RU2710927C1 - Orthodontic apparatus for distalization of molars and premolars and method of using it - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: group of inventions refers to medicine, namely to dentistry, and is intended for use in distalization of molars and premolars. For distalization, an orthodontic apparatus is used, comprising a plastic palate support with an orthodontic screw, a support and distalising tabs connected to the orthodontic screw, as well as an orthodontic ring which is connected to the distalising tab by an integral joint, wherein distalising tab is made of steel wire with cross-section of 0.9–1.1 mm. Braces are fixed on 17th, 16th, 15th, 14th, 24th, 25th, 26th, 27th teeth and leveling is performed on partial arcs, then installing an orthodontic apparatus for distalization so that the plastic base rests against the palate, the orthodontic rings are mounted on the molars, and the opening spring is mounted on the bracket arch between the first and second molars, further, the apparatus is activated so that the front roller abuts against the hard palate as a result thereof; after distalization of the second molars on the arc, composite stoppers are placed before the second molars, and the rest of the arc is cut off from the distal side and further activation of the apparatus is performed; after distalisation of the first molars between the first and second premolars, an opening spring is inserted; after distalization of second premolars, they are tied to 17, 16 and 27, 26 teeth with the help of metal ligature, support lugs are cut off from the first premolars and with a chain or closing spring distalised the first premolars, then, the bracket system is installed on canines and cutters and the cutters are leveled in the course of premolars distalization on a partial frontal arch, after which the orthodontic apparatus is removed.EFFECT: inventions allow improving reliability of teeth retention during distalization and simplifying the treatment process with improvement of its quality.11 cl, 1 tbl, 2 dwg, 3 ex

Description

The invention relates to medicine, namely to dentistry, in particular to an orthodontic apparatus for distalizing molars and premolars.

Known orthodontic apparatus for distalization (Orthodontic apparatus for normalizing the shape and size of the dentition: patent 2189196, Russian Federation; application No. RU 2000105574; application. 09.03.2000; publ. September 20, 2002), which contains a mouth guard with tooth rings and with working sleeves . A power arc made of metal with shape memory is installed in the working bushings. The power arc has ends placed with the possibility of interaction with thrust bushings on the tooth rings. Working bushings have slots for installing a power arch made with a diameter of 0.45-0.5 mm and a length corresponding to the size of the correct dentition. Kappa is made in the form of three moving parts, interconnected by a power arc. Working sleeves are fixed on the oral surfaces of the moving parts. The working and thrust bushings are made of metal or plastic.

The disadvantages of the technical solution are the relatively low reliability of tooth retention, the difficulty in manufacturing and the high risk of protrusion of the incisors when using this device. The relatively low reliability of tooth retention is due to the lack of a tight connection between the orthodontic rings and the apparatus. This is due to the fact that this unit is intended only for distalization, in which fixation by means of a detachable connection is sufficient, and not for holding. The difficulty lies in the fact that this device uses individual rings, bushings and guides (requiring specialized production). The risk of protrusion of the incisors arises due to the fact that when using this device, only tooth support is provided. In addition, this device is less comfortable for the patient and more bulky (a larger volume of plastic makes hygiene difficult).

Known orthodontic apparatus for the distalization of teeth with end defects of the dentition (Orthodontic apparatus for the distalization of teeth with end defects of the dentition: patent 2181574, Russian Federation; application RU 2001105464; claimed. 02.26.2001; publ. 27.04.2002). The device contains orthodontic rings, guides on the rings and a converting element of material with shape memory. The converting element is made in the form of a U-shaped wire arc enveloping the movable tooth in the bending zone. The rectilinear sections of the arc are located along the dentition, enveloping it from two sides. Using metal ligatures, the wire arc is labilely set with its straight sections in the slots of the guides. The guides are made in the form of open cylindrical bushings and are installed from the vestibular and oral surfaces of orthodontic rings. The slots of the guides are oriented horizontally relative to the longitudinal axis of the sleeve and perpendicular to the vertical axis of the tooth. In one straight section or symmetrically in another section of the arc between the tooth being moved and the teeth, medial to it, a spiral spring is made from the same wire and for the same wire, in which the difference between the extended and compressed position is equal to the distance of tooth movement and the length of the arc section from the end of the last guide to the end of the arc, which is equipped with a movement limiter.

The disadvantages of this technical solution are the relatively low reliability of tooth retention, the difficulty in manufacturing, the risk of protrusion of the incisors and the inability to increase the distalization from the planned one. The relatively low reliability of tooth retention is due to the lack of strong fixation of the orthodontic rings on the device, since this device is intended only for distalization, and not for retention. The difficulty in manufacturing is due to the need to use factory-made guide bushings and cylinders with individual parameters. The risk of protrusion of the incisors arises due to the fact that when using this device, only teeth are used as a support. The inability to increase the distalization from the planned one is due to the fact that it is necessary to install guides and a nitinol spring of the required size (depending on the necessary tooth movement) in the device before treatment begins. During treatment, this distance can only be adjusted with the removal of the apparatus.

Known orthodontic apparatus for distalization (Orthodontic apparatus for distalization: patent 6908306, United States of America; application No. US 20010999269; claimed. 15.11.2001; publ. 15.05.2003). The device comprises an arc of at least one force-generating element located between the force-dispersing element (e.g., the Nance button) attached to a hard palate or alveolar ridge and the first tooth (e.g., a molar) to be distilled. The device also contains individual rings on the second premolar. In the illustrated embodiment, the device comprises at least two force generating elements, each of which includes an elongated guide element (rod), respectively. Each force generating element also further comprises a connected compression spring, which is slidably mounted on a corresponding guide element (rod) within the limits determined by the adjustable spring stops.

The disadvantages of this technical solution are the relatively low reliability of tooth retention, difficulty in manufacturing and relatively high returns to the frontal group of teeth (provided that the first two and two second molars are distilled at once). The relatively low reliability of tooth retention is due to the appointment of the device exclusively for distalization and, accordingly, the lack of a tight connection of the rings with the device. The difficulty in manufacturing is explained by the use of individual rings on the second premolars and factory-made bars (not available on the market) that are compatible only with this device. The relatively high return to the frontal group of teeth is due to the fact that when using the device, distalization begins from the first and second molars at the same time. Provided that distalization begins from the second molars, it is necessary to increase the number of structural elements, which further complicates the manufacture of the apparatus, and also after distalization of the molars, it will be necessary to remove the apparatus for distalizing premolars, which can provoke a relapse (for example, reverse mesialization of a previously distalized tooth).

A known device for distalization (Method and device for the distal movement of molars and fangs: patent 5829970, United States of America; application No. US 19960639291; declared. 16.01.1996; publ. 03.11.1998). The apparatus contains a plate molded according to the shape of the sky and connected to the teeth through orthodontic rings and springs.

The disadvantages of this technical solution are the relatively low reliability of tooth retention, the difficulty in manufacturing and the lack of distalization of premolars and canines. The relatively low reliability of tooth retention is due to the lack of strong fixation on the apparatus of orthodontic rings. The difficulty in manufacturing is due to the need to use factory rods that are not commercially available. There is no possibility of distalizing premolars and fangs, since premolars are supporting. In addition, the above apparatus, when used, blocks most of the palate, which significantly complicates hygiene, worsens diction, and also increases the risk of tooth decay on incisors and canines.

A known apparatus for distalization (Device for molar distillation of the frog type: patent 203539458, People's Republic of China; Application No. CN 20132520642; Declared Aug. 23, 2013; Publ. Apr 16, 2014). The device contains a palatine support, support legs, a spiral, vertical force rings (orthodontic rings), adjustable side guides and molar distalizing legs. This device is the closest in technical essence to the claimed and is taken as a prototype of the claimed orthodontic apparatus.

The disadvantage of the prototype is the relatively low reliability of tooth retention due to the lack of a tight connection and the presence of a gap between the orthodontic ring and the distalizing foot, which are connected using a tube on the orthodontic ring and a loop on the distalizing foot. Another disadvantage is the simultaneous distalization of the first and second molars, which increases the risk of recoil to the incisors and increases the difficulty of activating the distalizing springs in the oral cavity after fixing the device. In addition, the prototype apparatus cannot be holding for distalized molars and is pendulum, which increases the likelihood of molar deviation (uprating) during distalization.

A known method of distalization of the lateral group of teeth of the upper jaw (Method of distalization of the lateral group of teeth of the upper jaw: patent 2561892, Russian Federation; application No. RU 2014145498; claimed 12.11.2014; publ. 10.09.2015), including the installation of an orthodontic mini-implant in the upper region the jaw, the installation of the bracket system to the second molars, the leveling of the teeth of the upper jaw, the distalization of the lateral teeth of the upper jaw, characterized in that the orthodontic mini-implant 10-12 mm long is installed at the stage of full-sized steel arcs in the region part of the upper jaw tuber so that the axis of the implant is parallel to the axis of the tooth and the implant head is at the level of the bracket groove, fix the lingual button on the palatal surface of the second molar, apply elastic traction from the bracket of the second molar to the mini-implant and then to the lingual button followed by alternate corpus distalization of the lateral group of teeth.

The disadvantage of this method is the complexity of its implementation, as well as a relatively large number of contraindications. The complexity of this method is due to the need to perform cone beam computed tomography before installing a mini-implant, as well as the need for surgical intervention when installing a mini-implant. At the same time, the installation of a mini-implant due to the risks of rejection of the mini-implant, infection and inflammation is contraindicated in some cases, namely during pregnancy, diabetes, autoimmune diseases, blood clotting problems, inflammation of the oral mucosa and malfunctioning of the endocrine system.

A known method of moving teeth in patients with distal occlusion (Method of moving teeth in patients with distal occlusion: patent 2641000, Russian Federation; application No. RU 2017100719; application. January 10, 2017; publ. January 12, 2018), containing the installation of a bracket system "Damon "Ormco firms until the first molars, not including the second premolar, removing the silicone impression of the upper and lower jaws and obtaining a gypsum model of the upper and lower jaws, installing the model in an occluder, making orthodontic crowns on the second premolar and second upper molars the jaw by stamping, fitting the design in the oral cavity, removing the silicone impression together with the orthodontic crowns and making the gypsum model; on the gypsum model, the orthodontic crowns are brazed to the palatal wire arch using silver-palladium solder and the soldering of wire processes to the vestibular and palatine surfaces of the second , the ends of the wire processes are rounded with a drill, bleach, grind and polish the structure, then install the structure in polo of the mouth, set the orthodontic button on the palatine surface of the first molars, set the orthodontic chains on the palatine and vestibular surfaces on each side, at the control examinations reveal the distal movement of the teeth 2.6 and 1.6, continue treatment until the desired result is achieved, then remove the device and begin the stage of the orthodontic Bracket system treatments. The above method was taken as a prototype of the proposed method, as it is the closest in the sequence of actions in general.

The disadvantage of this method is the complexity of its implementation, and the relatively low reliability of tooth retention. The complexity of the implementation is due to the need to take a cast to obtain a plaster model and use the Ormco "Damon" bracket system. Also, the complexity of the method is influenced by the use of a palatal arch, in which there is no orthodontic screw, which makes it impossible to activate during treatment. The relatively low reliability of tooth retention is due to the installation of an orthodontic button on the palatal surface of the molars.

The technical problem lies in the need to develop an easy-to-manufacture orthodontic apparatus for the distillation of molars and premolars, devoid of the above disadvantages, while maintaining the quality of treatment, as well as to develop an optimal method for distalizing molars and premolars using this apparatus.

The technical result consists in increasing the reliability of tooth retention in the process of distalization, as well as in simplifying the treatment process with improving quality.

The technical result is achieved by the fact that in an orthodontic apparatus for distalization, including a plastic palatine support with an orthodontic screw, a supporting and distalizing tabs connected to the orthodontic screw, and also an orthodontic ring connected to the distalizing tab, according to the invention, the orthodontic ring is connected to the distalizing tab with an integral connection while the distalizing foot is made of steel wire with a cross section of 0.9-1.1 mm

The technical result is also achieved by the fact that in the method of distalizing molars and premolars, including the installation of braces, the subsequent installation of the orthodontic apparatus, the further installation of the chain (elastic chain) and the completion of distalization using the bracket system, according to the invention, the braces are set to 17, 16, 15, 14, 24, 25, 26, 27th teeth and carry out the leveling stage on partial arcs, then set the orthodontic apparatus for distalization according to claim 1 so that the plastic base rests in the sky, orthodontic the lozenges were installed on the molars, and the opening spring was installed on the arch of the braces between the first and second molars, then the apparatus is activated so that as a result the front roller rests against the hard sky, after distalization of the second molars, composite stoppers are placed on the arc in front of the second molars, and the remainder of the arc from the distal side is cut off by a turbine and the apparatus is further activated, after the first molars are distilled, an opening spring is installed between the first and second premolars, after the distal The second premolars are tied to the 17th, 16th and 27th, 26th teeth using metal ligatures, the support legs are cut off from the first premolars and the first premolars are distilled with a chain (elastic chain) or closing spring, after which the bracket system is placed on the canines and incisors and the incisors are leveled during the distalization of the premolar on a partial frontal arch, after which the orthodontic apparatus is removed. Orthodontic rings are mounted on molars using glass ionomer cement. After the distalization of the second molars occurs, composite stoppers are placed on the arc in front of the second molars. Distalization (retraction) of canines and incisors is carried out using an arc of titanium - molybdenum alloy (TMA) with a cross section of 16-22 mm or 17-25 mm on the "T" loops. The orthodontic apparatus is removed after complete distalization (retraction) of the incisors.

The inextricable connection of the orthodontic ring with the distalizing tab allows you to get a tight connection, which ensures the fixation of the apparatus in the oral cavity when removing the supporting legs required to use the apparatus as a retainer.

The implementation of the distalizing tab of steel wire with a cross section of 0.9-1.1 mm is necessary to ensure optimal characteristics of deformation and elasticity. If the above range is exceeded, the force on the tooth will be too large, which will require frequent activation or will entail severe pain. When using steel with a thickness below 0.9 mm, the distalizing foot becomes too elastic and prone to deformation, which negatively affects the reliability of retention.

In the most preferred embodiment of the invention, the support legs are made of steel wire with a cross section of 0.6-0.8 mm If the specified range is exceeded, the support foot will not be flexible enough to fit on the abutment. When using a wire with a cross section below 0.6 mm, the flexibility of the support foot will be too high, which negatively affects the fixation of the apparatus in the oral cavity. Also in the most preferred embodiment of the invention, the support legs are fixed on the photopolymer composite material to the premolars, which increases the reliability and efficiency of the apparatus.

The selection of the optimal thickness parameters of the steel from which the distalizing foot is made was made as follows. It was made 28 devices with different cross-sections of the wire distalizing paws. Namely: with a cross section of 0.8 mm - 6 pcs.; with a cross section of 0.9 mm - 6 pcs; with a cross section of 1 mm - 6 pcs; with a cross section of 1.1 mm - 4 pcs.; with a cross section of 1.5 mm - 4 pcs. The manufactured devices were installed in 28 patients for 16 months, taking into account the fact that during the distalization of molars, the load on the tooth should vary between 150-250 g. In the treatment involving 5-7 screw activations (two turns), the load on the ring 150-250 is achieved by performing a distalizing tab from a wire with a cross section of 0.9-1.1 mm. The load was measured due to the deviation of a piece of wire (20-25 mm) using a dynamometer (cantor weights) by 2 mm. In the case of a distalizing tab made of a thicker wire, the load exceeds 250 g., And in the case of a thinner wire, the load becomes lower than 150 g.

To compare the results, a teleradiography was performed (hereinafter referred to as “TRG”) of the head in lateral projection before treatment and TRG-1 after distalization of the first molars, and TRG-2 after distalization of canines and incisors.

The axes and points used in the calculations: the X axis is the occlusal plane drawn through the cutting edge of the maxillary incisors and the mesial tubercle of the second maxillary molar. The Y axis is the perpendicular from the PNS point to the X axis. Point A is the distal point at the equator of the first molar. The distance from Y to A is the desired value of distalization, from Y to A1 is the distance after distalization of the first molar, from Y to A2 is after distalization of fangs and incisors. The calculation results are presented in the table.

According to the table, with a wire cross section of 0.8 mm Y-A2, the maximum loss of distalization (reverse mesialization of molars occurred). Retention characteristics are the worst. And with a wire cross section of 1.5 mm, the holding characteristics are the best, but the table does not show that with a wire cross section of more than 1.1 mm for 5-7 activations of the screw is impossible. Therefore, visits to these patients were carried out every two weeks, which is not optimal for treatment and patient comfort. The most optimal range of Y-A2 and visits once every 1.5 months was shown by an apparatus with a cross section of 0.9-1.1 mm.

The inventive device is illustrated in the drawing, where in FIG. 1 shows an orthodontic apparatus, a top view of the layout of the upper jaw, and in FIG. 2 shows an orthodontic apparatus in axonometric projection on a prototype of the upper jaw.

The orthodontic apparatus for distalization includes a plastic support of the palate, consisting of a frontal roll 1, a main plastic base 2 and a distal plastic base 3. The frontal roll 1 is rounded and its thickness is 2.5-3.5 mm. The main plastic base 2 is made in such a way that during use it fits snugly against the sky. The distal plastic base 3 is designed so that when used it is at a distance of 1.5-2.5 mm. from the sky. The front roller 1 is connected to the main plastic base 2 closely during molding, and the distal plastic base 3 is connected to the main plastic base 2 with the help of the orthodontic screw 4. Moreover, the middle part of the orthodontic screw 4 is not covered by the elements of the plastic support of the sky to maintain the possibility of activation. With the main plastic base 2 by molding connected supporting foot 5, made of steel wire with a cross section of 0.6-0.8 mm With the distal plastic base 3 are connected distalizing tabs 6 made of steel wire with a cross section of 0.9-1.1 mm An orthodontic ring 7 is connected to the distalizing foot 6 by means of a permanent connection (for example, soldering). The orthodontic ring is fixed to the tooth using glass ionomer cement (for example, Fuji 1). Braces 8 are attached to the orthodontic ring 7. An opening spring 9 is additionally installed on the braces of the braces 8. Composite stoppers (not shown in the drawing) can also be installed on the braces 8 during the treatment.

The proposed orthodontic device for distalization is simple to manufacture and involves the use of standard and affordable materials. The inventive method is as follows.

If necessary, on the 17th, 16th, 15th, 14th, 24th, 25th, 26th, 27th teeth, install braces 8 and carry out the leveling stage on partial arcs, starting with NiTi 14 and ending with SS 17 # 25. After that, a mold is taken from the upper jaw and the apparatus is made. Then the apparatus is installed in such a way that the main plastic base 2 rests against the sky, the orthodontic rings 7 are mounted on the molars, one tooth on each side (16, 26 or 17, 27), and the support legs are mounted on the corresponding pair of premolar (15 25 or 14, 24) and are fixed on a photopolymer composite. In this case, the orthodontic rings 7 are mounted on the molars using glass ionomer cement. Also, between the first and second molars, an opening spring 9 is installed on the bracket bracket 8. Then, the apparatus is activated by unscrewing the orthodontic screw 4, the front roller 1 abuts against a hard palate. The second molars are distilled due to the brackets 8 and the opening spring 9, additionally mounted on the arc of the brackets 8 between the first and second molars. At the same time, at this stage all other teeth and the palate are supported. After distillation of the second molars, composite stoppers are installed on the mesial side in front of the second molars on the brace arc 8, the remainder of the arc is cut off from the distal side by the turbine and the first molars are distilled due to the next activation of the apparatus by additional unwinding of the orthodontic screw 4. After the composite stoppers are installed on the arc before the second molars, and the remainder of the arc from the distal side is cut off by a turbine. At the same time, all other teeth and the palate are supportive. After distalization of the first molars, an opening spring 9 is installed between the first and second premolars on each side. Then, after distalization of the second premolar, they are tied to the 17th, 16th and 27th, 26th teeth with the help of a metal ligature. The support legs 5 are cut from the first premolars and the first premolars are distalized with a chain (elastic chain) or closing spring. All other teeth and palate are also supported. At this stage, the device turns into a support-holding device (analogue of the Nance button). During the distalization of the first molars, the orthodontic screw 4 is untwisted. If it is necessary to distal the teeth to a greater distance than that provided by the screw thread, the working screw length can be increased. The screw is dried and the distal ends of the thread are poured with a fluid composite, and then illuminated with a photopolymerization lamp (the center of the orthodontic screw 4 is left free from the composite). Then carry out further activation according to the treatment plan until its end. Next, install the bracket system on the fangs and incisors and level the incisors in the process of distalization of the premolars on a partial frontal arch. In this case, the canines and incisors are distalized using an arc made of titanium - molybdenum alloy (TMA) with a cross section of 16-22 mm or 17-25 mm. on the “T” hinges, after which the orthodontic apparatus is removed. If necessary, the apparatus is removed after complete distalization (retraction) of the incisors.

The claimed invention is illustrated by examples.

Example 1

A 12-year-old patient was treated with an aesthetic defect in the dentition. After carrying out all diagnostic measures, a diagnosis was made. Ds: skeletal 1st grade. Narrowing and shortening of the upper jaw, mesialization of 17, 16, 15, 14 teeth by 4 mm. Vestibuloposition 13. Slight crowding of the upper and lower incisors. The ratio of molars: on the 2nd; left 1st grade according to Engle.

An orthodontic treatment was carried out: an orthodontic apparatus was installed, designed for one-sided distalization, and a bracket-system "Forestodent" sprint "for 17, 15, 14 teeth. First, the 17th tooth was distalized on the Niti 18 # 18 arc using a niti opening spring. 4 mm in 4 months. Then the opening spring was removed, a stopper was installed in front of the second molar, and the screw began to be activated for 6 activations at a time every 1.5 months. After 3 months, the first molar was distalized. After that, an opening spring was installed between the premolars. After 2.5 months, there was a distalization of the second premolar. Then they cut off the support foot from the first premolar and began its distalization with a chain. After 2.5 months, there was a complete distalization of the first premolar. After that, the declared orthodontic apparatus was removed, and a bracket system was installed on the remaining teeth. After alignment and correction of fissure-tubercular contacts, the bracket system was removed and retention devices were installed. It took 18 months for the entire treatment period, and the complete bracket system lasted only 7 months. The bite was obtained orthognathic with 1st grade Angle on both sides.

Example 2

A patient at the age of 17 treated with an aesthetic defect in the dentition. After all diagnostic measures, the diagnosis was Ds: skeletal 2nd class, protrusion of the upper incisors by 9 °. The ratio of 6th 2nd grade (tubercle) according to Engle. Sagittal fissure 4.5 mm. Retrusion of lower incisors by 7 °. And their crowding.

Orthodontic treatment was performed. Namely: leveling was carried out on partial arcs of molars and premolars. After 2 months, the inventive orthodontic appliance was installed. During treatment, the Niti arch 18 # 18 and an opening spring between the first and second molars on both sides for 4 months were also used. The result was distillation of 4.5 mm, after which the opening spring was removed, and then the screw was activated. A further 6 activations were performed every 1.5 months. After 4 months, corpus distalization of the first molars was obtained. Then the support legs were cut off and distalization of the premolars with chain began with a change of traction 1 time in 1.5 months. After that, trems were obtained in the area of canines of 3.5 mm on each side. Then, the inspire ice “ormko” bracket system was installed and the fangs and incisors were retruded. After correction of the fissure-tubercle contacts, an orthognathic bite with Engle class 1 was obtained. After that, the bracket system was removed and the retainers were installed. treatment amounted to 22 months, the Declared orthodontic apparatus worked 16 months.

Example 3

A 34-year-old patient complained of an aesthetic defect in the dentition. After carrying out all diagnostic measures, a diagnosis was made. DS: Skeletal 2nd grade. Narrowing and shortening of the upper jaw. Crowding of the upper and slight crowding of the lower incisors. The ratio of 6th grade is 2nd grade according to Engle: on the right is tubercle, on the left is full 2nd grade.

Treatment plans with different options have been drawn up. The patient chose a plan using the inventive orthodontic apparatus.

Leveling was carried out on partial arcs of molars and premolars. After 3.5 months, our distalizer with two screws was installed. A niti spring was installed between the molars on both sides for 3 months on an Niti 16 # 22 arc. After distalization of the second molars, the springs were removed, composite stoppers were installed in front of the 17 and 27 teeth and the screws began to be activated. Spent 7 activations every 1.5 months. On the right, they activated by 14, and on the left by 21. Then, the support legs were cut off and the premolar was distilled by a chain (with a chain change of 1.5 months). Next, a bracket system was installed on the remaining teeth and the bite was corrected. After that, the ratio was obtained according to the 1st class of Engle on both sides.

Then the bracket system was removed and the retainers on HF and LF were installed. The total duration of treatment was 25 months. The distalization on the right (16) was 3 mm, and on the left (26) - 4.8 mm. The distiller worked in the oral cavity for 14 months.

Claims (11)

1. An orthodontic apparatus for distalization, including a plastic support of the palate with an orthodontic screw, a support and distalizing paws connected to the orthodontic screw, and an orthodontic ring connected to the distalizing foot, characterized in that the orthodontic ring is connected to the distalizing foot with an integral connection, the distalizing foot is made of steel wire with a cross section of 0.9-1.1 mm. 2. An orthodontic apparatus for distalization according to claim 1, characterized in that the plastic support of the palate consists of a frontal roller, a main plastic base and a distal plastic base. 3. An orthodontic apparatus for distalization according to claim 1, characterized in that the support legs are made of steel wire with a cross section of 0.6-0.8 mm. 4. An orthodontic apparatus for distalization according to claim 1, characterized in that braces are attached to the orthodontic ring. 5. An orthodontic apparatus for distalization according to claim 4, characterized in that an opening spring is installed on the arc of the braces. 6. An orthodontic apparatus for distalization according to claim 1, characterized in that the support legs are fixed on a photopolymer composite material to the premolars. 7. The method of distalization of molars and premolars, including the installation of braces, the subsequent installation of the orthodontic apparatus, the further installation of the chain of the elastic chain and the completion of the distillation using the bracket system, characterized in that the braces are set to 17, 16, 15, 14, 24, 25, 26, 27th teeth and carry out the leveling stage on partial arcs, then install the orthodontic apparatus for distalization according to claim 1 so that the plastic base rests in the sky, the orthodontic rings are installed on the molars, and the opening ins installed on the arc bracket between the first and second molars, then carry out the activation of the device so as to result in its front roller rested against the hard palate; after distillation of the second molars, composite stoppers are placed on the arc in front of the second molars, and the remainder of the arc is cut off from the distal side and the apparatus is further activated; after distalization of the first molars, an opening spring is installed between the first and second premolars; after distalization of the second premolar, they are tied to the 17th, 16th and 27th, 26th teeth with the help of a metal ligature, the support legs are cut off from the first premolar and the first premolar are distilled with a chain or closing spring, then the bracket system is placed on the canines and incisors and the incisors are leveled into the process of distalization of premolars on a partial frontal arch, after which the orthodontic apparatus is removed. 8. The method for distalizing molars and premolars according to claim 7, characterized in that the orthodontic rings are mounted on the molars using glass ionomer cement. 9. A method for distalizing molars and premolars according to claim 7, characterized in that, after the second molars are distalized, composite stoppers are placed in front of the second molars. 10. The method of distalization of molars and premolars according to claim 7, characterized in that the canines and incisors are distalized using an arc made of a titanium-molybdenum alloy (TMA) with a cross section of 16-22 mm or 17-25 mm on "T" loops. 11. The method of distalizing molars and premolars according to claim 7, characterized in that the orthodontic apparatus is removed after the complete distalization of the incisors.

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