RU2533051C2 - Method for correction of dentofacial anomalies by elastic exposure of corrective trays on apical portions of dental roots, and system of corrective elastic trays - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine, namely to orthodontia, dental orthopaedics and surgery, and aims at the apical correction of the dental root position in orthopaedic treatment, or for surgical or orthopaedic indications for the correction of the dental root position within one dental arch. A method for the correction of dentofacial anomalies is based on the staged dental migration by elastic strain energy with using a number of elastic corrective trays meeting each dental reposition from the initial position to the required position; the strain energy is applied to an activator attached along the crown portion of the tooth covering the marginal edge of the gum.

EFFECT: by concentrating and activating the effect of the corrective strain energy of the number of the corrective trays, the inventions enable providing higher effectiveness and accuracy of the correction of the dental position.

5 cl, 4 dwg

Description

The invention relates to medicine, namely to orthodontics, orthopedic and surgical dentistry, and can be used for apical correction of the position of the roots of teeth during orthodontic treatment, or according to surgical or orthopedic indications for correcting the position of teeth within the same dentition.

The prior art solutions are known which use elastic deformation forces arising in the elastic mouth to correct the position of the teeth, which define the vector of tooth movement.

Known double-jaw positioner made of silicone with nests for teeth of the upper and lower dentition and a rim covering the outer and inner surfaces of the gums, according to patent DE 4020647 (publ. 02.01.1992). The well-known silicone double-jaw positioner has zones of different hardness and is designed to correct the twisted position of the teeth while conducting interdental separation. The main disadvantage of the known device is the fact that the known design using a double-jaw positioner cannot be used for continuous wear, which limits the time of corrective action.

Another well-known solution is a single-jaw elastopositioner according to patent RU 2365355 (publ. August 27, 2009), made in the form of a silicone U-shaped mouth guard for the upper or lower dentition. However, it provides for less targeted, without the possibility of adjustments, influence of elastic forces on the teeth, the position of which is adjusted, since it involves the manufacture of only one correcting mouth guard with the correct position of the teeth and mainly their frontal segment, since it requires the presence of supporting sections with greater rigidity, which complicates the process production of corrective mouthguards.

The known method and system for the gradual movement of teeth according to the application of Australia AU 2011253781 (publ. 12.01.2012), where for the phased movement a series of at least three elastic polymer mouthguards is used, the sequential use of which provides step-by-step movement of the tooth due to elastic deformation forces of the elastic mouth guard less than 2 mm, and preferably less than 1 mm or less than 0.5 mm. Replaceable mouthguards are made outside the treatment process, at the same time, based on the calculation of digitized data of correction models of the dentition, and can be provided to the patient, for example, in the form of a single numbered set, which saves the patient from frequent visits to the doctor. The movement of teeth using a known method is possible along the vertical axis, rotation or inclination relative to the vertical axis. This decision, as the closest to the declared, is considered by the applicant as a prototype.

The technical result, the achievement of which the claimed solution is directed, is the concentration and activation of the corrective forces of elastic deformations of a series of correcting capes that are transmitted and act on the apical parts of the roots of the teeth, which increases the efficiency and accuracy of the adjustment of the position of the teeth during orthodontic treatment or for orthopedic or surgical indications .

The claimed technical result is achieved by the fact that in the method of phased movement of teeth, carried out due to the forces of elastic deformation when using a series of elastic correcting cap, corresponding to each change in the position of the teeth from the initial to the desired position, elastic forces are applied to the activator, fixed along the crown of the tooth with approach beyond the marginal gingival margin, which allows you to use the principle of the lever to transfer effort to the apical part of the root and its movement to the desired point.

The claimed technical result is also achieved by the fact that the elastic correcting mouthguards are made with a cavity, the geometry of which corresponds to the shape of the activator, while the activator is made in the form of a rectangular bar with a rounded upper edge and a length taken from the calculation of half the height of the crown of the moved tooth plus 2-4 mm below the marginal gingival margin.

The principle of operation of the proposed method and device is illustrated by the attached graphic materials.

Figure 1 shows the direction of possible movement of the teeth relative to the vertical axis. Figure 2 shows a General view of the mouthpiece 1. Figure 3 shows a physical model of the dentition 2 with formed activators 3 on the crown of the tooth 4, extending beyond the gum 5. Figure 4 shows a diagram of the operation of the device and the principle of the claimed method.

To implement the method carry out the following preparatory operations.

According to the original casts of the patient, for example, a physical model 2 is made of gypsum, exactly repeating the patient’s dentition. The teeth that are involved in the movement for apical correction of the root position are segmented on the model, remaining fixed in its composition with the help of devices (dynamic pins), the designs of which provide the ability to move the segmented teeth of the model.

On segmented teeth along the coronal part of the tooth 4, taking into account the approach beyond the marginal edge of the gum 5, activators 3 are mounted, which are rectangular bars with a rounded upper face with a cross-sectional area of 1.5-3 mm ² and a length taken from the calculation of half the height of the crown part the involved tooth 4 plus a protrusion of 2-4 mm, extending with a gap on the marginal edge of the gum 5. Activators are modeled and molded from plastic and then glued to the model. The original model is ready. According to the physical model, the first elastic mouthguard is produced by vacuum pressing of the heated material or by scanning and using a 3D printer, the surface of which faces the teeth corresponds to both the shapes and position of the crown parts of all teeth and the shapes of the formed activators 5. This first eliner will be used as a template for placing and gluing activators on the teeth in the patient's oral cavity.

Further, on the physical model, the segmented teeth 4 are moved in increments of 0.125-0.25 mm, changing the inclination of the tooth relative to the vertical axis. Mounted on the tooth activator 3 moves with the tooth. After moving through the physical model, we make a new mouthguard corresponding to the changed position of the activators.

A phased displacement scheme can also be constructed based on the calculation of digitized data of correction models of the dentition using known scanning methods and using a 3D printer.

As in the known method, making the eliners after selecting each movement, we get a whole series of correcting cap 1. The number of steps (movements) depends on what path you need to go to rotate the tooth to the desired position, i.e. the number of drops in a series depends on the number of steps.

The preferred material for the manufacture of cap is polycarbonate, which does not cause allergic reactions, is inert to biological tissues, does not cause mucosal irritation, and is transparent and therefore not noticeable when worn. The thickness of the sheets on the basis of which the mouthguards are made can vary from 1 mm to 3 mm. The thickness of the mouthpiece depends on the type of tooth movement and is determined by the manufacturer at the stage of manufacture of the mouthpiece. This range of thicknesses provides the necessary ratio of elasticity and rigidity of the mouthpiece material, allowing, on the one hand, to tighten the activator into the corresponding cavity, and on the other hand, to provide an elastic effect on it.

Description of the implementation of the method

On teeth requiring normalization of the position, non-invasive preparation of the tooth surface is necessary to fix the composite dental material on the tooth enamel. The cavity corresponding to the shape of the activator of the first cap-template is filled with dental composite material of light polymerization in the color of the tooth. Then the capa-template is put on and clearly positioned on the dentition in the patient's oral cavity. Then, with the dental light polymerization device (lamp), the capa pattern is illuminated in the activator zone. The composite material is polymerized, taking the form of an activator, and one part of the activator is glued to the enamel of the crown part of the patient’s tooth 4, and part 6 forms a protrusion. Next, the capa-template is removed from the dentition, while the activators 3 remain on the patient’s teeth, protrusion 6 going to the marginal edge of the gums 5 (figure 4). Then, the first mouthpiece from the corrective series is put on the patient’s dentition, made, for example, according to the model with the first movement step. A longitudinal activator 3 fixed on the tooth with an interference fit enters the displaced cavity of the mouthpiece 7, where the elastic deformation forces of the elastic material of the mouthpiece 1 act on it, where it begins to act as a lever with shoulders A and B, acting on the apical part of tooth 8, gradually turning it into desired position relative to the vertical axis.

The patient wears an eliner for two weeks, then changes to the next. Thus, we make a stepwise movement of the teeth to the desired position by making an apical correction of the root position, thereby normalizing the position of the crown of the tooth in the patient’s mouth. The last eliner in the series takes the form of the desired tooth position. At the end of treatment, the activators are removed from the surface of the tooth enamel by polishing.

The process of changing the position of teeth requiring correction is step-by-step regulated by the orthodontist-technologist, calculating the optimal path of tooth movements in such a way that all the teeth eventually line up in an even dentition. Thus, the search for the optimal way to align the dentition is carried out either on the model, by moving the segmented teeth, or using computer calculations, and not in the patient’s mouth, as is the case, for example, when using braces, which makes the treatment process more gentle and comfortable for the patient . Moreover, in contrast to the well-known series of correcting cap, the presence of an activator provides a given direction vector and enhances the effect of movement. The duration of treatment depends on the complexity of each clinical case and averages from 6 to 16 months. The correction method can be applied simultaneously to several teeth of the dentition.

Claims (5)

1. A method of correction of dentoalveolar anomalies based on the elastic effect on the apical part of the roots of the teeth with correcting burls, including stepwise movement of teeth, carried out due to the forces of elastic deformation using a series of elastic correcting burls corresponding to each change in the position of the teeth from the initial to the desired position, characterized in that elastic forces are additionally applied to the activator, fixed along the crown of the tooth with approaching the marginal edge of the gum, with the possibility of cottages efforts on the apical part of the root and move it to the desired point. 2. A system of corrective elastic mouthguards corresponding to each change in the position of the teeth from the initial to the desired position, characterized in that the elastic corrective mouthguards are made with cavities whose geometry corresponds to the position and shape of the activator, while the activator is made in the form of a rectangular bar with a rounded top face and length L≈½h + d, where h is the height of the crown of the tooth being moved, d is the length of the protrusion that extends beyond the marginal edge of the gum. 3. The system of corrective elastic cap according to claim 2, characterized in that d is the length of the protrusion that extends beyond the marginal edge of the gum, equal to 2-4 mm. 4. The system of corrective elastic cap according to claim 2, characterized in that the cross-sectional area of the activator is 1.5-3 mm ² . 5. The system of corrective elastic cap according to claim 2, characterized in that each cap is made of polycarbonate with a thickness of 1 mm to 3 mm.

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