RU2541038C1 - Method for echo-osteometry of jaws in retention period of orthodontic treatment - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: ultrasonic wave transmission velocity is measured within the osseous inter-root septums by means of intra-oral cone-shaped sensors fixed in a silicone impression. The sensors are placed in an intersection point of the mid-length of the inter-root septum and a conditional line drawn on an upper jaw 3mm above, and on a lower jaw 3mm below a gingival line.

EFFECT: method enables obtaining the objective data of the risk of recurrences following the orthodontic treatment by the use of the cone-shaped sensors positioned directly in the oral cavity.

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Description

The invention relates to medicine, namely to dentistry, and is intended to determine the density of bone tissue of the jaw based on an analysis of the echoosteometry of the alveolar departments of the jaw in the retention period of orthodontic treatment.

The proposed diagnostic method allows you to evaluate the density of the alveolar bone tissue by measuring the transmission speed of an ultrasonic wave (ultrasound) of 2.5 MHz in the studied area of the alveolar process of the upper jaw and the alveolar part of the lower jaw and differs from the known ultrasound diagnostic methods in the design and method of applying sensors.

At present, in the structure of dental morbidity in Russia and abroad, dentofacial anomalies and deformities take the third place after caries and periodontal diseases [2, 10]. The modern level of development of dentistry allows to achieve high aesthetic and functionally optimal results of the correction of the position of the teeth and the bite in general. However, after orthodontic treatment, despite the use of retention devices, according to many authors [1, 5], the position of the teeth often returns to its original position, i.e. relapses occur.

The likelihood of a relapse of orthodontic pathology in the retention period (the period after active treatment) is determined by many factors. One of the main factors is the condition of the bone tissue of the jaws. Therefore, the search for methods for an objective assessment of the bone tissue of the alveolar sections of the jaw is an urgent direction in terms of preventing the occurrence of relapses in the retention period of orthodontic treatment.

There is an external extraoral ultrasound method for examining the bone tissue of the maxillofacial region using the diagnostic tools EOM-01 and EOM-02. The evaluation of bone mineral density using the above devices is based on measuring the speed of passage of an ultrasonic wave. In dentistry, the method of external echoosteometry makes it possible to identify the dynamics of a decrease in the rate of propagation of ultrasound with an increase in the severity of chronic generalized periodontitis [8]. In orthodontics, extraoral studies of echoosteometry were performed by a number of authors: in the process of orthodontic treatment when restoring occlusal contacts in patients with dysocclusion of the dentition [6], in orthodontic treatment of close teeth [7], in studying the effectiveness of using ligature and self-ligating braces [9], with orthodontic correction for the prevention of complications of deformations of the dentition [4], with combined orthodontic treatment and compression-distraction osteosynthesis of the lower person juices in children [3].

The main disadvantage of the above external method of echosteometry of the jaw bones is the inability to accurately position the cutaneous sensors in order to prevent the entry of teeth roots with a higher density than the bone into the study area.

Comparative analysis with the above studies performed by external echoosteometry shows that the claimed method has higher accuracy of the research results due to the use of cone-shaped ultrasonic sensors positioned directly in the oral cavity. In addition, the claimed method differs from the known ones in that it diagnoses the condition of the bone tissue of the jaws in the retention period of orthodontic treatment.

The objective of the invention is to diagnose the condition of the bone tissue of the jaw with the aim of preventing relapse of dentition in the retention period of orthodontic treatment.

The technical result of the invention is to diagnose bone density by measuring the speed of ultrasound in the interroot section of the alveolar sections of the upper jaw and lower jaw in patients in the retention period of orthodontic treatment and based on this, obtain objective data on the risk of relapse after orthodontic treatment.

The technical result is achieved due to the fact that the time and speed of the ultrasonic wave are recorded between the cone-shaped intraoral ultrasonic sensors located at the intersection of the midline in the region of the interroot septum and the conditional horizontal line drawn 3 mm higher (in the upper jaw) or lower (in the lower jaw) line of the gingival margin.

The essence of the invention lies in the fact that in patients in the retention period of orthodontic treatment, the ultrasound wave velocity in the alveolar jaw bone is measured using the intraoral method of echoosteometry, which differs from the extraoral method by higher accuracy of the results due to local measurement of the bone site with conical intraoral ultrasound sensors .

The study of alveolar bone tissue was carried out using an ultrasonic bone echoostometer "EOM-06", consisting of a main unit with a display and intraoral conical measuring sensors. The diameter of the vertices of the cone-shaped sensors in contact with the mucous membrane of the oral cavity is 1.5 mm, which makes it possible to carry out point measurements in the region of interroot alveolar septa of the upper and lower jaw (Fig. 1). The sensors were fixed in a pre-prepared silicone imprint (figure 2), which was placed in the oral cavity (figure 3). The sensors were located at the intersection of the midline in the area of the interroot septum and the conditional horizontal line drawn 3 mm higher (in the upper jaw) or lower (in the lower jaw) of the gingival margin line. To reduce acoustic noise and achieve close contact with the studied surfaces, echogel was applied to the sensors. The signal received by the receiving sensor was displayed on the display of the echoosteometer in real time. The transit time of the ultrasonic wave (H, μs) was recorded, the distance between the sensors (S, m) was determined. The calculation of the speed of the ultrasonic wave (ultrasound) is made according to the formula:

U = S / H × 10 ⁶ ,

where U is the velocity of propagation of the ultrasound, m / s;

S is the width of the investigated area of the bone, m;

H is the transit time of the ultrasound in the studied area of the bone, μs.

Example 1

Patient P.A.A., born 1993 in the retention period of orthodontic treatment (3 years after completion of the active stage).

Objectively: tooth displacement 4.1. 0.5 mm vestibularly.

Diagnosis: vestibular position of the tooth 4.1. (K07.31).

Patient P.A.A. ultrasonic intraoral echoostometry of the alveolar ridge of the upper jaw at the intersection of the midline in the area of the interroot septum between the teeth was performed 1.1. and 2.1. and a conditional horizontal line drawn 3 mm above the line of the gingival margin of the upper central incisors. On the lower jaw - at the intersection of the midline in the area of the interroot septum between the teeth 3.1 and 4.1. and a conditional horizontal line drawn 3 mm below the line of the gingival margin of the upper central incisors. Intraoral ultrasound probes were installed and fixed at the above points using silicone prints.

When analyzing the data given in table. 1, one can note the high accuracy of determining the digital values of the ultrasound velocity in the alveolar bone, the low error of the method, Kv no more than 0.9%, which characterizes each set of measurements as homogeneous with a low degree of data spread. When comparing the average values of the speed of ultrasound in the upper and lower jaw in the frontal part, its decrease in the lower jaw is noted at 107.2 m / s, which indicates a decrease in bone density. Thus, the clinical picture of the vestibular displacement of the central lower incisor on the right (tooth 4.1.) By 0.5 mm is explained by a decrease in the density of the supporting bone tissue of the alveolar part of the lower jaw.

Example 2

Patient B.E.V., born in 1975 in the retention period of orthodontic treatment (3 years after completion of the active stage). Objectively: tooth displacement 3.1. 1.2 mm vestibularly. Diagnosis: vestibular position of the tooth 3.1. (K07.31). The patient underwent ultrasound intraoral echoostometry of the alveolar ridge of the upper jaw at the intersection of the midline in the area of the interroot septum between the teeth 1.1. and 2.1. and a conditional horizontal line drawn 3 mm above the line of the gingival margin of the upper central incisors. On the lower jaw - at the intersection of the midline in the area of the interroot septum between the teeth 3.1 and 4.1. and a conditional horizontal line drawn 3 mm below the line of the gingival margin of the upper central incisors. Intraoral ultrasound probes were installed and fixed at the above points using silicone prints.

The data obtained (table. 2.) demonstrate differences in the speed of ultrasound in the upper and lower jaw, which indicates a different density of bone tissue of the jaw. Kv does not exceed 0.8%. A decrease in the average value of the ultrasound velocity in the frontal part of the lower jaw by 39 m / s compared with that in the upper jaw, with a shift in the lower tooth 3.1. 1.2 mm vestibularly.

A comparative analysis of these tables confirms the fact that the state of bone tissue, namely its density, affects the stability of the results of orthodontic treatment in the retention period. A decrease in the speed of propagation of the ultrasonic wave characterizes a decrease in the density of the jaw bones, which leads to the displacement of teeth previously aligned during the orthodontic treatment.

table 2 Ultrasonic wave velocity (ultrasound) in the alveolar bone tissue of the jaw (method of intraoral echoosteometry) Measurement serial number Speed of ultrasound, m / s Upper jaw 1.1-2.1 Lower jaw 3.1-4.1 one 1011 980 2 1023 967 3 1019 975 four 1012 983 5 1021 965 6 1014 977 7 1011 982 8 1017 963 9 1015 981 10 1011 989 average value 1015.4 976.2 standard deviation 4.42 8.61 coefficient of variation, (Kv),% 0.4 0.8

The developed method of intraoral echoosteometry makes it possible to determine the density of the jaw alveolar bone with a high degree of accuracy, which makes it possible to recommend this research method for diagnosing the mineral density of the alveolar bone and predicting possible relapses of tooth position abnormalities after completion of orthodontic treatment.

The advantages of the method are high information content (sensitive to loss of bone density by 3-4%, and when x-ray examination, the phenomena of osteoporosis are diagnosed with impaired bone mineralization from 25-30%), ease of implementation, accessibility, painlessness and safety.

Information sources

1. Alimova M.Ya. Orthodontic retention devices / M.Ya. Alimova, I.M. Makeeva. - M.: MEDpress-inform, 2009. - 72 p.

2. Alimsky A.V. Age-related dynamics of the prevalence and changes in the structure of anomalies of the dentition in schoolchildren / A.V. Alimsky // Dentistry. - 2002. - No. 5. - S. 67-71.

3. Boyarina N.I. Echographic study of distraction regenerate in compression-distraction osteosynthesis of the lower jaw in children: Abstract. dis ... cand. honey. sciences / N.I. Boyar. - M., 2006 .-- 24 p.

4. Zhazaeva Z.A. The use of polychromatic polarized light for the prevention of complications in the orthodontic correction of dentition deformities: Abstract. dis ... cand. honey. sciences / Z.A. Zhazaeva. - M., 2005 .-- 21 p.

5. Zakrisson B. Important aspects of the long-term stability of the results of orthodontic treatment / B. Zakrisson // Orto Solo. - 2004. - No. 1. - S. 27-41.

6. Lukashin V.V. Clinical and functional state of the dentition in the restoration of occlusal contacts in patients with disocclusion of the dentition during orthodontic treatment: Abstract. dis ... cand. honey. sciences / V.V. Lukashin. - M., 2004 .-- 24 p.

7. Matveeva EA Study of the influence of the close position of the teeth on functional changes in the structures of the masticatory apparatus during orthodontic treatment: Abstract. dis ... cand. honey. sciences / E.A. Matveeva. - M., 2004 .-- 29 p.

8. Sedova M.S. The study of the state of the bone tissue of the lower jaw by the method of quantitative ultrasonometry: Abstract. dis ... cand. honey. sciences / M.S. Sedova. - M., 2010 .-- 23 p.

9. Yakubova M.Sh. Study of the effectiveness of the use of ligature and self-ligating braces in the straight-wai technique in the orthodontic treatment of patients with close teeth: Abstract. dis ... cand. honey. sciences / M.Sh. Yakubova. - M., 2005 .-- 21 p.

10. Philippe J. The evolution of orthodontic thought from 1728 to 2004 / J. Philippe // Orthod Fr. - 2005. - Vol.76, N 1. - P.7-11.

Claims (1)

The method of echoosteometry of the alveolar departments of the jaw in patients in the retention period of orthodontic treatment, characterized in that the ultrasonic wave propagation velocity is measured in the area of the bone interroot septum using intraoral conical sensors fixed in a silicone impression and installed at the intersection of the midline of the interroot septum and conditional line carried out on the upper jaw 3 mm higher, and on the lower jaw 3 mm below the line of the gingival margin.

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