RU2611753C2 - Dental splint - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: splint made from superelastic nickel-titanium in the form of two parallel wires connected at the ends. The wires are bent along the length, in accordance with the topology of the invloved teeth. In addition, smaller curvatures corresponding to the topology of individual teeth, divide the splint by a series of wave-like elements. The splint is made based on the concerned dentition reprint, installed in a slotted groove from the oral side of the dentition and fixed by bonding compositions. The splint is used to stabilize teeth, frayed as a result of periodontal disease.

EFFECT: application of this splint ensures optimum rigidity at minimum dimensions of the contact bed; it provides reliable splinting of mobile teeth and improved quality of patient's life.

5 dwg

Description

The invention relates to medicine and can be used in dentistry for fixing pathologically mobile teeth.

With a widespread periodontal disease (periodontitis), teeth acquire pathological mobility, leading, in the absence of treatment, to loosening and adentia. One of the elementary methods of preserving a tooth is to artificially stabilize it in the dentition by creating additional support for the neighboring teeth that have not lost normal stability, or by consolidating the movable teeth into blocks more stable than a single tooth [Domenic K. Paradontopathy. Warsaw, 1967, S. 300].

For stabilization, mechanical bonding of teeth is used with the help of tooth splints, various in their design, and the materials used. The development of this level of technology is due and determined mainly by the achievements of materials science.

Depending on the diagnosis of the disease, used tires are classified into temporary, permanent removable and permanent non-removable. The proposed solution relates to the latter, to which, according to a number of subjective sensations, the patients themselves prefer.

From a wide variety of known tire designs, analogues are selected in the prior art that are as similar as possible in terms of design features, installation method and effectiveness.

A known tooth tire is made of a 0.1 mm thick steel wire twisted into a bundle, braced to be such that the legs of the bracket serve as tire clips on the outermost teeth (Fig. 1); the intermediate beam connects the loose teeth [Domenic K. Periodontopathy. Warsaw, 1967, S. 313]. For its manufacture on the oral surface of the teeth, at the level of their contact points, parallel to the cutting edge of the teeth, perform a spline channel - a bed for the tire. At the bottom of the channel, a phosphate-cement gasket, a tire girder are successively laid and, finally, they are covered with liquid quick-hardening acrylate. The legs of the tire are placed in the corresponding channels of the last splinted teeth. After polymerization of the bonding compositions, the closure of the teeth is checked, deburring is removed and the contact surface of the block is polished.

The main disadvantage of the device is the difficulty in choosing adequate tire stiffness. Excess stiffness deprives the teeth of normal autonomous mobility, the lack of poorly stabilizes the teeth for therapeutic restoration. The steel material of the tire has increased strength fatigue, which shortens the life of the tire.

Known tires made of flexible materials, which are used in a variety of polymers and fiberglass [Polikushin VV, Kovaleva EI et al. A new look at the study of splinting of teeth / New in dentistry. 2005, No. 7. S. 79-82]. On the teeth prepared for splinting, place, pressing them into the recesses, semi-finished tape-like materials, impregnated for adhesion and covered from above with a self-hardening bonding compound. The fibrous structure of the material requires an increased thickness of the covering bonding, which creates discomfort in the mouth and makes chewing food difficult. The material is not mechanically strong enough, and splinting is unreliable.

By the greatest similarity of the technical nature of the device and the method of its use, this analogue is selected as a prototype.

The technical result of the proposed solution is to increase the reliability of stabilization of the dentition, increase the service life of the tire.

A tooth splint is proposed in the form of an element made of a solid biocompatible material curved according to the topology of the oral surface of the dentition.

The difference is that this element is made of titanium nickelide with a superelastic effect in the form of two wires with a diameter of 0.5 mm, arranged in parallel and connected at the ends, and curvatures form sections in accordance with the topology of individual teeth of the row.

The term “Topology” means the property of the figure, the relative position of the figures, the spatially geometric arrangement of the figures and the relationships between them, the shape of something (The Big Explanatory Dictionary of the Russian Language S. A. Kuznetsov, p. 1332). Moreover, the phrase "topology of the oral surface of the dentition" by the authors is understood as the relative position of the teeth of the splinted row. The phrase "topology of individual teeth" is understood as the location of individual teeth, their shape and the location of one tooth relative to another, including the gaps between the teeth.

The specified technical result is achieved by the fact that in the splint, made in the form of an element of solid biocompatible material, curved according to the topology of the oral surface of the dentition, the specified element is made of titanium nickelide with superelasticity effect, in the form of two wires parallel to each other, smoothly connected at the ends (Fig. 2).

It is preferable to partition the device along the length with additional bends of each wire in accordance with the topology of the individual teeth of the row to be rowed. Thus, the curvatures form sections in accordance with the topology of the individual teeth of the row to be sewn together (sections are shown in FIG. 2).

The technical result is achievable due to the deformation properties of superelastic titanium nickelide in their logical connection with the tire structure. The proposed tire structure simultaneously provides rigidity to the entire device and a reduction in tire pressure on the teeth. Thus, the sign of "curvature and sectioned tire configuration" in our opinion is significant and is in a causal relationship with the claimed technical result.

The tire is installed for constant wear on the oral side of the interested, most often the front row of teeth. To do this, it is made “in place” by hot bending of a nickel-titanium wire, installed in the bone bed of the dentition made for it, and fastened with bonding self-hardening compounds.

Healthy teeth and especially pathological ones with alternating loads in the acts of biting and chewing food experience microdeformation and, more noticeable in magnitude, functional mobility in the axial and transverse directions. In a splinted dentition, dynamic loads and interactions are distributed to separate sections of the consolidated block, depending on the degree and type of pathology, the design and properties of the tire, the method of attachment to the teeth and other, smaller factors. In contact places, in dynamics, conflicting stresses arise due to the inconsistency of the deformation mobility of the bone tissue of the teeth and the sections of the adhesive adhesively bonded to it.

The similarity between the deformation characteristics of titanium nickelide and living tissue (here, bone), discovered by the authors, minimizes the deformation conflict, which leads to an increase in the integral strength and reliability of the composite.

Wire, i.e. The lightweight and lightweight tire design provides optimum rolling stiffness with minimum contact bed dimensions. Slight trauma to the tissues of the teeth, small obstructions in the oral cavity do not reduce the quality of life of the patient. The diameter of the structural wire elements of 0.5 mm is optimal and less traumatic in similar designs.

The two-wire enclosed busbar design provides the necessary rigidity. In accordance with the topology of the dentition, the curvature and the sectioned configuration of the tire distributes the interaction stress over a large area of the dental tissue, reducing the specific pressure of the tire towards gentle values.

Using the properties of titanium nickelide (elastic deformation and biocompatibility) in a new, relatively prior art, logical connection with the technical result indicates that the proposal meets the patentability criterion of "inventive step".

The illustrations show:

FIG. 1. Tooth wire splint - from steel wire (analogue).

FIG. 2. The proposed tooth splint: 1 - wire; 2 - end contactors; 3 - sections; 4 - jumpers.

FIG. 3. Prepared oral surface for splinted teeth.

FIG. 4. The moment of application of the tire.

FIG. 5. Type of teeth after splinting.

Achievability of the technical result is confirmed by clinical examples of the treatment of periodontitis and the completion of orthopedic intervention.

Example 1

Patient I., 56 years old. The diagnosis of the disease is generalized periodontitis, the absence of a number of teeth, the mobility of the lower incisors of the first degree.

For treatment, a tire made of nickel-titanium wire with a diameter of 0.5 mm, formed according to the topology of the oral surface of the dentition (Fig. 2), was used. The use and installation of the tire is carried out, and its therapeutic effect is as follows:

1. Dissect the teeth to be splintered by milling the canal on the lingual surface of the dentition.

2. Perform an accurate impression of the prepared teeth with silicone materials.

3. Close the treated teeth with temporary fillings.

4. A super gypsum model is cast on the print.

5. According to the model, a tire is manufactured by hot bending (Fig. 2), which is maximally conjugated along the channel of the completed channel. The tire is coated with an opaque layer.

6. Remove temporary fillings, etch teeth and apply a bonding layer, restoration material.

7. A tire is installed in the prepared channel by attaching it and pressing it tightly to the bottom of the channel (Fig. 4).

8. Model the lingual surface of the composite block, process and polish the restoration material (Fig. 5).

The functional and therapeutic effect of the tire was observed in the dispensary mode for 10 months. The absence of complications, fatigue wear of the tire and the destruction of the restoration material, a positive history of the patient indicate the attainability of the technical result.

The accumulated statistical test results and clinical readiness indicate the "industrial applicability" of the proposed invention.

Claims (1)

A splint in the form of an element made of a solid biocompatible material, curved according to the topology of the oral surface of the dentition, characterized in that said element is made of titanium nickelide with a superelastic effect in the form of two wires with a diameter of 0.5 mm, arranged in parallel and connected at the ends, and curvatures form sections in accordance with the topology of the individual teeth of the row to be rowed.

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