Method for manufacturing removable combined gnathic maxillary prosthesis

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.

 

The invention relates to medicine, in particular to prosthetic dentistry and can be used for rehabilitation of cancer patients after combined treatment for cancer of the upper jaw.

At the planning stage of complex treatment of patients undergoing surgery to remove malignant tumors of the upper jaw, it is necessary to decide on the formation of optimal prosthetic bed and the next terms of producing rational maxillofacial prosthesis in the aftermath of the conducted radiation therapy, leading to delayed tissue regeneration.

The literature say about the advisability of early fabrication of maxillofacial prosthesis to prevent irreversible rough scarring, which greatly complicate the subsequent prosthetics. The increase of terms leads to the restriction of access to the future of prosthetic bed and complicates the removal of the cast, determination of Central occlusion, overlay dentures and, subsequently, its fixation and stabilization. The resulting scars change the position of the bodies dentition, what causes the dysfunction of breathing, swallowing, chewing and leads to permanent disfigurement of the face. Attempts to avoid such effects by using various metal structures, replacement remotely is a jaw fragment, give a temporary effect due to the development of osteomyelitis and implant failure (Lee E., Wilson J., 1973). The results of delayed bone grafting is also not always satisfactory, because they lead to a longer recovery time up to 2-3 years. Good aesthetic effect when this does not provide the full function of chewing, due to the impossibility of creating a "comfortable" prosthesis (PABSEC A.I., Olshansky V.H., 1997). Of great interest is the use of bone-skin graft using microvascular techniques for the reconstruction of the jaws after resection. This phase of rehabilitation measures are technically complex, require expensive equipment and requires further study and development. Therefore, of particular interest is the solution to this problem by orthopedic.

The closest is the way orthopedic treatment of cancer patients with resection of one of the upper jaw, including the formation of prosthetic bed and manufacture of permanent removable slozhnokonturnogo of the prosthesis by the method of injection molding comprising obtenerse part and full removable laminar denture (see log for "Maestro dentistry", №4 (9), 2002, p.4-7).

The disadvantages of this method are the difficulty of manufacturing the prosthesis and the limitations of treatment italiaracing rehabilitation of cancer patients.

The basis of the utility model laid the task of creating complex more rational way of orthopedic treatment of cancer patients with resection of one of the upper jaw, underwent surgery to remove malignant tumors of the maxillary sinus in the early postoperative period, and simplifying the manufacture of the prosthesis.

The problem is solved in that in the method of orthopedic treatment of cancer patients with resection of one of the upper jaw, including the formation of prosthetic bed and manufacture of permanent removable slozhnokonturnogo of the prosthesis by the method of injection molding comprising a permanent obtenerse part and full removable laminar denture, according to the utility model, the treatment is carried out in two stages, with the first stage, the formation of the prosthetic bed beginning in the early postoperative period during the first two months after radiotherapy by making temporary slozhnokonturnogo prosthesis collapsible design with two obtenerse parts made of elastic plastic surfaces, congruent cavity defect, and full removable laminar denture with the lock-element by using expansion joints, temporarily using it during further exposure for 5-6 months for the final formation of protechnology in the future as a dental impression spoons, and the second phase of treatment begins after the final formation of the prosthetic bed, which consists in the manufacture of permanent removable slozhnokonturnogo prosthesis, obtenerse part which performs hollow.

The method is as follows.

The method is carried out by the manufacturer slozhnokonturnogo full replacement removable laminar denture. At the first stage during the first two months after radiotherapy, due to postoperative muscle contraction and, consequently, limited opening of the mouth, the patient is made separable temporary removable slozhnokonturnogo prosthesis, comprising two obtenerse parts with surfaces congruent cavity defect is made within the first two months of elastic plastic, and full removable laminar denture with a locking-element by using expansion joints manufactured by the method of injection molding.

This temporary removable sonochemistry prosthesis due to their design features enhances the introduction of it in the postoperative cavity and the oral cavity, and forms a prosthetic bed for the future of the prosthesis and prevents the formation of scars and permanent disfigurement of the face.

At the second stage after eliminating muscle contracture and is formirovaniya prosthetic bed is made of solid permanent removable sonochemistry prosthesis by the method of injection molding, consisting of a hollow obtenerse part and full removable laminar dentures.

In the manufacture of permanent removable slozhnokonturnogo of the prosthesis in the upper jaw the complexity of the prosthesis was limited mouth opening and the absence of teeth on the right upper jaw, the difficulty of getting a seal cavity of the defect and the presence of wound surface of the prosthetic field, complicated radiation therapy. It was difficult getting the impression and the introduction of the prosthesis into the cavity of the mouth and nose as a single unit with the obturator.

This problem was solved by separating the imprint of three parts: two parts - cavity defect and one saved half of the upper jaw. Print off the following way: after the application of anesthesia as dental impression mass use basic wax, which is heated on a water bath, and introduce a phased manner by injection into the cavity formed after resection of the left half of the upper jaw. So get a wax model of obtenerse, fully reproducing the relief of the prosthetic field. Then, after removing the wax reproductions replace the wax on elastic plastic by the method of injection molding. Then this elastic obturator divided into two equal parts using a sharp scalpel and base obtenerse part in the field of separation make wedge-shaped notch for the locking-element using expansion joints. Then get a full anatomical impression alginate dental impression mass using standard dental impression spoon the rest of the prosthetic bed, which cast a plaster model and make individual slideshow spoon.

After that enter alternately into the cavity of the defect both elastic obtenerse part. The fit of individual spoons on the upper jaw produced using samples of Herbst, functional reprints receive with clearance a full surround continuous closing circular valve. Made the basis of full removable laminar slozhnokonturnogo of the prosthesis by the method of injection molding. Inspect the resulting construction in the mouth. Then set on wax cylinders plastic base and determine the Central value of the jaws.

Then, make the production of artificial plastic teeth and replace the wax on the plastic. For better adhesion to the mucosa of the prosthetic bed in the area of the defect and fixation of the obturator with prosthesis use lock-spacer system between their constituent parts.

With this method of treatment is achieved a good clinical result. The act of swallowing is restored in 1-2 days, speech function for 7-9 days and the ability to chew food, all the way through three weeks.

the Manufacture of collapsible temporary two-part obtenerse parts and castle-spacer element helps prevent scarring and permanent disfiguring the face, that allows you to create optimal conditions for the formation of prosthetic bed for future construction one-piece permanent removable slozhnokonturnogo prosthesis. To manufacture one-piece permanent removable slozhnokonturnogo prosthesis with hollow obtenerse part start after 6 months after the end of the first phase of rehabilitation of such patients.

The method consists in the following. As a dental impression spoons use the prosthesis. Before that produce bonding two obtenerse elastic parts and the basis of complete removable laminar denture using sticky wax. As a dental impression mass use correcting silicone mass. Make a plaster model and simulate obtenerse part by application of a heated base plate wax, overlapping the area of the defect and lines the inside surface (go inside the defect). Then replace the wax on the plastic by the method of injection molding. A pin is stuck obturator in the cavity of the defect. Stick with the inlet of the obturator plate base wax and receive a functional impression, using the basis of the former prosthesis. Make a plaster model, which produces the modeling basis of the permanent removable slozhnokonturnogo prosthesis, replace the wax on the plastic by the method of injection molding, etc is than when this happens, a chemical compound basis and obtenerse part of the prosthesis. Then set the wax cylinders on the basis of the prosthesis, determine the Central value of the jaws, make setting artificial teeth and replace the wax on the plastic. Made permanent construction is a one-piece permanent removable sonochemistry prosthesis with obtenerse hollow part. This facilitates weight design, because of its volume, improves fixation and stabilization, as well as restored the defect of the upper jaw, imitating the maxillary sinus, creates a resonance effect and contributes to the improvement of phonetics and speech functions in General.

The proposed method of orthopedic treatment allows a more rational and early rehabilitation of cancer patients with resection of one of the upper jaw and to simplify the manufacture of the prosthesis.

The way orthopedic treatment of cancer patients with resection of one of the upper jaw, including the formation of prosthetic bed and manufacture of permanent removable slozhnokonturnogo of the prosthesis by the method of injection molding comprising a permanent obtenerse part and full removable laminar denture, wherein the treatment is carried out in two stages, with the first stage, the formation of the prosthetic bed beginning in the early postoperative period during the first two months after radiotherapy those who FIPA by making temporary slozhnokonturnogo prosthesis collapsible design with two obtenerse parts, made of elastic plastic surfaces, congruent cavity defect, and full removable laminar denture with a locking-element by using expansion joints, temporarily using it during further exposure for 5-6 months for the final formation of the prosthetic bed and in the future as a dental impression spoons, and the second stage of treatment begins after the final formation of the prosthetic bed, which consists in the manufacture of permanent removable slozhnokonturnogo prosthesis, obtenerse part which performs hollow.



 

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FIELD: medicine; orthopedics.

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1 tbl, 3 ex

FIELD: medicine.

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FIELD: medical engineering.

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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 no

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FIELD: medical engineering.

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1 tbl, 3 ex

FIELD: medicine; orthopedics.

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FIELD: medicine.

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EFFECT: simplified production process; early stage cancer patient rehabilitation in half-maxilla resection cases.

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FIELD: medical engineering.

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EFFECT: accelerated adaptation period; improved strength characteristics.

19 dwg

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