RU2134557C1 - Method of revealing anomalies of teeth rows and device for its embodiment - Google Patents

Abstract

FIELD: medicine, more specifically, stomatology. SUBSTANCE: method includes examination of jaw models, their installation in common occlusion and subsequent determination with the help of template of deviations of teeth position. Template is installed so that tangent lines applied to it coincide with tangents which have no or minimum saggital displacement. Template is inclined in accordance with inclination of patient occlusion plane using template whose width of three front teeth is similar to that of model. Teeth and groups of teeth are set on models to correct position. Accuracy of correction is controlled by template. After that, medical apparatus is manufactured by models. Device is distinguished by unit for fastening template and by its design. EFFECT: higher efficiency. 6 cl, 5 dwg

Description

 The invention relates to medicine and in more detail to orthodontics.

 In the treatment of dentition anomalies, it is first necessary to diagnose the deviations from the norm that are present in them. A known method for the diagnosis of dentition abnormalities is to study models of the jaw of a patient (see Prof. Rolf Hinz, ZT Jens Hoepner, ZT Juergen Fuss, ZT Michael Ehlert, Skripte zum Fortbildungkurs "Das Elasto-KFO-System" fuer Zahntechniker, - die Praxis, Herne, 1992 - S. 3.1-33). This method does not allow with sufficient accuracy and reliability to determine the deviation of the shape of the dentition from the norm and, accordingly, to carry out the necessary treatment.

 A device for diagnosing dentition anomalies is also known, which is an articulator containing a base and upper and lower shelves with socles (see ibid., S. 34-37, 48-50). The disadvantage of this device is the inability to establish a template that allows you to determine the degree of deviation of the position of the teeth and the shape of the dentition from the norm.

 Closest to the proposed is a method for the diagnosis of dentition anomalies and a device for its implementation according to the patent of the Russian Federation N 2098042 IPC A 61 C 7/00, adopted by us as a prototype. The diagnostic method according to the specified invention consists in installing the models in an open position and then determining, according to the template with lines of the normal position of the teeth, the deviations of the position of the teeth and the shapes of the dentition from the norm. The device for implementing the method according to this patent contains a base with a lower shelf and racks mounted on it, on which the upper shelf is pivotally mounted. The method according to patent N 2098042 allows to evaluate the pattern of anomalies in the position of the teeth and the shape of the dentition on the models of the jaws gender. However, this method provides only the diagnosis of abnormalities of each of the dentitions separately and does not allow to control the occlusal ratio. The device for implementing the method is not suitable in the dental laboratory for moving the teeth to the correct position, since access to the models without removing the template from the device is impossible. Thus, the diagnostic results cannot be directly used for the manufacture of a medical dental apparatus - a positioner.

 The objective of the invention is to increase the accuracy and reliability of the diagnosis of anomalies of the dentition, providing the ability to correct anomalies on the models directly in the device, the manufacture of corrective medical treatment devices - positioners.

 To solve these problems, in the proposed method for the treatment of dentition anomalies in the diagnosis of anomalies, a template is used to determine deviations of the position of the teeth and the shape of the dentition from the norm, so that the tangents to the surfaces applied to it are aligned with the tangents to those without or having the least sagittal the displacement of the teeth of the model, and tilt it relative to the transverse and vertical planes in accordance with the inclination of the occlusal plane of the patient, using a template on which the sum ary width of the 1st, 2nd and 3rd of teeth corresponds to the total width of the teeth in the model.

 A new technique is also that on the model the teeth and groups of teeth are rearranged to the correct position, using the template they control the accuracy of the adjustment and, according to the corrected model, a therapeutic dental apparatus is made - a positioner.

 Correction of the position of the teeth on the model of the upper jaw can be performed both according to the template, and according to the adjusted model of the lower jaw of the patient.

 Due to the fact that the lines drawn on the template combine with the tangents to the teeth correctly located in the sagittal direction and tilt it, combining it with the occlusal plane, the tooth deviations are clearly visible to the doctor performing the diagnosis and give a specific task for the teeth to be rearranged on the model of dental equipment.

 The device for implementing the method, in contrast to the known one, is equipped with a template fastening unit mounted on the front arc, for installation of which mounting studs are provided on the racks of the latter; the fastening unit is a three-link hinge-rod mechanism, the first vertically located rod of which is rigidly fixed on the crosspiece of the front arc, the second rod is connected to the third clamping fork for the template at the end, by means of two hinges with mutually perpendicular axes, all hinges are made in the form of clamping bushings installed with the possibility of sliding along the rods, while on the first vertical rod is installed a ring-retainer position of the block. On the cross member of the front arc, in the direction opposite to the vertical rod of the template holder block, a rod stop is installed.

 The proposed device, in comparison with the known one, is more convenient in operation, provides free access to models, the ability to control the correctness of the movements made on the model.

 In FIG. 1 shows the proposed device, a General view in axonometric projection with a removed facial arc; in FIG. 2 is a view of the device in axonometric projection with the upper shelf removed; in FIG. 3 is a side view of the device with the upper shelf removed and the front arc retracted; in FIG. 4 - template mounting unit, in FIG. 5 - rod stop.

 The device comprises a base 1 with a lower shelf 2, uprights 3 and an upper shelf 5 fixed on the axes 4. On the shelves are provided basements 6 and 7, respectively, for mounting models. On the racks 3 there are landing pins 8 for the front arc 9. On the cross member 10 of the front arc there is a mounting block for the template 11. The block contains rods 12, 13 and 14 connected by split sleeves 15, 16, 17, equipped with tightening screws 18, 19 and 20. A clamp 21 of the template 11 is installed at the end of the rod 14. A ring 22 is mounted on the rod 12 — a travel stop along the rod 12 of the sleeve 15 with the rod 13, equipped with a fixing screw 23. A rod stop 24 is installed on the crosspiece 10 of the front arc to limit rotation facial d s 9 at its tip-over.

 The proposed method is carried out using the proposed device in the following sequence: models 25 and 26 using the front arc 9 are transferred to the device and gypsum on the socles 6 and 7. Then, the bite fork with fasteners is removed from the front arc 9 and the template mounting unit is mounted on it and rod stop 24.

 After that, the upper shelf 5 is removed from the axes 4. A template is selected from the set of templates, corresponding to the sum of the width of the 3 front teeth, the sum of the width of these teeth of the model and fixed in the clamp 21. Using the sleeves 15, 16 and 17, set the pattern 11 so so that the teeth located correctly along the sagittal are aligned with the corresponding teeth of the lower jaw model and tilt it to align with the occlusal surface. The doctor or dental technician assess the severity of the anomaly according to the established pattern. Then the technician proceeds to rearrange the teeth. To provide access to the models take the front arc back to the position in which the rod stop 24 rests on the table. If necessary, control over the correctness of each performed rearrangement of the front arc is turned in the opposite direction and the template is returned to its original position.

 To rearrange the teeth on the model of the upper jaw, the upper flange 5 with the upper jaw model is fixed in the device in the horizontal tilted position, where it is held by the support pin 27. The front arch 9 is removed, turned over and re-installed on the studs 8. The template attachment unit is installed on the upper surface of the front arcs 9, and the rod stop 24 - from the bottom. A template selected in the same way as described for the lower jaw is installed in the clamp 21 and fixed using the fastener block in the same way as described for the model of the lower jaw. The height of the sleeve 15 is fixed using the locking ring 22. In order to free the working field, clamp 18 weaken the fastening of the sleeve 15 and the template is taken to the side. At the same time, its vertical position is held by the locking ring 22. If necessary, control the template returns to its original position. At the initial setting of the template, it is necessary to set the rod 14 strictly along the midline of the articulator.

 Rearrangement of teeth on the model of the upper jaw according to the adjusted lower model is carried out, achieving harmonious, correct occlusal contacts.

 According to the adjusted models, medical dental devices are manufactured - positioners.

CLINICAL EXAMPLE
Patient Morozov A., 9 years old, medical history N 651.

 Received treatment at the clinic of the Department of Orthodontics and Pediatric Prosthetics MMSI January 12, 1998

 After a clinical examination, the diagnosis was made: deep incisal disocclusion, 6 mm sagittal fissure, protrusion of the maxillary and mandibular incisors, diastema, three in the frontal areas of the upper and lower jaws, shortening of the frenum of the tongue, infantile type of swallowing.

= 31,2
Ширина зубных рядов:
в области

= 35,8 норма 36,5
в области

= 46,5 норма 47,5
в области

= 36,0 норма 36,5
в области

= 47,0 норма 47,5
Длина переднего отрезка зубных рядов:
на в/ч = 21,5 норма 18
на н/ч = 19,0 норма 16
Ширина апикальных базисов:
в/ч = 42,0 норма 41,3
н/ч = 36,0 норма 35,2
Длина апикальных базисов:
в/ч = 37,5 норма 36,6
н/ч = 37,0 норма 37,0
Сумма

= 22,6
После проведения рентгенологического обследования и компьютерной расшифровки ТРГ головы в боковой проекции получены следующие результаты:
смещение верхних моляров в сагиттальной плоскости отсутствует (Uppet 6 to PtV - 12,8);
протрузия

- 54 (норма 70,0):
протрузия

- 106,0 (норма 95,0):
уменьшение межрезцового угла 1/1 - 119,0^o (норма 135):
зубо-альвеолярное укорочение в области

- Upper 1 to NL - 24,2 (норма 27,5):
зубо-альвеолярное удлинение в области

- Lower 1 to ML - 43,1 (норма 40,8).As a result of anthropometric study of the models, the following data were obtained:
Sum of sizes

= 31.2
The width of the dentition:
in the area of

= 35.8 norm 36.5
in the area of

= 46.5 norm 47.5
in the area of

= 36.0 norm 36.5
in the area of

= 47.0 norm 47.5
The length of the anterior segment of the dentition:
on / h = 21.5 norm 18
at n / h = 19.0 norm 16
Width of apical bases:
w / h = 42.0 normal 41.3
n / h = 36.0 normal 35.2
The length of the apical bases:
w / h = 37.5 normal 36.6
n / h = 37.0 normal 37.0
Amount

= 22.6
After an X-ray examination and computer interpretation of the TRH of the head in lateral projection, the following results were obtained:
there is no displacement of the upper molars in the sagittal plane (Uppet 6 to PtV - 12.8);
protrusion

- 54 (norm 70.0):
protrusion

- 106.0 (norm 95.0):
a decrease in the incisal angle 1/1 - 119.0 ^o (norm 135):
alveolar shortening in the region

- Upper 1 to NL - 24.2 (norm 27.5):
dentoalveolar elongation in the area

- Lower 1 to ML - 43.1 (40.8 norm).

(22,6), был выбран соответствующий прозрачный шаблон. Поскольку сагиттальное смещение

отсутствует, их положение на модели может быть взято в качестве ориентира для фиксации шаблона в устройстве. Шаблон устанавливается таким образом, чтобы нанесенная на нем касательная к первым молярам была сопоставлена с касательной к первым молярам гипсовой модели и фиксируется зажимом для шаблона. Плоскость шаблона по возможности сопоставляется с окклюзионной поверхностью. Наложение шаблона на модель позволяет наглядно продемонстрировать отклонения формы зубного ряда пациента от идеальной формы зубного ряда и просчитать степень выраженности аномалии.Then the working pair of models was transferred to the device according to the method described above using the front transfer arc of the company FAG (France). Based on the amount

(22.6), the corresponding transparent template was selected. Since sagittal displacement

missing, their position on the model can be taken as a guide for fixing the template in the device. The template is set so that the tangent applied to the first molars on it is compared with the tangent to the first molars of the gypsum model and is fixed with a clamp for the template. If possible, the plane of the template is mapped to the occlusal surface. The application of the template to the model allows you to clearly demonstrate the deviation of the shape of the patient’s dentition from the ideal form of the dentition and calculate the severity of the anomaly.

After the diagnostic measurements in the device, the following data were obtained from the examined patient:
- the shape of the dentition is U-shaped due to elongation in the frontal sections:
- the length of the anterior segment of the upper dentition is increased by 3.5 mm;
- the lengths of the anterior segment of the lower dentition is increased by 3 mm;
- displacement of fangs in the sagittal plane is not detected:
- oral inclination of the lateral teeth in / h and n / h (displacement of the buccal tubercles in the oral side by 0.8 mm);
- tooth-alveolar shortening in the front of the upper dentition by 3 mm;
- tooth-alveolar lengthening in the frontal part of the lower dentition by 2.5 mm.

 As a result of our studies, we were diagnosed with lengthening of the dentition, deep incisor deocclusion, protrusion of the incisors of the upper and lower jaws, alveolar shortening in the region of the upper anterior teeth and alveolar lengthening in the region of the lower anterior teeth.

 Thus, our proposed method and device for its implementation allows you to simultaneously study and evaluate the position of individual teeth and groups of teeth relative to the ideal shape of the dentition, the shape of the dentition in three planes and makes it possible in some cases to refuse to conduct anthropometric study of models.

Claims (6)

 1. A method for identifying dentition anomalies by examining jaw models, installing them in an occlusion and then determining according to the pattern with the tangents to the surface of the teeth applied to it corresponding to their normal position, deviations of the position of the teeth and shape of the dentition from the norm, characterized in that the pattern set so that the tangents applied to it are aligned with the tangents to the teeth of the model that have no or have the smallest sagittal displacement and tilt it relatively transversally and vertically stitches in accordance with the inclination of the occlusal plane of the patient, using a template on which the total width of the 1st, 2nd and 3rd teeth corresponds to the total width of these teeth on the model.  2. The method according to claim 1, characterized in that on the model the teeth and groups of teeth are rearranged to the correct position, using the template control the accuracy of the adjustment.  3. The method according to PP. 1 and 2, characterized in that the adjustment of the position of the teeth on the model of the upper jaw is carried out according to the template.  4. The method according to PP. 1 and 2, characterized in that the adjustment of the position of the teeth on the model of the upper jaw is carried out according to the adjusted model of the lower jaw.  5. A device for implementing the method according to PP. 1 and 2, containing a base with a lower shelf fixed on it and uprights, on which the upper shelf is pivotally mounted, with a template and a front arc, characterized in that it is equipped with a template mounting unit mounted on a front arc mounted on landing studs in the racks, block the fastenings are made in the form of a three-link hinge-rod mechanism, the first vertically located rod of which is rigidly fixed to the crosspiece of the front arc, the second rod is connected to the third bearing clamping fork for the template at the end, osredstvom two hinges with mutually perpendicular axes, all joints of the mechanism are designed as clamping bushes mounted for sliding along the rods, wherein the first vertical rod installed lock ring block position.  6. The device according to claim 5, characterized in that it is equipped with a limit bar of rotation of the front arc made with the possibility of installation on the arc in the direction opposite to the vertical rod of the template holder block.

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