth of the alveolar process.

The presence of the growth area, the mounting of the plate above and below the convex part of the palate's foramen (in the case of the double base at the top of the palate), and the action of the plate on them corrects the shape of the palate (See FIG. 6).

Derived from clinical indications, the second and third variants of the device may be applied when treating malocclusions.
Examples A 14 year old patient with dissatisfaction with aesthetic issues was addressed. Objectively, nasal breathing difficulty, upper dentition stenosis, cross bite, deep double base of palate palate. A first variation of the device for correcting the shape of the upper jaw was manufactured and fitted into the patient's mouth. The patient accepted the necessary recommendations for treatment with the device. After 3 months, an increase in the transverse dimension of the alveolar process of 9 mm in the fourth tooth region and 5 mm in the sixth tooth region was recorded. The alveolar arch was corrected. The shape of the top of the palate (its geometry) was corrected. The depth of the palate of the palate in the sixth tooth region was reduced by 3 mm. The device is removed 3 months after the start of the retention period and at the same time during the retention period the device is applied for 24 hours during 1.5 months and at night during 1.5 months Only applied.

Stimulation of growth of tissue lacking the jaw defect It is well known that bone tissue has a significant ability to regenerate. In trauma at the site of fractures and contusions, bone tissue has the property of regenerating and generating immature tissue (bone callus). Based on the above, it is an object to develop a treatment method and device intended to stimulate intensive growth of tissue by periodically micro-traumatizing the edge of the defect (micro-traumatization). did.

  As shown in FIGS. 9 and 10, the device for stimulating the growth of missing jaw tissue may consist of an outer section tooth fastening element (61) and an anterior section tooth fastening element (62). . These fastening elements are implemented in the form of a metal wire frame. The fastening element (61) of the side tooth section is provided with cross members (63), (64) arranged in the sagittal direction and / or the transverse direction on the tooth occlusal surface in the tooth gap and internodal recess, respectively. Have. The tooth fastening elements (61), (62) are connected to the lingual arcing device (6) via orthodontic springs (65). The lingual archwire device (66) includes a palatal plate (69) and an optional alveolar plate (70) that closes the missing tissue in the curved portion via springs (67) and (68), respectively. It is connected. In the case of a defective portion of the alveolar projection, the plate (70) for giving an injury may be provided with artificial teeth (71) as shown in FIG.

A device for stimulating growth of missing tissue can be used as follows.
The condition for transmitting the muscular force action (at the tooth joint) to the device is generated by periodic biasing of the crosspiece (64) in the forward direction. The cross member (64) is an inherent part of the tooth fastening element (61) and is disposed on the occlusal surface of the tooth. As a result, the plates (69), (70) are allowed to vibrate, thus resulting in minor damage to the palatal missing tissue and the margin of the alveolar defect. After every 20 to 25 days, periodic correction of the working surfaces of the plates (69), (70) frees space for tissue renewal. Alveolar arch correction is achieved by biasing the spring (65) and the lingual arcing device (66).

Minor damage to the missing tissue edges of the defect and the creation of free space for tissue renewal promotes the intensive growth of the missing tissue and filling of the jaw defect.
The method and apparatus can be used to correct missing tissue defects in both maxillary and mandibular alveolar processes. The method may be realized by other orthodontic appliances where the vibration is provided by a separate functional unit inserted in the orthodontic appliance and ensures low frequency vibration.

  Example: An 11 year old patient with dissatisfaction with aesthetic problems and mastication disorder visited a clinic. Objectively, Class III malocclusion by angle, maxillary dimension reduction in sagittal-transverse direction. Hard palate cleft 2x2 cm in size, post-operative scar on the hard palate and upper lip (palatoplasty and labuloplasty). It can also be seen that the top of the palate is in a low position. A device according to the variant shown in FIG. 9 was manufactured and fitted into the patient's mouth. Every 20-25 days, the lingual arcing device (66) and the spring (67) are biased in the sagittal and transverse directions, and at the same time are inherent parts of the tooth fastening element (61), and the occlusal surface of the tooth The cross member (64) arranged above was also urged forward. Alveolar arch correction in the sagittal-transverse direction was achieved by biasing the spring (65) and lingual archwire device (66). The mode of damaging and stimulating the tissue edges lacking cleft palate was ensured by the forward biasing of the cross member (64) of the tooth fastening element (61). Furthermore, the lifting and formation of the palate top was achieved by non-uniform biasing of the spring (67). The alveolar arch was normalized 5 months after the start of treatment. The fissure was completely closed 7 months after the start of treatment. The soft tissue edges were activated and sutured. As a result of the treatment, an increase in the transverse and sagittal dimension of the alveolar process of 9 mm in the first premolar region and 6 mm in the region from the 6th tooth to the 1st tooth of the median palatal suture was also achieved. The device was removed 4 months after the start of the maintenance period.

Correction of the shape of the alveolar arch It is well known that the tissue of the alveolar process is an adhesive elastic medium. The tissue of the alveolar process (more precisely the periodontal tissue) has a relatively good resistance to vertical loads and is very inferior to the horizontal direction. In the application of forward force and rotational force to the crown, the rotation axis of the tooth is within the crown (see FIG. 11) and within the root (see FIG. 11) depending on the value of the force and the position of the force application point. 12).

  As a result of the action of forward and rotational forces on the teeth, horizontal squeezing of the alveolar tissue by the roots occurs, which results in elastic deformation and movement of the teeth. Periodic removal of the device results in a partial return of the tooth to its initial position (see FIG. 13). Changes in the direction of the forward force-rotation force that occur in the mastication action promote a violent alternating change between the compression area and the tension area of the alveolar process (see FIGS. 14 and 15). Repeated removal of the effects of forward and rotational forces from the teeth during the periodic biasing of the device, combined with severe alternating changes in the alveolar compression and tension areas in the chewing action, Stimulates intensive growth of bone tissue. In addition, frequent removal of the device or its active element from the oral cavity reduces the effect of pushing the teeth out of the alveolar fossa against the teeth of the elements securing the metal wire frame and increases the force of the masticatory muscles on the individual teeth in the mastication operation And thus prevent relaxation of individual teeth.

  The efficiency of treatment with the proposed method was controlled by periodic measurements of the transverse dimension of the patient's dental arch and alveolar process. Measurements were taken between the buccal nodules of the 4th tooth, between the apex of the 6th tooth on the mesial buccal side, and between points located 10 mm below the apex. The tests performed showed that in the results of using the proposed method and apparatus, an increase in the size of both jaw dental arches and alveolar processes occurred with an average efficacy of 2 mm / month. Tooth movement with similar efficacy by other methods of anterior-rotating action on teeth usually results in root exposure (due to lack of alveolar bone tissue).

If the crown height of the deciduous and permanent teeth is small and their equator is not obvious, the method may be realized by a device with a composite detail of fastening elements. As a variant of the embodiment of the fastening element mentioned, the fastening element may be a fixed part in the form of a fastening unit. The fastening unit is glued directly on the individual teeth or fixed on the orthodontic ring. On the orthodontic ring, the metal wire frame that holds the individual sections of the dentition is fixed by a process that is maximally simplified for attachment and detachment of the device. The removal of the force acting on the teeth is performed by removing the device or its active element from the oral cavity.

Example An 18 year old patient complaining about aesthetic issues visited a clinic. Objectively, overbite, bilateral alveolar stenosis, overcrowding and rotation of both jaw incisors. A device for correcting the shape of the alveolar arch was manufactured and fitted into the patient's mouth. The initial energization of the device was performed 3 days after installation of the device. Subsequent energization was performed every 20-25 days. Patients were advised to remove the device at least once a day while taking food. Three months after the start of treatment, an increase in alveolar process was achieved in the fourth tooth region, 5 mm in the upper jaw and 6 mm in the lower jaw. The relationship between dentition and tooth position was normalized. To assure treatment results, it was recommended that the device be always worn for 1.5 months, removed while taking food, and then worn at night or for 2 months. A management test was performed every month, and after 4 months from the end of the maintenance period, the test showed stable results of corrective treatment (see FIG. 16).

  A 21-year-old patient complaining about an aesthetic problem visited a clinic. Objectively, overbite, narrowing of both alveolar arches, overcrowding and rotation of both jaw incisors, and protrusion of maxillary central incisors. A device for correcting the shape of the alveolar arch was manufactured and fitted into the patient's mouth. The initial energization of the device was performed 3 days after installation of the device. Subsequent energization was performed every 20-25 days. Patients were advised to remove the device at least once a day while taking food. Four months after the start of treatment, an increase in alveolar process was achieved in the area of the fourth tooth, 6 mm in the upper jaw and 7 mm in the lower jaw. The relationship between dentition and tooth position was normalized. To ensure treatment results, it was recommended to always wear the device for 2 months, remove the device while eating food, and continue or wear it at night for 2 months. A management examination was performed every month, and after 3 months from the end of the maintenance period, the examination showed a stable result of corrective treatment (see FIG. 17). The method has also been successfully used as a treatment for periodontal disease.

  While the above is a complete description of the preferred embodiments of the invention, various alternatives, modifications, and equivalents may be used. Accordingly, the scope of the invention should not be limited with respect to the above description, but instead should be limited with respect to the appended claims, as well as the full scope of their equivalents. In the claims that follow, the indefinite article “A” or “An” refers to one or more quantities of the article that follows the article, unless expressly specified otherwise. Any feature, whether preferred or not, can be combined with other features, whether preferred or not. The appended claims do not include means plus function unless such limitations are explicitly recited in a given claim using the phrase “means for” or “step for”. It is not construed as including step plus function limitations.

The figure which shows the 1st modification of the apparatus for correcting the shape of an alveolar arch. The figure which shows the 2nd modification of the apparatus for correcting the shape of an alveolar arch. The figure which shows the 3rd modification of the apparatus for correcting the shape of an alveolar arch. FIG. 3 represents an implementation of the device for correcting the shape of the alveolar arch, wherein the metal wire frame is arranged on the two groups of teeth in the outer section and connected to each other via a tongue spring and a vestibular spring Having separate components. The figure showing the 1st modification of the orthodontic apparatus for correcting the shape of an upper jaw. Sectional drawing of the apparatus according to a 1st modification. The figure showing the 2nd modification of implementation of the apparatus for correcting the shape of an upper jaw. The figure showing the 3rd modification of implementation of the apparatus for correcting the shape of an upper jaw. FIG. 3 represents a device with a palate plate for stimulating the growth of tissue with missing jaws. The figure showing the example of a change of the apparatus of FIG. 9 which has an alveolar plate provided with a palate plate and artificial teeth. FIG. 3 is a diagram representing alveolar pressure and tension areas, wherein these areas are distributed and mounted elements along the tooth height according to an embodiment of a method for correcting the shape of the alveolar arch. It is formed under the action of a metal wire frame provided. FIG. 3 is a diagram representing alveolar pressure and tension areas, wherein these areas are distributed and mounted elements along the tooth height according to an embodiment of a method for correcting the shape of the alveolar arch. It is formed under the action of a metal wire frame provided. FIG. 3 is a diagram representing alveolar pressure and tension areas and partial return of teeth to an initial position when the force applied by the device is removed, according to an embodiment of a method for correcting the shape of an alveolar arch . FIG. 4 is a diagram depicting alternating changes in compression and tension areas under the action of masticatory muscle forces, according to an embodiment of a method for correcting the shape of an alveolar arch. FIG. 4 is a diagram depicting alternating changes in compression and tension areas under the action of masticatory muscle forces, according to an embodiment of a method for correcting the shape of an alveolar arch. FIG. 3 is a diagram representing a patient's jaw model before and after orthodontic treatment, according to a particular embodiment of a method for correcting the shape of an alveolar arch. FIG. 3 is a diagram representing a patient's jaw model before and after orthodontic treatment, according to a particular embodiment of a method for correcting the shape of an alveolar arch.

Claims (15)

  A fastening element coupled via a metal lingual power unit and a metal vestibular power unit and implemented in the form of a metal wire frame, the metal wire frame gripping the teeth of the outer section of the dentition, And the lingual detail and the vestibular detail, wherein the lingual detail and the vestibular detail are arranged on the tooth neck from one side and distributed along the tooth height from the other side. And a metal wire frame mounted on the teeth of the front section of the dentition, wherein the connection of the fastening elements is a tooth of the front section of the dentition A device for correcting the shape of the alveolar arch, which is performed by at least one of a lingual spring and a vestibular spring via a metal wire frame mounted thereon.   The device according to claim 1, wherein the lingual details or vestibular details of the metal wire frame distributed along the tooth height are attached from the side of the tooth facing the direction of movement.   The metal wire frame is implemented from components disposed on at least one of individual teeth and groups of teeth and connected to each other via at least one of a lingual spring and / or a vestibular spring. Item 2. The apparatus according to Item 1.   Fastening elements connected via a lingual archwire device comprising a biasing unit and implemented in the form of a metal wire frame, the metal wire frame gripping the teeth of the outer section of the dentition and the tongue Implemented from side detail and vestibular detail, said lingual detail and vestibular detail are placed on the tooth neck from one side and distributed from the other side along the height of the tooth And a metal wire mounted on the teeth of the front section of the dentition and connected to the lingual arc device directly and / or via a spring A device for correcting the shape of the alveolar arch, wherein the one or more fastening elements are further connected via a spring to a lingual arcing device.   The device according to claim 4, wherein the lingual details or vestibular details of the metal wire frame distributed along the height of the teeth are attached from the side of the tooth facing the direction of movement.   The metal wire frame is implemented from components arranged on at least one of individual teeth and groups of teeth and connected to each other via at least one of a lingual spring and a vestibular spring, The apparatus according to claim 4.   A fastening element connected via a lingual arc device with a biasing unit and implemented in the form of a metal wire frame, said metal wire frame gripping the teeth of the outer section of the dentition; and Implemented from a lingual detail and a vestibular detail, wherein the lingual detail and the vestibular detail are arranged on the tooth neck from one side and distributed along the height of the tooth from the other side A fastening element, attached and connected by a crosspiece, and a metal wire frame attached on the teeth of the front section of the dentition and connected to the lingual arc device via a spring; A device for correcting the shape of the alveolar arch, wherein the one or more fastening elements are connected to the metal wire frame of the front section and are further connected to the lingual arcing device via a spring.   8. The device of claim 7, wherein any of the lingual detail and vestibular detail of the metal wire frame distributed along the tooth height is attached from the side of the tooth facing the direction of travel.   The metal wire frame is implemented from components arranged on at least one of individual teeth and groups of teeth and connected to each other via at least one of a lingual spring and a vestibular spring, The apparatus according to claim 7.   An apparatus for correcting the shape of an upper jaw including a fastening element, the fastening element being fixed on the teeth of the outer section of the dentition and connected to two plates, the plates being Arranged on both sides of the median palatal suture and connected to each other by a metal wire palate power element, the device is implemented in the form of a metal wire frame in which the fastening element grips the teeth of the outer section of the dentition, The device is characterized in that the connection of the fastening element with the plate is effected via a spring.   An apparatus for correcting the shape of an upper jaw including a fastening element, the fastening element being fixed on the teeth of the outer section of the dentition and connected to two plates, the plates being Arranged on both sides of the medial palatal suture and connected to each other by a metal wire palatal power element, the device additionally comprises a fastening element mounted on the teeth of the anterior segment of the dentition, said fastening element being Implemented in the form of a metal wire frame that grips the teeth of each section of the dentition, the plate being connected to the fastening elements of the outer section via springs, and over the teeth of the front section of the dentition The fastening element attached to the device is connected to the metal wire palate power element by a spring.   An apparatus for correcting the shape of an upper jaw including a fastening element, the fastening element being fixed on the teeth of the outer section of the dentition and connected to two plates, the plates being Arranged on both sides of the medial palatal suture and connected to each other by a metal wire palatal power element, the device additionally comprises a fastening element mounted on the teeth of the anterior segment of the dentition, said fastening element being Implemented in the form of a metal wire frame, wherein the metal wire frame grips the teeth of each section of the dentition and is connected to each other and to the plate via a spring by a palatal arc device. Device.   A method for stimulating the growth of a tissue lacking a jaw defect, wherein the defect is closed by a plate and the edge of the defect is stimulated, the method comprising: And space is freed for tissue renewal by periodically correcting the working surface of the plate.   An apparatus for stimulating the growth of tissue lacking a jaw defect, the device comprising a tooth fastening element in the outer section, one or more plates for closing the missing tissue, a tongue, Said lingual arcing device is connected to a fastening element and one or more plates via a spring, said device being realized in the form of a metal wire frame. The detailed parts of the metal wire frame for grasping the side teeth neck from the lingual and vestibular sides are sagittal and / or transverse, depending on the tooth gap and the cross member placed in the internodal recess A device characterized by being coupled.   A method for correcting the shape of an alveolar arch by periodic removal, biasing, attachment, and action of forward and rotational forces on a tooth, wherein the device is between periodic biases. The method is characterized in that the teeth are influenced by the force of the masticatory muscles by repeatedly removing the force generated by.

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