Method for fastening alveolar process having artificial teeth to obturator prosthesis in the cases of completely lacking maxilla

FIELD: medicine.

SUBSTANCE: method involves basic and auxiliary horizontally arranged surfaces joined by means of additional frontal, back and two lateral vertically arranged surfaces with a plane being formed. The frontal and back vertically arranged surfaces have recesses as retention grooves. Reference notches are made in the nose area on auxiliary surface. The alveolar process is manufactured base and wall. The base has reference notches. The wall has openings for reducing process weight. Teeth are mounted on the wall. Three openings arranged as triangle which base is turned towards pharynx are produced in auxiliary surface of the obturator prosthesis. Metal containers having matrices pressed into them are introduced into the openings. Three openings arranged as triangle which base is turned towards pharynx are produced on the base bottom. Pedicles (flow gates) having retention notches are mounted in the openings. Each flow gate ends in patrix engageable with corresponding matrix.

EFFECT: simplified and reliable method for fixing alveolar process.

3 cl, 3 dwg

 

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 known method of attachment of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw (Alavarez, Gpek, “Replacement prostheses of the upper jaw”. - Kiev: Health, 1981, p.7-31), including drilling in the prosthesis-the obturator hole installation hole matrices that are installed in metal containers, and fixing them using self-hardening plastic.

The known method is difficult to implement, since it does not allow individual alveolar bone. The present invention is to remedy these disadvantages.

The technical result consists in simplifying the attachment method of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw, and the use of the prosthesis of simplified construction and increased versatility

The result is achieved that the method of attachment of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw, including installation in metal containers matrices, drill in the prosthesis-obturate the d holes located at the triangle, facing the base to the throat, fix metal containers with matrices in the holes using self-hardening plastic, form a male mould with a leg with the retention notches and insert them into the matrix, causing the insulating material to the prosthesis obturator in the mounting area of the alveolar ridge, drill in the alveolar ridge of holes corresponding to the holes in the prosthesis-the obturator into the holes of the alveolar ridge make a self-hardening plastic, insert the legs of Patric with the retention notches in the openings of the alveolar ridge, tightly compressed between a prosthesis obturator and the alveolar bone and fix the rounded ends of Patric in the matrices in metal containers the prosthesis obturator and the alveolar bone matrix and patricai will polimerizuet in the apparatus under pressure, the excess crushed out of the holes of the plastic is removed, the alveolar additionally polished, after polymerization of the alveolar connect with prosthesis obturator through the clutch Patric and plastic matrices and those that form the male mould by strengthening at the end of the sprue and casting after casting, the sprue is cut with preservation 1 cm length of sprue, on the left the length of the sprue cause the retention notches for good adhesion with the plastic Alva is a regular process using self-hardening plastic protocel, and the fact that the holes of the alveolar ridge make a self-hardening plastic with a slight excess, and the excess plastic fill any cavities between the alveolar bone and the prosthesis obturator to create a tight contact. The implementation of the method of formation of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw is illustrated by figure 1-3, which depicts the prosthesis obturator and the alveolar bone with artificial teeth with matrices and Petricani, Patricia.

The prosthesis obturator 1 contains the main and auxiliary horizontally oriented 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 the retention grooves 9,10, on the supporting surface 3 in the region of the nose is made of a notch-benchmarks 11, alveolar 12 made in the form of the base 13 and the wall 14, on the basis of a notch-focus 15, the wall is made with holes 16 to facilitate the process weight 12, wall 14 is installed, the teeth 17 on the supporting surface 3 of the prosthesis of the obturator 1 is made three holes 18, arranged in a triangle, the base of which is turned to the throat, the holes 18 a metal container 19 is pressed into them by the matrix 20, the underside of the base 13 of the alveolar ridge 12 made three holes 21, arranged in a triangle, whose base is converted to the throat. The holes 21 is set legs (gates) 22 with the retention notches 23, each sprue ends Patricia 24 that communicate with the corresponding matrix 20.

The method is implemented as follows. For fastening of the alveolar ridge 12 are used, the matrix 20 of the firm “Bregent”installed in metal containers 19. Metal containers 19 are installed in the prosthesis-the obturator 1 in pre-drilled holes 18, arranged in a triangle, the base of which is turned towards the throat, and fixed using self-hardening plastic protocel THE 64-2-192-76 “Stoma” in Kharkov. Ukraine. Patricia 24 are made individually after additional shading (elongation) of the leg 22 of a plastic Patricia firm “Bregent” followed by casting for preparation of metal Patric 24. Patricia 24 is fixed on the end face of the sprue, and in this condition is molded. After casting, the sprue is cut out with a 1 cm length of sprue (leg 22). On the left the length of the sprue applied retention notches 23 for a good clutch with self-hardening plastic protocel in from the Erste 21 of the base 13 of the alveolar ridge 12. After polymerization, the metal container 19 with the matrix 20 in the holes 18 of the prosthesis of the obturator 1 in them are male mould 24. A thin layer of vaseline on the prosthesis obturator 1 in the mounting area of the alveolar ridge 12. The holes 21 of the alveolar ridge 12 is made self-hardening plastic with a slight excess. The excess plastic is needed to create a snug fit of the alveolar ridge 12 to the prosthesis-the obturator 1. There are inserted the legs 22 Patric 24 with the retention notches 23, and tightly compressed prosthesis obturator 1 and alveolar bone 12. Rounded end Patricia 24 at this point is fixed in the metal container 19 with the matrix 20 and legs 22 Patric 24 fixed in the holes 21 of the alveolar ridge 12 with self-hardening plastic. The excess plastic fill any cavities between the alveolar ridge 1 and prosthesis obturator 12 to create a tight contact. This design is placed in the apparatus under pressure, after polymerization of the alveolar bone 12 is maintained by coupling Patric 24 and the plastic matrix 20. The excess crushed plastics are cleaned, the alveolar 12 dipolarophiles. Metal containers 19 with plastic matrix 20 are arranged in a triangle, the base is converted to the throat, to create a reliable protiva istia straining the muscles of the lips during the articulation and mimic the movements of the facial muscles.

Example.

Excerpt FROM the HISTORY

Sokolov, V.S., born in 1938, has addressed in clinic DSPS “MedBioExtrem” 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 oral cavity, the spring of Posara caused injury to the cheeks on both sides.

In 1999, the prosthesis was stolen along with the bag in the train.

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, approximally 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 a soft, TKA is s cheeks. Approximally 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 due to surgical treatment on the tumor of the hard palate and bottom of the nose of a decade ago. The lack of separation of the nasal cavity and the oral cavity is 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. H the 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.

Treatment plan:

6. 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), to align the occlusal plane;

7. At the stage of adaptation to the prosthesis-the obturator fully complete correction of the prosthesis on the subject of eliminating Namin.

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

9. 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.

10. To solve the question about the possibility of using implants to restore the population full 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 of individual spoons on the contact surface with the soft tissues on the subject of the elimination of extrusion individual spoons 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 field pixelwise the grooves in the distal part of the upper edge of the soft palate in approximalely 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 peel pads, the emergence of Namin. To come to the dispensary inspection and replacement pads could not, since 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. She feels the project is positive. 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 centric relation of the prosthesis of the obturator and the lower jaw with wax template.

22.10.01. Feel satisfactory. 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 of 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, strengthened wbesite prosthesis-obturator to 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.

The invention allows to simplify the fastening of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw, and to use the prosthesis obturator simplified construction and increased versatility.

1. The method of attachment of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw, including installation in metal containers matrices, characterized in that the drill in the prosthesis-the obturator foramen, located at the triangle, facing the base to the throat, fix metal containers with matrices in the holes using self-hardening plastic, form a male mould with a leg with the retention notches and insert them into the matrix, causing the insulating material to the prosthesis obturator in the mounting area of the alveolar ridge, drill in the alveolar ridge of holes corresponding to the holes in the prosthesis-the obturator into the holes alveola the aqueous process of making self-hardening plastic, insert the legs of Patric with the retention notches in the openings of the alveolar ridge, tightly compressed between a prosthesis obturator and the alveolar bone and fix the rounded ends of Patric in the matrices in metal containers, the prosthesis obturator and the alveolar bone matrix and patricai will polimerizuet in the apparatus under pressure, the excess crushed out of the holes of the plastic is removed, the alveolar additionally polished, after polymerization of the alveolar connect with prosthesis obturator through the clutch Patric and plastic matrix.

2. The method of attachment of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw according to claim 1, characterized in that the shape of the male mould by strengthening at the end of the sprue and casting after casting, the sprue is cut with preservation 1 cm length of sprue, on the left the length of the sprue cause the retention notches for good adhesion with the plastic of the alveolar ridge using self-hardening plastic protocal.

3. The method of attachment of the alveolar ridge with artificial teeth to the denture-obturator in the complete absence of the upper jaw according to claim 1, characterized in that the holes of the alveolar ridge make a self-hardening plastic with a slight excess, and the excess plastic is apolnet possible voids between the alveolar bone and the prosthesis obturator to create a tight contact.



 

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1 tbl, 3 ex

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1 dwg

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