Method for determining tooth looseness degree

FIELD: medicine.

SUBSTANCE: method involves applying variable force to a tooth. Harmonic mechanical oscillations of frequency not exceeding 250 Hz are excited. Mechanical impedance Z is concurrently measured. Lower limit of changes shows extreme tooth looseness degree. The upper limit of changes shows physiologic tooth looseness degree. Mechanical impedance Z value is measured as Nxs/m, where N is the newton, s is the second and m is the meter.

EFFECT: high accuracy and objectiveness of measurements.

1 dwg

 

The present invention relates to medicine, namely to the dentist.

Normal teeth have the physiological mobility, which is necessary for the implementation of the trophic function. Evidence of physiological mobility is the presence of polished areas on the contact points between adjacent teeth (Courland VY Prosthetic dentistry. - M.: Medicine, 1969. - S).

The pathological condition of periodontal tissues of the tooth becomes abnormal mobility. Thus, the degree of tooth mobility is an indicator of the functional value of the periodontium. In remission abnormal mobility may decrease in exacerbation - increase (barer G.M. periodontal Diseases: clinical features, diagnosis, and treatment: Textbook. Manual / Himbeer, Tnemec. - M.: NERC, 1996. - 86 C.). To record objectively the difference today is not possible due to lack of accurate measuring devices.

According to some authors, the vertical form of atrophy of the walls of the holes of the teeth exacerbates the amplitude of tooth mobility (Vigabatrin. Orthopedic treatment of periodontal disease. M: "Triada - X, 1993. - P.40). However, clinical examination of patients with periodontal disease often a discrepancy is found the same degree of atrophy in verticalmargin and the degree of tooth mobility, it is obvious that it is not always vertical bone resorption holes of the teeth have a greater effect on the mobility of the tooth than horizontal.

The mobility of the tooth can be determined by palpation, using tweezers (Vinkopan. Orthopedic treatment of periodontal disease. M: "Triada - X, 1993. - P.41). However, the disadvantage of this method is the subjectivity of the definition.

There is a method of determining the mobility of a tooth by applying to the tooth a variable force, providing reciprocating oscillations. Measuring the amplitude of displacement of the tooth is produced by the selection of two of its components, the largest of which is judged elastic and viscous characteristics (see RF Patent №2065724, 1996, And 61 In 5/05 And 61 With 19/04).

The closest is a method of determining the state of holding the tooth tissues using protestati. Protectedly is mediated condition assessment supporting tissues of the tooth, i.e. the functionality of the periodontal device "Periotest 3218", evaluates the ability of periodontal tissues to return the tooth to its original position after the action on it of a certain external load (functional or pathological). Physical operation principle of this device is to convert electrical impulses into mechanical. The analyzed tooth percutanoues the striker tip, directed the m horizontally and at right angles to the middle of the vestibular anatomical plane of the crown abutment tooth, at equal intervals of time with effort. The results are displayed in the index (see I.yu.lebedenko and other Functional and instrumental methods of research in prosthetic dentistry. The tutorial. - M.: OOO "Medical and information Agency, 2003. - S-100).

However, the known methods of determining the mobility of the tooth does not have a high accuracy of measurement does not provide an objective criterion of the degree of mobility and measurement system units, suitable for logging.

The technical result of the proposed method is to improve the accuracy and objectivity of determining the mobility of the tooth, by identifying not only pathological but prepathological state occurring in the periodontal tissues, and identification of risk groups among patients.

New to the achievement of the technical result is that excite harmonic mechanical vibrations of the tooth with a frequency of not higher than 250 Hz, simultaneously measure the value of mechanical impedance Z.

New is also that the lower limit of the change corresponds to the extreme mobility of the tooth, and the upper limit corresponds to the physiological tooth mobility. The value of mechanical impedance is measured inwhere

N - Newton;

s - seconds;

m - meter.

Excited harmonic mechanical vibrations of the tooth in the frequency range 1...250 Hz with an amplitude of not causing pain. Simultaneously measured the amplitude of the harmonic oscillation or oscillatory speed. Both at a constant frequency harmonic excitation depends on the mechanical impedance Z is measured in unitsand inversely proportional to the magnitude of the mobility measured in units.

The authors experimentally detected and measured the dependence of the degree of pathology of tooth tissues and the values Z and K. the Authors have determined that at a frequency of 230 Hz impedance changes for teeth with varying degrees of pathology is 0...8000. The lower limit corresponds to the extreme mobility of the tooth, prior to the loss. The upper limit corresponds to the normal physiological tooth mobility. The use of a frequency not higher than 250 Hz is due to the fact that at higher frequencies the excitation of oscillations is observed deviation from the dependences of pathology and the measured values. The most convenient for measuring the range 200-230 Hz.

Comparative analysis of the prototype shows that the inventive method differs from the known fact that excite harmonic mechanical vibrations of the tooth frequency is th not higher than 250 Hz, at the same time measure the value of mechanical impedancethe lower limit of the change corresponds to the extreme mobility of the tooth, and the upper limit corresponds to the physiological tooth mobility that meets the criterion of "novelty".

A new set of features improves the accuracy and objectivity of determining the mobility of the tooth, which, in turn, allows us to judge the extent of vertical and horizontal destruction of periodontal tissues, to identify risk groups in order to conduct preventive measures against this disease, which meets the criterion of "industrial applicability".

The method is illustrated in the drawing, which shows a diagram of the use of devices to make measurements in the oral cavity, with 1 tooth, 2 - pin tip, 3 - receiving sensor, 4 - vukobrat, 5 - emitting piezoelectric element.

The method is as follows.

For measuring tooth mobility 1 use the composite sensor core structure consists of a contact tip 2, the receiving piezoelectric element 3, Zvukovaya 4, the radiating piezoelectric element 5. Radiating piezo generator of electrical oscillations of low frequency serves an AC sine wave of specified frequency. Foster piezoelement is connected to the selective voltmeter, configured for the used frequency. The voltage at the receiving element of the sensor is proportional to the mechanical impedance. The sensor is installed horizontally and at right angles to the middle of the vestibular surface of the coronal part of the investigated tooth. Dentition of the patient open. Excite longitudinal or transverse axis of the tooth harmonic mechanical vibrations of the tooth with a frequency of not more than 250 Hz, for example, in the range of 200-230 Hz with an amplitude of not causing pain. Determine the scale of the instrument measured voltage. The scale of the voltmeter calibrated in terms of impedance Z. the Range of impedance changes for teeth with varying degrees of pathology is 0...8000The lower limit corresponds to the extreme mobility of the tooth, prior to the loss. The upper limit corresponds to the physiological tooth mobility.

The proposed method of determining the mobility of the tooth illustrated by the following clinical examples.

Example 1. Patient Fedotov MV, 27 years old, came to the dental clinic to the dentist about the phenomenon of hyperesthesia teeth.

Inspection. Extraoral: symmetrical face, the height of the lower third of the face normal, nose and chin creases expressed moderately. The mouth opens on 4 see When you open your mouth there is a deviation of igney jaw. A state of physiological rest is 1.5 mm to palpation of the masticatory muscles dense, painless. Intraoral: mucosa of vestibule of mouth pale pink color, no pathological changes, wet, periodontal pockets are not visible gingival retraction no, mobility of teeth with tweezers is not observed. Index of oral hygiene Waheguru - Way good. Sample Schiller-Pisarev negative. Index PMA equal to 0. Bite: orthognathic. To determine the mobility of the teeth with the help of our device the sensor is installed horizontally and at right angles to the middle of the vestibular surface of the coronal part of the investigated tooth. Excited harmonic mechanical vibrations with a frequency of 230 Hz with simultaneous measurement of mechanical impedance, which, in the area of the teeth of the lower and upper jaw equal to the average limit, which corresponds to the average degree of mobility.

Dental formula:

PPOp the SPT
8765432112345678
76543211234567
SPTSPT

On the orthopantomogram, made in the position of Central occlusion, head of the mandible on the right and on the left are at the base of the slope the articular tubercle. Notes uniform horizontal atrophy of the bone tissue of the alveolar ridge in the area of the dentition of the upper and lower jaw, about 1/3 of the length of the tooth roots. The nasal septum is not curved, the maxillary sinus, roentgenocontrast.

Diagnosis: Partial absence of teeth on the upper jaw. Bruxism complicated generalized periodontitis of moderate severity, remission stage. Muscular - articular TMJ dysfunction.

Example 2. Sick Solomentsev E.V., 18 years old, came to the dental clinic to the dentist for a checkup.

Extraoral: symmetrical face, the height of the lower third of the face normal, nose and chin fold expressed moderately. The mouth opens at 4 cm, the movement of the mandible smooth, the state of physiological rest in norm.

Intraoral: mucosa of vestibule of mouth pale pink color, no pathological changes, wet, periodontal pockets are missing. Index of oral hygiene Waheguru - Way good. Sample Schiller-Pisarev negative. The index of ACA is 0. Tooth mobility on the proposed method corresponds to the upper limit. Bite orthognathic. Dental formula:

p
8765432112345678
8765432112345678
p

On the orthopantomogram, made in the usual position of occlusion, head of the lower jaw are placed at the base of the slope of the articular tubercle. Cortical locking plate retained throughout. The nasal septum is not curved, the maxillary sinus, roentgenocontrast.

Diagnosis: healthy.

The method for determining mobility of a tooth by applying to the tooth a variable force, characterized in that excite harmonic mechanical vibrations with a frequency of not higher than 250 Hz, simultaneously measure the value of mechanical impedance Z, the lower limit of the change corresponds to the extreme mobility of the tooth, and the upper limit corresponds to the physiological tooth mobility, and the value of the mechanical impedance Z is measured in,

where N is Newton;

s - seconds;

m - meter.



 

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