阅读说明：本技术 定制型颞下颌关节再定位牙合垫及其制作、应用方法 (Customized temporomandibular joint repositioning occlusal pad and manufacturing and application methods thereof ) 是由 何冬梅 杨驰 杨秩 朱慧敏 华江山 于 2021-01-15 设计创作，主要内容包括：本发明提供一种定制型颞下颌关节再定位的牙合垫及制作、应用方法,制作方法包括以下步骤：根据错颌畸形情况,分别通过以下三种方法确定患者下颌的矫正位置：肌肉去程序化、下颌前伸至张闭口关节弹响消失、关节盘复位后；获取患者的上下牙列数据；基于下颌的矫正位置以及上下牙列数据制作定制型颞下颌关节再定位的牙合垫,其中定制型颞下颌关节再定位的牙合垫包括：一体成型的牙合垫体,牙合垫体的唇侧包裹面和舌侧包裹面之间形成上牙槽以及下牙槽,其中上牙槽和下牙槽分置于牙合垫体的上下两侧,舌侧包裹面的下方设有舌侧斜面,特别针对错颌畸形引起的颞下颌关节紊乱病的咬合治疗,以及关节盘复位后的颞下颌关节再定位。(The invention provides a customized temporomandibular joint repositioning occlusal pad and a manufacturing and application method thereof, wherein the manufacturing method comprises the following steps: according to the malocclusion condition, the correction position of the lower jaw of the patient is determined by the following three methods respectively: programming muscles, eliminating the bouncing of the joints when the lower jaw extends forwards to the open-close mouth, and resetting the articular disc; acquiring upper and lower dentition data of a patient; making a customized temporomandibular joint repositioning bite block based on the corrected position of the mandible and the upper and lower dentition data, wherein the customized temporomandibular joint repositioning bite block comprises: the integrated occlusal pad body is characterized in that an upper alveolus and a lower alveolus are formed between a labial wrapping surface and a lingual wrapping surface of the occlusal pad body, wherein the upper alveolus and the lower alveolus are respectively arranged at the upper side and the lower side of the occlusal pad body, and a lingual inclined surface is arranged below the lingual wrapping surface, so that the occlusal pad body is particularly used for occlusion treatment of temporomandibular joint disorder caused by malocclusion deformity and repositioning of temporomandibular joint after the articular disc is reset.)

1. A method of making a customized temporomandibular joint repositioning bite block comprising the steps of:

1) determining the correction position of the lower jaw of the patient according to the malocclusion condition by the following three methods respectively: programming muscles, eliminating the bouncing of the joints when the lower jaw extends forwards to the open-close mouth, and resetting the articular disc;

2) acquiring upper and lower dentition data of a patient; making a customized temporomandibular joint repositioning bite block based on the corrected position of the mandible and the upper and lower dentition data, wherein the customized temporomandibular joint repositioning bite block comprises: the integrated denture cushion body (10) is characterized in that an upper tooth socket (20) and a lower tooth socket (30) are formed between a lip side wrapping surface (111) and a tongue side wrapping surface (112) of the denture cushion body (10), the upper tooth socket (20) and the lower tooth socket (30) are respectively arranged on the upper side and the lower side of the denture cushion body (10), and a tongue side inclined surface (113) is arranged below the tongue side wrapping surface (112).

2. The method of making a customized temporomandibular joint repositioning bite block according to claim 1, wherein the reduction of the disc involves manipulations and surgery.

3. The method for manufacturing the customized temporomandibular joint repositioning bite block according to claim 1, wherein a silicone rubber bite block recording material is squeezed into the oral cavity of the patient to obtain a space between the upper and lower dentitions after the temporomandibular joint repositioning, a dental model is obtained after the silicone rubber bite block recording material is fixed and molded, a scanner is used to scan the dental model to obtain data of the upper and lower dentitions, the data of the upper and lower dentitions are imported into 3D design software to design a bite block model according to requirements, and the customized temporomandibular joint repositioning bite block is manufactured based on the bite block model engraving.

4. The method of making a customized temporomandibular joint repositioning bite block according to claim 1, wherein the labial covering surface (111) covers part of the labial side of the upper dentition and part of the labial side of the lower dentition, and the lingual covering surface (112) matches the lingual shape of the upper and lower dentitions.

5. The method of making a customized temporomandibular joint repositioning bite block according to claim 1, wherein the upper socket (20) comprises a plurality of upper dental occlusal sockets corresponding to the teeth matching the upper dentition and the lower socket (30) comprises a plurality of lower dental occlusal sockets corresponding to the teeth matching the lower dentition.

6. The method of making a customized temporomandibular joint repositioning bite pad according to claim 5, wherein the occlusal surfaces of the superior socket (20) and the inferior socket (30) are beveled.

7. The method of making a customized temporomandibular joint repositioning bite block according to claim 1, wherein the lingual slope (113) below the lingual wrapping surface (112) is inclined lingual.

8. A customized temporomandibular joint repositioning bite block made according to the method of making a customized temporomandibular joint repositioning bite block of any one of claims 1 to 7.

9. The custom temporomandibular joint repositioning bite block according to claim 8, adapted for use in bite treatment of temporomandibular joint disorders caused by malocclusion and temporomandibular joint repositioning after reduction by the articular disc.

10. A method of using a customized temporomandibular joint repositioning bite block according to claim 8 worn between the upper and lower dentitions of a patient after a malocclusion correction procedure.

Technical Field

The invention relates to the field of treatment of temporomandibular joint disorders, and is particularly suitable for joint repositioning treatment of temporomandibular joint disorders caused by malocclusion.

Background

Temporomandibular Joint (TMJ) is the only left and right bilateral linkage Joint of the maxillofacial region that performs the opening and closing, mandibular protrusion, withdrawal and lateral, and chewing movements in daily life. Temporomandibular joint disorder (TMD) is a common disease of the oromandibular face, with an incidence of up to 33% in adults and 53.28% in orthodontic patients.

The clinical manifestations of temporomandibular joint disorder are: pain in the articular area and its surrounding masticatory muscles may be accompanied by migraine headaches, neck and shoulder pain, ringing or noise in the articular area, and abnormal jaw movements (including restricted mouth opening, deviation of mouth opening or kinking). Occlusion factors including occlusion interference, early contact, posterior tooth loss, too low vertical distance, especially deep occlusions, anterior retrograded occlusions, etc., have been found to be important causes of temporomandibular joint disorder (TMD). Therefore, correcting occlusal disorders is an important means of treatment, with occlusal pads being an important method of treatment for occlusions.

However, the existing occlusal pad has the defects of simple design and single structure, and has poor pertinence to correction of occlusion disorder. Meanwhile, occlusion change can occur after the temporomandibular joint disc is reset, and a patient with the maxillofacial deformity in the growth period needs to keep the occlusion relation and further induce to promote the formation of new condylar bone, so that the subsequent orthodontic treatment is facilitated, and the degree of the maxillofacial deformity is reduced. However, there is currently a lack of custom bite block designs that address the above problems.

Disclosure of Invention

The invention aims to provide a customized occlusal pad for repositioning temporomandibular joint and a manufacturing and application method thereof, the method effectively improves deep occlusion, inward inclination occlusion and occlusion interference of patient teeth by customizing the treatment suitable for patients with temporomandibular joint disorder caused by malocclusion and the occlusal pad for maintaining the position of temporomandibular joint after articular disc reduction, maintains the position of condylar process in temporomandibular joint fossa after articular disc reduction, improves mandibular retraction or deviation, is beneficial to condylar process reconstruction and regeneration of new bone, and promotes reconstruction to realize the individualized treatment of temporomandibular joint disorder and secondary dentogoromandibular joint disorder by correcting occlusion disorder and maintaining and inducing the position of condylar process after articular disc reduction surgery.

In order to achieve the above object, the present technical solution provides a method for manufacturing a customized temporomandibular joint repositioning bite block, comprising the steps of: according to the malocclusion condition, the correction position of the lower jaw of the patient is determined by the following three methods respectively: programming muscle, eliminating the bouncing of the joints when the mandible extends forwards to the open and close mouth, and resetting the articular disc (including manipulation and operation); acquiring upper and lower dentition data of a patient; making a customized temporomandibular joint repositioning bite block based on the corrected position of the mandible and the upper and lower dentition data, wherein the customized temporomandibular joint repositioning bite block comprises: the integrated tooth-closing cushion body is characterized in that an upper tooth socket and a lower tooth socket are formed between a lip side wrapping surface and a tongue side wrapping surface of the tooth-closing cushion body, wherein the upper tooth socket and the lower tooth socket are respectively arranged on the upper side and the lower side of the tooth-closing cushion body, and a tongue side inclined surface is arranged below the tongue side wrapping surface.

In a second aspect, a customized temporomandibular joint repositioning bite block is provided, which is made according to a method of making a customized temporomandibular joint repositioning bite block thereon.

In a third aspect, an application method of the customized temporomandibular joint repositioning occlusal pad is provided, and the occlusal pad manufactured by the scheme is worn between the upper dentition and the lower dentition of the patient after the malocclusion correction operation.

Compared with the prior art, the technical scheme has the following advantages and beneficial effects: the integrated occlusal pad is designed in a customized manner, the position of the lower jaw bone of a patient is kept by utilizing the limit relation between the upper dentition and the lower dentition of the patient, the temporomandibular joint is repositioned, the temporomandibular joint is stabilized, the normal occlusal relation of the patient is recovered through orthodontic treatment after stabilization, and the mode can also promote condylar reconstruction and new bone regeneration, so that a stable joint position is provided for the subsequent treatment to recover the normal occlusal relation.

Drawings

Fig. 1 is a schematic flow chart of a method of making a customized temporomandibular joint repositioning bite block according to an embodiment of the present invention.

Fig. 2 is a schematic diagram of a customized temporomandibular joint repositioning bite block worn on the upper and lower dentitions of a patient in accordance with an embodiment of the present invention.

Fig. 3-5 are customized temporomandibular joint repositioning occlusal pads according to an embodiment of the present invention.

In the figure: 10-customized temporomandibular joint repositioning occlusal pad, 11-occlusal pad body, 111-labial wrapping surface, 112-lingual wrapping surface, 113-lingual inclined surface, SD-upper dentition, 20-upper dentition, 30-lower dentition, XD-lower dentition.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments that can be derived by one of ordinary skill in the art from the embodiments given herein are intended to be within the scope of the present invention.

It will be understood by those skilled in the art that in the present disclosure, the terms "longitudinal," "lateral," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are used in an orientation or positional relationship indicated in the drawings for ease of description and simplicity of description, and do not indicate or imply that the referenced devices or components must be constructed and operated in a particular orientation and thus are not to be considered limiting.

It is understood that the terms "a" and "an" should be interpreted as meaning that a number of one element or element is one in one embodiment, while a number of other elements is one in another embodiment, and the terms "a" and "an" should not be interpreted as limiting the number.

The scheme provides a customized occlusal pad for repositioning temporomandibular joints and a manufacturing and application method thereof, and particularly designs the customized occlusal pad aiming at occlusion treatment of temporomandibular joint disorder diseases caused by malocclusion such as deep occlusion, inward inclination deep occlusion and the like and the scheme of repositioning temporomandibular joints of patients with jaw deformities such as mandibular deviation, retrosystole and the like after articular disc replacement, the manufactured customized occlusal pad for repositioning temporomandibular joints is worn between upper and lower dentitions of patients with malocclusion correction, the position of lower jaw is kept by the integrally formed occlusal pad through the limit relationship between the upper dentition and the lower dentition, the effect of repositioning temporomandibular joints is achieved, the temporomandibular joints are stabilized, the normal occlusal relationship of the patients is restored through orthodontic treatment after stabilization, and the mode can promote condylar reconstruction and new bone regeneration, provides stable joint guarantee for restoring normal occlusion relation of subsequent orthodontic treatment.

It is worth mentioning that the traditional cushion for treating the temporomandibular joint disorder is only designed in a single jaw structure of the upper jaw or the lower jaw or in a double jaw structure with the upper jaw and the lower jaw separated, and the requirement of repositioning the temporomandibular joint in the scheme cannot be met. The customized temporomandibular joint repositioning occlusal pad provided by the scheme is of a structure formed by integrally forming the upper jaw and the lower jaw, and the position of the lower jaw is kept by utilizing the limit relation between the upper jaw and the lower jaw.

According to a first aspect of the present invention, there is provided a method of manufacturing a customized temporomandibular joint repositioning bite block, the method comprising the steps of:

1) determining the correction position of the lower jaw of the patient according to the malocclusion condition by the following three methods respectively: programming muscles, eliminating the bouncing of the joints when the lower jaw extends forwards to the open-close mouth, and resetting the articular disc;

2) acquiring upper and lower dentition data of a patient; making a customized temporomandibular joint repositioning bite block based on the corrected position of the mandible and the upper and lower dentition data, wherein the customized temporomandibular joint repositioning bite block comprises:

in the integrated occlusal pad 10, an upper alveolus 20 and a lower alveolus 30 are formed between a labial wrapping surface 111 and a lingual wrapping surface 112 of the occlusal pad 10, wherein the upper alveolus 20 and the lower alveolus 30 are respectively arranged at the upper and lower sides of the occlusal pad 10, and a lingual inclined surface 113 is arranged below the lingual wrapping surface 112.

Among them, the means after the reduction of the articular disc include manipulations and operations.

Specifically, a silicone rubber occlusion recording material is squeezed into the oral cavity of a patient, a gap between an upper dentition and a lower dentition after the temporomandibular joint is repositioned is obtained through the three methods, a dental model is obtained after the silicone rubber occlusion recording material is fixedly molded and then taken out, the dental model is scanned by a scanner to obtain data of the upper dentition and the lower dentition, the data of the upper dentition and the lower dentition are imported into 3D design software to be designed according to requirements to obtain an occlusion cushion model, and the occlusion cushion is manufactured through engraving based on the occlusion cushion model.

It is worth mentioning that the present scheme requires the acquisition of upper and lower dentition data of the patient's full teeth. Correspondingly, the silicone rubber occlusion recording material needs to cover each tooth body of a patient, and the upper dentition data and the lower dentition data are imported into 3D design software to obtain an occlusion pad model through design, and conventional 3D design software is selected.

In addition, what the occlusal pad of this scheme mainly played is fixed spacing effect, is different from traditional occlusal pad, and the occlusal pad of this scheme designs on a body structure and accomplishes, puts between patient's upper and lower dentition when the occlusal pad cover, and the fixed effect is realized to spacing between the upper and lower dentition of accessible, stabilizes temporomandibular joint's position, and specially adapted temporomandibular joint's is relocated.

In other words, the customized temporomandibular joint repositioning occlusal pad obtained by the above manufacturing method is particularly suitable for temporomandibular joint disorders caused by malocclusion and for further correction of jaw deformities by means of articular disc reduction.

The specific structure of the customized temporomandibular joint repositioning bite block is designed as shown in fig. 3 to 5:

the occlusion cushion for the customized temporomandibular joint repositioning comprises an occlusion cushion body 10 which is integrally formed, wherein an upper dental alveolus 20 and a lower dental alveolus 30 are formed between a labial wrapping surface 111 and a lingual wrapping surface 112 of the occlusion cushion body 10, the upper dental alveolus 20 and the lower dental alveolus 30 are respectively arranged at the upper side and the lower side of the occlusion cushion body 10, a lingual inclined surface 113 is arranged below a lingual wrapping surface 112, and the occlusion cushion for the customized temporomandibular joint repositioning is customized for a patient after the malocclusion deformity is corrected and is suitable for treating the temporomandibular joint disorder caused by the malocclusion.

When the customized temporomandibular joint repositioning bite block is sleeved between the upper dentition and the lower dentition of a patient after a dislocation or mandibular malformation glenoid discreduction operation, the SD card of the upper dentition of the patient is occluded in the upper alveolar 20, and correspondingly, the XD card of the lower dentition is occluded in the lower alveolar 30, and because the upper alveolar 20 and the lower alveolar 30 are of an integrally formed structure, the baffle plate of the labial wrapping surface 111 wrapping the upper dentition and the lower dentition maintains the position of the lower dentition and limits the movement of the lower dentition to play a role in repositioning and stabilizing the temporomandibular joint, thereby promoting reconstruction and repair of the condyles.

Specifically, the labial covering surface 111 is a surface of the bite pad body 11 close to the labial side, and the labial covering surface 111 covers a part of the labial side of the upper dentition SD and a part of the labial side of the lower dentition XD, and in some embodiments, the labial covering surface 111 covers only one third of the labial sides of the upper dentition SD and the lower dentition XD.

The lingual wrapping surface 112 is a surface of the bite block body 10 close to the lingual side, the lingual wrapping surface 112 matches the lingual shapes of the upper dentition SD and the lower dentition XD, and the lingual wrapping surface 112 and the labial wrapping surface 111 are matched with each other to clamp the upper dentition SD and the lower dentition XD.

In this embodiment, the upper socket 20 includes a plurality of upper dental occlusal sockets corresponding to the teeth of the upper dentition SD, and the upper dental sockets are shaped to match the cusp shape of the teeth of the upper dental system SD. Similarly, the lower socket 30 includes a plurality of lower dental occlusal sockets corresponding to the teeth of the lower dentition XD, the lower dental occlusal sockets having a shape matching the cusp shape of the teeth of the lower dentition XD.

The upper tooth socket 20 is downwards sunken relative to the upper side surface of the bite block body 10, the sunken position is matched with the tooth position of the upper dentition SD, and the sunken shape is matched with the tooth cusp position of the tooth body of the upper dentition SD; the lower socket 30 is upwardly recessed with respect to the lower side of the bite-block body 10, the recessed position matches the position of the teeth of the lower dentition XD, and the recessed shape matches the position of the cusps of the teeth of the lower dentition XD. An interdental space is provided between the upper socket 20 and the lower socket 30, that is, the upper socket 20 and the lower socket 30 are spaced up and down.

Since the cusps of the teeth are gradually reduced in cross-sectional area, the inner occlusal surfaces of the upper and lower alveolus 20, 30 are designed to be inclined surfaces, so that the upper dentition SD and the lower dentition XD can be more conveniently slid into the bite-block body 10.

In addition, the lingual inclined surface 113 below the lingual wrapping surface 112 is inclined to the lingual side, and the lingual inclined surface 113 is used to guide the lower dentition XD into place. Specifically, in some embodiments, the lingual ramp 113 is partially pressed over the tongue body.

In the embodiment of the present scheme, the bite-block body 10 is made of a high molecular resin material, which is a good biomaterial, and has better biocompatibility, and no general allergy, rejection and other reactions occur, and the high molecular resin material can be manufactured in injection molding and demolding manners, and is convenient to manufacture, and the high molecular resin material can obtain the best shape matched with the individual patient in injection molding and demolding manners, and has better use effect.

In a second aspect, the scheme provides a customized temporomandibular joint repositioning bite block manufactured according to the manufacturing method of the temporomandibular joint repositioning bite block manufactured by the manufacturing method.

In a third aspect, the scheme provides an application method of the customized temporomandibular joint repositioning occlusal pad, which is applied to occlusion treatment of temporomandibular joint disorder caused by malocclusion and further correction of jaw deformity through articular disc reduction. The application method of the temporomandibular joint repositioning occlusal pad comprises the following steps:

1) determining the correction position of the lower jaw of the patient according to the malocclusion condition by the following three methods respectively: programming muscles, eliminating the bouncing of the joints when the lower jaw extends forwards to the open-close mouth, and resetting the articular disc;

2) acquiring upper and lower dentition data of a patient; and manufacturing a customized temporomandibular joint repositioning occlusal pad based on the correction position of the lower jaw and the data of the upper dentition and the lower dentition, wherein the specific structure of the customized temporomandibular joint repositioning occlusal pad is introduced above, and the occlusal pad is worn between the upper dentition and the lower dentition of the patient.

The present invention is not limited to the above-mentioned preferred embodiments, and any other products in various forms can be obtained by anyone in the light of the present invention, but any changes in the shape or structure thereof, which have the same or similar technical solutions as those of the present application, fall within the protection scope of the present invention.