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RU-2861495-C1 - METHOD FOR RELAXING MASTICATORY MUSCLES IN PATIENTS WITH DENTOALVEOLAR ANOMALIES DURING ORTHODONTIC TREATMENT AND DEVICE FOR IMPLEMENTING SAME

RU2861495C1RU 2861495 C1RU2861495 C1RU 2861495C1RU-2861495-C1

Abstract

FIELD: medicine. SUBSTANCE: group of inventions relates to orthodontics and orthopaedic dentistry, and is intended for use in a mandibular deprogramming programme and determining its correct position during orthodontic treatment of patients with dentoalveolar anomalies of the vertical type. Separation of the anterior dental arches is performed using a device with a bite block by an amount corresponding to the optimal occlusion. The device is placed on the upper jaw. The amount of separation is determined based on the nature of the dentoalveolar anomaly and the state of the masticatory muscles. The mass-inertial index (M c ) and torsional index (T i ) of the masseter and temporalis muscles are determined. Depending on the obtained indicators, the state is diagnosed as corresponding to a certain type of asymmetry, where a combination of Mc values from 90 to 100% and Ti from 90 to 75% corresponds to moderate rotational asymmetry, a combination of Mc values from 90 to 100% and Ti less than 75% corresponds to pronounced rotational asymmetry, a combination of Mc values from 75 to 90% and Ti from 90 to 100% corresponds to moderate intermuscular asymmetry, a combination of Mc values less than 75% and Ti from 90 to 100% corresponds to pronounced intermuscular asymmetry, a combination of Mc values from 75 to 100% and Ti from 75 to 100% corresponds to moderate mixed asymmetry, a combination of Mc values less than 75% and Ti less than 75% corresponds to pronounced mixed asymmetry. The separation of the anterior dental arches is carried out by 1.0 mm for a period of 2 weeks to 1 month for moderate rotational asymmetry, by 2.0 mm for a period of 2 weeks to 1 month for pronounced rotational asymmetry, by 0.5 mm for a period of 2 weeks to 1 month for moderate intermuscular asymmetry, by 1.5 mm for a period of 2 weeks to 1 month for pronounced intermuscular asymmetry, by 1.5 mm for 3 months followed by separation by 1.0 mm for a period of 2 weeks to 3 months for moderate mixed asymmetry, by 2.0 mm for 3 months followed by separation by 1.0 mm for a period of 2 weeks to 3 months for moderate mixed asymmetry. EFFECT: possibility of providing separation of the anterior dental arches, medial and lateral incisors, as well as canines and posterior teeth, optimal for the actual state of the masticatory muscles at a specific moment of the relaxation stage, with the possibility of varying the separation parameters during relaxation procedures. 4 cl, 14 dwg, 1 tbl, 3 ex

Inventors

  • Berezkina Tatyana Nikolaevna
  • Filatova Olga Olegovna
  • ORLOV ALEKSANDR EVGENEVICH
  • ORLOVA IRINA VIKTOROVNA
  • Nioradze Mariya Guramovna
  • Sevastyanov Arkadij Vladimirovich
  • FISHCHEV SERGEJ BORISOVICH
  • KLIMOV ANDREJ GENNADEVICH
  • Pavlova Svetlana Georgievna
  • Kondratyuk Andrej Aleksandrovich
  • Rozhkova Mariya Gennadevna
  • Puzdyreva Margarita Nikolaevna
  • Shtorina Anastasiya Aleksandrovna

Dates

Publication Date
20260505
Application Date
20250930

Claims (20)

  1. 1. A method for relaxing the masticatory muscles in patients with dentoalveolar anomalies during orthodontic treatment, in which
  2. - perform separation of the dental arches of the anterior jaw to a value corresponding to the optimal bite, using a device that includes a base with the occlusal surface of the dental arch of the upper jaw and a bite block with a wall thickness of 0.5-2.0 mm, covering the occlusal, vestibular and palatal surfaces of the base in the area of the teeth of the anterior jaw,
  3. - in this case the device is installed on the upper jaw,
  4. - the magnitude of the separation is determined based on the nature of the dentoalveolar anomaly and the condition of the masticatory muscles,
  5. - why the mass-inertial index (Ms) and torsional index (Ti) of the masticatory and temporal muscles are determined,
  6. - depending on the obtained indicators, the condition is diagnosed as corresponding to a certain type of asymmetry, where
  7. a combination of Mc values from 90 to 100% and Ti values from 90 to 75% correspond to moderate rotational asymmetry,
  8. a combination of Mc values from 90 to 100% and Ti less than 75% corresponds to pronounced rotational asymmetry,
  9. a combination of Mc values from 75 to 90% and Ti values from 90 to 100% correspond to moderate intermuscular asymmetry,
  10. a combination of Mc values less than 75% and Ti from 90 to 100% corresponds to pronounced intermuscular asymmetry,
  11. a combination of Mc values from 75 to 100% and Ti values from 75 to 100% correspond to moderate mixed asymmetry,
  12. a combination of values of Mc less than 75% and Ti less than 75% corresponds to pronounced mixed asymmetry,
  13. - the separation of the dental arches of the anterior jaw is carried out by a value of 1.0 mm over a period of 2 weeks to 1 month with moderate rotational asymmetry,
  14. by 2.0 mm over a period of 2 weeks to 1 month in cases of severe rotational asymmetry,
  15. by 0.5 mm over a period of 2 weeks to 1 month with moderate intermuscular asymmetry,
  16. by 1.5 mm over a period of 2 weeks to 1 month with severe intermuscular asymmetry,
  17. by 1.5 mm over 3 months, followed by separation by 1.0 mm over a period of 2 weeks to 3 months with moderate mixed asymmetry,
  18. by 2.0 mm over 3 months, followed by separation by 1.0 mm over a period of 2 weeks to 3 months in moderate mixed asymmetry.
  19. 2. The method according to paragraph 1, characterized in that the incisors and canines are separated.
  20. 3. A device for implementing the method according to paragraph 1, including a base with an occlusal surface of the dental row of the upper jaw, a bite block installed covering the occlusal, vestibular and palatal surfaces of the base in the area of the teeth of the anterior jaw, wherein the bite block is made with a wall thickness of 0.5-2.0 mm.

Description

The invention relates to the field of medicine, namely to orthodontics and orthopedic dentistry, and can be used in a program for deprogramming the lower jaw and determining its correct position during orthodontic treatment of patients with dentoalveolar anomalies of the vertical type (distal bite, deep bite, deep incisor disocclusion) and parafunctions of the masticatory muscles (increased tone of the masticatory muscles). The effectiveness of orthodontic treatment aimed at normalizing the position of teeth and jaws depends largely on the condition of the masticatory muscles and their degree of tension. Therefore, one of the most important stages of such treatment is the implementation of measures aimed at reducing muscle tone and relaxing them. The pattern of masticatory muscle function in a tense, hypertonic state, which has developed over many years, is difficult to correct, especially in the presence of dental and jaw anomalies. There are various methods for relaxing the masticatory muscles, including physiotherapeutic methods (ultrasound, laser, electrical stimulation, shock wave therapy and manual massage), hardware (muscle relaxation caps, for example, from the University of Michigan, Sabbagh aquasplint, Kois deprogrammer), medication (muscle relaxants, botulinum therapy) and various combinations of these. Each of the above-mentioned methods and devices, along with their advantages, also has a number of disadvantages. The University of Michigan muscle relaxation splint [1] is a housing with an anterior guide plane, designed for attachment to maxillary teeth. The splint is designed with a flat occlusal surface imprinted with the support cusps of the mandibular teeth, ensuring uniform, simultaneous tooth contact during jaw closure. During protrusive and laterotrusive movements, only the anterior teeth contact and lateral canine guidance occur, while the lateral teeth are simultaneously separated by creating an incisal platform and thickening the splint on the palatal surface of the maxillary canine. In terms of its mechanism of action, the splint is muscle relaxant and disengaging, with the possibility of converting it to a stabilizing function. A disadvantage of the University of Michigan muscle relaxation splint is its low relaxation effectiveness. When applied to the maxillary teeth, the splint partially or completely covers the palate, resulting in a loss of reference for tongue position and disruption of temperature and taste sensations. This prevents the ability to adjust breathing patterns and normalize tongue position, which impact the effectiveness of the relaxation process. When using this splint, limited contact between teeth in the distal areas is observed, and prolonged wear may cause extrusion of posterior teeth. Furthermore, this splint is standard, with fixed occlusal parameters, and cannot be used in multi-stage relaxation processes, where treatment must be carried out in stages with varying degrees of stimulation. The Kois deprogrammer [2] is a removable appliance placed on the upper dentition. It stabilizes the central position of the upper and lower dentition, creating a support point in the area of the lower central incisors and the anterior bite plate. There is no contact with the lateral teeth. The deprogrammer consists of a base (or plastic plate) and a vestibular arch. The appliance is worn for up to 22 hours a day for 2-4 weeks. The design of the Kois deprogrammer is extremely uncomfortable for the patient due to the rigidity of the base and the presence of a vestibular arch. This results in a short wearing period, which in turn does not provide a sufficient degree of relaxation or maintain the achieved level of relaxation. Relaxing the masticatory muscles with this device is especially difficult in patients with dental anomalies (e.g., crossbite, incisor occlusion, or disocclusion). Furthermore, in certain pathological conditions (particularly gingival recession in the area of the lower incisors), use of the device is highly undesirable due to the risk of exacerbating this condition (since the jaws close precisely on the lower incisors). The closest in technical essence to the claimed group of inventions is a method for treating parafunctions of the masticatory muscles complicated by distal and lateral displacement of the lower jaw, and a specialized mouthguard for its implementation [3]. The mouthguard for treating parafunctions of the masticatory muscles is made of hard plastic that separates the dental arches, has imprints of the antagonist teeth of the lower jaw and, in case of lateral displacements of the lower jaw, is equipped with an inclined pad on the oral side opposite to the displacement, and in case of distal displacements of the lower jaw - on the oral side in the area of the upper frontal teeth. The method for treating parafunctions of the masticatory muscles includes continuous wearing of the mouthguard for 2-8 months depending on the severity of the clinical