КОНТРОЛЬ СОСТОЯНИЯ ТКАНЕЙ ПРОТЕЗНОГО ЛОЖА

Комлев С.С.

Кандидат медицинских наук, ГБОУ ВПО Самарский Государственный Медицинский Университет Минздрава России

КОНТРОЛЬ СОСТОЯНИЯ ТКАНЕЙ ПРОТЕЗНОГО ЛОЖА

Аннотация

Контроль состояния тканей протезного ложа осуществляется в центральном соотношении челюстей на прямой и боковой телерентгенограммах головы пациента. В отличие от ортопантомографии челюстей при телерентгенографии снимки получаются с меньшим искажением и на пациента оказывается малое количество излучения. По середине окклюзионной поверхности верхнего валика и наносят рентгеноконтрастный материал например, ортодонтическую проволоку диаметром 0,4-0,6 мм. Далее размещают на верхний и нижний восковые базисы по линиям, проходящим по вершинам гребней альвеолярных отростков нижней и верхней челюстей, приклеивают ортодонтическую проволоку. Затем проводят боковую и прямую телерентгенографии головы с сомкнутыми челюстями.

Ключевые слова: зубной протез, протетическая плоскость, телерентгенография.

Komlev S.S.

Candidate of Medical Sciences, Samara State Medical University

MONITORING THE STATE OF PROSTETIC BED TISSUES

Abstract

Monitoring the state of prosthetic bed tissues is carried out in the central correlation of the jaws on the direct and side patient’s head teleroentgenography. On contrast to orthopantomography of jaws, teleroentgenography images are less distorted and the patient receives a small amount of radiation. In the middle of the occlusal surface of the upper roller a radiopaque material is applied, such as orthodontic wire with a diameter of 0.4-0.6 mm. Then it is placed on the upper and lower wax bases along the lines passing through the crest of the alveolar process of the lower and uppers jaws and orthodontic wire is glued. After that, side and direct teleroentgenography of the head with closed jaws is conducted.

Keywords: denture, prosthetic plane, teleroentgenography.

The invention relates to medicine, namely to the orthopedic dentistry and can be used for monitoring of the mutual position of edentulous alveolar processes, their location concerning to the prosthetic plane, the degree of atrophy of alveolar crests and mucous membrane on them. It also can be used for solution of the problem of surgical preparation of alveolar processes (partial removal or plastic of processes) before prosthetics patients with removable dentures and constructing artificial dentitions, as well as before dental implantation, i.e. to obtain significant information about dentoalveolar system.

Monitoring the state of prosthetic bed tissues is carried out in the central correlation of the jaws on the direct and side patient’s head teleroentgenography. On contrast to orthopantomography of jaws, teleroentgenography images are less distorted and the patient receives a small amount of radiation [2, 3].

There are: a method of determining the thickness of soft tissues above the crest of edentulous alveolar process (RF patent №2215497) and the method of determining the degree of atrophy of the alveolar process height under the base of removable denture (RF patent №2199974).

Both methods have two main drawbacks:

1. The state of prosthetic bed tissues is studied at ortopantomography, i.e. distorted images are obtained.
2. In both methods, a study of a single parameter is conducted (the thickness of the prosthetic bed’s soft tissues, or the atrophy of alveolar process height under the denture).
3. In addition, both methods are not related to constructing the artificial dentitions in total removable dentures, as they do not carry information about the location of prosthetic plane (the main landmark for constructing artificial dentitions).

The following method was taken as a prototype of the invention: «Method of determining the degree of atrophy the alveolar process height under the base of removable denture» (Patent №2199974).

The technical result, which the creation of the present invention aims to achieve, includes the objective studying the mutual position of hard and soft tissues of edentulous jaws in central relation, studying the degree of atrophy in individual periods while using total removable dentures. It also includes the study of the location of alveolar processes concerning to prosthetic plane for planning surgical preparation of alveolar processes before prosthetics and constructing the artificial dentitions, i.e. for obtaining a considerable information about patient’s dentoalveolar system.

The gist of invention is the following. After determining the central ratio of jaws the radiopaque material (such as thin orthodontic wire) is applied on wax bases with biting rollers of upper and lower jaws by prosthetic bed on the location of alveolar crests tops and in the middle of the occlusal surface of the upper roller. In position of central occlusion, side and direct teleroentgenography of head is received. On the obtained images is carried out a study of the location of alveolar processes with each other and concerning to prosthetic bed for planning surgical preparation of alveolar processes before prosthetics and constructing the artificial dentitions.

A method of monitoring the state of prosthetic bed tissues of edentulous jaws concerning to each other or to prosthetic plane on the teleroentgenography of head [1] is realized in the following way.

The lower biting roller is customized like upper one taking into account the height of lower portion of face. The central ratio of jaws is determined. Then, the radiopaque material such as orthodontic wire with a diameter of 0.4-0.6 mm. is applied in the middle of occlusal surface of the upper roller. After that, it is placed on the upper and lower wax bases along the lines passing through the alveolar crests tops on lower and upper jaws, as well orthodontic wire is glued. Then side and direct teleroentgenography of head with closed jaws is conducted. On the obtained images, the location of alveolar processes is studied with each other and concerning to prosthetic plane for planning surgical preparation of alveolar processes before prosthetics and constructing the artificial dentitions.

Clinical example. Patient T., 63 years old, medical history №1458, appealed to the GBUZ SO SSP №3 (base of the Chair of Orthopedic Dentistry SSMU) complaining of unsatisfactory results of prosthetics by total removable dentures with different doctors. Prosthetics was conducted three times. It was decided to conduct prosthetics by new total removable dentures. In order to study the location of the alveolar processes with each other and concerning to prosthetic plane before constructing artificial dentitions patient T. was directed to make a teleroentgenography of head, according to the proposed technique. This picture with radiopaque images (radiopaque material is located on the top of the alveolar process crest of upper jaw and on the occlusal surface of upper biting roller by prosthetic plane, the radiopaque material is located on the top of alveolar process crest of the lower jaw) was used to make total removable dentures for our patient, namely for constructing artificial dentitions in total removable dentures. The patient use prostheses successfully.

The proposed technique was applied to 27 patients with a total toothless with use of total removable dentures. Results of treatment are encouraging.

Reference

1. Komlev S.S. et al. A method of monitoring the state of prosthetic bed tissues of edentulous jaws concerning to each other or to prosthetic plane at the teleroentgenography of head, RF patent of prosthetic bed tissues of edentulous jaws concerning to each other or to prosthetic plane at the teleroentgenography of head, RF patent №2325869, 2008, 3p.
2. Rogatskin D.V., Ginali N.V., The skill of radiography. – STBOOK. 2007, 206, p.
3. Trofimova T.N., Garapach I.A., Belchikova N.S. Radiodiagnosis in dentistry. – MIA. 2010, 192p.