RU2706545C1 - Method for determining the effectiveness of dental treatment - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to dentistry. Method comprises the following steps: determining area of occlusal contacts and distribution of force of compression of teeth between right and left side using apparatus T-Scan III before and after dental treatment and recorded on personal computer, is analyzed using an Adobe Photoshop computer program and compared with a reference obtained experimentally. Values are recorded before the orthopedic treatment and afterwards. Substituting the values into the formula of the invention, the patient's clinical effectiveness indicator is calculated. Value of more than one modulus is considered to be a successful chewing denture.

EFFECT: invention provides the possibility of objective assessment of quality of dental intervention / correction in such an aspect as chewing.

1 cl, 4 dwg, 2 ex

Description

The invention relates to medicine, in particular to dentistry and can be used to determine the restoration of chewing function after dental treatment (orthopedic, therapeutic).

From the existing level of technology there is a known method for determining chewing effectiveness, including including the registration of the area of occlusal contacts using a wax plate - occlusion.

In the known method, it is proposed to soften the base wax plate, fold it in half. Between the halves of the plate is placed copy material. Insert the plate into the oral cavity. The plate is placed between the teeth of the upper and lower jaws of the patient, followed by closure of the dentition [1].

The disadvantages of this method include: low information content (does not allow the control of premature tooth contact directly in the patient’s oral cavity); the possibility of deformation of the wax when removing the plate from the oral cavity; the complexity of the process of transferring occlusiogram data to plaster models of the jaws; subjective assessment of the area of occlusal contacts.

The closest technical solution (prototype) is a technique for calculating the area of facets for tooth erasing in patients. A known method of electronically determining the area of occlusal contacts involves performing an occlusiography with a T-Scan apparatus, then processing a digital image of the occlusal contacts using a special program. Processing the prepared graphs in Adobe Photoshop with the calculation of the number of pixels in 1 mm ² and the calculation of the total area of the occlusal contacts, taking into account color indexation, reflecting the degree of intensity of the occlusal contacts [2].

The disadvantages of the prototype include:

- there is no specific formula that determines the result of dental treatment or the degree of approximation to the standard;

- the method is applicable only to characterize the facet area with increased tooth abrasion;

- the method is not applicable for evaluating the results of orthopedic or therapeutic dental treatment.

The problem to which the claimed invention is directed is to develop a method for determining the effectiveness of dental treatment, which allows to objectively evaluate the function of chewing after dental treatment and to determine the degree of restoration of chewing effectiveness using various types of dentures or restorations by comparing the results of patients with a standard obtained experimentally, identifying the dependence restoring chewing effectiveness from various factors using specific formulas.

The technical result of this method is: the possibility of an objective assessment of the quality of the performed dental intervention / correction in such an aspect as chewing, by changing the area of occlusal contacts.

The problem is solved due to the fact that in the method for determining the effectiveness of dental treatment after prosthetics or tooth restoration, the following differences are provided: the new one is that experimentally obtained benchmarks for the total area of occlusal contacts and the difference in the distribution of compressive strength of the teeth. Registration of indicators is carried out not only immediately after dental treatment, but also before it. In this way, the quality of the prostheses or restorations made is evaluated in terms of chewing effectiveness.

The essence of the proposed method is as follows:

Determination of the area of occlusal contacts using the T-Scan III apparatus. The width of the upper central incisor of the patient is measured, and this value is entered in the corresponding column in the "Patient record" window. Before the procedure, the patient was carefully instructed. Then, a sensor pre-selected for the size of the upper dentition was placed between the upper and lower teeth of the patient and the patient was asked several times with an effort to compress and then unclench the teeth. Of the scans obtained, the most accurate was chosen. The data of the windows of the two-dimensional film was stored in a single resolution and further measurements were carried out with them. Then they simplified the picture, removing everything except the occlusal contacts. The obtained screenshots were saved with their subsequent playback in the program Adobe Photoshop. We made a scaling so that the size of the sensor itself from the T-Scan III device corresponded to the resulting graph as follows:

- measured the width in the area of the base and branching of the large sensor of the T-Scan III, which are constant and are 25 and 10 mm, respectively;

- set the line width in the area of the base and branch 25 mm and 10 mm, respectively, with a virtual tool;

- calculated using the virtual tool "ruler" how many pixels are 10 mm,

length, which amounted to 106 pixels, therefore, in 1 mm 10.6 pixels, and in 1 mm ² = 112.36 pixels (10.6 X 10.6).

The total area of occlusal contacts was calculated.

The distribution of chewing pressure on the right and on the left side (balance of occlusion) was also taken into account, which was expressed in the difference between their percentage ratio. A difference of more than 5% was considered a deviation from the norm.

Received two indicators:

S is the total area of occlusal contacts,

P is the distribution of the compression force of the teeth.

These are indicators - before treatment (S _{before treatment} , P _{before treatment} ). The numbers are fixed. The next step is to conduct the same tests under the same conditions and in the same patient, immediately after orthopedic treatment - this will be an indicator of the total area of occlusal contacts and the distribution of compressive strength of the teeth after treatment - S _{before treatment} , P _{after treatment} ). Next, the differences (BP) between the total area of the occlusal contacts (SN) are calculated (the indicator was found empirically for a group of individuals with intact dentition and orthognathic bite that do not have any structures in the oral cavity) and S _{before treatment} (BP-1) and S _{after treatment} (BP-2). They calculate their ratio, which will be an indicator of the effectiveness of treatment and will give an objective assessment of the successful or vice versa unsuccessful dental treatment, as well as the difference in the distribution of chewing pressure. The general formula is as follows:

Where:

PEL - indicator;

BP 1 - difference value 1

BP 2 - difference value 2

SN - total area of occlusal contacts is normal

S _{before treatment} - total area of occlusal contacts before treatment

S _{after treatment} - total area of occlusal contacts after treatment

The invention allows to establish the effectiveness of the provided dental treatment according to objective indicators - the area of occlusal contacts and the difference in the distribution of the compression force of the teeth.

The possibility of carrying out the claimed invention is shown by the following example.

Example 1. Patient A, 26 l. He complained about the destruction of the tooth crown 36. The diagnosis was made: Defect of the hard tissues of the tooth 36. A treatment plan was drawn up. Before starting treatment, occlusionography was performed using the T-Scan III apparatus and its analysis was carried out - FIG. one.

All occlusal contacts are highlighted. The number of pixels of the selected area (red mark) is 15523 px. It is known that in 1 mm ² - 112.36 px. Therefore: 15523 ÷ 112.36 = 138.15 mm ² , which is a clear pathology. Chewing force distribution: on the right - 55.3%; on the left - 44.7%, i.e. chewing power is not evenly distributed.

After implementing the treatment plan, the patient underwent the same analysis - FIG. 2.

All occlusal contacts are highlighted. The number of pixels of the selected area (red mark) is 17087 px. It is known that in 1 mm ² - 112.36 px. Therefore: 17087 ÷ 112.36 = 152.1 mm ² . Chewing force distribution: on the right - 52.0%; on the left - 48.0%, i.e. chewing force is distributed almost evenly (a difference in the distribution of chewing pressure of 5% is acceptable).

Substituting the values in the formula of the methodology:

Receive:

что показывает успешное восстановление жевательной функции у данного пациента, после протезирования.

which shows the successful restoration of chewing function in this patient after prosthetics.

Example 2. Patient K., 48 l. He complained of destruction 36, pain when biting. The diagnosis was made: Crack in the area of root bifurcation 36. A treatment plan was drawn up. Before starting treatment, occlusionography was performed using the T-Scan III apparatus and its analysis was carried out - FIG. 3.

All occlusal contacts are highlighted. The number of pixels of the selected area (red mark) is 18802 px. It is known that in 1 mm ² - 112.36 px. Therefore: 18802 ÷ 112.36 = 167.34 mm ² , which is a pathology. Chewing force distribution: on the right - 51.7%; 48.3% on the left, i.e. chewing force is distributed almost evenly (a difference in the distribution of chewing pressure of 5% is acceptable).

After implementing the treatment plan, the patient underwent the same analysis - FIG. 4.

All occlusal contacts are highlighted. The number of pixels of the selected area (red mark) is 20771 px. It is known that in 1 mm ² - 112.36 px. Therefore: 20771 ÷ 112.36 = 185 mm ² . Chewing force distribution: on the right - 49.3%; on the left - 50.7%, i.e. chewing force is distributed almost evenly (a difference in the distribution of chewing pressure of 5% is acceptable).

Substituting the values in the formula of the methodology:

Receive:

что показывает успешное восстановление жевательной функции у данного пациента, после протезирования.

which shows the successful restoration of chewing function in this patient after prosthetics.

Bibliography

1. Sadykov M.I. Melenberg T.V. - patent RU 2195900.

2. Arutyunov S. D., Brutyan L. A., Antonik M. M., Scherbakov V. V. "A new technique for calculating the area of facets for tooth erasing." Bulletin of the Kazakh National Medical University No. 1-2018, pp. 530-532.

Claims (3)

A method for determining the effectiveness of dental treatment, including a computer analysis of the chewing effectiveness of patients, characterized in that they compare the area of occlusal contacts before and after the dental treatment with a standard determined empirically using the derived formula by mathematical calculation:

where PEL is an indicator; BP 1 - difference value 1, BP 2 - difference value 2, SN - total area of occlusal contacts is normal, S _{before treatment} - total area of occlusal contacts before treatment, S _{after treatment} - total area of occlusal contacts after treatment and with a PEL> 1 restoration of masticatory function in this patient is considered successful.

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