Apparatus for curing functions of (temporo) mandibular joints combined with habitual dislocations of lower jaw

FIELD: dentistry.

SUBSTANCE: apparatus can be used for orthopedic treatment of distinctions of (temporo)mandibular joints with habitual dislocations and semiluxations of lower jaw. Apparatus has lower jaw's movement restrictor provided with axis for free rotation; distal and proximal ends of apparatus are fixed to upper and lower jaws. Ends are tightly fixed at support orthodontic rings at 6^th upper and lower teeth. Rings are provided with locks. Parts of locks are fixed together by brace. The restrictor has row longitudinal holes at side of lower jaw to adjust width of opening of mouth. Axis is disposed in center of gum of restrictor.

EFFECT: portability; higher hygiene; comfort at use.

3 dwg

The invention relates to medicine and can be used in dentistry for orthopedic treatment of dysfunctions of the temporomandibular joints with habitual dislocation and subluxation of the mandible.

Treatment of dysfunctional States temporomandibular joints (TMJ) are primarily aimed at restoring neuromuscular regulation of masticatory muscles, restoring the synchronization of their reduction, strengthen the muscular-ligamentous apparatus of the joints.

To date a number of authors have proposed various orthoses for the treatment of TMJ dysfunction. Such devices include removable plates Schroeder (1909), Sinomania-Urban (1951), Kosakowo (1953).

The apparatus Schroeder (prosthodontics. M.: Medicine, 1988, s) consists of rubber palatal plate with a bandage, which rests in the area of coronal ridge of the lower jaw and prevents the wide mouth opening due to the emphasis on the cutting edge of its branches.

The apparatus Sinomania-Urban (diseases of the temporomandibular joint. Krasnodar, 1996, s) represents a palatal plate with a removable bandage, fixed to the palatal surface through the oval bushings. Pilot fortified on a springy metal plate and rests in the anterior branches of the lower jaw and prevents widely is at the mouth opening.

The apparatus Csatoday (prosthodontics. M.: Medicine, 1988, s) is a modification of supragingival bus Vankevich with small bilateral plastic rollers in the back parts of the tire that touches the anterior branches of the lower jaw on both sides and interfere with the wide mouth opening.

The disadvantages of the above devices:

1. Bulky, removable.

2. Poor fixation and stabilization

3. Injure the mucous membrane of the mouth in the area of emphasis of peloton, causing sharp pain and decubital ulcers.

4. Patients discontinue treatment early, without using any AIDS in connection with the callee discomfort and trauma to the oral mucosa.

Known fixed limiting device for the treatment of chronic arthritis of the TMJ, which was proposed in 1964 Vierges and Pwholesale (diseases of the temporomandibular joint Krasnodar, 1996. c.186). The apparatus is fixed on the teeth of the upper and lower jaw. The two crowns of upper and two lower jaw with vestibular side you solder along the segment of the injection needle length 3 mm Segments needle you solder on the vestibular surface at an angle of 45° to the chewing surfaces of crowns, the distal ends of the segments needles come closer to the occlusal surface. After fixation of crowns take polyamide filament length 10-15 cm One end of the bat is upravlyaut heated stopfrom to Bulavinov extensions the other end passes through the lower tube from front to back, and then through the upper rear to front. By setting the length of the polyamide yarn on the extent of limitations, the excess thread is cut and the end is also upravlyaut to Bulavinov thickening.

The disadvantages of this device are:

1. He restricts saggitaria and the transverse movement of the lower jaw.

2. Nylon yarn is often broken, promazyvaetsya teeth, floss often injured mucosa of the cheeks.

3. The ends of the polyamide yarn not be clearly zapravit heated tool, so it often slips through the tube.

4. May be used only in case of habitual dislocation of the lower jaw, i.e. its use is very limited.

All of the above devices do not provide treatment of TMJ dysfunction in combination with habitual dislocation of the lower jaw.

The prototype of the present invention is the limiting bus Waitrose (diseases of the temporomandibular joint. Krasnodar, 1996, C, see Appendix).

The bus consists of a hinge (1), axis (2), guide ring (3), limiter (4), cotter pin (5).

The crowns of the lower jaw perpendicular to the buccal surface you solder the axis (2), and to the crowns of the upper jaw - guiding ring (3). Crowns with soldered axis and the ring is polished and fixed in phosphate cement. Through the lumen to which LCA hold the hinge and bore wear on the axle. According to the planned degree of restriction of mouth opening in the upper half of the hinge on the level of the upper edge of the ring make a mark. On the stamp to the hinge you solder restrictive nut, give it an ovoid shape, grind and Polish. Hinge with stop, put on an axis sprintout and the lower hinge and pin cover self-hardening plastic.

The disadvantages of this system:

1. Cotter pin and the lower hinge cover plastic, which creates difficulties at follow-up in TMJ treatment.

2. Plastic often get and injure the mucosa of the cheeks sharp edges.

3. A number of patients plastic causes the burning sensation of the mucous membrane at the site of contact of the plastic.

4. Often there is infringement cheeks between the stopper and the ring, and ill abandon its use.

5. The limiter is not always is and injure transitional fold.

6. Bulky, not hygienic.

7. Does not provide a smooth opening of the mouth.

8. Crowns inflate the occlusion and often raspoliruyte.

The task of the invention: improved treatment effect and creating a comfortable environment for the patient in the treatment of dysfunctional TMJ syndromes, habitual luxation of intra-articular meniscus, regulate the degree of restriction of mouth opening, creating easy the th position of the mandible during treatment, creating aesthetics, hygiene, reaching the fixed vertical and transverse movements of the lower jaw, eliminating the possibility of injury of the mucosa of the oral cavity.

The technical result of the invention is:

Limiting the degree of opening of the mouth when the TMJ dysfunctions in conjunction with the usual sprains, subluxations, the transverse shift of the lower jaw and dislocated intra-articular meniscus, creating miniature, cosmetic, hygienic apparatus that does not cause pain and discomfort to the patient.

The device allows to adjust the degree of opening of the mouth during treatment due to the number of holes on the limiter, suitable for all age groups, except children with milk (temporary occlusion), securely fixed in the mouth, does not cause functional overload of the anterior teeth, as there is contact on all teeth. Locking fasteners make it easy to remove the device for x-ray monitoring during and after treatment. The device is simple to manufacture by casting, does not injure the surrounding tissue, provides smooth opening of the mouth without "jerking". The design of the device does not cause difficulties in adapting to the treatment.

The application of orthodontic rings are not overestimates bite without causing primary traumatic occlusion.

The essential novelty of the apparatus t is aetsa fixation limiter to support orthodontic rigid rings 6 and 6 teeth with any one side of the dentition locks, having the design shown in figure 2. Components castles details are captured between a bracket. The limiter in the middle of its length has an axle to ensure a smooth opening and closing of the mouth (figure 3).

Apparatus sick shall be available for 5-6 months, and in combination with fiziolechenie and electromyostimulation in 2-3 months, which reduces the treatment time in half.

For a better understanding of the design of the apparatus is mounted and installed in the oral cavity, schematically depicted in figure 1, where position 1 is the limit (2 parts - the upper and lower jaws), 2 - axis, 3 - orthodontic rings, 4 - locks, 5 - a number of holes in the longitudinal direction at the end of the stopper from the side of the lower jaw (figure 2), 6 - bracket parts of the castle, 7 - detail of the castle, rigidly mounted on the orthodontic ringsandteeth, 8 - removable part of the castle, 9 - hole in the removable part of the castle to accommodate the bend 10 of the bracket 6, 11 - groove, 12 - axle-clip limiter, 13 - slot, 14 - lug - cheek groove. Castle disassembled shown in figure 2.

The apparatus is used as follows.

When the TMJ in conjunction with the usual dislocation and subluxation of the mandible and dislocation of the meniscus pin is stuck onandthe teeth on the spine of the mouth orthodontic ring 3. Remove the prints together with orthodontic rings with the upper and lower jaws. Models of the upper and lower jaw with orthodontic rings with roller bite sagopafeat in occludator.

Orthodontic rings 3 on the topand lower jawthe teeth perpendicular to the buccal surface you solder the part 7 of the lock 4, axle-clamp 12 part 7 of the lock 4 in the upper jaw put on the upper part of the stopper 1, then the axis of the arm 12 of part 7 of the lock 4 on the lower jaw put on the lower part of the stopper 1, and the planned degree of restriction mouth set corresponding hole 5 in the longitudinal direction at the end of the limiter 1, from the side of the lower jaw.

Then the removable part 8 of the lock 4 is put on the guide cheeks 14 in the slot 13 on the portion 7 of the lock 4 on the upper and lower jaw and the fixed bracket 6 through the opening 9 curve 10 in the groove II. Details of the limiter 1 through the opening 2 pre rasklepyvajut.

The device was tested for 2 years in 25 patients. Revealed that limit vertical and transverse movements of the lower jaw eliminates pathological symptoms: pain, crunching, clicking in the TMJ, the output of the articular heads of the articular fossae, you can restore the synchrony of contraction of the masticatory paired muscles, strengthens the muscle-Pesochny apparatus and functions of the joint as a whole. Recommended for wide use in practical dentistry.

Apparatus for the treatment of dysfunctions of the temporomandibular joints in combination with habitual dislocation of the lower jaw with the limiter movement of the lower jaw with the axis for free rotation and is fixed to the upper and lower jaw distal and proximal ends, wherein the distal and proximal ends rigidly fixed to the supporting orthodontic rings onandthe teeth, with this ring equipped with locks having the construction shown in figure 2, and details that are fixed between the bracket side of the lower jaw, the limiter has a longitudinally directed a number of holes to adjust the width of the mouth opening and the axis is located in the middle of the length of the delimiter.