RU2489115C2 - Dentoalveolar prosthesis-obturator - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, in particular to dentistry, and can be applied for orthopedic rehabilitation of patients with post operational defects of upper jaw. Dentoalveolar prosthesis-obturator has metal basis, which consists of body closely adjoined to mucous membrane of preserved hard palate, systems of cast bearing-holding clasps and perforated plate, placed in continuation of hard palate and overlapping postoperative defect, with fixed on it obturator. Obturator is made hollow and has frame from rigid polyurethane, and external surface from elastic polyurethane. Obturator is made in such a way, that its external surfaces get 2 mm over scar ring of defect on its entire perimetre and have 1 mm wide retention points.

EFFECT: ensuring reliable fixation of jaw prosthesis, both on preserved teeth, and on boundaries of postoperative defect, improvement of hygienic condition in zone of postoperative defect.

Description

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

A known method of prosthetics for post-resection defects of the palate and a prosthetic obturator of the palate (RF Patent 2349284 from 04.17.2007).

Known resection removable denture of the upper jaw (RF Patent 2183437 from 06/20/2000).

Known resection removable denture of the upper jaw containing a base with artificial teeth and an obturator corresponding to the configuration of the defect. The obturator is made of monolithic silicone with a retention hole and is detachably connected to the basis with artificial teeth using a fixing element made in the form of a protrusion with a spherical head made of the base material, while the retention hole repeats the shape of the fixing element (RF patent 2283064 from 03/18/2005). Known denture denture (RF patent No. 95504 from 07/10/2010). Known post-resection prosthesis-obturator of the upper jaw and a method of manufacturing a post-resection prosthesis-obturator of the upper jaw (RF patent No. 2283063 from 2006.09.10). This post-resection prosthesis-obturator of the upper jaw containing a base with teeth and an obturator made of rigid plastic, in the form of a bowl open to the side of the defect, with a wall thickness of 3-4 mm. Thus, this obturator-sink prosthesis in the form of a bowl open towards the defect, in the near future after resection of the upper jaw allows you to restore speech, improve the aesthetics of the patient and extend the term of use of the prosthesis due to the possibility of making significant corrections to the obstructing part.

A maxillary prosthetic obturator is known, consisting of artificial teeth and a two-layer base made of nickel-titanium alloy and 1 acrylic plastic in the form of a hollow, cup-shaped structure that overlaps the edges of the defect along the entire circumference, to the depth of the flaw with the coating of the undercut zones and sections of the anatomical retention in this way so that the lateral walls of the obturator overlap the buccal scar cord, have the highest possible height, covering the preserved bone structures of the bottom of the defect and leaving the projection n open wasp 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).

This maxillary prosthetic obturator is selected for the prototype.

The objective of the present invention is to increase the effectiveness of treatment of patients with postoperative defect of the upper jaw by improving the fixation of the obstructing part of the jaw prosthesis in the cavity of the jaw defect.

The technical result of the invention is the provision of reliable fixation of the jaw prosthesis both on existing teeth and along the borders of the postoperative defect, improving the hygienic condition in the area of the postoperative defect.

The technical result is achieved due to the fact that the dentofacial prosthesis obturator has a metal base, consisting of a body tightly adjacent to the mucous membrane of the preserved hard palate, systems of cast supporting-retaining clasps and a perforated retention plate located in the continuation of the hard palate and overlapping the postoperative defect, with an obturator fixed on it, made hollow and having a frame made of hard polyurethane, and the outer surface of elastic polyurethane, made at the same time, the outer surfaces of the obturator extend 2 mm beyond the scar ring of the defect along its entire perimeter and have retention points 1 mm wide.

The choice of material for the manufacture of the prosthesis body is due to the fact that the adhesion of pathogenic and opportunistic microorganisms of the oral cavity to the polished metal is much lower than to a number of plastics traditionally used for these purposes, not to mention the fact that the strength characteristics of the metal are higher than those of plastics. 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.

The outer surface of the obturator of the proposed denture is represented by elastic polyurethane, which allows the obturator to fully correspond to the display of the prosthetic bed, despite the narrow fistula of the postoperative defect of the jaw, due to its elasticity. However, if the obturator is made entirely of elastic polyurethane, it has a large specific gravity, which negatively affects the fixation of the prosthesis. To avoid this problem, the obturator is made hollow. And the toxicity and the degree of adhesion of microbes to polyurethane is much lower than plastics, which is confirmed by laboratory studies, and accordingly contributes to reparative processes in the postoperative period.

The design of the denture-denture obturator is illustrated by the drawings in figure 1, where:

1. The basis of the prosthesis

2. Obturator

3. Obturator frame

4. The outer surface of the obturator

5. Clasps

6. Plots of formation of the external borders of the surgical field

7. Perforated Retention Plate

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. Next, on the model of the upper jaw made of wax, using a parallelometer, model the basis (1) of the future prosthesis with clasps (5) and the perforated retention plate (7) 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 entrusted basis of the prosthesis (1) is machined, polished and tried on in the oral cavity, except that the perforated retention plate (7) 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 1.5-2.0 mm.

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

11. Duplicate the resulting composition with a silicone mass.

12. Clasp wax is replaced with elastic polyurethane, obtaining the outer surface of the obturator (4).

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

14. Duplicate the resulting composition with a silicone mass.

15. Clasp wax is replaced with hard polyurethane, thus, the roof of the hollow obturator is obtained, consisting of two combined layers of hard - the obturator frame (3) and elastic polyurethane.

16. The resulting obturator roof is installed in a gypsum model and a prosthesis metal base is laid on top of it and wax obturator (2) is connected to the base (1) so that the wax fills all the perforations of the retention plate (7) of the base (1) as from the outside, and from its internal sides.

17. Next, the intra-oral surface of the obturator (2) is modeled from wax with the placement 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 denture with a metal base (1), with a hollow obturator (2) is made of elastic polyurethane with a rigid frame (3).

20. The sprues are cut, polished and polished the denture obtained from denture polyurethane and the sections of the formation of the external borders of the operative field (6).

Claims (1)

The dento-jaw prosthesis-obturator has a metal base consisting of a body tightly adjacent to the mucous membrane of the preserved hard palate, systems of cast supporting-retaining clasps and a perforated plate located in the continuation of the hard palate, and covering the postoperative defect, with a hollow obturator made on it and having a frame made of rigid polyurethane, and the outer surface of elastic polyurethane, made in such a way that the outer surfaces of the obturator extend by 2 mm per p the slaughter ring of the defect along its entire perimeter and have retention points 1 mm wide.

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