RU2831481C1 - Method of making therapeutic-and-prophylactic occlusion tray - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to dentistry and aims at treating patients with occlusion pathology combined with temporomandibular joint dysfunction. Method of making a therapeutic occlusion tray consists in the following. Cone-beam computed tomography controls condyles so that in all parts of the joint space has a width sufficient for the normal functioning of the temporomandibular joint, and the dimensions of the anterior-articular fissure are related to the dimensions of the posterior-articular fissure as 2:3. Upper and lower jaws are imprinted with silicone material using a single/two-stage technique. Models are cast from class 4 plaster. Tray is made on the lower jaw using a vacuum former using a plate and retention holes are created on the tray in the area of teeth 34, 35, 36, 37, 44, 45, 46, 47. Tray is installed in the oral cavity, the lower jaw is repositioned with the possibility of reducing the reducible dislocations. After deprogramming, fast-hardening plastic is poured in the area of teeth 34–37 and 44–47, filling the retention holes, closing the mouth in the central occlusion and waiting for polymerisation. Excess material is corrected and removed, and the position is transferred into an articulator for further correction of the position of the lower jaw.

EFFECT: normalization of spatial relationships of intra-articular structures and elimination of chronic mechanical injury of tissues of temporomandibular joint, relaxation of masticatory muscles, as a result of which the functioning of the joint is stabilized, the creation of favorable conditions for the subsequent integrated orthodontic treatment of patients with an operation on the upper and/or lower jaw.

1 cl, 2 dwg

Description

The invention relates to the field of medicine, namely dentistry, and is intended for the treatment of patients with various forms of occlusion pathology in combination with dysfunction of the temporomandibular joint.

Among such patients, one of the most common pathologies of the dental system is the muscular-articular dysfunction of the temporomandibular joint (TMJ). Competent orthodontic treatment does not cause temporomandibular disorders, but at the same time often does not lead to their elimination. In addition, orthodontic movement of teeth and subsequent normalization of the bite does not prevent the development of temporomandibular disorders in patients with an initially abnormal occlusion. During the final planning of orthodontic treatment, the orthodontist, orthopedic gnathologist and surgeon must work in close cooperation.

It is possible to use a therapeutic and prophylactic occlusion splint, the design of which allows normalizing the spatial relationships of intra-articular structures and eliminating chronic mechanical trauma to the tissues of the temporomandibular joint, relaxing the masticatory muscles, thereby stabilizing the functioning of the joint, creating favorable conditions for subsequent complex orthodontic treatment of patients with surgery on the upper and/or lower jaw. After deprogramming, a central occlusion is installed on a pre-fabricated therapeutic and prophylactic occlusion splint with retention holes in the area of the chewing teeth, thus fixing the TMJ.

The closest invention to such a mouth guard (prototype) is the intraoral occlusion device (RU 2730995 C1). The main disadvantage of this device is the complexity of manufacturing and adjusting the device in the patient's oral cavity.

The technical result of the invention is the creation of the claimed therapeutic and prophylactic occlusive mouth guard.

The invention is carried out as follows.

Under the control of cone-beam computed tomography (CBCT), the condyles are positioned in such a way that in all sections the joint space is wide enough for normal functioning of the TMJ, and the dimensions of the anterior joint space are related to the dimensions of the posterior joint space as 2:3. In the constructive position of the lower jaw, a repositioning diagnostic-occlusal splint is modeled from dental plastic with a pronounced occlusal relief.

A therapeutic and prophylactic occlusive splint is created as follows:

1. An impression is taken using silicone material in a one/two-stage method for the upper and lower jaws;

2. Cast models from class 4 plaster;

3. A splint is made for the lower jaw using a vacuum former with a plate of at least 2 mm;

4. Create retention holes on the mouth guard in the area of teeth 34, 35, 36, 37, 44, 45, 46, 47;

5. Place the mouth guard in the oral cavity;

6. The lower jaw is repositioned to a comfortable position with the possibility of reducing reducible dislocations and the position is fixed with the help of quick-hardening plastic in the chewing areas, for which, after deprogramming, quick-hardening plastic is poured into the area of teeth 34-37 and 44-47, filling the retention holes, the mouth is closed in central occlusion and polymerization is awaited;

7. Correction and removal of excess material is performed and the position is transferred to the articulator (variator) for further correction of the position of the lower jaw.

The invention is illustrated by graphic material, where Fig. 1 is a photo of a therapeutic and prophylactic occlusal mouth guard for the lower jaw, Fig. 2 is a photo of a therapeutic and prophylactic occlusal mouth guard for the lower jaw with overlays for raising the bite.

The invention is industrially applicable.

Claims (2)

A method for manufacturing a therapeutic and prophylactic occlusive splint, which consists in the following: under the control of cone beam computed tomography, the condyles are positioned in such a way that the joint space in all sections is wide enough for normal functioning of the temporomandibular joint, and the dimensions of the anterior joint space are related to the dimensions of the posterior joint space as 2:3; an impression of the upper and lower jaws is taken with silicone material using a one/two-stage method; models are cast from class 4 plaster; a mouth guard is made for the lower jaw using a vacuum former with a plate; retention holes are created on the mouth guard in the area of teeth 34, 35, 36, 37, 44, 45, 46, 47; the mouth guard is installed in the oral cavity; the lower jaw is repositioned if it is possible to reduce reducible dislocations; After deprogramming, pour quick-hardening plastic into the area of teeth 34-37 and 44-47, filling the retention holes, close the mouth in central occlusion and wait for polymerization; perform correction and remove excess material and transfer the position to the articulator for further correction of the position of the lower jaw.