RU2460505C1 - Method of correcting prognathic occlusion by sn finchenko - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, orthodontics and can be used for elimination of prognathic occlusion. Massage of masticatory muscles of face and neck, first slowly, in wave-like way, after that, intensive, pulsing movements are made. At the first stage deep pinches with turnings on entire surface of neck are made for 40-45 sec. At the second stage frequent dashing displacements of roller from massaged tissue on entire surface of fascia are performed above pectoralis major and deltoid muscle for 35-40 sec. At the third stage slow pinches of massaged tissue with subcutaneous fascia of upper quadrant of chest are performed for 1 min. At the fourth stage massaged tissue with fascia of upper quadrant of chest is stretched out, for 2 min. At the fifth stage, frequent superficial cross-like dashing is made on entire surface of neck for 30-40 sec. At the sixth stage longitudinal dashing is performed in upper segment of pectoralis major for 20 sec. All stages of massage are performed 3-4 times per session. Course includes 7-9 sessions, 30-40 minutes each. First two sessions are performed two consecutive days, then after two days of break one session is performed, then four days of rest and sessions on two consecutive days, then three days of rest and two procedures every other day.

EFFECT: method is simple in implementation and ensures reduction of trauma of soft tissues.

2 ex, 7 dwg

Description

The invention relates to medicine, namely to orthopedic and orthodontic dentistry, and can be used to correct prognathic bite.

There is a method of correcting a distal bite, including physical impact using orthodontic methods, including myogymnastics for training the muscles that extend the lower jaw, the use of fixing plates for mixing the jaw and various extraoral elastic traction (Handbook on Dentistry. / Ed. By A.I. Rybakov. M., 1966; Abolmasov N.G., Abolmasov N.N., Bychkov V.A., Al-Hakim A. Orthopedic Dentistry. M.: MEDpress-inform, 2005; Arsenina OI, Tsarik BC Seminar of Prof. M. Korn “Orthopedic treatment of adult patients with using the concept of jaw repositioning and TMJ correction. ”/ Orthodontics, No. 2, 2006; Persin LS Orthodontics. Diagnosis and treatment of dentoalveolar anomalies. M.: OJSC“ Medicine ”, 2004; Shcherbakov AS, Malocclusion in adults M.: Medicine, 1987).

Closest to the proposed is a method for the correction of a distal and mesial bite (RF patent No. 2076681, publ. 10.04.1997), in which the author describes a manual method for correction of bite. To implement the method, the displacement of the cervical vertebrae at the level from the fifth to the seventh is diagnosed by palpation and radiology. During one session, manipulations are performed aimed at eliminating the displacement of the lower jaw and the revealed displacement of the cervical vertebrae. Displacement (subluxation of the lower jaw) is produced by a rotational push of the lower jaw down in the sagittal plane with the head position on the right and left side. Manipulations on the spine are as follows: establish the interphalangeal joint of the third finger of one hand under the spinous process of the displaced vertebra. The fingers of the second hand are installed on the patient’s body, and the area of the tenor-hypotenor on the back surface of the right hand. Perform simultaneous movement with both hands with an effort of 15 to 25 kg / cm ³ , aimed at restoring the position of the displaced vertebra. The number of sessions is regulated during treatment as the bite is corrected, and if necessary, supplement the course treatment. However, the known method is traumatic for the patient, the effectiveness of the method depends on the high qualification of the manual doctor.

Also, the disadvantage of these methods is that there is no effect on one of the main causes of a pathological bite - the tone of the masticatory muscles.

A new technical task is to reduce soft tissue trauma, simplify the method and shorten treatment time.

To solve the problem in the method of correction of prognathic bite by affecting the chewing muscles of the face and neck, they are massaged, for this, at the first stage, grabbing a fold of massaged tissue with the first, second, third and fourth fingers of both hands, slowly perform deep tucks with turns along the entire front surface of the neck for 40-45 seconds, in the second stage, the second, third and fourth fingers of one hand and the first finger of the other hand perform frequent, hatching movements of the roller from the massaged tissue throughout the surface of the fascia lying over the pectoralis major and deltoid muscle for 35-40 seconds, in the third stage, capturing the platen from the massed tissue with the first, second and third fingers, perform slow tucks of the massed tissue with subcutaneous fascia of the upper quadrant of the chest, for one minute , at the fourth stage, capturing the roller from the massaged tissue with the entire palm of one hand, stretch the massed tissue with fascia of the upper square of the chest for two minutes, while the other hand performs a fixing function, in the fifth this ne, grabbing the roller from the massaged tissue with the second and third fingers of both hands, set at an angle of 90 degrees to the neck surface, perform frequent superficial cross-shaped strokes on the entire front surface of the neck, for 30-40 seconds, in the sixth stage, the second, third and fourth with fingers of one hand installed at an angle of 90 degrees to the pectoralis major muscle, perform longitudinal strokes in the upper segment of the pectoralis major muscle for 20 seconds, while the other hand performs a fixing function, also all stages of massage replenish three to four times during one session, the entire course includes 7-9 sessions, each lasting 30-40 minutes, and the first two sessions are performed two days in a row, after two days of a break they perform one session, then four days of rest, then the sessions are performed two days in a row, then three days of rest and two procedures every other day, and if the effect is not sufficiently pronounced, they take a break of five days, after which they conduct two more sessions with a two-day break.

The proposed method is based on the following. The function of the masticatory apparatus is determined by the state of the masticatory muscles. The shape of the bite is determined by the individual characteristics of the functions of individual muscles and the hypertonicity of certain areas. Prognathy (distal bite) is the anomaly that the bite demonstrates in connection with the anterior location of the upper jaw relative to the lower jaw. The lower jaw is distal with respect to the upper jaw. Patients with prognosis have a specific face configuration. The upper jaw and the upper lip protrude forward. The lower jaw with the lower lip, on the contrary, is moved posteriorly. Lips during prognathy almost always do not add up, so it seems that the face is tense. The furrow under the chin with a deep bite is sharply deepened. With a prognathic bite, the subcutaneous muscle of the neck is hypertonicized. Since the place of attachment of this muscle is the subcutaneous fascia and muscles of the chin and lower jaw, and the place of departure is the subcutaneous fascia of the upper quadrant of the rib cage (that is, the fascia lying above the pectoralis major and deltoid muscles), it is a persistent contraction of this muscle, as well as the pectoralis major , that is, hypertonicity, as practice shows, is one of the reasons for the displacement of the lower jaw posteriorly.

With the relaxation of these muscles, the normalization of their tone, the lower jaw takes a normal position. It is possible to restore muscle tone by actively acting on mechanoreceptors and proprioreceptors of the nervous system.

The method is as follows. Diagnostics is carried out: the correct position or displacement of the dentition can be determined, for example, by craniometric methods. The simplest and most affordable is the analysis of the profile of the face according to the photo or the study of the profile along mentally drawn lines. (Kalvelis D.A. Orthodontics. G. Elista, 1994.)

Figure 1-7 presents the stages of the method.

Within 7-9 sessions, lasting 30-40 minutes, manipulations are performed aimed at restoring the functional ability of the muscles of the face and neck. A smooth manual study of the neck muscles, as well as the pectoralis major muscle is performed, the movements are performed slowly, wavy, after which they are replaced by intense, pulsating movements. This provides the possibility of effective stimulation of mechanoreceptors and proprioreceptors and causes relaxation of the muscles, the hypertonicity of which caused a change in the occlusion.

The first stage (Fig.1-2). Grabbing a fold of massaged tissue with the first, second, third and fourth fingers of both hands, slowly perform deep tucks with turns along the entire front surface of the neck for 40-45 seconds.

The second stage (Figure 3). The second, third and fourth fingers of one hand and the first finger of the other hand perform frequent, hatching movements of the roller from the massed tissue over the entire surface of the fascia, lying over the pectoralis major and deltoid muscle for 35-40 seconds.

The third stage (Figure 4). Grabbing the roller from the massed tissue with the first, second and third fingers, perform slow tucks on the subcutaneous fascia of the upper quadrant of the chest, for a minute.

The fourth stage (Figure 5). Grabbing the roller from the massaged tissue with the entire palm of one hand, stretch the fascia of the upper quadrant of the chest, for two minutes. The other hand performs a locking function.

The fifth stage (Fig.6). Grabbing the roller from the massaged tissue with the second and third fingers of both hands, set at an angle of 90 degrees to the neck surface, perform frequent superficial cross-shaped strokes on the entire front surface of the neck, for 30-40 seconds.

The sixth stage (Fig.7). The second, third and fourth fingers of one hand, set at an angle of 90 degrees to the pectoralis major muscle, perform longitudinal strokes in the upper segment of the pectoralis major muscle for 20 seconds. The other hand performs a locking function.

The proposed scheme is performed three to four times during the session for 30-40 minutes. In this case, the first two sessions are two days in a row, after two days of a break, one session is performed, followed by four days of rest, then the session is performed two days in a row, then three days of rest and then two procedures every other day. If the effect is not sufficiently pronounced, after seven procedures, a five-day break is made for the patient to fully recover and maximize the manifestation of the therapeutic effect, after which two more sessions are conducted with a two-day break.

The proposed method includes 7-9 sessions, lasting 30-40 minutes, performed as follows: the first two sessions are two days in a row, after two days of a break they perform one session, followed by four days of rest for a full recovery, then the session is performed for two days in a row, then three days of rest, and then two procedures every other day. If the effect is not pronounced enough, after seven procedures a five-day break is made for the patient to fully recover and the maximum manifestation of the trace (long-term) effect, after which two more sessions are carried out with a two-day break. This amount is enough to obtain a sustainable result.

Example 1. Lenskaya Larisa Sergeevna, 17 years old, cosmetologist. Complaints - violation of biting and chewing, a feeling of discomfort and tension in the lower jaw. Objectively - retrusion and close arrangement of the lower incisors. The treatment was carried out according to the proposed method with a course of 7 sessions of 30 minutes for each, performed as follows: the first two sessions are two days in a row, after two days of a break they perform one session, followed by four days of rest for a full recovery, then the session is performed for two days in a row, then three days of rest, and then two procedures every other day. After the course, the pathological bite is eliminated, the angle of the lower jaw is changed. Follow-up 3 years, no relapse.

Example 2. Koroleva Inessa Alekseevna, 24 years old. Complaints - Profile change, lower jaw stiffness. Objectively - prognathia with a distal displacement of the lower jaw. The treatment was carried out according to the proposed method with a course of 9 sessions lasting 40 minutes, performed as follows: the first two sessions are two days in a row, after two days of a break they perform one session, followed by four days of rest for a full recovery, then the session is performed two days in a row, then three rest days and then two procedures every other day. Since the effect of the treatment was not sufficiently pronounced, after seven procedures, a break was made for five days, after which two more sessions were conducted with a two-day break. This amount was enough to obtain a sustainable result. After the course, the situation returned to normal and the mobility of the lower jaw increased. Follow-up for 2 years, no relapse.

The mode of the method is based on the analysis of clinical observation data. In total, seven people were treated according to the proposed method, aged 14 to 29 years. In all cases, there is a positive trend after the first session. The duration of the procedures less than 30 minutes did not provide a sustainable therapeutic effect, the duration of more than 40 minutes was unnecessary and did not have a decisive effect on the result of exposure. The optimal course was determined in 7-9 procedures.

It should be noted that the technique is quite simple to use, does not require special equipment, which also contributes to its widespread use. The method allows to reduce soft tissue injury that occurs during treatment with manual therapy or installation, for example, bracket system and reduce the duration of treatment.

Claims (1)

A method for correcting a prognathic bite by affecting the chewing muscles of the face and neck, characterized in that it is affected by massage, for this at the first stage, capturing a fold of massaged tissue with the first, second, third and fourth fingers of both hands, slowly perform deep tucks with turns throughout the front surface of the neck for 40-45 s, in the second stage, the second, third and fourth fingers of one hand and the first finger of the other hand perform frequent stroking movements of the roller from the massaged tissue over the entire surface of the fascia, l hovering over the pectoral and deltoid muscles for 35-40 s, at the third stage, grabbing the platen from the massed tissue with the first, second and third fingers, perform slow tucks of the massed tissue with subcutaneous fascia of the upper quadrant of the chest for one minute, at the fourth stage grabbing the roller from the massaged tissue with the entire palm of one hand, stretch the massed tissue with fascia of the upper quadrant of the chest for two minutes, while the other hand performs the fixing function, in the fifth stage, grabbing the roller from fabric with the second and third fingers of both hands, set at an angle of 90 degrees to the neck surface, perform frequent superficial cross-shaped hatching on the entire front surface of the neck for 30-40 seconds, in the sixth stage, the second, third and fourth fingers of one hand, installed at an angle 90 degrees to the pectoralis major muscle, perform longitudinal strokes in the upper segment of the pectoralis major muscle for 20 s, while the other hand performs a fixing function, also all stages of massage are performed three to four times in one of the first session, the entire course includes 7-9 sessions lasting 30-40 minutes each, and the first two sessions are performed two days in a row, after two days of a break they perform one session, then four days of rest, then the sessions are performed two days in a row, then three rest days and two procedures every other day, and if the effect is not sufficiently pronounced, they take a break of five days, after which they conduct two more sessions with a two-day break.

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