RU2630354C1 - Auricle prosthesis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: auricle prosthesis is made of medical dental silicone, manufactured by casting from a prototype, manufactured by 3D-printing, mirrored digital image of a computer tomogram of the opposite patient's auricle. The auricle prosthesis consists of two elements of the auricle and a base in place of adherence to the tissues of the prosthetic bed, connected together by fixing elements made of rigid dental polymer, having a round flat base, a neck and a hemispherical head. The hemispherical head ends are made oval. The section of transition from the head to the neck has an afflux with a rounding radius. The base of the mentioned elements is monolithically fixed in the part of the prosthesis - the auricle. In the part - the bases in the projection of the element heads, there are holes in the section 2 times smaller than the diametre of the fixing element heads.

EFFECT: precise individual manufacturing of the prosthesis of the reproduced patient's ear, as well as the possibility of quick and repeated replacement of a part of the prosthesis adjacent to the tissues of the prosthetic bed.

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Description

The invention relates to medicine, namely to facial prosthetics, and can be used for orthopedic rehabilitation of patients with a missing auricle.

The prior art method of maxillofacial prosthetics, including obtaining a print of the prosthetic element, obtaining a plaster model of the prosthetic element of the maxillofacial region, modeling on the plaster model the wax structure of the future prosthesis, molding the plaster model with the wax structure of the prosthesis into a molding cuvette using as a molding the mass of the backup silicone, keeping the molding material until it solidifies, opening the cuvette after solidification of the silicone backup mass, removing wax from the gypsum model and forming the casting strokes in silicone form, drying the gypsum model and isolating the gypsum model with varnish and release agent, heating the gypsum model and silicone mold, filling the cuvette through the gating ducts with the components of the polyurethane composition to obtain the prosthesis, heating and maintaining the gypsum model and a silicone mold filled with a polyurethane composition, removing the prosthesis made from the polyurethane composition after cooling the gypsum model and the silicone mold and its opening, the removal of the sprues and the final processing of the prosthesis, characterized in that in the process of manufacturing the prosthesis, the obtained gypsum model is dried in a microwave oven with a power of 300-700 W for 10-15 minutes, layers of insulating varnish are applied to the gypsum model, each of which is dried at room temperature for 5 minutes and then complete drying of the entire lacquer layer at a temperature of 100-110 ° C for 10-15 minutes, the gypsum model and the silicone mold are heated at a temperature of 115-125 ° C for 10-15 minutes, ne by pouring into the molding cuvette the initial components of the polyurethane composition are preheated in a thermal cabinet at a temperature of 110-120 ° C for 4-6 minutes, then removed from the thermal cabinet and cooled to room temperature, the components of the polyurethane composition are mixed and the volume of the molding cuvette is filled with the polyurethane composition before it leaves the counter-casting holes, the immediately cast molding cuvette is placed in the polymerizer and subjected to pressure treatment in a sealed polymerizer 2 atmospheres for 5 minutes without filling the internal volume of the polymerization unit with water, then the cuvette that was poured was kept in a thermal cabinet at a temperature of 115-125 ° C for 45-60 minutes, removed from the thermal cabinet, cooled in air to room temperature, and the cuvette was disassembled. in the manufacture of an auricle prosthesis or part thereof, an elastic obturator on a rigid basis of a removable denture, a composition containing 100 wt.% is used as a polyurethane composition. parts of polyisocyanate with an NCO content of 15-20% 400-700 wt. parts of oligopolyatomic alcohol with a molecular weight of from 2000 to 5000, as well as 6-15 wt. parts of a catalyst with a molecular weight of from 250 to 300 (RF Patent No. 2425653 of 08/10/2011).

There are various methods for the manufacture of prosthetic parts of the face, for example, a method for manufacturing a nose prosthesis is known, which involves repeated reproduction, in which a face mask is made, a nose is modeled on it, a nose is reproduced, a nose is waxed from the patient’s face, then wax the nose is gypsum in the cuvette, the wax is replaced with plastic, the prosthesis of the nose is fitted from the plastic on the patient’s face, and then a shape is obtained for duplication of the specified nose prosthesis, for this end The flaxen nose prosthesis made of plastic, with the tip of the nose up, is completely immersed in a cuvette with a liquid silicone duplicating mass, then after complete hardening the silicone mass is removed from the cuvette, cut from the back of the nose and the refined nose prosthesis is removed from it, and the obtained silicone mold is used to reproductions of the prosthesis of the nose (RF Patent No. 2352296, dated April 20, 2009).

It is known to manufacture an auricle ectoprosthesis in which a cast is taken from the auricle of the corresponding side in one of the same-sex relatives of the patient with the closest form of the auricle. To take an impression, elastic impression masses are used. The wax mold of the future prosthesis is cast according to the cast, which is fitted to the soft tissues. After that, the wax is replaced with plastic of the corresponding color (Kostur B.K., Minyaeva V.A. Maxillofacial prosthetics. - L.: Medicine, 1985. - 168 p.).

A disadvantage of the known solution is that a disposable plaster mold is used to make a wax template for the future prosthesis.

A known method of manufacturing an auricle prosthesis, including obtaining a wax template for an auricle prosthesis in a reusable collapsible die pre-made of gypsum, fitting a wax prosthesis template on a patient’s face in a seat, subsequent processing of the wax template by forming an individual relief on it to obtain a wax copy the prosthesis, which is then gypsum in the cuvette, replace the wax with silicone, remove the obtained silicone prosthesis from the cuvette, grind it (Patent No. 2421188 dated 06/20/2011).

An endoprosthesis of the ear is known, which is a synthetic base made by digital prototyping with computer simulation of the cartilaginous structure of the external auricle and subsequent milling on a numerically controlled machine; having a surface from the congruent abutment field with high accuracy of coincidence with the abutment field, as a result of which its base is individual, completely congruent to the receiving bed and acts as the inner frame of the auricle. An individual reconstructive endoprosthesis for otorhinolaryngology, performed by the method of digital prototyping, consists of a porous biosynthetic material and has a surface with a high accuracy coinciding with the adjoining field from the side of the congruent adjoining field. Due to the use of computer simulation and milling on a machine with numerical control, the reconstructive individual endoprosthesis for otorhinolaryngology has a three-dimensional structure. With high accuracy repeats the cartilage base of the outer auricle, the surface of the base of the endoprosthesis is completely congruent with the receiving abutment field. It not only allows you to completely restore the missing part of the outer Center for Scientific Cooperation "Interactive plus" 5 ear or the completely lost auricle as a result of injuries, burns, oncological diseases, but also reliably fixes, acting as the inner skeleton of the auricle. It does not require additional screw clamps (Education and science in modern conditions: materials of the VIII International scientific and practical conference. (Cheboksary, June 26, 2016) / editorial: ON Shirokov [et al.]. - Cheboksary : Central nervous system “Interactive plus”, 2016. - No. 3 (8). - 31-34 p.).

The problem to which the invention is directed is the accurate individual reproduction of the patient’s missing ear.

The technical result of the invention is the manufacture of a prosthesis for a mirror-reproduced ear of a patient of prolonged use with the possibility of quick and repeated replacement of a part of the prosthesis adjacent to the tissues of the prosthetic bed.

The technical result of the invention is achieved by the fact that the auricle prosthesis is made of medical dental silicone, cast by a prototype made by 3D printing, a mirrored digital image of a computer tomogram of the patient’s opposite auricle with a missing auricle, the auricle prosthesis consists of two elements the auricle and the base at the place of contact with the tissues of the prosthetic bed, interconnected by fixing elements made of of a stiff dental polymer having a round flat base, a neck and a hemispherical head, the edges of the hemispherical head are made wired, the section of transition from head to neck has a tide with a radius of rounding, the base of these elements is monolithically fixed in the prosthesis part — the sink, in the part - the base in the projection of the heads elements, there are openings in the section 2 times smaller than the diameter of the heads of the fixing elements.

In the previously described inventions, the shape of the auricle absent in the patient was displayed either with the help of an imprint of the ear of the next of kin or manually modeled by a wax technician, which in both cases leads to difficulties in accurately and individually reproducing the prosthesis. The proposed technology of 3D printing of a specific digital model of the mirrored image of the patient’s ear allows you to level the above disadvantage. A serious drawback in prosthetics of the auricle is the short operational period of the prosthesis, especially in terms of its fit to the tissues of the prosthetic bed, which is associated with the features of the structural material. The solution to this problem is due to the fact that in the attached prosthesis design, the part adjacent to the tissues of the prosthetic bed is removable and replaceable, while the artificial auricle does not require replacement for a long time, which, in turn, significantly reduces the cost of the prosthetics process. At the same time, the number and design of the fixing elements, by means of which the replaceable and non-replaceable parts of the prosthesis are connected, prevent their accidental separation and suggest professional use.

The design of the prosthesis of the auricle is illustrated in FIG. one.

1. Auricle prosthesis

2. Part of the prosthesis - “auricle”

3. Part of the prosthesis - “base of the prosthesis”

4. Locking element

5. The head of the locking element

6. The neck of the locking element

7. The base of the locking element

Prosthetics with the proposed prosthesis of the auricle is carried out as follows:

1. A CT scan of the patient’s head with the missing auricle is performed.

2. The resulting image of a computerized tomogram of the existing ear is translated into a digital CAD / CAM module of the system, where it is converted to a model of the missing auricle by mirror rotation and the formation of the border of contact with the prosthetic field.

3. The resulting digital model of the prosthesis of the auricle (1) is translated into a physical polymer prototype model using 3D printing.

4. A prototype prosthesis of the auricle (1) is disconnected with a diamond dental disk into two parts: the “auricle” (2) and the “base of the prosthesis” (3).

5. The “auricle” (2) and the “base of the prosthesis” (3) are separately installed in the dental cuvette and filled with duplicate dental silicone, after the polymerization of which the prototype is removed.

6. In the mold under pressure in a vacuum, pour medical dental silicone used for the manufacture of exoprostheses of the face.

7. The obtained parts of the prosthesis of the auricle (1) are processed from excess material and individualized by staining with paints.

8. Along the connecting surface of the prosthesis components (1), holes are drilled coaxially to each other to install fixing elements (4) made of rigid dental polymer having a round flat base (7), a neck (6) and a hemispherical head (5) , the edges of the hemispherical head are zavovanny, the transition from the head (5) to the neck (6) has a tide with a radius of rounding.

9. To fix the base of the fixing element (7) in the end part of the “auricle” prosthesis (2), holes are formed in the section 2 times smaller than the diameter of the base of the fixing element (7).

10. To fix the head of the fixing element (5) in the end part of the prosthesis, the “base of the prosthesis” (3), holes are formed in the section 2 times smaller than the diameter of the head of the fixing element (5).

11. The “auricle” (2) and the “base of the prosthesis” (3) are connected by means of fixing elements to obtain the prosthesis of the auricle (1).

Claims (1)

The prosthesis of the auricle is made of medical dental silicone, cast by a prototype made by 3D printing, a digitally mirrored digital image of a computer tomogram of the opposite auricle of the patient with a missing auricle, the prosthesis of the auricle consists of two elements of the auricle and the base at the abutment site to the tissues of the prosthetic bed, interconnected by fixing elements made of hard dental polymer, having a round the flat base, the neck and the hemispherical head, the hemispherical head edges are made worn, the transition section from the head to the neck has a tide with a radius of rounding, the base of these elements is monolithically fixed in the prosthesis part — the sink, in the part - the base in the projection of the element heads, there are holes in the section 2 times less than the diameter of the heads of the fixing elements.

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