RU2798963C1 - Method of designing borders of individual spoon in the area of retromolaral spaces of the upper and lower jaw in complete removable prostheses manufacturing - Google Patents

Abstract

FIELD: medicine; orthopedic dentistry.

SUBSTANCE: method is intended for use in the manufacture of complete removable dentures. The patient is taken an anatomical impression with a standard impression spoon. After making a rigid individual impression tray in the traditional way and adjusting its edges in the neutral zone of the anterior and lateral sections of the oral cavity, it is fitted in areas in the region of the tubercles and retromolar spaces. To perform the abovementioned actions, the degree of compliance of the mucous membrane of the tubercles of the upper and lower jaws, their severity and mobility are determined visually and by palpation. Next, the configuration and severity of the pterygo-maxillary depressions behind the tubercles are assessed. The patient is asked to open the mouth wide and the size and mobility of the pterygomaxillary and mandibular folds are determined. After that, the distal edge of the tray in the region of the tubercles is thinned to 1 mm, a patch is applied to the outer surface in this area to improve the adhesion of the impression material and the individual tray. Next, a fluid silicone mass is applied to the area of the bumps from the outside of the spoon. The spoon is brought into the oral cavity and held with fingers on the edentulous jaw. The patient is asked to open his mouth wide several times to fix the amplitude of displacement of the pterygo-mandibular folds. The individual spoon is removed from the oral cavity, excess silicone material is removed from the inner surface of the spoon. A thin cutter with a diameter of 2 mm in the projection of the tops of the tubercles makes a hole to facilitate the exit of excess silicone mass. A fluid silicone mass is applied on the inner surface of the spoon and a functional impression is taken with a three-fold wide opening of the mouth, for the final correction of the retromolar areas, then the functional impression is removed from the oral cavity.

EFFECT: due to the formation of a locking valve in the region of the tubercles of the upper and lower jaws, the method allows to improve the fixation of complete removable dentures.

1 cl, 5 dwg, 1 ex

Description

The method relates to medicine, namely to orthopedic dentistry, and can be used in the manufacture of complete removable dentures.

It is known from the literature sources and practical activities of orthopedic dentists that the region of the tubercles and the retromolar space plays an important role in the formation of the closing valve in the manufacture of complete removable dentures of the upper and lower jaws. For the formation of the closing valve, edging materials for individual spoons and functional tests are traditionally used.

A known method of designing the edge of the spoon to create a closing valve (RU 2714434). The spoon contains an additional layer of edging material in the sublingual region and the region of the tubercles of the lower jaw, located on the already existing layer. A method for manufacturing an individual dental spoon for taking impressions from the lower jaw, including a closing valve, consisting in the fact that after the formation of the spoon with the valve itself, adhesive glue is applied to the dry edges of the valve, then a layer of edging material is applied to the edges of the valve. After hardening and hardening of the layer of edging material, a second layer of edging material is applied to it in the sublingual region and the region of the tubercles of the lower jaw.

There is a known method (RU 2579280) of forming the edges of an individual spoon to obtain a functional impression from an edentulous jaw in the manufacture of complete removable lamellar dentures, including making a step at a distance of 1-1.5 mm on the inner surface of the palatal edge of an individual spoon, for the upper jaw, and applying silicone mass along the edges of the spoon, after which the spoon is inserted into the oral cavity and, using functional tests, the edges of the spoon are formed.

A known method (RU 2144339) consists in fitting an individual spoon and obtaining a functional impression with a silicone mass. The optimal boundaries and configuration of the edges of an individual spoon are set by the displacement of the most thinned, remelted wax 3-4 mm wide, which is glued end-to-end to the edge, starting from the location of the former second molars on the lingual side to the vestibular one of the same name. The spoon is fixed with fingers to prevent displacement and functional tests are carried out in their entirety, the exposed areas of the edge of the spoon are ground off in the distal sections. The wax is again glued back to the edge of the spoon and the procedure is repeated until a clearly defined wax edge in the retromolar region and a pronounced sticking effect are obtained.

The disadvantages of the known methods is the lack of consideration of individual anatomical data for assessing the configuration of such anatomical formations as pterygo-maxillary depressions and the severity of pterygo-maxillary and mandibular folds located in the zone of retromolar spaces of the upper and lower jaws with complete adentia. Also, through the retromolar spaces, the impression material is released in the process of taking an impression with individual spoons, which displaces the pterygoid maxillary and mandibular folds and forms areas of air leakage on the finished prosthesis, which leads to the opening of the valve and displacement of the prosthesis in the oral cavity.

The objective of the invention is to improve the quality of orthopedic treatment with complete removable dentures, by eliminating these shortcomings.

EFFECT: improved fixation of complete removable dentures of the upper and lower jaws, due to the individual, functional design of the retromolar sections of the impression trays of the upper and lower jaws.

The technical result is achieved by applying to the outer surface of the edges of an individual spoon in the region of the tubercles of the upper and lower jaws, after fitting in the oral cavity, but before the final impression, a fluid silicone material to form a zone of pterygo-jaw depressions and folds, as well as perforations in an individual spoon in the area of the bumps.

The method for designing the boundaries of an individual tray in the region of the retromolar spaces of the upper and lower jaws in the manufacture of complete removable dentures is as follows.

The patient takes an anatomical impression with a standard impression spoon. After making a rigid individual impression tray in the traditional way, and fitting its edges in the neutral zone of the anterior and lateral sections of the oral cavity, the stage of its fitting begins in the areas in the area of the tubercles and retromolar spaces. For this, the degree of compliance of the mucous membrane of the tubercles of the upper and lower jaws, their severity and mobility are determined visually and palpatorily. Next, the configuration and severity of the pterygo-maxillary depressions behind the tubercles are assessed. The patient is asked to open the mouth wide and the size and mobility of the pterygomaxillary and mandibular folds are determined. After that, the distal edge of the tray in the region of the tubercles becomes thinner to 1 mm, a patch is applied to the outer surface in this zone to improve the adhesion of the impression material and the individual tray (Fig. 1, Fig. 2).

Next, a liquid silicone mass is applied to the area of the bumps from the outside of the spoon (Fig. 3).

The spoon is inserted into the mouth and held with fingers on the edentulous jaw. The patient is asked to open his mouth wide several times to fix the amplitude of displacement of the pterygo-mandibular folds.

The individual spoon is removed from the oral cavity, excess silicone material is removed from the inner surface of the spoon. A thin cutter with a diameter of 2 mm in the projection of the tops of the tubercles makes a hole for the exit of excess silicone mass (Fig. 4).

A fluid silicone mass is applied to the inner surface of the spoon and a functional impression is taken with the obligatory three-fold wide opening of the mouth, for the final correction of the retromolar areas, and the functional impression is removed from the oral cavity (Fig. 5).

The application of the presented method in clinical practice has shown a high efficiency of orthopedic treatment, due to the formation of a locking valve in the region of the tubercles of the upper and lower jaws with complete edentulism and good fixation of removable dentures.

Clinical example

Patient R. (70 years old) complained of unsatisfactory fixation of complete removable dentures of the upper and lower jaws when talking and eating. On examination, it was determined that the cause of poor fixation of the prostheses (made about 5 years ago) is the insufficient fit of the prostheses and the discrepancy in length and shape in the foreign spaces of the upper and lower jaws. The patient is recommended to make new complete removable dentures of the upper and lower jaws. During the examination, the boundaries of the retromolar zones, the configuration and anatomical features of the pterygo-maxillary depressions and folds were determined. Individual trays were made and fitted using the presented method of border design in the region of the retromolar spaces of the upper and lower jaws in the manufacture of complete removable dentures. Dynamic observation for 3 years showed no complaints from the patient and any complications.

The patient notes good fixation of prostheses and their comfortable operation.

Description of images

Fig. 1 - Individual spoon of the lower jaw (n / h) with a thinned distal edge.

Fig. 2 - Individual spoon n / h with a plaster applied in the region of the mandibular tubercle, to improve the adhesion of the impression material.

Fig. 3 - An individual spoon n / h with applied fluid silicone mass in the area of the tubercle and retromolar space.

Fig. 4 - A hole in the area of the top of the tubercle n/h on an individual spoon n/h for the release of excess impression mass.

Fig. 5 - The final functional impression of the s/h with an individually designed retromolar space.

Claims (1)

A method for designing the boundaries of an individual spoon in the region of the retromolar spaces of the upper and lower jaws in the manufacture of complete removable dentures, which consists in the fact that the distal edge of the spoon in the region of the tubercles is thinned to 1 mm, a plaster is applied to the outer surface in this zone to improve the adhesion of the impression material and individual spoons, then a liquid silicone mass is applied to the area of the tubercles on the outside of the spoon, the spoon is brought into the oral cavity and held with fingers on the edentulous jaw; then the patient opens his mouth three times to fix the amplitude of displacement of the pterygo-mandibular folds; an individual spoon is removed from the oral cavity, excess silicone material is removed from the inner surface of the spoon; a cutter with a diameter of 2 mm in the projection of the tops of the tubercles makes a hole for the exit of excess silicone mass, a liquid silicone mass is applied to the inner surface of the spoon and a functional impression is taken with a threefold opening of the mouth, for the final correction of retromolar areas.

Images