RU2759124C1 - Method for determining narrowing of upper jaw, taking into account height of arch of hard palate in children with different degrees of severity of connective tissue dysplasia - Google Patents

Abstract

FIELD: dentistry.

SUBSTANCE: invention relates to dentistry and can be used to correct dentoalveolar anomalies of the upper jaw in children with connective tissue dysplasia, which is necessary when carrying out complex medical and social rehabilitation and prevention of its complications. The method for determining the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate in children with various degrees of severity of connective tissue dysplasia, is characterized by the fact that a device is used that includes a measuring device for determining linear dimensions with a specified accuracy, containing a bar with a scale and a depth gauge ruler, on which a fixed and a movable jaw for external measurements, made in the form of a truncated plate with a figured edge, on each of which oval and round threaded through holes are selected, and the movable jaw is equipped with a fixing screw, at the same time, removable intraoral pads are attached to the sponges, made in the form of a triangular plate with a needle-shaped end part at the apex, on each of which a recess is selected on the reverse side for seating and fixing the sponge plate in it, while in the recess area a figured protrusion is made for a dense and a straight fit and a through hole for the passage of the fixing screw, for which the assembled device is inserted into the oral cavity and, holding the ruler and spreading the jaws, the end parts of the intraoral pads are placed on the measuring points, located in the middle of the longitudinal fissures of the first premolars and the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw, where the values ​​of the narrowing of the upper jaw are recorded and, comparing with the values ​​of the height of the fornix of the hard palate, the severity of connective tissue dysplasia is diagnosed.

EFFECT: use of the invention provides an increase in the efficiency of treatment of dentoalveolar deformities due to the operational implementation of complex therapy with dynamic monitoring at the stages of correction of dentoalveolar anomalies.

1 cl, 3 tbl, 8 dwg

Description

The invention relates to dentistry and can be used to correct dentoalveolar anomalies of the upper jaw in children with connective tissue dysplasia, which is necessary when carrying out complex medical and social rehabilitation and prevention of its complications.

A known method of express diagnostics of the narrowing of the dental arch of the upper jaw in a permanent bite (see RU No. 2372028, class A61B 5/103, publ. 10.11.2009), in which a point located between the medial tops of the corners is transferred to a dense plate of transparent material crowns of central incisors, a point in the middle of the longitudinal fissures of the first premolars on the right and the corresponding point on the left, the anterior crossing point of the longitudinal and transverse fissures of the first molars on the right and the corresponding point on the left, a point located at the apex of the distal palatine tubercle of the first molar on the right and the corresponding point on the left ... Draw a straight line through two molar points on the right. Draw a second straight line through two molar points on the left. Connect the point of intersection of these straight lines with the point between the medial apexes of the corners of the crowns of the central incisors. Measure the distance from the obtained straight line to the points of the premolars on the right and left and the distance to the anterior points of intersection of the longitudinal and transverse fissures of the first molars on the right and left. The lengths of the right and left segments are used to diagnose one- or two-sided narrowing of the dental arch of the upper jaw and determine its quantitative value.

The known technical solution does not allow assessing the narrowing of the dentition of the upper jaw, taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia, because is intended in general for orthodontic treatment, for example, for express diagnostics of the narrowing of the dental arch of the upper jaw.

There is also known a method for measuring a method for diagnosing anomalies of the dentition in the sagittal direction on models of jaws in a permanent bite (see RU No. 2248751, class A61B 5/103, publ. 27.03.2005), while taking impressions from the upper and lower jaws, making plaster models of the jaws, determine the distance between the point formed at the intersection of the line drawn along the distal surfaces of the first molars and the perpendicular lowered onto it along the midline of the corresponding jaw from the mesial point on the labial approximal surface of the vestibularly located upper incisor when measured on the upper jaw, or the contact point of the central lower incisors when measured on the lower jaw.

In addition, there is a known method for assessing anomalies of the upper dentition in the sagittal direction (options) (see RU No. 2303396, class A61B 5/103, publ. 27.07.2007), where anomalies of the upper dentition in the sagittal direction are assessed with taking an impression from the upper jaw and the manufacture of a plaster control and diagnostic model. At the same time, the actual length of the anterior segment of the upper dental arch of a given patient is measured on the model - from the point between the medial incisors from their vestibular surface along the sagittal plane to the point of intersection with the line connecting the first premolars between the points Pont, where the optimal individual length of the anterior segment of the upper dental arch is determined ... It is compared with the actual length of the anterior segment of the patient's upper dental arch and, by their difference, the norm or severity of the anomaly is judged.

However, according to the known solutions, it is impossible to quickly and accurately assess the narrowing of the upper jaw, depending on the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia of mild, moderate and severe degrees, since there are no basic, clinically valid data of narrowing of the upper jaw, depending on the depth of the arch hard palate.

From the scientific literature, a method for measuring the height of the hard palate is known (see the Guide to Orthodontics / edited by F.Ya. 121), in which the height of the palate is measured using a planimeter or Corkhouse symmetrograph with a shearing grating at the level of the first premolars and the first permanent molars. In this case, the shearing grating is installed during examination in the frontal plane at the Pona measuring points on the premolars, and then on the molars. In accordance with the location of the ends of the symmetrograph needles, the contours of the teeth from the vestibular, chewing and lingual surfaces are drawn on a paper tape with a millimeter grid, then the contours of the alveolar process on the right and left halves of the jaw to the transitional fold of the mucous membrane from the vestibular surface and to the middle of the fornix of the palate from the lingual surface. After that, the median plane is marked and a tangent is drawn to the tubercles of the premolars and molars when oriented to the median palatine suture. In the drawing, the height of the fornix of the palate is determined at the level of the premolars and molars of the upper jaw. The results obtained are compared with the data typical for orthognathic occlusion, and the severity of the anomalies is assessed.

The known methods are distinguished by the complexity of the technological stages of their implementation and are not suitable for assessing the parameters of the narrowing of the upper jaw, depending on the height of the fornix of the hard palate, taking into account the severity of connective tissue dysplasia, for example, in outpatient dental conditions and, if necessary, additional studies on diagnostic plaster models upper jaw.

The method for determining the height of the fornix of the hard palate in children with connective tissue dysplasia (see RU No. 2672369, cl. A61B 5/107, A61C 19/04, publ. 11/14/2018) involves the use of a measuring rod with a handle, made in the form of a vertical ruler with a scale, fixedly mounted on one edge on the handle, and, on the ruler, a support bar is frictionally installed, for which, the device is inserted into the oral cavity and, holding by the handle, the support bar is placed between the second premolars and the first molars of the upper jaw, after which, advancing and turning the measuring ruler all the way towards the deepest point of the hard palate arch, fix the height of the hard palate arch.

The known solution can determine the height of the fornix of the hard palate, while not taking into account various anomalies of occlusion and deformation of the dentition of the upper jaw, which are detected in children with connective tissue dysplasia.

The problem to be solved by the claimed invention is to assess the narrowing of the upper jaw, mainly in children, taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia.

The technical effect obtained when solving the problem is expressed in carrying out accurate biometric measurements of the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia, incl. during outpatient dental procedures and on control diagnostic plaster models of the upper jaw, the results of which contribute to an increase in the effectiveness of treatment of dentoalveolar deformities, in particular, with anatomical deformities in the height of the fornix of the hard palate with varying degrees of severity of connective tissue dysplasia in children, due to the prompt implementation of complex therapy with dynamic monitoring at the stages of correction of dentoalveolar anomalies.

To solve the problem, a method for determining the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate in children with various degrees of severity of connective tissue dysplasia, is characterized by the fact that a device is used that includes a measuring device for determining linear dimensions with a specified accuracy, containing a bar with a scale and a depth gauge ruler , on which a fixed and movable jaw for external measurements is installed, made in the form of a truncated plate with a figured edge, on each of which oval and round through holes are selected with a thread, moreover, the movable jaw is equipped with a fixing screw, while removable intraoral overlays made in the form of a triangular plate with a needle-shaped end part at the top, on each of which a recess is selected on the reverse side for landing and fixing the sponge plate in it, while in the area of the recess there is a figured protrusion for a tight and even fit and a through hole for the passage of the fixing screw, for which, the assembled device is inserted into the oral cavity and, holding the ruler and pushing the jaws apart, the end parts of the intraoral pads are placed on the measuring points located in the middle of the longitudinal fissures of the first premolars and the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw, where the values of the narrowing of the upper jaw are recorded and, comparing with the values of the height of the fornix of the hard palate, the severity of connective tissue dysplasia is diagnosed. In addition, the device for measuring the constriction of the upper jaw contains a digital readout device.

Comparative analysis of the features of the claimed solution with the features of analogs indicates the compliance of the declared solution with the "novelty" criterion.

The set of essential features provides a solution to the stated technical problem, namely, an increase in the efficiency of diagnostics of the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia in children by performing simple diagnostic manipulations and prompt implementation of the drawn up plan of therapeutic and prophylactic actions to restore the narrowing and dentoalveolar anomalies of the upper jaw.

It is known that connective tissue dysplasia (CTD) is a genetically determined disorder of its development, characterized by defects in its basic substance and fibers. Currently, among the main causes of DST, there are changes in the rates of synthesis and assembly of collagen and elastin, the synthesis of immature collagen, and a violation of the structure of collagen and elastin fibers due to their insufficient cross-linking. This indicates that in DST, connective tissue defects in their manifestations are very diverse. At the morphogenetic level, the organs and tissues of the oral cavity are of connective tissue origin. At the same time, in children, changes in the hard palate are determined, as well as a high level of prevalence of dentoalveolar anomalies, dental caries, periodontal and temporomandibular joint (TMJ) diseases, but also other organs and systems.

The degree of CTD, as a rule, is determined by the method of T. Milkovsk-Dmitrova and A. Karkashev (1985) (see table 1): mild (I degree) - diagnosed in the presence of two main signs; medium (II degree) - with 3 major and 2-3 minor or 3-4 major and 1-2 minor; severe (III degree) - is determined in the presence of 5 main and 3 minor signs. Determination of the severity of CTD in each specific child is calculated by the sum of points. At the first (mild) severity of CTD (variant of the norm), the sum of points should not exceed 12, and at the average - 23. At severe severity, it is 24 or more points. In this case, the height of the vault of the hard palate is determined by means of a known device for measuring the height of the vault of the hard palate (see table 2, RU No. 177476, cl. A61B 5/107, publ. 02/26/2018).

In this case, to measure the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia, a device is used, which is based on a standard reading device for determining the linear dimensions of parts with a specified accuracy.

This device is illustrated in the drawing, where figure 1 shows a general assembly diagram of the device (front view); figure 2 is a general assembly diagram of the device (rear view); figure 3 is a general view of the assembled device; Figure 4 - removable intraoral pads of the device (A - front view, B - back side view). In addition, figure 5 shows a diagram of the measurement of the width of the dentition of the upper jaw when fixing in the middle of the longitudinal fissures of the first premolars of the upper jaw; figure 6 is a diagram of measuring the width of the dentition of the upper jaw when fixing at the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw; figure 7 is a diagram of measuring the width of the dentition on a plaster model of the upper jaw when fixing in the middle of the longitudinal fissures of the first premolars of the upper jaw; figure 8 is a diagram of measuring the width of the dentition on a plaster model of the upper jaw when fixing at the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw.

Thus, the claimed device is based on a standard measuring device for determining the linear dimensions of parts with a specified accuracy, for example, a digital caliper type (see https://aziada.ru/blog/electronny-shtangentsirkul-electronic-digital-caliper-instrykcia- na-russkom), while stationary 1 and movable 2 jaws for measuring external dimensions are made in the form of a truncated plate, on which two through holes 3, 4 are selected. intraoral pads for fixed 5 and movable 6 measuring jaws 1, 2. And in the hole 4 a thread is cut to connect with the screw 7 of the pad. In addition, a probe-depth gauge 8 is used for measurements (see Figs. 1, 2).

The measurement results are projected onto the display 9 (with the digital version of the measuring device), which is aligned with the movable jaw 2, or fixed on the scale of the measuring ruler 10 of the device by means of the screw 14 (see Fig. 3).

The pads 5, 6 are made of tool steel in the form of a triangular plate, on the top of which needle-shaped end portions 11 are made, and the edge of the needle coincides with the measuring surface of the patch. At the same time, on the reverse side of the plates, recesses are selected for a tight and even fit of the pads 5, 6 on the measuring jaws 1, 2. For this, a figured protrusion 12 is made on the plates for subsequent landing in the oval hole 3 of the jaw and a through hole 13 is selected for the passage of the screw fasteners (see Fig. 4).

To assemble the device on the jaws 1, 2, the pads 5, 6 are sequentially installed by fitting the protrusions 12 onto the fixing holes 3 and fastening with screws 7. This ensures a strict coincidence of the measuring surfaces of the jaws and pads.

In order to exclude possible injury to patients during measurement work, all parts of the device are made with streamlined shapes and without sharp corners.

The claimed technical solution for assessing the degree of narrowing of the upper jaw depending on the deformation of the hard palate in children with connective tissue dysplasia using a new device for measuring the narrowing of the upper jaw can be implemented by measurements both directly at the patient himself and on plaster control and diagnostic models of the upper jaw , obtained by taking an impression from the upper jaw with a clear imprint of the hard palate and dentition.

The method is implemented as follows.

The removable working parts of the measuring device are sterilized by known methods, for example in an autoclave. For assembly, the pads 5, 6 are fixed on the jaws 1, 2 by means of screws 7, while strictly observing the coincidence of the measuring surfaces of the jaws and pads.

The assembled device, holding by the measuring ruler, is introduced into the cavity of the patient's open mouth, having previously zeroed the readings on the instrument's ruler. Further, pushing apart the jaws 1, 2, the needle-shaped end parts 11 of the intraoral pads 5, 6 are fixed by means of a screw 14 at the measuring points that are located in the middle of the longitudinal fissures of the first premolars (see figure 5) and the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw (see figure 6), after which, remove the obtained values with an accuracy, for example, to hundredths of a millimeter.

To obtain objective data, the standard Pon-Linder-Hart method is used to determine the width of the dentition in children with permanent occlusion, while the presence of a relationship between the sum of the mesiodistal dimensions of the incisors and the width of the dentition in the area of the first premolars and molars is established. Further, the interpretation of the obtained data of the narrowing of the upper jaw is carried out, depending on the indicators of the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia. Thus, the doctor can easily determine the measuring points, which are located in the middle of the longitudinal fissures of the first premolars and the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw.

At the same time, the readings obtained by measurements are data for the subsequent determination of morphological deformities of the upper jaw in children with varying degrees of severity of CTD. The authors of the claimed invention have established the parameters of morphological deformations in the form of narrowing of the upper jaw taking into account the height of the arch of the hard palate at various degrees of severity of connective tissue dysplasia in children. In the structure of severity, the most frequently detected average degree (55.12 ± 1.05%), then mild degree - 32.05 ± 1.59% and severe degree - 12.83 ± 2.04%. In addition, studies have established that with a mild severity of CTD, the narrowing of the upper jaw between the premolars reaches -2.57 + 0.13 and the molars -2.16 + 0.15, the average - -2.90 + 0.17 and - 2.57 + 0.24, and severe - -6.69 + 0.47 and -6.58 + 0.43 (see table 3).

In the case of using plaster diagnostic models, an impression is taken from the upper jaw with the obligatory receipt of a clear imprint of the hard palate and dentition, according to which a control and diagnostic model of the upper jaw is made, then the narrowing of the upper jaw is measured using a new device. To do this, the end parts 11 of the device are installed between the measuring points, which are located in the middle of the longitudinal fissures of the first premolars (see figure 7) and the anterior point of intersection of the longitudinal and transverse fissures of the first molars (see figure 8) of the upper jaw. The obtained measurement readings are data for the subsequent determination of morphological deformities of the upper jaw in children with varying degrees of severity of CTD.

Thus, on the basis of the obtained measurement results, the narrowing of the upper jaw is determined taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia in children.

In contrast to the known solutions, a new method for determining the dependence of the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate with various degrees of severity of connective tissue dysplasia in children, has the following advantages:

- the versatility of the method in measuring in the oral cavity and on diagnostic plaster models, determines its ease of use;

- the ability to control the measurement by the doctor, carried out by simple adjustment of the movable jaw, which ensures the accuracy of the measurement;

- the possibility of adjusting the fixation of the needle-shaped end parts of the intraoral removable pads for measuring the width of the dentition of the upper jaw within the measuring points in the middle of the longitudinal fissures of the first premolars and the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw;

- removable intraoral overlays allow the most accurate installation of the device between the measuring points of the first premolars and the first molars of the upper jaw;

- practical approbation confirms the effectiveness of biometric measurements in outpatient settings of dental practices, based mainly on the convenience and ease of use, as well as the accuracy of measurements;

- adjustable working parts of the device due to the movable edge provide ease of use when measuring the narrowing of the upper jaw in children with different degrees of severity of connective tissue dysplasia, having various anatomical and topographic deformations of the height of the fornix of the hard palate.

In addition, the use of the device when detecting local (organs and tissues of the oral cavity) phenotypic signs of connective tissue dysplasia contributes to a more rapid adoption of complex therapeutic and prophylactic actions to restore narrowing and dentoalveolar anomalies of the upper jaw without complex clinical diagnostic measures.

An example of the practical use of the declared solution.

Patient A., 13 years old, was admitted to the GAU PC (Y) "Yakutsk Specialized Dental Center" by referral from a pediatrician. Complaints on admission: posture disorders, hyper-extensibility of the skin, epicanthus, chest deformity. The main diagnosis: osteochondrosis of the cervical spine, scoliosis, flat feet. Concomitant diagnosis: asthenic-depressive syndrome.

During a clinical examination, a rheumatologist diagnosed with connective tissue dysplasia of the 2nd degree. The degree of DST was determined by the method of T. Milkovska-Dmitrova and A. Karkashev (1985) and was over 21 points. Dental examination of the patient revealed a narrowing of the upper jaw, gothic palate, multiple dental caries, chronic catarrhal gingivitis, short frenum of the tongue, crowding of teeth in the anterior part of the lower jaw, deep and cross-occluded bite, dysfunction of the temporomandibular joint.

At the initial stage, the height of the vault of the hard palate was measured according to a known method (see RU 2 672369 C1, class A61B 5/107, publ. 11/14/2018), the value of which was 2.4 cm. Further, for biometric studies in conditions the dental office used a pre-sterilized and assembled claimed device to measure maxillary constriction. After seating the patient on the dental chair, the removable working part of the device was introduced into the oral cavity, having previously zeroed the values. Then, holding the device by the ruler, the fixed and movable jaws 1, 2 were bred with installed intraoral pads 5, 6, placing and fixing their needle-shaped end parts 11 between the measuring points, which are located in the middle of the longitudinal fissures of the first premolars and the anterior point, by means of a screw 14 the intersection of the longitudinal and transverse fissures of the first molars of the upper jaw, the values were taken with an accuracy of hundredths of a millimeter. The obtained measurement values were used to determine the morphological deformities of the upper jaw with DST. As a result, the indicator of the measuring points of the first premolar of the upper jaw was 2.74 mm, and for the first molar - (-2.49) mm.

To obtain objective data, the standard Pona-Linder-Hart method was used to determine the width of the dentition in children with permanent occlusion, and the presence of a relationship between the sum of the mesiodistal dimensions of the incisors and the width of the dentition in the area of the first premolars and molars was established.

Further, the interpretation of the obtained data of the narrowing of the upper jaw is carried out, depending on the indicators of the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia.

As a result, taking into account the index of the height of the fornix of the hard palate 2.4 cm, the results of measurements of the first premolar of the upper jaw 2.74 mm, according to the first molar - (-2.49) mm, the pronounced narrowing of the upper jaw, characteristic of the moderate degree of dysplasia, was interpreted. connective tissue.

The results obtained indicate that with a moderate severity of connective tissue dysplasia in a child, there is a significant narrowing of the upper dentition, which requires orthodontic treatment in order to correct it with the involvement of an ENT doctor, speech therapist, clinical psychologist, orthopedic traumatologist, dermatologist and neurologist.

Thus, the use of the present invention improves the efficiency of diagnostics of the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate at various degrees of severity of connective tissue dysplasia in children by performing simple diagnostic procedures, which for the prompt implementation of the plan of therapeutic and prophylactic actions to restore the narrowing and dentoalveolar anomalies of the upper jaw.

Table 1

A point scale for assessing the significance of phenotypic signs of CTD

by T. Milkovska-Dmitrova and A. Karkashova (1985)

Sign Points Sign Points Epicantus 2 Flat chest 2 Hypertelorism of the eyes 1 Dilated capillaries of the skin of the back, face 2 Vision pathology 4 Funnel-shaped deformity of the sternum 6 Blue sclera 1 Slight depression on the sternum 2 Wide nose 1 Kyphosis 4 Saddle nose 2 Scoliosis 4 Protruding ears 2 Asthenic physique 1 Adherent lobes 1 Clinodactyly of little fingers 1 Asymmetry of the nasal septum 2 Easy occurrence of hematomas 3 Scars on the skin 3 Hernia 3 High sky 3 Weakness of the abdominal muscles 3 Pallor of the skin 2 Transverse striation of the feet 3 Increased elasticity of the skin 3 Flat feet 3 Leather as "suede" 2 Corns 2 Soft skin 2 Incomplete syndactyly of 1 and 2 toes 2 Pronounced venous pattern 3 Sandal gap 2 Skin wrinkling 2 Hallux valgus 3 Dark spots 1 Hollow foot 3 Keel chest 5 Joint hypermobility 4

table 2

Indicators of deformation of the hard palate in children with varying degrees of severity of connective tissue dysplasia

Morphological parameters DST severity Easy (up to 12 points) Average (up to 23 points) Severe (over 24 points) The height of the vault of the hard palate according to the device for measuring the height of the vault of the hard palate up to 1.8 ± 0.02 cm From 1.9 ± 0.04
up to 2.7 ± 0.3 * cm From 2.8 ± 0.03
up to 3.2 ± 0.02 ** cm

Note: Р * - reliability of differences in DST of mild and moderate degrees and severity; Р ** - reliability of differences in DST of moderate and severe severity.

Table 3

Dependence of the narrowing of the upper jaw on the severity of connective tissue dysplasia (mm)

Indicators of narrowing of the upper jaw Mild degree
(depth of the height of the vault of the hard palate up to 18.0 + 0.02 mm) Average degree
(the depth of the height of the arch of the hard palate from 19.0 + 0.04
up to 27.0 + 0.3 mm) Severe degree
(the depth of the height of the arch of the hard palate from 28.0 + 0.03
up to 32.0 + 0.02 mm) 1 degree premolar 1 degree molar Grade 2 premolar Grade 2 molar Grade 3 premolar Grade 3 molar Minimum values -9.87 ± 0.46 -10 ± 0.47 -12.2 ± 0.36 -14 ± 0.18 -9.5 ± 0.59 -17.12 ± 0.74 Maximum values + 5.51 ± 0.38 + 7.69 ± 0.40 + 3.53 ± 0.11 + 6.13 ± 0.15 -5.24 ± 0.53 -3.37 ± 0.82 Average values -2.57 ± 0.13 -2.16 ± 0.15 -2.90 ± 0.17 * -2.57 ± 0.24 * -6.69 ± 0.47 ** -6.58 ± 0.43 **

Note: Р * - reliability of differences in the narrowing of the upper jaw in case of mild and moderate CTD and severity; Р ** - reliability of differences in the narrowing of the upper jaw with CTD of moderate and severe severity.

Claims (1)

A method for determining the narrowing of the upper jaw, taking into account the height of the fornix of the hard palate in children with various degrees of severity of connective tissue dysplasia, characterized by the fact that a device is used that includes a measuring device for determining linear dimensions with a specified accuracy, containing a bar with a scale and a depth gauge ruler, on which fixed and movable jaws for external measurements, made in the form of a truncated plate with a figured edge, on each of which oval and round threaded through holes are selected, and the movable jaw is equipped with a fixing screw, while removable intraoral pads made in the form a triangular plate with a needle-shaped end part at the apex, on each of which a recess is selected on the reverse side for planting and fixing the sponge plate in it, while in the region of the recess there is a figured protrusion for a tight and even fit and a through hole for the passage of the fixing screw a, for which the assembled device is inserted into the oral cavity and, holding the ruler and pushing the jaws apart, the end parts of the intraoral pads are placed on the measuring points located in the middle of the longitudinal fissures of the first premolars and the anterior point of intersection of the longitudinal and transverse fissures of the first molars of the upper jaw, where they fix the values of the narrowing of the upper jaw and, comparing with the values of the height of the fornix of the hard palate, diagnose the severity of connective tissue dysplasia.

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