RU2448665C1 - Method for making complete removable dentures - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to orthopaedic dentistry, namely complete tooth replacement. The method involves preparing impressions of upper and lower jaws, producing rigid plastic bases to be coated with dental wax, and finally forming the bases in the oral cavity. Dental wax in the form of strips is applied along the perimetre of borders of both bases and in addition both bases are coated with vertical strips from a fringe to denture borders within canines. 3-5 cross wax lines are applied on a palatal surface along a distal border of the basis of the upper jaw behind artificial upper incisors; one wax line is applied on a tongue surface of the denture basis of the lower jaw from each side under artificial teeth parallel the to fringe and gapped to match a width of lateral tongue surfaces.

EFFECT: improved fixation of the complete removable dentures.

3 dwg

Description

The claimed invention relates to medicine, namely to dentistry, and in particular to dental prosthetics. Prosthetics of edentulous jaws is complicated by atrophy of bone tissue of varying severity, decreased muscle tone and impaired coordination of movements of the facial muscles, as well as the presence of a large number of somatic diseases in patients with this type of pathology.

A known method of prosthetics is implantation, which consists in introducing implants into the bone tissue of the jaws (analogues of missing teeth), which make it possible to manufacture both removable and non-removable structures based on them [V.N. Trezubov, A.S. Scherbakov, L.M. .Mishnev. Orthopedic dentistry. St. Petersburg, "Tome" 2005, p.205-208; S.D. Arutyunov, V.N.Trezubov, Modern methods of prosthesis fixation. Moscow, "TEIS" 2003, p.111-115].

Implantation gives an excellent functional and aesthetic effect, however, there are enough contraindications associated with the general diseases of the patient; it is also an expensive procedure. These circumstances make implantation impossible for most elderly patients, namely they suffer from a complete lack of teeth.

The usual method for prosthetics of toothless jaws includes the following stages: taking anatomical impressions, obtaining individual impression spoons from the laboratory, fitting spoons in the oral cavity using functional tests, taking a functional impression, performing bite patterns, determining the central ratio and interalveolar height in the cavity the patient’s mouth, placing artificial teeth on a basis in the articulator, checking the design of the oral cavity, replacing the wax composition with plastic and plastic reduction of prostheses in the oral cavity [V.N. Trezubov, A.S. Scherbakov, L.M. Mishnev. Orthopedic dentistry. St. Petersburg, "Tome" 2005, p.339-393. V.N.Trezubov, L.M. Mishenev, N.Yu. Neznanova, S.B.Fishchev. Orthopedic dentistry. Technology of medical and preventive devices. St. Petersburg, "Special", 2003, p.163-196].

Over time, even in the absence of complaints, all patients have traces of chronic prosthetic trauma, poor fixation of prostheses, and in addition, insufficient effectiveness of chewing food.

The closest in combination of features to the claimed method is the prosthetics method with full removable structures, according to which imprints of the upper and lower jaws are obtained, hard denture bases are made with artificial teeth mounted on them, a softened dental wax is applied along the perimeter of the upper jaw base and formed in the patient's oral cavity using functional tests. A 2-3 mm thick wax strip is applied to the entire buccal and labial surface of the base of the lower jaw and a basis is formed using movements of the jaws, after which a 5-6 mm long wax strip is applied to the hyoid surface of the basis and this part is formed using tongue movements [P. Tanrykuliev. Clinic and prosthetics of patients with toothless jaws. Ashgabat, The Magarif, 1988, pp. 137-143, 147-156]. The specified method of volume modeling of the basis is quite effective in relation to the fixation of prostheses, the quality of chewing food and atraumatic. However, it increases the number of appointments with the dentist, but the accuracy of filling the volume of the vestibule of the oral cavity is not always achieved, since the coordination of the movements of the facial muscles, on which this method is based, is weakened in elderly patients.

The technical result to which the claimed invention is directed is to significantly improve the fixation of complete removable dentures.

The specified technical result is achieved by the fact that in the method of manufacturing complete removable dentures, including obtaining impressions of the upper and lower jaws, obtaining hard bases of plastic, applying softened dental wax on the surface of the bases of the prostheses and the final formation of bases in the oral cavity, the softened dental wax is applied in the form strips along the entire perimeter of the borders of the lower jaw prosthesis and along the perimeter of the borders of the upper jaw prosthesis in the form of a contour border, from a contour border and in the area of the canines, wax strips are vertically glued, reaching the borders of the prosthesis, and additionally 3-5 transverse strips of wax behind artificial upper incisors are applied on both sides of the middle palatine suture along the distal border of the base of the upper jaw prosthesis, and on the lingual surface of the base a prosthesis of the lower jaw on each side under artificial teeth is applied in a strip parallel to the edging with a gap corresponding to the width of the lateral surfaces of the tongue.

All these procedures are carried out on a rigid basis. Wax additives are heated above the flame of an alcohol lamp and formed in the oral cavity using functional tests. After the claimed simulation, the formed basis with wax modeling in the traditional way is replaced by a permanent polymer.

A strip of wax on the palatal surface of the distal edge of the upper prosthesis is laid to compress soft tissues and use their buffer zones to enhance fixation of the prosthesis when pronouncing vowels and nibbling food.

In addition, artificial transverse palatal folds are simulated, which improve the stabilization of the prosthesis during the movement of the tip of the tongue, facilitate sound production and enhance the sharpness of taste perception. And finally, vertical “columns” are modeled at the level of artificial fangs to create a man-made framework (skeleton) for the lips, allowing you to restore their lost anatomical shape and volume, and thereby the natural appearance of the mouth.

The placement of the wax strips on the upper and lower bases is shown in figure 1-3.

The figure 1 presents a front view of both bases.

Figure 2 is a bottom view of the basis of the upper jaw.

Figure 3 is a top view of the basis of the lower jaw.

A strip of dental wax 1 is placed around the perimeter of the base of the upper jaw (figure 1 and 2). From the contour edging 1 in the region of the upper canines, vertical strips of wax 2 are glued (figure 1). On the palatal surface of the basis of the upper jaw, transverse strips 3 are additionally placed (figure 2).

On the basis of the lower jaw, strips of 4 dental wax are applied (Figure 1 and 3). Strips 5 are glued in the region of the lower canines (figure 1). On the lingual surface of the basis of the prosthesis of the lower jaw (figure 3) additionally applied strips 6 of dental wax.

After applying strips of wax, hard plastic bases with artificial teeth are sent to the dental laboratory, where the wax is replaced with plastic, finishing, grinding, polishing the prosthesis using the known technology [V.N.Trezubov, L.M. Mishenev, N.Yu. Neznanova , S. B. Fischev. Orthopedic dentistry. Technology of medical and preventive devices. St. Petersburg, "Special", 2003, p.185-196].

The invention is further illustrated by examples of a specific embodiment.

Example 1

Patient K., 57 years old, turned to the clinic of orthopedic dentistry with complaints of complete loss of teeth in the upper and lower jaw.

Previously not prosthetized. When examining the oral cavity, there is a pronounced uniform atrophy in the upper jaw (III class Schroeder). Atrophy on the lower jaw is insignificant (I class Keller). After the manufacture of a complete removable denture of the upper jaw according to the proposed technology, satisfactory fixation and stabilization of the structure in the oral cavity at rest and during colloquial tests are noted. The lower prosthesis is made according to classical technology. Adaptation to prostheses in a patient proceeds without complications. The number of visits by the patient to the dentist: 3.

Example 2

Patient Z., 76 years old, turned to the orthopedic dentistry clinic with complaints of a violation of the fixation of a complete denture of the lower jaw in the oral cavity during chewing and speech formation. The prosthesis was made 2 months ago.

When examining the oral cavity, there is a strong uneven atrophy of the lower jaw (class IV Keller). After applying the proposed technique, the fixation and stabilization of the prosthesis in the oral cavity improved both during functional tests and the subjective sensations of the patient. The patient has no complaints. The number of visits by the patient to the dentist: 4.

Example 3

Patient O., 34 years old, as a result of a car accident 4 months ago lost all his teeth in the upper jaw. A manufactured prosthesis has an unsatisfactory fixation in the oral cavity. The alveolar part of the upper jaw is moderately expressed (II class Schroeder). After prosthetics with a full removable denture according to the proposed method, there is an improvement in the fixation of a complete removable denture of the upper jaw. The patient is preparing for implantation and rehabilitation with a fixed orthopedic design. The number of visits by the patient to the dentist: 3.

Thus, the inventive method can significantly improve the fixation and stabilization of complete removable dentures in the oral cavity, accelerate the patient’s adaptation to the manufactured device, and also reduce the number of visits required to make the prosthesis.

Claims (1)

A method of manufacturing complete removable dentures, including obtaining impressions of the upper and lower jaws, making hard bases of plastic, applying softened dental wax on the surface of denture bases and the final formation of bases in the oral cavity, characterized in that the softened dental wax in the form of strips is applied around the perimeter of the borders the basis of the prosthesis of the upper jaw and along the perimeter of the borders of the basis of the prosthesis of the lower jaw in the form of a contour edging, from the contour edging in the area of the fangs wax strips reaching the borders of the prosthesis are vertically stretched, 3-5 transverse strips of wax behind artificial upper incisors are applied on the palatal surface along the distal border of the base of the upper jaw prosthesis on both sides of the middle palatine suture, and on each tongue surface of the base of the lower jaw prosthesis under artificial teeth along a strip of wax parallel to the edging with a gap corresponding to the width of the lateral surfaces of the tongue.

Images