RU2731810C1 - Method for measuring the dynamics of chewing efficiency in stages of orthopedic treatment - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to orthopedic dentistry, and can be used for determination of increase of chewing efficiency in orthopedic treatment. Chewing efficiency before and after dental orthopedic treatment is assessed by the original design formula the change in chewing efficiency (CCE) is evaluated. For this purpose, chewing efficiency is determined before and after treatment by summation of chewing efficiency factors for teeth having antagonizing pairs, which are determined by producing an occlusiongram. If the chewing efficiency is positive, an increase in chewing efficiency in percentage relative to chewing efficiency before the beginning of dental orthopedic treatment is determined. If the chewing efficiency is negative, the chewing efficiency in the percentage relative to the chewing efficiency before the beginning of dental orthopedic treatment is reduced. Increase "0" indicates no chewing efficiency change in percentage ratio relative to chewing efficiency before dental orthopedic treatment and absence of changes of occlusal contacts between teeth or loss of contacts in one part of dentition and their appearance in another segment.

EFFECT: method enables measuring the dynamics of masticatory efficiency before and after dental orthopedic treatment by analyzing the occlusiongram and measuring the chewing efficiency with using the chewing sample.

1 cl, 1 tbl, 1 ex, 4 dwg

Description

The invention relates to medicine, namely to orthopedic dentistry and can be used to determine the change in chewing efficiency in dental orthopedic treatment.

In the course of orthopedic treatment, the shape of the teeth is restored, including their occlusal surface. The restoration of chewing efficiency and the quality of treatment depend on the number of antagonizing pairs of teeth and their occlusal points. Missing or overstated contacts can adversely affect the long-term prognosis of dental orthopedic treatment.

To determine the presence or absence of occlusal contacts before and after dental orthopedic treatment in the literature and practice, there is an analogue of obtaining occlusal contacts using articulating paper (Method of index assessment of occlusal contacts of posterior teeth, patent No. 2684182 published 03/06/2018). The essence of the method is as follows. Using articulating paper, the contacts of the teeth of the antagonists are recorded. Next, the patient's dentition is photographed. Subsequently, using a computer program, the contact points on the teeth are assessed.

The disadvantages of this method are the complexity of implementation, namely: the difficulty of photographing due to the limited view of the dentition, assessment of occlusal contacts only on the lower jaw, conversion into a digital image using photography, and the use of specialized software on a personal computer.

Another analogue of the method for registering occlusal contacts is a method for obtaining an occlusiogram (Patent No. 2195900, published 11/10/2000).

In this case, to register occlusal contacts, carbon paper is used, which is located between the wax plates. Disadvantages of the analogue: this method is effective only in the patient's mouth, but cannot be reused on jaw models; inaccuracy of the method due to the presence of a layer of wax between the teeth and the coloring pigment of the copy paper; the ability to shift paper; overestimation of the bite due to the presence of a double layer of wax; blurred contacts (based on the previous paragraph).

The prototype of the method for determining chewing efficiency before and after dental orthopedic treatment is a method for determining chewing efficiency according to the tables of N.A. Agapov based on Duchange data, in which the author proposed to take the chewing efficiency of each tooth for a certain coefficient, expressed as a percentage (%) of the total chewing efficiency.

The disadvantage of the prototype is the conditionally selected value of the coefficients that determine the chewing efficiency of the tooth, as well as taking into account only the presence or absence of a tooth in the dentition without taking into account its occlusal contacts and functional significance.

The technical result is the proposed method for measuring the dynamics of chewing efficiency before and after dental orthopedic treatment.

The dynamics of chewing efficiency is assessed as follows:

1) a special table is preliminarily compiled on the basis of the chewing efficiency coefficients measured functionally by the method of V.N. Trezubov (RF patent 2387408 "Method for evaluating the effectiveness of chewing") for teeth with antagonizing pairs;

2) the antagonizing pairs of teeth of a particular patient are determined before and after dental orthopedic treatment by obtaining an occlusionogram, after which the coefficient of chewing efficiency for each antagonizing pair of teeth is determined from the table;

3) the sum of the coefficients of chewing efficiency of each antagonizing pair of teeth is performed to obtain the final current value of the chewing efficiency;

4) the change (dynamics) of chewing efficiency is calculated according to the proposed formula, which takes into account the initial and current value of chewing efficiency.

The proposed method makes it possible to simply and effectively evaluate the dynamics of treatment of an orthopedic patient.

The method is implemented as follows. Before the start of treatment, the patient leaves an imprint of the occlusal relationship of the antagonist teeth in the central occlusion position on the base wax plate. Next, impressions are taken from the jaws, plaster models are obtained. Using a chemical pencil, mark the perforations of the base wax on the jaw models. Based on the occlusal contacts obtained, the chewing efficiency of the patient's dentition is calculated before treatment.

The analysis of occlusiograms, which is the basis of our method, correlates with the chewing efficiency, measured functionally using V.N. Trezubov's chewing test. The "100%" value was taken from the samples in patients aged 18-25 years with central occlusion in orthognathic bite with intact dentition. Further, a functional test was performed in 62 patients aged 18-65 years with central occlusion in orthognathic bite with the absence of one of the teeth. A decrease in chewing efficiency was revealed in each patient in the absence of a certain tooth of different group affiliation in the sequence 1.7-4.7 in each case. This allowed the creation of a table for calculating the chewing efficiency for each tooth in contact with the antagonists. A tooth with an antagonizing pair according to the occlusiogram was assigned a certain coefficient of chewing efficiency, based on the presence and absence of occlusal contact according to the occlusiogram. In this case, the occlusiogram shows an imprint in the form of depression on the wax, indicating occlusal contact. The presence or absence of an antagonizing pair is assessed, which is assigned a coefficient of chewing efficiency, determined by the functional test of V.N. Trezubov. Not every tooth is assessed, as in the statistical tables of N.A. Agapov, but the antagonizing pair. In this case, the coefficient is assigned not relative, but determined on the basis of V.N. Trezubov's functional test. The results are shown in Table 1.

Table 1

Antagonizing pair number 7 6 five 4 3 2 1 1 2 3 4 five 6 7 Chewing efficiency ratio,
% 12 12 ten 8 4 2 2 2 2 4 8 ten 12 12

The values of the coefficients of the chewing efficiency of antagonizing pairs are added to obtain the overall value of the dynamics of the chewing efficiency of the ILE.

After the orthopedic treatment has been carried out, the occlusiogram is re-obtained and evaluated, calculating the resulting value of the chewing efficiency with new occlusal contacts. Next, the change in the chewing efficiency of the chewing efficiency is calculated according to the formula:

IZhE = (X2-X1) / X2 * 100%, where

IZhE - dynamics (change) of chewing efficiency

X1 - chewing efficacy before treatment

X2 - chewing efficiency after treatment.

Positive values of the dynamics of chewing efficiency (more than zero) indicate an increase in chewing efficiency as a percentage relative to chewing efficiency before the start of dental orthopedic treatment. Negative values of the dynamics of chewing efficiency (less than zero) indicate a decrease in chewing efficiency as a percentage of the chewing efficiency before the start of dental orthopedic treatment, "0" increase - about the absence of the dynamics of chewing efficiency in percentage terms relative to the chewing efficiency before the start of dental orthopedic treatment and the absence changes in occlusal contacts between the teeth, or the loss of contacts in one part of the dentition and their appearance in another segment.

Description of drawings

Fig. 1 - Occlusiogram obtained before orthopedic treatment.

Fig. 2 - Models of jaws with marked occlusal contacts before orthopedic treatment.

Fig. 3 - Occlusiogram obtained after orthopedic treatment.

4 - Models of jaws with marked occlusal contacts after orthopedic treatment.

Clinical example of orthopedic treatment using the proposed method

Patient N., 21 years old. I consulted an orthopedic dentist for a defect in the hard tissues of the coronal part of the tooth 2.4. Before the start of treatment, an occlusionogram of the dentition was obtained (Fig. 1), impressions were taken and a model of the jaws was cast (Fig. 2). The models noted the occlusal relationship of the teeth (Figure 2). The absence of occlusal contacts on the central incisors and tooth 2.4 was recorded, and the chewing efficiency was assessed. It was:

X1 = 12 + 12 + 10 + 8 + 4 + 2 + 2 + 4 + 10 + 12 + 12 = 88%.

After orthopedic treatment and the manufacture of a cast stump insert with an artificial crown 2.4, an occlusiogram was obtained with new occlusal contacts (Fig. 3), the resulting contacts of the teeth on the jaw models (Fig. 4) were noted, the value of the chewing efficacy after treatment was calculated, it was:

X2 = 12 + 12 + 10 + 8 + 4 + 2 + 2 + 4 + 8 +10 + 12 + 12 = 96%.

The increase in chewing efficiency is equal to:

IZhE = (96% - 88%) / 88% * 100% = 9%

This result shows that as a result of orthopedic treatment, there is a positive value of the dynamics of chewing efficiency (greater than zero), which indicates an increase in chewing efficiency after dental orthopedic treatment in percentage terms relative to chewing efficiency before the start of dental orthopedic treatment of chewing efficiency, the number of antagonizing pairs increased, so This determines the positive dynamics of the results of orthopedic treatment.

Claims (2)

A method for measuring the dynamics of chewing efficiency at the stages of orthopedic treatment, including the assessment of chewing efficiency before and after dental orthopedic treatment, characterized in that the change in chewing efficiency is calculated according to the formula: IGE = (X2-X1) / X2 * 100%, where IGE is the change in chewing efficiency, where X1 is the chewing efficiency before treatment, X2 is the chewing efficiency after treatment; the assessment of chewing efficiency before and after treatment is carried out by summing the coefficients of chewing efficiency for teeth with antagonizing pairs, which are determined by obtaining an occlusiogram, while the 1st antagonizing pair is assigned a coefficient of chewing efficiency of 2%, the 2nd antagonist pair is assigned a coefficient of chewing efficiency of 2% , The 3rd antagonizing pair is assigned a chewing efficiency coefficient of 4%, the 4th antagonizing pair is assigned a chewing efficiency coefficient of 8%, the 5th antagonizing pair is assigned a chewing efficiency coefficient of 10%, the 6th antagonist pair is assigned a chewing efficiency coefficient of 12%, 7 -th antagonizing pair is assigned a chewing efficiency coefficient of 12%, and with a positive value of a change in chewing efficiency, an increase in chewing efficiency is determined as a percentage relative to chewing efficiency before the start of dental orthopedic treatment, with a negative value of the change in chewing efficiency, a decrease in chewing efficiency is determined as a percentage of chewing efficiency before the start of dental orthopedic treatment, "0" increase is about no change in chewing efficiency as a percentage of chewing efficiency before the start of dental orthopedic treatment and no changes in occlusal contacts between teeth or the loss of contacts in one part of the dentition and their appearance in another segment.

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