RU2454200C1 - Dentoalveolar prosthesis-obturator from polyurethane with intramucous implants - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, in particular to dentistry, and can be applied for orthopedic rehabilitation of patients with post-operation defects of jaw bones in case of their partial resection. Dentoalveolar prosthesis-obturator has basis with teeth, made from hard polyurethane with clasp elements of fixation. Obturator is made hollow and has frame from hard polyurethane, and external surface from soft polyurethane. Entire prosthesis is made by method of casting, including areas of formation of operation field external borders. On basis of prosthesis, adjoining hard palate, in zone of unresected jaw placed are two intramucous implants from polyurethane made with half-spherical head on neck, monolithically connected with basis plate, borders of half-spherical head are made ovalled, area of transition from head to neck has lug with radius of rounding.

EFFECT: insuring reliable fixation and stabilisation of prosthesis basis to prosthesis bed, its high congruence, especially on the border of upper jaw defect, minimal adhesion of microorganisms to prosthesis-obturator, and restoration of patient's phonetics, intelligible speech.

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Description

The invention relates to medicine, in particular to dentistry, and can be used for orthopedic rehabilitation of patients with postoperative defects of the jaw bones with partial resection.

A known method of molding dental and maxillofacial prostheses from plastics by conventional pressing consists in taking a mold, obtaining a model, modeling a wax obturator template, plastering a model with a wax template in a cuvette in a vertical position, packing and polymerizing the plastic in a vertical direction (see B .N. Kopeikin, Ya.S. Knubovets, V.Yu. Kurlandsky, IM Oksman. Dental prosthetics. Chap. 8, 9, article. "Technology of the use of plastics." M .: Medicine, 1978, p. 105-109; 272-275).

However, the parts of the prosthesis, the obturator and the denture are obtained separately and then rigidly fixed with glue, which significantly reduces the strength characteristics of the prosthesis and, as a result, limits the duration of its use, and the places where the obturator is attached to the prosthesis by gluing do not meet the requirements of studies on the adhesion of microorganisms of the cavity mouth to removable orthopedic structures. The design of the prosthesis itself, its rigidity and toxicity of the plastic do not ensure the formation of the prosthetic bed in the area of the operation.

Known for the formation of a maxillofacial denture-obturator of the upper jaw containing interconnected hard bases with teeth and a soft obturator, characterized in that it is equipped with clasps, the hard basis is made of hard polyurethane, and the soft obturator is made of soft polyurethane, and the entire prosthesis is made by lily , including areas of the formation of the external borders of the surgical field (application No. 2009144891 dated 04.12.2009).

The disadvantages of this prosthesis can be considered the severity of the prosthesis itself and, as a result, insufficient fixation.

Known removable denture for a toothless upper jaw on intramucosal implants containing a base plate with artificial teeth. In the body of the plate there are several intra-mucous implants made with a hemispherical head on the neck mounted perpendicularly to a flat round base (US patent No. 4382791, class A61C 8/00, publ. 10.05.83).

Known prosthesis has the following disadvantages:

- an acute angle on the head of the implant when removing from the hole is accompanied by pain in the patient;

- the internal angle under the implant head serves as a free zone where there is no filling with epithelized tissue, which leads to plaque formation;

- a flat smooth base does not have sufficient adhesive properties for a strong connection with the base plate.

Known removable denture for a toothless upper jaw on intramucosal implants (US Pat. No. 2183105 of the Russian Federation, IPC 7 A61C 8/00, 13/007. Publ. 2002, bull. No. 16), in the manufacture of which the above-mentioned problems are leveled.

The objective of the present invention is to increase the effectiveness of the treatment of patients with postoperative defects of the upper jaw.

The technical result is the manufacture of a denture denture-obturator made of polyurethane with intramucosal implants, which provides reliable fixation and stabilization of the denture base to the prosthetic bed, its high congruency especially along the border of the maxillary defect, the smallest adhesion of microorganisms to the prosthetic obturator and restoration of the patient's speech phonetics is clear.

The technical result is achieved by the fact that the denture denture obturator has a base with teeth made of rigid polyurethane with clasp fixing elements, and the obturator itself is hollow and has a frame made of hard polyurethane, and the outer surface is made of soft polyurethane, and the entire prosthesis is made by casting, including areas of the formation of the external borders of the surgical field, and on the basis of the prosthesis adjacent to the hard palate, in the area of the unresected jaw, there are two intralucous implants made of polyurethane, filled with a hemispherical head on the neck, seamlessly connected to the base plate, the edges of the hemispherical head are made wired, the transition from head to neck has a tide with a radius of rounding.

The obturator of the proposed prosthesis-obturator made of soft polyurethane allows you to fully match the display of the prosthetic bed, despite the narrow postoperative defect of the jaw, due to its elasticity. And the toxicity and degree of adhesion of microbes to polyurethane is much lower, which is confirmed by laboratory studies and, accordingly, contributes to reparative processes in the postoperative period. However, if the obturator is made entirely of polyurethane, it has a large specific gravity, which negatively affects the fixation of the prosthesis. This problem is solved if the obturator is made hollow. The improvement in prosthesis fixation is due to the presence of intramucosal implants in the design.

The design of the denture-jaw prosthesis made of polyurethane with intramucosal implants is illustrated in figure 1, where

1 - the basis of the prosthesis;

2 - obturator;

3 - sections of the formation of the external borders of the surgical field;

4 - intramucosal implants.

A denture-prosthetic obturator is made as follows.

1. Before surgery, the patient receives impressions from both jaws, register the bite or central ratio of the jaws.

2. Based on the received impressions, models are made, in accordance with the registration data of the bite and facial arch, the models are fixed in the articulator.

3. Immediately after surgery, the patient receives an impression of the upper jaw of the postoperative defect with alginate masses.

4. Based on the print made gypsum model.

5. On the model, the external borders of the surgical field are engraved in the vertical and horizontal directions with a width and depth of 1.5-2.0 mm.

6. The surface of the jaw defect is lined with a thin plate of clasp wax.

7. Duplicate the resulting composition with a silicone mass.

8. Replace clasp wax with soft polyurethane.

9. The surface of the obtained soft polyurethane plate on the model is lined with a plate of yoke wax.

10. Duplicate the resulting composition with a silicone mass.

11. Clasp wax is replaced with hard polyurethane, thus, the roof of the hollow obturator (2) is obtained, consisting of two combined layers of hard and soft polyurethane.

12. The resulting obturator roof is installed in a gypsum model and a prosthesis base is modeled on top of it from wax.

13. On the basis of the prosthesis (1), in the area of an unresected hard palate, two intraluminal implants (4) with a hemispherical head made zawed on the neck are modeled in the midline, the transition from head to neck has a tide with a radius of rounding.

13. Model the wax pattern of the obturator and denture with the setting of the teeth in the articulator, taking into account anthropometric indicators.

14. Duplicate the resulting composition with a silicone mass.

15. The wax composition is replaced with a hard polyurethane by casting, so that a denture with a base made of hard polyurethane (1) with a hollow obturator (2) is made of soft polyurethane with a rigid frame with intramucosal implants (4).

16. The sprues are cut, polished and polished the resulting prosthetic obturator from the prosthesis polyurethane and the areas of formation of the external borders of the surgical field (3).

Claims (1)

A denture-prosthetic obturator having a base with artificial teeth made of hard polyurethane with clasp fixation elements, the obturator is hollow and has a frame made of hard polyurethane, and the outer surface is made of soft polyurethane, and the entire prosthesis is made by casting, including areas of external formation the boundaries of the surgical field, and on the basis of the prosthesis adjacent to the hard palate, in the area of the unresected jaw there are two intra-mucous polyurethane implants made with a hemisphere a head on the neck, monolithically connected to the base plate, and the edges of the hemispherical head are made wired, the section of transition from the head to the neck has a tide with a radius of rounding.

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