The method of controlling the movement and resizing of fragments of the maxilla in children with unilateral cross-cutting cleft lip and palate

 

The invention relates to medicine, namely to the dentist, and may be applicable to control over the movement and resizing of fragments of the maxilla in children with unilateral cross-cutting cleft lip and palate. Put a reference point on the plaster model of the upper jaw. Applied to the model additional point E1 - anatomical connection point premaxillary bone of the upper jaw on the healthy side, symmetric her point E2. Define the process degirolami correction of fragments of maxilla reduction of protrusion of the premaxillary bones and the reduction of the diastasis fragments of the upper jaw to reduce the length of the segment between arterialnoy point of the large fragment and the point E2. The method improves the accuracy of control over the growth and motion of the fragments. 1 Il.

The method of controlling the movement and resizing of fragments of the maxilla in children with unilateral cross-cutting cleft lip and palate.

The invention relates to medicine, namely to the dentist, and is intended for anthropometric measurements of the upper jaw, in particular for controlling the movement and resizing of fragments of the upper colugo method is a technique developed Berkowitz S. (Stereophotogrammetric analysis of casts of normal and abnormal palates. Amer. J. Orthodont, 60, 1, 1971), according to which measured the palatal and alveolar surface model method stereophotogrammetry. This method is expensive, time-consuming, cumbersome, not acceptable in the modern world. In addition, it provides a limited number of characteristics which does not allow to judge in full on the size of the fragments and the dynamics of their movements during dehyrogenase treatment.

A prototype of the proposed control method is a method developed Boric V. (Maxillary arch analysis: utilizing a computer-based method. Cleft Palate-Craniofacial Journal, March, 1993, Vol. 30, No. 2), which has scanned photographic image models than has accelerated the process of introducing and processing of the material under investigation with the aid of a computer. He increased the number of reference points involved in the analysis of the model a, E, D, P, P1 and studied the ratio Pa/aP1, Aa/Dd, HH/Her (Fig.1). However, he's calculations did not take into account the dimensions of the upper jaw on the healthy side and premaxillary bones, as well as the impact of growth and protrusion of the bone on the process of reduction of the diastasis fragments of the alveolar ridge of the maxilla.

Objectives: to objectify the evaluation of the results of deneba; to offer a way to find out the amount of protrusion of the premaxillary bone and the impact of the growth of the bone in the process of reduction of the diastasis.

The method of control is as follows: the model is applied additionally: E1-anatomical connection point premaxillary bone of the upper jaw on the healthy side, as well as symmetric her point E2 and to reduce the length of the segment between arterialnoy point of the large fragment and the point E2 in the process degirolami correction fragments of the upper jaw define the reduced protrusion of the premaxillary bones and the reduction of the diastasis fragments of the maxilla.

The proposed control method is as follows: - remove the cast from the upper jaw of a child with unilateral cross-cutting cleft palate and made a plaster model; - put on her reference point (see drawing, which shows a diagram of the measurement model of the upper jaw with the help of the program "Maxilla"):

And the point of contact of the frenulum of the upper lip with the alveolar crest;

C, C1- the projection point of the canines;

D - enteralna point small fragment;

E - enteralna point a large chunk;

P, P1- Bugrova point at the distal edges of the alveolar process;

ustanavlivaut with two mutually perpendicular lines on a table or a card reader; as readers use a digital video camera or a beam scanner; - the information received to record, display, store in a processing unit; - identify the point in the computer database; - using conduct plotting and find additional points:

M - mid on bugrovoy line P-P1;

a, e, d is the projection point a, E, D Bugrova line;

E2 - symmetric point E1 on Its perpendicular to PP1;

and the line: a-a - conventional middle line of the upper jaw;

A-M - a true middle line of the upper jaw;

P-P1- Bugrova line;

- carry out the calculation of the transverse parameters:

C-C1- miklikova length;

D-E - size diastasis of the alveolar process of the maxilla;

P-P1- libprofile length;

E-E1 - the true size of the premaxillary bone;

X-Y - defect of the palate;

sagittal parameters:

A-a - sagittal size of the upper jaw;

P1-C1-D is the length of the small fragment;

R-s-a-S - the length of the large fragment;

R-s-a - the length of the upper jaw to the point And on the healthy side;

[P1-C1D]+[a-E] - length of the upper jaw to the point And without diastasis on the affected side;

[E-e]-[D-d] - rusestii premaxillary bone;

corners:

A P P1- the angle of deflection of a large fragment from the middle line;

D P1P is the angle of deviation of the small fragment from the middle line;

R M a is the slope of the line a-M to bugrovoy line P-P1;

proportions:

R-a/a-P1indicates the degree of asymmetry of the alveolar process of the maxilla;

E-e/a-a - a degree of deviation of the premaxillary bones on a large fragment;

- put the calculations in the individual card of the child.

The measurement process is standardized, fully automated using our developed specialized programs and takes 3-4 minutes In the scheme of studies we have made, all known from the literature point, angles, distances, proportions, allowing to judge in full on the size and dynamics of moving parts. To improve diagnostic information offered new points: E1 - anatomical connection point premaxillary bone of the upper jaw on the healthy side, allowing to judge about the size of the upper jaw on the healthy side of the P-C-E1 and premaxillary bones E1-E, and its protrusion E-E2. the decrease in segment E-E2 in the process degirolami correction is CE reduce diastasis fragments of the maxilla.

Clinical example: a newborn patient B. one-way end-to-end with cleft lip and palate before and after degirolami position correction fragments of the upper jaw removed the casts of the upper jaw, made a plaster model; have put on them a reference point (see drawing, which shows a diagram of the measurement model of the upper jaw with the help of the program "Maxilla"); model set with two mutually perpendicular lines on a table or the reader; the reader has used a digital camera or a beam scanner; the information obtained was recorded, displayed, maintained in the processing unit; identified point in the computer database; using spent plotting and found additional points; carried out the calculation of the transverse, sagittal parameters, angles and proportions; record calculations in individual card of the child; comparing the measurement results before and after degirolami position correction fragments of the maxilla.

Before treatment, the distance R-S-E1 more P1-C1-D 5 mm, indicating hypoplasia edge of the premaxillary bone, facing the defect and the small fragment. Distance E-E2 was 6 mm. After events proved, in the process degirolami position correction fragments of the maxilla reduction of the diastasis fragments from 16 to 6 mm was due to the elimination of the initial hypoplasia fragments and protrusion of the premaxillary bones.

Thus, the creation of "Maxilla" and the introduction of new points allowed to give an objective assessment of the results degirolami position correction fragments of the upper jaw, held before cheiloplasty in children with unilateral cross-cutting cleft lip and palate.

The method is tested on the 720 models of the upper jaw 168 children with unilateral cross-cutting cleft lip and palate and is recommended for use in the practice of dentistry. The method improves the accuracy of control of the growth and movement of fragments when degirolami position correction fragments of the maxilla in children with unilateral cross-cutting cleft lip and palate before cheiloplasty.

Claims

The method of controlling the movement and resizing of fragments of the maxilla in children with unilateral cross-cutting cleft lip and palate, including the application of reference points on a plaster model of the upper jaw, characterized in that čtk healthy side, symmetric her point E2 to reduce the length of the segment between arterialnoy point of the large fragment and the point E2 in the process degirolami correction fragments of the upper jaw define the reduced protrusion of the premaxillary bones and the reduction of the diastasis fragments of the upper jaw.

 

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