METHOD FOR DETERMINING THERAPEUTIC POSITION OF LOWER JAW WITH ENHANCED DENTAL ABRASION Russian patent published in 2020 - IPC A61C5/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to orthopaedic dentistry. Therapeutic position of the lower jaw is determined in five stages. At the first stage, impressions are obtained from the upper and lower jaws of the patient and jaw models are moulded from high-strength gypsum belonging to the IV hardness category. Jaw models are fixed in articulator according to face arc data. Using an anatomical and physiological method, a phonetic technique and a vertical LVI index, the therapeutic height of the lower one-third of the face is determined. That is followed by drug-induced muscle relaxant muscle mass with the preparation of type A botulinum toxin. At the second stage, 3 weeks after the drug-induced muscle relaxation, the therapeutic height of the lower one-third of the face is re-determined. Jaw models are separated in the articulator with due allowance for data obtained when determining the height of the lower one-third of the face. Wax modelling of occlusal surface of chewing teeth and frontal group of teeth on gypsum models of jaws, duplication of gypsum models of jaws with modelled wax by occlusal surface of chewing teeth and frontal group of teeth is performed. Making a tray for dissociating a bite to a certain new therapeutic height. That is followed by the patient's follow-up examinations once a month for three months. At positive dynamics and absence of complaints proceed to the next stage. At the third stage, temporary composite patches for chewing teeth are made and the frontal group of teeth is restored with MockUp technique. From the duplicated plaster models of jaws with the occlusal surface of chewing teeth and the frontal group of teeth modelled by wax, silicone keys are obtained. Composite material is introduced into the silicone key in layers and applied to a gypsum model on which there was no wax modelling of the teeth; the composite material is polymerised. Prepared in this way temporary occlusive patch is removed from imprint and then, after pickling of hard tooth tissues and application of primer, fixed in oral cavity of patient with composite fluid material. Then silicone keys are added with self-polymerising composite plastic and a frontal group of teeth is restored with MockUp technique. Tray is made to establish the height of the new physiological dormancy. Patient is examined once a month for three months. At the fourth stage, in 3 months, the optimal position of the lower jaw is determined in the horizontal plane by percutaneous electroneurostimulation using the Miomonitor apparatus. New position of the lower jaw is fixed by means of a silicone for bite registration. Imprints from the upper and lower jaws of the patient are obtained, and jaw models are cast from high-strength gypsum belonging to IV category of hardness. Models of jaws are fixed in articulator according to face arch by silicone for bite registration obtained after percutaneous electroneurostimulation, analysis of models in articulator. Temporary composite patch in the oral cavity is corrected under the control of a bite registration obtained by percutaneous electroneurostimulation. That is followed by the patient's follow-up examinations once a month for three months. Fifth stage involves replacement of temporary composite restorations with permanent orthopaedic structures from lithium disilicate or zirconium dioxide materials in fragments under control of occlusion height. Trays are made to maintain the new physiological dwelling height.

EFFECT: method enables providing qualitative miorelaxation of chewing muscles, improving quality of treating patients with enhanced dental abrasion.

1 cl, 4 dwg