RU2471450C1 - Method of extending upper dentition with simultaneous normalisation of tongue position in patients with cleft palate - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to orthodontics, maxillo-facial surgery and logopedics and is intended for simultaneous orthodontic and logopedic correction. Impression from upper jaw is made. Gypsum model is cast. Rings for support teeth are selected on model. Palatal clasp is made. Metal guides, to which protracting springs are welded, are soldered to support rings of molar teeth. To palatal clasp, in the area of first molars, soldered are massage elements, formed by wire ends, directed downward, 3.5-4 mm long, in number of 2-3 pieces, with ends, shaped by plastic in form of balls with 2-2.5 mm diameter. Apparatus is fixed on support rings, after which medicamental processing of support teeth by means of glass-ionomer cement is performed. It is recommended to patient not to take in food within 2 hours. A repeat visit is appointed in a month.

EFFECT: method makes it possible to extend upper dentition, normalise position of tongue and incisors simultaneously due to application of frame fixed construction for upper dentition.

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Description

This technique relates to medicine, namely to orthodontics, maxillofacial surgery and speech therapy. It can be used in patients with single and bilateral cleft lip and palate, isolated cleft palate. There are several ways to expand the upper dentition:

- T.F.Kosyreva 03/09/2000 - patent No. 2189196 - an orthodontic device was proposed to normalize the shape and size of the dentition. The apparatus consists of a mouthguard with rings for abutment teeth with working bushings. A power arc with shape memory is installed in the working bushings. The free ends of the power arc are placed with the possibility of interaction with the support sleeves on the tooth rings. The working bushings have slots for installing a power arch made with a diameter of 0.45-0.5 mm and a length corresponding to the size of the correct dentition. Kappa is made in the form of three moving parts interconnected by a power arc. Working sleeves are fixed on the oral surfaces of the moving parts. Working and supporting bushings are made of metal and plastic. The result is improved interaction of the working parts with the patient’s dentition, the possibility of individual adjustment of the device and ease of installation in the oral cavity.

- in the USA Arndt, Wendell W., Berendt 02.27.1991 - patent No. 5167499 - offered an orthodontic device for palatine expansion. It consists of an orthodontic arch of the M-shaped configuration, which has a memory and retains its shape. The central segment of the M-shaped arc consists of nickel-titanium and falls on the projection of the anterior tooth group and provides expansion in the premolar region. The ends of the stainless steel arc or other biocompatible material are inserted into the palatine tubes located on the molars. The device provides a fan extension of the dentition in the area of premolars and molars, as well as rotation and introduction of molars of the upper jaw.

- Yu.V. Miklyaeva on July 6, 2001 - patent No. 2195244 - a method was proposed for correcting defects in sound pronunciation and a set of probes for massage the muscles of the tongue. The technical result of this method is the elimination of identified muscle syndromes, improving the conductivity of the nervous system, ensuring the stability of muscle tone during speech load. The method includes evaluating the state of the muscles of the tongue and subsequent instrumental massage. The sequence of techniques for massaging the muscles of the tongue is performed as a reflex-segmental massage using specially made probes. The probes are made of various shapes from wires of different diameters, correspond to the length and width of the tongue, adapted to massage certain muscle groups.

The disadvantages of this method are:

- the ability to normalize the function of the language without improvement

the position of the teeth of the upper jaw;

- the short duration of the therapeutic effect.

The disadvantages of the devices are:

- lack of influence on the normalization of the position of the language;

- inclination of supporting molars;

- distalization of molars.

The aim of this invention is the simultaneous expansion of the upper dentition, the normalization of the position of the incisors, massage of the back of the tongue, the normalization of the position and function of the tongue. This goal is achieved by using a fixed frame structure for the upper dentition.

The proposed method is as follows: for supporting teeth (in children from 3 to 8 years, the second temporary molars, older than 8 years, the first permanent molars of the upper jaw) select standard or make individual support rings that are connected to each other by a horseshoe-shaped palatal arch with a diameter of 1.2 mm . Along the lateral fragments of the alveolar process of the upper jaw, at the level of the crowns of the premolars and canines, metal guides with a diameter of 0.8 mm are laid, welded to the supporting rings of the molars. Active guiding elements with a diameter of 0.6 mm are welded to the guides at the level of the first premolars in the permanent bite and at the level of the first milk molars in the replacement bite and are brought under the central incisors. Around the ligature of the palatal clasp in the area of the first molars, a wire with a diameter of 0.6 mm is drawn in free ends in an amount of 2-3 pieces, a length of 3.5-4 mm, down, the free ends are formed with plastic in the form of balls with a diameter of 2-2.5 mm. The invention is illustrated in the drawing, where: 1 - support ring, 2 - massage balls, 3 - palatal clasp, 4 - metal guide, 5 - traction spring.

For the manufacture of this apparatus, an impression is taken from the upper jaw with an alginate impression mass, after which a plaster cast is cast. On the model, rings for supporting teeth are selected. Next, the model with the rings is transferred to the technical laboratory. A dental technician makes a palatal arch, metal guides, actively acting elements to expand the upper dentition and fits a loose wire. After that, all the elements of the apparatus are joined by spot welding, plastic is applied to the free ends of the wire, thus forming a massage element in the back of the tongue.

In the oral cavity, drug treatment of the abutment teeth is carried out, after which the apparatus is fixed on the abutment rings using glass ionomer cement. An occlusiogram is performed, premature contacts of the molars are eliminated by grinding the rings in height.

The patient is advised not to eat within 2 hours, a second visit after 1 month. The advantages of this technology are:

- A stable position of supporting molars throughout the course of treatment due to their stabilization by the palatal arch.

- The movement of the teeth of the anterior group in the transversal and sagittal direction and the expansion in the area of the first milk molars or premolars due to the monthly activation by the doctor of active elements.

- Round-the-clock massage of the back of the tongue, including during meals and talking.

- This treatment method is complex and includes orthodontic and speech therapy treatment of the patient through the use of only one device.

Claims (1)

A method of expanding the upper dentition with simultaneous normalization of the position of the tongue in patients with cleft palate, which consists in the fact that the frame fixed structure is fixed to the supporting molars using rings, while they are connected by the palatal arch, characterized in that metal guides are soldered to the supporting rings of the molars , to which the traction springs are welded, the palatal arch in the region of the first molars contains massage elements formed by the ends of the wire pointing downward, 3.5-4 mm long, in quantity There are 2-3 pieces, the ends of which are decorated with plastic in the form of balls with a diameter of 2-2.5 mm.

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