RU2718271C1 - Method of mesialization of premolars and molars - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dentistry, and is intended for use in mesialization of premolars and molars. Bracket system is installed to a patient, and also two mini-implants are installed with indent from a transient fold at 1.5–2.5 mm, which are further connected by means of an arch. Thereafter, the mini-implants are connected to the bracket system by means of a chain or nickel-titrate spring. Mini-implants are set mesial to the canines perpendicular to the bone tissue surface and at an angle to each other 70–100° or more distally to the canines perpendicular to the bone tissue surface and at an angle to each other of 120–150°.

EFFECT: method ensured effectiveness of orthodontic treatment due to higher stability of mini-implants.

1 cl

Description

The invention relates to medicine, namely to dentistry, in particular, to a method for mesialization of premolars and molars.

A known method of mesialization (US 2008286711), in which they use a mini-implant (hereinafter referred to as “MI”) as a support, and the orthodontic force from the MI to the tooth is transmitted through the lever. In this case, the method uses an orthodontic apparatus in which the lever is factory-made and made of stainless steel. MI in the specified method is located cheek.

The disadvantages of the above device and method is the relatively not very high stability of the MI, since the MI can migrate, deviate and fall out. And also, to assemble this unit, it is necessary to use a factory-type lever.

Also known apparatus for distalization and mesialization (GR 1008288), which is fixed on two MI connected by an arc.

The disadvantages of this technical solution are the relatively low stability of MI, the ability to install exclusively on the upper jaw and the need for soldering (or welding), assembly and individualization of the device in a laboratory, as well as the use of factory-made parts from one manufacturer.

A known device for the distalization and mesialization of teeth (US 20140170585), including a bracket system, two MI, combined by an arc based on photopolymer resin. MI are located palatine and parallel to each other (at an angle of 90 ° to the gum and bone). This device is the closest to the claimed invention and was adopted as a prototype. As a prototype, the method of tooth mesialization using the above apparatus was selected, including the installation of MI, which are then interconnected by an arc, and then connected to the bracket system.

The disadvantage of the prototype is the relatively low stability of MI. This is due to their location sky and parallel to each other (at an angle of 90 ° to the surface of the sky), which entails the emergence of a force vector directed parallel to the applied force, which contributes to the migration (tilt) of the MI towards the acting force. The disadvantages include the use in the apparatus of an arc based on inaccessible photopolymerizable resin.

The technical problem is the need to develop a simple and effective orthodontic method for the mesialization of premolars and molars.

The technical result consists in increasing the stability of MI and, accordingly, in increasing the effectiveness of orthodontic treatment.

The technical result is achieved by the fact that in the method of mesialization of premolars and molars, during which the patient installs a bracket system, two mini-implants, which are then connected to each other using an arc, after which the mini-implants are connected to the bracket system by means of a lever and chain , according to the invention, mini-implants are set indented from the transitional fold 1.5-2.5 mm mesial to the canines perpendicular to the surface of the bone tissue and at an angle to each other of 70-100 ° or distally to the canines perpendicular to the surface of the bone tissue audio and angled relative to each other in the 120-150 °.

The technical result is also achieved by the fact that in the method of mesialization of premolars and molars, during which a bracket system is installed to the patient, two mini-implants, which are then connected to each other using an arc, after which the mini-implants are connected to the bracket system by means of a lever and chain (or NiTi-springs) according to the invention mini-implants are placed distally to the fangs with an indent from the transitional fold 1.5-2.5 mm perpendicular to the surface of the bone tissue and at an angle to each other of 120-150 °.

A 1.5-2.5 mm distance from the transitional fold is necessary for the correct operation of the apparatus. If the specified range is exceeded, then MI will injure the mucous membrane. If MI is set indented below 2.5 mm, then the distance from the tooth resistance point, which is located approximately in the middle of the tooth root, will lead to a more inclined, rather than corpuscular, movement of the tooth (corpuscular movement during mesialization is more physiological and preferable).

The choice of location for MI installation (distal or mesial) is affected by the anatomical features of the jaw structure, in particular, the interroot distance, proximity of the frenum (frenum), and bone density. For example, the mesial of the canine is established when the interroot distance on the mesial side is greater than on the distal side. For example, distal to the canine is established when the interroot distance from the distal side is greater than from the medial. In another case, if there is a tram on the distal side that needs to be closed, it is more preferable to install MI mesial to the root of the canine. In addition, it is more preferable to install MI further from the bridle, as well as in the area with denser bone tissue. Density of bone tissue can be detected using cone beam computed tomography, as well as taking into account data on previous tooth movements (where there was movement, the bone is less dense).

The MI installation perpendicular to the surface of the bone tissue and at an angle of 70-100 ° to each other (when the MI is located farther than the canines) and at an angle of 120-150 ° (when the MI is located distal to the canines) increases the stability of the MI by eliminating the possibility of a force vector directed parallel to the applied force (which contributes to the migration of MI towards the acting force). The MI slope to each other is due to a number of factors and the specific value of the angle does not significantly affect the clinical effect. With a decrease in the angle of inclination of the MI to each other, the total force vector shifts toward the bone tissue (MI stability increases), and with an increase, it moves toward the acting force (MI stability decreases).

It is worth noting that the specific value of the angle of inclination of the MI to each other is more dependent on the physiological features of the structure of the patient's jaw (width, radius of the upper or lower jaw) and the interroot distance. Also, the MI installation angle to each other is significantly affected by the MI installation location (distal or mesial to the canine). However, in practice it was found that when using the claimed invention (i.e., with the indicated indent from the transition fold, etc.), the optimal values of the angle of inclination of the MI to each other when they are located mesial to the fangs are in the range of 70-100 °, their location distal to the canines, the optimal value is in the range of 120-150 °.

The invention is illustrated by drawings, where in FIG. 1 presents an orthodontic apparatus designed to implement the proposed method and mounted on a layout of the upper jaw, front view, in FIG. 2 shows an orthodontic apparatus mounted on a mock of the upper jaw bottom view, in FIG. 3 shows an orthodontic apparatus mounted on a model of the upper jaw, side view, in FIG. 4 presents some elements of the orthodontic apparatus in the analysis.

The orthodontic apparatus used in the claimed method for the mesialization of premolars and molars includes a bracket system 1, MI 2, interconnected by an arc 3. MI 2 is installed in the canine area with an indent from the transitional fold of 1.5-2.5 mm. In this case, MIs are installed perpendicular to the surface of bone tissue and at an angle to each other of 70-150 °. Each MI 2 is also connected to the bracket system 1 via a nickel-titanium spring 4 (or chain) and a lever 5. In addition, as a rule, a silicone orthodontic tube is put on the connecting arc 3, the edges of which are filled with a fluid flowing composite photopolymer material.

The method is as follows.

The patient is given a brace system 1, and then MI 2 is set indented from the transitional fold by 1.5-2.5 mm. MI is set mesial to the fangs perpendicular to the surface of the bone tissue and at an angle to each other of 70-100 ° or distal to the fangs perpendicular the surface of bone tissue and at an angle to each other in 120-150 °. Then MI 2 is connected between each other with a blast 3, and then connected to the bracket system 1 through a nickel-titanium spring 4 (or chain) and lever 5.

The claimed invention is illustrated by examples.

Example 1

Patient aged 15 liters. was admitted with a diagnosis of trema, diastema of the upper jaw. According to the results of diagnostic measures, it was decided to carry out treatment using the proposed method. A bracket system was installed for the patient (Forestodent Sprint). After passing the leveling stage and switching to full-sized steel arcs with the help of the chain, the gaps between the incisors and fangs on the upper jaw were closed. MI (Forest Orthodoxy L-8 mm. D-1.7 mm) were installed with a spacing of 1.5 mm from the transition folds perpendicular to the surface of the bone tissue at an angle of 70 ° to each other (mesial to the canines). Next, on 16 and 26 teeth, orthodontic rings and a palatal arch were installed. Then a connecting arc was installed from one MI to another. After that they added a “lever” to the MI from the first premolar with the help of chain. After the mesialization of the first premolar (right and left), we reinstalled the “lever” on the second premolar (15 and 25) and set the chain from the lever to the connecting beam. After mesialization of the second premolar, a similar manipulation was repeated with the first and second molars of the upper jaw.

After the closure of three due to the mesialization of premolars and molars of the upper jaw, fissure-tubercular contacts were corrected with intermaxillary elastic. Was obtained 1st grade by Engle in molars and fangs. Also, control shots of OPTG and TRG of the head were taken in lateral projection, after which a decision was made to remove the bracket system and orthodontic apparatus and retainers were installed. All treatment took 2 years 3 months.

Example 2

Patient aged 16 L. was admitted with a diagnosis of secondary adentia of 36 and 46 teeth due to complicated caries. According to the results of diagnostic measures, it was decided to carry out treatment using the proposed method. The patient had a brace system (Damon Q Ormco). After the leveling stage and the transition to full-length steel arches, MIs were installed on the lower jaw (Forestodent Orto Easy L-6 mm and D -1.7 mm) with a spacing of 2.0 mm from the transition folds perpendicular to the bone surface at an angle of 100 ° to each other ( mesial to fangs). Using the chain from the lever on the 37th and 47th teeth to the connecting beam, the 37th and 47th teeth were mesialized. Chain changed every 4 weeks. During the treatment, 38 and 48 teeth erupted, which took the place of 7 teeth. The treatment period was 1 year 9 months. In the course of treatment, a slight MI migration was visually determined in the direction of bone tissue by 1 mm on each side. After that, the bracket system and orthodontic apparatus were removed and the retention apparatus was installed.

Example 3

Patient aged 16 L. was admitted with a diagnosis of secondary adentia of 16 and 26 teeth. According to the results of diagnostic measures, it was decided to carry out treatment using the proposed method. A brace system (Inspire ice Ormco) was installed for the patient. MI (forest agent Ortho Easy L-10 mm and D -1.7 mm) are indented 2.5 mm from the transition folds perpendicular to the surface of the bone tissue at an angle of 150 ° to each other (distal to the canines). Further on the 17th and 27th teeth, orthodontic rings and palatal arch were installed. After the leveling stage and the transition to full-width steel arcs using the claimed apparatus and chain, mesialization of the 17th and 27th teeth was performed in place of the 16th and 26th teeth. During treatment, there was a slight migration of MI towards the premolars by 1-1.5 mm on each side, after which MI strengthening was noted. In the course of treatment, the 18th and 28th teeth erupted in place of the 17th and 27th teeth. Activation (chain replacement) was performed every 4 weeks. The treatment period was 27 months. After that, the orthodontic apparatus and bracket system were removed and installed by the retainers. MI slope and migration were minimal.

Example 4

Patient aged 15 liters. was admitted with a diagnosis of secondary adentia of 16 and 26 teeth. According to the results of diagnostic measures, it was decided to carry out treatment using the proposed method. A bracket system was installed for the patient (Forestoden Sprint). After the leveling stage and the transition to full-sized arches, MIs were installed (forest agent Ortho Easy L-10 mm) with a spacing of 2.0 mm from the transition folds perpendicular to the surface of the bone tissue at an angle of 120 ° to each other (distal to the canines). After the leveling stage and the transition to full-width steel arcs). Further, on the 17th and 27th teeth, orthodontic rings and palatal arch were installed using the claimed apparatus and chain. The mesialization of the 17th and 27th teeth was performed in place of the 16th and 26th teeth. Activation (chain replacement) was performed every 4 weeks. MI migration was not detected. The treatment period was 26 months. Then they removed the bracket system and the orthodontic apparatus and installed the retainers.

Claims (1)

1. The method of mesialization of premolars and molars, during which a bracket system is installed on the patient, two mini-implants, which are then connected to each other using an arc, after which the mini-implants are connected to the bracket system by means of a lever and chain, characterized in that mini-implants are set indented from the transitional fold 1.5-2.5 mm mesial to the canines perpendicular to the surface of the bone tissue and at an angle to each other 70-100 ° or distally to the canines perpendicular to the surface of the bone tissue and at an angle to each other of 120 -150 °.

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