Device facilitating personal hygiene activities in patients with postoperative jaw defects
SUBSTANCE: device is monolithic, of soft polymer with intraoral and occlusive surfaces and a surface facing a nasal cavity. The occlusive surface is configured to mount on a fibrous ring and has retention elements 1-2 mm wide along the whole period of the occlusive part of the device facing the nasal cavity. An outer diameter of the occlusive surface is configured to exceed the diameter of the fibrous ring by 2-3 mm. The intraoral surface is configured to match a patient's hard palate and has a ring on the outer surface.
EFFECT: invention enables marking the limits of the patient's mouth and nose if observing the postoperative upper jaw defects during individual hygiene activities.
The invention relates to medicine, namely to orthopedic dentistry, and can be used for carrying out the activities of individual hygiene in patients with postoperative defects of the upper jaw.
As a result of surgical intervention in the upper jaw for cancer diseases or injuries of different origin occurs the message of the oral cavity with the nasal cavity.
To distinguish these anatomical structures and restore chewing and rehearsaling functions in the dental practice of dental prosthetics prostheses with obturators. The prior art discloses a maxillary denture-obturator is made integrally and contains two functional elements: the base of the prosthesis with artificial teeth made of hard polyurethane and the obturator of elastic polyurethane. The lower border of the obturator firmly attached to the mucous fistula surgical field coated zones undercut regions and anatomical areas of retention. The obturator is fully repeats the postoperative defect and has the shape of a hollow Cup-shaped structure. The border of the obturator can have a different thickness and length. The surface of the obturator facing the cheeks, has a maximum height and a rounded end hour�ü, pressed against the bone structure of the upper border of the postoperative defect (Patent RF №2477103 from 10.03.2013).
Known dentoalveolar prosthesis-obturator having a base with artificial teeth and clasp with fixing elements made of rigid polyurethane. The obturator is hollow and has a frame made of rigid polyurethane, and the outer surface is made of soft polyurethane. The entire prosthesis is made by casting, including sections forming the outer boundaries of the surgical field. The technical result of the invention is the production of lightweight dentoalveolar prosthesis-obturator is made of polyurethane for high congruence of the base of the prosthesis to the prosthetic bed, especially along the border of the defect of the upper jaw, the lowest adhesion of microorganisms to denture-obturator and recovery phonetics patient, intelligible speech (Patent RF №2452431 from 10.06.2012).
Known dentoalveolar prosthesis-obturator having a metal base composed of a body, firmly attached to the lining of the saved hard palate, systems cast of clammers and a perforated plate located in the continuation of the hard palate and overlying the postoperative defect, fixed on her obturator is hollow and has a frame made of rigid polyurethane, and the outer surface of �and hard polyurethane, made in such a way that the outer surface of the obturator go to 2 mm for scar ring defect around its perimeter and retention points of 1 mm (Patent RF №2489115 dated 10.08.2013). All of these designs are final prosthesis and perform the main purpose of the recovery of the patient.
Patients with a history of cancer status, often arrive in a state of immunodeficiency that is associated with the specifics of the applied pharmacotherapy. This entails a change of microbiocenosis of the oral cavity and active formation on the borders of the prosthesis microbial biofilms is often represented by pathogenic microorganisms. The result is inflammation in the scar area of the ring and tissue bordering the prosthesis, resulting in a decrease of the retention properties of the prosthetic bed and patient dissatisfaction fixation and stabilization of the prosthesis. Recommended by experts daily antiseptic treatment of the oral mucosa and prosthetic bed involves the removal of the specified prosthesis, causing problems, primarily associated with the exposure of the message of the cavities of the mouth and nose and undesirable penetration of the disinfectant into the respiratory system.
The task, which directed the invention is the provision ol�management activities, personal hygiene in patients with postoperative defects of the jaws.
The technical result of the invention is to ensure separation between the cavities of the mouth and nose in patients with postoperative defect of the upper jaw during the execution of the procedures of individual hygiene. The technical result is achieved due to the fact that the device for carrying out the activities of individual hygiene in patients with postoperative defects of the jaws is made integrally of a soft polymer and has two surfaces and intraoral obturator, the obturator surface has the shape of a bowl, with a retention element of a width of 1-2 mm around the perimeter of the obturator portion of the prosthesis facing the nasal cavity, the boundaries of the outer diameter which exceeds the diameter of the fibrous ring (2-3 mm) and intraoral surface facing into the cavity, shaped to fit the hard palate of the patient and has on the outer surface of the ring.
This design is intended for the separation of the cavities of the mouth and nose in patients with postoperative defects of the jaws during the execution of the procedures of individual hygiene. The elasticity of the material of construction and design features, namely, that the boundaries of the outer diameter of the obturator portion exceeds the diameter of the fibrous ring (2-3 mm), allow to provide stable fixation of�already listed the device in the message area of the cavities of the mouth and nose during hygiene procedures. To facilitate retrieval of the device the outer surface has a ring to which it is possible to attach dental floss or any other supporting elements.
The design of the proposed device for carrying out the activities of individual hygiene in patients with postoperative defects of the jaws is illustrated by drawings, where Fig.1:
1. Occlusive surface of the device.
2. Retention elements on the perimeter of the occlusive portion of the device.
3. The boundaries of the outer diameter of the occlusive portion of the device.
4. Intraoral surface of the device.
5. Ring intraoral surface device.
6. Fibrous ring.
7. The nasal cavity.
8. The mouth.
The device for carrying out the activities of individual hygiene in patients with postoperative defects of the jaws is produced as follows.
The patient in the final stages of prosthetics (uses the final prosthesis obturator) receive impressions alginate mass and made working plaster model. On the model carry out the etching of the inner surface of cicatricial ring (6) from the side of the nasal cavity (7), 2-3 mm around the perimeter. Further, from wax model occlusive surface of the device (1), with retention elements (2) and borders on�ports of the outdoor diameter (3), passing through the previously etched inner surface of the scar ring. And also simulate the intraoral surface of the device (4) facing the patient's mouth (8), the ring (5) designed for ease of later retrieval of the device by the patient. Received wax design duplicate special dental mass and produce a device for carrying out the activities of individual hygiene in patients with postoperative defects of the jaws of soft polyurethane molding. The device is processed and priazovets in the oral cavity of the patient.
The device for carrying out the activities of individual hygiene in patients with postoperative defects of the jaws, made of monolithic reinforced soft polymer with intraoral and occlusive surfaces and the surface, facing the cavity of the nose, thus obturating surface is made with possibility of accommodation on the fibrous ring and has retention elements with a width of 1-2 mm around the perimeter of the occlusive portion of the device facing the nasal cavity, and the outer diameter of the obturator surface made with the possibility of exceeding the diameter of the annulus of 2-3 mm, and intraoral surface is arranged to conform to the shape of the hard palate PA�of yenta and has on the outer surface of the ring.
SUBSTANCE: method of repairing a demountable dental prosthesis of the upper jaw consists in matching and fixation of fragments of the demountable dental prosthesis by glue, manufacturing a stone model by the fixed prosthesis, extension by a dental cutter of fracture borders and formation on external borders of retention cavities, parallel to the fracture line, in the quantity of three, on the entire length of the fracture line, equally distant from each other. The ratio of the area of the line, which passes on the fracture line, and the area of the retention cavities must correspond as one to three, while initially the area corresponds to the diameter of the cutter, selected individually by a value obtained as a result of division of the fracture line length by five. After the described preparation the prosthesis is washed, dried, placed on the model, and the formed in the process of milling slots are filled with plastic with the following polymerisation in boiling water under pressure. The obtained prosthesis is processed, ground, polished and fixed in the oral cavity.
EFFECT: restoration of durability and functional characteristics of the broken demountable dental prosthesis by the method affordable for the patient.
SUBSTANCE: in oral cavity of patient in prosthesis bed flexibility of mucous membrane is measured in oral cavity of patient in prosthesis. Borders of poorly flexible areas are determined. Before packing basic plastic paste on model in cuvette, on prosthesis bed borders of poorly flexible areas are outlined. They are extended for 1.5-2 mm in towards flexible areas. Durable insulating material with width not less than value of flexibility of mucous membrane is fastened on said extended boarders of poorly flexible areas. Cuvette with gypsum model is filled with paste of basic plastic and placed under the press. Plastic polymerisation is carried out. After polymerisation prosthesis is extracted from cuvette and processed.
EFFECT: method, due to preparing gypsum model of jaw before packaging basic plastic, makes it possible to reduce excessive pressure, trauma and atrophy of prosthesis bed tissues in the area of poorly flexible areas of prosthetic bed.
SUBSTANCE: computer analysis of the patient's speech material is performed. The frequency of sound is determined in the norm for a phoneme, selected from the group: "s", "ts" and "f", the frequency of the same sound for the patient before prosthetics, the frequency of the same sound after prosthetics. After prosthetics the phonetic rehabilitation index (FRI) is calculated by the mathematical formula. If FRI is larger than one, successful phonetic adaptation of the patient to dental prosthesis by the phoneme is determined.
EFFECT: method makes it possible to increase the accuracy of estimating the quality of performed dental intervention, and correction.
3 dwg, 1 ex
SUBSTANCE: odontopreparation is followed by impression taking. A dental model is injected into cast. Anatomic forms of retainer teeth is restored in wax, and an intermediate part of the prosthesis is modelled. The cast model is imprinted in silicone. The teeth are prepared. A reinforcing fibre tape is prepared. A segment of fibre tape impregnated with universal adhesive is placed on the teeth along the full length taking into account a profile of the masticatory surface up to an equator. The prepared segment is fixed on the teeth with the universal adhesive by polymerisation in halogen light. Self-hardening plastic is placed into the silicon impression to be inserted into the oral cavity. After the plastic is self-polymerised, the impression together with the denture is removed from the oral cavity. The denture is removed from the impression and polymerised additionally within its intermediate portion.
EFFECT: by reinforcing the denture with the fixed reinforcing fibre tape, the method enables increasing durability of the temporary denture, making the temporary denture at one visit and maintaining its aesthetic properties.
1 dwg, 2 ex
SUBSTANCE: invention refers to medicine, particularly to dentistry, and can be used in orthopaedic dentistry for oncologic patients. A removable resection upper jaw denture with a myogymnastic element comprises an immobilising and resection portions and a removable myogymnastic element. The immobilising portion is configured in the form of a fixing plate having a clasp fixation system on the rest teeth. The resection portion is provided with artificial plastic teeth, contacts directly the rest upper jaw tissues and form a prosthetic bed for a permanent denture. The myogymnastic element is configured in the form of an orthodontic wire individually curved for each patient and having various cross-sections with a bead of a variable diameter sliding along the orthodontic wire. Plastic deposits are made in a base in attachment points of the myogymnastic element. The orthodontic wire is fixed by tension into blind canals.
EFFECT: invention enables combining the dental prosthetics and correction of postoperative tongue dysfunction in the oncologic patients.
SUBSTANCE: group of inventions refers to medicine, is applicable in dentistry and involves a method for preparing a dental instrument, the dental instrument configured to be used by a dentist, a set of pads to be used by the dentist (versions) and a method for the tooth preparation for treatment (versions). A method for making the dental instrument comprising the pad and configured to be used by the dentist; the instrument has at least one dental cutting instrument used for the tooth structure extraction, involves the stages: detecting the pad sized after the above tooth and after at least a portion of an adjacent tooth; modelling the pre-detected horizontal, vertical and inclined motions, which are supposed to be repeated by at least one dental cutting instrument to extract at least a portion of the detected portion of the tooth to be extracted; detecting the first and second guide edges inside the pad; making the above detected pad with the above first and second guide edges. The above first guide edge corresponds to the above pre-detected horizontal, vertical and inclined motions. The second guide edge inside the pad is remote from the first guide edge at a distance d. The second guide edge corresponds to the above pre-detected horizontal, vertical and inclined motions. The first and second guide edges are thereby presented to contact the dental cutting instrument to direct its horizontal, vertical and inclined motions in accordance with the pre-detected horizontal, vertical and inclined motions to remove at least the above portion of the pre-detected portion of the tooth to be extracted.
EFFECT: group of inventions enables providing the accurate tooth treatment for the following stage of treatment both by experienced and inexperienced dentists.
21 cl, 8 dwg
SUBSTANCE: invention refers to medicine and is applicable in treating lower molars with destruction in root bifurcation. Laboratory and radiographic examinations of an involved tooth are performed. A crown-radicular separation is followed by introducing an osteotropic material. Residual dental stumps are prepared for whole-piece crowns. A working impression of the lower jaw and an auxiliary impression of the upper jaw are made. The whole-piece crown with a washing space surrounding the separated bifurcation is made. It is fixed on dental cement.
EFFECT: method ensures the integrated treatment involving surgical and orthopaedic interventions and enables preserving the dental functions and restoring its anatomical shape.
SUBSTANCE: invention refers to medicine, particularly to orthopaedic dentistry, and can be used for partial laminar and clasp prostheses. A clasp system for fixing a removable partial denture of a single tooth consists of a basis with artificial teeth and a denture clasp. One end of the clasp comprises a mechanical device consisting of an inner O-ring abutment and an outer matrix and configured as a pivot, while the other end comprises a clasp seat in a rigid socket on an artificial dental crown. The outer matrix is fixed in the prosthesis basis and detachable together with the prosthesis, while the inner O-ring abutment is ball-shaped and connected to a clasp arm. The seat of the clasp socket is mounted on the artificial dental crown vertically or horizontally either from the lingual, or palatal, or approximal surface.
EFFECT: invention enables providing a more stable fixation of the detachable clasp system, a masticatory effectiveness and an appearance, and also avoiding the negative effect on the parodontium.
3 cl, 12 dwg, 3 ex
SUBSTANCE: group of inventions refers to medicine, namely to dental orthopaedics, and aims at developing a physical or virtual dental model as a supplement for making a dental implant. The method involves imaging upper and lower jaws, a motion field of the temporomandibular joint in disclusion, a contact region of the teeth in occlusion and in an extensive field of motion. A path of travel between the lower and upper jaws is calculated. Making the dental implant is ensured by using a fastening device taking into account the patient's diagnostic information, comprising the fastening device with a lower part and an upper part movable in relation thereto. The upper part represents the upper jaw, while the lower part is the lower jaw. Three-dimensional digital data of the lower and upper jaws, as well as occlusion in the central position are taken into account to calculate the motion and limitations fields of the jaws in relation to each other.
EFFECT: by using the individual patient's data, the group of inventions enables the temporomandibular joint compliance, developing the supplementary model providing the substantial saving of consumable materials and reducing the time for developing the physical and virtual dental model.
19 cl, 5 dwg
SUBSTANCE: invention relates to field of medicine, in particular to dentistry, and can be applied for orthopedic dental rehabilitation of oncologic patients with post-operation defects of upper jaw and dentitions. Disconnecting post-operation dentoalveolar prosthesis of upper jaw for formation of prosthetic bed in the section of performed operation and initial impact for epithelisation of defect boundaries contains basis, scar ring former, retention elements and artificial teeth. Artificial teeth are obtained by initial model after scanning patient's own teeth in pre-operation period. Prosthesis is made in one piece by method of computer milling from plastic disc.
EFFECT: invention makes it possible to make disconnecting post-operation dentoalveolar prosthesis for upper jaw for all types of its resection, which provides formation of prosthetic bed in the section of performed operation, optimal fixation under unfavourable clinical conditions of prosthetic bed, recovery of chewing function and restoration of height of the lower third of face after surgery.
FIELD: medical engineering.
SUBSTANCE: method involves producing an opening of diameter reaching 2 mm with diamond or hard alloy bore in adhesive cover after preparing abutment tooth and prosthesis or widening already available perforation also to diameter of 2 mm. The prosthesis is set on the abutment tooth and place is marked for creating and directing pin-canal in the area of cutting one-third of the frontal abutment tooth or in the lateral abutment tooth equator area. The pin-canal direction is to correspond to path for introducing the prosthesis. The pin is screwed-in with screwdriver and holder to a depth of about 2 mm into dentin. The prosthesis is set on the abutment for making control. The pin is filed-off to adhesive cover layer after having fixed the prosthesis on composition cement.
EFFECT: prolonged service life; high functional value.
FIELD: medical engineering.
SUBSTANCE: method involves taking anatomical imprint from jaw under prosthetic repair, casting supergypsum model for carrying out parallelometric studies, model duplication, modeling future clasp carcass skeleton from wax, enclosing the wax model into cell filled with gypsum, evaporating wax and filling the arisen cavity with polymer. The clasp carcass model is reproduced as metal one from polymer model for all models taken in production. Polymer for manufacturing clasp carcass model is reactive composition hardening at room temperature and composed of two ingredients taken in 2:1 proportion by weight. The first ingredient portion is based on polymethyl methacrylate, and the second one is polymethyl methacrylate with dimethylaniline added in the amount of 1-2% by mass.
EFFECT: significantly accelerated carcass manufacturing process; high accuracy in reproducing sizes; improved connection of locks and telescopic crowns to polymer carcass; low production costs.
FIELD: medical engineering.
SUBSTANCE: device has vestibular and oral parts connected to each other with crosspieces manufactured from orthodontic wire placed in interdental spaces by producing jaw imprints. Working and auxiliary models are molded. To place treating bandage, general clinical equator of all teeth included into the splint is to be determined on working model using parallelometer. Then, space between the clinical equator line and gingiva and a gingiva part 7-8 mm remote from gingival papillae are covered with dental wax layer of thickness equal to or less than 1.5 mm. Next to it, duplicate model is produced for manufacturing the splint having recess equal to wax layer thickness 1.5 mm. Changing wax for transparent plastic, filing and polishing the splint is carried out by applying method of common use.
EFFECT: enhanced effectiveness of treatment.
SUBSTANCE: method involves reinforcing crown part defect with wave-shaped wires. The wires are taken in advance from gold-coated metal network, Ѕ tooth root length long wire portion is twisted and fixed in the canal. Free ends of the wires are distributed along vestibular surface of tooth cutting edge and bent towards vestibular tooth surface 1-1.5 mm below the cutting edge. Free ends of the wires are fixed in oval tooth cavity on the vestibular tooth surface side. Artificial enamel layer is produced from macrofilled composite material anatomically matching in shape the incisor crown part, fixing the wave-shaped wires in composite material. Artificial dentine is produced from microfilled composite material.
EFFECT: high strength of incisor walls; long service life under chewing loading.
SUBSTANCE: method involves carrying out odontopreparation, forming cylindrical tooth stump to gingival level, forming a projecting part on this place and fixing net carcass on the stump followed by crown part restoration using composite material. When forming stump, occlusion surface is filed off by 0.9-1.2 mm and additional retention zones like 0.2-0.3 mm deep horizontal grooves are formed on the aproximal surfaces. The carcass is produced from gold-plated metal wire net having 0.4 mm large meshes to fit the stump. Before being fixed, the net carcass is treated twice with masking agent leaving meshes open. Final crown part restoration follows with anatomical tooth shape being taken into account.
EFFECT: fully restored anatomical tooth shape; high strength of tooth walls; long service life; high esthetic quality.
SUBSTANCE: method involves applying preparative endodontic treatment, fixing reinforcing net in prepared cup-like tooth cavity formed and produced in root base zone. The cup-like tooth cavity is formed after having temporarily fixed crown part walls along the fracture line using enveloping composite ring, gingiva retraction and preparing demineralized tissues. The crown part walls are formed from composite material keeping to anatomical shape of tooth under restoration after having fixed root fracture with glass ionomer cement being used. The net is shaped in advance to make it congruent to cavity of tooth under restoration and fixed in the cavity by means of fluid composite. The formed cavity is filled with microfilled composite. Macrofilled composite is used for building tooth crown part and tubercles.
EFFECT: high strength of the structure; long service life.
FIELD: medical engineering.
SUBSTANCE: method involves carrying out electrochemical degreasing metal prosthesis carcass surface, anodic etching and cathodic etching and then coating with 0.1-0.3 mcm thick primary gold layer from acid electrolyte. Next to it, 40-50 mcm thick basic gold layer is deposited from alkaline electrolyte.
EFFECT: improved esthetic properties; lowered toxic properties of alloy.
FIELD: medical engineering.
SUBSTANCE: method involves producing plaster jaw model from imprints taken in advance and modeling half-finished wax bite cap article next to it. Silicon mould is manufactured by applying manual molding method with through sprue holes used for filling space, produced after removing half-finished wax bite cap, with plastic. The silicon mould is withdrawn after having plastic polymerized, flow gates are cut off and their attachment places are polished.
EFFECT: simplified process; normalized lower face part height.
FIELD: medical engineering.
SUBSTANCE: method involves molding plaster jaw models from obtained anatomical imprints. Then, intermediate modeling of future dental bridge structure is carried out using wax, dental row plaster model segment imprint is produced on the area restricted with bearing teeth, intact dental row plaster die is manufactured, transparent dental kappa is produced from acryl using hot forming and adjusting abutment teeth stumps imprints and marginal area of intermediate portion of temporary dental bridge structure.
EFFECT: high strength; stable tooth row occlusion.
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.