RU2579279C1 - Device to measure length of the tongue frenulum part - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to instrumental methods of diagnosing anomalies of the oral cavity, and aims at determining dimensions of frenulum of tongue in adults and children. Device for measuring the length of frenulum of tongue from excretory salivary glands to apical point of frenulum attachment includes working and auxiliary parts made of medical steel with thickness of 1-1.5 mm and a measuring scale on working part as a school ruler. Device is solid, has a handle, working part and bent neck connecting the handle with the base of the working part. Working part is made with a slot and a measuring scale calibrated with divisions in mm, conditionally from 0 mm at semi-circular cut of the working part end which can be fixed on the outlet ducts of salivary glands of the oral cavity bottom up to 30 mm at the base of the working part. Handle, neck and working part are made so that to enable the location of working part along the whole length of the tongue, repeating its anatomic landmarks.

EFFECT: invention provides accurate measurement of length of the tongue frenulum part from excretory ducts of salivary glands to apical point of frenulum attachment for further determination of indications for surgical intervention on frenulum.

1 cl, 3 ex, 8 dwg

Description

The present invention relates to medicine, in particular to dentistry, and in particular to instrumental methods for diagnosing anomalies of the oral cavity, and is intended to determine the size of the frenum of the tongue in adults and children.

The length of the frenum of the tongue determines the mobility of the tongue (Dibart S, Mamdu Karima, 2007). Shortening the frenum of the tongue can contribute to the formation of malocclusion (Abolmasov N.G., Abolmasov N.N., 2008). The swallowing and reproduction of speech sounds may also be impaired. To prevent the consequences of a shortened frenulum of the tongue, it is necessary to correctly and accurately measure the length of the frenulum, because the exact length of the frenum can become a further criterion for determining indications for an operation to lengthen it. Currently, there are no clear indications for plastic frenum of the tongue and surgical intervention is difficult without an accurate measurement of the length of the frenum. Clear criteria defining indications cannot be determined, because in the literature available to us there are no data on measuring devices for measuring the length of the frenum of the tongue.

When examining the dental status of patients in the city of Khabarovsk, the authors were faced with the fact that getting the exact length of the frenum of the tongue was problematic. This is due primarily to the fact that there are no measuring devices for this anatomical structure, and the use of any auxiliary objects, in particular rulers, graduated probes, etc., gives only approximate values, since the rulers do not have bends, and the probes they are not long enough for optimal measurement of an anatomically curved bridle. For example, periodontal probes with a label in the end region have a length of 11.5 mm, and bell-shaped probes with a gradation millimeter scale applied to the working part up to 15 mm long, although the size of the bridle often exceeds these values. Sometimes doctors determine the size and indications for surgery to lengthen the shortened frenulum of the tongue "by eye", which is unacceptable when distinguishing between norm and pathology.

The second problem was the lack of clear anatomical definitions of those structures of the frenum of the tongue that are measured for operational purposes. In this regard, in the framework of the study, we determined the desired part of the frenulum as the mobile part of the frenum of the tongue because the frenulum anatomically can be conditionally divided into two parts as follows. The part going from the excretory ducts of the salivary glands of the bottom of the oral cavity and attached to the inner surface of the lower jaw to the mucous-gingival connection on the lower jaw from the lingual side in the region of the frontal group of teeth is a relatively motionless part of the frenulum, therefore, it can conditionally be designated as “immobile part The frenulum of the tongue as shown in FIG. one.

The part that starts from the excretory ducts of the salivary glands of the bottom of the oral cavity and ends with the apical point of attachment of the frenulum to the lower surface of the tongue can be arbitrarily called the “mobile part” of the frenulum of the tongue, as shown in FIG. 1, due to its mobility associated with the movement of the muscles of the tongue and also with the mobility of the mucosa.

In our study, we measured only this “mobile part” of the frenulum of the tongue, since it is of particular importance for surgical correction — in particular, to increase the length of the frenum of the tongue, and therefore we distinguished it terminologically in a separate anatomical part of the frenulum and introduced the term “mobile part” frenulum of the tongue.

The proposed device is fixed in place of the excretory ducts of the salivary glands of the bottom of the oral cavity, so the length of the part of the frenum of the salivary glands of the bottom of the oral cavity to the apical point of the frenum on the lower surface of the mucous membrane of the tongue in the vertical direction. The reference point is the excretory ducts of the salivary glands of the bottom of the oral cavity, where a semicircular cutout of the device with the first horizontal division of the measuring scale, conventionally taken as zero, is installed.

Known device Lee Seoung-Xo (US 5226428 A) for measuring the size of the tongue and its bridle. The analogue includes a set of five rulers: the main line and four auxiliary lines. The basic principle is to use the basic and put forward a set of additional rulers when measuring the size of the tongue and frenum of the tongue.

However, the significant disadvantages of this device for measuring the length of the frenum of the tongue are inaccurate results, because the main line is straight and there is no complete fit to the frenum of the tongue. There is no single device, but there is a set of rulers, when the choice of auxiliary rulers is carried out by selection depending on the length of the frenum of the tongue, which requires additional time. No other prototypes were found in the literature available to us.

There is a “Method for determining indications for plastic frenulum of the tongue with dentoalveolar anomalies in children” (G. Zolotukhina, T. Kosyreva, Patent RU 2134539). But its significant drawback is the lack of a device with which measurements were made.

All of the above creates a need for a device for measuring the length of the frenum of the tongue, namely the part that undergoes surgery to increase the length of the frenum and is defined by us as the “mobile part” of the frenum of the tongue.

The objective of the invention is to provide a device devoid of the above disadvantages for accurate measurement of the length of the frenum of the tongue from the excretory ducts of the salivary glands to the apical point of attachment of the frenum to further determine indications for surgical intervention on the frenulum.

The technical result consists in measuring in millimeters a portion of the length of the frenum of the tongue from the excretory ducts of the salivary glands of the bottom of the oral cavity to the apical point of the frenum of the tongue by using the proposed device to measure the length of this part of the frenum of the tongue.

The technical result is achieved by the use of a device for measuring the length of a part of the frenum of the tongue from the excretory ducts of the salivary glands to the apical point of attachment of the frenum, when the mouth is maximally open and the tongue raised upward vertically touches the enamel palatine tubercles of the upper central incisors from the lingual side. A sterile instrument in the position of the “writing pen” is installed with a semicircular notch of the working part on the area of the excretory ducts of the salivary glands so that the tongue raised vertically rests on the working part of the device and adjoins it, and the mobile part of the frenulum of the tongue is located in the slot, while the semicircular cut the end of the working part is securely fixed on the excretory ducts of the salivary glands of the bottom of the oral cavity, which allows the measurement of part of the bridle. The measurement is carried out as follows: through the slot of the working part of the installed device, the location of the apical point of the frenum of the tongue is determined, this point is fixed on a measuring scale 30 mm long from the first horizontal mark, conditionally taken as zero, in accordance with the divisions available on both sides of the slot with a division step 1 millimeter, and thus, the length in mm of the frenum of the tongue is determined.

The proposed device is one-piece, made of medical steel, the thickness of which is 1-1.5 mm and is represented by the working and auxiliary parts and a measuring scale on the working part. The device has a handle, a curved neck and a working part with a slot and a measuring scale, graduated in increments of 1 mm, conditionally from 0 millimeters at a semicircular cutout of the end of the working part to 30 millimeters at the base of the working part. The working part of the device, applied to the tongue, most accurately repeats the anatomy of the "mobile" part of the frenum of the tongue along its entire measured length, clearly visible in the slot of the working part. The device is shown in FIG. 2 (Fig. 2.1, Fig. 2.2), on which in a side projection and top view the parts of the device are indicated: a handle, a neck and a working part. The neck of the device connects the handle and the working part.

The dimensions and shape of the device are shown in FIG. 3 (Fig. 3.1, Fig. 3.2). In FIG. 3.1 is a drawing and dimensions of the device, made in side view. The height of the device is 100 mm. The handle has a length of 52 mm. Pairing - the places of bends have smooth transitions without corners - the transition of the auxiliary part (handle) to the neck is 4.5 mm; the neck and outer radius are 50 mm; the neck is 51.5 mm long. The coupling of the neck with the working part with an inner radius of 10 mm, the length of two bends of the transition of the neck to the working part is 3 mm and 16.5 mm. The length of the working part from the bend to the end of the device is 32.5 mm All these bends allow you to position the tool along the entire length of the tongue, repeating its anatomical landmarks.

FIG. 3.2 shows the drawing and dimensions of the device from above. The length of the device is 160 mm. The handle has a flat shape with blunt, rounded edges, the interface of which has a radius of 5.5 mm. The length of the handle to its direct transition into the neck is 55 mm, width - 11 mm. The elongated neck has a width of 6.7 mm to 12.5 mm at the point of transition to the working part. The length of the integral working part is 44 mm. The working part has the shape of a sakura flower petal and several designated widths: 17 mm and 19.3 mm.

In FIG. 3.2 it is seen that the working part is provided with a through central slot of a rectangular shape along the longitudinal axis. The length of the slot is 30 mm, the width is 3 mm. On the front surface on both sides of the slot along its entire length there are divisions - a measuring scale in millimeters, with a conditionally zero mark on the semicircular cutout of the end of the working part. Numbers from 0 to 30 on the surface of the working part were not applied due to the clarity of measurement according to the type of school ruler. The working part of the device ends with a semicircular cutout with an inner radius of 2.5 mm, with an outer radius of 4 mm. A semicircular cut allows you to reliably fix the device on the excretory ducts of the salivary glands, which affects the accuracy of the results.

The working part of the device is represented by its photograph in FIG. four.

Photographs of the device are shown in FIG. 5, in side view in FIG. 5.1 and above in FIG. 5.2, while the device is located on the surface of the above drawings - FIG. 3 (Fig. 3.1 and Fig. 3.2).

The advantages of the proposed device are as follows:

- meets the requirements of ergonomics, minimal time;

- simplicity of design, ease of use;

- a cheap, cost-effective way, does not require specially trained personnel; it is easily sterilized by standard methods and, thus, the possibility of infection is excluded;

- perfectly accurately repeats the anatomical curvature of the frenulum along the entire measured length of the part of the frenum of the tongue;

- minimal errors in obtaining results due to the strong fixation of the bottom of the oral cavity on the excretory ducts of the salivary glands and the presence of a measuring scale on the working part in millimeters;

- the ability to justify surgery on the frenum of the tongue to increase its mobility.

The use of the proposed tool can be illustrated by the following examples.

Example 1. Child N., 9 years old. Directed by an orthodontist for diagnosis and, if necessary, correction of a shortened frenum of the tongue. The clinical case is represented by a series of photos in FIG. 6. A photo of the initial inspection is shown in FIG. 6.1. The device is used as follows: ask to open your mouth as much as possible and reach out with the tip of the tongue of the anterior palate. The sterile instrument is held in the position of the "writing pen" like a fountain pen, covering the neck with distal phalanges of the I, II, III fingers. The device is applied with a semicircular cutout by the working part to the area of the excretory ducts of the salivary glands so that the frenum of the tongue is located in the incision of the instrument, as shown in FIG. 6.2. Measurements were made according to the divisions located on the slot of the working part of the instrument, the apical point of the frenum of the tongue was determined: from the excretory ducts of the salivary glands of the bottom of the oral cavity to the upper apical point of the frenum of the tongue in the vertical direction. The result was recorded on a scale in mm. The length of the frenum of the tongue was 14 mm, which is not enough for the normal function of the tongue. Then, the instrument was removed from the oral cavity and surgery was performed, as shown in FIG. 6.3. A photo with the device in the oral cavity after surgical correction when measuring the changed length of the frenum of the tongue up to 20 mm is presented in FIG. 6.4.

Example 2. Child O., 12 years old, sent by a dentist at the place of residence for a shortened frenum of the tongue in order to correct it. Using a sterile device, the frenum of the tongue was determined, which is represented by two photographs in FIG. 7. The length of the bridle was 21 mm, which corresponds to the norm. In FIG. 7.1 and FIG. 7.2 installation of the device and its reliable fixation on the excretory ducts of the salivary glands of the bottom of the oral cavity are clearly visible. In FIG. 7.2 is well defined part of the frenum of the tongue in the slot of the working device. We paid attention to the distal position of the tongue (posterior): the back of the tongue closed the airways. The patient is referred for consultation and treatment by a speech therapist and otolaryngologist.

Example 3. Child N., 10 years old, a shortened frenulum of the tongue was found during treatment with the goal of sanitation of the oral cavity. Using the sterile device of the invention, the size of the frenum of the tongue from the excretory ducts of the salivary glands of the bottom of the oral cavity to the apical point of the frenum, which was 5 mm, was clearly seen during examination and is shown in FIG. 8 (Fig. 8.1). The child could not reach the front of the palate with the tip of his tongue with the maximum open mouth. Surgical correction using a laser. Fig 8.2 photo of the test for the consistency of the frenum of the tongue, its length after the operation was 18 mm

Claims (1)

A device for measuring the length of the frenum of the tongue from the excretory ducts of the salivary glands to the apical point of attachment of the frenum, including the working and auxiliary parts made of medical steel 1-1.5 mm thick, and a measuring scale on the working part according to the type of school ruler, characterized in that the device is integral, has a handle, a working part and a curved neck connecting the handle to the base of the working part, while the working part is made with a slot and a measuring scale graduated by divisions in mm, conditionally from 0 millimeters at a semicircular cutout of the end of the working part, made with the possibility of fixing on the excretory ducts of the salivary glands of the bottom of the oral cavity, up to 30 millimeters at the base of the working part; while the handle, neck and working part are made in such a way as to allow the working part to be located along the entire length of the tongue, repeating its anatomical landmarks.

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