RU2722884C1 - Composite jaw prosthesis with replaceable occlusive part - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to orthopaedic dentistry, and is intended for use in complex jaw prosthesis of patients with extensive defects of maxillofacial tissues. Bone defect of upper jaw of patient is tightly covered with moist sterile tissues so that edges of defect remained open to depth of 5–10 mm. Impressions are taken from both jaws by alginate or silicone mass, according to which models from gypsum are moulded. Model of the upper jaw is installed on the platform of the vacuum apparatus and squeezed on it with a standard plate of silicone. Squeezed plate is removed from gypsum model of upper jaw, obturating part of plate is cut with scissors or cutter so that edges of plate overlap along entire perimeter of bone defect by 5 mm. Obturating plate in the form of a "hat with margins" is fitted in a bone defect of the upper jaw and an impression of the upper jaw is taken with an alginate or silicone mass. Impression is cast by gypsum, having removed from it a plate in the form of a "hat with fields". Further, a wax base with wax beads is made, central occlusion or central ratio of jaws, artificial teeth is determined. Fitting the wax structure of the prosthesis in the oral cavity, prosthesis polymerisation, treatment and polishing. In the oral cavity, the obturating part of the prosthesis of a thin plate in the form of a "hat with margins" is first pre-inserted, and a replacement resection prosthesis is fitted in which the occlusive portion of the main prosthesis tightly enters the removable obturating part from the silicone plate. For better sealing obturating parts can be lubricated with Corega gel.

EFFECT: use of this prosthesis provides dense defect obturation of the defect in the nasal or maxillary sinus cavity with the possibility of fast replacement of the occlusive part at its infection or change of the size or shape of the defect without change of the resectional prosthesis, facilitated fitting of the occluding prosthesis in the oral cavity at large sizes of the jaw bone defect.

1 cl, 5 dwg

Description

The invention relates to medicine, in particular to orthopedic dentistry, and can be used for complex-maxillary prosthetics of patients with extensive tissue defects in the maxillofacial region.

Known lightweight design for prosthetics of patients with defects of the upper jaw, consisting of a combined basis. Moreover, a part of the basis facing the prosthetic bed with a flaw relief, including a hollow volumetric obturator and supporting-restraining devices, is made of cast-in-place from superelastic titanium nickelide, and the alveolar bone with artificial teeth is made of plastic. [Prosthesis obturator of the upper jaw. Patent 2281059 RU].

The disadvantage of this design is that for its manufacture, two significantly different material stiffnesses are used, which are connected only by mechanical connection, which in turn leads to a reduction in the life of such a prosthesis due to the inevitable detachment of plastic at the junction with metal, microbial contamination of these areas and spalling of the edges of the plastic.

Known dentition denture obturator made of polyurethane. It is represented by a base of rigid polyurethane and a hollow obturator of soft polyurethane with a rigid frame. [A method of manufacturing a denture-obturator denture. Patent 2454968 RU].

This maxillary denture-obturator of the upper jaw is selected for the prototype.

A significant drawback of this design is the use of polyurethane, especially a soft pad, which significantly limits the service life of a hollow polyurethane obturator (maximum 6 months) due to the loss of its elastic properties and as a result of injury to the tissues of the prosthetic bed.

Existing designs of post-resection dentures on the upper jaw provide for the manufacture of fixing, replacing and obstructing parts. One of the design flaws is that the obturating part of the prosthesis becomes infected by accumulating mucus from the nasopharynx and oral cavity, desquamated epithelium, tear fluid, etc., which leads to irritation and inflammation of the mucous membrane, as well as to the weight of the replacement prosthesis. In addition, over time, a bone defect in the jaw increases, its shape changes. These violations require frequent relocation of the obstructing part of the prosthesis or premature replacement of the resection prosthesis itself.

Since the obturating part of the prosthesis is very quickly infected under the influence of secretions from the nasopharynx and oral cavity, the obturating part we offer from the plate can be made as an expendable part in several copies.

The objective of the present invention is to provide a resectable denture of the upper jaw, which allows to completely eliminate these disadvantages.

EFFECT: dense obstruction of the defect into the nasal or maxillary cavity with the possibility of quick replacement of the obturating part when it is infected or changing the size or shape of the defect without changing the resection prosthesis itself, facilitated fitting of the obstructing prosthesis in the oral cavity with large sizes of the jaw bone defect.

The inventive post-resection prosthesis consists of 2 parts:

1. An obturating part made of a standard DiscusDental silicone plate (USA) and squeezed on a DiscusDental vacuum press (USA) from a gypsum model of the upper jaw. The excess plate is cut so that the edges of the bone defect along the entire perimeter are covered by 3-4 mm, so that the obturating part immersed in the defect only to a predetermined depth (0.5-10 mm):

2. Actually a resection prosthesis, which fits in the oral cavity after fixing the obturating plate in the bone defect and has an obturating part, which is immersed in the recess of the plate, repeating its shape.

We have proposed the construction of a jaw resection prosthesis in which the obturating part made of a thin silicone plate densely lining the bone defect of the upper jaw (Fig. 1). It is separated from the main prosthesis and is an expendable part for instant replacement (Fig. 2) or, if necessary, is quickly made of a standard plate by vacuum pressing on a plaster model in accordance with the new boundaries of the bone defect of the upper jaw.

A method of manufacturing a replacement post-resection prosthesis of the upper jaw with a removable obturating part is as follows:

- the bone defect of the upper jaw is tightly plugged with moist sterile wipes so that the edges of the defect remain open to a depth of 5-10 mm;

- impressions are removed from both jaws with an alginate or silicone mass;

- cast models are cast (Fig. 3);

- the model of the upper jaw is mounted on the platform of the vacuum apparatus and crimped on it with a standard silicone plate.

- the squeezed plate is removed from the gypsum model of the upper jaw, the obturating part of the plate is cut with scissors or a milling cutter so that the edges of the plate overlap a bone defect by 5 mm around the entire perimeter (Fig. 4);

- an obturating plate in the form of a “hat with fields” is fitted into a bone defect in the upper jaw and an impression is taken from the upper jaw with an alginate or silicone mass;

- the print is cast with gypsum after having previously removed the plate in the form of a “hat with fields”;

- a wax base is made with wax rollers;

- determined by central occlusion or the central ratio of the jaws;

- staging of artificial teeth;

- fitting the wax structure of the prosthesis in the oral cavity;

- polymerization of the prosthesis, processing, polishing;

- in the oral cavity, the obturating part of the prosthesis from a thin plate in the form of a “hat with fields” is first fitted, then the replacement resection prosthesis is fitted in which the obturating part of the main prosthesis fits tightly into the removable obturating part from the silicone plate. For better sealing, the obturating parts can be lubricated with Correga gel.

Brief Description of the Drawings:

FIG. 1 - post-resection prosthesis of the upper jaw with an embedded removable obturating part;

FIG. 2 - post-resection prosthesis of the upper jaw with the removed removable obturating part;

FIG. 3 - post-resection defect in a plaster model of the upper jaw;

FIG. 4 - gypsum model of the upper jaw with a silicone removable obturating part;

FIG. 5 - ready removable maxillary denture of the upper jaw making up for the post-resection defect and the absence of teeth.

Claims (2)

1. A maxillary post-resection prosthesis with a removable obturating part, the manufacture of which includes the removal of impressions of both jaws with an alginate or silicone mass, the production of a gypsum model based on the impressions obtained, characterized in that the bone defect of the upper jaw is tamped with wet wipes so that the edges of the defect remain open to the depth 5-10 mm, a composite jaw prosthesis is made of 2 parts, the first obturating part made of a silicone plate molded on a vacuum press apparatus and immersed in the jaw defect, the second obturating part of the resection prosthesis is inserted into the first obturating part the full depth of the first obturating part. 2. A maxillofacial post-resection prosthesis with a removable obturating part according to claim 1, characterized in that the first silicone obturating part has edges extending 3-5 mm beyond the bone defect.

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