RU2482814C1 - Method of manufacturing dentoalveolar prosthesis-obturator - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to dentistry, and is intended for rehabilitation of patients with postoperative defects of jaw bones and teeth. Impressions of jaws are obtained before operation, bite is registered. Models are made. Models are fixed in articulator. Basis of future prosthesis with clasps and perforated retentional plate, located in projection of future postoperative defect, is modelled on the model of upper jaw. Gate system is installed. Casting form is made. Wax is replaced with metal. Obtained basis of prosthesis is processes mechanically. Perforated retentional plate is air-braded. After operation impression of upper jaw is obtained. Gypsum model is made. External boundaries of operation field are engraved on the model in vertical and horizontal directions with 2.0-2.5 mm width and depth. Surface of jaw defect is lined with clasp wax plate. Depressions with 4 mm diameter are made in staggered order throughout its surface with bulbous-end periodontal probe. Obtained composition is duplicated with silicone mass. Clasp wax is replaced with elastic polyurethane with obtaining external surface of obturator. Surface of obtained plate from elastic polyurethane on the model is lined with clasp wax plate. Obtained composition is duplicated with silicone mass. Clasp wax is replaced with rigid polyurethane, roof of hollow obturator, consisting of two superposed layers is obtained. Obtained obturator roof is installed into gypsum model, metal basis of prosthesis is applied above it. Obturator is connected with basis with wax in such a way that wax fills all perforations of retentional plate of basis. Modelling of intaoral surface of obturator with positioning of artificial teeth in articulator is performed. Obtained composition is duplicated with silicone mass. Wax composition is replaced with rigid polyurethane by method of casting. Gates are cut off, obtained dentoalveolar prosthesis-obturator is grinded and polished.

EFFECT: method makes it possible to ensure high congruency of prosthesis basis to prosthetic bed and the smallest adhesion of microorganisms due to manufacturing lighter dentoalveolar prosthesis-obturator with metal basis and hollow obturator.

Description

The invention relates to medicine, in particular to dentistry, and can be used for the rehabilitation of patients with postoperative defects of the jaw bones and teeth for the manufacture of a denture-obturator denture.

A known method of manufacturing a hollow obturator of a resection prosthesis of the upper jaw by injection molding (see Vares E.Ya., Nagurny V.A. in the book "Centralized production of dentures using a new and improved technology". Plastic pressing. Zhytomyr 1992, with .53-155). According to the method, a defect mold is taken from a rigid plastic material of the Ftorax type, the model is cast, a wax pattern is modeled, the model is plastered into a syringe cuvette and molded plastic under vertical pressure. In this case, two hemispheres of rigid plastic are obtained. Then they are glued together and a ready-made obturator is obtained, resembling a sphere that cannot accurately repeat the configuration of the postoperative defect of the upper jaw. Along the conjugation line, the adhesive creates favorable conditions for a sharp increase in adhesion of periodontopathogenic microorganisms that contribute to the emergence and maintenance of inflammation of the mucous membrane of the prosthetic bed.

A maxillary prosthetic obturator is known, consisting of artificial teeth and a two-layer basis made of nickel-titanium alloy and acrylic plastic in the form of a hollow bowl-shaped structure that overlaps the edges of the defect along the entire circumference, deep into the flaw with the coating of the undercut zones and sections of the anatomical retention so that the lateral walls of the obturator overlapped the buccal cicatricial cord, had the highest possible height, covering the preserved bone structures of the bottom of the defect and leaving the projection open ovyh moves. At the same time, the mouths of the excretory ducts of the parotid salivary glands did not overlap with the prosthesis base, providing free excretion of saliva into the oral cavity (A. A. Radkevich, V. G. Galonsky, V. T. Manchuk, V. E. Gunter. “Clinical case of replacement prosthetics complete maxillary post-resection defect. ”Siberian Medical Journal, 2009, No. 4).

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 formation of the external borders of the surgical field (RF Patent No. 2426517).

The disadvantages of this prosthesis can be considered the weight of the prosthesis itself and, as a consequence, its insufficient fixation.

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 of the invention is the manufacture of a lightweight denture denture obturator with a metal base and a hollow obturator, providing high congruence of the prosthesis base to the prosthetic bed, especially along the border of the defect of the upper jaw, the least adhesion of microorganisms.

The technical result is achieved by the fact that the method of manufacturing the denture-jaw prosthesis obturator consists in the fact that before the operation the patient receives impressions from both jaws, bite or central ratio of the jaws is recorded, models are made from the obtained impressions, in accordance with the registration data of the occlusion and facial arch, fix the models in the articulator, then on the model of the upper jaw of wax, using a parallelometer, model the basis of the future prosthesis over the entire surface of the hard palate with clasps and perforated of the retention plate located in the projection of the future postoperative defect, then the gating system is installed and the wax is replaced with metal, the mandated prosthesis base is machined, polished and tried on in the oral cavity, except that the perforated retention plate is sandblasted for better adhesion with polyurethane , then after the operation, the patient receives an impression of the upper jaw of the postoperative defect with alginate masses, a gypsum is made from the resulting impression On the model, the outer borders of the surgical field are engraved in the vertical and horizontal directions with a width and depth of 2.0-2.5 mm, the surface of the jaw defect is lined with a thin plate of clasp wax, the recesses are made on the plate over the entire surface with a 4.0 mm diameter periodontal probe. in a checkerboard pattern for mechanical retention, duplicate the resulting composition with a silicone mass, replace the clasp wax with elastic polyurethane, after which the surface of the obtained plate is made of elastic polyurethane and on the model they are lined with a plate of yoke wax, they duplicate the resulting composition with silicone mass, they replace the clasp wax with hard polyurethane, so the roof of the hollow obturator consists of two combined layers, the obtained obturator roof is installed in a gypsum model and a prosthesis metal base and wax are laid on top of it connect the obturator with the base, so that the wax fills all the perforations of the base retention plate from both its external and internal sides, then model tion of wax buccal surface of the obturator with the production of artificial teeth, the wax composition to replace rigid polyurethane molding method, sprues are cut, ground and polished denture.

The problem of denture-jaw prosthetics-obturators made of rigid plastic is that often a narrow postoperative defect of the jaw does not correspond to the wide imaging of the prosthetic bed of the maxillary sinus of the obturator, due to which the fit of the prosthesis is not congruent and a gap forms between the base of the prosthesis and the prosthetic bed, which prevents a complete re-formation, which prevents a complete re-formation. .

In addition, the plastic is toxic and hygroscopic, which contributes to increased adhesion of microorganisms to the structural material from which the basis of the obturator prosthesis is made. This fact helps to slow the reparative processes in the postoperative period. The use of polyurethane for leveling the above problems is today a priority. And the system of molded support-holding clasps (for example, the Ney system) provides reliable fixation of the prosthesis on existing teeth and prevents the atrophic processes of prosthetic bed tissues.

A method of manufacturing a denture-denture obturator is 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. Next, on the model of the upper jaw of wax, using a parallelometer, model the basis of the future prosthesis with clasps and a perforated retention plate located in the projection of the future postoperative defect.

4. Next, the gating system is installed and the mold is made.

5. The wax is replaced with metal.

6. The ordered prosthesis base is machined, polished and tried on in the oral cavity, except that the perforated retention plate is sandblasted for better adhesion with polyurethane.

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

8. Based on the print made gypsum model.

9. On the model, the outer borders of the surgical field are engraved in the vertical and horizontal directions with a width and depth of 2.0-2.5 mm.

10. The surface of the jaw defect is lined with a thin plate of clasp wax, on the plate over the entire surface, recesses are made with a periodontal button probe of 4 mm diameter in a checkerboard pattern for mechanical retention.

11. Duplicate the resulting composition with a silicone mass.

12. Clasp wax is replaced with elastic polyurethane, obtaining the outer surface of the obturator.

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

14. Duplicate the resulting composition with a silicone mass.

15. Clasp wax is replaced with rigid polyurethane, thus, the roof of the hollow obturator is obtained, consisting of two combined layers: from hard - the obturator frame and elastic polyurethane.

16. The resulting obturator roof is installed in a gypsum model and a prosthesis metal base is laid over it and the obturator is connected to the base with wax, so that the wax fills all the perforations of the base retention plate from both its external and internal sides.

17. Next, the intraoral surface of the obturator is modeled from wax with the setting of artificial teeth in the articulator, taking into account anthropometric indicators.

18. Duplicate the resulting composition with a silicone mass.

19. The wax composition is replaced with a hard polyurethane by casting, thus, a dentition with a metal base, with a hollow obturator made of elastic polyurethane with a rigid frame is obtained.

20. The sprues are cut, polished and polished the resulting dentofacial prosthesis-obturator from the prosthesis polyurethane and the areas of formation of the external borders of the surgical field.

Claims (1)

A method of manufacturing a denture-jaw prosthesis-obturator, which consists in the fact that before the operation the patient receives impressions from both jaws, bite or central ratio of the jaws is recorded, models are made according to the obtained impressions according to the registration data of the occlusion and facial arch, the models are fixed in the articulator, then on the model of the upper jaw of wax, using a parallelometer, simulate the basis of the future prosthesis over the entire surface of the hard palate with clasps and a perforated retention plate located in the projection of the future postoperative defect, then the gating system is installed and the wax is replaced with metal, the obtained denture base is machined, polished and tried on in the oral cavity, except that the perforated retention plate is sandblasted for better adhesion with polyurethane, then after the operation in a patient an impression of the upper jaw of the postoperative defect is obtained with alginate masses, a gypsum model is made from the resulting impression, external granules are engraved on the model the eggs of the surgical field in the vertical and horizontal directions with a width and depth of 2.0-2.5 mm, the surface of the jaw defect is lined with a thin plate of clasp wax, on the plate over the entire surface, recesses are made with a periodontal button probe 4.0 mm in diameter in a checkerboard pattern for mechanical retention duplicate the resulting composition with a silicone mass, replace the clasp wax with elastic polyurethane, after which the surface of the obtained plate of elastic polyurethane on the model is lined with a yoke plate of wax, duplicate the resulting composition with a silicone mass, replace the clasp wax with hard polyurethane, so that the roof of the hollow obturator consists of two combined layers, the resulting obturator roof is installed in a gypsum model, a metal prosthesis base is applied over it and the obturator is connected to the base with wax, so that the wax fills all the perforations of the base retention plate from both its external and internal sides, then the oral surface is modeled from the wax These obturators with staged artificial teeth, replace the wax composition with hard polyurethane by casting, cut the sprues, grind and polish the prosthesis.