RU175626U1 - Orthodontic device on occlusal plates for the treatment of mesial occlusion in children before and during tooth change - Google Patents

Abstract

An occlusal orthodontic appliance for treating mesial occlusion in children before and during tooth change. A useful model relates to medicine, namely to dentistry, specifically to devices for treating dentofacial anomalies, and can be used to treat patients with mesial occlusion in combined with reverse incisal occlusion / disocclusion, palatine occlusion (single and double-sided), narrowing and shortening of the dentition of the upper jaw before during the period of tooth change. Orthodontic device for occlusal overlay for the treatment of mesial occlusion in children before and during the period of tooth change, it contains a palatine screw, which is used as a three-dimensional Burtoni screw with three independent guides, side and front beams, and the apparatus is fixed and contains occlusal lining in the side sections attached to the side beams and made of plastic, in which metal hooks are mounted for the use of a face mask. The proposed device provides optimization of the design and increase the operational comfort of the orthodontic about the device and its functionality. 2 ill.

Description

The utility model relates to medicine, namely to dentistry, specifically to devices for treating dentofacial anomalies, and can be used to treat patients with mesial occlusion in combination with reverse incisal occlusion / disocclusion, palatine occlusion (single and bilateral), narrowing and shortening of the dentition of the upper jaw before during the change of teeth.

In dental practice, various orthodontic appliances are used to treat mesial occlusion: a removable orthodontic plate device on the upper jaw with a tripartite Bertoni screw (Richardson A. Early treatment of Class III malocclusion in mixed dentition. Br Dent J 1999; 186: 177), non-removable apparatus for disclosure of the middle palatine suture on occlusal mouth guards (McNamara) (McNamara JA Jr. An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod 1987; 21: 598-608), Postnikov apparatus for treating mesial occlusion (patent for PM No. 92323).

Fixed orthodontic apparatus for the expansion of the upper jaw on occlusal overlays - McNamara is designed to expand the upper jaw during the change of teeth (after the eruption of the first permanent molars in the upper jaw). This unit includes a Hairax screw and plastic occlusal mouth guards, covering temporary molars and the first permanent molars on the upper jaw.

The disadvantages of this device are the limitation of its use until the eruption of the permanent first molars in the upper jaw, the inability to lengthen the anterior segment of the dentition.

Known removable plate apparatus with a three-sided screw, which is held by supporting and holding clamps, welded into the plastic palatal plates of the apparatus (Baccetti T, McGill LS, McNamara JA. Sceletal effects of early treatment of Class III malocclusion with maxillary expantion and face-mask therapy. Am J Orthod Dentofacial Orthop 1998; 113: 333-43).

The disadvantages of this apparatus are the complexity and cumbersome design, orthodontic (dentoalveolar) expansion of the dentition of the upper jaw, in contrast to the orthopedic (opening of the middle palatine suture), requires cooperation from the patient.

Closest to the claimed utility model (prototype) is a non-removable Postnikov apparatus (patent for PM No. 92323) for the treatment of mesial occlusion in children 6-12 years old, including palatine screw, side beams, rings or crowns for 4th and 6th teeth . As a screw, a three-dimensional Burtoni screw with three independent guides is used and a front beam is installed to extend the upper incisors mesially. The disadvantages of this apparatus are the impossibility of its use in patients during the period of occlusion of temporary teeth or at the stage of early tooth changes, the absence of a splint effect, orthodontic (dentoalveolar) expansion of the upper dentition.

The utility model solves the technical problem of expanding functionality, optimizing the design and improving the operational comfort of the orthodontic apparatus.

The stated technical problem is solved by the fact that the orthodontic apparatus on occlusal plates for the treatment of mesial occlusion in children before and during the tooth change period contains a palatine screw, which is used as a three-dimensional Burtoni screw with three independent guides, the side and front beams, and the device is fixed and contains occlusal pads in the side sections, mounted on the side beams and made of plastic, in which metal hooks are mounted to use the face mask.

The essence of the utility model is illustrated by photographs, where in FIG. 1 shows the proposed orthodontic apparatus, FIG. 2 - x-ray with the device installed on the upper dentition, side view

The proposed orthodontic apparatus includes two occlusal pads (mouth guards) 1, one frontal guide beam 2, connected by ends with a three-sided Burtoni screw 3. The occlusal mouthguards are made of acrylic plastic 3 mm thick, the guide beam is made of round steel wire (0.4-0, 6 mm). In the occlusal mouthguards, metal hooks 4 for the face mask are welded with the ends. In the central part of the sky there is a tripartite screw (for example, Bertoni), to which all the above components of the device are attached.

The utility model effectively performs orthopedic expansion of the upper jaw in the region of the median palatine suture (controlled, single or double-sided), and the presence of a frontal beam guide allows simultaneous extension of the anterior segment of the dentition, thereby correcting the dentition in the sagittal and transverse directions. In addition, the occlusal lining-mouthguards act as a splint, eliminating the mismatch between the central ratio and central occlusion, thereby providing a functional (neuromuscular) effect.

The anterior beam may be temporarily fixed to the palatal surface of the maxillary incisors on a composite material of light or chemical cure. Two hooks 4 are welded into the occlusal mouthguards 1 on both sides for fastening the elastic rings connecting the device to the face mask (not shown in the photographs). The apparatus is fixed and includes occlusal plates with a tripartite screw mounted in them, an arc element (guide beam) in the region of the front teeth to effect traction on them, with metal hooks for the front arch.

The proposed device is effective in the treatment of dentoalveolar anomalies in adolescents and children, in particular in the treatment of mesial occlusion in combination with reverse incisal occlusion / disocclusion, palatine occlusion (single or bilateral), narrowing and shortening of the dentition of the upper jaw.

The proposed orthodontic apparatus is convenient in fixation. And since it is non-removable, the constant effect on the dentofacial system under the supervision of an orthodontist makes it possible to reliably predict the result of treatment, and also significantly reduces the duration of treatment. The device can be used in the treatment of patients during the period of occlusion of temporary teeth or at the stage of early tooth change. The device is effective in the treatment of mesial occlusion, including accompanied by reverse incisal occlusion / disocclusion, palatine occlusion, anomalies in the shape and size of the dentition. This device allows you to effectively implement the first stage of orthodontic treatment (early treatment).

Patients with a gnatic form of mesial occlusion and reverse incisor disocclusion in combination with narrowing and shortening of the upper dentition are equipped with the proposed device, the main element of which is a tripartite Bertoni screw with three independent guides and plastic mouth guards. Occlusion mouthguards are fixed on temporary molars and fangs using glass-ionomer cement or double-cured cement.

To extend the teeth of the anterior part and lengthen the upper dentition, a beam 2 was used. Depending on the type of narrowing of the upper dentition, uniform or uneven activation of the screw 3 can be used. The screw is activated using a special key (not shown in the photographs). As a result of treatment, orthopedic expansion and lengthening of the upper dentition, mesial displacement of the upper incisors occurs.

To create a constant pressure of the beam on the upper incisors and to correct the reverse incisal occlusion / disocclusion, the front beam 2 can be fixed to the palatal surfaces of the incisors with a composite material of light or chemical curing. At the level of temporary canines, two hooks are mounted in the occlusal mouth guards from the vestibular surface to allow the use of a face mask. Plastic mouthguards can be adjusted in thickness by sawing with a mill or welding using self-hardening plastic, which allows the use of the proposed device in children under 6 years of age with sagittal and transverse occlusion anomalies and disorders in the temporomandibular joint.

The proposed orthodontic apparatus is used as follows.

Clinical example

A 6-year-old patient came to the orthodontics department with complaints of difficulty biting food, protruding chin (according to the parents). Mesial occlusion in the mother is determined.

Results of clinical examination methods:

- face configuration is not changed

- profile: convex

- position of the upper lip: sinks

- position of the lower lip: protrudes

Conclusions:

Cephalometry Results:

- lower promacognathia

- upper retrognathia

Diagnosis:

Bilateral palatine occlusion

Reverse incisive disocclusion

Narrowing of the upper dentition

Shortening of the anterior segment of the upper dentition (Fig. 2)

The treatment was carried out using the proposed orthodontic apparatus. Trilateral screw activation was performed daily for 14 days (this activation period was sufficient to correct palatin occlusion). After the activation of the screw for expansion was completed, a face mask (Petit) with a wearing regimen of at least 12 hours a day was included in the treatment protocol. After 1.5 months from the start of treatment, the central incisors of the upper jaw established themselves in the correct ratio with the incisors of the lower jaw. The presence of diastema on the upper jaw was confirmed, confirming the opening of the median palatine suture. The device was in the oral cavity for 4 months for retention relative to the obtained width of the dentition and the possibility of using a facial mask. Positive changes were achieved in the maxillofacial complex (based on the analysis of situational TRH of the head in the lateral projection). After removing the device, the patient was made a functional Frenkl apparatus of the third type for use at night and during the day - for 2-3 hours - to maintain the result.

The orthodontic apparatus made according to the utility model is especially recommended for medical use for children during the period of active growth. The presence of occlusal pad-kapp allows you to set the lower jaw in a central ratio by eliminating functional or dentoalveolar obstructions. The use of the utility model allows for the comprehensive treatment of dentofacial anomalies in patients at the stage of early tooth change, making it possible to effectively carry out the first stage of orthodontic treatment. Rapid adaptation to the apparatus of poorly cooperating patients was noted.

The proposed model can be implemented on the basis of developed materials, technological processes and equipment.

As a result of treatment using the utility model, orthopedic expansion of the upper jaw and lengthening of the upper dentition, mesial displacement of the upper incisors anteriorly occur. Orthopedic expansion of the upper jaw (opening of the median palatine suture) causes the mobilization of the sutures surrounding the upper jaw, then allowing the upper jaw to be effectively protected using a face mask. Occlusive linings (mouthguards) can eliminate the mismatch between the central occlusion and the central ratio, acting as a splint. The use of the apparatus at the stage of occlusion of temporary teeth allows early correction of existing skeletal disorders in the sagittal and transverse planes. The presence of occlusal plates (kapp) allows you to set the lower jaw in a central ratio by eliminating functional or dentoalveolar obstructions. Occlusive pads can be performed both without fingerprints and with fingerprints of antagonist teeth, depending on the clinical situation. Occlusive pads can be adjusted during treatment, thereby changing the position of the lower jaw in accordance with the objectives of the treatment. Due to the presence of pads (kapp), the device can be used in cases of TMJ disorders in children. The possibility of positioning the lower jaw allows the use of the proposed apparatus for the treatment of occlusion anomalies in the transverse region - transverse incisal occlusion / disocclusion of any genesis and form (dentoalveolar, gnatic, articular, muscular). In poorly cooperating patients, rapid adaptation to the device occurs. Using the apparatus, an orthopedic expansion is performed (true disclosure of the median palatine suture and periandibular sutures: cheek-maxillary, sphenoid-maxillary sutures, the impact on which is limited in children and adolescents), which ensures effective skeletal protraction of the upper jaw when applying the facial mask. The use of the proposed apparatus allows for the comprehensive treatment of dentofacial anomalies in patients at the stage of occlusion of temporary teeth and early tooth changes, that is, in children before and during tooth changes.

The proposed device provides optimization of the design and increase the operational comfort of the orthodontic unit and its functionality.

Claims (1)

An orthodontic device on occlusal plates for the treatment of mesial occlusion in children before and during the tooth change period, containing a palatine screw, which uses a three-dimensional Burtoni screw with three independent guides, side and front beams, characterized in that the device is fixed and contains occlusal plates in the side sections, mounted on the side beams and made of plastic, in which metal hooks are mounted for applying the face mask.

Images