RU2796906C1 - Mouthguard and method of a mouthguard manufacturing - Google Patents

Abstract

FIELD: medicine; dentistry.

SUBSTANCE: group of inventions relates to medicine, namely to a mouthguard and a method of its manufacturing. To make a mouthguard, impressions are taken, models are cast and plastered in an articulator, the bite height is increased and a primary model of the mouthguard is made. The choice of the jaw for placement of the mouthguard is carried out on the basis of diagnostics, depending on physiological features of the maxillofacial region of the patient. On the primary model of the mouthguard, contacts are modeled in the position of antherization of the lower jaw model in the articulator, as well as primary contacts in the initial position of the central ratio, and a transition between multiple and primary contacts is formed in such a way that when the teeth close, the lower jaw slides forward. After that, using the angle of inclination of the incisive table of the articulator, the frontal slope and lateral slopes are formed at the angle of inclination of the incisive table during lateral movements for the canine at 51 degrees, for the first premolar at 44 degrees, for the second premolar at 35 degrees, for the first molar at 26 degrees.

EFFECT: increased efficiency and quality of splint therapy due to mouth guard designed and manufactured on the basis of complete diagnostics and individual parameters of the patient.

9 cl, 39 dwg

Description

The present invention relates to medicine, in particular to dentistry, and in particular to a method for manufacturing a mouthguard and a mouthguard made by this method and intended for the treatment and prevention of muscle and joint dysfunctions, arthrosis and other diseases of the temporomandibular joint (TMJ). In addition, kappa can be used in other branches of medicine, for example, in osteopathy, in the treatment of postural problems of patients, in the combined treatment of trigeminal neuritis, facial nerves, headaches and facial pain in neurology, sports medicine to improve training results [A61C 7/00 , A61C 7/36].

Known from the prior art DESIGN OF FASTENING OCCLUSIVE TIRE FOR THE TREATMENT OF PATHOLOGIES OF THE TEMPOROMANDIBULAR JOINT [EN 207098 U1, publ. October 12, 2021], including an occlusal splint and attachments formed on the teeth. The occlusal splint consists of a biting part and a burl part. The burl part is designed to fix the occlusal splint on the teeth. The surface of the burl part adjacent to the teeth is provided with recesses of a predominantly spherical shape, made to match in shape and location with the attachments formed on the teeth from a composite material.

The disadvantage of the analogue is the absence of structural elements that contribute to the reproduction of lateral occlusal movements directed along the path of "canine guidance", which lengthens the period of restoration of the occlusal-articulatory relationship of the dentition.

The closest in technical essence is the MICHIGAN TIRE [lecture OCCLUSIVE TIRES: TYPES AND ROLE IN COMPLEX THERAPY OF PATHOLOGY OF THE TEMPOROMANDIAN JOINT JOINT // Naumovich Semyon Antonovich, Doctor of Medical Sciences, Professor, Head. Department of Orthopedic Dentistry, Belarusian State Medical University, Naumovich Sergey Semenovich, Candidate of Medical Sciences, Associate Professor, Department of Orthopedic Dentistry, Belarusian State Medical University // Modern Dentistry (Minsk). - 2014. - No. 1. - S. 7-10], belonging to the group of resolving (permissive) tires with contacts throughout the dental arch, which is the most commonly used and versatile design. These designs create simultaneous contacts on all teeth when the articular heads are set in the correct position. It is very important that the positioning of the articular heads in the central relation coincides with the uniform contacts of the teeth on the splint. Stabilizing splints evenly distribute the load during parafunctions, reduce muscle tone, set the articular heads in a central relationship with the creation of a free central occlusion. The most famous is the Michigan splint for the upper jaw. These tires are made by means of an articulator with preliminary fixation of the central ratio. With eccentric movements, only the anterior teeth should be in contact with the immediate disengagement of the lateral teeth, which is achieved by thickening the splint on the palatal surface of the upper canine with the creation of lateral canine guidance. The occlusal surface of the splint is modeled flat, sometimes slight indentations are allowed for the cusps of the teeth of the opposite jaw.

The main technical problem of the prototype is the fact that these tires are installed mainly on the upper jaw, which does not provide variability in the use of known tires depending on criteria, such as the patient's bite, missing teeth in the upper or lower jaw, the position of the occlusal plane, as well as the subsequent treatment.

The objective of the invention is to eliminate the disadvantages of the prototype.

The technical result of the invention is to increase the efficiency and quality of the splint therapy due to the kappa, designed and manufactured on the basis of a complete diagnosis and individual parameters of the patient.

This technical result is achieved due to the fact that the method of manufacturing a mouthguard, characterized by preliminary removal of impressions from the patient's jaws, casting models of the patient's jaws from gypsum, plastering the models of the patient's jaws in the articulator through the register of the central ratio and along the facial arc, increasing the bite height and making the primary models of a mouthguard in the form of a plastered model of the selected jaw, characterized in that the choice of the jaw for placement of the mouthguard is carried out on the basis of diagnostics depending on the physiological characteristics of the patient's maxillofacial region or depending on the subsequent orthodontic or orthopedic treatment, after which contacts are modeled on the primary model of the mouthguard in the final position of the lower jaw after closing the teeth on the mouthguard in the position of antherization of the model of the lower jaw in the articulator, as well as the primary contacts in the initial position of the central ratio, form the transition between the contacts in the final position of the lower jaw after the closing of the teeth on the mouthguard and the primary contacts in such a way that when the teeth closed, the lower jaw slipped forward, after which, using the angle of the incisive table of the articulator, the lateral slopes and the frontal slope were formed, while the lateral slopes were formed at the angle of the incisive table during lateral movements for the canine at 51 degrees, for the first premolar - 44 degrees , for the second premolar - 35 degrees, for the first molar - 26 degrees, and the kappa is made individually for each patient based on the diagnosis and cephalometric analysis data.

In particular, the jaw for placing the mouth guard is selected depending on the patient's bite. In particular, the jaw for placement of the mouth guard is chosen depending on the missing teeth to create occlusal support.

In particular, the jaw for placement of the kappa is chosen depending on the position of the occlusal plane.

In particular, the change in the bite height and antherization of the lower jaw model in the articulator is carried out on the basis of diagnostics and cephalometric analysis data.

In particular, a primary mouthguard model is made by light curing a light curing material.

In particular, the angle of transition between the contacts in the position of antherization of the bottom model

jaw in the articulator and primary contacts is 40-45 degrees.

In particular, the frontal slope is formed at an incisal table inclination angle of 40 degrees.

This technical result is also achieved due to the fact that the kappa, made of a light-cured material and having antagonist contacts in the final position of the lower jaw after closing the teeth on the kappa, as well as primary contacts between the antagonists and the occlusal surface of the kappa, characterized in that the transition angle between the contacts in the final position of the lower jaw after closing the teeth on the mouthguard and primary contacts is 40-45 degrees, the angle of the lateral slopes in the direction of canine guidance in the canine area is 51 degrees, in the area of the first premolar - 44 degrees, in the area of the second premolar - 35 degrees, in the area of the first molar is 26 degrees, and the angle of the frontal slope is 40 degrees, and the mouth guard is made individually for the patient based on the diagnosis and data of cephalometric analysis in accordance with the criteria for selecting the jaw for wearing the mouth guard, depending on the individual characteristics of the patient or subsequent treatment.

Brief description of the drawings.

In FIG. 1 shows an example of a jaw model.

In FIG. 2 shows a collapsible model of the jaw.

In FIG. 3 shows the register of the central ratio

In FIG. 4 shows the facial arch.

In FIG. 5 shows an articulator.

In FIG. 6 shows the installation of the facial bow in the articulator.

In FIG. 7 shows a mounting rack with a transfer table.

In FIG. 8 shows the fork of the front transfer bow.

In FIG. 9 shows the transfer of the fork of the front bow to the transfer table of the mounting rack.

In FIG. 10 shows the application of plaster on the surface of the transfer table.

In FIG. 11 shows the installation of the front bow fork on the cast.

In FIG. 12 shows the removal of the fork joint of the facebow.

In FIG. 13 shows the removal of the transfer table from the mounting stand.

In FIG. 14 shows the transfer of the transfer table to the articulator.

In FIG. 15 shows the installation of the model of the upper jaw in the articulator.

In FIG. 16 shows the zero position of the incisal table.

In FIG. 17 shows a die for plastering the upper jaw.

In FIG. 18 shows the implementation of the rim on the model of the upper jaw.

In FIG. 19 shows the distribution of plaster over the surface of a model of the upper jaw.

In FIG. 20 shows the placement of an air bubble film interlayer.

In FIG. 21 shows a plaster cast of a model of the upper jaw.

In FIG. 22 shows the reapplying of plaster on a set plaster of a model of the upper jaw.

In FIG. 23 shows the articulator with the transfer table removed and the model of the upper jaw in plaster.

In FIG. 24 shows the reversal of the articulator.

In FIG. 25 shows the installation of the model of the lower jaw on the cast model of the upper jaw through the register of the central ratio.

In FIG. 26 shows the raising of the incisal pin.

In FIG. 27 shows a plaster cast for a lower jaw model.

In FIG. 28 shows the installation of a mandibular model casting die under the lower inverted frame of the articulator.

In FIG. 29 shows the implementation of the side on the model of the lower jaw.

In FIG. 30 shows the distribution of gypsum over the gypsum plate for the model of the lower jaw.

In FIG. 31 shows a kappa on the upper jaw with a crossbite.

In FIG. 32 shows a kappa with missing teeth.

In FIG. 33 shows a kappa on the lower jaw with a high angle of inclination of the occlusal plane.

In FIG. 34 shows the displacement of the lower jaw forward (anterization).

In FIG. 35 shows a simulation of multiple contacts.

In FIG. 36 shows the simulation of the angle of inclination between the primary contacts and the final position of the mandible on the kappa (multiple contacts).

In FIG. 37 shows the displacement of the position of the hinge axis after splint therapy in accordance with example No. 2 of the effectiveness of treatment on the kappa of the present invention.

In FIG. 38 shows the dynamics of the right TMJ based on MRI data in accordance with example No. 2 of the effectiveness of treatment with a kappa of the present invention.

In FIG. 39 shows the dynamics of the left TMJ based on MRI data in accordance with example No. 2 of the effectiveness of treatment with a kappa according to the present invention.

Implementation of the invention.

In an advantageous embodiment of the invention, the method for making a kappa is as follows.

Previously, impressions are taken from the upper and lower jaws of the patient and models are cast from gypsum of at least 4 hardness classes (see Fig. 1). In a non-limiting embodiment of the technical solution, the model of the lower jaw is made collapsible as shown in FIG. 2.

A register (see Fig. 3) of the central ratio of the patient's upper and lower jaws is preliminarily prepared to record the central position of the patient's upper and lower jaws, independent of occlusion.

Carry out gypsum models through the facial arc (see Fig. 4) to account for cranial features during gypsum.

The front bow post is installed in the articulator (see Fig. 5). The facial bow stand sets the parallelism of the lower and upper frames of the articulator and the facial bow (installation of the facial bow into the articulator is shown in Fig. 6).

In another embodiment of the technical solution, the fork of the face bow is screwed onto the transfer table of the mounting post (see Fig. 7).

The mounting rack is made with the possibility of adjusting the transfer table in height.

Gypsum is mixed.

Next, the fork of the front arc is fixed from its movement (shown in Fig. 8). The transfer of the fork of the front bow to the transfer table of the mounting rack is shown in Fig. 9. Spread the plaster over the surface of the transfer table (see Fig. 10) and place the fork of the facial bow on the plaster distributed over the transfer table (see Fig. 11). Remove the fork joint of the facial bow (see Fig. 12) and remove the transfer table together with the plaster from the mounting post (see Fig. 13). The transfer table is transferred to the articulator (see Fig. 14).

The model of the upper jaw is installed in the articulator (see Fig. 15), while paying attention to the position of the incisal table, which should be at zero, which determines the parallelism of the upper and lower frames (see Fig. 16).

Install the plate for plastering the upper jaw (see Fig. 17) under the upper frame of the articulator.

The distance between the die and the top of the model of the upper jaw is checked, if this distance is more than 1 cm, the plastering of the upper jaw is carried out in two stages. If the distance is less than or equal to 1 cm, plastering is carried out directly to the plate.

With adhesive tape, a rim is formed on the model of the upper jaw to limit the spread of the plaster (see Fig. 18). The plaster is kneaded and spread over the surface of the model of the upper jaw (see Fig. 19).

In the case, as mentioned above, if the distance between the die and the top of the upper jaw model is more than 1 cm, a layer of air bubble film is placed between the plaster and the die, mainly consisting of two layers (see Fig. 20, 21). Waiting for the plaster to set.

After the plaster has hardened, the zero position of the incisive pin is checked, as well as the distance between the die and the top of the plaster on the model of the upper jaw, which should be less than or equal to 1 cm. Next, the plastering of the model is repeated directly to the articulator die.

Gypsum is kneaded, the surface of the hardened gypsum is wetted on the model of the upper jaw, part of the gypsum is applied to the plate, the rest is applied to the hardened and wetted gypsum on the model of the upper jaw (see Fig. 22). Waiting for the plaster to set.

Next, proceed to the plastering of the model of the lower jaw. To do this, remove the transfer table and remove it from the articulator. The cast model of the upper jaw remains in the articulator (see Fig. 23). Turn the articulator over (see Fig. 24).

For plastering the model of the lower jaw, the incisal table of the articulator is placed from below. The model of the lower jaw is installed on the cast model of the upper jaw through the register of the central ratio (see Fig. 25). To compensate for the thickness of the register, the incisal pin is raised by 6 mm (see Fig. 26).

Place the mandibular cast plate (see Fig. 27) under the lower inverted frame of the articulator (see Fig. 28).

The distance between the die and the top of the model of the upper jaw is checked, if this distance is more than 1 cm, the plastering of the upper jaw is carried out in two stages. If this distance is less than or equal to 1 cm, plastering of the lower jaw model is carried out directly to the die and the lower inverted frame of the articulator. By means of adhesive tape, a rim is formed on the model of the lower jaw to limit the spread of the plaster (Fig. 29). The gypsum is kneaded and spread over the surface of the lower jaw model, as well as over the surface of the gypsum die for the lower jaw model (Fig. 30). Waiting for the plaster to set.

Further, depending on the physiological characteristics of the maxillofacial region of the patient, it is determined on which of the jaws the mouth guard will be installed. This determination is carried out as follows and depending on the following criteria:

1) Depending on the bite.

Different types of bite can be the basis for evaluating the most suitable jaw for the placement of the mouth guard. For example, in case of a crossbite, a mouthguard on the lower jaw will only increase the reverse overlap of the jaws, which can lead to excessive trauma to the cheeks or crowding of the teeth in the lower jaw and, accordingly, a lack of space in the front, it is more advisable to make a mouthguard on the upper jaw so as not to strengthen it ( see Fig. 31).

2) Depending on missing teeth.

To perform the function of creating occlusal support, a mouthguard is made for the jaw where the most teeth are lost, especially with end defects (see Fig. 32).

3) Depending on the position of the occlusal plane.

A high angle of inclination of the occlusal plane leads to a decrease in the angle of disocclusion of the dentition. In such cases, it is possible to make a mouthguard on the lower jaw, which will lead to a reverse rotation of the occlusal plane.

4) Depending on the subsequent orthodontic or orthopedic treatment. When making a mouthguard before orthodontics or orthopedics, further treatment should be planned. When braces or crowns are placed first on one jaw, the kappa can remain on the antagonists and continue to effectively assist in the treatment of the patient.

After selecting the jaw to make the mouthguard in the articulator, by raising the incisal pin a few millimeters, the bite is increased to obtain space for the mouthguard material. The change in the bite height is carried out on the basis of diagnostics and cephalometric analysis data.

Next, the primary model of the kappa is made. To do this, a light-curing material is applied to the selected cast jaw model to create occlusal splints and shaped into the model of the selected jaw.

In a non-limiting embodiment of the technical solution, a light-curing material is selected as the specified material for creating primosplint occlusal splints.

After that, the model of the light-cured material is subjected to light-curing and returned to the cast jaw model in the articulator.

Further, with the help of protrusion screws or inserts of the articulator, the lower jaw model is displaced (anterized) forward in the articulator (see Fig. 34). Anterization is carried out on the basis of diagnostics, axiography data and cephalometric analysis.

In the specified displaced front position on the kappa, multiple contacts are modeled by means of a cutter - the final position of the lower jaw after closing the teeth on the kappa (see Fig. 35).

After the formation of the final position, the model of the lower jaw is returned to its original position of the central relationship by returning the protusion screws to the zero position or removing the inserts (depending on the model of the articulator). In this position on the kappa, by means of a cutter, from two to four primary contacts are formed between the occlusal surface of the kappa and the antagonists. A smooth transition is modeled between the primary contacts and the final position of the lower jaw on the kappa (multiple contacts), so that when the teeth close, the lower jaw slides forward, the angle of inclination of this slope is no more than 40-45 degrees (see Fig. 36). The resulting position is not stabilized and occurs only at the moment of complete closure of the antagonists. Next, form the side slopes.

The lower jaw model is again shifted to the anterior position and the angle of inclination of the incisive table of the articulator is adjusted by 51 degrees in the canine position. The possibility of lateral movements from the front position along the slopes is modeled on the kappa using the incisal table inclination angle. The track of the canine area increases on the kappa in such a way that the antagonists and the surface of the kappa diverge during lateral movement. At the same time, the tilt angle of the table during lateral movements for the canine is set at 51 degrees, for the first premolar - 44 degrees, for the second premolar - 35 degrees, for the first molar - 26 degrees.

After the formation of the side slopes, the frontal slope is modeled and formed. To do this, using an adjustable incisal table, the inclination of the front slope of the kappa is set at an angle of 40 degrees. Next, check the kappa.

At the same time, it is checked that the sides of the mouth guard do not have a rand or other obstacles blocking the lateral and protrusive movements. If they are present, they are removed by polishing in the same way as all interfering and mediotrusion contacts. They also polish the impressions of the teeth on the kappa for a smooth transition and sliding on its surface.

The side walls of the kappa are brought to the equator of the lateral teeth to ensure the stability of the position in the oral cavity.

In the area of the anterior teeth, the area from the left lateral incisor to the right one is freed from the material of the mouthguard to ensure overlapping of the canines. Next, the kappa is completely polished and disinfected.

In addition, the claimed invention relates to a kappa intended for the treatment and prevention of muscle and joint dysfunctions, arthrosis and other TMJ diseases. Said kappa is made of light-cured material.

In a non-limiting embodiment of the invention, a light-curing material is selected as said material for creating primosplint occlusal splints.

The kappa has multiple contacts - the final position of the lower jaw after closing the teeth on the kappa (see Fig. 35), modeled in the position of antherization of the model of the lower jaw forward in the articulator. In this case, antherization is carried out on the basis of diagnostics, axiography data and cephalometric analysis. Also, the kappa has two to four primary contacts between the occlusal surface of the kappa and the antagonists, modeled in the initial position of the central relationship by returning the protusion screws to the zero position or extracting the inserts (depending on the articulator model).

A smooth transition is made between the primary contacts and the final position of the lower jaw on the kappa (multiple contacts), so that when the teeth close, the lower jaw slides forward, the angle of inclination of this slope is no more than 40-45 degrees (see Fig. 36).

The kappa contains lateral slopes made in the direction of canine guidance, while the angle of the lateral slopes in the canine region is 51 degrees, in the region of the first premolar - 44 degrees, in the region of the second premolar - 35 degrees, in the region of the first molar - 26 degrees.

Kappa also contains a frontal slope with an angle of not more than 40 degrees. Rationale for the choice of slope angles.

The temporomandibular joint is formed during fetal development, but it has a flattened shape and an unformed tubercle.

A powerful stimulus for the formation of the tubercle of the temporomandibular joint is the appearance of the anterior teeth, since before they appear, all movements are carried out in a horizontal plane. The appearance of teeth leads to the fact that there are interferences on the way of functional movements. The neuromuscular system begins to bypass these interferences by changing the direction of movement.

As the lower jaw and skull grow, under the influence of function, the tubercle takes a certain shape. It can be flattened if the teeth are not steeply inclined and retain the possibility for the lower jaw to move freely and vice versa, the cusp begins to form very pronounced if the teeth are tilted too much and prevent such movements.

Thus, the function sets one or another direction and form of development of the articular tubercle. At the same time, the pattern of functional masticatory movements is determined by the severity of occlusion. The steeper, more pronounced occlusion, the more vertical movements a person must make in order to open his mouth. Accordingly, a more sheer tubercle is formed with this.

A classic 1988 study by Nickel and MacLachlan showed the development of cusp slope in degrees with age, so that cusp formation occurs during teething and is almost complete by 14-15 years of age. Further, if the joint continues to grow, its steepness does not change much. Based on these premises, there is an understanding that since the temporomandibular joint was formed under the influence of function, that is, occlusion, there is a correlation between the degree of severity of the cusp and the degree of inclination of the cusps of the teeth.

If you look at the sagittal section through the tubercle of the temporomandibular joint and the central incisors, you can see that the path that the condyle of the temporomandibular joint passes along the tubercle (sagittal articular path), and the path that the lower incisor passes along the palatal surface of the upper (sagittal incisive path) have a clear correlation with each other. Since the lower jaw is a single bone, and all the movements that the condyle makes are congruent with the movements of the lower jaw.

If you draw lines through these paths, and lower the resulting tangutes to the reference plane (in this case, the Frankfurt horizontal), you can measure the angles - the angle of inclination of the sagittal articular path and the incisive path.

The same relationship exists between all teeth and the joint. But the angle of each tooth is different, since the distance from the joint to the incisors, canines, premolars and molars is different. In addition, when moving forward (protrusion), you can see the displacement only in the sagittal plane, and chewing movements occur during lateral excursions. Therefore, the angle of inclination of each tooth is different. During lateral movement, the incisors and premolar lead, and the canine has not yet erupted, thus, different teeth are responsible for lateral movement at different periods of time, as the teeth erupt, therefore there is a strong correlation between the inclinations of the teeth and the angle of inclination of the sagittal articular path.

These angles can be measured with an articulator and an adjustable incisal table, as well as with a number of other devices.

Appropriate measurements were taken and data were obtained for a flat joint (with an unexpressed angle of inclination of the sagittal articular path), medium and steep, since for a different degree of severity of the tubercle, there will correspond a different degree of severity of the inclination of the teeth and, consequently, the tubercles and slopes of the teeth. When working with patients with dysfunctions of the temporomandibular joint, for the manufacture of a mouth guard according to the present invention and the formation of its slopes, parameters with data for a flat joint are taken. This is because steeper occlusion creates more aggressive and blocking tooth tilts, which are more efficient in terms of chewing food, but put more strain on the muscles to make these movements. And in the case of muscle and joint dysfunctions, it is necessary to reduce chewing loads on the joint and muscles. Therefore, regardless of the severity of the joint, the most “flat” data are used to form the occlusal surface of the kappa.

With the help of these parameters, the incisal table is adjusted and, by carrying out lateral movements with the incisive pin along the incisal table, the appropriate angle of inclination of the mouthguard slope is set depending on the antagonist's tooth.

The formation of retrusion control (restriction and direction during backward movement) follows the same principles as the protrusion modeling (forward movement). That is, in fact, the incisive table is turned with its working wing back and the return movements of the models relative to each other in the articulator are carried out along it. Thus, the necessary retrusion slope is formed.

In addition, if measurements of the Gibbs chewing loop are taken, its angle during chewing excursions in healthy people is approximately 40-42 degrees.

Since, as mentioned above, the degree of severity and amplitude of these movements is determined by the severity of occlusion, therefore, for retrusion, an inclination angle of approximately 40-42 degrees is used.

When installing a mouthguard in the oral cavity, the following rules for wearing a mouthguard are observed.

1. Wearing a mouthguard only at night.

2. During the period of adaptation (the first 3-4 days of use), the time of wearing the mouth guard can be increased.

3. The mouthguard does not change the position of the mandible and does not form anything new, so the patient should not place the jaw artificially in any ratio on the mouthguard. Its main task is to forget about it after putting it on the dentition.

4. After installing the mouth guard, the patient should come to visit No. 1 for correction no earlier than 2-3 days, but no later than 4 days. At this visit No. 1, interferences that cause discomfort to the patient (roughness, sharp surfaces, excessive pressure on the teeth, etc.) are eliminated. Occlusion is usually not corrected.

5. Visit No. 2 - in 1.5-2 weeks, but no later than 3 weeks. At this visit, the objective condition of the patient and his reaction to splint therapy are fully checked, the occlusion index is calculated, palpation is performed, etc. Drug therapy is prescribed (according to indications, in accordance with the diagnostics), since the correction of dysfunction of the temporomandibular joint (TMJ) is complex.

6. Visit No. 3 - in 1.5-2 weeks, but no later than 3 weeks. At this visit, the objective condition of the patient and his reaction to splint therapy are fully checked, the occlusion index is calculated, palpation is performed, etc. Physiotherapy and exercise therapy are prescribed.

7. Visit No. 4 - in 1.5-2 weeks, but no later than 3 weeks. At this visit, the final control of the performed splint therapy is carried out, and, as a rule, all the symptoms of TMJ and pain either completely disappear or decrease significantly. Kappa is stored in special containers. After use, the kappa is processed and cleaned with toothpaste and a brush. Special treatment and additional disinfection are carried out at control appointments.

Examples of the effectiveness of treatment on the kappa in accordance with the claimed invention.

Example 1. Patient M., born in 1993. Dental history: Restriction of mouth opening. Lack of clear contact between the teeth when closing. Feeling of discomfort while chewing food (lost weight). Sensation of tightness in the muscles on the left side. Previously pawned ears. Pain in the forehead, closer to the bridge of the nose. Marked sensitivity of the anterior teeth. Frequent headaches (3 times a week, GSB score 6-7). Feeling of pulsation and discomfort in the area of both TMJ.

Diagnosis: Muscular and joint dysfunction. Myofascial pain. Bruxism. Capsulitis of the left TMJ. TMJ pain dysfunction syndrome K (07.60). Pronounced hypomobility of the articular heads. Bilateral complete anteromedial dislocation of both TMJs. Bibalanced occlusal scheme. Gingival type of smile. Pronounced dolichofacial type of skull growth, tendency to skeletal form of open bite, mesiofacial type of mandibular growth, II skeletal class, upper jaw is in a neutral position, lower jaw - pronounced retrognathia, face height within the normal range, protrusion of the upper and lower incisors are sharply increased, the slope of the upper incisors is normal, the lower ones are sharply increased, the inter-incisor angle is reduced. Convex profile, retrusion of the upper lip. Deviation of the nasal septum. Displacement of C2, C3, C4, changes in the cervical spine.

As part of the complex treatment, therapy was carried out on a kappa in accordance with the present invention, made individually for the patient on the basis of diagnostic data.

1 month after treatment. Decreased hypertonicity, noted the absence of headaches, restoration of sleep disturbance. Restoration of the possibility of eating.

Example 2 Patient E., born in 1989 Dental history: problems with chewing solid food, crunching when chewing in the right TMJ, rapid fatigue of the masticatory muscles, recurrent headaches, pain in the joints, back. Posture problems. Diagnosis: disc displacement in the right TMJ with reduction. Stiffness in the joint (M25.6). Osteoarthritis of the right and left TMJ, muscular and articular dysfunction of both joints.

As part of the complex treatment, therapy was carried out on a kappa in accordance with the present invention, made individually for the patient on the basis of diagnostic data.

A year and a half after treatment (April 2017-December 2018): the position of the hinge axis shifted after splint therapy (Fig. 37), positive dynamics of the right and left TMJ was noted based on MRI data with a difference of one and a half years (Fig. 38 and 39). The patient noted the restoration of chewing functions, reduction of periodic pain.

The technical result of the invention - an increase in the efficiency and quality of splint therapy - is achieved by a mouthguard made individually for each patient on the basis of diagnostics and cephalometric analysis data in accordance with the criteria for choosing a jaw for wearing a mouthguard, depending on individual characteristics, in particular, such as bite of the patient, missing teeth in the upper or lower jaw, the position of the occlusal plane, as well as subsequent treatment.

It should be understood that the preferred embodiments of the invention described above by way of example do not limit the scope of the present invention. Upon reading this description, those skilled in the art may suggest many changes and additions to the described embodiments, all of which will fall within the scope of the invention as defined by the claims.

Claims (9)

1. A method for manufacturing a mouthguard, characterized by preliminary removal of impressions from the patient's jaws, casting models of the patient's jaws from plaster, plastering of the patient's jaw models in the articulator through the register of the central ratio and along the facial arch, increasing the bite height and making the primary model of the mouthguard in the form of a plastered model of the selected of the jaw, characterized in that the choice of the jaw for placement of the mouthguard is carried out on the basis of diagnostics depending on the physiological characteristics of the maxillofacial region of the patient or depending on the subsequent orthodontic or orthopedic treatment, after which contacts are modeled on the primary model of the mouthguard in the final position of the lower jaw after closing teeth on the mouth guard in the position of antherization of the lower jaw model in the articulator, as well as primary contacts in the initial position of the central ratio, form the transition between the contacts in the final position of the lower jaw after closing the teeth on the mouth guard and the primary contacts in such a way that when the teeth are closed, the lower jaw slips forward, after which, using the angle of inclination of the incisive table of the articulator, the lateral slopes and the frontal slope are formed, while the lateral slopes are formed at an angle of inclination of the incisive table during lateral movements for the canine of 51 degrees, for the first premolar - 44 degrees, for the second premolar - 35 degrees , for the first molar - 26 degrees, and the kappa is made individually for each patient on the basis of diagnostics and cephalometric analysis data. 2. The method according to p. 1, characterized in that the jaw for placing the mouthguard is chosen depending on the patient's bite. 3. The method according to claim 1, characterized in that the jaw for placing the mouth guard is selected depending on the missing teeth to create occlusal support. 4. The method according to p. 1, characterized in that the jaw for placing the mouth guard is selected depending on the position of the occlusal plane. 5. The method according to claim 1, characterized in that the change in the bite height and antherization of the lower jaw model in the articulator is carried out on the basis of diagnostics and cephalometric analysis data. 6. The method according to p. 1, characterized in that the primary model of the kappa is made by light curing a light curing material. 7. The method according to claim 1, characterized in that the transition angle between the contacts in the position of antherization of the lower jaw model in the articulator and the primary contacts is 40-45 degrees. 8. The method according to claim 1, characterized in that the frontal slope is formed at an incisal table inclination angle of 40 degrees. 9. Kappa made of light-curing material and having antagonist contacts in the final position of the lower jaw after closing the teeth on the mouthguard, as well as primary contacts between the antagonists and the occlusal surface of the mouthguard, characterized in that the transition angle between the contacts in the final position of the lower jaw after closing the teeth on the kappa and primary contacts is 40-45 degrees, the angle of the lateral slopes in the direction of canine guidance in the canine area is 51 degrees, in the area of the first premolar - 44 degrees, in the area of the second premolar - 35 degrees, in the area of the first molar - 26 degrees, and the angle of the frontal slope is 40 degrees, and the mouth guard is made individually for the patient based on the diagnosis and data of the cephalometric analysis in accordance with the criteria for choosing the jaw for wearing the mouth guard, depending on the individual characteristics of the patient or subsequent treatment.

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