Method for making releasing postoperative maxillofacial prosthesis

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to dentistry, and is applicable in making a releasing postoperative maxillofacial prosthesis for all types of maxillectomy. A patient's oral cavity is optically imprinted. An optical imprint is digitised by means of a computer unit of CAD/CAM system. Planned surgical area boundaries are modelled on the formed image, and the above boundaries are virtually engraved vertically and horizontally at a width and a depth of 2.5 mm. A base of the releasing postoperative maxillofacial prosthesis is modelled with retention elements, and scanned patient's dental arch images are attached by matching technique. The modelled construction of the releasing postoperative maxillofacial prosthesis with artificial plastic-plate teeth is milled. The made prosthesis is processed, ground and polished. The prosthesis is fixed in the patient's oral cavity.

EFFECT: by providing a one-piece configuration of the releasing postoperative maxillofacial prosthesis with the retention elements by computed milling, the method enables recovering the masticatory function, ensuring the prosthetic bed formation within the surgical area and the optimum fixation in the unfavourable clinical environment of the prosthetic bed.

1 dwg

 

The invention relates to medicine, in particular to the dentist, and can be used for the manufacture of divisive postoperative prosthesis for the upper jaw in all its resection.

Also known construction resection of the denture in the upper jaw, consisting of two detachable parts basis and obturator (see B. K., Koster, C. A. Minyaeva. "Maxillofacial prosthetics". Medicine, 1985, S. 33-34).

There is a method of forming dental and maxillofacial prostheses made of plastic by conventional molding, which consists in obtaining imprint (stamp), the fabrication of the plaster model, modeling wax pattern of the obturator, sagipsul model with a wax pattern in the cell in a vertical position, packing and polymerization of plastics in a vertical direction (see C. N. Kopeikin, J. C. Kubovic, C. Y. Kurland, I. M. Oksman. Prosthodontic appliances, chief 8, 9, Art. "Technology of plastics". M.: Medicine, 1978, S. 105-109; 272-275).

However, these designs of prostheses are delayed, usually for 14-20 days after surgery, when the epithelialization of the wound surface finishes. Accordingly, these prostheses may not be used to formalize the edges of the surgical field, the further fixation of the prosthesis.

Know directly the e prosthesis after resection by the method of I. M. The oksman in three steps. First, prepare the hook part of the denture with clasps on the abutment teeth. For this, remove the stamp from the upper jaw cast model, simulate the locking plate of wax and replace it with plastic, then get the auxiliary seal with the lower jaw. Cast models and gypsum them occludator.

This is followed by manufacturing resection of part of the prosthesis. Models of the upper jaw mark the border of the resection in accordance with the plan of operation. Then on the side of the tumor is cut at the level of the cervical one tooth, so that in subsequent prosthesis does not interfere epithelialization of the bone wound. The remaining teeth are cut together with the alveolar ridge to the apical base. The surface of the fixing plates make rough, defect fill with wax and set of artificial teeth in occlusion of the lower jaw. Artificial gum molars and premolars model roller coming in the front-rear direction. In the postoperative period platen forms a bed in the mucosa of the cheeks, which will serve as the point of anatomical retention. A wax reproduction of the prosthesis to replace the plastic. After surgery, the prosthesis is superimposed on postoperative wound (see A. S. Shcherbakov, E. I. Gavrilov, V. N. Tregubov, E. N. Zhulev. Prosthetic dentistry. SPb.: The IPC "Folio", 1998, S. 526-527). Dunn is I design chosen for the prototype.

The disadvantage of this design is that the boundaries of the prosthesis corresponding to the boundaries of the surgical field, which does not allow to put additional pressure on this area, and that the inner surface of the prosthesis is made rough, which in turn contributes to increased adhesion aggressive microflora of the oral cavity to her and, as a consequence, the formation of a persistent factor in maintaining inflammation and prolonged wound healing.

A known method of manufacturing a divisive postoperative maxillary denture for the upper jaw by obtaining the plaster model to the mission plan and outline the proposed boundaries of the surgical field and remove the corresponding teeth, engrave data boundaries in the vertical and horizontal directions of the width and depth of 1.5-2.0 mm, and then simulate the wax composition divisive postoperative maxillary denture with artificial teeth, clasps and retention elements, carry out the duplication of the obtained plastic-wax composition, substitution of wax on the plastic with the subsequent recovery of deleted sections forming the outer boundaries of the surgical field soft padding, then fix the plate in silicon duplicate and will polimerizuet in vacuum conditions, followed by grinding and is the join surface of the plate, converted to the defect to a mirror finish (Patent RF №2427344).

This method is chosen for the prototype.

The present invention is to restore chewing function and formation of the prosthetic bed of dental prosthesis in cancer patients with postoperative defects of the maxilla and dentition with integrity teeth.

The technical result is the production release of postoperative dental prosthesis for the upper jaw in all its resection capable of forming a prosthetic bed in the area of operation, optimal fixation with adverse clinical conditions prosthetic bed, restore chewing function and restore the height of the lower third of the face after surgery.

The technical result is achieved by a method of manufacturing a divisive postoperative dental prosthesis for the upper jaw is to obtain the optical impression of the oral cavity of the patient and transfer him to the digital format by a computer module CAD/CAM system, the modeling of the obtained image of the boundaries of the proposed surgical field with virtual engraving data boundaries in the vertical and horizontal directions of the width and depth of 2.5 mm, further modeling of the basis of asobayire postoperative dental prosthesis retention elements and attach the scanned image of the dentition of the patient by the method of matching images, milling simulated prosthesis construction of the plastic disk.

Prosthetic dental rehabilitation of cancer patients with postoperative defects of the jaws is carried out in three stages prosthetics. In the first stage, in the preoperative period, made decoupler plate, bearing function of the separation of the cavities of the nose and mouth and providing initial impact for epithelialization of the borders of the defect. The second stage consists in the manufacture and use of the patient forming a prosthesis-obturator used to temporarily restore chewing efficiency and the formation of the annulus defect sky, playing the role of the additional retention element, which is especially important in patients with complete absence of teeth. And the final stage of the prosthesis is characterized by the fabrication of the final prosthesis-obturator.

The proposed method can be used on the first of the suggested steps.

As a result of the treatment the patient is not only the distinction between the mouth and nose, which in turn provides the possibility of a meal, but restores the chewing function and restore the height of the lower third of the face that are due to the presence in the resulting denture teeth and teeth that I have which is an exact copy of the dentition and teeth of the patient in the preoperative period.

Design divisive postoperative plate for the upper jaw is illustrated in the drawing, where:

1. the base plate,

2. the retention elements of the prosthesis,

3. the sections forming the outer boundaries of the surgical field,

4. milled artificial teeth.

Divisive postoperative dental prosthesis for the upper jaw is made as follows.

1. Receiving the optical impression of the oral cavity of the patient.

2. The translation of the optical imprint it into a digital format through computer module CAD/CAM system.

3. Modeling the obtained image boundaries of the proposed surgical field with virtual engraving data boundaries in the vertical and horizontal directions of a width and a depth of 2.5 mm

4. Modeling basis divisive postoperative dental prosthesis retention elements and attach the scanned image of the dentition of the patient by the method of matching images.

5. Milled simulated design divisive postoperative dental prosthesis with artificial teeth of the plastic disk.

6. Processed denture, grind, Polish.

7. Fix the prosthesis in the oral cavity of the patient.

A method of manufacturing a divisive postoperative dental prosthesis for the top jaw is to obtain the optical impression of the oral cavity of the patient and transfer him to the digital format by a computer module CAD/CAM systems, modeling the obtained image boundaries of the proposed surgical field with virtual engraving data boundaries in the vertical and horizontal directions of the width and depth of 2.5 mm, further modeling basis divisive postoperative dental prosthesis retention elements and attach the scanned image of the dentition of the patient by the method of matching images, milling simulated prosthesis construction of the plastic disc.



 

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2 dwg

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FIELD: medicine.

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1 dwg

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EFFECT: high strength; stable tooth row occlusion.

FIELD: medicine.

SUBSTANCE: method involves applying endodontic treatment of root, fixing pin manufactured from gold-coated metal gauze having free wires on opposite ends and repairing dental crown part with composite materials depending on particular morphological features of the dental row and length of area between the abutment teeth, to be substituted. The pin is fixed in root canal and mediodistal slot made in advance on its base with twisted wires. The wires on the opposite ends are bent towards vestibular side and additionally fixed with beams fixed in advance on the abutment teeth. The wires are brought above the upper and under lower beams. The beams and wires are treated with masking agent before repairing dental crown part.

EFFECT: enhanced effectiveness in restoring functional and esthetic properties of dental row; accelerated treatment procedure; reduced risk of traumatic complications.

2 cl

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