RU2428951C1 - Ma postnikov's method of treating mesial occlusion in combination with deficit of space in dentition - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: median palatine suture is extended by means of application of unattachable apparatus with palate screw, lateral bars and rings or crowns on 4-th and 6-th teeth. Undetachable apparatus is fixed to crowns by means of glass-ionomer cement. Upper jaw dentition is elongated in sagittal direction and upper incisors are moved forward by means of additionally installed anterior bar. Anterior bar is fixed to upper incisors, for which purpose after treatment with 3.5% orthophosphoric acid, on bar applied is adhesive, which is later used to fix composite material of light hardening to teeth and bar. From composite material formed is roll between teeth and bar, which protrudes beyond the edge of upper incisors and separates upper and lower incisors, and during food biting off and pressure of upper bar moves upper incisors from reverse incisal overlap. Undetachable apparatus with palate screw is removed after 1-2 months and bracket-system is fixed on upper jaw teeth. Space for 3-rd teeth is created by means of opening springs. On lower jaw dentition bracket system is fixed after six months from treatment beginning.

EFFECT: method makes it possible to create space for impacted canines, reduce treatment terms.

4 cl, 7 dwg, 2 ex

Description

The invention relates to medicine, namely to dentistry, and can be used to treat mesial occlusion, combined with retention of permanent teeth and a lack of space in the dentition, and can be used in orthopedic dentistry, mainly in children.

A known method of treating mesial occlusion in combination with retention of permanent teeth and a lack of space in the dentition (DE 2656693, 06/22/1978), including the expansion of the middle palatine suture using a fixed device with a palatine screw in such a way that creates a place in the dentition for the retarded fangs due to the simultaneous expansion of the middle suture and the extension of the frontal part of the teeth.

Disadvantages: in the known method, the median palatine suture is expanded, but the entire dentition of the upper jaw in the sagittal direction is not extended.

The objective of the proposed technical solution is to create a method for expanding the median palatine suture and lengthening the dentition of the upper jaw in the sagittal anterior direction, which allows to simultaneously eliminate mesial occlusion in combination with retention of permanent teeth and a lack of space in the dentition.

The problem is solved by the proposed method for the treatment of mesial occlusion in combination with retention of permanent teeth and a lack of space in the dentition, including the expansion of the middle palatine suture by installing a fixed device with palatine screw, side beams and rings or crowns on the 4th and 6th teeth, moreover, the non-removable device is fixed on the crowns to the teeth using glass ionomer cement, the dentition of the upper jaw is extended and the upper incisors are advanced by means of an additionally installed front beam, this front beam is fixed to the upper incisors with a light composite material, for which, after etching with 3.5% phosphoric acid, an adhesive is applied to the beam, which then fixes the composite material to the teeth and beam, from which the roller is formed between the teeth and the beam, which protrudes the edge of the upper incisors and divides the upper and lower incisors, and when biting off food and the pressure of the upper beam, removes the upper incisors from the reverse incisal overlap; after which the fixed device with palatine screw is removed from the teeth after 1-2 months and the bracket system is fixed to the teeth of the upper jaw, the place for 3 teeth is created using opening springs, and the bracket system is fixed to the lower dentition six months later start treatment.

Used in the inventive method, the non-removable device is a device illustrated by the drawings, in which Fig. 1 shows a device for treating mesial occlusion in combination with retention of permanent teeth and a lack of space in the dentition on a gypsum model, and Fig. 2 shows a device in the patient's mouth according to example 2 before treatment, bottom view, figure 3 is a device in the patient’s mouth according to example 2 after treatment, bottom view, figure 4 is a front view of the patient of example 2, the teeth are removed from the reverse incisal overlap, figure 5 - the same side view, created by me 23 for the tooth 6 - view of the roller 7 - the location of the roller cutter on the upper, side view.

A device for treating mesial occlusion in combination with retention of permanent teeth and a lack of space in the dentition according to the proposed method includes a three-dimensional Burtoni screw 1 (Figs. 1, 2), an additional front beam 2, side beams 3 and 4, orthodontic crowns 5 and 6, three independent guides 7, 8, 9. The bracket system 14 includes an opening spring 13. A roller 12 of composite material is formed between the front teeth 11 and the beam 2.

The device consists of a three-dimensional screw "Burtoni" 1, four orthodontic crowns or orthodontic rings 5 and 6 on 4 and 6 teeth to separate the bite. Crowns and screw are interconnected by metal beams 3 and 4, welded by laser welding.

A method of treating mesial occlusion in combination with retention of permanent teeth and a lack of space in the dentition are used as follows.

In the area of 4 and 6 teeth (if necessary, if the teeth are tight, to separate them and prevent tooth turning), separators are installed - rubber orthodontic rings with a diameter of up to 2 mm. After two days, the rings are removed and the described device is installed for the patient for 1-2 months, the main element of which is the three-dimensional Burtoni screw 1 with three independent guides 7, 8, 9, for which orthodontic crowns or rings are installed on the 4th and 6th teeth 5 and 6, which are connected to the beams 3 and 4 and the Burtoni screw 1 by laser welding. To extend the teeth of the anterior section and to extend the upper dentition, beam 2 is additionally applied, after the extension of the upper incisors, the front beam can be fixed to the upper incisors with light material or completely removed. In addition, a roller 12 made of composite material is modeled on the maxillary incisors in order to create conditions for optimal extension of the upper incisors in the vestibular manner to lengthen the upper dentition. After etching with 3.5% phosphoric acid and drying on the beam 2 and the front cutters 11, an adhesive is applied — an Orthosolo material from the Ormco company (USA), and then a roller 12 is formed from the Ormco blugloo composite material (USA). Preliminary application of the adhesive is necessary to increase the strength of the connection of the roller 12 with the beam 2 and the teeth 11, which is very important for the proposed method of treatment, since the patient has to wear the described device for several months while chewing food, which creates constant loads on the roller. In addition, the roller 12 is made of light-cured material in such a way that it protrudes beyond the edge of the teeth 11 and directly contacts the teeth of the lower jaw when biting and chewing food, thereby disconnecting the bite, as well as crowns in a fixed device.

The roller protrudes beyond the edge of the upper incisors and when biting off food and the pressure of the front beam of a fixed device, removes the upper incisors from the reverse incisal overlap. When the upper incisors are brought forward, the screw 1 is untwisted and removed. With the simultaneous expansion of the front and side rows, the patient will have less pain.

Depending on the type of narrowing of the upper jaw, you can apply the uniform or uneven untwisting of the Burtoni screw. The activation of the screw "Bertoni" is made a quarter of a turn every other day at night using a special key 10 (figure 1). As a result of treatment, the upper dentoalveolar arch expands and lengthens, the palatine suture opens, and the protrusions of the upper incisors are anteriorly. This creates free space for the retina fangs on the upper jaw (Fig.3-5).

Orthodontic treatment with non-removable devices carries an increased risk of tooth plaque formation, can cause enamel demineralization and tooth decay to prevent this phenomenon, orthodontic crowns are placed on glass ionomer cement (Fuji, Japan), which contains fluorine, which feeds the tooth and prevents the development caries under crowns.

After the incisors are removed from the reverse incisal overlap and the extension of the upper dentition, the apparatus is removed, the crowns are cut with a crown saw and the bracket system 14 is fixed on the teeth of the upper jaw. A place for 3 teeth (fangs) is created using opening springs 13. The bracket system on the lower dentition is fixed six months after the start of treatment. At the same time, every five months they undergo a laser therapy course on the Optodan apparatus (Russia, Saratov) for 10 days on Channel I for 2-3 minutes in the area of the teeth being held.

Within 24-26 months without surgical treatment, mesial occlusion is eliminated and the upper canines are placed in the dentition.

In the claimed method, the upper jaw does not block the lower and due to this, the upper jaw freely grows anteriorly, which accelerates growth and shortens the treatment time compared to the known method (1.5-2 years instead of 3 years in the known method). In addition, after extension of the frontal part of the teeth of the upper jaw in the present method, it is possible to stabilize the position of the teeth of the upper jaw by removing the front beam and leaving the other two. In addition, the inventive method provides not only the expansion, but also the lengthening of the entire upper dentition in the sagittal direction, places are created for the growth of new teeth not only in the lateral segments of the upper dentition, but also in the front, while also aligning the upper dentition in the half ellipse, and the lower dentition in the form of a parabola.

Clinical examples

Example 1

Patient Yu., Age 12 years, 2 months. Complaints about an ugly smile. D.S. Mesial bite, narrowing of the upper dentition. Reverse incisal overlap, close position of the upper and lower incisors of the II degree, retention of 13 teeth, lack of space in the dentition.

Treatment: use for 2 months of a device for expanding the palatine suture and extending the upper incisors vestibularly, followed by treatment with a bracket system using laser therapy in the region of 13 tooth. After 3 months, the reverse incisal overlap was eliminated, the upper dentition was expanded. After 1 year and 6 months, the treatment is completed, an orthognathic bite is obtained. 13 tooth in the dentition.

Example 2

Patient D., 13 years 4 months. Complaint about aesthetics of the face, difficulty chewing food.

D.S. Mesial bite. Reverse incisal overlap. Palatal occlusion - 14, 15, 16, 17, 24, 25, 26, 27 teeth. Lack of space for 13 teeth, lack of space for 23 teeth. Retention 13, 23 teeth. 63 is stored in the dentition (figure 2).

Treatment: a device was used to expand the palatine suture and extend the upper incisors vestibularly for 3 months, 63 teeth were removed. After treatment with the bracket system, after 8 months, the 23rd tooth was placed in the dentition without surgical intervention. Created a place for 13 tooth, which began to erupt after 16 months from the start of treatment. An orthognathic bite was obtained, facial aesthetics, smile, profile improved. Laser therapy was used.

The proposed method allows to correct the mesial bite in combination with the retention of permanent teeth and a lack of space in the dentition, to create a place for retina fangs, to improve the aesthetics of the face in patients of childhood and adolescence.

The applicant asks to name the claimed invention “Method of M. A. Postnikov for the treatment of mesial occlusion in combination with a shortage of space in the dentition”.

Claims (4)

1. A method of treating mesial occlusion in combination with a lack of space in the dentition, including the expansion of the middle palatine suture by installing a fixed device with a palatine screw, side beams and rings or crowns on the 4th and 6th teeth, characterized in that the fixed apparatus fixed to the crowns using glass ionomer cement, extend the dentition of the upper jaw in the sagittal direction and extend the upper incisors by means of an additionally installed front beam, and the specified front beam is fixed to the upper m incisors, for which, after etching with 3.5% phosphoric acid, an adhesive is applied to the beam, which then fixes the composite material of light curing to the teeth and the beam, from which a roller is formed between the teeth and the beam, which protrudes beyond the edge of the upper incisors and divides the upper and lower incisors, and when biting off food and the pressure of the upper beam, removes the upper incisors from the reverse incisal overlap; after which the fixed device with palatine screw is removed and the bracket system is fixed on the teeth of the upper jaw, the place for 3 teeth is created using opening springs, and the bracket system is fixed on the lower dentition six months after the start of treatment. 2. The method according to claim 1, characterized in that as the adhesive using the material "Orthosolo" company "Ormco" (USA). 3. The method according to claim 1, characterized in that as a composite material using light material "blugloo" company "Ormco" (USA). 4. The method according to claim 1, characterized in that during the treatment period every five months they conduct a course of laser therapy for 10 days on the apparatus "Optodan" in the area of the teeth being held.

Images