Method for inhibiting sagittal mandible growth vector

FIELD: medicine.

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

 

The invention relates to medicine and can be used for the treatment of dento-maxillary anomalies, namely the distal occlusion.

There is a method of containment of the sagittal vector growth of the upper jaw control functions Frenkel type I. The method relates to a functionally active. The method used in the period of active growth of the jaws of the patient. The method consists in removing the pressure of the lips and cheeks on the alveolar processes and the dentitions in the areas of their underdevelopment, in the normalization of the closure of the lips, tongue position, their functions and relationships. The growth of the upper jaw restrain by forming on canines and premolars pressure directed to the opposite side of the sagittal vector growth of the jaw. (“Guide to orthodontics / edited Pahorkatina. - M.: Medicine, 1982, s, 294-295).

Closest to the present invention is a method of containment of the sagittal vector growth of the upper jaw using a face-bow, in accordance with which exert the same force to the molars of the upper jaw, symmetrically located relative to the palatal suture, and as a result of mechanical impact, change arterialnoe the sagittal direction vector growth of the upper jaw on vertically downwards (“Guide to orthodontics / edited Pahorkatina, M.:Medicine, 1982, s, 212).

The disadvantage of this method is the long term treatment: from 18 to 36 months, and the lack of extension of the upper dentition. The latter is due to the fact that provide a mechanical effect on the bones of the skull in the upper jaw mainly aimed at curbing the sagittal vector growth of the upper jaw. Insufficient expansion of the dentition keeps the jaw thrust, which prolongs the treatment time and reduces the cosmetic effect of the treatment.

Thus, identified as a result of patent searches similar and the prototype that is closest to the claimed method of containment of the sagittal vector growth of the upper jaw, when the implementation does not ensure the achievement of the technical result consists in the reduction of terms of treatment of distal occlusion and improve the cosmetic effect of the treatment results.

The invention “Method of containment of the sagittal vector growth of the upper jaw” solves the problem of creating an appropriate way, which allows to achieve a technical result, which consists in reducing the duration of treatment of distal occlusion and improve the cosmetic effect of the treatment results.

The invention consists in that in the method of containment sagittal century the ora growth of the upper jaw, in accordance with that change arterialnoe the sagittal direction vector growth of the upper jaw in a vertically downward force acting upward and backward toward the crown, when this force is applied to the sixth teeth of the upper jaw, symmetrically located relative to the palatal suture, pre-determine that changes in the aesthetics of the face caused by changes in the skeleton of the skull, which study the teleradiograph patient and determine if skeletal anomalies, namely the presence of distal occlusion, and then mobilize the upper jaw, which reveal the Palatine suture to a normal shape of the sky with a small hypercorrection the width of the upper dentoalveolar arc of the patient, then effort value from 300 to 400 g on each side of the upper jaw, change arterialnoe the sagittal direction vector growth of the upper jaw in a vertically downward force acting upward and backward toward the crown, when this force is applied to the sixth teeth of the upper jaw, symmetrically located relative to the palatal suture, 12-14 hours a day to normalize bite on sagittal and vertically.

The technical result is achieved in the following way. In the proposed method, pre-determine that changes in the aesthetics of the face caused by changes in the skeleton skull, DL is what study teleradiograph patient and determine the presence of skeletal abnormalities, namely, the presence of distal occlusion. This allows you to make the right decision in the treatment of the patient, thus reducing the treatment time.

The increase of the upper jaw and its forward position generally be characterised by the term “maxillary prognathia”. At the front position of the upper jaw to the skull, malocclusion and facial aesthetics are sharply vyrazhennymi. The shape of the face in profile in the lengthening of the maxilla in front of the location of the convex or bulging. She violated the stronger, the higher the value of ANB angles, MM, and less than the value inclinations angles and H-RP. At the same time violations of the lower jaw: the body is shorter, jaw developed normally, but her body is located distally due to the reduced size of the mandibular angles or bent necks articular processes of the posterior branches of the lower jaw is shortened (“Guide to orthodontics / edited Pahorkatina. - M.: Medicine, 1982, figure 22 a, b, page 103). Thus, for dentoalveolar form distal occlusion is characterized by a mismatch in the degree of convexity of the profile of the person and the angle ANB. Varieties of dentoalveolar and geneticheskoi forms the distal occlusion are often combined with each other and with malocclusion in transversal and vertical directions. (“Guide to orthodontics/ edited Pahorkatina. - M.: Medicine, 1982, s, 102, 104). The definition of these disorders can identify remedial measures: orthodontic, surgical or combined.

The ANB angle is constructed as follows: point A - subspinosa point Downs, most poterialo located point on the anterior contour of the apical base of the upper jaw; dot N - nation, at the intersection of the median plane with nosolobnogo seam; the supramental point Downs, most poterialo located on the front contour of the apical base of the mandible. The angle ANB determine what caused the changes in facial aesthetics: incorrect position of teeth, or changes in the skeleton of the skull. The angle ANB more than 4° indicates that the defect is caused by changes in the skeleton of the skull.

The upper jaw consists of a jaw body and four processes: frontal, Palatine, zygomatic, and alveolar. The jaw body contains a cavity maxillary (gaymorovu) shirt. Using processes - Palatine, frontal and zygomatic upper jaw connects to the skull bones, with the zygomatic bone. Bone sutures between the bones of the facial skeleton, more flexible than bone (ABB Dentistry. - M.: Medicine, 1990, p.7-8). Creating the optimum tension or compression in the joints, can stimulate or inhibit the functional activity of osteoblasts. The seams are what I kind of absorbers, perceiving and distributes pressure, especially in the area of the buttresses of the facial skeleton. They are constantly being rebuilt when changing function. This feature is used when the mobilization of the maxilla. Revealing the Palatine suture we thereby changing the functional load on the facial sutures of the skull, reducing it. Resulting in weakened resistance of the facial sutures of the skull bones and reduced adhesive force of the upper jaw bone of the facial skeleton, in particular reduced adhesive force of zygomatic process of the maxilla with the zygomatic bone. In result, it becomes possible to move the lower jaw forward and stimulate its growth. Disclosure palatal suture to a normal shape of the sky with a small hypercorrection top dentoalveolar arc patient brings to the normal anatomical shape of dentoalveolar arc of the patient, which improves the aesthetic appearance of the face. In addition, the expansion of dentoalveolar arc also helps to move the lower jaw forward and stimulate its growth and expansion to the anatomic shape stimulates migration and the growth of the lower jaw in accordance with the anatomical norms for this patient. The result reduces the treatment time and improves the aesthetic appearance of the face of the patient after treatment, comparedwith the prototype.

The limitation in the size of disclosure palatal suture and hypercorrection top dentoalveolar arc (which reveal the Palatine suture to a normal shape of the sky with a small hypercorrection top dentoalveolar arc patient) takes into account the permissible restrictions on changes in the functional load of the joints of the facial bones of the skull and allows not to exceed them. Small hypercorrection top dentoalveolar arc is a consequence of the disclosure of the palatal suture and its value due to the amount of disclosure palatal suture to a normal shape of the sky. The presence of small hypercorrection top dentoalveolar arc, i.e. the expansion of the upper arch, provides an additional ability to move the lower jaw forward and encouraging the growth that complements the effect of the weakening of the bone joints between the bones of the facial skeleton skull and faster treatment.

Empirically, the authors found that the mobilization of the upper jaw by the weakening of the bone joints between the bones of the facial skeleton in the aperture palatal suture allows, without causing pain in the teeth, to increase the force applied to the sixth teeth of the upper jaw to a value of from 300 to 400 g on each side of the upper jaw, while in the prototype this effort ranges from 250 to 300 g per side. This allows to further decrease the strength of the coupling is placed zygomatic process of the maxilla with the zygomatic bone, that contributes to a more rapid extension of the lower jaw forward and stimulates its growth. The amount of effort depends on the age of the patient that determines the flexibility of the bone joints between the bones of the facial skeleton.

Adhesive force of zygomatic process of the maxilla with the zygomatic bone is reduced as well due to the fact that they make every effort to sixth teeth of the upper jaw, which is anatomically closely spaced from the zygomatic processes of the upper jaw. It also helps to speed up the extension of the lower jaw forward and stimulates its growth.

Due to the fact that exert the same force to the sixth teeth of the upper jaw, and also due to the fact that the sixth teeth symmetrically located relative to palatal suture, ensures the uniform distribution of efforts on both sides of the bones of the upper jaw, which further provides improved aesthetic appearance of the face, ensures equal conditions for promotion and development of the lower jaw on both sides, and, consequently, reduces the treatment time.

Due to the fact that change arterialnoe the sagittal direction vector growth of the upper jaw in a vertically downward force acting upward and backward toward the crown, keep arterially vector growth of the upper jaw. The growth of the lower Chol is ti continues normally forward and down. The result provides conditions for the elimination of underdevelopment of the lower jaw and lower jaw in the anatomical development can catch up to the top. As a result, compensated skeletal anomaly, namely the presence of distal occlusion, caused by underdevelopment of the lower jaw or hyperacuity the upper jaw.

Deterrence sagittal vector growth of the upper jaw in antirealism direction to perform the normalization of the bite on sagittal and vertically, which is selected as the controlled parameter.

The duration of the impact force directed upwards and backwards toward the crown, 12-14 hours per day obtained experimentally and is the optimal condition for reduction of terms of treatment and obtain good aesthetic results.

Thus, from the above it follows that the claimed method of containment of the sagittal vector growth of the upper jaw in the implementation ensures the achievement of the technical result consists in the reduction of terms of treatment of distal occlusion.

In figure 1, 2 and 3, 4 are depicted, respectively, pictures of jaw models before and during treatment and x-rays of the skull before treatment and during treatment after palatal expansion, the first patient; figure 5, 6 and 7, 8 - appropriate pictures of models and x-rays of the spines of the skull of the second patient.

Way to deter the sagittal vector growth of the upper jaw is as follows. Pre-determine that changes in the aesthetics of the face caused by changes in the skeleton of the skull, which study alertthingy patient and determine if skeletal anomalies, namely the presence of distal occlusion. Then mobilize the upper jaw, which reveal the Palatine suture to a normal shape of the sky with a small hypercorrection the width of the upper dentoalveolar arc of the patient. Then the force value from 300 to 400 g on each side of the upper jaw, change arterialnoe the sagittal direction vector growth of the upper jaw in a vertically downward force acting upward and backward toward the crown, when this force is applied to the sixth teeth of the upper jaw, symmetrically located relative to the palatal suture, 12-14 hours a day to normalize bite on sagittal and vertically.

In all examples, the complete method to implement the method in the oral cavity of the patient on symmetric fangs and symmetric sixth teeth of the upper jaw fixed without removal of the expansion screw, similar in combined orthodontic device for the treatment of malocclusion (“Guide to orthodontics” edited Pahorkatina, M.: Medicine, 1982, C. 340).

In addition, the used face-bow, consisting of external and intraoral arcs, soldered in the middle part. The ends of the intraoral arc fixed on symmetric sixth teeth of the upper jaw. The outer arc has two side plot - extraoral, which are bent in the direction of extraoral traction, konturirovany on the shape of the face, passively cover the cheeks and over the hooks for the imposition of extraoral traction. Additionally, the device comprises a support for extraoral traction, for example in the form of a standard head cap with the module placed in the parietal-occipital region. Module cap contains a rubber rod with holes for connection of the hooks face-bow with those around them the values of the resulting force when connecting to this hole. (“Guide to orthodontics” edited FA Khoroshilkina, M.: Medicine, 1982, s, 212). Extraoral sites arc connected with the holes in the rubber rods beanies, corresponding to the force from 300 to 400 g without causing pain in the teeth. Intraoral part of the arc is not adjacent to the vestibular surfaces covered her teeth. Extraoral sites of a face-bow fixed on the crown of the skull of the patient in such a way that under the action of forces, which form the thrust, arterialnoe the sagittal direction vector growth of the upper jaw is changed to vertically downwards.

Example 1. Patient T., year RZD. 1992, di is the prognosis: distal deep occlusion, the narrowing of the dentition.

The patient was treated in accordance with the claimed method.

Pre-determined that changes in the aesthetics of the face caused by changes in the skeleton of the skull. For this he studied alertthingy patient and determined the presence of skeletal anomalies, namely the presence of distal occlusion (results listed in Table 1). Then mobilized the upper jaw, which revealed the Palatine suture to a normal shape of the sky with a small hypercorrection the width of the upper dentoalveolar arc of the patient. Then force the size of 400 g on each side of the upper jaw, changed arterialnoe the sagittal direction vector growth of the upper jaw in a vertically downward force acting upward and backward toward the crown, and the force applied to the sixth teeth of the upper jaw, symmetrically located relative to the palatal suture, 12-14 hours a day to normalize bite on sagittal and vertically.

The results of treatment are summarized in Table 1 and confirmed images of the casts of the jaws and x-ray of the skull before treatment and after treatment (figure 1, 2, 3, 4).

Table 1
The results of the treatment of the patient So
Research objects Before treatment, mmAfter treatment, mm
saggitaria slit60
vertical overlap5,53
the disparity in the molar region on the left/right4/40,5/0,5
the disproportion in the field of fangs on the left/right4,5/5,52/2
The teleradiograph:  
SNA8585
SNB7980
ANB65
NSL/ML2828
HS/NL116109
NSL/NL1715
NL/ML1717
HS/NL116109
ILi/ML9998
ILs/Ili132to 140.5

The data in the table, comparison of jaw models and images of the skull bones show positive changes in the mutual arrangement of the jaws and teeth of the patient. Visually the patient markedly improved the shape of the face in profile.

Duration of treatment was 5 months, with the number of visits 8.

Por what measures 2. Patient W., the year of the Russian Railways. 1994, distal deep occlusion, reduced dentition.

The patient was treated in accordance with the claimed method. For the sixth teeth of the upper jaw pinned effort, the amount of 400 g on each side of the upper jaw.

The results of treatment are summarized in Table 2 and confirmed by the images of the casts of the jaws and x-ray of the skull before treatment and during treatment after disclosure of the palatal suture (figure 5, 6, 7, 8).

Table 2
The results of treatment of patient W.
Research objectsBefore treatment, mmAfter treatment, mm
saggitaria slit70,5
vertical overlap4,53,5
the disparity in the molar region on the left/right3,5/3,50/0,5
the disproportion in the field of fangs on the left/right3,5/3,50
the narrowing of the dentition in the area of premolars/molars-6/-90/-1,5
The teleradiograph:  
SNA8078
SNB74,574,
ANB5,53,5
NSL/ML2726
HS/NL125109
NSL/NL1111
NL/ML1717
ILi/ML102100
ILs/ILi118136

The data in the table, comparison of jaw models and images of the skull bones show positive changes in the mutual arrangement of the jaws and teeth of the patient. Visually the patient markedly improved the shape of the face in profile.

The treatment duration was 6 months, with the number of visits 8.

Way to deter the sagittal vector growth of the upper jaw, including the study of teleroentgenogram of the patient, identification of the distal occlusion, the imposition of a device that includes a cap imposed on the parieto-occipital region, rubber traction, the front arc, consisting of intraoral arch and two lateral extraoral sites, all intraoral thrust fix on the sixth teeth of the upper jaw, are using this device a force directed upwards and backwards towards the crown of the head, the force applied to the sixth teeth of the upper jaw, symmetrically located relative to the palatal suture, from which causesa fact, what initially mobilize the upper jaw, which reveal the Palatine suture to a normal shape of the sky with a small hypercorrection the width of the upper dentoalveolar arc, then make the effort value of 300 - 400 g on each side of the upper jaw, on 12-14 hours a day until the normalization of the bite on sagittal and vertically.



 

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The invention relates to dentistry

FIELD: medicine.

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

FIELD: medicine.

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.

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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.

3 dwg

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.

3 dwg

FIELD: medicine.

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.

3 dwg

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

FIELD: medicine.

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

FIELD: medicine.

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.

Orthodontic device // 2275882

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.

2 dwg

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