RU2611734C1 - Method for functional impression production after upper jaw resection - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dentistry, and is intended for use in manufacturing of an obturator-prosthesis for patients with partial resection of the upper jaw and complete absence of teeth. An impression of the patient's mouth is obtained using alginate mass, which is used to make a plaster model on which the upper jaw defect is laid using plastic for manufacture of individual light-curing spoons, stopping at 3 mm before defect borders, polymerized to give a hemisphere, which is adapted and fitted inside the defect cicatrical ring controlled by vision. Then plates made from the same material with thickness of 4 mm are arranged on the inner surface of the hemisphere, from the center to the periphery, the plates are photo-polymerized. Simultaneously to the hemisphere production, an individual spoon is made in the working model according to the standard technology is made to cover the defect. The resulting spoon is adapted in the mouth cavity, using the known functional tests. Areas providing the greatest pressure on the mucous membrane of prosthetic bed are ground. After clinical functional tests, the hemisphere is connected to the spoon basis on the model obtaining the individual spoon with monolithically connected basis and occlusive part. A hole with a diameter corresponding to the diameter of the cannula is made in the center of the spoon basis bottom surface, in the projection of the occlusive part. A thin layer corrective of silicone impression material is applied on the obtained individual spoon and the prosthetic bed tissues are pressed without an effort. Then the same mass is introduced through the opening in the bottom plate of the spoon occlusive part under pressure. The mass hits the top plate and flows through the gaps between plates to the periphery to display the defect annulus fibrosis borders.

EFFECT: invention provides a high-precision functional impression, showing the inner surface of the cicatrical ring and the upper jaw defect.

Description

The invention relates to medicine, in particular to dentistry, and can be used to manufacture an obturator prosthesis for patients with partial resection of the upper jaw and complete absence of teeth.

A known technique for obtaining a functional impression from the upper jaw after resection, when the impression is obtained with a standard spoon, which is pre-corrected using a thermoplastic mass. For this, a thermoplastic mass is placed on a standard spoon, on top of it are two gauze napkins moistened in an isotonic sodium chloride solution. A spoon is introduced into the mouth and pressed all the way to the jaw. Using active and passive movements, they form the edge of the impression along the boundary of the transition fold and in the region of the defect. The spoon is removed until the final solidification of the mass. After removing the impression, excess mass is removed and the outer gauze napkin is removed. An elastic silicone impression mass is applied to the surface of the pre-impression coated with an inner layer of gauze. A spoon is introduced into the mouth and pressed to the jaw. After the elastic mass has hardened, the print is removed. A model is cast on such a double print. On the model, plaster or lead foil cover the places to be isolated, as well as the remaining teeth. If the model has a complex relief of the defect, then using the parallelometer fill in the place of undercuts. An individual spoon is prepared according to the usual method. It is tested in the oral cavity. Occlusal thermomass rollers are glued onto a spoon. The central ratio of the jaws is determined. The functional impression is removed under pressure from the occlusal rollers. After receiving the functional impression, the model of the upper jaw is cast. The fixing part of the prosthesis is made, which can be in the form of a molded or plastic base with clasps (A. S. Shcherbakov, E. I. Gavrilov, V. N. Trezubov, E. N. Zhulev. “Orthopedic dentistry.” P. 526) .

The disadvantages of this technique include the impossibility of its use in patients with complete absence of teeth, as well as the ambiguity of obtaining a negative display of the inner surface of the scar ring.

There is a method of obtaining a functional impression after resection of the upper jaw, which is carried out as follows: an anatomical impression is obtained with an alginate mass using a standard spoon, using which a gypsum model is made and an obturator is modeled on it by lining a positive imaging of a sky defect with wax and simulating a resected alveolar ridge, the resulting composition set in the oral cavity and fit by filling up the possible gaps with wax, get an impression on which an individual spoon is prepared according to standard technology, the resulting spoon is adapted in the oral cavity using known functional tests, then retention metal staples are placed in the wax obturator fixed in the jaw defect and a corrective layer of silicone impression mass is applied to the resulting composition, after which an impression is made of a previously made individual spoon with the base layer of the impression mass introduced into it (RF Patent No. 2423955 of 07.20.2011).

The disadvantages of this method include the possibility of getting a liquid corrective layer of silicone impression mass in the upper respiratory tract when receiving a functional impression, as well as the ambiguity of obtaining a negative display of the inner surface of the scar ring.

This invention is selected as a prototype.

The problem to which the invention is directed is to obtain a highly accurate functional impression of the scar ring of a defect in the upper jaw with partial resection and complete absence of teeth for the manufacture of an obturator prosthesis.

The technical result of the invention is the manufacture during the process of the device, preventing the penetration of the impression mass into the respiratory tract, and obtaining with its help a high-precision functional impression showing the inner surface of the scar ring, a defect in the upper jaw with partial resection and complete absence of teeth for the manufacture of an obturator prosthesis .

The technical result is achieved due to the fact that the method of obtaining a functional impression after resection of the upper jaw is as follows: an impression is obtained by the alginate mass of the patient’s oral cavity, according to which a gypsum model is made, on which the defect of the upper jaw is lined with plastic for making individual spoons of light polymerization, without reaching 3 mm to the boundaries of the defect, polymerized, a hemisphere is obtained, which is adapted and fitted inside the scar ring of the defect under the control of vision, after why on the inner surface of the hemisphere, from the center, they are placed concentrically to the periphery of a plate of the same material with a thickness of 4 mm and photopolymerize, parallel to the manufacture of the hemisphere, on the working model an individual spoon is made according to standard technology, blocking the defect, the resulting spoon is adapted in the oral cavity using known functional tests, polish the areas that exert the greatest pressure on the mucosa of the prosthetic bed, after conducting clinical functional tests, connect to the floor model sphere with the base of the spoon, this way we get an individual spoon with the base and the obturating part monolithically connected, in the center of the bottom surface of the base of the spoon, in the projection of the obturating part, a hole is made with a cutter with a diameter corresponding to the diameter of the dispenser cannula, a corrective layer of silicone impression is applied on the individual spoon with a thin layer masses and without effort squeeze the tissues of the prosthetic bed, after which the same mass is injected through pressure through the hole in the lower plate of the obstructing part of the spoon, mass hits the upper plate and spreads through the gaps between the plates to the periphery to display the boundaries of the fibrous ring of the defect.

One of the main problems that impedes a functional impression is the communication of the oral cavity and nasal cavity. With the uncontrolled introduction of silicone impression material, which is necessary for a high-quality display of the border of the orophasal message, mass can enter the respiratory tract and, as a result, asphyxiation. The proposed device solves the identified problem. We apply a corrective layer of silicone impression mass on a received individual spoon with a thin layer and squeeze the tissue of the prosthetic bed without effort. Then, through the hole in the lower plate of the obturating part of the spoon, we inject the same mass under pressure, the mass strikes the upper plate and spreads through the gaps between the plates to the periphery to display the boundaries of the fibrous ring of the defect.

A method of obtaining a functional impression after resection of the upper jaw is as follows:

1. An impression is obtained of the alginate mass of the oral cavity of the patient.

2. Cast the gypsum model.

3. On a plaster model, with a plasmass for the manufacture of individual spoons of light polymerization, a defect of the upper jaw is lined up, not reaching 3 mm to the boundaries of the defect, polymerized, a hemisphere is obtained.

4. The resulting hemisphere is adjusted and fitted in the oral cavity, inside the scar ring of the defect under visual control.

5. From the center of the hemisphere on the inner surface, concentrically are placed to the periphery of a plate of the same material 2 mm thick and polymerized.

6. On the working model, an individual spoon is made according to standard technology, blocking the defect.

7. The resulting spoon is adapted in the oral cavity using known functional tests, polished areas that exert the greatest pressure on the mucous membrane of the prosthetic bed.

8. On the model, the hemisphere is connected to the base of the spoon, thus an individual spoon is obtained with the base and the obturating part monolithically connected.

9. In the center of the lower hemisphere of the obstructing part of the individual spoon, a hole is made with a milling cutter with a diameter corresponding to the diameter of the dispenser cannula, for making a silicone impression mass.

10. A corrective layer of silicone impression mass is applied in a thin layer and the prosthetic bed tissue is squeezed without effort.

11. Through the hole in the bottom plate of the obstructing part of the spoon, the same impression mass is introduced under pressure.

Claims (1)

The method of obtaining a functional impression after resection of the upper jaw is as follows: an impression is obtained by the alginate mass of the patient’s oral cavity, according to which a gypsum model is made, on which the defect of the upper jaw is lined with plastic for making individual spoons of light polymerization, polymerizing before reaching 3 mm to the boundaries of the defect, receive a hemisphere, which they adapt and fit inside the scar ring of the defect under the control of vision, after which on the inner surface of the hemisphere, from the center a, they are placed concentrically to the periphery of a plate of the same material with a thickness of 4 mm and photopolymerized, parallel to the manufacture of the hemisphere, an individual spoon is made on the working model according to standard technology, blocking the defect, the resulting spoon is adapted in the oral cavity using known functional tests, the areas that render the greatest pressure on the mucous membrane of the prosthetic bed, after clinical functional tests are carried out, connect the hemisphere with the base of the spoon on the model, thus making indie a visual spoon with a base and an obturating part monolithically connected, in the center of the lower surface of the base of the spoon, a hole is made in the projection of the obturating part with a cutter with a diameter corresponding to the diameter of the dispenser cannula, a corrective layer of silicone impression mass is applied in a thin layer on the individual spoon and squeeze the prosthetic bed tissue without effort then, through the hole in the lower plate of the obstructing part of the spoon, the same mass is injected under pressure, the mass strikes the upper plate and spreads through the intervals between the plates to the periphery to display the boundaries of the fibrous ring of the defect.