RU2731796C1 - Device for releasing a place in a denture of the lower jaw for permanent teeth eruption - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dental instruments, and can be used for elongation of denture of lower jaw and free space for eruption of permanent teeth with its deficiency. Disclosed is a device, characterized by that on crowns of premolars from their outer side, and on molars – on the tongue side there are rigidly fixed beams Ø 0.9 mm with freely movable springs Ø 1.1 mm, on the ends of which there are detachable movable limiters Ø 1.0 mm for adjustment of spring compression with increasing distance between molars and premolars, and on molars and premolars opposite sides on the beams there are tubes with inner Ø 1.0 mm for inserting springs on the beams, wherein one of them is introduced into the elastic tube – insulation, at that, from the lingual side of the teeth necks there is an elastic arc of steel Ø 1.2 mm, coated with bioinert material, the ends of which are rigidly fixed to crown crowns of premolars. Device, by double-sided springs in relation to displaced tooth, creates pressure from the outer and inner sides of the tooth for controlled tooth movement along the guide beams, which prevents one-sided inclination or turning of the molar and reduces complications when moving the tooth, higher effectiveness of orthodontic treatment. Cast crowns are modeled individually by tooth shape with account of interdental contacts; therefore, teeth separation is not required when fixing the device. This makes it easy to fit in the oral cavity, provides 100 % adhesion to the tooth surface, which reduces the number of decementings and reduces the patient's discomfort. This simplifies structure as a whole, reduces labor intensity of doctor and mechanic. Device does not require cooperation of medical staff with a patient, since it is activated by an orthodontist once every two weeks. It does not require activation for the first two weeks of treatment, as length of springs is more than distance between crowns of teeth by 5 mm. Thus, from the first day of treatment, the springs are compressed and move teeth that speeds up the treatment process. Length of beams is more than distance between moved teeth by value of place, which is required to create for teething. Activation consists in creation of pressure by compression of spring in area of soldered beam and fixation on beam of limiter, for example, of light-curable material. It simplifies activation of the device and reduces patient discomfort, reduces time of teeth movement. Spring on tongue side is covered with bioinert elastic material for language isolation and convenience to patient.

EFFECT: reduced labor intensity of the doctor's work, higher efficiency of orthodontic treatment, reduced discomfort of the patient.

1 cl, 1 ex, 1 dwg

Description

The proposed invention relates to medicine, namely to dental instruments, and can be used to lengthen the dentition of the lower jaw and free up space for the eruption of permanent teeth in case of its deficiency.

According to a number of authors (Khoroshilkina F.Ya. Orthodontics. - M .: OOO "MIA", 2006. - 544 p .; Persia LS Orthodontics. - M .: "Engineer", 1996. - 270 p. And the incidence of a deficit of space in the dentition of the lower jaw for eruption of permanent teeth is about 20% of all anomalies in the position of individual teeth. This is the result of: early loss of temporary teeth, lack of early prosthetics, underdevelopment of the lower jaw, due to a shortened frenum of the tongue, bad sucking habits, infantile swallowing, mouth breathing. The number of children with this pathology tends to increase.

To lengthen the lower dentition, it is customary to use in orthodontic practice removable lamellar devices, which include screws and clasp fixation on the molars. The plate on the lower jaw consists of: a base made of acrylic plastic, a vestibular arch, clasps for molars, screws with sectoral cuts of the base for moving molars posteriorly and lengthening the dentition (Khoroshilkina F.Ya. Orthodontics. - M .: OOO "MIA", 2006 . - 544 p.).

The main disadvantage of removable structures on the lower jaw is their poor fixation in the oral cavity due to: dropping by the tongue, uncontrolled support on the moved teeth, slipping of the clasp from the moved tooth during screw activation, prolonged movement of molars, which leads to low treatment efficiency. The design requires frequent activation of the screw by the patient himself.

For the closest analogue, a device was adopted - the Gerling-Gashimov apparatus (Handbook of orthodontics, M.G.Bushan, Z.S.Vasilenko, L.P. Grigorieva, etc. - Chisinau: Kartya Moldaveniaske, 1990 - 488 p.), Consisting of : supporting hollow rings on the first premolars, with a shortened lingual arch and an active part soldered to them, in the form of arc segments with a screw thread. The free ends of the arc with thrust nuts are inserted into the tubes of the rings on the movable molars. Requires daily activation of the screw by the patient himself to move the molars.

The disadvantages of this design include:

- complications during the movement of teeth: uncontrolled one-sided support leads to a rotation of the molar along the axis during its movement;

- insufficient fixation area of the rings to the tooth surface entails the risk of de-cementing during active orthodontic treatment;

- unreliability in the operation of the screw due to the formation of dental calculus with insufficient oral hygiene;

- the doctor's work is lengthened, since an additional stage in treatment is required before fixing the structure - the separation of the teeth by the doctor;

- patient discomfort with daily activation of the screws, since the cooperation of the medical staff with the patient and his relatives is required.

The listed disadvantages lengthen the treatment time up to a year.

Tasks:

- to increase the effectiveness of orthodontic treatment;

- to increase the reliability of the movement of teeth, ensuring the prevention of the rotation of the tooth along the axis and the reliability of fixation of the device;

- to reduce the labor intensity of the dental technician and orthodontist;

- reduce discomfort for the patient;

- to reduce the time to move teeth

The essence of the utility model is that on the crowns of premolars on their outer side, and on the molars on the lingual side, rigidly fixed beams ∅ 0.9 mm are located, with freely movable springs ∅ 1.1 mm on them, at the ends of which there are removable movable restraints ∅ 1.0 mm to regulate the compression of the spring when the distance between molars and premolars increases, and on the sides opposite to the bars on molars and premolars there are tubes with an inner ∅ 1.0 mm for inserting springs on the bars into them, one of which is inserted in an elastic tube - insulation, while on the lingual side relative to the necks of the teeth there is an elastic arch made of steel ∅ 1.2 mm, covered with bioinert material, the ends of which are rigidly fixed to the crowns of the premolars.

EFFECT: due to double-sided springs in relation to the tooth being moved, pressure is created from the outer and inner sides of the tooth for controlled movement of the tooth along the guide bars, which prevents unilateral inclination or rotation of the molar and reduces complications when moving the tooth, increases the efficiency of orthodontic treatment.

Cast crowns are modeled individually according to the shape of the tooth, taking into account the interdental contacts, therefore, separation of the teeth is not required when fixing the device. This makes it easier to fit in the oral cavity, provides 100% adherence to the tooth surface, which reduces the amount of decementation and reduces patient discomfort. This simplifies the overall design, reduces the complexity of the doctor and technician.

The device does not require the cooperation of the medical staff with the patient, since it is activated by the orthodontist once every two weeks. It does not require activation for the first two weeks of treatment, since the length of the springs is 5 mm longer than the distance between the crowns of the teeth. Thus, the springs from the first day of treatment are compressed and move the teeth, which speeds up the treatment process. This reduces the complexity of the doctor's work, increases the effectiveness of orthodontic treatment, and reduces patient discomfort.

The length of the bars is greater than the distance between the teeth to be moved by the amount of space required for the eruption of teeth.

Activation consists in creating pressure by compressing the spring in the area of the soldered beam and fixing it to the limiter beam, for example, of a light-curing material. This simplifies the activation of the device and reduces patient discomfort, shortens the time to move teeth. The spring on the tongue side is covered with a bioinert elastic material for tongue isolation and patient comfort.

For better understanding, the device is shown schematically in FIG. 1, where: item 1 - orthodontic crowns for molars, item 2 - orthodontic crowns for premolars, item 3 - bar ∅ 0.9 mm, the length of which is greater than the distance between the teeth being moved by the amount of space that needs to be created, item 1. 4 - spring ∅ 1.1 mm, its length is 5 mm longer than the distance between the crowns of the moved teeth, item 5 - a tube with an inner ∅ 1.0 mm and a length corresponding to the mesio-distal size of the tooth crown, item 6 - lingual arch ∅ 1.2 mm, covered with bioinert material, and the ends of the arch are rigidly fixed to the crowns of premolars, item 7 - a stopper made of light-cured material ∅ 1.0 mm, item 8 - an elastic tube ∅ 1.2 mm.

The device is used as follows: it is fixed on the teeth of the lower jaw on glass ionomer cement to fix non-removable orthodontic structures. The spring loaded bars are inserted into the tubes of orthodontic crowns of premolars and molars. The lingual arch rests on the cervical region of the incisors and canines. To isolate the tongue, the spring is covered with an elastic tube.

The design is immediately active, since the length of the springs is 5 mm longer than the distance between the crowns of the moved teeth. The length of the bars is greater than the distance between the moved teeth by the amount of space you want to create. If the created space is not enough, then the spring is activated once every two weeks. Activation consists in creating pressure on the distalized tooth by compressing the spring in the area of the soldered beam and fixing a limiter made of light-curing material to the beam. When the springs are activated on both sides relative to the tooth, the tooth moves without turning it along the axis or tilting.

Example

Patient A., 9 years old. As a result of the early loss of temporary molars (84, 75 teeth), permanent molars (46, 36 teeth) erupted closer to the dentition and shortened it by the mesio-distal size of the permanent premolar. Thus, there is a lack of space for 44 and 35 teeth, 5 mm on each side.

To free up space in the dentition of the lower jaw for the eruption of permanent teeth 44 and 35, an impression was taken from the lower part, a plaster model was cast and the proposed device was manufactured.

Orthodontic crowns of items 1 and 2 were fixed on glass ionomer cement to fix orthodontic constructions on teeth 43, 46, 34, 36. Beams p. 3 ∅ 0.9 mm with a spring on p. 4 ∅ 1.1 mm were inserted into the tubes of p. 5. The lingual arch of p. 6 ∅ 1.2 mm rests on the cervical region of the incisors and canines. The design is immediately active, since the length of the springs is 5 mm longer than the distance between the crowns of the moved teeth. The length of the bars is greater than the distance between the moved teeth by the amount of space you want to create. Activation was carried out once every 2 weeks, which consists in creating pressure on the distalized tooth by compressing the spring in the area of the soldered beam and fixing on the limiter beam p. 7 1.0 mm made of light-cured material. By activating the springs twice a month, lengthening of the dentition was obtained, and a place was created for the eruption of permanent teeth. To isolate the tongue, the spring was covered with an elastic tube n. 8 ∅ 1.2 mm. Within three months of treatment, a distance of 5 mm was obtained.

The device was tested on 23 patients, who received an average distance of 1.5 mm per month, which lengthened the dentition to create space for erupting permanent teeth. At the same time, there were no complications in the form of uncontrolled rotation of the tooth along the axis, due to double-sided springs in relation to the moved tooth. The bars on the inner and outer sides of the molars create conditions for controlled movement of the teeth and do not allow the molars to bend and turn in the other direction, which reduces the number of complications during the movement of teeth, increases the effectiveness of orthodontic treatment.

Claims (1)

A device for freeing up space in the dentition of the lower jaw for the eruption of permanent teeth, containing crowns on molars and premolars with parallel tubes with springs attached to them, characterized in that on the crowns of premolars from their outside, and on molars from the lingual side fixed beams ∅ 0.9 mm are located, with movable springs ∅ 1.1 mm put on them, at the ends of which there are removable movable stops ∅ 1.0 mm to regulate the compression of the spring when the distance between molars and premolars increases, and on the sides opposite to the beams on molars and premolars there are tubes with an inner мм 1.0 mm for the introduction of springs on the beams into them, and one of them is inserted into the tube - insulation, while an elastic steel arch of ∅ 1.2 mm is installed on the lingual side against the necks of the teeth, coated with bioinert material, the ends of which are fixed to the crowns of the premolars.

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