RU2491030C2 - Method of tooth extraction (versions) - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used for teeth extraction. Tooth is moved out of jaw by means of vertical effort, as such used is force of initial shape recovery of, at least, one active wire element from material with shape memory effect, which is curved from initial shape for the value which is not less than the value of required displacement of moved out of jaw tooth. When active wire element is installed into oral cavity, suitable section on moved out tooth, to which middle section of active wire element is fixed, is used as the point of application of recovery force. Two support teeth of one dentition, between which in the same dentition moved out of jaw tooth is located, to which terminal sections of active wire element are respectively fastened, are used as support. As active wire element used is segment of titanium nickelide wire with diameter 1.0-3.5 mm. To fasten middle and/or terminal section of active wire element to respective tooth fixation means in form of lock or bond is used. If two active wire elements are used, they are placed in oral cavity from two opposite sides of one dentition, in which tooth which is to be extracted, is located. Process of extracted tooth movement from jaw is realised for 14-40 days with vertical effort 15-35 gs. In case of two-stage tooth extraction, at the first stage tooth to be extracted is moved out of jaw until part of root of tooth to be extracted is moved out of alveolus. At the second stage the middle section of active wire element is detached from tooth to be extracted and is re-attached to it in the point of application of force located closer to root of tooth to be extracted than the point of force application at the first stage. At the first stage vertical effort 15-35 gs is provided, at the second stage vertical effort, which is less or equal to vertical effort, used at the first stage, is provided.

EFFECT: method makes it possible to extract teeth in patients who have contraindications to extraction of teeth by traditional methods due to small trauma of orthodontic tooth extrusion.

16 cl, 11 dwg, 3 ex

Description

The invention relates to dentistry, namely, to an atraumatic method for removing milk teeth in children and permanent teeth in adults.

The traditional method of removing teeth by pulling with forceps [for example, patent RU 2148385 C1, publ. 05/10/2000] due to mainly vertical effort, despite its simplicity and widespread use in dentistry, it has a number of contraindications. In particular, this method cannot be used if the patient suffers from hemophilia, thrombocytopenia or other blood diseases in which there is prolonged bleeding from the hole of the extracted tooth, stomatophobia, a number of neurological diseases, diabetes mellitus, etc. In addition, the pain and relatively high invasiveness of the traditional method can contribute to the development of stomatophobia, especially in children. Further, in most cases, when removing teeth in the traditional way, anesthesia is required, which also imposes a number of restrictions on its use.

Another traditional method of tooth extraction by pulling with a loop is known, which has somewhat lesser psychological and physiological trauma. For example, a tool is known for removing teeth in children using a tool in the form of a slingshot, to the ends of which a loop is attached [application JP 2004305681 A, publ. 11/04/2004]. However, practically the same contraindications and disadvantages are inherent in this method as the traditional method for removing teeth with forceps described above.

Meanwhile, it is known that in the field of dentistry such as orthodontics, in the treatment of such an anomaly, when an individual tooth does not reach the level of the occlusal plane, i.e. in supraocclusion and infraocclusion of individual teeth, orthodontic extrusion is used to extend the tooth from the jaw due to its body movement using a suitable orthodontic apparatus mainly in the vertical direction, i.e. in the same direction as with tooth extraction, only, unlike tooth extraction, here the tooth is extended from the jaw only until the level of the occlusal plane is reached, after which the retention stage of treatment is carried out in order to ensure stable remission after removal of the orthodontic apparatus.

There are various methods of orthodontic extrusion and related devices. In particular, orthodontic extrusion methods are known, according to which the force of restoring the original shape of the active wire element from a material with a shape memory effect, which is bent from the original by the amount of required movement when installed in the oral cavity, is used as the point of application of force as the acting vertical force use a suitable point on the tooth to be moved, to which the middle section of the active wire element is attached, and at the extreme there are at least two abutment teeth of the same dentition, between which the movable tooth is located and to which the extreme sections of the active wire element are attached, respectively.

For example, the above method is implemented in the known orthodontic apparatus, which comprises a support part with guide bushings, a bush fixed to the tooth being moved, and an active titanium nickelide wire element having shape memory and passing through all of the above bushings [patent RU 2148385 C1, publ. 05/10/2000]. The supporting part is made in the form of rigidly fixed orthodontic crowns, worn on at least two supporting teeth of the dentition, between which the movable tooth is located. The end holes of the bushings on the abutment teeth may be blocked by threaded caps.

This orthodontic device is used as follows. Orthodontic crowns are made in the shape of supporting teeth, and guide bushings are fixed on their vestibular surface. A sleeve is fixed on the crown fixed to the tooth, the direction of which relative to the axis of the tooth is determined by the program of its movement. Further, in the oral cavity, crowns are fixed on the abutment teeth and the crown on the moved tooth. The distal end of the sleeve of one of the crowns on the supporting teeth is closed with a cap. The active wire element is cooled and inserted into the bushings from the medial side. The medial end of the sleeve of the other of the crowns is also fixed with a cap. In the process of warming the shaft, the latter takes the form specified by the tooth movement program until the physiological bite is formed and remains as a fixing device for a retention period. At the same time, when using this orthodontic device, the movement program may include moving the tooth in the vestibulo-oral, mesio-distal and vertical directions (orthodontic extrusion).

However, it is not known from the prior art to use orthodontic methods and apparatuses similar to those described above for tooth extraction.

The main technical objective of the present invention is to develop an atraumatic method of tooth extraction in patients with contraindications to tooth extraction by traditional methods, in particular, patients suffering from hemophilia, thrombocytopenia, stomatophobia, a number of neurological diseases, diabetes mellitus, etc., due to the expansion of the field the use of suitable orthodontic appliances to the area of tooth extraction of both the upper dentition and the lower dentition.

To solve the technical problem, it is proposed to use the known method of orthodontic tooth extrusion, according to which the tooth is pulled out of the jaw using vertical force, which uses the force of restoration of the original shape of the active wire element from a material with a shape memory effect, which is bent from the original shape by an amount not less than the required movement of the tooth extended from the jaw when installing the active wire element in the oral cavity, as e points of application of the recovery force use a suitable area on the retractable tooth, to which the middle section of the active wire element is attached, and at least two abutment teeth of the same dentition, between which the tooth extends from the jaw is located in the same dentition, are used as a support to which the extreme sections of the active wire element are attached, respectively, as a method of tooth extraction.

Here, a significant significant difference is that in the area of orthodontics, the moved tooth is advanced from the jaw a relatively small distance, not allowing the tooth root to be removed from the avelola, i.e. solely for the purpose of correcting the position of this tooth, and in the present invention, on the contrary, orthodontic extrusion is used to remove the root of the tooth from Avelola completely for a relatively long time with relatively small efforts, which determines the non-invasiveness of the claimed method.

Using the claimed method, it is possible to remove not only permanent teeth in adults, but also milk teeth in children.

As an active wire element, it is better to use a piece of titanium nickelide wire with a diameter of 1.0-3.5 mm.

It is better to choose the length and initial arc shape of the active wire element corresponding to the length and arc shape of the part of the dentition, including the tooth to be removed and supporting teeth adjacent to it, when the active wire element is placed in the oral cavity in a position in which its longitudinal axis lies in a plane that parallel to the occlusal plane or at an acute angle to it.

To attach the middle portion and / or the outermost portion of the active wire element to the corresponding tooth, a fixation tool in the form of a bond can be used to attach the portion of the active wire element directly to the surface of the corresponding tooth or to the surface of the crown mounted or mounted on the tooth.

Also, to attach the middle portion and / or the outermost portion of the active wire element to the corresponding tooth, you can use the fixation tool in the form of a lock, fixed on the surface of the tooth or crown using a bond or attached to the crown, mounted or mounted on the tooth, to which the corresponding section is attached active wire element. In this case, it is possible to use a lock that allows the active wire element to move relative to the lock along the arch of the dentition.

According to one embodiment, two active wire elements can be used that are located in the oral cavity on two opposite sides of the same dentition in which the tooth is removed.

The active wire element is removed from the oral cavity after the complete extraction of the root of the extracted tooth from the alveoli.

The process of extending the extracted tooth from the jaw is best carried out within 14-40 days.

It is better to provide a vertical force of 15-35 gf.

The method may include two stages, in the first of which the extracted tooth is pulled out of the jaw until the part of the root of the removed tooth is extended from the avelola, and in the second stage, the middle section of the active wire element is detached from the removed tooth and reattached to it at the point of application of force located closer to the root of the tooth being removed than the point of application of force in the first stage, after which the tooth being removed is pulled out of the jaw until the root of the tooth being removed is completely extended from the avelola. Here, it is better when the process of extending the extracted tooth from the jaw at each stage is carried out within 14-40 days.

In the second stage, the middle section of the active wire element is best attached to the neck of the tooth being removed.

At the first stage, it is better to provide a vertical force of 15-35 gf, and at the second stage, a vertical force that is less than or equal to the vertical force used at the first stage.

The middle portion of the active wire element in the one-stage method or in the first stage of the one-stage method is better to attach closer to the cervical part of the extracted tooth.

Further, the invention will be explained in more detail using examples using references to the accompanying drawings, in which:

figure 1 is a schematic top view of the lower row of teeth with mounted orthodontic apparatus according to one embodiment of the method of the present invention;

figure 2 is a front view of the lower row of teeth with mounted orthodontic apparatus at the initial stage of tooth extraction according to the embodiment of figure 1;

figure 3 is a front view of the lower row of teeth with mounted orthodontic apparatus at the final stage of tooth extraction according to the embodiment of figure 1;

4 is a schematic bottom view of the upper row of teeth with an orthodontic apparatus mounted on them according to another embodiment of the method of the present invention;

5 is a front view of the upper row of teeth with an orthodontic apparatus installed on them at the initial stage of tooth extraction according to the embodiment of FIG. 4;

6 is a front view of the upper row of teeth with the orthodontic apparatus installed on them at the final stage of tooth extraction according to the embodiment of FIG. 4;

7 is a schematic top view of the lower row of teeth with an orthodontic apparatus installed on them according to another embodiment of the method of the present invention;

Fig. 8 is a front view of the lower row of teeth with an orthodontic apparatus installed on them at the initial stage of the first stage of tooth extraction according to the embodiment of Fig. 7;

Fig.9 is a front view of the lower row of teeth with an orthodontic apparatus installed on them at the final stage of the first stage of tooth extraction according to the embodiment of Fig.7;

figure 10 is a front view of the lower row of teeth with an orthodontic apparatus installed on them at the initial stage of the second stage of tooth extraction according to the embodiment of Fig.7;

11 is a front view of the lower row of teeth with an orthodontic apparatus installed on them at the final stage of the second stage of tooth extraction according to the embodiment of FIG. 7.

As shown in all FIGS. 1-11, an orthodontic apparatus 1 is used to implement the method of the present invention, generally comprising an active wire element 3 with fixation means 2 on the abutment teeth and the tooth extended from the jaw, i.e. on the tooth to be removed.

In a preferred embodiment, the active wire element 3 is made of a piece of wire of titanium nickelide (Ni-Ti or nitinol) with a diameter of 1.0-3.5 mm, for example, an industrially produced wire of nitinol with a diameter of 0.12 ". However, the present invention is not limited to the use of such a nitinol wire, and any suitable material with a shape memory effect, for example, martensitic metal alloys (Cu-Zn-Al, Cu- Al-Ni, Co-Ni, etc.), and polymers that are currently being created with a shape memory effect, for example, based on relatively small molecules that are connected by metal ions (compositions based on ultra-high molecular weight polyethylene on and polysiloxane, etc.).

The length and initial arc shape of the active wire element 3 is selected corresponding to the length and arc shape of the part of the dentition, including the tooth being removed and supporting teeth adjacent to it, between which the tooth is being removed, based on the fact that the preferred location of the active wire element 3 in the oral cavity is the position in which its longitudinal axis lies in a plane parallel to the occlusal plane (options for tilting to this plane at a relatively small acute angle in various directions depending on the specifics of the dentition of the patient).

At the preliminary stage, in addition to the selection of the active wire element 3, as described above, the selection of fixing means 2 is carried out.

As a fixing means in the simplest embodiment, any suitable bond can be used that can fix the corresponding portion of the active wire element directly on the surface of the corresponding tooth, for example, on pre-etched enamel, or on the surface of a temporary crown mounted on a tooth or mounted on a tooth (temporary crown). Any suitable bond can be used here: chemical curing adhesives, glass-curing light curing cements, light curing composite materials, etc.

Also, any other means known in orthodontics, for example, conventional orthodontic locks fixed to the etched enamel area of the vestibular surface of the teeth, for example, tube locks [patent RU 2144335 C1, publ. 01/20/2000] or locks-bushings [patent RU 2148385 C1, publ. 05/10/2000]. In this case, the lock should ensure that the portion of the active wire element 3 is securely fixed to the corresponding tooth, at least in the vertical direction. Moreover, such embodiments are possible, in particular when using a lock-tube or lock-sleeve, when the active wire element 3 has the ability to move relative to the lock (and, accordingly, relative to the corresponding tooth) along the arch of the dentition. In the latter case, various options are possible. For example, the middle section of the active wire element 3 can be fixed on the tooth to be removed with the possibility of moving relative to the lock along the arch of the dentition, while one extreme section or both extreme sections of the active wire element 3 are fixed on the supporting tooth or teeth without allowing any relative movement. Alternatively, the middle portion of the active wire element 3 may be fixed to the tooth being removed without any movement, with one extreme portion or both extreme sections of the active wire element 3 being fixed to the supporting tooth or teeth with the possibility of movement relative to the lock along the arch of the dentition. These options are selected depending on the specifics of the patient’s dentition in order to slightly move the supporting tooth or teeth from the tooth being removed or, conversely, to bring it closer to it.

Also, at the preliminary stage, the necessary amount of displacement of the extracted tooth should be determined, for example, on the basis of an X-ray examination. Usually, this amount of displacement of the extracted tooth is 2-3 mm for primary teeth, and 4-5 mm for permanent teeth.

Next, you need to determine the methodology of tooth extraction based on the following recommendations.

The orthodontic apparatus 1 described above may have a single or double construction, i.e. in the first case, the orthodontic apparatus 1 includes one active wire element 3 with fixation means 2 installed in the oral cavity from the side of one surface of the teeth of the dentition, mainly vestibular (see Figs. 1-3), and in the second case, one active wire element 3 with its means of fixation 2 is installed in the oral cavity from the side of the vestibular surface of the teeth of the dentition, and the second active wire element 3 with its means of fixation 2 is from the palatine surface (see Figs. 4-6 or Figs. 7-11).

An orthodontic apparatus 1 of a single construction (see Figs. 1-3) is recommended for use when removing incisors or canines of a milk bite with a resorbed root, and an orthodontic apparatus 1 of a dual construction is used to remove canines of a permanent occlusion, premolars or molars.

The process of removing a milk tooth is recommended to be planned in one step, which takes time from the installation of an orthodontic apparatus 1 in the oral cavity to the complete extraction of the root of the removed milk tooth from the alveoli (see Figs. 1-3 and Figs. 4-6).

The process of removing a permanent tooth is recommended to be planned in two stages, where at the first stage a part of the root of the removed permanent tooth is pulled out from the alveoli (see Figs. 7-9), and in the second stage, using the same orthodontic apparatus 1, the root of the removed tooth is pulled out of aveloli completely (see figures 10-11).

To remove the tooth, first the orthodontic apparatus 1 is installed in the oral cavity so as to attach to the crown part of the abutment teeth the extreme sections of the active wire element 3 by means of fixation 2. Here, as abutment teeth, one tooth can be used located on opposite sides of the tooth being removed adjacent to it (see FIGS. 4-6), or two teeth on each side of the tooth being removed (see FIGS. 1-3 or FIGS. 7-11). Other options are possible.

Further, at the location of the tooth to be removed, the force applied to the active wire element 3 is directed to the cervical part of the tooth to be removed, for example, by pressing a finger on the middle portion of the active wire element 3 towards the cervical part of the tooth to be removed. Under the influence of such an applied force, the active wire element 3 bends arcuately mainly in a vertical plane from its original shape. Here, usually, a bending arrow is used, equal to the above amount of movement of the extracted tooth, i.e. 2-3 mm for deciduous teeth or 4-5 mm for permanent teeth. Immediately after this, the curved middle portion of the active wire element 3 is fixed on the tooth to be removed closer to its cervical part using suitable fixation means 2, after which the initial stage of tooth extraction immediately begins (see Figs. 1-2, Figs. 4-5 and 7-8).

Under the action of martensitic transformation forces, the active wire element 3 seeks to return to its original shape, while creating a vertical force that pushes the tooth to be removed from the jaw to extract the tooth root from the avelola. For example, if you use a wire segment of nitipole with a diameter of 0.12 '' as an active wire element 3, with a deflection arrow of 2-5 mm, a vertical force of 15-35 g is ensured (in some cases, this force is optimal up to 25 g ), which ensures the return of the active wire element 3 to its original form with the corresponding extension of the tooth root from the avelola for 14-40 days.

In a single-stage tooth extraction process, after 14-40 days, the root of the extracted tooth is fully extended from the avelola (see Figs. 1-3 and Figs. 4-6).

In a two-stage process, after 14-40 days, the root of the extracted tooth is partially ejected from the avelola (see Fig. 9), after which the middle portion of the active wire element 3 is detached from the removed tooth and reattached to it, but already to the neck of the removed tooth (see Fig. 10), after which after 14-40 days the root of the extracted tooth is fully advanced from the avelola (see Fig. 11).

The optimal duration of tooth extraction is a period of about 30 days for a one-stage process, and about 30 days for each of the stages of a two-stage process.

After the complete extension of the root of the extracted tooth from the avelola at the final stage of tooth extraction (see Fig. 3, 6 or 11), the orthodontic apparatus 1 is removed and removed from the oral cavity together with the removed tooth.

The proposed method of tooth extraction is further illustrated by clinical examples in the form of extracts from the medical history.

Example 1 (see FIGS. 1-3).

Daniel, 6.5 years old.

September 7, 2008. Tooth 31 (incisor 1 on the lower jaw on the left) cut through 1/4 of the size of the crown and is located lingually behind tooth 71 (milk incisor I on the lower jaw on the left). Diagnosed tooth mobility 71 II degree. According to x-ray diagnostics, physiological resorption of tooth root 71 is observed for 1/2 length. According to the anamnesis, the child suffers from thrombocytopenia. On the crown parts of tooth 71, tooth 72 (milk incisor II on the lower jaw on the left), tooth 73 (milk canine III on the lower jaw on the left), tooth 81 (milk incisor I on the lower jaw on the right), tooth 82 (milk incisor II pa lower jaw on the right), when using a photocomposite dental adhesive, a piece of pitinol wire with a diameter of 0.12 '' was fixed (see figure 1). On the tooth 71, a curved section of the wire segment is fixed closer to the cervical region of this tooth (see figure 2).

When viewed on September 28, 2009, as a result of vertical movement, tooth 71 left the alveoli and its root was exposed (see Fig. 3), after which the wire segment from tooth 72, tooth 73, tooth 81 and tooth 82 was bonded.

Example 2 (see FIGS. 4-6).

Masha, 10 years old.

07/05/2009 The tooth mobility 64 is diagnosed (the first milk molar IV in the upper jaw on the left) II degree. On the orthopantomogram, physiological resorption of the roots of the tooth 64 is observed to be 1/2 of the length, while a root in length is formed at the tooth germ 24 (the first premolar 4 on the upper jaw on the left). The child suffers from stomatophobia. On tooth 63 (milk canine III on the upper jaw on the left), tooth 64, tooth 65 (second milk molar V on the upper jaw on the left) from the vestibular and palatine surfaces of the dentition, two pieces of nitinol wire with a diameter of 0 were fixed using a photocomposite dental material, 12 '' (see figure 4). On the coronal part of the tooth 64, the curved sections of the wire segments are fixed closer to the cervical region of the tooth (see figure 5).

When viewed from 08/05/2009, as a result of vertical movement, tooth 64 emerged from the alveoli and its root was exposed (see Fig. 6), after which the wire sections were bonded on both sides of tooth 63 and tooth 65.

Example 3

Olga Nikolaevna, 40 years old.

10/09/2010 of the year. Complains of soreness of a crowned tooth located on the lower jaw on the right. When examining the oral cavity, a metal-ceramic crown was found on tooth 44 (the first premolar 4 on the lower jaw on the right). According to the orthopantomogram, local periodontitis of moderate severity in the tooth region 44 is noted and its mobility of the II degree is diagnosed. When collecting the anamnesis, it turned out that the patient has an allergic reaction to previously introduced anesthetics, and there is also a concomitant disease: hypertension. On tooth 42 (incisor 2 on the lower jaw on the right), tooth 43 (fang 3 on the lower jaw on the right), tooth 44), tooth 45 (second premolar 5 on the lower jaw on the right), tooth 46 (first molar 6 on the lower jaw on the right) from the vestibular and lingual surfaces of the dentition, two pieces of nitinol wire with a diameter of 0.12 '' were fixed using a photocomposite material (see Fig. 7). On the coronal part of the tooth 44, the curved sections of the wire segments are fixed closer to the cervical region of this tooth (see Fig. 8).

When examined on November 7, 2010, as a result of vertical movement, tooth 44 moved out of the alveoli, as a result of which the roots of the tooth were exposed 1/4 of the length (see Fig. 9), after which the middle sections of the wire segments were re-glued below (see figure 10).

On examination 10.12.10, tooth 44 moved out of the alveoli completely (see Fig. 11), after which both segments of wire from tooth 42, tooth 43, tooth 45 and tooth 46 were bonded.

It should be understood that the above examples are used only to illustrate the possibility of carrying out the invention and a number of its advantages, and these examples are not limited by the scope of legal protection presented in the claims, while the specialist in the field of dentistry is relatively simple able to carry out other variants of the invention without departure from the scope of legal protection.

Claims (16)

1. A method of tooth extraction, according to which the tooth is pulled out of the jaw using a vertical force, characterized in that the tooth is pulled out of the jaw using orthodontic extrusion of the tooth, while the vertical force is used to restore the original shape of at least one active wire an element made of a material with a shape memory effect, which is bent from the original shape by an amount not less than the required movement of the tooth extended from the jaw when installing an active wire In the oral cavity, as a point of application of the restoration force, use a suitable area on the retractable tooth, to which the middle section of the active wire element is attached, and at least two abutment teeth of the same dentition, between which are in the same dentition, are used as a support a row is located a tooth extended from the jaw, to which the extreme sections of the active wire element are attached, respectively. 2. The method according to claim 1, characterized in that the milk tooth is removed. 3. The method according to claim 1, characterized in that as an active wire element using a piece of wire made of titanium nickelide with a diameter of 1.0-3.5 mm 4. The method according to claim 1, characterized in that the length and initial arc shape of the active wire element is selected corresponding to the length and arc shape of the part of the dentition, including the tooth to be removed and the abutment adjacent to it, when the active wire element is placed in the oral cavity in position in which its longitudinal axis lies in a plane that is parallel to the occlusal plane or is at an acute angle to it. 5. The method according to claim 1, characterized in that for fixing the middle section and / or the extreme section of the active wire element to the corresponding tooth, a fixation tool in the form of a bond is used. 6. The method according to claim 1, characterized in that for fixing the middle section and / or the extreme section of the active wire element to the corresponding tooth, fixing means are used in the form of a lock fixed on the corresponding tooth. 7. The method according to claim 6, characterized in that they use a lock that allows the active wire element to move relative to the lock along the arc of the dentition. 8. The method according to claim 1, characterized in that the second active wire element is used, while the wire elements are located in the oral cavity from two opposite sides of the same dentition in which the tooth is removed. 9. The method according to claim 1, characterized in that the active wire element is removed from the oral cavity after the complete extraction of the root of the extracted tooth from the alveoli. 10. The method according to claim 9, characterized in that the process of advancing the extracted tooth from the jaw is carried out within 14-40 days. 11. The method according to claim 1, characterized in that they provide a vertical force of 15-35 gf. 12. The method according to claim 1, characterized in that the middle portion of the active wire element is attached closer to the cervical part of the extracted tooth. 13. A method of tooth extraction, according to which the tooth is pulled out of the jaw using vertical force, characterized in that the tooth is pulled out of the jaw in two stages by orthodontic extrusion of the tooth using at least one active wire element as the vertical force to restore the original shape from a material with a shape memory effect, in this case, at the first stage, the active wire element is bent from the original shape by an amount not less than the amount of required tooth movement, put forward of the jaw, when installing the active wire element in the oral cavity, as a point of application of the recovery force, use a suitable area on the retractable tooth, to which the middle section of the active wire element is attached, and at least two abutment teeth of one dentition are used as a support, between which in the same dentition there is a removable tooth extended from the jaw, to which the extreme sections of the active wire element are attached, respectively, and the removed tooth is pulled out of the person until the part of the root of the tooth to be removed from the alveoli, and in the second stage, the middle section of the active wire element is detached from the tooth being removed and reattached to it at the point of application of force located closer to the root of the tooth being removed than the point of application of force in the first stage, after which the extracted tooth is pulled out of the jaw until the root of the removed tooth is completely extended from the alveoli. 14. The method according to item 13, wherein the process of advancing the extracted tooth from the jaw at each stage is carried out within 14-40 days. 15. The method according to item 13, wherein in the first stage, the middle section of the active wire element is attached closer to the cervical part of the extracted tooth, and in the second stage, the middle section of the active wire element is attached to the neck of the removed tooth. 16. The method according to item 13, wherein in the first stage provide a vertical force of 15-35 g, and in the second stage provide a vertical force that is less than or equal to the vertical force used in the first stage.

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