The prosthesis jaw

 

(57) Abstract:

Usage: in oral and maxillofacial surgery with improved interaction with tissues and enhanced functionality of the prosthesis. The inventive prosthesis jaw contains a perforated base with means of attachment, made in the form of cylinders mounted on axes at the ends of the base, and the cylinder is equipped with ball swivel ends 2, the side support surfaces as oriented to the base faces 6 and swivel limiters in the form of rivets 3, made with the possibility of installation in equal diameters response rivet holes 4 and 5, located at the base and cylinders can be locked down opposite each other, while, on the basis of the response to the rivet holes 5 are grouped on the axes, and the cylinders are oriented perpendicular to the faces 6. 2 Il.

The invention relates to medicine, in particular to oral and maxillofacial surgery and can be used in the production of maxillary dentures for operations osteosynthesis.

It is known that fractures of the jaws comprise about 2.5% of all fractures of the bones of the skeleton. Fractures of the mandible are the justi 25 30 days and saves the patient from which can be deformations (wire bus, superimposed on the teeth). With an open fracture of the mandible, due to the displacement of bone fragments, broken not only swallowing, and chewing, the tongue loses the support and drops.

The correct form of one or another part of the face should not affect the function of organs.

The main goal of plastic surgery is to restore form and the main function is completely lost or destroyed organs and parts of the face, particularly those involved in breathing, swallowing, speech, eating, mobility of the lower jaw.

In closed fractures of the upper and lower jaws produce the reposition of bone fragments and fixation wire tires, or perform the operation of osteosynthesis connection of fragments of bone, metal and plastic devices. Recently received a distribution of binding damaged jaws nylon thread and tape standard tires. Fragments of a jaw fixed with nylon thread, wire, needles, rods or staples. Significant bone defects with enough soft tissue substitute canned with bones or taken out of the body injured.

However, this requires additional home the most frequently used implants, made of organic glass. Implants of this material causes the least amount of reaction in the body. In the preoperative period prepares the implant out of the bar plexiglass with a platform for robust bone fragments. After extracting half of the lower jaw implant is introduced into the wound one end into the joint cavity, and the other under the periosteum and secured in the form of "Russian castle" to the fragment of a jaw with two bone sutures of nylon yarn. However, when using implants made of plexiglass not excluded cases of suppuration of postoperative hematomas, which leads to the necessity of removal of the implants and repeated surgery (facial Defects and their elimination" of Arsentev, M. Knowledge, 1980).

So now when you perform operations osteosynthesis used titanium implants made from a sheet of perforated titanium.

Known system DTM, designed for primary and secondary final bone restore mandibular (jaw) malformations, including temporo-mandibular joint, after radiotherapy and other methods of recovery, not giving due to one reason or another positive is uchet titanium implants certain shapes, which allow you to easily and accurately apply the implants to the bone contours of the chin and mandibular angle. Thus, we achieve automatic adjustment and cosmetically acceptable reconstruction.

Due to the fact that the implant has the shape of a basket, a particle spontz can be adapted and attached to any defect, and connected with the jaw plate without producing cracks and cavities, the pieces spontz is added to the hydroxyl Apatite granules.

Rigid fixation system is achieved by connecting monokaryotic titanium screws having various capabilities of their placement, because the bond capillary tube overwhelmed with jaw pads.

Head screws and svenciausios holes mutually adjusted and guarantee the precise coupling of the implants.

Autogenous Pontos, which is generated from the iliac crest and, if necessary, mixed with hydroxyapatite, is filled in the implant, which is made in the shape of a basket and compressed so that no gaps between the pieces of bone and jaw plates. (The prospect of Germany "AOSW LEIBINGER DUMBACH, TITAN-MESH-SYSTEM (DTM)" Oswald Leibinger GmbH, Germany, 1990).

Also known dental protezy bone defects in the facial part of the skull (U.S. Pat. US N 3435525).

However, these systems have one major shortcoming. The use of these systems is possible only in cases when the lower jaw is subject to prosthetics, partially preserved, thus ensuring that osteosynthesis.

In the complete absence or complete damage of the lower jaw to make her prosthesis is not possible.

The alleged invention aims to eliminate this drawback and expand the functionality of the prosthesis when conducting operations in the field of maxillofacial surgery. This is achieved by the fact that the prosthesis to the jaw that contains a perforated base, means mounting is made in the form of a cylinder mounted on axes at the end of the base, and the cylinder is equipped with ball swivel ends, the lateral support surfaces in the form oriented to the base of the flats and swivel limiters in the form of rivets, made with the possibility of installation in equal diameters response rivet holes located at the base and cylinders can be locked down opposite each other, while, on the basis of the response to the rivet holes are grouped in OS is found, that claimed the prosthesis to the jaw meets the criteria of the invention of "novelty."

The comparison of the proposed solutions not only prototype, but also with other technical solutions in this field of technology is not allowed to reveal in them the features distinguishing the claimed solution to the prototype that allows to conclude that the criterion of "inventive step".

The invention is illustrated by drawings (Fig. 1 and Fig. 2). In Fig. 1 shows a scan of titanium implant perforated form; Fig. 2 the design of the prosthesis to the jaw where:

1 titanium implant

2 hinges

3 rivet

4 holes in the hinges

5 additional holes in the titanium implant

6 flats

The installation of the prosthesis to the jaw as follows. Originally performed pre-installation of the prosthesis to ensure cosmetically acceptable reconstruction. This is achieved by determining the required angle fixing hinges 2 relative to the titanium of the implant 1 and the subsequent fixing of hinges 2 by setting the second rivet 3 in another hole 4 of the hinge and in one of the holes 5 in the titanium implant is made in the area of installation of the hinges. For ccli fixing hinges at the required angle relative to the titanium implant is the final installation of the prosthesis jaw surgery osteosynthesis. In case you need full restoration in the mandible, the prosthesis of the lower jaw by means of hinges is attached to the upper jaw. For the best "vivement and adaptation in the upper jaw end of the hinges has a spherical shape.

A special coating of titanium implants and hinges allows as much as possible to reduce the healing process, and to provide full resistance to corrosion of the prosthesis to the jaw. Large perforation of the implant significantly facilitate the ingrowth of blood vessels and neovascularization of bone of the graft. The implant is stable enough without any premaxillary fixation and does not require post-operative fixation. The hinges allows the operation of osteosynthesis associated with complete dentures in the lower jaw. In the case of a partial fracture of the lower jaw hinges can not be used by unplugging them from the titanium implant. The decision is taken separately in each case surgery osteosynthesis. Titanium implant with a predetermined shape and easily modifiable enables correct, symmetrical and aesthetically acceptable reconstruction of the jaw, including the issue is on the geometric shape and material used, physical and biochemical properties of the implant is regulated to a curved base jaw. As the prosthesis to the jaw during chewing passes the functional stimulus (the stimulus) on the bone, there is no danger of bone loss from protection under the pressure."

Given that the proposed design of the prosthesis to the jaw allows complete prosthetic lower jaw, we can conclude that even when large defects of the jaw, which can be reconstructed, there is no need for osteotomy of the respective large and hard of transplants of the iliac crest and their adaptation to the jaw pieces.

Furthermore, the design of the proposed prosthesis jaw allows (if necessary) to make it implants certain desired shapes (for example the left side of the jaw, right side of the jaw or chin).

Thus, the proposed prosthesis jaw has the following main advantages:

allows operation of osteosynthesis related to the full, not partial, prosthetics lower jaw;

allows cosmetically acceptable reconstruction in maxillofacial trauma and significantly roserade perforated base, having a means of attachment, characterized in that the fastening is made in the form of a cylinder mounted on axes at the ends of the base, and the cylinder is equipped with ball swivel ends, the lateral support surfaces in the form oriented to the base of the flats and swivel limiters in the form of rivets, made with the possibility of installation in equal diameters response rivet holes located at the base and cylinders can be locked down opposite each other, on the basis of the response to the rivet holes are grouped on the axes, and the cylinders are oriented perpendicular to the flats.

 

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FIELD: medicine.

SUBSTANCE: method involves using obturating prosthesis having basic and auxiliary surface connected to each other with additional anterior, posterior and two lateral vertically arranged surfaces forming a cavity. The anterior and posterior vertically arranged surfaces have slot-like recesses. Reference notch marks are produced on the auxiliary surface near nose. The alveolar process is manufactured as base and wall. Reference notch marks are produced on the base. Wall has holes for making process lightweight. Teeth are set on the wall.

EFFECT: simplified prosthesis design.

6 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: method involves basic and auxiliary horizontally arranged surfaces joined by means of additional frontal, back and two lateral vertically arranged surfaces with a plane being formed. The frontal and back vertically arranged surfaces have recesses as retention grooves. Reference notches are made in the nose area on auxiliary surface. The alveolar process is manufactured base and wall. The base has reference notches. The wall has openings for reducing process weight. Teeth are mounted on the wall. Three openings arranged as triangle which base is turned towards pharynx are produced in auxiliary surface of the obturator prosthesis. Metal containers having matrices pressed into them are introduced into the openings. Three openings arranged as triangle which base is turned towards pharynx are produced on the base bottom. Pedicles (flow gates) having retention notches are mounted in the openings. Each flow gate ends in patrix engageable with corresponding matrix.

EFFECT: simplified and reliable method for fixing alveolar process.

3 cl, 3 dwg

FIELD: medical engineering.

SUBSTANCE: device has partial removable palatine plate prosthesis bearing artificial temporary. The palatine plate has an anterior and two lateral segments connected to each other by means of screw in the anterior palatine fornix region allowing autonomous displacement. Cramp iron members are set on the fangs and on the boundary separating the anterior and lateral segments and on the second temporary molars. Shield for moving upper lip aside is placed in the area of dental arch defect along alveolar process with anterior segment. The shield forms slit between shield surface and gingiva. The shield is stretched to contact point of fang to the first permanent molar. Shield edge is made oval and congruent to transit fold contour.

EFFECT: cosmetically full-valued substitution of upper dental arch defect.

3 dwg

FIELD: medical engineering.

SUBSTANCE: method involves producing maxillary defect imprint, manufacturing its plaster model and modeling wax pattern of obturator prosthesis. The model is compressed with single basis wax layer. Recess is formed on the palatine part corresponding to defect shape. The basis and wax copy of artificial alveolar process is modeled and teeth setting is carried out. Plate is produced from basis wax as a cover closing the recess formed on the palatine part. The cover models the palatine fornix in which a hole of 10-15 mm large diameter is produced. The plate is fixed with wax on defect edges. The so modeled hollow obturator prosthesis is plastered into cuvette composed of two parts - bottom and cover. Model with obturator prosthesis in vertical position is plastered into lower cuvette part. Upper cuvette part is set and filled with liquid gypsum on vibrating table. Gypsum flows inside of obturator through an opening in palatine part. Metal wire loop is introduced into the obturator through an opening in wax plate. Wire diameter is 1.0-1.5 mm as large. The cuvette is hold to achieve full hardening of gypsum. The cuvette is opened after removing wax by applying evaporation method. Obturator model and upper cuvette part are filled with dough-like plastic. Both parts of the cuvette is joined and pressed in vertical direction using bench press. The plastic is polymerized. The prosthesis is removed from the cuvette. Gypsum and reinforcing wire are removed from the cuvette through the palatine part opening. The opening is closed with self-hardening plastic. The prosthesis is filed and polished and fitted in the oral cavity.

EFFECT: improved strength properties; exact correspondence to prosthesis bed.

10 dwg

FIELD: medicine.

SUBSTANCE: method involves manufacturing silicon cliché stensil for reproducing morphologic pattern of palatine surface of removable maxillary plate prosthesis base and individual pattern of transverse palatine sulci. The cliché stensil is a fragment of adjusted double anatomical maxilla impression with imprint of individual pattern of transverse palatine sulci. To do it, adjusted double anatomical maxilla imprint is to be produced using imprint silicone mass. After having produced the impression, palatine surface fragment is cut out from it. Wax is heated on oral side at the laboratory stage for manufacturing removable plate prosthesis when modeling removable final wax reproduction of maxillary plate prosthesis base; and the palatine surface is printed by means of earlier produced cliché stensil.

EFFECT: high accuracy in reproducing of individual palatine sulci pattern; full-valued rehabilitation of patients with partially or completely failing teeth.

FIELD: orthopedic stomatology.

SUBSTANCE: method of forming elastic silicone substrate on rigid plastic basis consists in that mechanically and chemically treated surface of rigid basis adjusting to prosthetic bed is moistened with monomer being a member of basis plastic composition, dried, and coated with adhesive primer. After 1 min pause, basis is introduced for 3-4 min into microwave field emitted by source with power 450-600 W. After microwave treatment, surface is coated by cold-cured elastomer and substrate layer is then formed in mouth cavity. Adhesive strength of layer is thus increased by more than 1.5-2 times when compared to conventional method.

EFFECT: increased strength of bond between soft substrate and rigid plastic basis, and prolonged service time of denture.

1 tbl, 3 ex

FIELD: medicine; orthopedics.

SUBSTANCE: compound-jam post-resection denture can be used for making compound-jam prosthetic appliances for patients having wide defects of tissues of jam-face area. Denture is made in form of removable construction which has fixing, substituting and hollow sealing parts. Groove is made additionally in denture which groove locates onto top surface of sealing part. There is also channel passing through denture which has input being made inside the groove. Output of channel is disposed between second pre-molar and first pre-molar inside interior to provide muscular retention of denture. Bottom of the groove is made to have inclination to input of channel.

EFFECT: possibility of self-release of liquid stored onto top part of sealing part of denture.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves is fulfilled in two stages. Collapsible structure of temporary combined gnathic prosthesis is manufactured at the first stage during the first two months. The prosthesis has two obturating parts having surfaces congruent to defect cavity manufactured from flexible plastic and removable full laminar dental prosthesis having locking thrusting member manufactured by means of transfer molding. The second stage involves manufacturing permanent one-piece removable combined gnathic prosthesis using transfer molding method after holding during 5-6 months to eliminate muscle contracture and form prosthesis bed. The prosthesis has hollow obturating part and full removable laminar dental prosthesis.

EFFECT: simplified production process; early stage cancer patient rehabilitation in half-maxilla resection cases.

FIELD: medicine.

SUBSTANCE: method involves covering dental structures or prostheses with ribbon manufactured from fibers and coating it with filling material layer. The ribbon is manufactured from fluorine-containing copolymer monofiber of circular cross-section woven as ribbon as it is shown on dwg 1.

EFFECT: provided dental structure balanced life when splinting and high adhesion degree of prosthesis to filling material.

2 dwg

FIELD: medical engineering.

SUBSTANCE: device has double layer base and artificial teeth. Base layer, facing prosthesis bed having external edges positioned in active movable part of mucous membrane in making engagement to transition vault fold enveloping upper lip frenulum and buccal folds with closing valve being formed, is manufactured from superelastic titanium nickelide. The base layer compensating alveolar process bone tissue atrophy is manufactured from acrylic plastic.

EFFECT: accelerated adaptation period; improved strength characteristics.

19 dwg

FIELD: medicine.

SUBSTANCE: method involves opening palatine suture to normal palate shape with slight width hypercorrection of superior dentoalveolar arch. Device having cap covering parietooccipital area, rubber braces, facial arch composed of intraoral arch and two lateral extraoral parts. Intraoral arch ends are fixed on the sixth maxillary teeth. The device is applied for acting with forth directed upwards and backwards towards the crown of head. A force is applied to the sixth maxillary teeth arranged symmetrically relative to the palatine suture. Force of 300 to 400 g is applied to each side of the maxilla for 12-14 h per day to reach occlusion normalization in sagittal and vertical plane.

EFFECT: accelerated treatment course; improved cosmetic results.

8 dwg, 2 tbl

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