The method of prosthesis fixation-obturator in the complete absence of the upper jaw

 

The invention relates to medicine, in particular to prosthetic dentistry and is intended to compensate for defects of the upper jaw of different origin, including its complete absence. The technical result consists in the simplification of the method of prosthesis fixation-obturator, increase reliability, reduce injuries of the mucous membranes of the oral cavity, as well as in the use of prosthesis--the obturator is of simple design and versatility. The prosthesis obturator includes main and auxiliary surface interconnected by means of an additional front, rear and two side vertically oriented surfaces with the formation of the cavity, the front and rear vertically oriented surface with recesses in the form of grooves. The method of prosthesis fixation-obturator in the complete absence of the upper jaw includes an introduction of the prosthesis of the obturator into the oral cavity to divide the cavity of the mouth and the nasal cavity, the grooves of the prosthesis-obturator form place to perebazirovka pads, clean prepared surface with adhesive, applied soft padding, the prosthesis obturator enter the distal part of the mouth so that the rear groove of the prosthesis-obturatorius-obturator then podavlyayut prosthesis and release the upper lip so that the muscles of the upper lip to the base of the nose got in the front groove of the prosthesis of the obturator, while dense, but free fit of the cheeks to the side surfaces of the prosthesis-obturator forms a reliable valve prosthesis-obturator prosthesis obturator leave in the mouth for a period of polymerization pads, after polymerization pads remove the prosthesis obturator from the oral cavity, remove excess soft strip. 3 Il.

The invention relates to medicine, in particular to prosthetic dentistry and is intended to compensate for defects of the upper jaw of different origin, including its complete absence.

Fixation of the prosthesis of the obturators were previously carried out with the help of a spring Pochara. working on raspredilenie, thereby holding the prosthesis. One end of the spring is inserted into the crowns of the teeth on the lower jaw, and the other end in the prosthesis obturator. The bending spring is on the middle of its length. While in the area of the distal sites of the oral cavity, springs cheeks hurt. Also difficult is the installation procedure of the springs in stumps jaw (E. J. Vares, G. P. Knotko. Replacement prostheses of the upper jaw. Kiev, Health, 1981, S. 7-31), including the introduction of the obturator prosthesis in the oral cavity to divide the cavity of the mouth and the nasal cavity.

The known method is difficult to implement, because it requires additional fastening elements, such as springs of Posara or magnetic elements.

The present invention consists in correcting these shortcomings.

The technical result consists in the simplification of the method of prosthesis fixation-obturator, increase reliability, reduce injuries of the mucous membranes of the oral cavity, as well as in the use of the prosthesis is of simple design and versatility.

The result is achieved that the method of prosthesis fixation-obturator in the complete absence of the upper jaw, including the introduction of the obturator prosthesis in the oral cavity to divide the cavity of the mouth and the nasal cavity, the grooves of the prosthesis-obturator form place to perebazirovka pads, clean prepared surface with adhesive, applied soft padding, the prosthesis obturator enter the distal part of the mouth so that the rear groove of the prosthesis-obturator captured the top edge of the soft palate, pulling the upper lip and accordingly osnovaniya lips at the base of the nose got in the front groove of the prosthesis of the obturator, when this dense, but free fit of the cheeks to the side surfaces of the prosthesis-obturator forms a reliable valve prosthesis-obturator prosthesis obturator leave in the mouth for a period of polymerization pads, after polymerization pads remove the prosthesis obturator from the oral cavity, remove excess soft strip.

The implementation of the method of prosthesis fixation-obturator in the complete absence of the upper jaw and the design of the prosthesis-obturator illustrated in Fig.1 and 2, which depicts the prosthesis obturator and its section a-A. In Fig.3 shows a General view of the prosthesis.

The prosthesis obturator 1 contains the primary and secondary surfaces 2 and 3 are interconnected by means of an additional front, rear and two side vertically oriented surfaces 4, 5, 6 and 7 with the formation of the cavity 8, the front and rear vertically oriented surfaces 4 and 5 are made with grooves in the form of grooves 9, 10.

The method is implemented as follows.

Formed in the groove 10 of the prosthesis of the obturator 1, in which the distal edge must enter the top edge of the soft palate and into the front groove 9 - muscles of the upper lip to the base of the nose, is the deepening of the grooves for formirovaniya exceptions injury during functional use. Side surfaces 6, 7 of the prosthesis of the obturator 1 free fringe the edge of the prosthesis in the contact area, but at the same time provide a reliable valve that prevents the penetration of air from the nose to the mouth and Vice versa due to the wet and rolling of the mucous membrane of the cheeks, with a large area of contact. The retention grooves 9, 10 roughened spherical cutter, grooving is applied to the adhesive for reliable connection with soft lining. Apply a soft lining on the grooves 9, 10 for the formation of a dense coverage of soft strip plots pinktornado rings. The prosthesis obturator 1 rear edge of the wound in the upper edge of the soft palate and thus there is a soft molding strip in the groove 10. Index finger prosthesis obturator 1 is pressed upward, the upper lip is significantly stretched anteriorly to avoid lubrication pads. The prosthesis obturator 1 is pressed all the way up, then closes the upper lip so that the muscles of the upper lip to the base of the nose got in the groove 9, squeeze the excess soft strip in the nose and in the mouth. During the time required for polymerization of the soft strip, the prosthesis obturator is in the mouth (no tubs in the oral cavity is the removal of the prosthesis of the obturator 1 by pulling the upper lip to the front. Cut the excess soft strip, the cut edges are treated with a varnish to close the formed pores. The prosthesis is ready for operation.

A new set of actions aimed at fixing the prosthesis-obturator new design, show the novelty of the method, the presence of his inventive step for the average person, to confirm industrial applicability here is a photo of the prosthesis with the alveolar ridge and teeth.

Consider the following example.

Excerpt from the history

Sokolov, B. C., born in 1938, has addressed in clinic DSPS “Honey bioexcel” in the orthopedic Department in 1999 with complaints of difficulty swallowing, speech and chewing, destruction of teeth on the lower jaw, Zapadnye upper lip and the absence of teeth on the top.

History: In 1987 he was made a Subtotal resection of the upper jaw about tumors of the hard palate and bottom of the nasal cavity with subsequent radiotherapy.

In 1989, manufactured prosthesis maxillofacial hospital. Made obturator fixed with the help of a spring Pochara. The prosthesis obturator served almost 10 years, helped to separate the nasal and oral cavity. The patient had problems with the installation of the prosthesis in the cavity Charice.

Objective: the oral cavity and the nasal cavity is a single cavity due to the absence of the maxillary bone. In the nasal cavity is missing a Shoe, the lower nasal turbinates. Saved the upper arches of the maxillary cavities, partially-distal, approximal and side walls; the upper and middle nasal turbinates on both sides. On the distal border of the mouth saved the soft palate, the side surface is formed of the soft tissues of the cheeks. Approximal border at the base of the nose is limited to the muscles of the lips. The mucous membrane of the nasal cavity hyperemic, edematous, in the upper and middle nasal passages there are remnants of food and Muco-purulent discharge. When pronouncing the words slurred speech, words are hardly distinguishable, independent swallowing liquids is extremely difficult.

On the lower jaw are missing 47, 46, 45, 42, 35, 38 tooth. Destroyed coronal portion of the teeth 43, 41, 31, 32 to the level of the gums. On the R-picture channels filled with removing sealing material over the top into the cavity of the granuloma. There is a convergence 34, 36 in the direction of the missing 35. 34 stamped crown in satisfactory condition.

Diagnosis: condition after Subtotal resection of the upper jaw of sredstvopovysheniya the nasal cavity and the oral cavity, complicated by throwing food into the nasal cavity, catarrhal inflammation of the mucous membrane of the nasal cavity, mainly in the area of the nasal Concha. Dysfunction of the swallowing, wrong speech articulation, impaired function of mastication. Violation of the aesthetics of the lower third of the face. Zapadnye upper lip due to the absence of the upper jaw bone. Cosmetic defect due to the lack of upper teeth. Partial absence of teeth in the lower jaw(47, 46, 45, 42, 35, 38) (class III by Kennedy) due to caries and its complications, multiple fillings, changed in color, partial destruction of the tooth crown(43, 41, 31, 32). Convergence 34 and 36 in the area of the missing 35. Dentoalveolar elongation of the anterior teeth in the lower jaw due to the lack of teeth-antagonists. Parodontopathy due to lack of natural self-purification and lack of dental hygiene.

The treatment plan.

1. To manufacture the prosthesis obturator with fixation with preserved soft tissues without the use of a spring Fasara to divide the nasal cavity and the oral cavity. To make tabs LCSW(43, 41, 31, 32), to make a bridge prosthesis with support(48, 44, 43, 41, 31, 32, 33) to restore(47, 46, 45, 42), align occlusionquery of Namin.

3. During the rehabilitation period to normalize fully swallowing, and speech.

4. If successful, adaptation and rehabilitation to eliminate Zapadnye upper lip and restore the front group of teeth with the help of manufacturing the prosthesis-obturator disconnect artificial alveolar bone with teeth. To restore speech to a patient in connection with an altered vault of heaven.

5. To solve the question about the possibility of using implants to restore full function of chewing computer after examination of the skull base and the solution to the financial problems of the patient.

14.01.99. Feel satisfactory. No complaints. Cut the softened tooth tissue, responsivene channels 43, 41, 31, 32, 2/3 modeled tab.

19.01.99. Feel satisfactory. No complaints. Commit tabs on vistat, uncut 48, 44, 43, 41, 31, 32, 33 for the manufacture of bridges. Removed the casts of the lower jaw for the manufacture of stamped crowns. Removed cast Rotanova cavity for manufacturing individual spoons.

01.02.99. Feel satisfactory. No complaints. Fitting crowns, removal of the cast for the spikes of the crown and the manufacture of the intermediate part of bridge-like prosthesis. Correction indivial spoon the muscles of the cheeks, the elimination of excessive undercut in the region of the distal border of the upper edge of the soft palate and approximalely border in the upper part of the muscles of the lips at the base of the nose. Removed cast individual spoon Cialiscom-69 for the manufacture of hollow obturator prosthesis.

09.02.99. Feel satisfactory. No complaints. The imposition of the bridge based on 48, 45, 44, 43, 42, 41, 31, 32, 33 and fixing it on vistat. The fitting upper part of the prosthesis of the obturator along the borders of the prosthesis, removal of excessive undercut in the region of the locking grooves in the distal part of the upper edge of the soft palate in the approximal region of the upper edge of the lip and the base of the nose. The deepening of the locking grooves, clinical relocation of soft padding, maximum thinning of the walls of the obturator. Fixing caps for hollow obturator to protocel, processing junctions. Patient education is the imposition and removal of the prosthesis of the obturator. Recommendations on the use and care of the prosthesis.

With 10.02.99. on 16.02.99. Correction of the prosthesis in the area Namin, attend pronunciation of sounds. The patient is warned of perebazirovka pads in 6 months. 13.12.00. Feel satisfactory. Complaints about the exhaust, since she lived in the Tver region, where caring for a sick relative.

Objective: the articulation and swallowing recovered. On the distal border of the prosthesis in the region of the soft palate appeared insignificant Namin.

Produced relines denture-obturator soft padding, the patient is assigned to receive to restore teeth in the anterior part to correct cosmetic defects of the dentition and the failure of the upper lip as a result.

20.12.00. Feel satisfactory. Complaints about the pain of the prosthesis of the obturator in the area of the soft palate. Made the correction basis of the obturator in the area Namin.

08.10.01. Feel satisfactory. Complaints about the pain of the prosthesis of the obturator in the area of the soft palate.

Objectively: there was a partial peeling pads, violated its elastic properties. Made the relocation of a soft gasket. On the prosthesis-the obturator in the anterior part has three grooves for the orientation of the bite of the roller on the plaster model and the prosthesis-the obturator in the oral cavity. Removed the cast from prosthesis-obturator and lower jaw for the manufacture of roller bite.

15.10.01. Feel satisfactory. No complaints. The definition of Central vetorial.net. No complaints. Fitting wax alveolar bone with artificial teeth 45, 44, 43, 42, 41, 31, 32. 33, 34, 35, based on the three guide grooves in the anterior division of the obturator and the occlusion of the teeth in the area 45, 44, 34, 35.

29.10.01. Feel satisfactory. No complaints. Fitting the finished artificial alveolar ridge without 45, 35 teeth to reduce the weight of the structure. To create opportunities to implement conditionally demountable prosthesis obturator with artificial alveolar process used attachments firm “Bregent”. Ersatz Patricia strengthened in artificial alveolar ridge, and the matrix in a metal container fixed in the base of the prosthesis of the obturator on protocel. Weight loss artificial alveolar process by creating the appropriate holes. Recommendations for the care of the prosthesis and rehabilitation of speech.

06.11.01. Feel satisfactory. No complaints. Made control panoramic x-ray. Recommendations for the care of the prosthesis. Control examination after 6 months.

Thus, pre-manufactured denture very closely matches the parameters pinktornado ring formed by the top edge of the soft palate, muscles perspecive reliable valve, prevents the penetration of air from the nose to the mouth and Vice versa, simplifies the method of prosthesis fixation-obturator, which is quite simple and versatile design of the prosthesis. Thus, the invention allows to simplify the method of prosthesis fixation-obturator, improve reliability, reduce trauma to the mucous membranes of the oral cavity and to use the prosthesis is of simple design and versatility.

Claims

The method of prosthesis fixation-obturator in the complete absence of the upper jaw, including the introduction of the prosthesis of the obturator into the oral cavity to divide the cavity of the mouth and the nasal cavity, characterized in that the grooves of the prosthesis-obturator form place to perebazirovka pads, clean prepared surface with adhesive, applied soft padding, the prosthesis obturator enter the distal part of the mouth so that the rear groove of the prosthesis-obturator captured the top edge of the soft palate, pulling the upper lip and accordingly the base of the nose, keeping the prosthesis obturator, then podavlyayut prosthesis and release the upper lip so that to the muscles of the upper lip to the base of the nose was in front of deltora forms a reliable valve prosthesis-obturator the prosthesis obturator leave in the mouth for a period of polymerization pads, after polymerization pads remove the prosthesis obturator from the oral cavity, remove excess soft strip.



 

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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.

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FIELD: medicine.

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FIELD: medical engineering.

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EFFECT: improved strength properties; exact correspondence to prosthesis bed.

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EFFECT: increased strength of bond between soft substrate and rigid plastic basis, and prolonged service time of denture.

1 tbl, 3 ex

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EFFECT: possibility of self-release of liquid stored onto top part of sealing part of denture.

1 dwg

FIELD: medicine.

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.

FIELD: medicine.

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.

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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.

19 dwg

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