RU2236827C1 - Spoon for taking imprints from mandible and maxilla in single-step with partially lacking teeth - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has handle and bed for keeping imprint material manufactured as ribbon curved to repeat alveolar process shape with a through slot being created for imprint material to be treated. The ribbon has thickening working surfaces joined with horizontal cross-pieces. The thickening working surfaces are made as widening boards in the dental row defect zone having vestibular and oral working surfaces.

EFFECT: low consumption of imprint and auxiliary materials.

3 dwg

Description

The invention relates to medicine, namely to orthopedic dentistry, and can be used for simultaneous removal of impressions from the dentition of the upper and lower jaws with a partial absence of teeth closed in the central occlusion position.

Known spoons for taking impressions from the upper and lower jaws are standard and individual (see. "Guide to practical exercises in orthopedic dentistry" V.Yu. Kurlyandsky. M: Medgiz, 1961, p.52-53; "Dental prosthetics" V. N. Kopeikin, L. M. Demner, M .: Medicine, 1985, p.116-118; A. S. Scherbakov, V. N. Trezubov, E. N. Gavrilov, E. N. Zhulev “Orthopedic dentistry” : Textbook. 5th edition, 1997, pp. 86-92).

Standard impression trays are most often made from plastic or metals (stainless steel, aluminum). Impression spoons have various shapes and sizes. The impression spoon for the upper jaw consists of a pen, a bed for the palate. The spoon for the lower jaw has a horseshoe-shaped shape, its inner edge has a side for the oral part of the alveolar process of the jaw. To obtain impressions, spoons are selected according to the size of the upper and lower jaws, then impression material is prepared, which is applied to the spoon and inserted into the oral cavity. Using this method, prints are obtained alternately from the upper and lower jaws.

The disadvantages of this method are the longer time spent by the doctor, since an impression from the teeth of the antagonists is almost always necessary, an additional consumption of the impression mass to obtain it (than with simultaneous removal of impressions), as well as the use of two spoons to take impressions.

In recent years, not plaster, but special elastic materials have become more commonly used as impression materials. However, they have poor adhesion to metal spoons and at the time of removal of the impression from the oral cavity are separated from the spoon and deformed. To avoid this, impression spoons with holes on the entire surface of the spoon for holding impression material were proposed (E.I. Gavrilov. Theory and clinic of prosthetics with partial removable dentures. M: Medicine, 1973, p.297).

The traditional manufacturing technology of fixed dentures (stamped-brazed, solid cast, cermet) provides for the following clinical and laboratory stages:

1) the selection of spoons and impressions from the upper and lower jaws;

2) casting jaw models;

3) the manufacture of wax bases with bite rollers;

4) determination of the central ratio of the jaws (bite);

5) gypsum models in the occluder and the manufacture of prostheses;

6) verification of prosthetic designs in the patient's mouth;

7) the final manufacture of prostheses and their imposition to the patient.

Impressions are made separately from each jaw. Then the technician casts two models (one from the working jaw, the other from the jaw of the teeth of the antagonists) to compare them to the central occlusion position. On models it makes wax bases with bite rollers. After this, the doctor determines the central occlusion on the next patient visit, and then the technician plaster the models in the central occlusion into the occluder, the used rollers are thrown out of the wax.

The disadvantages in carrying out the above steps include the additional expenditure of time of a doctor and a dental technician, the expenditure of auxiliary materials, and additional manipulations to the patient.

There is a method of producing an instant impression from both jaws, where conventional standard metal spoons with a through groove in the shape of the alveolar process are used to obtain an impression, and there is an elastic elastic mesh between the dentition. It should be noted that in this way a working impression is obtained from only one jaw, and from the other only an imprint of the chewing surface of antagonist teeth.

The most important disadvantages include the fact that an elastic-elastic mesh when closing the dentition creates a slight change in the height of the bite, and when the jaws are closed where the mesh is bitten by not prepared teeth, the lower jaw is reflexively possible and the fixation is not central, but lateral occlusion.

The closest technical solution adopted by the authors for the prototype is an impression tray, which consists of a work surface with a through groove, jumpers and handles (I. B. Dolbnev, BC Sirunyants, V. I. Forost, invention (19) RU (11) 2004 212 C1 (51) 5 A 61 C 9/00).

The working surface is made in the form of a continuous metal tape curved horseshoe-shaped in the shape of the alveolar ridge, and the surface of the tape is concave towards the through groove, and the interface between the outer and inner arches of the tape is made in the form of jumpers.

The disadvantage of this spoon is the complicated configuration of the working surface, which complicates its industrial production, as well as the consumption of the impression mass with included defects in the dentition and to remove the impression for removable structures (where more impression mass is required). In addition, the adhesion of the alginate mass to the metal (spoon) is poor and at the time the impression is removed, it separates, which in turn requires additional gluing of the spoon with adhesive plaster or the introduction of an additional portion of alginate material to create additional retention from the vestibular side.

The technical solution of the invention is the simultaneous removal of impressions from the upper and lower jaws with a partial absence of teeth (Kennedy classification 3 class) and saving impression and auxiliary material.

The technical solution is achieved by the fact that the working surface expands in the form of a bead vertically in the area of the dentition defect with the vestibular and oral surfaces, and the jumpers are located horizontally with respect to the working surface and connect the sides of the working surface. With bilateral included defects of the dentition, a spoon is used, the working surface of which extends vertically in the form of a flange in the area of the dentition defect with the vestibular and oral surfaces and is located in the defect region on the right and left sides of the midline of the face. To save impression mass with a one-sided dentition defect enabled, you can use a spoon with a one-sided (right or left) side of the bead vertical in the area of the dentition defect. Due to the fact that human dental arches have different sizes, the spoon can be made in five sizes along the width and length of the space between the outer and inner sides, i.e. the size of the through groove.

Figure 1 shows a General view of the spoon for removing an instant impression from the jaw with a bilateral included defect in the dentition.

Figure 2 shows a General view of a spoon for removing an instant impression from the jaw with a one-sided included dentition defect (right).

Figure 3 shows a General view of the spoon for removing an instant impression from the jaw with a unilateral included defect in the dentition (left).

The device consists of a handle 1, a working surface that extends in the form of a bead vertically in the area of the dentition defect from the vestibular surface 2, a working surface that expands in the form of a bead vertically in the area of the dentition defect from the oral surface 3, jumpers 4, which are located horizontally in relation to the working surface and they are connected, a through groove 5, which is located between the side and the jumpers in the shape of the alveolar process.

The device operates as follows. Before taking the impression, the doctor selects a spoon in size. To do this, the spoon is inserted into the oral cavity and positioned so that the conjugations between the outer and inner sides are located behind the dentition, behind the “wisdom teeth”, and in their absence, behind the tubercles of the upper jaw. Further, the patient is invited to close his teeth several times in a central occlusion, while the unhindered closure of the jaws and the level of location of the spoon in relation to the dentition are controlled. The spoon is removed from the oral cavity. After selecting a spoon, the prepared impression mass (for example, “YPEEN”, “HY-DRORGUM”, “KROMOPAN”, “AIDSEX”, etc.) is placed in the through groove 5 between the outer 6 and 7 inner edges of the spoon, the spoon is inserted into the oral cavity and the patient it is proposed to slowly close the dentition, while the doctor controls the placement of the spoon in the oral cavity along the handle of 1 spoon, which should be located along the line of closing of the lips and coincide with the median line of the face. After polymerization of the impression mass, the patient is invited to open his mouth and a spoon with an elastic impression is removed from the oral cavity. Upon receipt of impressions for the manufacture of metal stamped dentures, a small amount of alginate mass is sufficient (less than when removing impressions in the classical way). Upon receipt of impressions for the manufacture of ceramic-metal or solid cast dentures, when it is necessary to have a very accurate display of the neck of the teeth in the gum region, the impression is filled with a corrective impression mass, reintroduced into the oral cavity and the dentition closes in a central occlusion. After polymerization of the corrective layer of the impression mass, the impression tray is removed from the oral cavity.

Further, the dental technician casts the models of the upper and lower jaws with their fixation in the occluder in a known manner.

The proposed design of the spoon for receiving dental impressions makes it possible to simultaneously obtain impressions from both jaws in the central occlusion position, reduces the stages of the manufacture of fixed prostheses. It takes half as much impression material to produce prints as when removing prints with conventional spoons and spoons for instant prints designed for removable and non-removable structures. The time spent at the doctor’s appointment is reduced, and the number of patient visits to the doctor is also reduced, since there is no need to determine central occlusion. Casting of models is carried out with their simultaneous fixation in the occluder. There is no need to make wax rollers, thereby creating the conditions for saving auxiliary materials.

Example: Patient L., 32 years old, complained of violations of chewing function.

Objectively: Tooth 2.5 removed, 2.4 - intact, 2.6. - a seal was restored (Black class 1.2), thermometry (-), percussion (-) and sounding (-).

Diagnosis: Defect in the dentition of the upper jaw, Kennedy Grade 3.

Treatment plan: it is recommended to manufacture a stamped bridge with a support of 2.4, 2.6 teeth, to restore lost functions.

Treatment: we produce antiseptic dental treatment (3% hydrogen peroxide and furatsilina solution). Dissection of 2.4 and 2.6 teeth under stamped crowns. Immediate impression removal with alginate mass, for example “YPEEN” with the proposed spoon.

Indications for the use of this technique: patient I. experiences fear and stress at a dentist's appointment. To reduce the time spent at the doctor’s office, as well (the design of the spoon for receiving dental impressions makes it possible to simultaneously produce impressions from both jaws in the central occlusion position) to shorten the stage of manufacturing prostheses of a fixed structure, save impression material, a spoon was proposed for simultaneous removal of the impression with partial absence of teeth.

The technique of obtaining impressions: we produce antiseptic treatment of teeth (for example, a solution of furatsilina). Before removing the impression, a spoon is selected in size. To do this, the spoon is inserted into the oral cavity and is positioned so that the conjugations between the outer and inner sides are located behind the dentition.

Further, the patient is invited to close her teeth several times in a central occlusion, while the ease of closing the jaws and the level of the location of the spoon in relation to the dentition are controlled. The spoon is removed from the oral cavity.

After selecting a spoon, a prepared impression mass, for example, “YPEEN”, which fits into the through groove 5 between the outer 6 and inner edges of the 7 spoon, the spoon is inserted into the oral cavity and the patient is invited to slowly close the dentition, while controlling the placement of the spoon in the oral cavity by the handle of the spoon, which should be located along the line of closure of the lips and coincide with the median line of the face. After polymerization of the impression mass, the patient is invited to open his mouth and a spoon with an elastic impression is removed from the oral cavity. Upon receipt of impressions for the manufacture of metal stamped dentures, a small amount of alginate mass is sufficient. Further, the dental technician casts the models of the upper and lower jaws with their fixation in the occluder in a known manner.

Next visit: We produce antiseptic treatment of teeth and crowns (for example, 3% hydrogen peroxide, alcohol). We carry out the fitting of stamped crowns on the supporting teeth 2.4 and 2.6. Remove the impression with the same spoon with crowns. We remove the impression from the oral cavity.

Next visit: We perform antiseptic treatment of teeth and structures (for example, 3% hydrogen peroxide, alcohol). We carry out fitting and fixation of a stamped bridge with a support of 2.4, 2.6 teeth on a material for permanent fixation, for example, “Meron”.

At the Department of Orthopedic Dentistry VGMA them. In 85 patients, N.N. Burdenko made prostheses using the proposed spoon, and 30 impressions were made for the production of diagnostic models in patients with a continuously progressive course of schizophrenia in the regional clinical psychiatric hospital in the dental office. Using the proposed spoon allows you to get simultaneously impressions from both jaws in the central occlusion position, reduces the patient's time in the chair and saves impression materials and auxiliary (wax) by 32%.

Claims (1)

A spoon for simultaneous removal of impressions from the upper and lower jaws, containing a handle and a bed for impression material, made in the form of a tape curved in the shape of the alveolar ridge with the formation of a through groove for the impression material and including thickened working surfaces connected by horizontal jumpers, characterized in that thickened working surfaces are made in the form of vertically expanding sides in the area of the dentition defect from the vestibular and oral surfaces.

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