CC BY
7"BicnuK стоматологИ", № 2, 2017
17. Diiev E. V., Ilyk R. R., Labunets V. A., Diieva
T. V. Determination of the normative and the actual duration of the total cost dentist-orthopedist working time on manufacturing fixed single structures relying on implants.
Medychnyjforum. 2016;8(08):52-55.
18. Diiev E. V., Obydnyak V. Z. Metodycheskye aspektbi ustanovlenyja norm truda stomatologa-ortopeda na yzgotovlenye mostovydnuh zubnuh protezov s oporoj na ym-plantatbi. Zbirnyk naukovyh robit uchasnykiv mizhnarodnoi' naukovo-praktychnoi' konferencii' «Suchasni tendencii' u medychnyh ta farmacevtychnyh naukah» [Methodical aspects of establishing labor standards orthopedic dentist to manufacture bridge relying on implants. Collection of works by the international scientific-practical conference "Modern Trends of medical and pharmaceutical sciences, 2-3 December]. Kiev; 2016:40-43.
Hagiftmra 23.03.17
УДК 616-089.29+616.314.26.003.121
O. A. Glazunov, DM
SE "Dnipropetrovs'k Medical Academy of the Ministry of Health"
EVALUATION OF N. I. LARIN METHOD OF BITE-BLOCK OCCLUSAL PLANE FORMING
ABSTRACT
In the article presented the analysis of 46 diagnostic medical images when occlusal plane is formed by the method of NI Larin has been done. It is shown that in the frontal segment acute corners are formed on the line of the cosmetic center and the occlusal plane: on the right it is 5.26 ± 0.23 and on the left -5.91±0.034, and at the level of the canines the distance between them, depending on the size of the teeth, is 1 9 mm - 2.5 mm.
Key words: photostatic studies, occ lusal plane, toothless jaws.
О. А. Глазунов
Государственное учреждение «Днепропетровская медицинская академия МЗ Украины»
ОЦЕНКА МЕТОДА ФОРМИРОВАНИЯ ОККЛЮЗИОННОЙ ПЛОСКОСТИ ПРИ-КУСНОГО ВАЛИКА ПО Н.И. ЛАРИНУ
В статье проведен анализ 46 диагностических снимков, при формировании окклюзионной плоскости по методу Н.И.Ларину. Показано, что в
фронтальном участке на линии косметического центра и окклюзионной плоскости образуются острые углы: справа 5,26°±0,23 и 5,91°±0,034 слева, а на уровне клыков расстояние между ними в зависимости от типоразмера зубов , составляет 1,9 мм - 2,5 мм.
Ключевые слова:, фотостатические исследования ,окклюзионная плоскость, беззубые челюсти.
О. А. Глазунов
Державний заклад «Дшпропетровська медична академiя МОЗ Украши»
ОЦ1НКА МЕТОДУ ФОРМУВАННЯ ОКЛЮЗ1ЙНО1 ПЛОЩИНИ ПРИКУС-НОГО ВАЛИКА ПО Н.1. ЛАР1НУ
У статтi проведено аналiз 46 дiагностичних зтмюв, при формувант оклюзШног площини за методом Н.1.Ларта. Показано, що у фронталь-нт дыянщ на лiнii косметичного центру та оклюзтног площини утворюються гострi кути: праворуч 5,26°±0,23 i 5,91 °±0,034 злiва, а на рiвнi iклiв вiдстань мiж ними в залежностi вiд типо-розмiру зубiв, становить 1,9 мм - 2,5 мм. Ключов1 слова:, свтлино статичш до^джен-ня, оклюзтна площина, беззубi щелепи.
Clinical observations show that the reason for the decrease in the functional efficiency of a large number of complete removable prostheses is the error in determining the central occlusion (up to 33 % according to A.N. Gubskaya [3]).
The initial and critical moment in determining the central occlusion is the formation of the occlusal plane (OP).
The method for OP forming on bite - block (BB) is known [8]. It includes determining of the height of the upper BB, depending on the type of the upper lip, forming the OP parallel to the pupillary line in the anterior part and the naso-aural in the lateral sections of the platen with the help of pupil's rulers. This is done by cutting or building up the wax on the plane of the BB.
Disadvantages of the method are that the formation of the OP the upper BB with the help of the student's rulers is subjective, since it is carried out "by eye", and this can cause errors in the determination of this plane horizontally and as a result - incorrect positioning of teeth, inadequate prosthetics.
A method for obtaining an OP on tomographic image of toothless jaws is known [6] as well. It involves forming the OP of the upper BB parallel to the naso-aural and pupil line with the use of rulers,
© Glazunov O. A., 2017.
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adjusting the lower block to the top, applying the radiogenic contrast material on it, obtaining a computer tomogram of toothless jaws, correcting of the BB's generated surface.
The method under description has several disadvantages:
a) the accuracy of the nose-ear line placement can be determined only after obtaining a computer tomogram, which allows errors at the initial stage and the possibility of this procedure rerun;
b) the use of such an expensive method many times exposes patients to additional irradiation and takes a long time.
A method for constructing the OP is also known [7]. It involves applying a projection of the OP on the wax block of the upper jaw set in the mouth, parallel to the naso-aural line by means of laser parallelometer, the beam of the fixed module being induced on the base of the nose alae and guide along the naso-aural line. Thus a line of the Camperian horizontal line is formed, and the laser beam of the mobile module is directed to the previously obtained height of the wax block and the projection of the occlusal plane is determined on it in the frontal area.
The disadvantages are that the use of the above mentioned method involves the presence of a laser parallelometer with the help of which the projections of the laser lines are marked with a dental spatula on the wax block of the upper jaw, to the level that the block is cut. This may cause errors, since the occlusal plane is formed visually.
In this country a method for OP on the wax block of the upper jaw forming with the use of Larin's apparatus is widely used [5]. The device contains an occlusal plate in the form of a tooth row with a handle in the front part, two vertical parallel rods that guide the movement of the T-shaped plate-shaped indexes. The occlusal plate and plate-like indexes are interconnected by means of a carriage provided with a sliding screw, and are strictly parallel to each other.
Formation of the OP with the help of the device mentioned is carried out simultaneously by pressing the occlusal plate to the softened wax block and keeping of the place of locking stop (the level of the lips' incision) in the anterior section of the BB and under the control of the anthropometric landmarks (nose alae and the middle of the antilobuim).
However, with the use of the apparatus mentioned, the OP of the block is completely formed according to Camperian horizontal line, since its bases and plate-like T-shaped indicia are parallel to each other.
Objectives of the study. To investigate the two planes parameters adequacy by the photostatic method: one passing through the pupil, and the other through the nasal-ear line.
Materials and methods. Before photographing, the head of the person examined was fixed using a photostat constructed by the authors of this article (Certificate No. 5 dated 03.06. 2013, Ukrainian Research Institute of Industrial Medicine). The photostat consists of a protective miner's helmet, which has an internal polyethylene frame with a regulator of the head circumference. The helmet is rigidly connected with vertically moving along a pillar of stomatological head support; the second head support serves to fix the occipital area. In the middle of the helmet visor is hingedly fixed with the possibility of fixing the index of the mid-sagittal plane. By means of clamps the pillar is attached to a dental chair. Fixation of the head was carried out in the following way: they set the patient under examination, offered to rest his back in the back of the chair, and occipital area was fixed by the head support, then the head support and a helmet were lowered and the helmet was tightly put it on the head. Focusing on the index of the mid-sagittal plane, the head was fixed by the regulator of the circumference. Further, the pointer was folded up and fixed.
Photostatic images were obtained from the same distance from the examining using a Nikon RS 7000 camera, mounted on a professional tripod SLik PRO 330 DX.
In 23 patients with intact dentition were obtained 46 photostatic images in full and half face. The patients aged 42-50 y.o., there were 11 men and 12 women. On the photocopies from the photographs of the persons under examination , the checkpoints at the base of the nasal septum, in the middle of the philtrum, at the base of nose alae and in the middle of the antilobluiti. At the level of the incision of the lips, a projection of the pupillary line (a') was carried out parallely and the lines of the cosmetic centre (O - O') and nasal width (i.e. the line of eye teeth - A' and B - B') were dropped to the pupillary line perpendicular. The naso-otic lines (Camperian horizontals) were delineated on both sides (b). Then the Camper's horizontal lines (b) were lowered parallel down to the point of the cosmetic center (O) (Figure 1), with this two opposing rectangular triangles formed (Fig. 2). The size of the formed corners at the point of the cosmetic center (O) was determined with the aid of a protractor. 92 measurements were made. The parameters of the deviation of the projection of the nasal-ear line (b ') from the pupillary line (a') at the level of their intersection with the canine line (h) (Figure 2) were determined by the formula h = v x tan <a [1], where h - the height of the leg of the right triangle, i - the width of the three front teeth, a - the angle of intersection of the projection lines with the cosmetic center
"BicnuK cmoMamojioziï", № 2, 2017
Fig. 1. Anthropometric markings for the construction of the occlusal plane: a - the pupillary line; a' - the projection of the pupillary line; b - naso - otic line; b'-projection of the naso-otic line
Fig. 2. Interrelation of the nose main parameters with the projections of the pupillary and nasal-otic lines: O-O- line of the cosmetic center; A - A' and B - B'-the lines of eye teeth; h - the distance between the projection lines (a 'and b') at the points C and D, their intersection by the lines of the eye teeth A - A 'and B - B'; a - the angle between the projections of the pupillary (a ') and naso-otic (b') lines; i - width of three anterior teeth.
Table
The value of the canines deviation from the occlusal plane, formed by the method of Larin
Teeth group Width of 6 front teeth Estedent, mm The canine deviation, mm
From the left From the right
I 40 1.890 2.066
II 43 1.904 2.081
III 46 2.173 2.379
IV 49 2.319 2.530
Results of the study. At all 46 photostatic shots the convergence of the projection lines at the point of the cosmetic center was noted. In Fig. 2 it is shown that when intersecting the projection lines of the pupillary (a') and naso-otic (b') lines with those of the canine teeth, at the point of the cosmetic center (O), counter rectangular triangles are formed: A A'O'C on the right and A B'O'D on the left. In the indicated triangles, the acute angles a on the right and a1 on the left are of interest. The magnitude of these angles characterizes the displacement relative to each other of the planes passing through the pupillary and naso-otic lines, according to our data is the following: on the right - from 4 ° to 7 average M ± m = 5.26° ± 0.023 and on the left - from 5° to 9° on the average M ± m = 5.91 ± 0.037.
In the rectangular triangles A A'O'C and A B'O'D, the parameters of the catheti AC and B'D -is the height h, corresponding to the size of the canines from the occlusal plane. The catheti A'O and B'O of rectangular triangles are equal to half the width of six front teeth, for example, of the "Estedent" type. We give an example of calculation. If A'O for the 1st group of teeth is 20 mm, the average value of the angle, for example, to the right is a = 5.26 then the height h = 20 mm x tg 5.26°. According to V. M. Bradis [2] tables, we find: tg 5.26 ° = 0.0945. And so the height h = 20 mm x 0.0945 = 1.89 mm. In the same way, the height h was determined both to the right and to the left of the cosmetic center for all four groups of Estedent teeth. The data are presented in the table.
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As is evident from foregoing, the canine deviation from the occlusal plane examined is different even in symmetrical teeth: on the right -1.9 - 2.32 mm, on the left - 2.1 - 2.5 mm, which can lead to a disruption of the aesthetics of the face and function. N. V. Kalinina [4] takes up the position that natural impression is produced when the upper central incisors and canines are on the same level. Correct formation of the occlusal plane and the construction of dentition in complete removable prostheses, correspondingly to the level of this plane, increase both the aesthetic and functional characteristics of the chewing apparatus.
Conclusions. The results of our research give the right to draw the following conclusions:
a) when constructing the occlusal plane of the bite - block in the frontal region by the method of N. I. Larin inaccuracies take place due to the fact that it is tilted upward from the plane formed at the level of the pupillary line, an average of 5.2° on the right and 5.9° on the left;
b) at the level of the canines, when they are staged depending on the Estedent teeth size, the deviations are 1.9 - 2.5 mm.
The data obtained necessitate the necessity to improve the method of occlusal plane formation according to N. I. Larin for its accuracy increase, which is the result of our further research and presentations.
REFERENCES
1. Bevz G. P. Bevz V. G. Geometrija [Geometry]. Kyi'v.: Vezha; 2008:190-192.
2. Bradis V. M. Chetyrehznachnye matematicheskie tablicy [Four-digit mathematical tables]. Moskva.: Prosveshhenie; 1992:55-58.
3. Gubskaja A. N. Opredelenie central'noj okkljuzii pri protezirovanii bezzubyh cheljustej [Definition of Central occlusion in prosthetics of toothless jaws]: Abstract of a candidate's thesis of medical sciences. Kiev; 1954:10.
4. Kalinina N. V., Zagorskij V. A. Protezirovanie pri polnoj potere zubov - 2-e izdanie, pererabotano i dopolneno [Prosthesis with complete loss of teeth - 2nd edition, revised and enlarged]. M.: Medicina; 1990:109.
5. Larin N. I. Refined methods of formation of the occlusal plane by using the apparatus for prosthetics of toothless jaws. Stomatologija. 1960;3:54-57.
6. Sadykov M.I., Komleva T.N., Melenberg T.V., Komlev S.S., Shelemetev S.V. Sposob poluchenija proteticheskoj ploskosti na tomogramme bezzubyh cheljustej [A method of obtaining prosthetic plane on the tomogram of the edentulous jaw] Patent 2272568. Russian Federation, IPC (2006. 01) AND 61 IN 6/14. / applicants and patent owners - they are the same (RU).- No. 2004124084/14; it is 06.08.2004; published 27.03.2006.
7. Shumskij A.V., Jurchenko S.Ju Sposob postroenija proteticheskoj ploskosti [Method of constructing prosthetic plane]Patent 2360644. Russian Federation, IPC (2006. 01) AND 61 19/04., A. 11/00 61 And 61 In
5/103.: the applicant and holder of patent No. 2008122533/14; stated 06.06.2008; published 10.07.2009.
8. Evdokimov A. I. Rukovodstvo po ortopedicheskoj stomatologii [Manual of prosthodontics]. M.: Medicina;1974:273:295- 297.
The article acted 24.04.17
УДК 675.001.5+616.314-089.843
Е. И. Семенов, к. мед. н.,
B. В. Лепский, к. мед. н., Т. Г. Вербицкая, к. биол.н.
C. А. Шнайдер, д. мед. н.
Государственное учреждение «Институт стоматологии и челюстно-лицевой хирургии Национальной академии медицинских наук Украины»
ВЛИЯНИЕ ГЕНЕТИЧЕСКОГО ФАКТОРА НА ДОЛГОСРОЧНОСТЬ ФУНКЦИОНИРОВАНИЯ ДЕНТАЛЬНЫХ ИМПЛАНТАТОВ
Исследован полиморфизм генов ММР1 1607 тъО, ММР9 Л-82020, Т1МР С536Ту 22 пациентов более 5 лет пользующихся ортопедическими конструкциями с опорой на дентальные импланта-ты и не предъявляющих жалоб на их эффективность. Частота нормальных гомозигот гена ММР1 1607 insG была обнаружена у 2 пациентов или у 9,1 % от общего количества осмотренных, гетерозиготные мутации были выявлены у 18 пациентов (81,8 %), полная мутация наблюдалась у 2 пациентов (9,1 %). Частота нормальных гомозигот ММР9 A-8202G была обнаружена у 6 пациентов (27,3 %), гетерозиготные мутации у 10 пациентов (45,6 %), гомозиготная мутация у 6 пациентов (27,3 %). Гетерозиготная мутации гена Т1МРС536Т была обнаружена у 2 пациентов (9,1 %), у остальных пациентов полиморфизм гена отсутствовал. Ключевые слова: полиморфизм генов, дентальные имплантаты.
© Семенов Е. И., Лепский В. В., Вербицкая Т. Г., Шнайдер С. А., 2017.
