RU2288670C1 - Method for treating vertical dentoalveolar lengthening at included defects of dentura - Google Patents

Abstract

FIELD: medicine, stomatology.

SUBSTANCE: the present innovation deals with treating vertical dentoalveolar lengthening either in children and in adults. The innovation includes separation and manufacturing a cappa for maxilla and/or mandibula. In projection area of the roots of dentoalveolar lengthening one should create perls-protrusions upon a cappa and, moreover, in the course of therapy it is necessary to stratify a bioenert material in area of the tubers of lengthened teeth. Thus, the innovation enables to save support teeth of antagonistic jaw and cortical plate in area of dentoalveolar lengthening and create steady distribution of masticatory pressure upon the whole dentura.

EFFECT: higher efficiency of therapy.

1 cl, 2 ex, 1 tbl

Description

The present invention relates to medicine, namely to dentistry, and can be used in the treatment of vertical dentoalveolar tooth lengthening in children and adults.

Dental maxillary deformities are one of the leading symptoms of a partial tooth loss clinic. Prosthetics of such patients is impossible without complicated preliminary preparation. Dental maxillary deformities lead to traumatic occlusion, disorders in the temporomandibular joint, masticatory parafunction, regional blood circulation function in the periodontium is impaired, which impedes rational prosthetics or completely excludes its possibility. The urgency of the problem is obvious if we take into account the significant incidence of deformations with partial tooth loss and the widespread use of surgical methods to eliminate deformations - the removal, grinding of a significant amount of hard tissue with preliminary depulpation (Gavrilov E.I. Deformations of the dentition. M .: Medicine, 1984 , 96 p., Ill.).

For the only analogue (prototype) discovered by us, the method for the treatment of dentoalveolar elongation proposed by E. Gavrilov was adopted. Deformation of the dentition. M .: Medicine, 1984, S.62-71, ill. The method involves grinding the tubercles of the moved teeth, shortening the teeth that violate the occlusion, with the preliminary removal of the pulp, elimination of deformities using the bridge. The antagonists make a bridge. The intermediate part of the prosthesis is an openwork lattice for strengthening plastic, which allows fixing new portions of this material with an interval of 1 time in 2-3 weeks, when it becomes necessary to increase the interalveolar distance. The teeth located in the dentoalveolar elongation are in contact with the plastic of the intermediate part of the prosthesis, the remaining teeth are disconnected. There is a functional overload of the periodontium, its restructuring along with the alveolar process and a gradual dentoalveolar shortening.

Disadvantages: the possibility of developing caries and its complications, the possibility of developing near-apical foci of inflammation, the preparation of healthy teeth and the manufacture of additional orthopedic structures on the teeth of the antagonizing jaw are necessary, which in the future can lead to the development of primary traumatic occlusion. Local disconnection of the group of teeth leads to overload of the supporting teeth and the teeth of the antagonists, unilateral tension of the masticatory muscles and, as a result, to the TMJ dysfunction.

Tasks: the exclusion of the provocation of the development of caries and periapical inflammatory processes, the exclusion of the preparation of healthy teeth, the simplification of the method of lengthening the teeth, reducing the morbidity and cases of TMJ caused by overloading of the antagonist teeth and the uneven distribution of stress on the dentition, and reducing the treatment time.

The technical result is the preservation of the abutment teeth of the antagonizing jaw and cortical plate in the area of dentoalveolar elongation, the creation of an even distribution of chewing pressure on the entire dentition.

The positive effect of this proposal is that this kappa covers the entire dentition, evenly distributing chewing pressure and, in turn, has a beneficial effect on the masticatory muscles and TMJ. The same kappa can be used in the treatment of periodontal diseases by investing in it with drugs.

The essence of the invention is the manufacture of mouthguards on the upper and / or lower jaw, in the area of the projection of the roots of the dentoalveolar elongation on the mouthguard create pearls - protrusions and during treatment with a frequency of 1-2 times 1-2 weeks on the inner surface of the mouthguard in the region of the tubercles of elongated teeth bioenergy material.

The method was tested on 22 patients for 1.0-1.5 years.

Indicators Ways Prototype (according to Gavrilov) The proposed method one. Teeth Antagonists are prepared Remain unchanged 2. Tooth strain antagonists Significantly present (traumatic occlusion occurs) No antagonists stress on teeth 3. Chewing pressure distribution Tooth overload in the area of dentoalveolar elongation and, as a result, periodontal functional overload Chewing pressure is evenly distributed over the entire dentition four. Chewing muscle condition Unilateral tension of the masticatory muscles can lead to parafunction and displacement of the lower jaw Bilateral uniform contraction of the masticatory muscles 5. TMJ function Asynchronous, leading to dysfunction Synchronous unloading elements of TMJ 6. Terms of treatment 1.5 to 2.0 years 0.5 to 1.0 years

The method is as follows.

1. Take impressions from the upper and lower jaws. The working and auxiliary models are cast, wax patterns are made.

2. Determine the central ratio of the jaws and plaster the model into an articulator.

3. Carry out the design of the mouthguard, mark the location of the pearls - protrusions in the area of the projection of the tooth roots of the dentoalveolar elongation, and then stamp the rigid mouthguard from Pro-form material on the APIK-1 apparatus. On the inner surface of the mouthguards in the area of dentoalveolar elongation, reinforcement is laid. Fiberglass can be used as reinforcement.

4. Fit the mouthguard in the oral cavity and eliminate premature contacts with a uniform interalveolar separation of 1-2 mm. On the next visit, layering on the reinforcement of any bioinert material composite materials of light or chemical curing or plastic. This procedure is carried out after 7-14 days to obtain the desired result.

Examples:

I. Patient K., 26 years old, East. bol. No. 1426, complained of insufficient chewing of food, an aesthetic defect.

Anamnesis morbi. Therapeutic oral sanitation was carried out regularly, 25.26 lost 4 years ago as a result of complicated caries, not prosthetics.

Anamnesis vite. Pyelonephritis from the age of 20, was under medical observation. Allergic status is calm.

When examining the oral cavity, 35.36 teeth were absent; intramuscular dentition was absent. Available seals were in satisfactory condition. When teeth are closed, the bite is orthognathic, in the region of 25.26 dentoalveolar elongation. The movement of n / h in the sagittal and transverse directions was blocked.

P P P from from P P P P P eighteen 17 16 fifteen fourteen 13 12 eleven 21 22 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 P P P from 0 0 P

Diagnosis: Partial lack of teeth n / h III Kennedy class. Chewing effectiveness 82% according to Oxman. Vertical dentoalveolar elongation in the region of 25, 26. Pyelonephritis.

Treatment plan: Conducted therapeutic rehabilitation of the oral cavity. An uncoupling mouthguard was made on the h / h for the treatment of vertical tooth displacement in the area of 25, 26. Once every 14 days, a chemical curing composite was layered inside the mouthguard in the area of dentoalveolar elongation.

The results of the treatment. The patient used mouthguard for 5 months. Movements n / h normalized. After eliminating the dentoalveolar elongation, ceramic-metal bridges were made with support for 34, 37 teeth.

II. The method was carried out on patient N., 25 years old, East. bol. No. 1430, but at the same time bioenergy material was laid on the inner surface of the mouthguard once a week.

P 0 0 P P P 0 eighteen 17 16 fifteen fourteen 13 12 eleven 21 22 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 0 P from P P

The results of the treatment. I used the patient mouthguard for 4.5 months. After elimination of the dentoalveolar elongation, a solid cast bridge was made with support for 15 and 18 teeth.

Claims (2)

1. A method of treating vertical dentoalveolar elongation with included defects in the dentition, including tooth separation, characterized in that mouth guards are made on the upper and / or lower jaw, pearls are formed on the inside of the projection root of the dentoalveolar elongation on the mouthguard and during treatment bioenergy material is layered on the inner surface of the mouthguard in the region of tubercles of elongated teeth. 2. The method according to claim 1, characterized in that the bioenergy material on the inner surface of the mouthguard in the area of the tubercles is layered with a frequency of 1-2 times in 1-2 weeks.