MINISTRY of HEALTH UKRAINE
VINNYTSYA NATIONAL MEDICAL UNIVERSITY
to the name of М. And.Pie
" It is ratified"
on a methodical conference
departments of stomatology of child's age
Manager of department
doc. Filimonov Y.V.
. ______
" _____ "______20
METHODICAL POINTING
FOR INDEPENDENT WORK OF STUDENTS AT PREPARATION TO PRACTICAL (SEMINAR)
EMPLOYMENT 13
Educational discipline / ОртодонтіяModule № / 13
Rich in content module № / 13
Theme of employment / Classifications of ортодонтичної apparatus. Methods of treatment of ортодонтичних of patients. Apparatus treatment. Functionally is a sending apparatus.
Course / 3
Faculty / Stomatological
Autor / VASILCHUK OLEKSANDR SEMENOVICH
Vinnytsya 2011
1. Actuality of theme : Classification of ортодонтичних vehicles
on principle of action, on a method and scene, after the type of support, after the mestome of location, on the method of fixing, on the type of construction - enables correct choice of construction of vehicle for successful treatment of зубощелепових anomalies.
For valuable ортодонтичного treatment additionally which apply the mechanisms of stimulation of processes of остеоре-парації the next categories of actions can be taken: medicinal therapy, physiotherapy massage, vacuum, use of different types of currents, magnetic and ultrasonic fields, surgical interferences with to the area of the moved teeth.
By a considerable step forward there was створен-ня of functionally-sending ортодонтичних vehicles in development of arsenal of ортодонтичних remedies.
The vehicles of functional action show by itself ramps (with the angle of slope 30-45°), накушувальні grounds, occlusal protective straps which move teeth or all bottom jaw in sagital, are differently constructed, трансверзальному and vertical directions. For them no actively operating elements are stopped up. The source of force is retractive possibility of masseters in a period the collision of certain teeth with sloping of площи-ною, накушувальною ground or оклюзійни-ми protective straps in other areas; dental rows are here disconnected. Vehicles operate irregularly
2. Concrete aims:
To learn and know classifications of ортодонтичної apparatus, methods of treatment of ортодонтичних of patients, apparatus treatment, functionally - sending apparatus.
Base knowledge, abilities, skills, necessary for a study themes (міждисциплінарна integration)
Names of previous disciplines / Got skillsОртодонтія. / -Classification of зубощелепно - facial anomalies and deformations.
-Biomechanics of moving of teeth.
-Forces are for Schwarza.
- Theories of alteration of fabrics of paradontium.
Physiotherapy. / : medicinal therapy, physiotherapy massage, vacuum, use of different types of currents, magnetic and ultrasonic fields, surgical interferences with to the area of the moved teeth
Orthopaedy. / Constituents of removable and unremovable orthopaedic constructions.
4. A task is for independent preparation to employment.
To learn and know classification of зубощелепно - facial anomalies and deformations, biomechanics of moving of teeth, force for Schwarza.
Theories of alteration of fabrics of paradontium, medicinal therapy, physiotherapy, are a massage, vacuum, use of different types of currents, magnetic and ultrasonic fields, surgical interferences with to the area of the moved teeth. Constituents of removable and unremovable orthopaedic constructions
4.1. List of basic terms, parameters, descriptions which a student must master at preparation to employment :
Term / DeterminationStimulation of processes of остеорепарації .
Massage .
Vacuum therapy. / - it комп-лекс measures, sent to резорбцію of bone fabric of alveolar sprout and formation of new layers of bone in places which are not subject to pressure.
mechanical irritation of fabrics, which is used in medical aims.
A vacuum therapy is the use of низько-го pressure in medical aims
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Apparatus method of treatment / Essence of action of ортодонтичних vehicles consists in continuous, fragmentary or alternately-operating pressure on teeth, alveolar sprouts and jaws by means of the special mechanical adaptations which are activated extensible гвин-тами, by a spring wire, rubber rings, ligatures or efforts of masticatory and mimic musculature (at the disconnected bite) or змі-ною of stereotype motions of bottom jaw after допо-могою sending occlusal and накушувальних grounds, ramps and elements which provide normalization of mimic musculature : lip пелоти, cheek shields, vestibular мантелі -заслонки for a tongue and other
Continuous-action force presses on a tooth without the phase of calmness during the protracted period and that is why not при-пускає of necessary reorganization of fabric.
VEHICLES of ФУНКЩОНАЛЬНО-НАПРАВЛЯЮЧОЇ ACTION / With the aim of removal of hard action of unremovable vehicles on teeth them it was begun to do removable: капа Schwarza, Биніна, vehicle Schwarza with a накушувальною ground and ramp, vehicle of Катца with a накушувальною ground and other Використову-вання of reduction of masseters as a basic energy source for moving of teeth allowed to give onejaw unremovable and removable vehicles an intermaxillary action due to a presence in their construction of passively operating функціонально-на-правляючого element (of ramp, накушувальної ground, occlusal protective straps
4.2. Theoretical questions to employment:
-Classification of зубощелепно - facial anomalies and deformations.
-Biomechanics of moving of teeth.
- Forces are for Schwarza .
-Theories of alteration of fabrics of paradontium.
- Medicinal therapy, physiotherapy massage, vacuum, use of different types of currents, magnetic and ultrasonic fields, surgical interferences with to the area of the moved teeth
-Constituents of removable and unremovable orthopaedic constructions.
4.3. Practical works (task) which are executed on employment :
Study and interpretation of classification of зубощелепно - facial anomalies and deformations.
- Study of biomechanics of moving of teeth.
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- Forces are for Schwarza.
-Theories of alteration of fabrics of paradontium at ортодонтичному лікувані.
- Medicinal therapy, physiotherapy massage, vacuum, use of different types of currents, magnetic and ultrasonic fields, surgical interferences with to the area of the moved teeth.
- Constituents of removable and unremovable orthopaedic constructions
A plan and organizational structure of lesson are after discipline.
№ / Stages of employment / Distribution of time / Types of control / Facilities of studiesPreparatory stage / 15хв / practical / textbooks.
1.1 / Organizational
question. / task, situatioonal tasks, verbal опи-тування after the стан-дартизованими lists of questions. / manuals, methodical recommendations.
1.2 / Forming of motivation.
1.3 / Control of initial level of preparation.
2. / Basic stage / 55хв
3. / Final stage / 20 хв / test tasks / test tasks
3.1. / Control of eventual level of preparation.
3.2. / General estimation of educational activity of student.
3.3 / Informing of students is of theme of next employment.
VI. Literature:
basic: - П. С. Фліс Ортодонтія.
additional: - Хорошилкина Ф. I. Руководство for ортодонтии.
Laid down the methodical pointing: ace. Васильчук О. С.
Table of contents of theme :
Classification of ортодонтичних vehicles
After. Ф. I. Хорошилкіною, the basic constructions of ортодонтичних vehicles are classified thus.
On principle to the action distinguish four groups:
• functionally-operating
• functionally-sending
• mechanically operating
• combined action.
On a method and scene :
• onejaw
• onejaw intermaxillary action
• двощелепні
• extraoral
• combined.
After the type of support :
• реципрокні
• stationary.
After the mestome of location :
• внутрішньоротові - oral (sky, language), vestibular (назубні);
• extraoral - main (frontal-cervical, parietal-cervical, united);
• neck;
• jaw (верхньогубні, нижньогубні, підборідні, підщелепні, on the corners of bottom jaw, united).
On the method of fixing :
• unremovable
• removable
• united.
On the type of construction :
• arc
• капові
• пластинчасті
• block
• framework
• elastic.
Methods of ортодонтичного treatment
Stimulation of processes of остеорепарації - it комп-лекс measures, sent to резорбцію of bone fabric of alveolar sprout and formation of new layers of bone in places which are not subject to pressure.
On the first stage of ортодонтичної action the processes of stimulation are sent to overcoming of barrier of за-хисних forces of organism and processes of destruction, роз-смоктування bone must prevail over про-цесами formation of new bone.
On the second stage processes of destruction and утво-рення fabric must be on possibility урів-новажені.
On the third, finishing, stage the processes of stimulation must be directed on to the приско-рення mechanism of transformation of new bone education on valuable bone fabric, id est the processes of regeneration must prevail over the про-цесами resolving. Than stronger will be кіст-кова fabric upon completion ортодонтичного лі-кування, the less relapses, as relapses arise up from insufficient ретенційного періо-ду, from unfinished treatment.
To the mechanisms of stimulation of processes of остеоре-парації the next categories of actions can be taken: medicinal therapy, physiotherapy (massage, vacuum, use of different types of currents, magnetic and ultrasonic fields), surgical interferences with to the area of the moved teeth.
Activators of functional action - it комп-лекс of ортодонтичних adaptations, each of which it is possible to use in rare case for the functional operating on a ортодонтичний device, and through him - on the moved tooth (teeth). Функ-ціональні ортодонтичні activators can be located in the cavity of mouth and led in an action by the teeth of opposite jaw, and розташову-ватися can outside of cavity of mouth and led in an action by a mechanical or electromechanics way.
MASSAGE
A massage is a mechanical irritation of fabrics, which is used in medical aims.
There is mechanical подразнен-ня of superficial and deep fabrics at a massage, peripheral nervous receptors, that causes different рефлек-торні reactions which cause the change of function of ор-ганів and fabrics. An operating degree is on the nervous system of за-лежить from the receptions of massage, intensity and time of realization of procedure. For example, grinding and stroking reduce excitability, that приво-дить to the analgesia, and рублення, pat and ві-брація, opposite, strengthen her. As a result of механіч-ного irritation there is expansion of vessels of skin and deep fabrics, that causes strengthening of крово- and лімфотоку, metabolism, intensity of biochemical processes and protective functions of fabrics. In a skin as a result of acceleration of disintegration of albumens and фер-ментативної activity active substances (histamine, ацетилхолін) appear biologically, what нада-ють гуморальну operating on tone of vessels. In the muscles of зни-кає fatigue as a result of speed-up leadingout of foods of the power breaking up. Змен-шується was swollen and stimulated metabolism in fabrics, that promotes them retractive function and capacity. There is a redistribution of blood in the massaged fabrics; it influences on the functions of the сер-цево-судинної system. A massage stimulates регене-ративні processes in fabrics as a result of improvement of мікроциркуляції, increases mobility of fabrics.
VACUUM-THERAPY
The method of the dosed vacuum on the mucous membrane of обо-лонку and bone fabric is worked out under керівни-цтвом In. And. Кулаженко (1960).
A vacuum therapy is the use of низько-го pressure in medical aims. In the hearth of action of ство-рюється local decompressing and there is involvement of the staggered fabrics, increase of проник-ності vessels, that at a subzero enough vacuum results in the break of fabrics and formation of гемато-ми. The damage of fabrics and vessels results in ак-тивізації of physiology processes, sent to liquidation of arising up hearth. In the hearth of відбува-ється zymolysis of некротизованих albuminous molecules, and as a result is education biologically of active substances (histamine, ацетилхо-лін and other). Immunobiological проце-си activate, metabolism and фагоцитоз. As a result of розвиткумісцевої hypoxia cellular protective and adaptation processes are stimulated, there is opening of ре-зервних capillaries and development of new мікросудин. In the mechanism of action matters also irritation of nervous receptors in a hearth both a vacuum and foods of breaking up of albumens, that рефлектор-но stimulates репаративні processes in the hearth of по-шкодження. It does not follow to eliminate also a гуморальну action biologically of active substances which get in a blood river-bed and influence on different processes in an organism. Destroyed tissue structures and мікро-судини brush up quickly, that favourably по-значається on their functional ability. In ортодонтії use vacuum-dilution, even a 40 mm of рт. century which is created in area of chums of пе-реміщуваних teeth. The course of treatment consists of 8-10 procedures which are conducted on the measure of розсмокту-вання haematomas. Thus протеолітичні фермен-ти, that freed oneself from tissue structures in the area of haematoma, прискорюють репаративні processes, that assists reduction of duration of treatment.
From data of Т. And. Коваленко (1985), after a vacuum stimulation of the ортодонтичне moving of teeth for adults for certain grows short in 1,3-1,5 times (rice. 6.67).
ULTRASOUND
For the acceleration of moving of teeth after допо-могою of ортодонтичних vehicles Д. Новоселов, And. Н. Чумаков (1983) suggested to influence on a bone by an ultrasound. Got by them показа-ли is given, that ultrasound by intensity 0,4 W/см2 здій-снює is expressed local influence on the mineral component of bone fabric.
Mechanism of action : under an action to the ultrasound in fabrics there is a punctuational compression and розтягу-вання particles, that sets them in fluctuating motion or уздовж straight ultrasonic wave, or athwart to him. At fluctuating motions energy to the ultrasound is passed from a particle to the particle which assists a deep enough action, особ-ливо in a homogeneous environment. On verge of розділь-них environments and fabrics it can take place віддзер-калення of ultrasonic wave which creates terms for interference and formation of areas of підвищено-го of ultrasonic pressure. This process takes place especially often on verge of such different after акустич-ним resistance fabrics, as a bone- tendon, кіст-ка is a muscle, where represented to a 60 % energy which can subjectively show up being in dull pain.
The mechanical vibrations of tissue particles result in a "cellular massage", changes of physical and chemical processes and formation of heat. At large intensity to the ultrasound in the phase of stretch there can be a break of intermolecular forces of coupling, gravitation and origin of microcavities of -кавітація, which tears the shell of cages and destroys the molecules of chemicals. There is much energy at кавітації of виді-ляється, especially on verge of division of environments. Fluctuating motions of particles of tissue environments are accompanied by ionising and change of bioelectric processes in cages, by the increase of chemical activity of different processes, formation of chemicals.