The way to increase prosthetic field with complete atrophy of the alveolar process of the mandible
(57) Abstract:The invention relates to medicine, namely to dentistry. The purpose of the invention is the increase in the prosthetic field, improving the fixation of the prosthesis, eliminating the need to manufacture forming temporary prosthesis and accelerate the preparation of the mouth for prosthetics. The essence consists in the formation of the prosthetic field due not only speaking, but also due to the vestibular surfaces of the body of the mandible by means of displacement of the mucosa and the jaw-hyoid muscles of the floor of mouth and the formation of the transition folds, creating a trapezoidal flaps of mucous cheeks and sew them with the mucous membrane of the floor of mouth under the edge of the lower jaw and close the wound surface from the lingual side of the body of the mandible free edge of the trapezius flap. The advantage of the suggestions in improving functional outcomes. The invention relates to medicine, namely to dental surgery.There is a method of increasing the prosthetic field with complete atrophy of the alveolar process, which consists in the dissection of the mucosa from the lingual side at the base of the alveolar process, the peeling her blunt way and cast to the edge of the lower jaw, where fixed with sutures. Further impose a pre-fabricated form the prosthesis with long edges and leave it to the patient to complete healing of wounds.The disadvantage of this method is the increase in the prosthetic field only due to the lingual surface of the body of the mandible, which reduces the possibility of fixation of complete dentures, creates a wound surface, which epitheliums secondary tension, lengthening the healing time, the need to produce a temporary form of prosthesis.The aim of the invention is the increase in the prosthetic field to improve the fixation of the prosthesis, eliminating the need to manufacture forming temporary prosthesis, the acceleration of the preparation of the mouth for prosthetics.This goal is achieved by increasing the prosthetic bed, not only by speaking, but by the vestibular surface of the body of the mandible, the formation of the transition fold bias and the stitching of the lining of the floor of mouth and cheeks on the edge of the lower jaw.The method is as follows.Under local wiring and infiltration anesthesia, departing from the midline projection of the alveoli is impressive. On the midline of the lateral parts of the lower jaw there are two bridge flap. From the ends of the horizontal section from the vestibular side to side cheeks spend a vertical slits for forming the trapezoidal flaps. The height of the trapezoidal flaps must be equal to the height of the body of the mandible, i.e., of 2.0-2.2 see From the lingual side mucous with muscle bottom of the mouth move up to the level of the edge of the lower jaw. Bridge pieces usepreview from the body of the jaw. Trapezoidal flaps down under the bridge, "P"-shaped seam base of the trapezoidal flaps sew with the lining of the floor of mouth under the body of the mandible, the free edge of the trapezius flap stitched to the edges of the mucous membrane of the floor of mouth, closing lingual wound surface of the lateral parts of the body of the mandible. In places of contact of the mucous membrane of the trapezoidal flaps with bridges are deepithelization trapezoidal flaps. When forming the trapezoidal flaps and displacement of the bottom of the mouth to the level of the edge of the lower jaw periosteum of the body, the jaw is not damaged and does not exfoliate from it.Thus, in the result of the operation of the prosthetic field increases at the expense of speaking is the stenosed, because the wound is closed and does not require the manufacture forming the prosthesis.Examples of specific use.1. Patient B. 1927 birth, outpatient map N 52137, turned 16.01.95, dental polyclinic N 1 for prosthetics. Diagnosis: complete secondary edentulous, atrophy of the alveolar process of the mandible. The patient twice made dentures, which he could not use due to insufficient fixation. 28.01. held surgical preparation of the mouth for dentures, consisting in the increase in the area of prosthetic field under the wire and infiltration anesthesia with 2% solution of novocaine in 20 ml.Progress: from the vestibular side of T to T held horizontal incisions, departing 3 mm from the midline projection Trofimovna alveolar ridge, which ends in the side cheeks held vertical cuts equal to 2 see Derived trapezoidal flaps of mucous membrane separated and mobilized through the mucous membrane of the cheeks. From the lingual side is made horizontal cuts equal to the length of the cuts from the vestibular side, stepping back from the middle line of proekti is on the mouth along with the muscle is shifted to the level of the edge of the lower jaw, the ends of the ligature carried out under the base of the trapezoidal flaps vestibular side so that the left free edge of the trapezius flaps sufficient to close the wound surface from the lingual side. Under the bridge mucoperiosteal flaps held free edges of the trapezoidal flaps vestibular side, pre-decapitalization in contact with mucoperiosteal bridge rags, and their edges are sewn with offset mucosa floor of mouth. Thus, in the result of the operation is increased prosthetic field with vestibular and lingual side. After 7 days the stitches removed and after 10 days from the date of removal of the stitches started manufacturing of the prosthesis. Control 27.02.95, uses the prosthesis, fixation of its good.2. The patient, outpatient map N 52525, addressed to the city dental polyclinic N 1 13.01.95, for restoration. Diagnosis: complete secondary edentulous, atrophy of the alveolar process of the mandible. After removal of the last tooth on the lower jaw of the patient stopped using removable dentures due to poor fixing. 28.01. held surgical preparation of the mouth for dentures, consisting of STE 25 ml conducted the incision of the mucous membrane from the vestibular side of T to T teeth, stepping back from the middle line of the projection of the alveolar ridge by 3 mm further from the end of the incision in the side cheeks were two incision of the mucous membrane, 2,2, see Formed a trapezoidal flap. The periosteum of the mandible are not damaged. From the lingual side held the incision of the mucosa. Departing at 3 mm from the midline projection of the alveolar ridge and without damaging the periosteum, made a "pocket" to the edge of the lower jaw. "P"-shaped suture the mucosa of the floor of mouth beneath the edge of the lower jaw and sewn with the base of the trapezoidal flap vestibular side. The free edge of the trapezoidal flap brought under the pre-separated mucoperiosteal flap in contact with him dipetalonema. The free edge of the trapezoidal flap sewn to the edge of the mucous membrane of the floor of mouth. While the wound surface lingual side of the lower jaw is completely closed. A similar operation was carried out on the other side of the jaw. Healing by primary intention. After 10 days, started manufacturing of removable dentures. Control 14.03.95 g showed a good fixation of the prosthesis.Significant differences from the prototype is the formation of a trapezoidal flap with La jaw, closing the wound surface lingual side of the body of the mandible.The advantages of the proposed method:
1) prosthetic field increase both through language and through the vestibular surfaces of the body of the mandible and improve the fixation of the prosthesis;
2) remove the wound surface lingual side of the jaw body;
3) eliminate the need to manufacture forming the prosthesis and accelerate the production of the permanent prosthesis;
4) accelerate the preparation of the mouth for prosthetics. The way to increase prosthetic field with complete atrophy of the alveolar ridge of the mandible, which consists in shifting the mucous membrane of the floor of mouth with jaw-hyoid muscle, characterized in that, to increase the prosthetic field, improve the fixation of the prosthesis, eliminating the need to manufacture forming temporary prosthesis and accelerate the preparation of the mouth for prosthetics, prosthetic field increase not only through language but also through the vestibular surfaces of the body of the mandible by means of displacement of the mucosa and the jaw-hyoid muscles of the floor of mouth and the formation of the transition folds, creating a trapezoidal flaps of mucous cheeks, Shiva the second side of the body of the lower jaw free edge of the trapezoidal flaps.
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
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.
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.
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.
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.
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.
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.