Ministry of health of ukraineministry of health of ukraine icon

Ministry of health of ukraineministry of health of ukraine




Скачати 126.9 Kb.
НазваMinistry of health of ukraineministry of health of ukraine
Дата19.06.2013
Розмір126.9 Kb.
ТипДокументи

MINISTRY OF HEALTH OF UKRAINEMINISTRY OF HEALTH OF UKRAINE

Vinnitsa National Medical University Vinnitsa National Medical University

NClosed.namamedPirogovM.I.Pirogov


"Approved" "Approved"

on methodological meetingonmetodichniy meeting

Department of Children's Dentistry Department of Children's Dentistry

Head of Department Head of Department

Assoc. Assoc. Filimonov Y.Filimonov Y.

"" '20

GUIDELINESGuidance

Individual work of students in preparation for actually (Seminars) Lesson Individual work of students in preparation for the practical (Seminars) I

 

Educational disciplineStudydistsiplina

orthodonticsorthodontics

The module numberThemodulenumber

15 15

Information-rich module numberContentmodulenumber

15 15

Subject classesThemeSession

Treatment apparatus. Apparatus treatment. Mechanical operating equipment . Mechanical operating equipment.

RateRate

3 3

FacultyFaculty

DentalDentistry

Autor

^ DMITRIEV NIKOLAI OLEKSANDROVICH



Vinnitsa 2011Vinnitsa 2011

Relevance of the topic:Relevanceofthose:

The essence of the orthodontic apparatus is continuous, intermittently or alternately, the current pressure on the teeth, alveolar bone and jaw with special mechanical devices that are activated by sliding hvyn ¬ Tamimi, spring wire, rubber rings, ligatures or effort of chewing and mimic muscles (in development 'united bite) or media ¬ Noah stereotypical movements of the mandible with the help of my guides ¬ occlusion and nakushuvalnyh platforms, inclined planes and elements to ensure normalization of mimic muscles: pelota lip, buccal shields vestibular manteli - dampers for the tongue and so on.The force of these devices' action lies in the very construction of the device and does not depend on the contractile ability of the masticatory muscles. The active part of the device is the source of force: arch and spring springiness, elasticity of rubber recoil and ligatures, the force developed by the screw, omega, levers, etc. The intensity of appliances' action is regulated arbitrarily by the doctor, who uses their active

^ Specific objectives:Specificobjectives:

  1. Have an understanding of modern methods of orthodontic treatment Have an understanding of modern methods of orthodontic treatment of the disease

  2. To study the nature of hardware methods used in the treatment of orthodontic pathologyVivchiti essence hardware methods used in the treatment of diseases ortodontichnoyi

  3. Having a clear idea of ​​the indications for the use of mechanical and operating equipment Having a clear understanding regarding the evidence for the use of mechanical and operating equipment

  1. Basic knowledge, skills, skills needed to study topics (interdisciplinary integration)Basic knowledge, skills, skills needed to study those (mizhdistsiplinarna Integration)

The names of previous courses The names of previous distsiplin

These skillsTheseskills

AnatomyAnatomy

Know the anatomy of the maxillofacial area and joint rights. Know the anatomy of jaw-litsevoyi areas and joint rights.

PhysiologyPhysiology

Understand the nature of effects on the compression and decompression efforts Understand the nature of impact on the compression and relief zusil

PropaedeuticsPropaedeutics

Know the times of teething.Knowtheteethingperiod.


4.4. Tasks for independent work in preparation for employment.task for self-employment under an hour of preparation for classes.

4.1.4.1. A list of key terms, parameters, characteristics that must learn the student in preparation for the lesson:list of key terms, parameters, characteristics that should be learned student in preparation for classes:

TimeTime

DefinitionDefinition

Apparatus mechanical actionApparatusmechanicalaction

  • Apparatus characterized by the fact that the power of action inherent in the design of the apparatus and is independent of the contractile capacity of masticatory muscles. Apparatus characterized by the fact that the strength of their actions in school design of the device and not depends on the contractile ability of masticatory muscles. The source of power is the active part of the system: elasticity arc springs, rubber elasticity and traction ligatures, the force that develops screw, Omega, levers, etc..source of power is the active part of the apparatus: the arc elasticity, springs, rubber traction elastichnist and ligatures, strength, a waving screw, Omega, lever and others.

Apparatus YenhlyaApparatusYenhlya

These versatile machines bulk of these devices is vestibular arc of stainless steel wire thickness 0,8-1,0 mm. These versatile machines osnovnovu Part tsih vestibular apparatus is an arc of stainless steel wire thickness 0,8-1,0 mm. At both its ends is a screw cutting, which screwed nuts. At both its ends are hvintovi cutting, where nahvinchuyut nuts. In supporting the teeth (1-AI permanent molars) wear crowns or rings (Engle used a bandage rings) with tubes arranged horizontally from the buccal side.to anchor tooth (1-AI permanent molars) wear crowns or rings (Engle koristuvavsya bandage kiltsyami) range of printing tubes, horizontally roztashovanimi For buccal side. Arc, bent with the fingers in the form of teeth, inserted in the tube.arcvihnutu with your finger to form teeth, inserted in the tube. Nuts provide an opportunity to establish an arc in any sagittal position from contact with the teeth to a certain distance from them. Nuts give mozhlivist Set arc in any sagittal position from contact with the teeth to viznachenoyi distance from them.


^ 4.2.4.2. Theoretical problems for the class:TheoreticalIssuesinClasses:

  1. What hardware methods of orthodontic treatment you know? What hardware methods of orthodontic treatment you know?

  2. What impressions and impressions against non-removable apparatus for treatment? Name the show and to show to non-removable apparatus treatment?

  3. What are the fixed orthodontic appliances do you know? What are the main fixed ortodontichni devices you know?

  4. Classification of orthodontic apparatusKlasifikatsiyiorthodonticapparatus

  5. Discover the basics and describe fixed sets of mechanical action.Rozkriyte basic principles of fixed devices and describe mechanical action.



4 . 3. Practical work (tasks) are performed in class:March 4 Practical work (tasks) to perform in class ..:

  1. Stationary arc EngleStationaryarcEngle

  2. Apparatus AinsworthApparatusAinsworth

  3. Apparatus MershonaApparatusMershon

  4. Machine A.Apparatus A. I. I. PozdnyakovPozdnyakov

  5. Apparatus Eisenberg - HerbstApparatusEisenberg - Herbst

  6. activator KlammtaactivatorKlammta

  7. Apparatus BryuklyaApparatusBryuklya

  8. Bionator BaltersaBionatorBaltersa

  9. Flexible shaper BimleraFlexibleshaperBimlera

^ 5.5. Plan and organizational structure of instruction in the discipline.plan and organizational structure of educational classes distsiplini.

NumberNumber

Stages of trainingStagesofClasses

^ Average timeDistributionofhours

Types of controlTypesofcontrol

Means of educationMeansofeducation

A.A.

The preparatory phaseThepreparatoryphase

15 min15 min

practical problems, situational problems, oral questioning by standardized list of questions.Practical Tasks situatsiyni tasks, verbal questioning by standardized perelikami stuffs.

textbooks, manuals and guidelines.Textbooks, Manuals, Guidelines.

1.11.11.11.1

O Organizational issues.Onorganizationalmatters.




1.21.2

Formation of motivation.Formationmotivatsiyi.

1.31.3

ControlControl

entry-level training.entry-leveltraining.

2.2.

The main stage.Themainstage.

135hv135hv

3.3.

The final stageThefinalstage

30 min30 min

teststests

teststests

3.1.3.1.

Control of the final level of training.Control of the final level of training.




3.2.3.2.

The total score of student workload.Overall Assessment of student workload.

3.33.3

Informing students about the topic the next lesson.Informing students about the subject next Session.


Track topics:Contents of those:

Appliances of Mechanical Action

The force of these devices' action lies in the very construction of the device and does not depend on the contractile ability of the masticatory muscles. The active part of the device is the source of force: arch and spring springiness, elasticity of rubber recoil and ligatures, the force developed by the screw, omega, levers, etc. The intensity of appliances' action is regulated arbitrarily by the doctor, who uses their active

^ Fixed Orthodontic Appliances

of Mechanical Action

Development of the instrument method of orthodontic treatment, substantiated scientifically and practieaTly, is connected with the name of Angle. The method is characterized by the following principles: the treatment is aimed at achieving ideal occlusion without teeth extraction; the idea of the 1st permanent molar as the "key" of occlusion; patient's age; treatment with standard mechanical appliances. For this purpose Angle offered vestibular round arches (stationary, expansive, sliding). These appliances got further development in the arch devices of Herbst, Mershon, Simon, Kork-haus—Lindy, Stanton, Cwillford. They include screw appliances and bracket systems.

These orthodontic appliances are fixed with the help, of crowns or rings on unprepared permanent teeth (premolars, molars) after conducting the so-called orthodontic separation. For this purpose there are used elastics, spring separators, plastic wedges, ligature, which are introduced between teeth and left for a couple of days. If it is necessary to disconnect dental arches for the treatment, crowns are used, if it is not needed to raise occlusion — rings are applied. Crowns and rings reach the teeth necks and are fixed with phosphate cement, but rings may decement. To improve their fixation they should be cemented with glassinomer cement or special adhesive glue, made on the basis of epoxide resins.

Angle's appliances are called universal, because they may be used for the treatment of different types of dentognathic anomalies. The main part of these appliances consists of a vestibular arch made of stainless steel wire 0.8—1.0 mm thick. There are threads on its either part, on which nuts are wound. Crowns or rings are put onto the abutment teeth (the 1st permanent molars) — Angle used bandage rings — with tubes located horizontally from the buccal side. The arch, bent with the help of fingers by the form of the dental arch, is inserted into the tubes. Nuts allow fixing the arch in any sagittal position: from contact with teeth to a certain distance from them.

Angle's stationary arch is used for the vestibular transfer of irregularly located frontal teeth: tying them up to the arch with ligatures, transferring them. The arch is activated by means of tightening nuts and moving the arch forward. Not infrequently hooks are soldered to the arch, or incorrectly located teeth are covered with crowns, vertical bars or hooks are soldered to them and under the influence of rubber recoil or ligatures teeth are moved to the needed side (mesially, distally, vertically) or rotated.

Angle's expansive arch is used for dental arch dilation. Depe/rding on the region, in which dental arch should be dilated (in the region of molars or premolars), the arch is set accordingly. To dilate dental arch in the region of molars the arch is straightened and by means of drawing its ends together under tension is introduced into tubes; if it is necessary to dilate it in the region of premolars and canine teeth, one uses the arch bent by the needed form of dental arch, and teeth are pulled to it with ligatures.

Angle's sliding arch is used for the inclination of the frontal teeth to the palatine or lingual side. The arch is turned into the sliding one: nuts are taken off, and in the region of canine teeth medially open hooks are soldered to the arch. After the arch is introduced into tubes, on both sides rubber rings are put on the hooks and fastened on the posterior end of the tube. Rubber recoil dislocates the arch distally, and in such a way pressure is exerted onto the frontal teeth

When treating vertical occlusion anomalies with Angle's appliance one acts in the following way. For teeth drawing the arch is located closer to their cutting edge and with ligature wire it is pulled to the necks of the transferred teeth. At teeth immersion the arch is set closer to the necks and also tied up to the teeth with a wire ligature. In both cases the arch due to its elasticity tries to take its initial position and pulls along all the teeth tied to it.

The appliance is also used for the levelling of sagittal dental arches correlations (at progenia, prognathism) by means of applying oblique intermaxillary rubber recoil (Bekker is considered the inventor of oblique intermaxillary rubber recoil (1892); Angle improved the method). In this case Angle's appliances are used simultaneously on the upper and lower jaws. The arches are tightly fixed to the teeth with ligatures; there is a hook on one of them. If the hook is soldered to the arch of the upper jaw in the region of canine tooth—premolar, rubber recoil force dislocates the upper dental arch backwards, and the lower one — forward to some extent. If the hook is located on the arch of the lower jaw, reverse action takes place.

^ Aisnwort's appliance.Crowns or rings are made for the 2nd, more seldom —1st premolars.

Tangent bars are bent using orthodontic wire 0.8—1.2 mm in diameter, spanning the teeth, subject to dislocation, from the palatine side in the neck part. The bars are pressed close to the crowns (rings). From the vestibular side to the rings on the premolars vertical tubes are soldered with the internal diameter by 0.1—0.2 mm larger than the diameter of the wire, using which the arch is bent.

The vestibular elastic arch is bent using orthodontic wire 0.8—1.2 mm in diameter in such a way that it touches the frontal teeth only. The arch ends are bent at a right angle straight or in the form of a hook, then inserted into tubes and shortened by the size of vertical tubes. Rings with bars are fixed with cement on abutment teeth. On the next day the arch is introduced with its ends (with an effort) into the tubes. Arch elasticity, which is activated periodically, dislocates teeth. If the vestibular elastic arch becomes short in the process of treatment, a new one is bent or another arch is prepared right away with compensatory U-loops near the canine teeth.

^ Aisnwort's appliance is used for irregular dilation of dental arch and elimination of the narrow location of incisors

Simon's appliance.For the 1st permanent molars supporting rings are made, to which, near the medial-buccal angles, vertical tubes are soldered with an internal diameter of 1.8-2.5 mm depending on the diameter of the tube wire. From the oral side tangent bars (made of wire 1.2—1.5 mm in diameter) are soldered to the rings, the bars being adjacent to the premolars and canine teeth. Vestibular elastic arch is bent of orthodontic wire (0.8—1.2 mm in diameter) with U-loops in the region of premolars, vertical prominences, which come into vertical tubes and fix the arch. Free ends of the arch are bent inwards at the angle of 10—15° in such a way that they set against the distal-buccal areas of molars. The arch itself should be tightly adjacent to the frontal and lateral teeth. With the help of the appliance the dental arch is dilated in the region of premolars and molars, the molars being rotated. The arch is activated by means of pressing the U-loops.

^ Mershon's appliance for dental arch dilation.Supporting rings with locks on the lingual-palatine side in the form of horizontal tubes soldered to a ring are made for the 1st permanent molars. Lingual arch is bent of orthodontic wire (0.8—1.0 mm in diameter). Elastic processes with their being adjacent to the lingual surface of the teeth, subject to transfer, are made of orthodontic wire 0.4—0.6 mm in diameter. The processes may have the form of a snake or a safety pin. They are soldered to the arch by means of contact welding, or one of their ends is wound onto the arch for the processes not to lose elasticity. Teeth transfer and dental arch dilation take place due to elastic properties of the arch and processes.

In 1926 Angle offered a tetrahedral arch with brackets for all teeth instead of a round arch with supporting rings for molars.

It should be mentioned that achievements of this period created real conditions for modern school appearance and creation of improved constructions of fixed mechanically acting arch appliances (Johnson, Tweed, Andrews, Rickets, Y.M. Maly-hin, Block). Johnson offered a system of twin arches and tried to use advantages and eliminate defects of Angle's appliances with the help of this device. As this was a compromise (constructive), he could not solve the problem finally

After the analysis of Angle's appliances' advantages and disadvantages the development of fixed arch devices was fundamentally going on in two directions.

Begg offered to use the round arch, making it light by means of creating auste-nitic steel together with Wilcock, and named his appliance the system of light wires. For the purpose the author used very elastic, so-called Australian wire — stainless steel wire 0.4 mm in diameter. Auxiliary springs can not be soldered to such a wire, therefore additional loops for rubber recoil are bent on the arch itself. To make the action of the vestibular arch more tender, Begg used vertical loops. They level the force of action between irregularly located teeth. The length of the arch increases at the expense of the loops, and in such a way the action of the force decreases. The number and type of loops depend on dental arch irregularity. The loops are usually applied at the beginning of treatment. Rings of stainless steal are made for the molars and all the teeth subject to transfer. Special bars for arch strengthening are soldered to them, and if it is necessary — also hooks for inclined or corpus transfer of teeth

in the mesial or distal direction. Teeth corpus transfer of this system is achieved in two stages: at first, tilt-and-swivel transfer of the tooth crown, and then its root inclination.

Andrews continued improving the orthodontic lock (bracket) and tetrahedral arch. As a result, he patented an appliance of programmable action, in which it was not necessary to bend arches in the process of treatment, so the system was named the technique of straight wire

F.Y. Khoroshilkina and Y.M. Malyhin denote that today many constructions are known, which are based on the application of edgewise technique. Edgewise-brackets differ in size and form, groove direction, its angulation relative to the base of the lock, the presence of an additional supportive platform for tacking it to the tooth, combination with other elements. These supplements are made to achieve different aims and to accomplish different tasks.

Due to the usage of modernized systems the treatment with fixed arch appliances becomes more efficient and exact, arches bending becomes simpler, errors at their bending are excluded, which provides universal teeth transfer in possible directions with achieving their corpus transfer. To quickly expose suture junctions Derich-sweiler's appliances are used, as well as Malyhin's, Levkovych's, Khoro-shilkina's, Tril's, etc., which provide intensive exposure of the palatine suture. To lighten the construction, improve oral cavity hygiene, and control the state of the mucous tunic, these constructions are made without the basis with Biderman's screw or made dismountable according to Khoroshilkina.

Fixed appliances of mechanical action also include a crown with hooks and vertical bars, put in action with the help of rubber recoil; fixed metal (made of soldered crowns) or plastic gum shields with hooks for the vertical transfer of teeth under the action of rubber recoil force with elastic loops for diastems elimination; appliances of Korkhaus and Schwarz, which preserve place in dental arch after the early extraction of milk or permanent teeth.

A.I. Pozdniakova's appliance for bringing teeth out of palatine position consists of crowns, fixed on the 1st permanent molar and the tooth with palatal location. A bar is soldered to the crown of the molar from the vestibular side, the other end of the bar bears on the tooth standing in front of the transferred one. Hooks are soldered to the crown of the palatally located tooth. The appliance is put into action with elastic recoil or ligature, which is applied on the hooks of the transferred tooth and vestibular bar.

^ A.I. Pozdniakova's appliance for canine teeth transfer in the distal-buccal direction

two crowns are made — one for the canine tooth, and one for the 1st permanent molar. Hooks are soldered to the crown on the canine tooth from the vestibular and lingual sides. Bars are soldered horizontally to the molar crown from the vestibular and lingual surfaces, which end with hooks at the levelpf the 1st premolars. Rubber rings are put on between the hooks of the canine tootnand the molar, and the tooth is transferred with the help of the rings. Rubber recoil should be changed every 1—2 days. The tooth is transferred orally and distally.

^ Aisenberg—Herbst's appliance is used to transfer the upper frontal teeth orally, change their inclination and dental arch shortening at the presence of spaces between the frontal teeth For the 1st milk molars or 2nd permanent premolars rings (crowns) are made, to which horizontal wire (0.8 mm in diameter) bars are soldered from the vestibular side. The bars are directed forward, adjacent to the vestibular surface of teeth, and end in the region of canine teeth with hooks, opened backwards. After fixing the rings with cement, elastic rubber, (rings) is stretched on teeth between hooks. The tractive force is regulated by a selection of rubber rings of necessary length, width, and thickness.

^ Z.S. Vasylenko's appliance for teeth rotation For the rotated tooth a crown or a ring is made with a horizontally soldered oval tube from the vestibular

side. Internal intersection of the tube equals the double diameter of the lever's wire in height and one diameter in thickness. On the 2nd premolar or the 1st molar of the dental arch side, opposite to the rotated tooth, a ring is put with a round bar 0.8—1.0 mm in diameter soldered to its lateral surface, tangent to two adjacent teeth. To the same ring from the vestibular side a U-brace is soldered with the length equal to the tooth width and distant from the ring by 1.5 mm. An elastic lever is bent of orthodontic wire 1 mm in diameter. The end of the lever, which enters the tube, is bent in the form of a loop with a bumper preventing lever rotation.

The other end of the lever is bent in the form of a hook and is brought behind the U-brace on the molar from the medial side. Tooth rotation takes place under the action of activated flexible lever until the hook stops at the distal end of the U-brace. This serves as an indication to the next activation of the lever or bending of a new one.

Fixed appliances have advantages over removable ones as they act constantly, round the clock, depend little on the patient, but have a number of drawbacks. These appliances do not provide full-value action on the dentognathic apparatus: practically do not stimulate sutural and appositional jaws growth, do not influence the renewal of myodynamic balance in the craniofacial area and renewal of the dentognathic apparatus function, violate the esthetics. Difficulty of the exact dosage of force,, long-term stay of arches, reinforced with ligatures, of crowns, rings, and other details of fixed constructions in the mouth complicate oral cavity care, may be the reason for dental enamel damage. Ligatures, injuring dental bulbs, provoke swelling of the gingival margin and not infrequently lead to the formation of pathologic "pockets".

^ Removable Appliances of Mechanical Action

Determination to eliminate at least partially the described above drawbacks of fixed appliances promoted the development, approbation, and implementation of removable mechanically acting orthodontic appliances. This was enabled by the invention of methylmethacrylate — the basic component of modern plastics.

Construction of the plastic basis of removable appliances is conducted by the method of hot polymerization; the method of cold polymerization of self-hardening plastic; the method of plastic casting; the method of stamping acrylic plastic after its warming-up, the so-called pneumovacuum formation.

These devices include plate appliances in combination with screws, springs, vestibular arches. The first removable plate appliances for the treatment of occlusion anomalies were offered after the discovery of caoutchouc vulcanization (1839). In the 1960s Kingsley constructed a plate with a dilating screw. Nord improved it, having offered a sc*ew of his construction. Further improvement of Nord's idea belongs to Schwarz.

V.S. Kurylenko's appliance for teeth transfer in the mesiodistaldirection It is a removable plate, into which movable and immovable levers of orthodontic wire (0.6 mm in diameter) are welded. The movable lever, being adjacent to the approximal surface near the very neck of the transferred tooth, provides its transfer without rotation around the vertical or horizontal axis. The active lever easily revolves in the basis and may be used for the transfer of 2 and even 3 teeth, especially if it is needed to transfer them in one direction. Retracting arch, inclined plane, and other elements of removable orthodontic appliances may be built into the plate, which shortens the term of anomalies treatment.

Removable appliances of mechanical action include S.I. Doroshenko's appliance, Robert's appliance appliances for distal teeth transfer

Nowadays there are used removable appliances with different location of screws (of definite size, dimensions, and in certain quantity) in accordance with the area, which should be dilated or brought out in the vestibular direction

All the appliances with mechanical action require proper fixation. To attach endurance to plate appliances various clasps are used: ordinary retentive, Jackson's throw-over, Schwarz' arrow-like, Adams' clasps. Wire of different thickness and elasticity is used to make these clasps. Retentive, arrow-like, and Jackson's clasps are made of stiff wire 0.7—1.1 mm thick (arrow-like clasps are bent with the help of special forceps), Adams' clasps — of stiff or stiff-elastic wire 0.6—0.7 mm in diameter.

In orthodontics, in order to dilate dental arches and transfer individual teeth removable appliances with springs and vestibular arches are widely used, and Coffin's dilating plate is considered their predecessor. These appliances act by means of unbending or pressing corresponding loops. Springs location, the form of their bend and of vestibular arch depend on clinical presentation. To make vestibular arches stiff wire 0.7—0.8 mm in diameter is usually used, for flexible processes — 0.5—0.6 mm, for Coffin's spring — 1.0—1.5 mm.

Removable appliances act in discontinuous manner, as children use them during a couple of hours in the course of a day. At that, the factor of injuring a child is excluded in the period of treatment and stay in a collective, because children can use removable appliances at home only. Characterizing the described above removable appliances it should be mentioned that they act with less force, with breaks (they can be taken off), they are more hygienic. Removable orthodontic appliances, during a short period of time creating enhanced functional load on a certain area, stimulate bony tissue rebuilding: irritation is transferred not only to the teeth but also to the bony tissue of the jaw.

The slower the appliance acts, the more harmonious the processes of resorption and apposition of bony tissue around the transferred teeth are. The fact that the orthodontic appliance, with which the treatment was conducted, may be also used as a retentive one, is very important. These appliances are administered at treating dento-gnathic anomalies at any age with their individual construction in every case. But sometimes, despite all their positive qualities, removable appliances appear to be insufficiently effective. This is explained by the fact that children break doctor's instructions about the way and duration of using the appliances. Irregular wearing of them, big breaks in application may lead to the wrong idea of their seemingly ineffective action. This implies that the decisive role in using removable appliances is played by children's discipline and parents' careful control of children.

^ Appliances of Mechanical Action with Extraoral Support

Long-term usage of intraoral constructions of orthodontic appliances made orthodontists use appliances with extraoral action (F.Y. KJioroshilkina, 1974; E.Y. Va-res, 1981; V.A. Zahorskyi, 1985; I.V. Tokarevych, 1992; Verdon, 1972; Delaire, 1979; Petit, 1983; Roberts, 1988; Q.M. Guo, 1994, and others). But they do not provide the intensive action on dental arches because of the impossibility of extraoral efforts' influence on the whole dental arch by its separate sectors

^ Appliances of Combined Action

These appliances are used at combined pathology in most cases and comprise about 75 % of all removable appliances.

Functional appliances may be supplemented by separate active elements — screws and springs, used at the necessity to accelerate individual teeth transfer.

An important milestone in the development of orthodontics were the treatment method by Andresen and Haupl (1953) and their appliance named "activator", which promoted the recovery of the functions of mouth closure, breathing, mastication, and partially swallowing, activated the masticatory muscles and stimulated TMJ growth.

Soon there appeared Klammt's open activator, Bimler's occlusion shaper, Baiters' bionator and their modifications. Andresen—Haupl's appliance was also modified for a couple of times, by Macary and Kesling, Kurz, P.S. Flis, G.P. Leonenko

These appliances consist of two plates — upper and lower, joined with basis material or wires. They may be supplemented by a vestibular arch, a spring, and a screw. In the plates, adjacent to the internal surface of alveolar processes, there is a bed for palatine and lingual surfaces of upper and lower teeth, into which teeth are placed at jaws closure. Their correlation is created with the help of wax rolls before making the appliance (usually it is recommended to set the lower jaw almost in direct ratio to the upper one). In the process of treatment the dental bed is sawed out according to the

direction of teeth transfer. Depending on the clinical presentation and the aim of treatment dental arches of both jaws may be disconnected (growth takes place in the vertical direction) or their masticatory surfaces touch the biting platform. The action of such appliances is based on the contraction of the masticatory and expression muscles and the force of mechanical elements action. At jaws closure teeth undergo certain load, which stimulates tissue rebuilding.

Activators have been mainly used at night. Presently it is recommended to use them also during the day (as long as possible), as muscles activity is more evident at daytime and after food intake than at night.

Lately, the so-called elastic open Klammt'sactivator has won recognition. It almost completely consists of vestibular arches and springs, except for thin palatine plastic plates (1.2 mm thick), which begin from the canine teeth and end by the last molar. These plates might have directing surfaces or not. If it is necessary, it is possible to introduce supplementary wire elements, bandages, or modify the vestibular arches. Appliance's activity becomes apparent at tongue and lower jaw movements. The author recommends using the appliance in infancy, during the whole day and night.

Activators' drawbacks include their slow action, which almost excludes the possibility of using activators in young people and adults. Besides, at full-blown anomalies the desired effect is not always achieved, which makes it necessary to combine activators with other orthodontic appliances.

The idea of creating new constructions of activators was to try to lighten the construction's weight, reinforce its constructional inflexibility against the deforming action of mastication forces, increase the time of using the appliance (especially during the daytime), enable the patient to talk having the appliance in the mouth, etc.

^ Khurgina's appliance is the combination of Katz' biting platform and a dilating screw. It is used at treating prognathism and deep overbite at the presence of upper dental arch narrowing.

Guliayeva's appliance is a combination of Angle's sliding arch and an inclined plane. Crowns with horizontal tubes are put onto the 1st permanent molars, a steel

arch is inserted into the tubes; in the region of canine teeth hooks are soldered to the arch. Rubber rings, which contribute to the arch's action, are fastened between the hooks and distal ends of the tubes. In the region of frontal teeth metal processes are soldered to the arch, and an inclined plane is soldered to the processes. This appliance is used for the treatment of posterior occlusion.

Briickl's appliance consists of a removable plate for the lower jaw in the anterior region, a vestibular arch, and clasps. During dental arches closure the upper frontal teeth touch the inclined plane with their palatine surfaces and diverge in the vestibular direction; and as a result of vestibular arch activation the lower frontal teeth bend orally (the inclined plane from the lingual side and near the cutting edge should not be adjacent to them). Dental arches are disconnected in lateral areas. This appliance is recommended at any age at palatine inclination of the upper frontal teeth and forced progenia, if fusiform vestibular declination of the lower frontal teeth is observed, accompanied by diaereses and diastema, deep frontal overbite. Baiters' bionator.There are three types of the appliance (l)for the elimination of dental arches constriction, protrusion of frontal teeth and deep overbite (1);

  1. for the elimination of open bite (2);

  2. for the elimination of mesial occlusion (3).

Bionators are made on models, plastered in constructive occlusion in the occluder or articulator. Their basic details are:

  • lateral plastic shields, covering the lingual or palatine surfaces of the lateral teeth of both jaws to the distal surfaces of the, 1st permanent molars, which join in the anterior part of the lower jaw from thebuccal side for the increase of appliance's support;

  • palatine clasp, bent backwards in the first two types of appliances for speech orientation; in the third type the palatine clasp is bent forward. Occlusive side plates for the upper milk molars, premolars, which go from oral lateral plastic shields, serve as supports in the bionators of the 1st—2nd type. In the bionator of the 3rd type occlusive side plates are made for the lower milk molars;

  • vestibular dental arches with loops or arched bends-processes in tjare lateral parts of dental arches, distant from the teeth by 2 mm, are intended for cheeks alienation. Arches' ends are introduced into plastic shields between the canine teeth and the 1st milk molars or the 1st premolars.

At posterior occlusion elimination the vestibular arch is bent onto the upper frontal teeth, at mesial occlusion elimination — onto the lower ones. In the bionator of the 2nd type a plastic shield is made in the anterior part, it separates the tongue apex from dental arches at the pernicious habit, prevents laying the tongue between teeth and the pressure onto the frontal teeth. Plastic shields for cheeks or lips abduction or a removable shield in the form of a vestibular plane are connected to the bionator, which prevents cheeks and lips retraction between dental arches, promotes correct lips closure, normalizes tongue and teeth position in the lower jaw.

^ Elastic Bimler's shaper is an appliance of wireframe construction with
elastic wire joining details, which are the acting force at lower jaw movements. There
are three main groups of occlusion shapers: A, B, and C. Group A — seven kinds for dentognathic anomalies elimination at neutral or distal dental arches correlation, combined with diaereses presence, dental arches constriction, frontal teeth congestion, their torsion, deep or open bite. The kinds of occlusion shapers of this group differ from one another by the presence of additional arches, screws, springs, which correct the position of upper incisors, canine teeth, and premolars.


Group B — five kinds of occlusion shaper for dentognathic anomalies elimination at neutral or distal dentitions correlation, combined with upper teeth retrusion and deep overbite. They differ from one another by the action of the orthognathic screw (dilation, narrowing), and by the presence, form, and location of springs.

Group C — six kinds of occlusion shapers for the treatment of dentognathic anomalies at neutral or medial dental arches correlation, combined with reverse overbite, and elimination of mesial occlusion combined with the cross one. These kinds differ from one another mainly by the location and form of springs.

Appliances of combined action may include Khurgina's appliance Robert's device — type 2 N.D. Dankov's appliance) and others.

At lower jaw underdevelopment accompanied by compression in lateral parts N.V. Rashchenko with co-authors worked out and offered appliances, which provide purposeful influence both on individual teeth and on the alveolar processes during teeth eruption and their roots formation. The essence of the appliances construction consists in the following: a dental-gingival splint of Weber's type is made and divided into 3 fragments — one frontal and two lateral, joined with one anothejTwith the help of spirals and Q-loops. Q-loops (1—4) are bent using orthodontic wire 0.8 mm in diameter, located vertically from the oral side, closer to the lingual surface of the lower incisors and parallel to their long axis. Spirals are made of wire 0.6 mm in diameter (winding it onto a rod 1—1.5 mm in diameter) and welded from the vestibular side between fragments. Rubber rings or an expansive arch are the active elements of the offered appliances. The rubber rings are put onto hooks, which are welded on the vestibular surface of the frontal and lateral fragments. On the lateral fragments the hooks are welded distally open, on the frontal — medially. The frontal fragment, in contrast to the lateral ones, is made in the form of a vestibular shield. To use the Angle's arch cannulae are welded into the lateral fragments, Q-loops may be not used at that. Activated arches are made by common technique. To incline the crown parts of masticatory teeth in the vestibular direction Adams' clasps are welded from the oral side. If a "block" is present, occlusion disconnection is performed with the help of occlusive side plates on one or both sides. If pressure should be excluded from one

tooth, plastic is cut out in the region of the tooth. Different variants of appliance construction for lower jaw dilation can be seen in the

For the distal transfer of individual teeth or a group of teeth S.I. Tril's appliance has been worked out and introduced into practice. The device works in the following way. Occlusive side plates (1) and (7) are set into the oral cavity on teeth and fastened with clasps (3). With the help of the sector-like located screw (10) the effort of the distal transfer of a dental arch part (6) is created. The dental arch (4) and

opposing teeth serve a support at the transfer of the part. The arch (11) directs the vestibularly located tooth (12) into the dental arch to the place of the transferred dental arch part (6). Smooth surface (9) of the occlusive side plate (7) does not create obstacles to the distal transfer of teeth (6).

To treat unilateral cross bite S.I. Tril's appliance has been worked out
The device consists of the basis part (1), which is set on the unaffected dental arch
part, and the part (2), set on its deformed part. The basis parts (1) and (2) are joined
with an orthodontic screw (3) and a vestibular arch (4). The part (1) has imprints of
the occlusive surface of the unaffected dental arch part (5) and opposing teeth (6).
Prolonged oral bandage (7) rests on the lingual surface of the teeth of the opposite
jaw (8) and embraces their vestibular surface (9). The part of the basis (2), set onto
the deformed dental arch part, has an imprint of the occlusive surface of this part (10)
and smooth occlusive surface (11), directed to the opposing teeth. .„rU

The device operates in the following way. Orthodontic appliance parts (1) and (2) are set in the oral cavity and fastened with the help of occlusive side plates and Adams' clasps built into them. The device is activated with the help of the orthodontic screw (3). The unaffected part of the dental arch, teeth-antagonists, elongated oral bandage (7), which leans against the lingual surface of the teeth (8) of the opposite jaw serve as support at transfer. Wrapping teeth-antagonists from the vestibular side (9) prevents their rotation under the influence of efforts needed for the transfer of the deformed jaw part.

Materials for self-control:

^ SELF-CONTROL QUESTIONS

  1. Orthodontic appliances classification by F.Y. Khoroshilkina.

  2. Enumerate the structural components of functionally acting appliances.

  3. What group of muscles is influenced by functionally acting appliances?

  4. Name functionally acting devices.

  5. Enumerate the structural components of functionally directing appliances.

  6. What group of muscles is influenced by functionally directing appliances?




  1. Name removable and fixed functionally directing appliances.

  2. Enumerate the structural components of mechanically acting appliances.

  3. Name the representatives of removable and fixed mechanically acting appliances.

  4. What is the operating principle of removable appliances?

  5. When are combined appliances used?

  6. What devices are used for the prophylaxis of dentognathic pathology?


TESTS

1. Dilating Q-spring was offered by:

A. Andresen.

B. Coffin.

C. Kalvelis.

D. Frensel.

E. Schwarz.

2. Structural components of functionally act-
ing appliances are:


A. Expansive arch.

B. Inclined plane.

C. Buccal shields.

D. Occlusive side plates.

E. Screw and labial bandages.

3. What group of muscles is influenced by
functionally acting appliances?


A. Masticatory.

B. Expression.

C. Muscles elevating and protruding the jaw.

D. Muscles elevating the lower jaw.

E. Combined group of muscles.

4. Structural components of functionally di-
recting appliances are:


A. Expansive arch.

B. Inclined plane.

C. Buccal shields.

' D. Occlusive side plates.

E. Screw and labial bandages.

5. What group of muscles is influenced by
functionally directing appliances?


A. Masticatory. 1 B. Expression.

C. Muscles elevating and protruding the
jaw.

D. Muscles elevating the lower jaw.

E. Combined group of muscles.

6. Structural components of mechanically
acting appliances are:


A. Expansive arch.

B. Inclined plane.

C. Buccal shields.

D. Occlusive side plates.

E. Screw and labial bandages.

7. Structural components of combined appli-
ances are:


A. Expansive arch.

B. Inclined plane.

C. Buccal shields.

D. Occlusive side plates.

E. Screw and labial bandages.

8. Which of these appliances is mechanically
.acting?


A. Bynin's gum shield.

B. Schwarz' gum shield.

C. Katz' crown.

D. Briickl's appliance.

E. Schwarz' appliance with retracting arch.

^ 9. Appliances of combined action:

A. Screw + elastic pushers.

B. Occlusive side plate + inclined plane. 'y

C. Inclined plane + biting platform.

D. Screw + inclined plane.

E. Labial bandages + buccal shields.


^ RIGHT ANSWERS TO THE TESTS:



Test

Answer

1

B

2

C

3

B

4

B

5

A

6

A

7

E

8

E

9

D



Literature.

  1. A. A. P. S Fleece. Orthodontics. Textbook for students in higher educational institutions iv level of accreditation. Newknyha.Kyyiv - Vinnitsa, 2007. 305s

  2. 2. Two. HB Golovko. Orthodontics. The development of occlusion, diagnosis dentalmental anomalies, orthodontic diagnosis. Guide students in higher educational level IV accreditation. Poltava. 2003.in 2003. 294s

  3. Betelman AI, Pozdnyakova AI, AF Mukhina, Yu Alexandrov M. Ortopedycheskaya Stomatology of child age. K., 1972, - 260 p.

  4. B in W and Mr. M. G. Handbook of ortodontyy, 1990 - 486 p.

  5. Grigorieva LP occlusion in children. Poltava, 1995, - 225 p.

  6. Zubkov LP, Horoshylkyna F. J. Y. treatment and profylaktycheskye restructuring in ortodontyy. "Health" - Kyiv, 1993, - 343 p.

  7. Kalvelys D. A. A. Ortodontyya. - Riga, 1964, - 238 p.

  8. Kryshtab con. Ortodontyya and protezyrovanye in children's age of. K., 1987, pp. -98.

  9. Orders MOH of Ukraine № 146 of 23.10.1991 p., № 168 of 21.11.1991 p., № 130 of 9.06.1993 p., № 359 of 19.12.1997 p., № 305 of 22.11.2000 ρ, № 33 of 23.01.200Op.

  10. Πersyn L. S. S. Ortodontyya. - Moscow, 1998, - 298 p.

  11. 13.Kuroedova VD, Syrыk VA, Smaglyuk L. V. B. Collection testovыh of issues and otvetov "Ortodontyya." AMyK "Poltava" - C. 1995, - 102 p.

  12. Φylycheva T. B. Fundamentals lohopedyy, 1989, - 105 p.

  13. Xoroshylkyna F. J. J. Guide to ortodontyy. - M., Medicine, 1982, pp. -464.

  14. Xoroshylkyna F. J. J. Guide to ortodontyy ed. second. - M., Medicine, 1999, pp. -712.

  15. Sharova T., G. I. PohozhnykovOrtodontycheskaya Stomatology of child age. - M., «Medicine», 1991, - 288 p.



Yshodnыy text (anhlyyskyy):

MINISTRY OF HEALTH OF UKRAINE

Suggest better translation of variants


Original Text:

Підручник для студентів вищих медичних закладів освіти iv рівня акредитації.

Show alternative translations

Схожі:

Ministry of health of ukraineministry of health of ukraine iconMinistry of public health of ukraine ministry of education, science, youth and sports of ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of Health of Ukraine

Ministry of health of ukraineministry of health of ukraine iconThe Health Ministry of Ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of Health of Ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of health of ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of Health of Ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of Health of Ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of Health of Ukraine

Ministry of health of ukraineministry of health of ukraine iconMinistry of Health of Ukraine

Ministry of health of ukraineministry of health of ukraine iconThe Health Ministry of Ukraine

Додайте кнопку на своєму сайті:
Документи


База даних захищена авторським правом ©zavantag.com 2000-2013
При копіюванні матеріалу обов'язкове зазначення активного посилання відкритою для індексації.
звернутися до адміністрації
Документи