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.

 

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