RU2543041C2 - Removable resection upper jaw denture with myogymnastic element - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to dentistry, and can be used in orthopaedic dentistry for oncologic patients. A removable resection upper jaw denture with a myogymnastic element comprises an immobilising and resection portions and a removable myogymnastic element. The immobilising portion is configured in the form of a fixing plate having a clasp fixation system on the rest teeth. The resection portion is provided with artificial plastic teeth, contacts directly the rest upper jaw tissues and form a prosthetic bed for a permanent denture. The myogymnastic element is configured in the form of an orthodontic wire individually curved for each patient and having various cross-sections with a bead of a variable diameter sliding along the orthodontic wire. Plastic deposits are made in a base in attachment points of the myogymnastic element. The orthodontic wire is fixed by tension into blind canals.

EFFECT: invention enables combining the dental prosthetics and correction of postoperative tongue dysfunction in the oncologic patients.

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Description

The invention relates to medicine, can be used in practical dentistry.

There are a number of diseases in which surgical interventions on the tissues of the tongue are indicated. These include malignant tumors and tumor-like processes, injuries, burns, etc. Actual, in our opinion, is the treatment of cancer of the tongue. Cancer of the tongue is from 40 to 70% of malignant tumors of the oral cavity. The number of men among patients with tongue cancer is 2-3 times higher than the number of women. The age of patients ranges from 20 to 80 years, the average age is 50 years (according to WHO). The most common type of surgery for tongue cancer so far is hemiglossectomy (half-resection of the tongue). This operation was first performed by the Pimperhell Dane in 1916. This operation entails severe violations of vital functions: speech, eating, traumatizes the psyche of patients [1]. Such patients have difficulty chewing because for the formation of a physiologically correct food lump, more effort and time is required. The function of speech suffers as a result of a violation of the process of sound production and pronunciation, because the remaining half of the language assumes a position unusual for it in the norm and does not fully compensate for the entire volume of articulation movements. For the speedy restoration of the functions of the tongue, patients are assigned a comprehensive myogymnastics, including exercises for self-training of the muscles of the tongue and a hardware method. Often, the tumor process of the tissues of the tongue is combined with oncological processes in the bone tissue, including upper jaw. There may also be combined lesions of the tissues of the tongue and hard tissues of the maxillofacial region (gunshot and non-gunshot wounds, burns and injuries). To replace the missing part of the upper jaw, give soft tissue support, and also restore the functions of chewing, breathing and speech, these patients are shown a resection prosthesis of the upper jaw. Thus, there is a fairly large group of patients with combined pathology of the tissues of the tongue and tissues of the maxillofacial region. In the case when the patient needs a resection prosthesis of the upper jaw, and to restore the function of chewing and speech, a comprehensive myogymnastics of the tongue, we propose to combine a resection prosthesis of the upper jaw, which includes an artificial palate or palatal fixation plate with a removable individual replaceable myogymnastic element.

Among the known devices, the closest to the claimed one is the Mirru vestibular plate with a bead, which is shown in the presence of bad habits - sucking a finger, biting the lower lip, as well as weakness of the muscles of the maxillofacial region - muscles of the tongue and circular muscle of the mouth (Dr. Hinz Dental Co. ) [2]. This device (analogue) is used in milk and removable bites, consists of an extraoral ring, labial bumper, a process for fixing beads and beads to eliminate lethargy of the lingual muscle and setting the tongue in the correct position. The apparatus proposed by M.A. Danilova, E.A. Zalazaeva, V.A. Bronnikov is also known [3]. This apparatus consists of a lip bumper, an extraoral ring, which is fixedly connected to the outer surface of the lip bumper along the line of closure of the lips, a process from a wire for fixing a bead, motionlessly connected to the inner surface of the lip bumper and having three bends located on each side, a bead, bite pad, motionlessly connected to the lip bumper and a visor on the incisors of the lower jaw, motionlessly connected to the bite pad.

The disadvantages of the apparatus, in our opinion, are standard sizes (use only in milk and removable bites), uniform arrangement and inability to replace the myogymnastic element (beads on wire), standard trajectory of movement and diameter of the bead, impossibility of simultaneous combination of prosthetics and correction of postoperative language dysfunctions.

The purpose of the invention: the development of a removable resection lamellar denture of the upper jaw with a removable myogymnastic element.

The goal is achieved by combining a removable resection prosthesis and a removable individual replaceable myogymnastic element. The present invention is presented in the diagram, where in Fig.1 is a top view of the prosthesis.

The prosthesis consists of a fixing part, which includes a fixing plate 1 and a clamping system for the remaining teeth 2; resection part 3, which is in direct contact with the remaining tissues of the upper jaw and forms a prosthetic bed for a permanent prosthesis; and a removable, individual, replaceable myogymnastic element (SIZME), which is an orthodontic wire of various cross sections 4, individually bent for each patient, with a multifaceted bead of varying diameter sliding on it 5. The myogymnastic element is installed for the period of myogymnastics in the basis of the prosthesis. In places of fixation of SIZME, the basis of the prosthesis is thickened, making special flows of plastic. Fixation is carried out in the blind holes 6, by tensioning the wire element. On the resection part of the prosthesis are artificial teeth 7 made of plastic. The patient is given recommendations to try to touch the bead and move it along the path indicated by the wire. The time of myogymnastics is 2-3 hours a day, the rest of the time the patient uses his prosthesis without the myogymnastic element. With the improvement and increase in the volume of movement of the tongue, the myogymnastic element is replaced by a new one with a more complex trajectory and a bead of a smaller diameter. These manipulations are carried out until there is a compensatory restoration of the function of the language in sufficient volume. After treatment, the blind holes are closed with self-hardening plastic and polished.

Example. Patient B. 1945 He turned to the Department of Orthopedic Dentistry and Orthodontics with complaints about the inconvenience of chewing food, speech impairment, and an aesthetic defect. From the anamnesis: previously underwent surgery for resection of half of the upper jaw, combined with resection of half of the tongue for malignant neoplasm.

The patient was decided to make a resection prosthesis of the upper jaw with a myogymnastic element. The patient was provided with orthopedic treatment with further follow-up. Recommendations are given for performing complex myogymnastics using the myogymnastic element.

After a partial restoration of the volume of movement, the trajectory of the movement of the myogymnastic element was changed to restore the full compensatory volume of movement of the tongue. The volume of motion has recovered.

Thus, the use of the proposed removable resection prosthesis of the upper jaw with a myogymnastic element makes it possible to carry out high-quality prosthetics and accelerate the rehabilitation period in such patients and improve the further quality of life.

Information sources

1. Fedyaev I.M., Bayrikov I.M., Belova L.P., Shuvalova T.V. Malignant tumors of the maxillofacial region. - M: Medical book, N. Novgorod: Publishing house of the NMMD, 2000. - 160 p.

2. L. S. Persin, V. M. Elizarova, S. V. Dyakova / Pediatric Dentistry. - M: Medicine, 2003 - 640 p.

3. Danilova M.A., Zalazaeva E.A., Bronnikov V.A. / Apparatus for the correction of myofunctional disorders in children with spastic forms of cerebral palsy. - Patent for utility model No. 116766 U1.

Claims (1)

A removable resection prosthesis of the upper jaw with a myogymnastic element, containing the fixing and resection parts and a removable myogymnastic element, while the fixing part is made in the form of a fixing plate having a clam fixation system for the remaining teeth, the resection part is made with artificial teeth made of plastic with the possibility of its placement in direct contact with the remaining tissues of the upper jaw and the formation of the prosthetic bed for a permanent prosthesis, and the myogymnastic element is made in the form of an indie idualno curved for each patient different cross-section orthodontic wire bead with a variable diameter, mounted slidably on orthodontic wire, wherein in the base at places miogimnasticheskogo fixing element made of plastic nodules, and orthodontic wire is fixed by the voltage in the blind channels.