RU2384308C2 - Myodynamic soft complete denture, method for making myodynamic soft complete denture - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: complete denture comprises artificial teeth, a plastic solid basis and a perforated solid basis joined together by links and constraints into a uniform integral product. Additionally, the denture has a soft layer of soft acrylic resin or silicone materials. The perforated solid basis is arranged inside of the plastic solid basis and the soft layer of acrylic resin or silicone materials and moulded of metal, with a cross-section thickness 0.2 mm to 0.5 mm and apertures of diametre to 5-6 mm equispaced on the whole plane. The group of inventions includes method for making the complete denture.

EFFECT: improved consumer properties of the denture due to higher durability and accuracy of making.

4 cl, 50 dwg

Description

The invention relates to the field of dentistry, orthopedics, removable complete dentures.

Known analogues

Full removable dentures made entirely of plastic are known, they consist of plastic teeth and a plastic (red-pink) basis.

Full removable dentures are also known, into which an additional reinforced mesh 0.1-0.15 mm thick is added to strengthen the prosthesis.

The main disadvantages of complete removable dentures are quite frequent fractures during eating due to the natural “aging” of materials, accidental fall of the prosthesis during hygiene procedures, etc., as well as the inability to repair the prosthesis in the usual way, the need to take additional casts, the impossibility of introducing a reinforced mesh to the prosthesis again.

Dentures have a significant wall thickness of 2 mm and significant weight. In conventional prostheses made of plastic, the use of a soft base is sharply limited, since it weakens the structure.

A common drawback of complete removable dentures is that the prosthesis does not take into account the compliance of the mucous membrane of the prosthetic field of the upper or lower jaw (the prosthetic field is the total (total) area of the prosthesis support), which is different in different zones of the prosthetic field. The prosthetic field of the prosthesis itself also does not have pliability, cushioning properties, and if it does, if a soft lining is used, it does not correspond to the real mucosity of the mucosa due to the static casting of impressions (in one position) and the pressure set by the doctor himself (with fingers ) As a result, an imbalance and overturning of the prosthesis in the patient's mouth are possible when eating, biting a thread, communicating, etc. When taking casts in the patient’s oral cavity, a technique is used when casts are taken separately from the upper jaw, then from the lower jaw, or vice versa. The patient’s ability to form a prosthetic field with his own muscle myodynamics, the vestibular and oral surfaces of the prosthesis are limited, the patient cannot fully close his mouth, perform movements with his lower jaw, tongue, lips, etc., the patient is limited by the design of the impression spoon and fingers of the doctor.

Also, with this technique of taking impressions, the complete removable prosthesis made does not fully take into account the peculiarities of the patient’s muscle dynamics and all the features of the transitional fold during the movement of the lower jaw and the patient’s chewing muscles, and after the prosthesis is manufactured in laboratory conditions, namely, finishing, grinding, polishing, differences between the prosthetic field of the prosthesis itself and the real prosthetic field in the patient's oral cavity become significant. In the case of the presence of pronounced contraforts, sharp and overhanging bone protrusions, the use of the prosthesis becomes difficult, sometimes impossible. Well-known analogues: full removable prostheses made entirely of plastic, have a limited, rather short service life, the use of a soft base in them is limited, the strength of the prosthesis increases due to the thickness of the structure, which means that the weight of the prosthesis increases, and the space of the oral cavity decreases.

Bibliographic data of published sources of information

- Textbook “Dental prosthetics”, comp. Kopeikin V.N. and Demner L.M. The sixth section "Removable prostheses and the technology of their manufacture." Chapter XIV. Removable laminar dentures to replace dentition defects. Publishing house "TRIADA-X", M., 2003 (The textbook is intended for students of the dental departments of medical schools. LR License No. 066029 of July 28, 1998. The closest analogue (prototype). Full removable laminar prosthesis).

Myodynamic soft full denture

A method of manufacturing a myodynamic (soft) full denture due to the use of a perforated solid base (made of metal or other materials) in the structure, having a cross section thickness of 0.2 to 0.5 mm and uniformly applied holes (perforation) over the entire plane diameter up to 5-6 mm, eliminates the possibility of fracture of removable dentures, which significantly lengthens its service life

Myodynamic soft full removable denture due to the use of a perforated solid base in the design is made thinner than conventional prostheses (up to 1.5 mm in total thickness), which means it is lighter. The space of the oral cavity increases, diction is restored faster, adaptation is easier.

Due to the use of a perforated solid base in the construction, any kinds of soft materials (acrylic, silicone, etc.) are firmly held (mechanically) and their configuration is maintained in the fourth layer (final) - a soft layer, preventing deformation. Due to the use of a perforated solid base in the design, which, repeating the individual characteristics of the alveolar processes, the transitional folds of the oral cavity of the upper or lower jaw of a person, is an individual impression spoon and provides myodynamic modeling of the fourth soft (final) layer, i.e. the fourth layer (final), the soft layer is modeled directly in the patient’s oral cavity as follows: the impression mass is applied to the inner and outer surfaces of the perforated solid base of the upper and lower prostheses (if there is only one prosthesis, then one prosthesis), the prostheses are inserted into the patient’s oral cavity, where he makes all the necessary movements with his lower jaw, lips, tongue, buccal muscles, etc. The fourth layer formed by the myodynamics of the patient’s muscles is transferred to the soft mass in the laboratory, and if a self-hardening soft mass is used, the prosthesis is finally formed in the patient’s mouth.

The myodynamic soft full removable prosthesis completely repeats all the features of the prosthetic field in the patient’s oral cavity, and the vestibular and oral sides of the prosthesis repeat all the features of the patient’s myodynamics.

As a result of introducing a perforated solid base into the design of the myodynamic soft removable prosthesis and applying the functional modeling of the fourth (final) soft layer, the manufacturing accuracy of the prosthesis sharply increases, its functionality, adhesive ability, the mobility and tipping of the prosthesis are minimized, and the strength of the prosthesis is increased due to the shock absorption properties , the configuration of the prosthesis maximally corresponds to the functional activity of the muscles of the oral cavity, since The Fourth (final) soft layer is formed directly in the patient's mouth.

The technique allows you to start prosthetics at an earlier stage after surgery (removal).

The replacement of the fourth (final) layer, due to the perforated solid basis, can be carried out repeatedly, without constructive changes to the rest of the prosthesis. The prosthesis is not susceptible to fractures.

Myodynamic soft full removable denture consists of several layers interconnected, combined into a single integral product. It has four layers interconnected by chemical and mechanical bonds.

The first layer is artificial teeth (plastic, ceramic, etc.).

The second layer is a solid base (solid acrylic or other plastic, mass, such as nylon, etc.).

The third layer is a perforated solid base (made of metal or other materials) having a cross section thickness from 0.2 to 0.5 mm and uniformly applied holes (perforations) with a diameter of up to 5-6 mm across the entire plane, which, repeating individual features of the alveolar processes, the transitional folds of the oral cavity of the upper or lower jaws of a person, is an individual impression spoon and provides myodynamic modeling of the fourth soft (final) layer, and also provides strong mechanical retention the adhesion to the fourth layer (final) is a soft layer and withstands the configuration of the soft layer, preventing deformation.

The fourth layer (final) is a soft layer (consists of soft acrylic plastic, or silicone materials, or other soft materials).

Brief description of the attached drawings and photos

(sheets 1-5)

To clarify the described myodynamic soft complete denture in the attached list:

Sheet 1. Cross-sectional diagrams

Where:

Figure 1. Scheme of a transverse section of the prosthesis on the upper jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

3 - Perforated solid base.

4 - Soft layer (final).

5 - Plaster model.

Figure 2. Scheme of a transverse section of the prosthesis on the lower jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

3 - Perforated solid base.

4 - Soft layer (final).

5 - Plaster model.

Sheet 2.

Where:

Photo. 3. The prosthesis on the upper jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

4 - Soft layer (final).

5 - Gypsum model

Photo. 4. The prosthesis on the upper jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

3 - Perforated solid base.

4 - Soft layer (final).

5 - Plaster model.

Sheet 3.

Where:

Photo. 5. Dentures on the upper and lower jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

3 - Perforated solid base.

Photo. 6. Dentures on the upper and lower jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

3 - Perforated solid base.

5 - Plaster model.

Sheet 4.

Where:

Photo 7

3 - Perforated solid base on the upper and lower jaw on the inside.

Photo 8

Where:

3 - Perforated solid base on the upper and lower jaw from the outside.

Sheet 5.

Where:

Photo 9. Dentures on the upper jaw, where:

2 - Solid basis (solid acrylic or other plastic, mass).

3 - Perforated solid base

6 - Impression mass.

Photo 10. Dentures on the upper and lower jaw, where:

1 - Artificial teeth.

2 - Solid basis (solid acrylic or other plastic, mass).

6 - Impression mass.

A method of manufacturing a myodynamic soft complete denture

The proposed object is made in the following way:

primary casts;

making an individual impression spoon;

making bite patterns;

definition of central occlusion.

All primary stages are carried out in the usual manner.

A method of manufacturing a myodynamic soft complete removable denture is considered from the receipt of models of the upper and lower jaws and bite patterns in the dental laboratory, after determining the central occlusion by the doctor (Photo 11). Models are fixed (plastered) in the occluder (Photos 12, 13) or articulator, the size, color and shape of artificial teeth are selected, the boundaries of future prostheses are marked on the models and the center line is drawn along the alveolar processes in the usual manner.

When determining the central occlusion, the doctor forms the upper bite pattern, taking into account all the features of this patient, namely marks the center line, fang lines, smile height line on the pattern, forms the lower plane of the upper pattern (adjacent to the lower pattern) so that the lower edge of the pattern matches the level of the cutting edge of the central incisors and fangs was parallel to the eye line, and the vestibular plane of the template inserted into the patient’s mouth gave the face a normal look, without any discomfort (for example, closing lips without visible tension), etc. Next, the templates are removed from the models (Photo 14). The upper template is placed back on the upper model, on the lower model in the center (in the area of the tongue) a soft wax roller (3-6 cm in diameter) is placed, a thin (0.5-1 mm) plate (can be made of plexiglass), an occluder ( articulator) is closed, the plate is glued with sticky wax to a roller that is mounted on the lower model (the occluder is closed, and the wax roller has hardened (cooled down)). Then on the plate mark, guided by the upper template, the center line (on which the necessary marks are made by the doctor), the line of the fangs, the vestibular line (arc) along the outer lower edge of the template. The upper template is removed (Photo 14-18). Marks are made around the roller on which the plate is fixed, so that later it can be installed in its place. The staging plate prepared in this way is removed from the lower model together with a wax roller glued to it.

Then, a plate of clasp wax (thickness 0.5 mm), preheated in warm water to an elastic state, is applied to the upper and then to the lower models and carefully squeezed with a soft swab over the entire surface of the prosthetic field of the model. Then the operation is repeated and a second one is placed on top of the first plate, also on the upper and lower model (Photo 19-23).

Then they simulate a perforated solid basis: they take a perforated plate of clasp wax (thickness 0.5 mm), since the industry does not produce perforated clasp wax, we ourselves evenly apply holes with a diameter of up to 5-6 on the entire plane of clasp wax (thickness 0.5 mm) mm (Photo 24, 25). Then, on the upper, then on the lower model, we apply a plate of perforated clasp wax (thickness 0.5 mm), preheated in warm water to an elastic state, and carefully compress it with a soft swab over the entire surface (on top of the two previous layers).

After the wax has hardened, the upper layer, consisting of a perforated plate of clasp wax, is cut off according to the previously marked borders of the prosthesis on the model of the lower jaw and model of the upper jaw, and from the oral (palatal) side on the model of the upper jaw, it is cut back 1-1.5 cm from the central line of the alveolar ridge (if the doctor indicates additional areas that must be covered with a soft layer, then they are also captured, also departing from their edge 1-1.5 cm).

Then, the simulated perforated solid base is pinned (the sprues are glued), removed from the model (from the lower and upper) and both are transferred to the foundry laboratory (Photo 26, 27).

Then, having received a perforated solid base cast from metal (upper and lower), it is finished, the sprues are cut off, polished (coated if necessary with titanium nitrite, gold, etc.) and the correct fit on the model is checked (Photo 28, 29).

Next, gently remove the perforated solid base and the double layer of clasp wax from the lower model (put them aside) (Photo 30).

Then we set the staging plate together with the wax roller glued to it in its former place on the lower model according to the marks made earlier.

Next, on the upper model, pour perforated solid basis with molten wax onto a (double) layer of clasp wax, then on a perforated solid basis, in the center of the alveolar ridge along the entire arc, glue wax with a setting roller made of base wax and having a width of about 1 cm and a height of 1 5 cm

Then we start setting the upper central incisors so that the cutting edge touches and is installed according to the marked arc on the setting plate, the center line on the setting plate coincides with the line (mentally) drawn between the central incisors.

Side incisors are also set along the marked arc on the setting plate, but 0.5 mm higher than the setting plate. The cutting tubercles also touch the set plate, with the cutting tubercle coinciding with the marked line of fangs on the setting plate and the marked arc, and the fangs (teeth) themselves form the turning points of the dental arch (Photo 31). Next, the remaining teeth are set in the usual manner.

Then we remove the staging plate with the wax roller glued to it from the lower model. We put back the plate with a double layer of clasp wax, put on top a perforated solid basis for the lower model, pour it with molten wax to the (double) layer of clasp wax, then on the perforated solid basis, in the center of the alveolar process throughout the arc, glue the staged wax a roller made of basic wax about 1 cm wide and 1.5 cm high. Next, we set the lower teeth in the usual manner according to the upper teeth (antagonists) and the particular bite of the patient a (Photo 32).

Next, we apply a clasp wax plate (thickness 0.5 mm) on the palatal surface of the composition of the upper prosthesis, preheated in warm water to an elastic state, and carefully squeeze a soft swab over the entire surface (hard palate) of the prosthesis to artificial teeth, cut off the excess, the palatine part the prosthesis is carefully aligned, modeled and smoothed (in the usual manner).

Then, retreating from the necks of the artificial teeth by 5-7 mm, cut off and remove all excess wax from the perforated solid base from the vestibular side to the composition of the upper jaw prosthesis (upper model).

Further, having retreated from the necks of artificial teeth by 5-7 mm, we cut off and remove all excess wax from the perforated solid base from the vestibular and oral sides on the composition of the lower jaw prosthesis (lower model).

At the border (along the edge) of the perforated solid base from the vestibular and oral sides of the composition of the lower prosthesis (on the lower model), we cut off and remove a double layer of clasp wax.

Along the border (along the edge) of the perforated solid base from the vestibular side of the composition of the upper prosthesis (on the upper model), we cut along the line “A” and remove a double layer of clasp wax.

Then we remove the prostheses from the upper and lower models, turn them over so that the artificial teeth are below.

Next, on the inner (adjacent to the mucous) surface of the composition of the upper prosthesis in the center of the alveolar ridge (unless otherwise noted by the doctor), make an incision with a hot spatula, separate and remove the double layer of clasp wax from the outside of the center (inner) side of the perforated solid base (solid palate touch).

Then on the inner (adjacent to the mucosa) surface of the lower prosthesis composition, departing from the center of the alveolar ridge from 2 to 5 mm to the right and left, make incisions with a hot spatula, separate and remove the double layer of clasp wax from the outer and inner sides of the perforated solid base (from the center) leaving a strip of double clasp wax with a width of 4 to 10 mm in the center (Photo 33, 34).

We put prostheses on the model, pour them with wax on the model (fix), the upper prosthesis along the “A” line and at two (arbitrary) points over the edge of the perforated solid basis in the area of the canines, the lower prosthesis at 5-6 points (arbitrary) around the perimeter over the edge of a perforated solid base.

We disconnect the models from the occluder (articulator) and plaster the models with the wax composition of the prostheses in the cuvettes in the opposite way, immersing the models in gypsum flush with the wax border of the solid basis (Photo 35), around the entire perimeter of the models, i.e. the lower part (wax-free) of the perforated solid base will be covered with gypsum (gypsum).

Further, all operations are carried out in the usual manner. The cuvette is assembled, the gypsum in the first part is isolated, the second part of the cuvette is molded (molded), the wax is removed, the gypsum inside the cuvette is treated with an insulating varnish, plastic molding and polymerization are carried out.

Further, all operations are carried out in the usual manner, after the polymerization is complete, the cuvettes must slowly cool to room temperature, they are opened, prostheses are removed, the prostheses are finished, sanded and polished, and the edges of the perforated solid basis must be clean, without gypsum residues, etc., the edge of the solid base (red acrylic plastic) bordering the perforated solid base is ground at an angle of 45% to the perforated solid base (Photo 36, 37, 38).

The prostheses are then transferred to the orthopedic dentist's office.

There are two ways to apply the fourth layer (final) - a soft layer (consists of soft acrylic plastic, or silicone materials, or other soft materials).

Method one

The doctor independently forms a fourth layer (final) in the patient’s oral cavity - the soft layer.

For example, VOCO self-curing material is taken - (Ufi Gel P) Ufi gel P based on A-silicones, according to the attached instructions, this material is used, i.e. the material is kneaded and applied to the inner and outer parts of the perforated solid base of the upper and lower prostheses in sufficient quantities, with a thin layer of 1-1.5 mm, both prostheses are inserted into the patient's oral cavity. The patient closes his mouth in the position of central occlusion, fixes this position for 1 minute, then within 5 minutes the patient reproduces chewing and swallowing movements. The prosthesis is treated by a doctor according to the instructions.

Second way

The doctor takes, for example, a silicone impression mass of condensation type STOMAFLEX CRÈME from SpofaDental, according to the attached instructions, this material is used, i.e. the material is kneaded and applied to the inner and outer parts of the perforated solid base of the upper and lower prostheses in sufficient quantities, with a thin layer of 1-1.5 mm, both prostheses are inserted into the patient's oral cavity. The patient closes his mouth in the position of central occlusion, fixes this position for 1-1.5 minutes, then within 5-6 minutes the patient reproduces chewing and swallowing movements. Then the prostheses are removed and transferred to the technical laboratory (Photo 39-42).

Further, the dental technician carefully cuts off excess mass that has fallen on a solid basis, and a thin strip of contrasting wax is poured along the border of the solid basis and the impression mass and is cleaned (it is leveled with the common surface) (Photo 43-46).

Then the prosthesis (upper and lower) is gypsum at the base of the cuvette (each in its own) with artificial teeth down to the border of the contrasting wax, and the entire palatal part of the prosthesis is closed (gypsum) with the gypsum to the line “A”.

Gypsum freezes, becomes insulated or soaked in water.

Then the cell is collected and cast (filled) with gypsum the second part of the cell.

Then the cuvette opens, the impression mass is removed, the gypsum is covered with an insulating layer, a soft mass is prepared (silicone or acrylic, etc.). It is then molded in a cuvette under pressure and polymerized according to the instructions for the particular material used. Further, according to the instructions for the particular material used, it is processed and the finished dentures are transferred to the doctor’s office.

Claims (4)

1. A complete removable denture, including artificial teeth, a solid basis made of plastic and a perforated solid basis, interconnected by chemical and mechanical bonds in a single integral product, characterized in that it is additionally equipped with a soft layer of soft acrylic plastic or silicone materials, and perforated the solid basis is located inside the solid basis of plastic and the soft layer of acrylic plastic or silicone materials and is made of metal by casting, having in cross section Inu from 0.2 to 0.5 mm and over the whole plane uniformly deposited hole diameter of 5-6 mm. 2. The complete removable prosthesis according to claim 1, characterized in that the soft layer of soft acrylic plastic or silicone materials repeats the individual characteristics of the alveolar processes, transitional folds of the oral cavity of the upper or lower jaw of a person. 3. The complete removable prosthesis according to claim 1, characterized in that the soft layer is modeled directly in the patient’s oral cavity by functional modeling using an impression mass or self-hardening soft silicone mass. 4. A method of manufacturing a complete removable denture, including the manufacture of a solid base made of plastic and tooth positioning, characterized in that it includes a cast perforated solid base made of metal and the final soft layer, which is modeled directly in the patient’s oral cavity using functional modeling using an impression mass or a self-hardening soft mass of silicone, and a perforated solid basis is located inside the solid basis of plastic and the soft layer of acrylic plastic or silicone materials and made by casting, having a cross section thickness of 0.2 to 0.5 mm and uniformly applied holes with a diameter of up to 5-6 mm over the entire plane.

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