RU2283063C1 - Post-resection maxillary obturator prosthesis and method for manufacturing it - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has base with teeth and clammers, and rigid plastic obturator shaped as bowl open towards defect having wall thickness of 3-4 mm. Method involves taking maxillary imprint, casting plaster model, modeling missing jaw part from wax as a base bearing teeth and clammers, plastering the model in a cell, extracting wax by boiling and packing plastic. Gypsum is layered as column in the center of maxillary defect 3-5 mm far from defect walls having height reaching hard palate projection level.

EFFECT: simplified manufacturing process; prolonged service life.

2 cl, 1 dwg

Description

The invention relates to medicine, namely to dentistry, and can be used for the manufacture of an obturator-shell of a post-resection prosthesis of the upper jaw after its complete or partial resection.

A known method of manufacturing a hollow post-resection prosthesis-obturator of the upper jaw, which consists in the fact that the model from the mold is obtained directly in the cell with horizontal placement of the impression. After modeling the wax pattern, a stamp is obtained from the gypsum of the obturator model, reduced by the thickness of the wax pattern. Plastic packaging is carried out simultaneously in horizontal and vertical directions. (RF patent No. 2183438, class A 61 C 13/16, 2002.)

The disadvantage of this invention is the great complexity of the manufacturing process, requiring a special cuvette, and the inability to make significant corrections necessary to fit the prosthesis to the changing conditions of the prosthetic bed, due to the process of maturation of scars in the wound and, as a result, to reduce the defect volume due to the thinness of the obstructing part and risk of opening the cavity of the obturator.

Closest to the proposed is a method of manufacturing a post-resection prosthesis-obturator of the upper jaw, which consists in taking an impression of the upper jaw with an alginate mass, casting a gypsum model, compressing the area of the defect with a base wax plate, the existing undercuts are covered with an additional portion of wax, the model is gypsum in a cuvette and replace wax with plastic. Thus, an obturator cap is obtained, which is fitted in the oral cavity. The walls of the cap are thinned to a thickness of 1.5 mm and then the impression is taken together with the cap to complete the manufacture of the prosthesis restoring the missing part of the jaw, which is a basis with teeth and clasps. When the second part of the prosthesis is already ready, it is glued with plastic with a cap, thus obtaining a thin-walled closed-cavity obturator. (Ryabov S.V. Prosthetics of acquired defects of the hard palate. Nizhny Novgorod Medical Journal No. 3, 2000, S.35-38.)

The disadvantage of this invention is the great complexity of the manufacturing process and the inability to make significant volume corrections of the obturator due to its thinness.

The technical result of the invention is to simplify the manufacturing process of the obstructing part of the prosthesis and to extend the period of its use due to the ability to make significant corrections in the postoperative period and in the long term.

The advantage of the proposed method is that the design of the obturator in the form of a bowl open towards the defect is a good resonator, not inferior to the hollow obturators in any way, so speech is restored completely, this design allows for numerous significant corrections in height and volume of the obturating part without fear of damaging the structure , which extends the terms of using the prosthesis in the postoperative period and in the long term.

The technical result is achieved by the fact that the post-resection prosthesis-obturator of the upper jaw contains a base with teeth and an obturator made of rigid plastic, in the form of a bowl open towards the defect, with a wall thickness of 3-4 mm.

The technical result is also achieved by the fact that in the method of manufacturing an obturator of a post-resection prosthesis of the upper jaw, which consists in taking casts, obtaining a gypsum model of the upper jaw, casting a gypsum model, modeling the missing part of the jaw from wax, consisting of a base with teeth and clasps, plastering the model into a cuvette , wax digestion and plastic packaging, a distinctive feature is that in the center of the upper jaw defect, the model is layered with gypsum with a column that does not reach the wall to a defect of 3-5 mm, and a height reaching the projection of the level of the hard palate.

The method is as follows (drawing): take a cast of the upper jaw, cast a plaster model of the upper jaw. Then, in the center of the location of the defect of the upper jaw, gypsum is layered on the model with a column that does not reach the walls of the defect 3-5 mm and a height that reaches the projection of the level of the hard palate. The missing part of the jaw, consisting of a base 1 with teeth 2 and clasps 3, is modeled from wax, the model is gypsum plated into a standard cuvette, wax is boiled and plastic is packaged. After polymerization of the plastic and extraction of the prosthesis from the cuvette, the finished obturating part 4 is obtained in the form of a shell (or in the form of a bowl open towards the defect). After that, the prosthesis is treated so that the wall thickness of the obturator is not more than 3-4 mm, polished and set to the patient. Subsequently, during the period of scar tissue maturation and reduction of the defect volume when the prosthesis begins to be squeezed out, the obstructing part is corrected in the required volume, which does not impair the quality of the obturator and increases the duration of use of the prosthesis.

Example

Patient K. was admitted with a diagnosis of osteoblastoclastoma of the upper jaw on the right. An operation was performed on the resection of the upper jaw on the right with the removal of 17, 16, 15, 14, 13, 12, 11 teeth and the alveolar process with the formation of a 3 × 3 cm mouth-nostril. On the 14th day after the operation, casts were taken during the ligation, For this, an alginate impression mass was used, which was directly injected into the oral cavity, applied to the upper and lower jaws, while filling the defect cavity and the entire oral cavity when the jaws were closed in central occlusion. This technique made it possible to accurately display the defect without stretching the tissues and to obtain models in the bite after casting them from gypsum, which allowed them to be immediately gypsum into the occluder. The borders of the prosthesis were drawn on the model of the upper jaw, gypsum in the form of a column was laid in the center of the bottom of the defect, slightly not reaching the projection of the hard palate and 4-5 mm apart from the walls of the defect. Then, a wax composition of the prosthetic obturator with teeth and clasps was performed. After that, the model of the upper jaw with the wax composition of the prosthesis was gypsum plated in a standard cuvette, the wax was boiled and replaced with a rigid plastic. After polymerization of the plastic, the prosthesis was removed from the cuvette and polished, while the obturating part immediately had the shape of a “shell” or bowl. The patient received a prosthesis on day 21 after surgery. A month after installation, the patient complained of poor fixation and extrusion of the prosthesis due to reparative processes and maturation of scar tissues, leading to a decrease in the volume of the defect. A correction was carried out - the obturating shell was reduced in height by 1/4. During the first year, several similar corrections were made. The need for a new prosthesis was not observed.

Thus, this obturator-sink prosthesis in the form of a bowl open towards the defect, in the near future after resection of the upper jaw allows you to restore speech, improve the aesthetics of the patient and extend the term of use of the prosthesis due to the possibility of making significant corrections to the obstructing part.

Claims (2)

1. Post-resection prosthesis-obturator of the upper jaw containing a base with teeth and an obturator made of rigid plastic, in the form of a bowl open to the side of the defect, with a wall thickness of 3-4 mm 2. A method of manufacturing a post-resection prosthesis-obturator of the upper jaw by taking an impression of the upper jaw, casting a plaster model, modeling the missing part of the jaw using wax, consisting of a base with teeth and clasps, plastering the model into a cuvette, digesting the wax and packing the plastic, characterized in that in the center of the location of the defect of the upper jaw, gypsum is layered on the model with a column that does not reach the walls of the defect 3-5 mm and a height that reaches the projection of the level of the hard palate.