RU2808196C1 - Method for manufacturing an individual elastic guard for massaging periodontal tissues, and guard obtained by the specified method, and method for preventing periodontal disease using the manufactured cap - Google Patents

Abstract

FIELD: medicine; physiotherapeutic dentistry.

SUBSTANCE: invention is intended for use in the treatment and prevention of periodontal diseases. At the first stage, using the hardware method of three-dimensional visualization of the internal structures of the oral cavity (intraoral scanning), a digital 3D model of the upper and lower jaws is obtained, while the central ratio of the jaws is automatically determined in the program. Then, using a special computer modelling program (CAD module), an individual mouthguard is designed, which is a mouthguard made of elastic plastic with nests for the dentition, made according to the relief of the alveolar process of the upper or alveolar part of the lower jaws. The inner surface of the guard has protrusions in the gum area with a diameter of 2±1 mm; height 2±1 mm; the density of location is 3±1 protrusion per 1 cm², the height of the guard for the upper jaw is 2±0.5 cm, for the lower jaw 1.5±0.5 cm; width 1.5±0.5 cm - for the guards of the upper and lower jaws, the depth of the guards for the upper and lower jaws, measured along the midline passing between the sockets, is 4±0.5 cm. The resulting digital model is sent to the milling program (CAM module). A block of special material is fixed by the operator in the holder of the milling machine, and the modelled cap structure is ground under water cooling, after which it is polished with sets of polishers, rubber and pastes. Guards are sequentially installed in the oral cavity, while fixation is carried out along the sockets for the corresponding teeth, first on the upper jaw and then on the lower one. Next, the patient is offered to close the dentition with force, the patient is offered to make at least 10 vertical movements with the lower jaw with closed lips, then after the massage, the elastic caps are removed from the oral cavity, washed, dried, and 1-2 drops of the medicinal substance are injected into each of them. Next, the elastic guards are again sequentially installed and fixed in the oral cavity along the sockets, then the patient makes at least 20 vertical movements, supplementing them with closing of the teeth, then the patient makes at least 20 horizontal movements with the lower jaw, due to which a horizontal periodontal massage, gum mucosa massage and rubbing of the medicinal substance into the surrounding tissues are performed, then after the periodontal massage procedure is completed, the elastic guards are removed from the oral cavity and washed with water.

EFFECT: inventions, due to the massage of the gums with drugs, make it possible to stop inflammatory processes and activate microcirculation and trophicity of periodontal tissues.

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Description

The group of inventions relates to medicine, namely to physiotherapeutic dentistry, and is intended to develop a method for manufacturing an individual mouthguard, the mouthguard itself and the method of its application (use) for the treatment and prevention of periodontal diseases.

The urgency of the problem is due to the high prevalence of inflammatory periodontal diseases, which ranges from 80 to 100% in various age groups [1].

That is why the development of a new device to eliminate the local inflammatory process in periodontal tissues, which would be accessible and easy to use, is an urgent task [2,3].

Currently, there are various types of physiotherapeutic effects on periodontal tissue, among which gum massage is the most widespread [3,4,5].

Of the known methods of gum massage, the most famous is finger massage. Its disadvantages are:

- low efficiency of massage, since the surface of the working field is smooth;

- high probability of injury to the gums by nails.

Today, a periodontal splint for massage of the gums and periodontium is known (Tupikova L.N., 1983), however, it has a number of disadvantages:

-low massage efficiency (no protrusions on the inner surface)

- difficulty in manufacturing (made by taking impressions);

- the likelihood of inaccurate representation of the relief of the alveolar processes of the upper and alveolar parts of the lower jaws, resulting from deformations during impression taking and making models.

The problem to be solved, which the stated technical solution is aimed at, is the development of a method for manufacturing an elastic individual mouthguard to ensure the possibility of stopping inflammatory processes, activating microcirculation and trophism of periodontal tissues, taking into account the anatomical features of the alveolar process of the upper jaw and the alveolar part of the lower jaw.

Advantages of the elastic mouth guard we developed for periodontal massage:

- high efficiency of massage (due to the presence of protrusions on the inner surface);

- accurate display of the relief of the alveolar processes of the upper and alveolar parts of the lower jaws through the use of CAD/CAM;

- the ability for the doctor to adjust the size and shape of the mouthguard during its manufacture at all stages;

- the ability to massage the gums with medications (introduced into the mouth guard) and thereby increase the effectiveness of the procedure.

The solution to this problem is achieved by using an elastic individual mouthguard for periodontal massage. In fig. an elastic individual mouth guard is shown: a – front view; b – top view; c, d – rear view; d – side view.

The essence is a method for manufacturing an elastic individual mouth guard for periodontal massage, characterized in that it is manufactured in several stages, namely:

1 - at the first stage, using a hardware method of three-dimensional visualization of the internal structures of the oral cavity (intraoral scanning), a digital 3D model of the upper and lower jaws is obtained, and the central relationship of the jaws is automatically determined in the program.

2 - Next, using a special computer program, simulations (CAD module) are performed to design an individual mouth guard, which is a mouth guard made of elastic plastic, silicone with sockets for the dentition, made according to the relief of the alveolar process of the upper or alveolar part of the lower jaws, while the inner the surface of the mouthguard has protrusions in the gum area with a diameter of 2±1 mm; height 2±1 mm; the density of location is 3±1 protrusions per 1 cm ² , the height of the mouthguard for the upper jaw is 2±0.5 cm, for the lower jaw 1.5±0.5 cm; width 1.5±0.5 cm - for mouthguards of the upper and lower jaws, depth of mouth guards for the upper and lower jaws, measured along the midline passing between the sockets, is 4±0.5 cm.

3 - then a shipment is made according to the previously received digital model by loading it into a programmable milling machine for digital milling and the actual production of the workpiece block is carried out, by loading it into a programmable milling machine for digital milling and the actual milling (CAM module) is performed to obtain a workpiece block .

4 - Next, the workpiece block made of a special material is strengthened by the operator in the holder of the milling machine, and the modeled burl structure is ground under water cooling, after which it is polished with sets of polishers, rubber bands and pastes.

Clinical case implemented using the claimed method:

Patient A, 23 years old. Diagnosis: Chronic catarrhal gingivitis. Concomitant diseases: none. Complaints of periodic bleeding of the gums when brushing teeth, bad breath. Objectively: The mucous membrane in the area of the teeth of the upper and lower jaws is hyperemic, swollen, bleeds upon probing, and there are supra and subgingival dental deposits. On 3D computed tomography, there are no changes in bone tissue in the area of the teeth of the upper and lower jaws. Treatment was carried out according to the proposed method.

Under infiltration anesthesia Sol. Ultracaini 4% -1.7 ml, supragingival and subgingival dental plaque was removed using an ultrasonic scaler. Drug treatment of the mucous membrane. The trays are then placed sequentially in the mouth. Fixation is carried out in the sockets for the corresponding teeth, first on the upper jaw, and then on the lower jaw. Then the patient is asked to slowly close the teeth with little effort. In total, the patient is asked to make 10 vertical movements of the lower jaw with lips tightly closed.

After the massage, the elastic trays are carefully removed from the mouth, washed, the sockets are dried, and 1-2 drops of the medicinal substance are injected into each of them.

Elastic trays are again sequentially installed and fixed in the oral cavity according to their sockets. The patient makes 20 vertical movements, supplementing them by tightly closing the teeth. Then the patient makes 20 horizontal movements of the lower jaw (back and forth, left and right), due to which a horizontal periodontal massage is performed, a massage of the gum mucosa and rubbing of the medicinal substance into the surrounding tissues.

Upon completion of the periodontal massage procedure, the elastic trays are carefully removed from the mouth and washed with water. Storage is carried out in a disinfectant solution.

The patient was given recommendations: 1. Compliance with the rules of oral hygiene; 2. Carrying out periodontal massage daily, 2 times a day for 10-15 minutes for 1 month.

The patient was invited for re-examination on days 7 and 14, after 1 month.

The patient's clinical indicators improved; the patient noted a decrease in hyperemia, swelling, and bleeding gums on the third day.

Bibliography

1 KG. Karakov. Photodynamic therapy is an effective way to influence periodontopathogenic microorganisms in the treatment of periodontitis / Babayan E.G., Markarova G.V., Chavushyan K.D., Gadzatseva Z.M. // Medical Bulletin of the North Caucasus. 2010. T. 17. No. 1.-p. 13-16.

2. K.G. Karakov. Medicines in periodontology / Porfiriadis M.P., Danchenko T.P., Mkhitaryan A.K. Stavropol 2011

3. 7. K.G. Karakov. Basics of periodontal therapy / Vlasova T.N., Oganyan A.V., Tagieva L.G.//Dental Yug.2011.No.5.-p.16-18.

4. Alexandrov V.V. Fundamentals of rehabilitation medicine and physiotherapy: textbook. manual for the system of postgraduate prof. education / V.V. Aleksandrov, A.I. Algazin. – Moscow: GEOTAR – Media, 2009. – 144 p.

5. Kovalevsky A.M. Treatment of periodontitis: practical work. manual / A. M. Kovalevsky. – Moscow: MIA, 2010. – 160 p.

Claims (3)

1. A method for manufacturing an elastic individual mouthguard for massaging periodontal tissues, at the first stage of which a digital 3D model of the upper and lower jaws is obtained using a hardware method of three-dimensional visualization of the internal structures of the oral cavity, the central relationship of the jaws is automatically determined through the program and, using a computer program for design, the modeling of an individual mouth guard made of elastic plastic with sockets for the dentition, made according to the relief of the alveolar process of the upper or alveolar part of the lower jaws, and the previously obtained digital model is sent to a programmable milling machine for digital milling, a block of the workpiece is performed by loading it into a programmable milling machine for digital milling and strengthen the workpiece block in the holder of the milling machine, then grind the modeled burl under water cooling and polish it with sets of polishers, rubber bands and pastes. 2. A mouth guard made by the method according to claim 1 has an outer and inner surface, made of an arched shape from elastic plastic by milling using a computer program for each patient, and the inner surface has protrusions in the gum area with a diameter of 2±1 mm and a height of 2± 1 mm; the location density is 3±1 protrusions per 1 cm ² , and the depth of the mouth guard for the upper and lower jaws, measured along the midline passing between the sockets, is 4±0.5 cm, while the height of the mouth guard for the upper jaw is 2±0, 5 cm, for the lower jaw 1.5±0.5 cm and width 1.5±0.5 cm for the upper and lower jaws. 3. The method of treatment using a mouth guard according to claims 1 and 2, which consists in the fact that the mouth guards are sequentially installed in the oral cavity, while the fixation is carried out along the sockets for the corresponding teeth, first on the upper jaw and then on the lower jaw, then the patient is asked to close the dentition with force, while the patient is asked to make at least 10 vertical movements of the lower jaw with closed lips, then after the massage, the elastic mouth guards are removed from the oral cavity, the sockets are washed, dried and 1-2 drops of a medicinal substance are injected into each of them, then the elastic mouth guards again sequentially installed and fixed in the oral cavity according to the sockets, then the patient makes at least 20 vertical movements, supplementing them by closing the teeth, then the patient makes at least 20 horizontal movements with the lower jaw, due to which a horizontal periodontal massage is performed, a massage of the gum mucosa and rubbing in the medicinal substances into the surrounding tissues, then after completing the periodontal massage procedure, the elastic trays are removed from the oral cavity and washed with water.