RU2578100C1 - Method for producing functional impression in case of a complete lack of teeth on the lower jaw - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention can be used in the prosthesis in the absence of teeth on the lower jaw. When the fit individual spoons form the thickness of 1.5-2.0 mm beads. Edging spoon performs thermal mass in the sublingual area. Then spoon produce pressure on the orthopedic bed with a force of 4-10 N and produce functional impression.

EFFECT: method allows to increase the reliability of the fixation and stabilization of the denture in the lower jaw, reduces the time to manufacture the individual rigid spoon.

1 cl, 2 ex

Description

The invention relates to medicine, in particular to orthopedic dentistry, and can be used in prosthetics in the complete absence of teeth in the lower jaw.

A known method of obtaining a differentiated functional impression with a full removable prosthetics (patent RU No. 2271771, class А61С 9/00), including the manufacture of a model according to a preliminary impression, isolation on the model surface of the sections corresponding to the mucous membrane of the prosthetic bed with low flexibility, which is performed by applying clasp wax plates, on a model pretreated with petroleum jelly. After that, an individual spoon is made, while wax plates corresponding to the unstable mucous membrane of the prosthetic bed are stored on the inner surface of the spoon. Then conduct functional tests, fringe, remove wax and perform a functional impression.

The disadvantage of this method is the complexity of its implementation. The registration of zones of malleable mucous membrane takes place according to the set parameters, while the mucosal compliance of a particular patient is not evaluated. There is no data on the fixation and stabilization of a complete denture on the lower jaw made by this method.

A known method of forming the outer edge of an individual spoon for functional impressions with complete tooth loss (patent RU No. 2271770, class A61C 9/00), which is based on the manufacture of the model, drawing the borders and edges of the individual spoon on the model on the transitional fold from the movable mucosa membranes of the alveolar process. A strip of base wax is applied along the applied border, an individual spoon is made according to a preliminary impression, it is fitted, a thickened outer edge of the spoon is formed in the region of the vestibular and buccal edges. Retention cuts are made on the outer edge and the corresponding edge of the spoon is edged with a silicone impression mass, which is made out using functional tests.

The disadvantages of the known method, taken as a prototype, are the complexity of forming the outer edge of the spoon, the increase in the length of time required for the manufacture of an individual spoon by a dental technician. Volumetric modeling of the edges of the spoon is not always justified, and often violates adaptation, lengthening the time of getting used to a new removable laminar denture, worsens the fixation and stabilization of a complete removable denture, especially on the lower jaw.

The objective of the claimed invention is to increase the reliability of fixation and stabilization of a complete removable denture on the lower jaw and the simplification of the method.

The problem is solved in that according to the method of obtaining a functional impression in the complete absence of teeth on the lower jaw, which includes making an individual spoon according to a preliminary impression, fitting it in the oral cavity, edging and making a functional impression, when fitting an individual spoon, the thickness of the sides is 1.5- 2.0 mm, the spoon is edged with thermomass in the sublingual region, after which the spoon is applied to the prosthetic bed with a force of 4-10 N and a functional impression is made.

The advantages of the claimed method are to increase the reliability of fixation and stabilization of a removable denture on the lower jaw due to the formation of the thickness of the sides of an individual spoon 1.5-2.0 mm in the sublingual region. Performing edging with thermomass in the sublingual region allows you to slightly increase the area of the prosthetic bed. The pressure on the prosthetic bed when receiving the first print allows you to gently, symmetrically, evenly load the mucous membrane of this area. This method allows to reduce the time for the manufacture of individual hard spoons. The method is simple to use and does not require additional material costs.

A method of obtaining a functional print is as follows. An anatomical impression is removed with an alginate mass, along which a plaster model is cast. The reference points of the future individual hard spoon are plotted on the model. The spoon itself is made by a dental technician from self-hardening plastic. During functional tests, special attention is paid to freeing up free space for tongue movement, reducing the thickness of the sides of an individual rigid spoon in the sublingual region to 1.5-2.0 mm.

On the inner surface of the spoon, apply a Dentafol thermomass with a brush, heated on a dental tile to a temperature of 45-50 degrees Celsius, from the distal part of the hyoid region of the lower jaw to the location of the first premolar, excluding its contact with the apex of the alveolar ridge. The layer of the heated impression mass is not more than 0.2-0.4 mm. After that, a strong short-term total loading of the mucous membrane of the prosthetic bed of the sublingual region is carried out (the pressure on the SOP within 4-10 N, depending on the degree of atrophy of the alveolar part of the lower jaw and the mucous membrane of the prosthetic bed). Carefully remove the mass from the area of the alveolar ridge and mucous tubercles. Then the impression is made by corrective silicone mass, like a “double impression”, slightly reducing the pressure on the mucous membrane of the oral cavity. In the dental laboratory, when modeling the basis of the prosthesis by a dental technician, an increase in thickness in the sublingual region is excluded.

With severe atrophy of the alveolar part of the lower jaw (Keller's class 2, 3, 4) (A. Scherbakov Orthopedic dentistry (5th edition) / A. S. Scherbakov, E.I. Gavrilov, V.N. Trezubov, E.N. Zhulev. - St. Petersburg: Tome, 1998. - 576 p.) And normal or hypertrophied mucous membrane (Type 1 according to Supple) (A. Scherbakov Orthopedic dentistry (5th edition) / A. S. Shcherbakov, E.I. Gavrilov, V.N. Trezubov, E.N. Zhulev .-- St. Petersburg: Tome, 1998. - 576 p.) Load the entire sublingual region with a force of 8-10 N; in case of unexpressed atrophy of the alveolar part of the lower jaw (Keller class 1) and atrophic mucous membrane (Type 2 according to Supple), the loading is carried out with a force of 4 N. The pressure strength is determined, for example, after training the arm muscles to feel pressure when receiving a functional impression on mechanical scales.

Example 1. Patient A., 61 years old, with a complete absence of teeth on the upper and lower jaws. I used full removable laminar dentures for 8 years, applied for prosthetics due to impaired fixation and stabilization of the prosthesis on the lower jaw. Atrophy of the alveolar part of the lower jaw Keller class 2. Atrophy of the mucous membrane of the prosthetic bed of the lower jaw type 3 according to Supple. During the treatment, the application of the heated Dentafol thermomass to the entire sublingual region and obtaining an impression under a pressure of 8-10 N were used. Liberation of the apex of the alveolar ridge and mandibular tubercles from the stiff mass. Production of a functional impression of corrective silicone mass of low viscosity.

During the application of the finished laminar denture to the lower jaw, fixation and stabilization according to B.V. Svirin (Svirin B.V. Clinical and functional rationale for orthopedic treatment of patients after complete loss of teeth in the lower jaw with pronounced atrophy of the alveolar part: abstract of thesis ... of a doctor of medical sciences / BV Svirin. M., 1998. - 38 pp.)

Example 2. Patient S., 75 years old, with a complete absence of teeth on the upper and lower jaws. He has been using full removable laminar dentures for more than 5 years. Complaints about the unsatisfactory fixation of the removable mandibular prosthesis and pain under the basis of the prosthesis. Atrophy of the alveolar part of the lower jaw Keller class 3. Atrophy of the mucous membrane of the prosthetic bed of the lower jaw type 2 according to Supple. During the treatment, the application of the heated Dentafol thermomass to the sublingual region from the most distal borders to the site of the first premolar placement and the impression of pressure 4-5 N. The area of the apex of the alveolar ridge and mandibular tubercles from the stiff mass was applied. Production of a functional impression of corrective silicone mass of low viscosity.

During the application of the finished laminar denture, fixation and stabilization according to B.V. Svirin meets the rating perfectly.

Claims (1)

A method of obtaining a functional impression in the complete absence of teeth on the lower jaw, including the manufacture of an individual spoon according to a preliminary impression, its fitting in the oral cavity, edging and production of a functional impression, characterized in that when fitting an individual spoon, the thickness of the sides is 1.5-2.0 mm, the edging of the spoon is performed by thermomass in the sublingual region, after which the spoon produces pressure on the prosthetic bed with a force of 4-10 N and a functional impression is made.