Resection removable denture in the upper jaw

 

(57) Abstract:

The invention relates to medicine, in particular to prosthetic dentistry and is intended to fill the defect of the upper jaw of different origin in those cases, when there is a message of the maxillary sinus or sinuses from the oral cavity into the inlet of the defect is the defect in the presence of teeth on the healthy side of the jaw. The technical result consists in the restoration of masticatory function with partial resection of the upper jaw when there are teeth on the healthy side of the jaw. Resection removable denture in the upper jaw contains the obturator 1, made of elastic plastic, the base of which is rigidly connected to the base 2 of the prosthesis. The obturator is made hollow with thin elastic walls repeatable reliefwartrol spatial configuration of the defect of the upper jaw. The base 2 of the prosthesis with metal tube 3, one end of which is connected to the cavity 6 of the obturator, and the other by threaded connection 4 with the tooth cap 5. 1 C.p. f-crystals, 1 Il.

The invention relates to medicine, in particular to prosthetic dentistry and is intended to fill the defect veruh with oral cavity and an inlet opening in the defect is the defect in the presence of teeth on the healthy side of the jaw.

Known design resection of the denture in the upper jaw (see A. D. A. lubotsky. "Orthopedic care after resection of the upper jaw" in the book "Questions of dentistry and maxillofacial surgery". M., 1963, S. 246-251) [1]. It contains the prosthetic base and hollow obturator of hard plastic, which is connected with the basis narashimha. With this construction, the prosthesis is accomplished in the following way. The prosthesis obturator is made up of surgical intervention, modeling the replacement part of the prosthesis is done arbitrarily. 3-4 weeks after the operation the adjustment of the obturator by layering soft black gutta-percha in areas of insufficient adhesion of the prosthesis to the edges of the defect. Then the gutta-percha is replaced by plastic. Replaces part of the prosthesis, the obturator does not fill completely formed postoperative defect. However, the imposition and removal of the obturator freely. Fixation of the prosthesis is carried out with the help of supporting and retaining clasps, telescopic crowns, and other elements of the fixing device laminar or clasp dental prosthesis on the healthy side of the upper jaw, if it has teeth. If the upper jaw bezzi design are: production of the obturator initially approximately and he does not fill the postoperative defect, therefore, the retention points are not used, so when chewing on the side of the defect arises as a lever of the first kind, that is the cause of back-and-forth movements of the parts of the prosthesis, in the defect. This in turn leads to the fact that:

- loosened, pywikipedia and break the abutment teeth on the abutment side, therefore, the service life of the prosthesis is reduced. In the absence of teeth on the healthy side of the upper jaw this prosthesis is not fixed at all and does not restore chewing function;

- when chewing absent-tight separation of the nasal and oral cavity, and the liquid food enters the nose;

- broken foncia speech, and remains open nasalized speech;

- arise from bedsores hard obturator and rubs at his movements;

when contractures of the lower jaw, the introduction of the prosthesis is difficult or impossible.

Also known construction resection of the denture in the upper jaw, consisting of two detachable parts basis and obturator (see B. K., Koster, C. A. Minyaeva. "Maxillofacial prosthetics". Medicine, 1985, S. 33-34) [2] . It contains the basis of the prosthesis and full obturator and the functions of the prosthesis is carried out as follows. At 10-12 days after surgery using functional tests by the formation of the obturator from thermoplastic plastic, which is included in the region of the defect only enough to use some of the retention points and not play fully its shape. After a series of technological operations is made hollow obturator with permanent magnets. This prosthesis is significantly easier to use in the presence of contractures. But as the obturator does not form defect, its disadvantages are:

- fixation of the two parts under masticatory loads very problematic, therefore, to achieve a hermetic their connection is not possible;

- replaces part of the prosthesis, the obturator does not fill the cavity of the defect, therefore, the retention points are not used. This leads to the above-mentioned disadvantages.

The closest to the technical nature of the claimed resection is removable denture in the upper jaw (see S. N. Radnaev. "Prosthetics with unilateral resection of the upper jaw and no teeth" in the collection "Reconstructive surgery of the maxillofacial area", Krasnoyarsk, 1989, S. 99-102) [3]. It contains a basis, to which is rigidly attached monolithic optoelektonnye items but due to the elasticity of the obturator piassava prosthesis easier and less painful. The disadvantages of this design are:

the weight of the structure and disturbance commit;

- stiffness, which become elastic plastic in the monolith, causes bedsores;

- introduction of monolithic obturator may then, when the input hole in the defect corresponds to the magnitude of the defect. If not, then the retention points are not used, therefore, the prosthesis has all of the above disadvantages;

- due to the repeated correction terms of adaptation increase.

The technical result of the invention is to restore chewing function with partial resection of the upper jaw when the inlet is already the defect when there are teeth on the healthy side of the jaw, achieved by opening of the obturator when it is placed in the defect zone and the repetition of the obturator given reliefwartrol spatial configuration of the defect.

This is achieved by resection in removable denture in the upper jaw containing the obturator is made of elastic plastic, the base of which is rigidly connected to the base of the prosthesis according to the invention, the obturator you the project of the upper jaw, the basis of the prosthesis equipped with a metal tube, one end of which is connected with the cavity of the obturator, and the other by threaded connection with tooth-cap.

The figure shows a schematic drawing resection of the denture in the upper jaw. It contains a hollow obturator 1, made of elastic plastic. The base of the obturator 1 is rigidly connected with the base 2. The base 2 is provided with a metal tube 3, one end of which is connected with the cavity of the obturator 6, and the other, by threaded connection 4, with the tooth cap 5. Elastic obturator 1 in the specific example made of elastoplast and has a wall thickness of 3 mm Pre-make a mold of postoperative defect and cast model of the defect, which in a ditch by the method of normal curing of plastics are made of hollow elastic obturator with a wall thickness of 3 mm

The defect of the upper jaw with resection of the denture is compensated as follows. Pre-patient removes denture tooth cap 5. Due to the fact that the obturator 1 is flexible, thin wall, the patient can easily collapse it into a tube for painless insertion through the narrow opening of the entrance to the defect. DL is Benia it through a metal tube 3 with the atmosphere is balanced air pressure in the obturator 1 with the atmosphere. Wall of the obturator 1 finish in the defect and take initial set form, repeating complex reliefwartrol spatial configuration of the cavity of the defect. It uses all retention points of the defect, and the prosthesis is firmly held in the cavity of the defect. Then the patient by means of a threaded connection 4 puts the tooth cap 5 and closes the cavity of the obturator 1, which prevents the falling of the walls of the obturator 1 and the loss of the prosthesis when it is used. During operation of this construction can eliminate the negative effects arising from the use of previously existing designs.

Resection removable denture of the claimed design has been tested on a group of patients of 12 people. Patients had postoperative defect of the upper jaw due to cancer. The inlet of the defect in each patient was already the defect and had the teeth on the healthy side of the jaw. They were conducted orthopedic treatment using the inventive resection of the denture. Due to the fact that the prosthesis is fully repeats the shape of the cavity of the defect, he tightly held in the mouth when chewing on the patient side of the tion of the upper jaw, not had any sores and ensure the full integrity of the oral and nasal cavities.

Sources of information

1. A. D. A. lubotsky, "Orthopedic care after resection of the upper jaw". In Proc. of "Questions of oral and maxillofacial surgery". M., 1963, S. 246-251.

2. B. K. Koster, C. A. Minyaeva "Maxillofacial prosthetics". Medicine. 1985, S. 33-34.

3. Prototype: S. N. Radnaev "Prosthesis with unilateral resection of the upper jaw and no teeth." In Proc. of "Reconstructive surgery of the maxillofacial region. Krasnoyarsk. 1989, S. 99-102.

1. Resection removable denture in the upper jaw containing the obturator is made of elastic plastic, the base of which is rigidly connected to the base of the prosthesis, characterized in that the obturator is made hollow with thin elastic walls with the possibility of placing it in the cavity of the defect of the upper jaw and repetition reliefwartrol spatial configuration of the latter, while the alignment of the air pressure in the cavity of the obturator and the atmosphere, the prosthetic base fitted with a metal tube, one end of which is connected with the cavity of the obturator, and the other by threaded connection with tooth-cap.

 

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