RU2714478C1 - Orthodontic apparatus for denture correction and method of using it - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions includes an orthodontic apparatus for correcting dentitions and a method for use thereof, relates to the field of medicine, namely to dentistry, and aims at providing normal growth of the lower jaw in the sagittal plane. Orthodontic apparatus for correcting dentitions includes a plastic base for placing on a solid palate, orthodontic rings to be fixed on molars, as well as a wire arc, middle part of which is fixed in plastic basis, and end parts are attached to orthodontic rings. On a wire arc between middle part and end parts there are deformed activation loops on which there is at least one turn. Plastic base is equipped with a bite part, wherein the bite part of the plastic base on the distal side is provided with an additional roller. Method of using the orthodontic apparatus consists in that the apparatus is placed in a patient so that the plastic base rests against the hard palate, and the orthodontic rings are fixed on the molars, followed by activating the apparatus. Patient wears the apparatus for two to four months, after which the sagittal fissure is measured and, in the absence or slow mesial growth of the lower jaw, the bite part of the plastic base on the distal side is provided with a plastic roller so that it provides inclination of the plastic base to the occlusal plane at 15–20 degrees. Patient wears modified apparatus for one to two months, followed by additional measurement of sagittal fissure and, if missing or slow mesial growth of lower jaw, the bite part of the plastic base is equipped with a larger plastic roller so that it provides inclination of the plastic base to the occlusal plane at 30–40 degrees, after which the patient wears an additional modified apparatus according to the plan until the end of treatment.

EFFECT: inventions allow improving the reliability of the orthodontic apparatus, as well as providing the conditions for normal growth of the lower jaw in the sagittal plane when treating with using it.

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Description

The invention relates to medicine, namely to dentistry, in particular to an orthodontic apparatus for correcting dentitions and to a method for its use.

Known orthodontic apparatus for separation and correction of dentition (Orthodontic apparatus for separation and correction of dentition: patent 131601, Russian Federation; application No. RU 2013109751; application 05.03.2013; publ. 08.28.2013), including supporting elements fixed on the first molars for fixing the apparatus inside the oral cavity, a plastic base plate placed on the hard palate of the upper jaw, a wire arc fixed by the middle part in the specified plate and attached by two end parts to the supporting elements, I distinguish Make sure that it is completely mounted on the upper jaw, and the supporting elements are mounted on the upper molars, being made in the form of orthodontic rings with lingual locks, into which the U-shaped end parts of the wire arc are arranged tightly parallel to the sagittal plane, and it contains areas of the first premolar or first milk molars deformable omega-shaped or penta-shaped loops to activate the apparatus, the base plate is equipped with a front bite part, contoured Anna on the palatal surface of incisors and canines. This device is the closest in technical essence to the claimed and taken as a prototype.

This device is used as follows: install it to the patient so that the base plate made of plastic (plastic base) rests against the hard palate, and the supporting elements (orthodontic rings) for fixing the device are fixed on the first molars, after which the device is activated and not removed until the end of treatment. During treatment, the patient can slide on the bite of the base plate with the lower incisors to the stop with the upper incisors, due to which the lower jaw extends forward, which contributes to its development. Also, in the course of treatment, it is possible to correct the position of the upper first molars (due to their rotation), adjust the inclination of the molars in the buccal direction and expand the dentition in the molar region, which helps to free up space for erupting permanent teeth exactly in the dentition. At the same time, in the process of treatment, the base plate rests on the incisors in the upper incisors and pushes them forward, which contributes to the treatment of a deep bite with the palatine position of the incisors and the normalization of the occlusal plane. This method is the closest in technical essence to the claimed and adopted as a prototype.

The disadvantages of the above device and the method of its use are the lack of reliability of the device and the slow growth of the lower jaw in the sagittal plane (or its complete absence). The lack of reliability of the device is expressed in the frequent fracture of the steel wire (paws) in the region of the U-shaped end part of the wire arc or in the area of attachment of the orthodontic ring. The slow growth of the lower jaw in the sagittal plane (or its complete absence) is due to the fact that the sagittal gap does not decrease and the lower jaw does not grow or grows too slowly. This leads to an increase in treatment time and the emergence of a stable habit of chewing and facial muscles to keep the lower jaw in the back position.

The technical problem lies in the need to develop an effective and reliable orthodontic apparatus, as well as the method of its use, devoid of these disadvantages.

The technical result consists in increasing the reliability of the orthodontic apparatus, as well as in providing conditions for the normal growth of the lower jaw in the sagittal plane during treatment with its use.

The technical result is achieved by the fact that in the orthodontic apparatus for correction of dentitions, including a plastic base, designed to be placed on a hard palate, orthodontic rings, designed to be fixed on molars, as well as a wire arc, the middle part of which is fixed in a plastic base, and the end parts attached to the orthodontic rings, while on the wire arc between the middle and end parts are made deformable loops for activation, and the plastic base is equipped with a bite part In accordance with the invention, at least one turn is made on deformable loops for activation.

The technical result is also achieved by the fact that in the method of using the orthodontic apparatus, during which the apparatus is installed to the patient so that the plastic base rests against the hard palate, and the orthodontic rings are fixed on the molars (fixed, for example, due to SIC-fuji 1), after why the device is activated, according to the treatment plan, the patient wears the device for two to four months, after which they measure the sagittal gap and, in the absence or slow mesial growth of the lower jaw, the main part of the plastic base from the distal side (add) is provided with a plastic roller so that it provides a plastic base inclination of 15-20 ° to the occlusal plane, then the patient wears the modified device for one to two months, after which an additional measurement of the sagittal gap and, in case of absence or slow mesial growth of the lower jaw, the bite of the plastic base is provided with a larger plastic roller so that it tilts the plastic base to the occlusio hydrochloric plane 30-40 °, after which the patient is further modified apparatus according to the treatment plan.

Performing on deformable loops to activate at least one turn provides increased reliability of the orthodontic apparatus by increasing the elasticity of the loop in the area of the turn. Moreover, in the most preferred embodiment of the invention, two turns are made on each deformable loop for activation. Also in the most preferred embodiment of the invention, the orthodontic rings are equipped with lingual locks, and the end parts of the wire arc are made U-shaped and tightly fixed in these locks, as well as tied with ligature wire (to prevent the apparatus from falling out of lingual locks).

According to the claimed method, the patient wears the device without modifications of the plastic base from two to four months, since within this period it is possible to evaluate the growth of the lower jaw in the sagittal plane. In this case, the exact period in the specified range is selected depending on the treatment plan. The initial modification of the apparatus (the addition of a roller providing a slope of the plastic base to the occlusal plane of 15-20 °) allows for normal growth of the lower jaw in the sagittal plane in the absence (or too slow growth) at the first stage of treatment. At the same time, observing the inclination of the plastic base by adding a roller to the occlusal plane of 15-20 ° allows you to provide the necessary growth (or simply displacement) of the lower jaw and does not cause much discomfort to the patient. The patient gradually gets used to the inclination of the plastic base, the diction has time to be rebuilt, the facial and chewing muscles adapt both at rest and during meals. A larger slope of the basis has a more pronounced therapeutic effect, but it is more difficult for the patient to adapt to such a slope of the basis. Therefore, a gradual increase in the inclination of the basis due to the supply of its roller contributes to greater patient comfort, better adaptation, better cooperation with the doctor and less likelihood of damage to the temporomandibular joint (overstretching of the TMJ and muscles, dislocation or subluxation of the TMJ). In some cases, a slope of 15-20 ° may be insufficient and after 1.5-2 months in the absence or slow mesial growth of the lower jaw in the sagittal plane, the apparatus is additionally modified to achieve a slope of the plastic base to the occlusal plane of 30-40 °. The specified range of values of the angle of inclination allows you to set the lower jaw in the most correct ratio to the upper jaw (I class according to Engle), but not to impede the lateral movements of the lower jaw during meals and not to injure the mucous membrane of the lower jaw. With an increase in the inclination of the basis, trauma of the mucosa on the lower jaw and blocking of movements are possible, which can significantly worsen the psycho-emotional state of the patient and trust in the attending physician, which, with a smooth increase in the inclination of the basis, risks of negative situations are significantly reduced.

The invention is illustrated by drawings, where in FIG. 1 presents the inventive orthodontic apparatus on the layout of the upper jaw in axonometric projection; in FIG. 2 presents the inventive orthodontic apparatus on the layout of the upper jaw, top view; in FIG. 3 presents the inventive orthodontic apparatus without orthodontic rings, side view; in FIG. 4 presents the inventive orthodontic apparatus without orthodontic rings, equipped with an additional roller inclined to the occlusal plane of 15 °; in FIG. 5 presents the inventive orthodontic apparatus without orthodontic rings, equipped with an additional roller inclined to the occlusal plane of 30 °.

The orthodontic device for correction of dentition includes a plastic base 1 with a bite part, designed to be placed on a hard palate, orthodontic rings 2, intended to be fixed on molars, and a wire arc 3. The middle part of the wire arch 3 is fixed in a plastic base 1. Orthodontic rings are equipped lingual locks 4, and the end parts of the wire arc 3 are made U-shaped and tightly fixed in these lingual locks 4. On the wire arc 3 between the middle and end parts are made deformable activation loops, on which two turns are made 5. Preferably, the arc is made of wire with a diameter of 0.9 mm, since standard lingual locks are designed specifically for this diameter of the wire. Also, the wire diameter may be 0.6; 0.7 or 0.8 mm. (subject to lock modifications). If necessary, the bite portion of the plastic base 1 can be equipped with a plastic roller 6 (the size of the roller 6 depends on the treatment plan).

The above implementation option of the inventive orthodontic apparatus is most preferred, but does not limit the scope of legal protection of other implementation options. For example, only one turn 5 can be made on deformable loops of the wire arc 3, and the wire arc 3 itself can be attached to the orthodontic ring 2 without using any lingual locks 4 (for example, by welding or soldering). Also, the inventive device can be used in conjunction with a bracket system, which significantly increases efficiency and reduces treatment time.

The inventive method is as follows.

The orthodontic apparatus is installed to the patient so that the plastic base 1 rests against the hard palate. Orthodontic rings 2 are fixed on molars (for example, due to the glass-ionomer cement "Fuji 1"). The middle part of the wire arc 3 is fixed in the plastic base 1, and its end parts are fixed in the lingual locks 4. Also on the wire arc 3 between the middle and end parts are made deformable loops for activation on which at least one turn 5 is made on each side. After installing the device, it is activated. The patient wears the device for a period of two to four months (depending on the treatment plan). Then measure the sagittal fissure. If the mesial growth is normal (within 1-2 mm in 2 months), the patient continues to wear the orthodontic apparatus unchanged. If there is no or too slow (less than 1 mm) mesial growth, the bite of the plastic base 1 is provided with a plastic roller 6 of such a size that it tilts the plastic base 1 to the occlusal plane of 15-20 °. The patient wears a device modified in this way for one to two months (depending on adaptation to the inclined plane, the presence of pain in the temporomandibular joint, and also on the degree of reduction of the sagittal gap). Next, an additional measurement of the sagittal fissure is performed. If the mesial growth is normal (1-2 mm), the patient continues to wear the orthodontic apparatus unchanged. In the absence or slow mesial growth of the lower jaw (less than 1 mm), the bite of the plastic base 1 is provided with a larger plastic roller 6, so that it provides an inclination of the plastic base to the occlusal plane of 30-40 °, after which the patient wears an additionally modified device plan before the end of treatment.

The claimed invention is illustrated by examples.

Example 1

Patient M.I. at the age of 9 years old he complained of a defect in the dentition. As a result of the diagnosis, the diagnosis was established: the bite was replaceable, deep, in combination with the distal (vertical overlap of 5 mm, sagittal fissure of 3 mm). Orthodontic treatment was prescribed using the inventive device and method.

The patient was installed the claimed orthodontic apparatus. Two months later, a sagittal fissure was measured and the absence of mesial growth of the lower jaw was revealed. The bite of the plastic base was equipped with a plastic roller of such a size that it ensured the inclination of the plastic base to the occlusal plane of 15 ° (the roller was added low to smoothly adapt the patient to the device, since the device violates the diction and makes eating difficult). After which the patient wore a modified device for one month. An additional measurement of the sagittal fissure showed a mesial growth of 1.2 mm, which is normal. No additional modification was required and the patient wore the device for another three months before the end of treatment. After carrying out functional tests: the act of swallowing without displacement of the lower jaw distally; maximum mesial displacement of the lower jaw and the impossibility of distal displacement of the lower jaw to the 2nd class in molars. A tele-radiography was made (hereinafter referred to as “TRG”) of the head in lateral projection and a comparison was made with the TRG made before the start of treatment. The values of SNB, WITS, b-angle and bite height returned to normal.

As a result of treatment, the dentofacial defect was eliminated.

The sagittal fissure is absent, the incisors are in contact with the antagonists. The molars close in the first class according to Engle. Cutter overlap 2.5 mm. The treatment is over, the device is removed. Assigned follow-up visits to the doctor orthodontist 1 time in 3 months.

Example 2

Patient V.P. at the age of 10 he complained of a defect in the dentition. As a result of the diagnosis, the diagnosis was established: the bite is replaceable, deep, in combination with the distal (vertical overlap of 5 mm, sagittal fissure of 5 mm). Orthodontic treatment was prescribed using the inventive device and method.

The patient was installed the claimed orthodontic apparatus. Two months later, a sagittal fissure was measured and the absence of mesial growth of the lower jaw was revealed. The bite of the plastic base was equipped with a plastic roller of such a size that it ensured the inclination of the plastic base to the occlusal plane of 20 °. After which the patient wore a modified device for two months. An additional measurement of the sagittal fissure showed a mesial growth of 0.3 mm, after which the bite of the plastic roller was equipped with a plastic roller so that it provided an inclination of 40 ° to the occlusal plane. Then the patient wore the device seven months before the end of treatment.

After carrying out functional tests: the act of swallowing without displacement of the lower jaw distally; maximum mesial displacement of the lower jaw and the impossibility of distal displacement of the lower jaw to the 2nd class in molars. A TRG-2 of the head was made in lateral projection and a comparison was made with the TRG-1 performed before treatment. The values of SNB, WITS, b-angle and bite height returned to normal.

As a result of treatment, the tooth defect was eliminated.

The sagittal fissure is absent, the incisors are in contact with the antagonists. The molars close in the first class according to Engle. Cutter overlap 2.0 mm. The treatment is over, the device is removed. Assigned follow-up visits to the doctor orthodontist 1 time in 3 months.

Example 3

Patient P.S. at the age of 11 he complained of a defect in the dentition. As a result of the diagnosis, the diagnosis was established: the bite was replaceable, deep, in combination with the distal (vertical overlap of 4 mm, sagittal fissure of 6 mm). Orthodontic treatment was prescribed using the inventive device and method.

The patient was installed the claimed orthodontic apparatus. Two months later, a sagittal fissure was measured and the absence of mesial growth of the lower jaw was revealed. The bite of the plastic base was equipped with a plastic roller of such a size that it ensured the inclination of the plastic base to the occlusal plane of 15 ° (the roller was added low to smoothly adapt the patient to the device, since the device violates the diction and makes eating difficult). After which the patient wore a modified device for two months. An additional measurement of the sagittal fissure showed a mesial growth of 0.5 mm, after which the bite of the plastic roller was equipped with a plastic roller so that it provided an inclination of 30 ° to the occlusal plane. Then the patient wore the device five months before the end of treatment.

After carrying out functional tests: the act of swallowing without displacement of the lower jaw distally; maximum mesial displacement of the lower jaw and the impossibility of distal displacement of the lower jaw to the 2nd class in molars, the head TRG-2 was made in lateral projection and a comparison was made with the TRG-1 performed before treatment. The values of SNB, WITS, b-angle and bite height returned to normal.

As a result of treatment, the tooth defect was eliminated.

The sagittal fissure is absent, the incisors are in contact with the antagonists. The molars close in the first class according to Engle. Cutter overlap 3 mm. The treatment is over, the device is removed. Assigned follow-up visits to the doctor orthodontist 1 time in 3 months.

Claims (4)

1. An orthodontic device for correction of dentitions, including a plastic base, designed to be placed on a hard palate, orthodontic rings, designed to be fixed on molars, as well as a wire arc, the middle part of which is fixed in a plastic base, and the end parts are attached to orthodontic rings, at the same time, deformable loops for activation are made on the wire arc between the middle part and the end ones, and the plastic base is equipped with a bite part, characterized in that on deformable stitches For activation, at least one turn is made, while the bite part of the plastic base on the distal side is equipped with an additional roller. 2. An orthodontic apparatus for correcting dentitions according to claim 1, characterized in that two turns are made on each deformable loop for activation. 3. The orthodontic apparatus for correcting dentitions according to claim 1, characterized in that the orthodontic rings are equipped with lingual locks, and the end parts of the wire arc are made U-shaped and tightly fixed in these locks. 4. The method of using the orthodontic apparatus according to claim 1, during which the apparatus is installed to the patient so that the plastic base rests against the hard palate, and the orthodontic rings are fixed on the molars, after which the apparatus is activated, characterized in that the patient wears the apparatus from two up to four months, after which the sagittal fissure is measured and, in the absence or slow mesial growth of the lower jaw, the bite of the plastic base on the distal side is equipped with a plastic roller so so that it provides an inclination of the plastic base to the occlusal plane of 15-20 °, then the patient wears a modified apparatus for one to two months, after which an additional measurement of the sagittal gap is performed and, in the absence or slow mesial growth of the lower jaw, the bite of the plastic base is provided with a larger plastic roller, so that it provides an inclination of the plastic base to the occlusal plane of 30-40 °, after which the patient wears an additionally modified device according to the plan to the windows Chaniya treatment.

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