RU2404723C2 - Method for manufacturing of upper jaw denture with hollow obturator - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to the field of dentistry, and may be used to manufacture removable denture that separates nose and mouth cavities by means of hollow obturator with walls of specified thickness. Method for manufacturing of upper jaw denture with hollow obturator consists in production of upper jaw defect and prosthetic bed impression, making a model out of it, modelling of wax mould of obturator and denture, package and polymerisation of plastic. Obturator is modelled directly onto model from impression produced in patient's mouth cavity by paving of positive reflection of palate defect with wax plate, having thickness that corresponds to thickness of future obturator and simultaneous modelling of resected alveolar ridge. Afterwards horizontal gypsuming of wax structure is carried out into cuvette, trapezoid tails are shaped to replace wax with rigid plastic. Produced obturator is processed and placed onto initial model, above which denture is modelled with mechanical fixtures and arrangement of teeth. Produced structure goes through clinical stage of fitting and alignment of occlusive contacts, afterwards wax prosthesis with obturator is returned to laboratory, where it is packed into cuvette with further replacement of wax for plastic according to classic technology.

EFFECT: using standard cuvette to manufacture monolithic denture of upper jaw with hollow obturator made of rigid plastic.

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Description

The invention relates to medicine, in particular to dentistry, and can be used for the manufacture of a removable dentofacial (resection) prosthesis, uncoupling the nasal cavity and mouth through a hollow obturator with walls of a given thickness.

A known method of manufacturing a hollow obturator of a resection prosthesis of the upper jaw by injection molding (see Vares E.Ya., Nagurny V.A. in the book "Centralized production of dentures using a new and improved technology". Plastic pressing. Zhytomyr, 1992, p. 53-155). According to the method, a defect mold is taken from a rigid plastic material of the Ftorax type, the model is cast, a wax pattern is modeled, the model is plastered into a syringe cuvette and molded plastic under vertical pressure. In this case, two hemispheres of rigid plastic are obtained. Then they are glued together and a ready-made obturator is obtained, resembling a sphere that cannot accurately repeat the configuration of the postoperative defect of the upper jaw. Along the conjugation line, the adhesive creates favorable conditions for a sharp increase in adhesion of periodontopathogenic microorganisms that contribute to the emergence and maintenance of inflammation of the mucous membrane of the prosthetic bed.

There is a known method of molding dental and maxillofacial prostheses from plastics by conventional pressing, which consists in taking a mold, obtaining a model, modeling a wax obturator template, plastering a model with a wax template in a cuvette in a vertical position, packing and polymerizing plastic in a vertical direction (see Kopeikin V.N., Knubovets Ya.S., Kurlyandsky V.Yu., Oksman I.M. Denture technology, chap. 8, 9, article "Technology of the use of plastics". M: Medicine, 1978, p.105 -109; 272-275).

The closest to implementation of the claimed method is a method of manufacturing an obturator of a resection prosthesis of the upper jaw using a cuvette, in which a cast of a defect in the upper jaw is taken, a model is obtained, a wax pattern of the obturator is modeled, and plastic is polymerized and polymerised in a vertical direction, according to the invention, a model is made from a cast in the cuvette with horizontal placement of the impression and after modeling the wax pattern, a pseudo-stamp of the obturator model is obtained, reduced by a thickness wax pattern, and the packaging and polymerization of plastic is carried out simultaneously in horizontal and vertical directions. As a result, a stamp is made of gypsum with an obturator dressed on it with a given wall thickness. After removing the stamp from the gypsum, a ready-made obturator is obtained, which is then rigidly fixed to the base of the prosthesis. (RF patent No. 2183438 (13) C1 dated November 20, 2000). This prosthesis is selected for the prototype.

However, in the manufacture of the aforementioned prosthesis, it is necessary to use a special cuvette, and parts of the prosthesis, obturator and denture are obtained separately and then rigidly fixed with glue, which significantly reduces the strength characteristics of the prosthesis and as a result limits the time of its use, and the place where the obturator is attached to the prosthesis by gluing does not meet the requirements of studies of adhesion of pathogenic microorganisms of the oral cavity to removable orthopedic structures.

The present invention is the manufacture of a denture with a hollow obturator with walls of a given thickness, monolithically connected to the basis of the prosthesis with joints that meet the rules of hygiene, and favorably affecting the wound surface of the mucous membrane of the prosthetic bed, which contributes to optimal separation of the nasal and oral cavities.

The technical result is the manufacture of a monolithic denture of the upper jaw with a hollow obturator of rigid plastic using a standard cuvette.

The technical result is achieved by the fact that the denture of the upper jaw with a hollow obturator and the method of its manufacture consists in obtaining an impression of the defect of the upper jaw and prosthetic bed, making a plaster model on it, modeling the wax pattern of the obturator and denture, packing and polymerisation of plastic. The obturator is modeled directly on the model based on a print obtained in the patient’s oral cavity by lining a positive image of the sky defect with a wax plate having a thickness corresponding to the thickness of the future obturator, while simulating the resected alveolar ridge. After that, horizontal wax-up of the wax composition is carried out in a cuvette, trapezoidal shanks are modeled to replace the wax with hard plastic. The resulting obturator is processed and placed on the original model, a denture with mechanical fixation and tooth setting elements is modeled on top of it, and the bonding line is coated with the prosthesis base so that the interface between the halves of the hollow obturator is located in the thickness of the dentition base to a depth of at least 2.0 mm . The fabricated design goes through the clinical stage of trying and removing occlusal contacts. After that, the wax prosthesis with the obturator is returned to the laboratory, where it is packaged in a cuvette, followed by wax replacement with plastic according to the classical technology, in which the undercuts and the joints of the hollow obturator with the dentition base are replaced with plastic in one piece, which ensures the least adhesion of pathogenic microorganisms in the process patient use.

The design of the resection prosthesis of the upper jaw with a hollow obturator is illustrated in the drawing, where:

1. The basis of dentition.

2. Hollow obturator.

3. Clasps for fixing the dentition.

4. The boundaries of the jaw prosthesis with a hollow obturator.

A maxillary denture with a hollow obturator is made as follows:

1) an impression of the postoperative defect is obtained with alginate impression masses;

2) make a plaster working model according to the print;

3) line the positive display of the defect of the upper jaw with a wax plate having a thickness corresponding to the thickness of the manufactured hollow obturator (2);

4) pack the wax composition in a standard cuvette and replace the wax with plastic;

5) a resected alveolar ridge is modeled from wax;

6) pack the wax composition in a standard cuvette and replace the wax with plastic;

7) compare the parts of the hollow obturator (2) on the model and model the basis of the prosthesis (1), make and install a clasp (3), perform the setting of artificial teeth;

8) in the clinic, the prosthesis is fitted taking into account the occlusal relationships of the dentition;

9) pack the wax composition and the hollow obturator (2) matched from two halves into a standard cuvette and replace the wax with plastic with a separate coating of the junction of the dentition base with the hollow obturator (4);

10) grind and polish the resulting dentofacial prosthesis and the interface between the base of the prosthesis and the hollow obturator (4).

Claims (1)

A method of manufacturing a maxillary denture with a hollow obturator, which consists in obtaining an impression of the defect of the upper jaw and prosthetic bed, obtaining a model from it, modeling the wax pattern of the obturator and denture, packing and polymerising plastic, characterized in that the obturator is modeled directly on the impression model obtained in the patient's oral cavity by lining a positive display of a defect in the sky with a wax plate having a thickness corresponding to the thickness of the future obturator and one belt modeling of the resected alveolar ridge, after which horizontal wax-up of the wax structure in the cuvette is carried out, trapezoidal shanks are modeled to replace the wax with hard plastic, the resulting obturator is processed and placed on the original model, a denture with mechanical fixation elements and tooth setting is modeled on top of it, the resulting structure goes through the clinical stage of trying and removing occlusal contacts, after which the wax prosthesis is returned to the laboratory in the obturator w, where it is carried into the cell packing followed by displacement of the plastic wax to the classical technology.

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