CN108294837B - Appliance for correcting open-bite malformation, preparation method and application thereof - Google Patents
Appliance for correcting open-bite malformation, preparation method and application thereof Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
- A61C7/08—Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch
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- Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
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- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
The invention discloses an appliance for correcting open-bite and closed-bite deformity, a preparation method and application thereof, wherein the appliance comprises a base, the base is a substrate manufactured according to the shape of the upper jaw and/or the lower jaw of a human oral cavity, and the substrate at least comprises a binding surface which is attached to the upper jaw and/or the lower jaw and a smooth surface which is contacted with the periphery of the tongue; a molar occlusal surface support is fixedly arranged on the base and at least arranged at the position of premolar and/or molar; a fixing clamping piece is fixedly arranged on the base support and clamped on the periphery of the teeth and/or in the adjacent tooth gaps; particularly, when the base is a lower jaw base, the tongue surface lifting protrusion is arranged at the position from the premolar to the molar of the base, and the tongue surface lifting protrusion is used for lifting the tongue body. The appliance provided by the invention fills the blank of the existing intraoral appliance for correcting the open bite or the III or II malocclusion caused by the bad habit of tongue, improves the clinical treatment rate, and can prevent the recurrence of the open bite after correction, and the clinical treatment effect is 100%.
Description
Technical Field
The invention belongs to the field of auxiliary appliances for orthodontics, and particularly relates to an appliance for correcting open-bite malformation, a preparation method and application thereof.
Background
The term open teeth bite was invented by caraveli in 1842, and the prevalence population varied from 1.5% to 11%. The prevalence decreases with sucking habits, while oral function matures with age. Prevalence 4.2% at 6 years of age, together with AOB, and prevalence decreases to 2% at 14 years of age. (Arese et al, 2011). Gradual factors and environmental factors are the causes of opening and closing, and the gradual factors comprise the position, the shape and the size of the tongue; the upper and lower jaws are particularly growth types of the lower jaws and the vertical relation of the base bones of the upper and lower jaws, and in environmental factors, infant swallowing, nasopharynx abnormality, mouth breathing with enlarged adenoid body, finger sucking, excessive tongue body and the like can cause the tongue to stretch forwards to open and close the teeth, and to be class III or class II; among many factors, the most important factor is abnormal tongue posture position (Mason, profsit, 1974), and the continuation of swallowing and swallowing of the infant type can make the tongue extend forwards and the tongue bottom position cause the anterior teeth to be opened and closed, the tongue body is squeezed and jammed between the upper jaw and the lower jaw to influence swallowing and beauty, and the growth type of the lower jaw and the vertical relation of the upper jaw and the lower jaw basal bone are influenced, so that the influence of mind and social adaptation caused by the evaluation of the appearance is brought to the face, and more attention is paid to the diagnosis rate.
The existing correction method comprises a functional correcting buccal screen corrector, a tongue spur corrector, a natural TE corrector, a chewing gum tongue muscle training method, a fixed corrector and an extramaxillary operation, but the blocking correcting buccal screen corrector, a pressing-down grinding occlusal plate type corrector, a multi-curved arch and other fixed correctors and the surgical treatment are not corrected from the tongue forward extension and bottom tongue habits of the etiology, so that the clinical recurrence rate is high and the long-term effect is poor; compared with the existing palatal spur appliance, the palatal spur appliance is only used for blocking the tongue from extending forwards without the functions of tongue muscle training and depressing molar teeth; compared with the existing method for training the tongue muscle by putting chewing gum on the front part of the oral palate, the tongue muscle is easy to fatigue, the training compliance of a patient is uncertain, and the curative effect is uncertain. Compared with the foreign natural TE appliance, the upper jaw is fully covered by transparent polyester material, and the lower jaw TE appliance has no occlusal support and has no definite function of depressing and grinding teeth; this was not effective for patients with open dental occlusion, which was representative of the corrective concept followed by the natural theory taught in korea to design the TE appliance of the invention by Seong-Hum Kim for 10 years.
Disclosure of Invention
In view of the above-mentioned defects or shortcomings of the prior art, a first object of the present invention is to provide a corrector for correcting open-bite and closed-bite deformities, which is used for preventing and correcting the open-bite and closed-bite or III or II malocclusion deformities of teeth, which are caused by bad habit of tongue from the primary stage of permanent teeth to the primary stage of primary teeth during the growth and development stage, and has a correction effect on the open-bite and closed-bite or III or II malocclusion deformities through tongue training, which has been confirmed through clinical experiments.
The second purpose of the invention is to provide a preparation method of the appliance for correcting open-bite and closed-bite deformity, the upper jaw and the lower jaw of the appliance are separately manufactured in a split type, the relation is not required, a jaw rack is not required, and the manufacturing method is flexible, rapid and simple.
A third object of the present invention is to provide a use of an appliance for correcting an open bite deformity for correcting an open bite and/or a class ii and/or class iii malocclusion caused by an unfavorable habit of the tongue.
In order to achieve the above purpose, the invention adopts the following technical solutions:
according to the first object of the invention, the appliance for correcting open-bite malformation comprises a base, wherein the base is a model component manufactured according to the shape of the upper jaw and/or the lower jaw of a human oral cavity, and the base at least comprises a binding surface which is bound with the upper jaw and/or the lower jaw and a smooth surface which is contacted with the periphery of the tongue;
a molar occlusal surface support is fixedly arranged on the base and at least arranged at the position of premolar and/or molar; a fixing clamping piece is fixedly arranged on the base support and clamped on the periphery of the teeth and/or in the adjacent tooth gaps;
particularly, when the base is a lower jaw base, the tongue surface lifting protrusion is arranged at the position from the premolar to the molar of the base, and the tongue surface lifting protrusion is used for lifting the tongue body.
Optionally, the tongue surface is raised and is protruding along the oral cavity center towards the tooth direction gradually thick, and the protruding most distal end extreme point is raised to the tongue surface and is 1 ~ 3mm apart from the oral cavity bottom.
Optionally, the tongue surface lifting protrusion is a smooth protrusion in a shape of a cone, the thickness of the tongue surface lifting protrusion is 1-1.5 cm, and the length of the tongue surface lifting protrusion is 1.5-2.5 cm.
Optionally, the fixing clip member includes at least one molar arrow head clip and at least one anterior labial arch, the molar arrow head clip is a periodontal clip inserted between adjacent molar occlusal supports, and the anterior labial arch is an arc periodontal clip surrounded in the anterior area.
Optionally, the anterior labial arch comprises a pair of "U" shaped curves and a beam connecting the "U" shaped curves, the "U" shaped curves are located at the cuspid teeth, and the beam surrounds the anterior teeth area;
the anterior labial arch is bent by a steel wire with the diameter of 0.7-0.9 mm, a U-shaped curve is bent downwards from the position 1/3 near the middle of the cuspid and 1/3, the width of the U-shaped curve is 4-5 mm, the length of the U-shaped curve reaches the position 3-4 mm below the neck of the cuspid and then upwards spans the gap between the cuspid and the premolar, and a cross beam is positioned at the position 1/3 in the anterior tooth.
Optionally, the fixing and clamping piece comprises at least one molar adjacent-to-intermediate hook, one end of the molar adjacent-to-intermediate hook is fixed on the base, and the other end of the molar adjacent-to-intermediate hook is clamped in the tooth gap;
the molar adjacent hook is bent by a stainless steel wire of 0.8-1.0 mm, the buccal side free end of the molar adjacent hook extends into a gap below the adjacent contact, and the buccal side of the molar adjacent hook is tightly attached to the gap between two adjacent teeth and is turned to the maxillofacial surface to be tightly attached.
Optionally, the molar occlusal surface support is bent according to the inclination angle of the dental crown, and the molar occlusal surface support is attached to the mesial sulcus, the distal sulcus or the whole occlusal surface sulcus of the occlusal surface, or the molar occlusal surface support is attached to the occlusal surface and arranged in the lingual and buccal directions.
According to the third purpose of the invention, the base is made of a dental model of a patient to be corrected, and a molar occlusal surface support and a fixed clamping piece are embedded on the base according to the correcting device for correcting open-bite deformity;
optionally, the base is made of self-setting plastic, and the molar occlusal surface support and the fixing and clamping piece are both made of steel wires; the average thickness of the base is 1.5-2 mm; the diameter of the steel wire is 0.7-1 mm.
The appliance for correcting the open-bite and occlusion deformity is applied to correcting the open-bite and occlusion and/or class II malocclusion deformity and/or class III malocclusion deformity caused by bad habit of tongue.
The appliance has good correction effect on correcting vertical growth type true open bite and horizontal growth type false open bite, expands the adaptation diseases and can prevent the recurrence of the open bite; the device can be used for assisting opening and closing correction by matching with a fixed appliance, or used for fixing a retainer when the correction is finished, or used for correcting the infantile dysphagia habit in the growth and development period, is simple and economic to manufacture, is simple and comfortable to wear in clinic, and can improve the clinical effect; the basic model is used as a retainer for fixing the appliance after correction or an infant lifts the tongue body, corrects the tongue posture, expands the width of the upper jaw and the like; the variability can realize the correction of open-close deformity by matching with a fixed appliance; the appliance has good retention, enlarges the appliance adaptation range, makes up the blank of the existing intraoral appliance for correcting the open bite or the class III or class II malocclusion caused by the poor practice of tongue, expands the existing correction method, can prevent the recurrence of the open bite after correction, has better compliance for patients, improves the clinical treatment rate, has 100 percent of clinical treatment effect, obtains good economic benefit and social benefit, and can be popularized and applied.
Drawings
The accompanying drawings, which are included to provide a further understanding of the disclosure and are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and together with the description serve to explain the disclosure without limiting the disclosure. In the drawings:
FIG. 1 is a schematic perspective view of a basic appliance for correcting open-bite malformation in accordance with the present invention;
FIG. 2 is a schematic front view of a basic appliance for correcting open-bite malformation in accordance with the present invention;
FIG. 3 is a schematic perspective view of the orthodontic appliance for open-bite deformity of the invention;
FIG. 4 is a schematic front view of the orthodontic appliance for correcting open-bite malformation according to the present invention;
FIG. 5 shows that the patient has a 3 month MEAW appliance in 2015 to treat the intraoral image + facial image + NTA appliance (variability) for 2 months;
FIG. 6 shows the patient having a 2016 number of MEAW appliances over the end of treatment X-pieces;
FIG. 7 is a 2016 number of intraoral images + facial images of a patient in one year;
FIG. 8 is a patient's first 2016. 6 month intraoral NTA holder (baseline);
FIG. 9 shows a patient wearing 6 month X pieces of a 12 month NTA holder (basic type) in 2016;
FIG. 10 shows a patient wearing a 6 month intraoral image and facial image of a 12 month NTA holder (basic) in 2016;
FIG. 11 is a 6 month intraoral image of a patient wearing a 12 month NTA holder (baseline) in 2016;
FIG. 12 is a corresponding schematic view of a tooth name as referred to herein;
the reference numerals in the figures denote:
1-base, 1-1 lingual surface lifting protrusion, 2-molar occlusal surface support, 3-fixed clamping piece, 3-1 molar arrow head clamp, 3-2 anterior labial arch, 3-1 '-first molar adjacent hook and 3-2' -second molar adjacent hook;
the present invention will be described in further detail with reference to the accompanying drawings.
Detailed Description
The following detailed description of specific embodiments of the present disclosure is provided in connection with the accompanying drawings. It should be understood that the detailed description and specific examples, while indicating the present disclosure, are given by way of illustration and explanation only, not limitation.
In the present disclosure, unless otherwise specified, use of the directional terms "upper" and "lower" generally refer to the definition in the drawing figures of the accompanying drawings, and "inner" and "outer" refer to the inner and outer of the contours of the corresponding parts.
The noun explains:
human teeth can be classified into anterior teeth (incisors), cuspids, premolars, and molars, and the specific correspondence is shown in fig. 12. One tooth is divided into three parts, the crown, the neck and the root. The crown part is provided with enamel and hard white substance. Enamel surrounds the dentin, followed by nerves and pulp. The gum is called around the teeth. The gum is also called as alveolus, and the root of the tooth is implanted in the alveolus, including tissues such as periodontal ligament, gingiva and alveolar bone, which are divided into an upper gum and a lower gum and have the function of fixing the tooth.
The open and close teeth are divided into 3 degrees: the vertical distance between the incisor margins of the upper incisor and the lower incisor is the standard of the vertical distance from the incisor end of the upper jaw incisor to the incisor end of the lower jaw incisor; degree I: the upper and lower open teeth are vertically separated within 3 mm; II degree: the upper and lower open teeth are vertically separated by 3-5 mm; and (3) III degree: the upper and lower open teeth are vertically separated by more than 5 mm.
The type II malocclusion and the type III malocclusion are distinguished according to Angle malocclusion classification, and specifically comprise the following steps:
type II malocclusion, with the lower arch and lower jaw in the distal position. If the mandible is receded by a distance of 1/4 molars or half of the premolar, i.e. the mesial buccal cusps of the upper and lower first permanent molars are opposite, a mild mesial-distal malposition is called. If the mandible is further retracted so that the mesial buccal cusps of the upper first permanent molars bite into the lower first permanent molars and the second premolars, a complete distal-medial-malocclusion relationship is established.
Class III malocclusion, with the lower arch and lower jaw in the mesial position. If the mandibular advancement 1/4 is by molar or half premolar distance, i.e., the mesial buccal cusp of the upper first constant molar is opposite the distal buccal cusp of the lower first constant molar, a slight mesial-distal misalignment is referred to. A complete mesial-malocclusion relationship is achieved if the lower jaw is medially displaced by a distance of 1/2 molars or 1 premolar, such that the mesial buccal cusp bite of the first permanent molars of the upper jaw is between the lower first and second permanent molars.
The main innovation points are as follows:
the correcting device for correcting the open-close deformity, which is innovatively designed by the invention, can be abbreviated as NTA correcting device, the principle expands the correcting concept and adaptation disease along the natural theory, the upper and lower jaw split type correcting device is innovatively designed, the lower jaw plastic extends to the gaps at the two sides of the tongue root, the occlusal surface of the correcting device is supported, the tongue body is lifted and upper and lower jaws are pressed to grind teeth by utilizing the functions of the tongue body during swallowing and speaking, the teeth are pressed down by the tongue muscle, the tongue tip is trained to retreat, and the habit of spitting the tongue is broken; the lifting of the tongue has an expanding effect on the maxillo-palatal part during childhood; the device can also be matched with a fixed appliance to assist in the open-close correction of the teeth; or used for fixing the retainer when the correction is finished, which is a principle and function that TE does not have, is favorable for correcting infantile dysphagia habit in the growth and development period and accordingly causes open-bite occlusion, III or II malocclusion correction, and enables the NTA corrector to be flexibly applied. The problem of urgent clinical need is solved, the NTA appliance is innovated, the defects of the existing appliance can be overcome, the clinical effect can be improved, better economic benefit and social benefit can be expected, and no relevant literature report exists through domestic and foreign literature retrieval.
Firstly, appliance principle:
the innovatively manufactured NTA appliance has the advantages that the lower jaw plastic extends to the gaps at the two sides of the tongue root to form bulges, namely the tongue surface lifting bulges are matched with the molar occlusal surface support, the tongue body is lifted and the upper and lower jaws of the molar teeth are pressed by utilizing the function of the tongue body during swallowing and speaking, the tongue tip is trained to retreat, the molar teeth are pressed down by the tongue muscle, and the infant tongue spitting habit is broken; the lifting of the tongue has an expanding effect on the maxillo-palatal part during childhood; the NTA appliance manufactured in an innovative mode can be flexibly applied, can be worn on the lower half mouth only and is only used for correcting tongue spitting habit, tongue body lifting and tongue muscle training, or manufactured into an upper jaw and a lower jaw which are worn on a patient in a split mode respectively to lower molars, and can also be matched with a fixed appliance to assist in tooth opening and closing correction, or used for a retainer for a patient with tooth opening and closing after the fixed correction. The indications are expanded: patients in the age range from the replacement stage to the permanent stage; the device can be used for preventing and treating open-close teeth and patients with class III or class II malocclusion caused by bad habit of tongue, can be matched with a fixed appliance to assist in open-close correction, or can be used for keeping the open-close teeth and patients after the fixed correction; has expansion effect on maxilla in childhood, and can prevent recurrence of open teeth after correction.
Secondly, the manufacturing method comprises the following steps: the upper jaw and the lower jaw of the NTA appliance are manufactured separately, the relation is not required, and the upper jaw frame is not required, so that the NTA appliance is different from the manufacturing method of the existing appliance; the base support is made of self-solidifying plastic, and other parts are made of stainless steel;
1. manufacturing of basic NTA appliance: the fixing clamping piece comprises a molar arrow head clamp and an anterior labial arch, the molar arrow head clamp is a periodontal clamping piece inserted between adjacent molar occlusal surface supports, and the anterior labial arch is an arc periodontal clamping piece clamped and surrounded in the anterior tooth area. The anterior labial arch comprises a pair of U-shaped curves and a beam connecting the U-shaped curves, the U-shaped curves are positioned at the cuspid, and the beam surrounds the anterior teeth area; the anterior labial arch and molar arrow head clip are bent by using steel wires with the diameter of 0.7-0.9 mm, a U-shaped curve is bent downwards from the mesial 1/3 and the middle 1/3 of the cuspid, the width of the U-shaped curve is 4-5 mm, the length of the U-shaped curve reaches the position 3-4 mm below the neck of the cuspid and then upwards crosses the interproximal space between the cuspid and the anterior molar, and the cross beam is positioned at the middle 1/3 height of the anterior tooth. The molar occlusal surface support at the anterior molar and the molar is bent by 0.9-1 mm stainless steel wires and is L-shaped, the molar occlusal surface support is bent according to the inclination angle of a dental crown, the molar occlusal surface support is attached to the proximal sulcus, the distal sulcus or the whole occlusal surface sulcus of the occlusal surface, or the molar occlusal surface support is attached to the occlusal surface in a deviated buccal direction, and a tongue palate side connector (namely, the distance between the farthest end of the molar occlusal surface support embedded in the base and the soft tissue of the dental bed) is 2-4 mm away from the tissue surface and is about 3mm away from the tissue surface. The tongue surface elevation bulge is gradually thickened towards the tooth direction along the oral cavity center, and the distance between the farthest end point of the tongue surface elevation bulge and the oral cavity bottom is 1-3 mm. Optionally, the tongue surface lifting protrusion is a smooth protrusion in a shape of a cone, the thickness of the tongue surface lifting protrusion is 1-1.5 cm, and the length of the tongue surface lifting protrusion is 1.5-2.5 cm
2. The preparation of the variant NTA appliance comprises the following steps: the difference of variant and basic type is exactly that fixed joint spare is different, because the NTA of variant is rescued the ware and is used with the correction ware cooperation of correcting the tooth position, consequently can not use the fixed joint spare of basic type, and need use the adjacent hook of molar, the retention device upper and lower jaw premolar and the adjacent hook of molar are bent with 0.8 ~ 1.0mm stainless steel wire, adjacent hook buccal side free end is 1mm deep and is adjoined contact below clearance, buccal side closely pastes two adjacent tooth clearances and turns to jaw face and paste tightly, the reformulation connector is embedded by the plastic base. The palate side connector (namely, the farthest end of the molar occlusal surface support embedded in the base body is away from the gum soft tissue) is 2-4 mm away from the tissue surface and is about 3mm, the comfort and the fixing effect of a patient wearing the dental appliance are guaranteed by the distance, the steel wire and the base body are prevented from being embedded too shallowly to cause the separation of the steel wire and the base body, and the risk of damage of the wearing device is avoided.
In an embodiment of the invention:
the appliance for correcting open-close deformity comprises a base 1, wherein the base 1 is a model component manufactured according to the shape of the upper jaw and/or the lower jaw of a human oral cavity, and the base 1 at least comprises a binding surface attached to the upper jaw and/or the lower jaw and a smooth surface contacted with the periphery of the tongue; a molar occlusal surface support 2 is fixedly arranged on the base 1, and the molar occlusal surface support 2 is at least arranged at the premolar and/or molar position; a fixed clamping piece 3 is fixedly arranged on the base 1, and the fixed clamping piece 3 is clamped on the periphery of teeth and/or in the gaps between adjacent teeth; particularly, when the base 1 is a lower jaw base, the tongue surface lifting protrusion 1-1 is arranged at the position from the premolar to the molar of the base 1, and the tongue surface lifting protrusion 1-1 is used for lifting the tongue body. The above solutions comprise two types of appliances, one is a basic appliance (as shown in fig. 1 and 2), and the other is a variant appliance (as shown in fig. 3 and 4), the basic appliance is used for correcting the open teeth and the malocclusion of III type due to bad habit of tongue; the variant mainly aims to cooperate with a fixed appliance to correct the bad habit of tongue, which causes open teeth and/or class II and/or class III malocclusion. In particular to a tongue surface lifting component 1-1 which is used for lifting the tongue body and training the tongue muscle; the molar occlusal surface support 2 is matched with tongue muscles to train and lower anterior molar and molar so as to correct open occlusion and/or class II and/or class III malocclusion caused by poor tongue posture positions such as low tongue position, tongue spitting, baby swallowing and the like, and can be used for correcting a posterior retainer of a patient through a fixed corrector, so that the problems of preventing and correcting primary dentition, functional and bony open occlusion or class III or class II malocclusion from a primary deciduous period to a primary period of permanent teeth in a growth development period are basically solved, and the basic type and variability can be matched with the fixed corrector to correct the deformity; the NTA appliance designed by the invention has good retention, can be used for tongue muscle function training during swallowing and speaking to correct the open bite and the mandibular protrusion or retraction, effectively shortens the treatment time, enlarges the correction indications, expands the existing correction method, can prevent relapse, improves the clinical treatment rate, has 100 percent clinical treatment effect, obtains good economic and social benefits, and can be popularized and applied.
In the embodiment of the invention, the tongue surface lifting protrusion 1-1 is gradually thickened towards the teeth along the center of the oral cavity, the distance between the farthest end point of the tongue surface lifting protrusion 1-1 and the oral bottom is 1-3 mm, and through the observation of clinical experience, the tongue surface lifting protrusion 1-1 cannot be only a protrusion with a simple structure, the farthest end point of the tongue surface lifting protrusion is equivalent to the farthest end point of a cone-like object, but the tip of the cone-like object is a smooth body which horizontally extends out along the oral bottom of the lower jaw, so that the shape in the mouth of a human body can be compounded, the wearing comfort level is met, the tongue surface lifting protrusion can be effectively used for lifting the tongue body, and the tongue muscle is trained.
Optionally, the tongue surface lifting protrusion 1-1 is a smooth protrusion in a cone-like shape, the thickness of the tongue surface lifting protrusion 1-1 is 1-1.5 cm, the length of the tongue surface lifting protrusion 1-1 is 1.5-2.5 cm, and the size of the size can meet the use requirements of patients of different ages, so that the application range of the appliance is expanded.
Also, in the embodiment of the present invention, for the basic type of appliance, the fixing clip member 3 includes at least one molar arrow head clip 3-1 and at least one anterior labial arch 3-2, the molar arrow head clip 3-1 is a periodontal clip interposed between the adjacent molar occlusal brackets 2, and the anterior labial arch 3-2 is an arc-shaped periodontal clip caught around the anterior area. For example, in the structure shown in fig. 1 and 2, the upper jaw and the lower jaw are respectively and exclusively provided with a pair of molar arrow head clips 3-1 and an anterior labial arch 3-2, so that the whole appliance can be worn in the mouth, and meanwhile, effective fixation is carried out, and the matching use of the base 1 and the molar occlusal surface support 2 is ensured.
For example, the anterior labial arch 3-2 comprises a pair of U-shaped curves and a beam connecting the U-shaped curves, wherein the U-shaped curves are positioned at the cuspids, and the beam surrounds the anterior teeth area; the anterior labial arch 3-2 is bent by a steel wire with the diameter of 0.7-0.9 mm, a U-shaped curve is bent downwards from the position 1/3 near the middle of the cuspid and 1/3, the width of the U-shaped curve is 4-5 mm, the length of the U-shaped curve extends to the position 3-4 mm below the neck of the cuspid and then upwards crosses the gap between the cuspid and the premolar, and the cross beam is positioned at the position 1/3 in the anterior teeth.
Also, in the embodiment of the present invention, for the modified appliance, the fixing clip 3 includes at least one molar abutment hook, one end of which is fixed to the base 1 and the other end of which is clipped in the slit; the molar interproximal hook is bent by 0.8-1.0 mm stainless steel wires, the buccal side free end of the molar interproximal hook extends into a gap below an adjacent contact, the buccal side of the molar interproximal hook is tightly attached to the gap between two adjacent teeth and is turned to be tightly attached to the jaw surface, for example, in the structure shown in fig. 3 and 4, the molar interproximal hook is arranged between adjacent molar occlusal surface supports and comprises a first molar interproximal hook 3-1 'and a second molar interproximal hook 3-2', the whole appliance can be worn in the mouth at least, meanwhile, effective fixation is carried out, and the base 1 and the molar occlusal surface support 2 are ensured to be matched for use.
In the embodiment of the invention, the molar occlusal support 2 is bent according to the inclination angle of the dental crown, the molar occlusal support 2 is attached to the mesial sulcus, the distal sulcus or the whole occlusal sulcus of the occlusal surface, or the molar occlusal support 2 is attached to the occlusal surface and arranged in the lingual cheek direction. Because the shapes of the crowns of the intraoral teeth of different patients are different, when the molar occlusal surface support 2 is arranged, the molar occlusal surface support is made according to a dental model of the patient, and is attached to the surface of the crown, so that the tooth axis is positioned, the tongue and palate side connecting body (namely, the distance between the farthest end of the molar occlusal surface support 2 embedded in the base 1 and the soft tissue of the dental bed) is 2-4 mm away from the tissue surface and is about 3mm, the comfort and the fixing effect of the patient when wearing the dental implant are ensured by the distance, the steel wire and the base 1 are not separated due to the fact that the steel wire and the base are too shallow embedded, and the risk of damage of the wearing device is avoided.
The preparation method of the appliance for correcting the open-bite and closed-bite deformity comprises the following steps that a base 1 is manufactured by utilizing a dental model of a patient to be corrected, and a molar occlusal surface support 2 and a fixed clamping piece 3 are embedded on the base according to the appliance for correcting the open-bite and closed-bite deformity; for example, the base 1 is made of self-setting plastic, and the molar occlusal surface support 2 and the fixed clamping piece 3 are both made of steel wires; the average thickness of the base 1 is 1.5-2 mm; the diameter of the steel wire is 0.7-1 mm.
The appliance for correcting the open-bite and occlusion deformity is applied to correcting the open-bite and occlusion and/or class II malocclusion deformity and/or class III malocclusion deformity caused by bad habit of tongue.
The manufacturing method comprises the following steps:
(1) two models are taken clinically, one model is used for measurement, and the other model is used for manufacturing an NTA appliance in an innovative design;
(2) trimming the upper and lower jaw models;
(3) respectively bending a fixing clamping piece 3 and a molar occlusal surface support 2 on the upper jaw model and the lower jaw model by using stainless steel wires, and bending the molar occlusal surface support 2 by using 0.8-1 mm stainless steel wires according to requirements; the fixed clamping piece 3 is bent by a stainless steel wire with the thickness of 0.8-1 mm according to requirements;
(4) plastic coating: polymerizing red or colorless transparent self-setting powder to form a base, and accumulating plastic protrusions (tongue surface lifting protrusions) with the length of about 1.5 multiplied by 0.8cm at the positions extending to gaps on two sides of a tongue root at a lower jaw molar base plate for lifting a tongue body;
(5) and (5) polishing, and finishing the manufacture of the appliance.
The using method comprises the following steps:
giving the manufactured appliance to a clinician, wearing the appliance for bringing the appliance into a standard case, wherein the wearing time is 24 hours every day, including wearing at night, and the appliance is matched with a fixed appliance for 1-2 years; the open-close fixed appliance finishes wearing the NTA retainer for about 1 to 2 years; it is suitable for patients with maxillary stenosis due to tongue posture position such as bad tongue habit, open and close teeth, or type III or type II patients for about 2-3 years.
Typical cases are as follows:
patients with open and close teeth benefit from a certain property: the degree of opening and closing is more than 5mm, belongs to a patient with more than three degrees of opening and closing, and is wearing a dental appliance (MEAW appliance).
In 2015, 3 months, the MEAW appliance is matched with the treatment mouth portrait + the facial portrait + the NTA appliance (variability) for 2 months, and in the figure 5, after 2 months, the open teeth are closed, and the open teeth are closed by 3-4 mm;
the MEAW appliance treatment ended X-piece at month 5 in 2016, fig. 6, with a partial open bite closure.
Lip phenomenon has occurred in the 6 month mouth + face image of 2016, fig. 7, but the patient requested removal of the appliance and replacement of the primary appliance.
Intraoral NTA holder (base) figure 8, 6 months 2016, worn;
wearing 6-month X-piece by the NTA holder (basic type), fig. 9, covering teeth of upper and lower teeth for 2-3 mm, normally for 3mm, and approaching to normal state, wearing 6-month internal image and facial image by the NTA holder (basic type) in 2016 and 12 months (fig. 10); NTA holder (base model) was worn for 6 months intraoral image (fig. 11). Therefore, the open-close situation of the teeth of the patient worn for more than one year is obviously improved, the appliance is proved to have the effect of correcting the open-close and/or the II-type malocclusion and/or the III-type malocclusion caused by the bad habit of tongue, the effect is obvious, and the tracking curative effect proves that the relapse is not caused.
Collecting clinical experiment data:
thereafter, a survey of wear tracking data was also conducted randomly for 20 patients, the data in table 1 below are averages of 20 patients, the treated patients' skull topograms were measured using the Steiner and Tweed analysis, and the statistical t-test analysis gave the following table 1:
TABLE 1
ODI (°), low anterior/anterior and high posterior/anterior have significant statistical significance. P <0.05, has significant statistical significance; p <0.01, with very significant statistical significance.
As can be seen from the experimental data in Table 1, ODI (degree), anterior-inferior height/anterior height and posterior height/anterior height have significant statistical significance, the clinical effect is obvious, the orthodontic tooth paste has good orthodontic effect on both vertical growth type true open bite and horizontal growth type false open bite, and the adaptation disease is expanded; the device can be used for assisting the open-close correction of teeth by matching with a fixed appliance, or used for a retainer at the end of the fixed correction, or used for correcting the infantile swallowing disorder habit in the growth and development period, is simple and economic to manufacture, is simple and comfortable to wear clinically, can improve the clinical effect, has good economic and social benefits, and shows that no relevant literature reports and published patents exist at home and abroad at present from literature retrieval.
The preferred embodiments of the present disclosure are described in detail with reference to the accompanying drawings, however, the present disclosure is not limited to the specific details of the above embodiments, and various simple modifications may be made to the technical solution of the present disclosure within the technical idea of the present disclosure, and these simple modifications all belong to the protection scope of the present disclosure.
It should be noted that the various features described in the foregoing detailed description may be combined in any suitable manner without contradiction, and the disclosure does not separately describe each possible combination in order to avoid unnecessary repetition.
In addition, any combination of the various embodiments of the present disclosure can be made, and the same should be considered as the disclosure of the present disclosure, as long as the combination does not depart from the spirit of the present disclosure.
Claims (8)
1. The appliance for correcting the open-bite and closed-deformity is characterized by comprising a base (1), wherein the base (1) is a model component manufactured according to the shape of the upper jaw and/or the lower jaw of a human oral cavity, and the base (1) at least comprises a binding surface attached to the upper jaw and/or the lower jaw and a smooth surface contacted with the periphery of the tongue;
a molar occlusal surface support (2) is fixedly arranged on the base (1), and the molar occlusal surface support (2) is at least arranged at the position of premolar and/or molar; a fixed clamping piece (3) is fixedly arranged on the base (1), and the fixed clamping piece (3) is clamped on the periphery of teeth and/or in the gaps between adjacent teeth;
when the base (1) is a lower jaw base, a tongue surface lifting protrusion (1-1) is arranged at the position from premolar to molar of the base (1), and the tongue surface lifting protrusion (1-1) is used for lifting a tongue body;
the tongue surface lifting protrusion (1-1) is gradually thickened towards the direction of teeth along the center of the oral cavity, and the distance between the farthest end point of the tongue surface lifting protrusion (1-1) and the oral bottom is 1-3 mm;
the tongue surface lifting bulges (1-1) are smooth bulges in a cone-like shape, the thickness of the tongue surface lifting bulges (1-1) is 1-1.5 cm, and the length of the tongue surface lifting bulges (1-1) is 1.5-2.5 cm.
2. The appliance for correcting open-bite malformation of claim 1, wherein the fixing clip (3) comprises at least one molar arrow clip (3-1) and at least one anterior labial arch (3-2), the molar arrow clip (3-1) is a periodontal clip inserted between adjacent molar occlusal supports (2), and the anterior labial arch (3-2) is an arc periodontal clip inserted around the anterior area.
3. The appliance for correcting open dental deformity according to claim 2, wherein the anterior labial arch (3-2) comprises a pair of U-shaped curves and a cross bar connecting the U-shaped curves, the U-shaped curves being located at the cuspids, the cross bar being enclosed in the anterior dental zone;
the anterior labial arch (3-2) is bent by a steel wire with the diameter of 0.7-0.9 mm, a U-shaped curve is bent downwards from the mesial 1/3 and the middle 1/3 of the cuspid, the width of the U-shaped curve is 4-5 mm, the length of the U-shaped curve is 3-4 mm from the downward neck of the cuspid to the position of the front molar, and then the U-shaped curve upwards spans the gap between the cuspid and the premolar, and a cross beam is positioned in the middle of the anterior teeth at the height of 1/3.
4. The appliance for correcting open-bite and closed-bite deformities according to claim 1, wherein the fixed clamping piece (3) comprises at least one molar interproximal hook, one end of the molar interproximal hook is fixed on the base (1), and the other end of the molar interproximal hook is clamped in a tooth gap;
the molar adjacent hook is bent by a stainless steel wire of 0.8-1.0 mm, the buccal side free end of the molar adjacent hook extends into a gap below the adjacent contact, and the buccal side of the molar adjacent hook is tightly attached to the gap between two adjacent teeth and is turned to the maxillofacial surface to be tightly attached.
5. The appliance for correcting open and closed deformity of teeth of claim 1, wherein the molar occlusal surface brackets (2) are bent according to the inclination angle of the dental crown, and the molar occlusal surface brackets (2) are attached to the proximal sulcus, the distal sulcus or the entire occlusal sulcus of the occlusal surface, or the molar occlusal surface brackets (2) are attached to the occlusal surface in the deviated buccal direction.
6. A preparation method of an appliance for correcting open and closed deformity is characterized in that the base (1) is made of a dental model of a patient to be corrected, and a molar occlusal surface support (2) and a fixed clamping piece (3) are embedded in the appliance for correcting open and closed deformity according to any claim from 1 to 5.
7. The preparation method of the appliance for correcting the open-bite and closed-bite deformity according to claim 6, wherein the base (1) is made of self-hardening plastic, and the molar occlusal surface support (2) and the fixing and clamping piece (3) are made of steel wires; the average thickness of the base (1) is 1.5-2 mm; the diameter of the steel wire is 0.7-1 mm.
8. Use of an appliance for the treatment of open bite deformity according to any one of claims 1 to 5 for the treatment of open bite and/or malocclusion type ii and/or malocclusion type iii due to poor habit of the tongue.
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| CN108852537A (en) * | 2018-09-07 | 2018-11-23 | 佛山市佛冠义齿有限公司 | Protruding canine teeth tractor |
| CN109091255A (en) * | 2018-09-07 | 2018-12-28 | 佛山市佛冠义齿有限公司 | Lead bow formula jaw pad rectifier |
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| JPH07213538A (en) * | 1993-12-07 | 1995-08-15 | Chikami Mirutetsuku Kk | Dentition holding appliance and its fabrication |
| CN101888814A (en) * | 2007-08-29 | 2010-11-17 | 克里斯多佛·约翰·法雷尔 | Orthodontic appliance |
| CN104825240A (en) * | 2015-04-24 | 2015-08-12 | 西安交通大学口腔医院 | Appliance for guiding mandible forward and/or getting rid of bad habit of sucking lower lip and preparation method thereof |
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| CN1085069A (en) * | 1993-07-12 | 1994-04-13 | 欧索-泰公司 | The positive tooth therapeutic kit of a kind of preforming for multiracial use |
| JPH07213538A (en) * | 1993-12-07 | 1995-08-15 | Chikami Mirutetsuku Kk | Dentition holding appliance and its fabrication |
| CN101888814A (en) * | 2007-08-29 | 2010-11-17 | 克里斯多佛·约翰·法雷尔 | Orthodontic appliance |
| CN104825240A (en) * | 2015-04-24 | 2015-08-12 | 西安交通大学口腔医院 | Appliance for guiding mandible forward and/or getting rid of bad habit of sucking lower lip and preparation method thereof |
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