The method of treatment of frontal narrowing of the upper jaw
The invention relates to medicine, namely to orthodontics, and may be applicable for treatment of frontal narrowing of the upper jaw. Impose orthodontic apparatus containing cutting extenders, screw, stopper. Open the Palatine suture with a screw in the anterior part of upper jaw to the formation of the artificial diastema not less than 4 mm, Conduct the closing diastemas, aguis technique. To consolidate the results of treatment retention apparatus. The method allows to reduce the treatment time, improve the functional and aesthetic results, to prevent complications. 4 Il.
The present invention relates to the field of medicine, namely, orthodontics, and can be used for the treatment of dento-maxillary anomalies with narrowing of the upper jaw.
Known methods of treatment using a variety of orthodontic appliances to expand the upper jaw. With the expansion of the jaw there is a change in the shape and size of the dentition[1, 2, 3, 6].
There is a method of treatment for narrowing of the upper jaw with orthodontic braces with rescueme extender, taken as a prototype . The disadvantage of this method is the area of the maxillary cusps and buttresses in the molar region. When removing apparatus unruly patient relapse narrowing and other anomalies.
The technical result - the reduction of treatment time, improve functional results, prevention of complications.
This technical result is achieved by the fact that impose orthodontic device, which additionally contains in the distal stopper, conduct disclosure palatal suture speed 1/4 turn before the formation of artificial diastema not less than 4 mm, and closing out aguis technique.
In Fig.1 shows a device for extending the front portion of the upper jaw by the proposed method, Fig.2 - oral cavity of the patient Century before treatment, Fig.3 - state upper jaw after the expansion of the frontal area with the formation of artificial diastema, in Fig.4 - the mouth at the final stage of treatment.
The proposed method for the treatment of narrowing of the upper jaw in the anterior part consists of the following.
step 1 - lay apparatus containing cutting extenders 1, which extends the screw 2 and the stopper 3 in the distal (Fig.1). A week after blending apparatus appoint activation screw 1/4 turn every other day. The average time of expansion was from ervy phase of expansion of the upper arch ends with the formation of artificial diastema from 4 to 10 mm thanks to the distal removable device with the stopper.
step 2 - cut cutting extenders and leave the device in the oral cavity without activation screw for 2-3 months. Closing diastemas performed within 1 month using common aguis techniques . This creates a place for technoecology teeth in the upper jaw. Terms of further treatment depends on the severity and complexity of dentofacial anomalies.
stage 3 - fix result of treatment common way is the retention apparatus [2, 6].
As an example, here is an extract from the medical history of a patient Century, 12 years old, which appealed to the Department of prosthetic dentistry bgmu with complaints about incorrect position of the front teeth on the upper jaw and the protrusion of the chin.
At clinical examination of the oral cavity revealed: anterior occlusion of the dentition in the lateral parts (III class Anglo). The narrowing of the dentition of the upper jaw in lateral sections in the area of premolars - front 6 mm, small narrowing in the molar region is 2 mm, the underdevelopment of the frontal portion of the upper jaw. Reverse cutting overlap with sagittal slit of 1.5 mm Close position of the front teeth on the upper jaw with the lack of space in the dental arch for canines that have not yet erupted (Fig.2). Short temper is Reztsova expander 8 mm, Stage II - the creation of space by lengthening the dental arch of the upper jaw for proper eruption of the canines and the normalization of the occlusion with aguys technique. Using the tool extender achieved a significant expansion of the frontal portion of the upper jaw (Fig.3). Created space for the eruption of the canines and normalized occlusion using fixed machinery (Fig.4). Achieved good occlusal and esthetic results. However, the patient reported an improvement of nasal breathing, obviously associated with the extension of the upper respiratory tract in the area of the nasal passages.
According to the described method were treated 12 patients. The proposed method of treatment in comparison with the known methods of treatment of frontal narrowing of the upper jaw has the following advantages:
- reduction of treatment time 2 times;
- allows you to create space for crowded teeth and to normalize their situation;
- fast erection palatal suture with the formation of artificial diastemas and its closing time 2 - 2.5 months, no complications, which is confirmed by x-ray observations in the field palatal suture;
- comprehensive treatment using aguis techniques at the final stage darmali
1. Dmitrienko, S. C., Ivanov L. P., Nikitin S. N.. Orthodontic apparatus for expanding the upper jaw with simultaneous protrusion of the anterior teeth. /Volgograd honey. Academy date of Deposit of the 20.02.98. Volgograd. - 1998. - S. 5.
2. Dubinko S. A. Clinic and treatment of deformities of the dental arches: author.... Kida. the honey. Sciences. - Kazan, 1963. - 27 S.
3. The koev J. the Extension of the upper jaw due to disclosure palatal suture using the apparatus of Inserti. /J. The Koev/ Dental - 1960. No. 3. - S. 56.
4. Loganovsky A. I. Morphology of the median palatal suture and its importance in the expansion of the upper jaw: author.... Kida. the honey. Sciences. - Riga, 1967. - 28 S.
5. Napadow M. A. Atlas of orthodontic technique. M., 1970. - 56 S.
6. Guide to orthodontics / edited by Professor F. J. Khoroshilkina. - 2nd ed., revised and enlarged extra - M.: Medicine, 1999. - 800 C.
The method of treatment of frontal narrowing of the upper jaw, including the imposition of orthodontic apparatus containing the tool extender and screw, the disclosure of palatal suture, the closure of the diastema, the consolidation of the results of treatment retention apparatus, characterized in that impose apparatus having a stopper, the disclosure of palatal suture with a screw carried out in frwee extenders, conduct closing diastemas, aguis technique.
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
SUBSTANCE: method involves carrying out gingiva retraction, forming L-shaped notches on central incisors medial surface and cutting edges. L-shaped reinforcing members produced in advance in conformance with the notches are arranged in the notches filled with fluid composite. The reinforcing members are set 1-1.5 mm below incisor cutting edges level. Guided polymerization of vestibular, oral and cutting surfaces being over, diastem is eliminated by coating medial surface of incisors layer-by-layer with composite material selected for being applied to frontal teeth group. The central incisors are polished and cutting edge is adjusted to recreate anatomical shape.
EFFECT: enhanced effectiveness of treatment.
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: device has removable maxillary plastic plate and mandibular one. The plates are separate and joined with flexible tie rod. To provide uniform load distribution, the maxillary plate is manufactured as supporting member. The supporting member has arch in frontal part that is congruently adjacent to vestibular surface of the frontal teeth. The arch is manufactured from wire and rigidly connected to basis. Premolars and molars have cramp iron members on frontal contact surface. The mandibular plate is manufactured as mandibular alveolar part base and internal surface of lower teeth. The plate is fastened to dental row with cramp iron members and has flexible tie rod hooks.
EFFECT: enhanced effectiveness of treatment; no disturbances to speech and chewing; self-standing replacement of flexible tie-rod.
SUBSTANCE: method involves introducing endoscope into maxillary sinus through a bed which depth corresponds or exceeds implant length. Auto-osteogenic tissue as biomaterial is laid on sinus fundus under endoscopic control through remaining beds. The auto-osteogenic tissue contains osteoblasts and chondroblasts in combination with finely granulated porous titanium nickelide having particle size from 1 to 1000 mcm. Implants are set.
EFFECT: enhanced effectiveness of treatment; reduced risk of traumatic complications; improved implant integration conditions.
FIELD: medicine, oral surgery.
SUBSTANCE: one should cut mandibular branch through both cortical plates and spongy substance of the bone, carry out osteotomy of maxillary body at the level of pear-shaped foramens, vomer and pteromaxillary articulation at affected side, conduct additional osteotomy of pteromaxillary articulation at intact maxillary side, apply compression-distraction apparatus at affected maxillary side to fulfill compression and distraction of osseous fragments. The innovation in question enables to conduct operative interference since the age of 5-6 yr and provide individual schedule of distraction.
EFFECT: higher efficiency.
2 dwg, 1 ex
FIELD: medicine, oral surgery.
SUBSTANCE: one should apply compression-distraction apparatuses in area of mandibular angles, perform mental osteotomy, go on osteotomic line along mandibular body up to angles, compress osseous fragments followed by distraction of osteotomized mandibular fragment. The innovation enables to conduct therapy at the age of 5-6 yr.
EFFECT: higher cosmetic result.
2 dwg, 1 ex
SUBSTANCE: method involves carrying out X-ray examination and determining longitudinal axis tilt of retained tooth and computer tomography. Maxillary computer tomography is carried out in three-dimensional Descartes coordinates with central occlusion being preliminarily fixed with individual silicon gumshield. The gumshield has 2-4 mm thick bilateral occlusion surface. Calculated free space value being found greater than thickness (vestibulo-oral size) of the retained tooth, positive prognosis for successful moving out is determined by building geometrical model, carrying out mathematical analysis of received data. The calculated free space value being found equal to retained tooth thickness, prognosis for difficult moving out is produced. The calculated free space value being found less than retained tooth thickness, unfavorable prognosis for moving out is produced.
EFFECT: high accuracy in predicting orthodontic correction results in three-dimensional space.
18 dwg, 1 tbl
SUBSTANCE: method involves making local anesthesia. Angular or trapezoid incision is done. Mucoperiosteal flap is separated. Projecting spongious bone tissue is withdrawn above the tooth crown, between the crown, roots and cortical plate from external and lingual surface with the exception of inferior surface. The tooth is extracted. The bone cavity is filled with Colapola KP sponge and 1-2 Alvostasa sponges. 1-2 apposition catgut sutures are placed. Laser radiation therapy is administered at the second day after the operation once a day for 3 min using Optodan apparatus. The first apparatus channel is used during the first 3 days, and the second one during the following 3 days.
EFFECT: enhanced effectiveness of treatment; accelerated healing process.
FIELD: medical engineering.
SUBSTANCE: device has mandibular base plate having members for separating jaws. The members for separating jaws are fabricated from 1.2 mm thick wire shaped as two parallel arcs. Each end of the first arc is fixed in the base plate between the canine tooth position and the first premolar position. Each end of the second arc is fixed between the first premolar position and the first molar position. Arc tops are joined with the base plate. The base plate has hard palate topography and is manufactured from flexible plastic. Supporting-and-holding cramp iron members are mounted on distal part of the base plate.
EFFECT: complete jaws dysocclusion.