RU2656526C1 - Method of distal jet of the second molar of the upper jaw - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry – orthodontics, and is intended for use in treatment of dentoalveolar anomalies in patients with distal occlusion. By the method of selective laser melting, make orthodontic crowns and install them on the first and the second premolars and the first and the second molars. Moreover, crowns on the first and the second premolars and the first molar are welded together by laser welding to strengthen the support. Expanding screw – "Vector 80 maxi" – is installed on the orthodontic crowns of the first and the second molars from the vestibular side, and the guide rod of the screw is cut off. Then activate the device with a key and a screw lock for one or several turns until a sense of pressure appears. Activation is carried out for 1–2 months until the distance between the first and the second molars of the upper jaw is reached, which is required for further orthodontic treatment.

EFFECT: method allows to achieve the hull displacement of the second molar of the upper jaw and to optimize the conditions for further orthodontic treatment.

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Description

The invention relates to medicine, namely to dentistry, orthodontics, and can be used in the treatment of dentofacial anomalies in patients with distal occlusion.

A known method for distalization of the premolar of the upper jaw using a device consisting of springs, a wire element for the distalization of teeth and locks for fixing the wire elements. The device contains the vestibular and palatine parts; the vestibular part consists of an orthodontic arch with bends at an angle of 90 ° to stabilize the support, elastic traction, presented in the form of a chain, the length of which is determined by clinical indications. One end of the chain is worn on a bracket fixed on a distalized tooth from the vestibular surface, the other end on a hook on a locking device. The palatine part consists of a bracket, a metal button with an opening for the arch, fixed from the palatine side to the distalized tooth. A partial arc is established between the bracket and the button, on which the opening nitinol spring is worn (Patent for PM No. 131599, class A61C 1/00, published on 08.27.2013).

The disadvantages of this apparatus are the possibility of rotation of the moved teeth, as well as the inability to use for distalization of the second molars of the upper jaw, since there is no sufficient support for the body movement of the second molar of the upper jaw.

There is also a method of distalizing the lateral group of teeth of the upper jaw using the palatal apparatus Distal Jet [Geis A. DISTAL JET and its capabilities in the treatment of malocclusion of class II. / A. Geis, G. Doll, A. Korano // Clinical Dentistry 2000; 1: 52-56], [Carano A., Testa M. The distal jet for upper molar distalization. J Clin Orthod, 1996; 30: 374-380].

The main elements of the device are: lingual tubes, palatal arch, bayonet mounts and guide tubes, Nance device (Nance button). The original unit has been modified [Quick AN, Harris AMP. Molar distalization with a modiSed distal jet appliance. J Clin Orthod 2000; 34: 419-423], [Bowman SJ. Modifications of the distal jet. J Clin Orthod 1998; 32: 549-556] and now consists of a two-sided system of tubes and pistons, welded into an acrylic palatine button and fixed in fastenings on the first or second premolar. From the distal side, the tubes pass through the sky parallel to the occlusal plane to the first molars, where they enter the lingual locks on their rings like a piston. A superelastic nickel-titanium spring is located between this tube system and piston.

The disadvantages of this apparatus are the possibility of rotation of the moved teeth; lack of control over tooth detailing, as well as discomfort due to the cumbersome design of the apparatus.

Closest to the claimed invention is a method of distillation and rotation of the first molars of the upper jaw using the palatine apparatus Pendulum [Hilgers JJ. The pendulum appliance for Class II noncompliance. J. Clin Orthod 1922; 26: 706-714]. Pendulum device consists of: orthodontic crowns (rings), springs and palatine acrylic button. The springs are made from a beta-titanium arc. Orthodontic crowns are made of conventional or thin-walled sleeves (0.15-0.18 mm thick) according to the generally accepted technology for the manufacture of crowns by stamping. Orthodontic rings can be made of stamped orthodontic crowns (by cutting the chewing surface), banding chrome-nickel tape 0.15-0.2 mm thick and 3.5 to 6 mm wide and standard workpieces. Orthodontic crowns (rings) are installed on the first molars of the upper jaw. The orthodontic arch is a power element of the structure. The palatine acrylic button is its supporting part.

This device is taken as a prototype.

The known device is used to expand the upper dentition with simultaneous rotation and detailing of molars of the upper jaw. The disadvantages of the apparatus are the extrusion of second molars, an increase in the angle of the mandibular plane and lower front height of the face, a decrease in incisal overlap [Ghosh J, Nanda RS. Evaluation of an intraoral maxillary molar distalization technique. Am J Orthod Dentofacial Orthop 1966; 110: 639-646], [Bussik TJ, McNamara JA Jr. Dentoalveolar and skeletal changes associated with the pendulum appliance. Am J Orthod Dentofacial Orthop 2000; 117: 333-343], as well as unreliable fixation due to errors in the manufacture of stamped crowns and the discomfort associated with the bulkiness of the apparatus.

The objective of the present invention is to remedy these disadvantages by increasing the efficiency of moving a permanent molar with dentoalveolar anomalies, providing optimal physiological movement of the second molar of the upper jaw and increasing the quality of life of the patient.

This goal is achieved by the proposed method for moving the second molar in the distal direction.

The proposed method for the distal movement of the second molar of the upper jaw contains the body movement of the second molar of the upper jaw in the distal direction by means of an expanding screw and orthodontic crowns, wherein the orthodontic crowns are made by selective laser melting and installed on the first and second premolars and the first and second molars, and the crowns on the first and second premolars are welded together by laser welding to strengthen the support, the expanding screw “Vector 80 maxi” is installed on the first and second molars from the vestibular side, and the screw guide rod is cut off, then the device is activated with a key and a screw lock for one or several revolutions, they are activated one or several times until the required distance between the orthodontic tooth crowns 2.6 and 2.7 is obtained.

The method is illustrated in graphic materials. In FIG. 1 depicts a method of moving a permanent molar of the upper jaw (top view) using orthodontic crowns and a screw located on orthodontic crowns 2.6 and 2.7 of teeth mounted on the teeth 2.4, 2.5, 2.6 and 2.7. In FIG. 2 shows an apparatus activation screw; FIG. 3 shows a top view of the apparatus. In FIG. 4 shows the dentition with the device installed; FIG. 5 - view of the key with which the device is activated. In FIG. 1 shows a device for implementing a method for moving a second maxillary molar (view of the vestibular surface), consisting of an orthodontic crown of a second molar 7, an orthodontic crown of a first molar 8, an orthodontic crown of a second premolar 9, an orthodontic crown of a first premolar 10 and an expansion screw, which, in its the turn consists of a housing 1, an activation lock 2 with an opening for activation 3, an activation screw with thread 4, a guide rod 5, a washing hole 6, which is mounted on orthodontic crowns the second molar 7 and the first molar 8, the orthodontic crowns on the second premolar 9, the first premolar 10 and the first molar 8 are soldered together.

The method is as follows. In FIG. 1 shows a method of two-way movement of second molars of the upper jaw (top view) using an apparatus containing orthodontic crowns 1 mounted on teeth 2.4, 2.5, 2.6, 2.7, and a screw located on orthodontic crowns 2.6 and 2.7 of teeth 2.

In FIG. 2 shows the apparatus activation screw, consisting of a housing 1, an activation lock 2 with an activation hole 3, an activation screw with a thread 4, a guide rod 5, a washing hole 6.

In FIG. 3 shows an apparatus for distally moving the second molar of the upper jaw (view of the occlusal surface).

In FIG. 4 shows an apparatus for distalizing a second molar of the upper jaw (view of the occlusal surface), mounted on both sides.

In FIG. 5 shows the key for activating the expansion screw.

The proposed method is carried out using an expansion screw containing a screw housing 1, an activation lock 2 with an activation hole 3, an activation screw with a thread 4, a guide rod 5, a washing hole 6 that is mounted on the orthodontic crowns of the second molar 7 and the first molar 8, orthodontic crowns on the second premolar 9, the first premolar 10 and the first molar 8 are soldered together, the lock 2 screws, thread 3 for the key, the guide rod 5 of the screw

The device consists of orthodontic crowns and the expanding screw “Vector 80 maxi”. Orthodontic crowns are made by selective laser melting [Tara MA, Eschbach S, Bohisen F, Clinical outcome of metal-ceramic crowns fabricated with laser - sintering technologi. Int J Prosthodont 2011; 24: 46-8.], [Williams RJ, Bibb R, Collis J. Use of CAD / CAM technology to fabricate a removable partial denture framework. J Prosthet Dent 2006; 96: 96-9], which consists in directing the laser onto a substrate consisting of a thin layer of cobalt-chromium powder. The laser beam hits the powder, melting it, and the powder particles are combined. The laser beam moves in a given trajectory and creates layer by layer thin layers of material, sequentially sintering them with each other.

Orthodontic crowns are installed on the first and second premolars, the first and second molars of the upper jaw. Depending on the clinical case, the apparatus can be used for both unilateral and bilateral distalization of the second molars of the upper jaw. Orthodontic crowns on the first and second premolar and first molar are welded together by laser welding to strengthen the support.

The expanding screw "Vector 80 maxi" for distal movement is installed on the first and second molars from the vestibular side.

The screw installation for orthodontic crowns is carried out by laser welding (laboratory stage) to increase the strength of the apparatus. The guide rod of the screw is cut off to prevent injury to the mucous membrane during movement of the jaws. Activation of the device is achieved by acting on the screw. A special key, which comes with a set of expansion screw "Vector 80 maxi", is placed in the lock of the screw and perform translational motion, due to which the screw expands. The rotation of the screw is made in the direction from top to bottom until a feeling of pressure appears. There is the possibility of constant control over the movement of the second molar of the upper jaw. The screw is activated daily at night. Within 7 days, the distance between the teeth is about 1 mm. The activation of the device is carried out for 1-2 months to achieve the desired result. Then the device is removed, and the stage of orthodontic treatment begins using the bracket system. The use of the proposed device is advisable in a permanent bite, when in the dentition there are already permanent premolars and molars; as well as in the absence of third molars of the upper jaw.

The movement mechanism is as follows. The active element - the screw causes a force directed to move the molar of the upper jaw distally. The screw is activated by acting on the screw lock with a special key. The key is placed in the screw lock hole and the screw is rotated in a top-down direction. A turn of the screw by one revolution provides an expansion of the space between the teeth by 0.1 mm, which is necessary for the distalization of the molar.

The technical result achieved by the device for distalization of the molar of the upper jaw is body movement of the second molar of the upper jaw, optimization of conditions for further orthodontic treatment.

The fundamental difference between this method and the prototype is the absence of a palatine basis, which allows for minimal discomfort; the manufacture of orthodontic crowns by selective laser melting makes it possible to ensure their strength and reliable fixation and to prevent damage to the apparatus at the stage of orthodontic treatment; achieved body movement of the second molar of the upper jaw in the shortest possible time.

The advantages of the proposed method over the well-known is that there are no inconveniences associated with the use of the apparatus due to the lack of palatal basis. A dosed load effect is achieved on the second molar of the upper jaw, which eliminates the negative effect on periodontium. Fabrication of the structure by laser welding provides hanging strength of the apparatus, eliminating the possibility of breakage at the stage of orthodontic treatment. Rapid body movement of the second molar of the upper jaw allows you to reduce the time of orthodontic treatment. The proposed invention is quite simple to activate, which reduces the number of visits to the doctor - orthodontist. The ability to conduct complete oral hygiene can reduce the risks of tooth decay.

Clinical example

Patient: Tatyana V., 26 years old. Diagnosis: Distal occlusion. The crowded position of the teeth of the upper jaw in the front. Tooth 28 is missing. Treatment: Removing the silicone impression from the upper and lower jaw. Obtaining a gypsum model of the upper and lower jaw. Installation of models in the occluder. Next, scan gypsum models of the upper and lower jaw. Orthodontic crowns for teeth 2.4, 2.5, 2.6 and 2.7 are made by the method of selective laser melting (laboratory stage). Next, try and fit the orthodontic crowns 2.4, 2.5, 2.6 and 2.7 teeth in the oral cavity. A silicone impression is removed from the upper jaw along with orthodontic crowns. A gypsum model is made on which orthodontic crowns are already installed. The contact surfaces of the crowns 2.4, 2.5 and 2.6 of the teeth are connected together by laser welding (laboratory stage). Make fitting and fitting crowns in the oral cavity. Remove the silicone impression from the upper jaw. A gypsum model is made, orthodontic crowns of teeth 2.4, 2.5, 2.6, connected in one design, and an orthodontic crown 2.7 are installed on it. Using the laser welding method, an expanding screw “Vector 80 maxi” is installed on orthodontic crowns of teeth 2.6 and 2.7 (laboratory stage). Set the resulting structure in the oral cavity. Activate the device with a hook and screw lock for 1 revolution in the direction of top-down. The patient is given recommendations. At the control examination after 7 days, the distance between the orthodontic crowns of teeth 2.6 and 2.7 was 1 mm. It was decided to continue the activation of the device. At the control examination on day 14, the distance between the orthodontic crowns of teeth 2.6 and 2.7 was 2 mm. It was decided to continue the activation of the device. At the control examination on day 21, the distance between the orthodontic crowns of teeth 2.6 and 2.7 was 1 mm. It was decided to continue the activation of the device. At the control examination on day 28, the distance between the orthodontic tooth crowns 2.6 and 2.7 was 3.9 mm. It was decided to continue the activation of the device. At the control examination on day 35, the distance between the orthodontic tooth crowns 2.6 and 2.7 was 4.5 mm. The necessary result has been achieved. It was decided to remove the device and begin the stage of orthodontic treatment using the bracket system.

The proposed method can be used by dentists orthodontists in municipal outpatient dental institutions, in private dental offices and clinics.

The present invention allows to achieve body movement of the second molar of the upper jaw and optimize the conditions for further orthodontic treatment. The advantages of the proposed method over the well-known is that there are no inconveniences associated with the use of the apparatus due to the lack of palatal basis. A dosed load effect is achieved on the second molar of the upper jaw, which eliminates the negative effect on periodontium. Fabrication of the structure by laser welding provides hanging strength of the apparatus, eliminating the possibility of breakage at the stage of orthodontic treatment. Rapid body movement of the second molar of the upper jaw allows you to reduce the time of orthodontic treatment. The proposed invention is quite simple to activate, which reduces the number of visits to the doctor - orthodontist. The ability to conduct complete oral hygiene can reduce the risks of tooth decay.

Claims (1)

A method for distally moving a second molar of the upper jaw, comprising corpuscular movement of a second molar of the upper jaw in the distal direction by means of an expanding screw and orthodontic crowns, wherein the orthodontic crowns are made by selective laser melting and installed on the first and second premolars and the first and second molars, the crowns being the first and second premolars and the first molar are welded together by laser welding to strengthen the support, the expanding screw “Vector 80 maxi” is installed pour on the orthodontic crowns of the first and second molars from the vestibular side, and the guide rod of the screw is cut off, then the device is activated with a key and screw lock for one or several revolutions until a pressure sensation appears, they are activated for 1-2 months until the necessary further orthodontic treatment, the distance between the first and second molars of the upper jaw.

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