ORTHODONTIC DEVICES AND METHODS

Field of the Invention

Embodiments of the invention relate to medicine and orthodontics in particular. More specifically, embodiments of the present invention relate to correction of the form of the dental alveolar arch towards both its increase and decrease, to correction of the form of the upper jaw, namely, dental, alveolar and basal arches, to stimulation of growth and filling of defects of missing jaw tissues, particularly palate cleft and alveolar process, and to correction of the form of dental alveolar arch in the lingual and vestibular directions.

Background

As far back as 1880, Continuous has designed a device constituting of vestibular and lingual arches connected with each other by crosspieces in the region of lateral teeth, (see, CONSUMMATE OCCLUSION, Robert Murray Ricketts, 1996, Fig 2-2).

Also known is a device executed in the form of lingual and vestibular springs acting upon frontal teeth and fastened on a lingual arch connecting fastening elements of wireframes on separate lateral teeth (see, USA patent Ns 1142467, 8.06.1915).

The devices described above provide correction of teeth in a frontal section, but in view of a rigid attachment of arches to wireframes of lateral teeth, they are characterized by limited opportunities for transversal movement of the latter.

There are also known nonremovable orthodontic devices constituting arches fastened in retainers rigidly fixed on teeth. The mentioned devices allow to provide a correction of the form of dental arch and position of separate teeth via forward-rotary influences on teeth, (see, PCT application N° WO 048868 A2, A61 C 7/14 02.06.2005).

The above-mentioned arch devices do not stimulate intensive growth of the alveolar process and correction of the form of dental alveolar arch, owing to which the terms of treatment are prolonged.

Moreover, during the teeth movement, the surface of the alveolar process wall adjacent to the tooth root is periodically exposed to intensive resorption in places of squeezing.

An orthodontic device for correction of dental arches (see, the patent of the Republic of Armenia Ns 512. A 61C7/00, 1999) on its technical essence is closest to the claimed variants of devices. The device consists of fastening elements, which are connected through lingual and vestibular arches with activation units and executed in the form of metal wireframes clasping teeth of dentition's lateral segments. The latter

/§lfd !!piWβraέl!! lδf ^" Mifeξiaetails located at necks of teeth from the lingual side and dispersedly mounted along the height of teeth from the vestibular side and connected by crosspieces disposed in interdental spaces.

The design of the device provides corpus (bodily) shifting of teeth: lateral teeth - by forward-rotary influences on them, and frontals - by efforts of vestibular and lingual arches dispersed along the height of incisors. Since the device is removable, there is an opportunity to periodically renew forces exerted by wireframes and arches and decreasing in the course of time through removal of the device and activation of its elements.

Practical use of the device allows to achieve a corpus (bodily) shifting of teeth and increase in transversal dimensions of an alveolar process with the intensity of 0,3- 0,4 mm per month. However, the given device has the limited opportunities in realization of sagittal-transversal shifting of teeth and is actually deprived of an opportunity to stimulate the growth of an alveolar process in case of a jaw constriction in the lingual direction. Moreover, the design of the device does not provide stable dispersal of arches along the height of incisors, which results in decrease of the treatment intensity, owing to necessity of the frequent correction of arches.

A device known as Derichsweiler's nonremovable orthodontic device for accelerated rupture of a median palatine suture, constituting a plastic basis with a screw and metal reinforcements, free ends of which are rigidly fastened with rings or corona in the region of lateral teeth (see, Khoroshilkina F. Y., Maligin Yu. M. "Fundamentals of designing and technology of manufacturing of orthodontic devices", Publishing House "Medicine" 1977, page 97, fig. 35). The design of the device provides stability of installation in a cavity of a mouth, however being nonremovable it facilitates development of inflammatory diseases of the mucous tunic.

Also known is an orthodontic device for accelerated rupture of a median palatine suture containing nonremovable basic parts in the form of rings or corona, which are rigidly disposed on teeth of dentition's lateral segments and connected with each other through vestibular arches. The device has fixing units executed in the form of vertically disposed tubes soldered on their lingual surface and a removable part constituting a plastic basis with a screw and metal reinforcements, the free ends of which are bent and mounted in the vertically disposed tubes, (see, Khoroshilkina F. Y., Maligin Yu. M. "Fundamentals of designing and technology of manufacturing of orthodontic devices", Publishing House "Medicine", 1977, page 98, fig. 36)

O'd ^' weS/ffiiϋ.ilϋbiS^i ^' Hlescribed devices are insufficiently convenient in usage. Their removal and installation in the cavity of mouth are possible only at direct participation of a doctor, particularly an orthodontist.

Another known an orthodontic device for accelerated rupture of the median palatine suture (invention patent of the RA Ns 511 IPC ⁵ A61C 7/36, 1999) favorably differs from analogues in that being removable it provides conditions for as much as possible simplified removal and installation of the device, simultaneously providing the stability of the device. The device consists of removable and non-removable parts. The non-removable parts constitute orthodontic rings, which have fixing units and are rigidly fastened on teeth of dentition's lateral segments and connected with each other through vestibular arches. The removable part contains basic plates, which have vestibular arches and are located on both sides of median palatine suture, and a power element in the form of soldered springs connecting basic plates.

The previously mentioned design is chosen as a closest analogue for variants of proposed devices for correction of the form of upper jaw. The designs of the closest analogue as well as analogues do not provide effective correction of the configuration (geometry) of palatal fornix, simultaneous corpus (bodily) shifting of teeth and correction of their axial position. Moreover, the designs do not provide correction of the form of dental alveolar arch in a frontal section.

In a known method an upper jaw palate cleft may be closed by bringing down a palatal process through influence of a nasal plate on palatal processes of the upper jaw in an oral direction. The method is realized by an obturator consisting of dental-gingival and nasal plates with fastening units for elastic power element. The obturator is effective during the period of active growth of children, before their reaching the age of 7-8 years. The known method and obturator provide bringing down and closing of a palatal process, but they are not intended for correction of the form of dental arch (see, USSR inventors certificate NQ 848020 IPC ⁷ A61C 7/00, 23.07.1981).

A method for stimulation of growth of missing tissues of upper jaw by irritation of edges of palate cleft is also known. The method is realized by the McNeill's appliance consisting of an upper jaw plate with fastening elements and pelots, which are fastened on plate through buckles to irritate edges of defect (see, Khoroshilkina F. Y., Maligin Yu.M. "Fundamentals of designing and technology of manufacturing of orthodontic devices", Publishing House "Medicine" 1977, page 98, fig. 36).

A method for closing, irritation of edges of palate cleft and simultaneous correction of the form of dental arch by a palatal plate is also known. The method is

^• fddl ilzfelSclH if In Fόiϋ ^' if l^i:l!a ^;i! 'dB vϊ&e-o btu rato r (see, Mailyan P. D. "New means for orthodontic treatment ". Kolomna, District of Moscow, page 58). This development is chosen as a closest analogue for the proposed group of inventions.

The device consists of removable and fixed parts. The fixed parts are orthodontic rings, which are rigidly fastened on lateral teeth and connected with each other by vestibular arches and provided with fixing units. The removable part -a basis of the device- is realized in the form of plates adjoining to the base of lateral teeth from the lingual side, which have closed lingual-vestibular arches with correction units for engagement with fixed parts. A lingual arch is fastened on plates through springs and palatal plates are fastened on lingual arch through orthodontic springs. The basis of the device is fastened to fixing units of fixed parts through lingual-vestibular arches.

The above mentioned devices are intended for closing a surface of defect by a plate, and in the result of long-term usage, due to irritation of edges of cleft and formation of new tissues, promote reduction of cleft's dimensions. Advantage of the closest analogue is that it provides correction of the form of dental arch too.

However above mentioned obturators and methods, on the basis of which they operate, do not provide intensive stimulation of growth of missing tissues and filling of defects of jaw.

Primordially, the correction of teeth position was realized by forward influences of active details of removable orthodontic devices on teeth that was carried out by periodic removal of the device, restoration of its decreasing influences and its fitting in a cavity of a mouth.

In the beginning of the 20 ^th century, Mershon and Crozat developed devices that allow forward influences to be carried out simultaneously on lingual surfaces of lateral and frontal teeth (see, " Directory on orthodontics ", Kishinev 1990, page180, Fig. 27 and page 188, Fig. 28). At about the same time, Ainsworth designed a device, carrying out forward influence respectively on lingual and vestibular surfaces of lateral and frontal teeth (see, Kolesov "Stomatology of childhood" Moscow 1970, Fig. 106).

Today, the advanced removable devices of forward influence - appliances of Crozat-Ricketts and Wilson, are widely used in practice (see, respectively "CONSUMMATE OCCLUSION" R. Ricketts 1996, Figures 2-7 and "ENHANCED ORTHODONTICS " R. Wilson, W. Wilson, page 55.).

The above-described devices carrying out a method of periodic activation and influence on teeth by forward forces allow to achieve correction of teeth position and form of dental arch. However, the expansion and lengthening of a dentition by the

ay$el$iihtiύne'ii Mhoβ results in a buccal (vestibular) inclination of teeth, that is, corpus (bodily) shifting of teeth is not provided.

In 1886, Angle, the founder of modern non-removable orthodontic equipment designed a device of forward influence, which is non-removably fastened on vestibular surfaces of teeth. In 1916, for the first time he offered a method of influence by forward - rotary forces, carried out by the fixed arch device, providing corpus (bodily) shiftings of teeth. Subsequently, Angle, through improvement of a design of non-removable orthodontic device for forward - rotary influence on teeth, has executed it in the form of arches fastened in locks, rigidly fixed on teeth. A method and devices, developed by Angle, have allowed achievement of a corpus (bodily) shifting of teeth and correction of the form of dental arch, (see, "CONSUMMATE OCCLUSION " R. Ricketts 1996, Figures 2-5B and 2-6A).

However, for high-grade deformations of a dental alveolar arch, achievement of corpus (bodily) shifting of teeth in vestibulolingual directions through influence of forward - rotary forces on them by fixed arch devices is possible to realize only after preliminary correction of geometry of dental arch and alignment of teeth.

As a rule, the mentioned preliminary correction is carried out by removable or non-removable devices of forward influence, which are mounted in an oral in the initial stages of treatment. This means that the process of correction of a dental alveolar arch is multistage, and the forward - rotary influences on teeth by non-removable arch devices are carried out at later stages of orthodontic treatment.

As is well known, the movement of teeth in an alveolar process is possible due to the coordinated processes of resorption and regeneration (apposition) of an alveolar bone. Moreover, the surface of alveolar process faced to a root of tooth in places of squeezing and tension of walls of bone-medullar cavities is periodically subjected respectively to resorption and apposition.

The application of large forces in non-removable arch devices can result in resorption of not only alveolar bone, but roots of teeth too, therefore in practice, small forces are used more often. Summarizing the above-mentioned, it should be stated that nonremovable arch devices do not ensure intensive correction of the form of alveolar process and require a long-term treatment.

For elimination of staged treatment at the high-grade deformations of a dental alveolar arch, the removable designs of orthodontic devices providing forward and rotary forces on teeth were offered. Devices of the given design constitute the metal wireframes on dentition's segments, which are dispersed along the height of teeth and

6diiMS ^' #Mϊ!< w ^' iffi ©SaόWlotfter by orthodontic arches and/or springs (see the invention patent of the Republic Armenia Ns 512, IPC A61C7/00, 1999, and applications for the inventions of the Republic Armenia N9.20050147, 20050148, 20050149 IPC A61C7/00, 2005). The above-described devices were applied by a method attributable to removable devices - by periodic removal of the device, restoration of decreasing influences and its fitting.

Such a method of treatment with the specified devices is favorably distinguished from known subjects, that at significant deformations of a dental alveolar arch, it allows to exclude multistage nature of a treatment and to achieve forward - rotary influence on all teeth in the necessary direction. Regardless of the fact that during the use of these devices the generally accepted in orthodontics values of forces on crowns of separate teeth of 50-150 gm were applied, torques on root apexes of teeth exceeded similar values provided by other devices of forward - rotary influence in several times. It is stipulated by that the fastening metal wireframes with elements, dispersedly mounted along the height of teeth's crowns, at realizing of rotary influence on teeth provide the maximum large arm of applied forces and promote the increase of torque on roots of teeth. The above-mentioned property allows movement of an axis of rotation of teeth to the root apexes and, consequently, to create zones of a tension and squeezing of an alveolar bone, which are adjacent to the lingual and vestibular surfaces of roots of teeth. Depending on an axial position of teeth, the value, sequence and combination of applied forward and rotary forces on them are adjusted during their movement. The application of the above-mentioned method and devices provides a corpus (bodily) shifting of teeth and a simultaneous growth of an alveolar process dimension, with the intensity of about 0,3-0,4 mm / months. However, as a result of long-term influence of elements of fastening metal wireframes, mounted in interdental spaces, the teeth are influenced by the forces pushing out of them from the alveolar sockets that results in loosening of separate teeth.

Summary

A task of a claimed group of inventions is to create designs of devices capable to intensify a correction process of the form of alveolar process and a dental arch.

In accordance with a first variant of a device, the put task is solved that in the known device containing fastening elements, which are connected through lingual and vestibular metal wire power units and executed in the form of metal wireframes clasping teeth of dentition's lateral segments and performed of lingual and vestibular details

the one side and dispersedly mounted along the height of teeth from the other side and connected by crosspieces. According to the invention the device has a metal wireframe mounted on teeth of dentition's frontal segment and a connection of fastening elements is carried out through a metal wireframe of frontal segment by lingual and/or vestibular springs.

In accordance with a second variant of the device, the put task is solved that in the known device containing fastening elements, which are connected through a lingual arch with power units and executed in the form of metal wireframes clasping teeth of dentition's lateral segments and performed of lingual and vestibular details located at necks of teeth from the one side and dispersedly mounted along the height of teeth from the other side and connected by crosspieces, according to the invention a device has a metal wireframe mounted on teeth of dentition's frontal segment and connected directly and/or through springs with a lingual arch, and the fastening element or elements are additionally connected with a lingual arch through springs.

In accordance with a third variant of the device, the put task is solved that in the known device containing fastening elements, which are connected through lingual arch with power units and executed in the form of metal wireframes clasping teeth of dentition's lateral segments and performed of lingual and vestibular details located at necks of teeth from the one side and dispersedly mounted along the height of teeth from the other side and connected by crosspieces, according to the invention it has a metal wireframe mounted on teeth of dentition's frontal segment and connected with a lingual arch through springs, and the fastening element or elements are connected with a metal wireframe of frontal segment and additionally with a lingual arch through springs.

The nature of all variants of the claimed group of inventions is also that lingual or vestibular details of metal wireframes dispersed along the height of teeth are mounted from the teeth side facing to the movement direction.

The nature of all variants of the claimed group of inventions is also that a metal wireframe is performed of components disposed on a separate tooth and/or group of teeth of a segment and connected with each other via lingual and/or vestibular springs.

A task of the group of inventions is to ensure increased functionalities of devices for correction of the form of upper jaw, namely, dental alveolar and basal arches. In accordance with a first variant of execution of a device for correction of the form of upper jaw, the put task is solved that in the known technical solution containing fastening elements, which are fastened on teeth of dentition's lateral segments and connected with two plates located on both sides of median palatine suture and

^αul i ^, vvitB!liarø6tiier by a metal wire palatal power element, according to the invention fastening elements are executed in the form of metal wireframes clasping teeth of dentition's lateral segments and a connection of fastening elements with plates is carried out through springs.

In accordance with a second variant of execution of a device for correction of the form of upper jaw, the put task is solved that in the known technical solution containing fastening elements, which are fastened on teeth of dentition's lateral segments and connected with two plates located on both sides of median palatine suture and connected with each other by a metal wire palatal power element, according to the invention the design additionally contains a fastening element mounted on teeth of dentition's frontal segment, fastening elements are executed in the form of metal wireframes clasping teeth of dentition's segments, the plates are connected with fastening elements of lateral segments through springs, and a fastening element of frontal segment is connected with a metal wire palatal power element by springs.

In accordance with a third variant of execution of a device for correction of the form of upper jaw, the put task is solved that in the known technical solution containing fastening elements, which are fastened on teeth of dentition's lateral segments and connected with two plates located on both sides of median palatine suture and connected with each other by a metal wire palatal power element, according to the invention the design additionally contains a fastening element mounted on teeth of dentition's frontal segment, fastening elements are executed in the form of metal wireframes clasping teeth of dentition's segments and connected with each other and plates by a palatal arch- through springs.

The task of a proposed method is the intensification of stimulation of growth of missing tissues and filling of defects of jaw. The put task is solved that in the known method, according to which a defect is closed by a plate and the edges of defect are irritated, according to the proposed method, the plate is imparted by vibratory motions and by periodical correcting of a plate's working surface a space is freed for neoformations of tissues.

The task of a proposed device is to create a device design providing of intensification of stimulation of growth of missing tissues and filling of defects. The put task is solved by that in comparison with the known technical solution containing fastening elements of lateral segments' teeth, a plate or plates closing missing tissues of defect and a lingual arch, which is connected to fastening elements and a plate or plates through springs, according to the invention fastening elements are realized in the

fdWffifaPfrøt ^j JlESMpfeSlffiRβS, details of which clasping necks of lateral teeth from lingual and vestibular sides are connected by crosspieces disposed in interdental spaces, as well as, in intertubercular recesses of teeth in sagittal and/or transversal directions.

Such a design allows to achieve vibratory motions of a plate or plates due to periodic activation in frontal direction of crosspieces disposed in intertubercular recesses. Furthermore, the design allows dental alveolar movements both in sagittal and transversal directions.

The task of another proposed method is the intensification of correction of the form of alveolar process and increase of a convenience of the device usage. The put task is solved that in the known method for correction of the form of dental alveolar arch, which is realized through fitting, periodic removal and activation of the orthodontic device and influence on teeth by forward and rotary forces, according to the invention, in intervals between periodic activation through repeatedly removing of forces developed by the device, teeth are influenced by forces of masticatory muscles.

Brief Description of the Drawings

Embodiments of the invention may be understood by reference to the drawings, in which:

Figs. 1 , 2, 3, respectively depict first, second and third variants of devices for correction of the form of dental alveolar arch.

Fig. 4 depicts a version of the execution of a device for correction of the form of dental alveolar arch, where a metal wireframe has separate components disposed on two groups of teeth of a lateral segment and connected with each other via lingual and vestibular springs.

Fig. 5 represents a first variant of an orthodontic device for correction of the form of the upper jaw.

Fig. 6 represents a cross-section view of the device, according to the first variant.

Fig. 7 represents a second variant of execution of a device for correction of the form of the upper jaw.

Fig. 8 represents a third variant of execution of a device for correction of the form of the upper jaw.

Fig. 9 depicts a device with a palatal plate for stimulation of growth of missing tissues of jaw.

Fig. 10 depicts a modification of the device of Fig. 9 with a palatal plate and an alveolar plate with artificial teeth.

p ^' jyfi ⁱ ^ ^' fti^'Splb ^' Pzones of squeezing and tension of an alveolar process, which are formed under influence of a metal wireframe with elements, dispersedly mounted along the height of a tooth according to an embodiment of a method for correction of the form of dental alveolar arch.

Fig. 13 depicts zones of squeezing and tension of an alveolar process in the case of removal of forces exerted by the device, and partial return of a tooth to an initial position according to an embodiment of a method for correction of the form of dental alveolar arch.

Fig.s 14-15 depict alternating changes of zones of squeezing and tension under influence of forces of masticatory muscles according to an embodiment of a method for correction of the form of dental alveolar arch.

Figs. 16-17 depict jaw models of patients before and after orthodontic treatment in accordance with the examples of a particular execution of a method for correction of the form of dental alveolar arch.

Detailed Description

CORRECTION OF THE FORM OF THE DENTALALVEOLAR ARCH

As shown in FIG. 1 , a device for correction of the form of dental alveolar arch, in accordance with a first variant of the execution, has fastening elements (1) in the form of metal wireframes clasping teeth of dentition's lateral segments and a metal wireframe (2) mounted on a teeth of dentition's frontal segment, which is connected with fastening elements by lingual springs (3) and/or vestibular springs (4).

As shown in FIG. 2, a device for correction of the form of dental alveolar arch, in accordance with a second variant of the execution, has fastening elements (11), in the form of metal wireframes clasping teeth of dentition's lateral segments and a metal wireframe (12) mounted on teeth of dentition's frontal segment. The latter is connected directly (13) and/or through spring (14) with a lingual arch (15), the ends of which are fixed on fastening elements (11). The lingual arch (15) has activation units (16) and is additionally connected with one or two fastening elements (11) through springs (17). The performance of the metal wireframe in the form of separate components (see, Fig. 4) may be a version of the proposed variants and in particular of the second variant. In this case, the component wireframes (8) clasping a separate tooth and/or group of teeth of a segment are connected with each other via lingual springs (9) and vestibular springs (10).

'AMevi ^' c^W dbtfeiiiion of the form of dental alveolar arch, in accordance with a third variant of the execution, has fastening elements (21), in the form of metal wireframes clasping teeth of dentition's lateral segments and a metal wireframe (22) mounted on teeth of dentition's frontal segment. The latter is connected with a lingual arch (24) through springs (23), and the ends of a lingual arch (24) are fixed on the fastening elements (21). The lingual arch (24) has activation units (25) and is additionally connected with the fastening element or elements (21) through springs (26). The metal wireframe (22) of frontal segment in its turn is connected with the fastening element or elements (21) through a spring or springs (27).

The characteristic feature of the group of inventions is that the metal wireframes are performed of lingual and vestibular details located at necks of teeth from the one side and dispersedly mounted along the height of teeth from the other side and connected by crosspieces disposed in interdental spaces. At the same time, lingual (see, Fig. 3) and vestibular (see, Figs. 1, 2, 4) details of metal wireframes dispersed along the height of teeth are mounted from the side of the teeth facing to the movement direction, namely, in the first case the device is intended for constriction, and in second for expansion of a dental alveolar arch.

A device for correction of the form of dental alveolar arch, in accordance with a first variant is used as follows. After fitting of the device in a cavity of mouth, the patient is trained on peculiarities of treatment with it. The device is activated through every 15- 20 days. By activation of lingual (3) and vestibular (4) springs in sagittal and/or transversal directions, as well as, in combination and alternation (proceeding from the clinical indications) with turning of metal wireframes of fastening elements (1) and frontal segment (2) around of their longitudinal axis a correction of the form of dental alveolar arch is achieved.

A device for correction of the form of dental alveolar arch, in accordance with a second variant is used as follows. After fitting of the device in a cavity of a mouth, the patient is trained on peculiarities of treatment with it. The device is activated through every 15-20 days. By activation of a lingual arch (15), its activation units (16), as well as springs (17) and (14) accordingly disposed between a lingual arch (15) and wireframes (11) and (12) in sagittal and/or transversal directions, as well as, in combination and alternation (proceeding from the clinical indications) with turning of metal wireframes of fastening elements (11) and frontal segment (12) around of their longitudinal axis a correction of the form of dental alveolar arch is achieved.

Wlevici-IKftiltion of the form of dental alveolar arch, in accordance with a third variant is used as follows. After fitting of the device in a cavity of a mouth, the patient is trained on peculiarities of treatment with it. The device is activated through every 15-20 days. By activation of a lingual arch (24), its activation units (25), springs (27) connecting fastening elements (21) and the wireframe of frontal segment (22), as well as, springs (26) and (23) accordingly disposed between a lingual arch (24) and wireframes (21) and (22) in sagittal and/or transversal directions, as well as, in combination and alternation (proceeding from the clinical indications) with turning of metal wireframes of fastening elements (21) and a frontal segment (22) around of their longitudinal axis a correction of the form of dental alveolar arch is achieved.

Example: A woman of 27 years old with complaints related to cosmetic defect has addressed to the clinic. Objectively: a distal deep bite (malocclusion of class 11-1 by Angle), constriction of both dental alveolar arches, irregular position and overcrowding of teeth in a frontal segment.

Two devices have been made and fitted in the cavity of patient's mouth: according to the first variant of the device- for the top teeth line, and according to the second variant of the device- for the lower teeth line.

By activation of a lingual (3) and vestibular (4) springs and wireframes (1) and (2) on the top jaw and by activation of activation units (6) of lingual arch (5), springs (7) and (4) accordingly disposed between a lingual arch (5) and wireframes (1) and (2), as well as, wireframes (1) and (2) on the lower jaw an expansion of dental alveolar arch was ensured. After 3.5 months from the beginning of treatment the measurements of transversal dimensions of dental alveolar arch in the area of 4-th teeth have registered the increase of top and lower jaws, accordingly on 5.0 and 6.5 mm. The position of teeth was considerably normalized, gaps have appeared between teeth that were used in the next months for the correction of teeth position. The growth of the dental alveolar arch in the lateral section of the lower jaw was achieved too. The occlusion was corrected after 6 months. The devices were taken off after 3 months from the beginning of the retention period.

Example: A patient of 19 years old with complaints to cosmetic defect and asymmetry of the face after orthodontic treatment has addressed to the clinic. Objectively: asymmetry of the face, the left side prevailed by its sizes over the right one. The biometric study of jaw models has shown an excess of the transversal sizes of the left side alveolar arch in respect of the palatal suture on 3-5 mm. Compelled

of the lower jaw to the left. The Wilson occlusal plane is inclined downwards from the right to the left.

Two devices for the top and lower teeth lines of the patient have made and fitted in accordance with the third variant of the device for correction of the form of a dental alveolar arch.

During the first 2 months by unilateral activation of activation elements (25) of the arch (24) and springs (23), (26), and a wireframe (21) the increase of the right side of both jaws was achieved. Simultaneously, the correction of the Wilson occlusal curve was realized -dental alveolar contraction of the right segment of the lower jaw. By activation of springs (23), (26) and the wireframe (22) a dental alveolar shift of frontal segments of both jaws to the right was achieved on the 3 ^rd month of treatment. During the 4 ^th month, the devices were not activated. On 5 ^th and 6 ^th months by activation of springs (23) and (26), activation units (25) of arch (24), and a wireframe (21) a dental alveolar shift of left lateral segments of both jaws in lingual direction was achieved.

The face asymmetry was considerably diminished after 6 months of the treatment. The devices were taken off after 3 months from the beginning of the retention period.

Practical use of the proposed variants of the devices for correction of the form of dental alveolar arch has shown, that they:

• ensure dental alveolar movement of a frontal segment in sagittal- transversal directions,

• achieve a uniform and/or non-uniform expansion and constriction of a teeth line,

• ensure successive dental alveolar movement of lateral or frontal segments in different directions,

• intensify sagittal- transversal movements, both in separate, and simultaneously in several segments of teeth line.

CORRECTION OF THE FORM OF THE UPPER JAW

In clinical practice frequently are encountered hypoplsia and deformation of the upper jaw, the reasons of which could be derangement of mineral metabolism (rickets, dyspepsia) in early childhood, infectious and chronic diseases, dysphagia, dysphasia, disphrasia, early loss of temporary or permanent teeth, disorder of chewing and facial muscles (para function) etc..

^{/* U} -H9 l ^' ήe ^'''' ciiyi ^: 6'f ^1| iill ^ι iificant constriction of dental, alveolar and basal arches that mostly occurs in the case of high-grade rickets, the cupula of a palate usually has a double fundus.

It is well known that bone tissue is a viscous-elastic medium, the elasticity of which considerably rises at it growth.

Taking into account the above-mentioned, a device has been designed so that at a correction of convex parts of the palatal fornix to combine the influence of plates on them with the rupture of the median palatine suture and the growth of a dental alveolar process. Namely, above and below the convex parts of the palatal fornix a zone of growth of the bone tissue (zone with the increased elastic properties of the bone tissue) is formed. The influence of plates on convex parts of the palatal fornix and presence of two zones with the increased elastic properties of the bone tissue allows to considerably increase the efficiency of correction of the form of cupula of a palate.

As shown in Fig. 5 and Fig. 6, a device for correction of the form of upper jaw in accordance with a first variant consists of fastening elements (31) which are executed in the form of metal wireframes clasping teeth of dentition's lateral segments. Plates (33) are fastened on orthodontic springs (32) soldered to the fastening elements (31). Plates (33) are located on both sides of median palatine suture -on convexes of the palatal fornix (see. Fig. 6) and connected with each other by a metal wire palatal power element (34), which may be executed, in particular, in the form of soldered springs.

As shown in Fig. 7 device for correction of the form of upper jaw in accordance with a second variant consists of fastening elements mounted accordingly on teeth of dentition's lateral segments (41) and frontal segment (42), which are executed in the form of metal wireframes clasping teeth of dentition's corresponding segment. Plates (44) are fastened on orthodontic springs (43) soldered to the lateral fastening elements (41). Plates (44) are located on both sides of median palatine suture -on convexes of the palatal fornix and connected with each other by a metal wire palatal power element (45), which is connected with a frontal segment's fastening element (42) through orthodontic springs (46).

As shown in Fig. 8, a device for correction of the form of upper jaw in accordance with a third variant consists of fastening elements mounted accordingly on teeth of dentition's lateral segments (51) and frontal segment (52), which are executed in the form of metal wireframes clasping teeth of dentition's corresponding segment. A palatal arch (54) is fastened on orthodontic springs (53) soldered to the fastening elements (51) and (52). Plates (56) are fastened to a palatal arch (54) through orthodontic springs (55)

4M BSMM^M' Mhi ^' h of median palatine suture -on convexes of the palatal fornix and may be connected with each other , in particular, by two metal wire palatal power elements (57).

In the third variant of the device execution, proceeding from the clinical indications, wireframes clasping teeth of dentition's corresponding segment may be performed of components parts disposed on a separate tooth and/or group of teeth of a segment and connected with each other via lingual and/or vestibular springs

In all variants of the proposed device, fastening elements are executed in the form of metal wireframes, which are performed of lingual and vestibular details located at necks of teeth from the one side and dispersedly mounted along the height of teeth from the other side and connected by crosspieces disposed in interdental spaces. At the same time, dispersedly mounted details of metal wireframes are mounted from the side of separate teeth or group of teeth facing to the movement direction.

A device for correction of the form of upper jaw in accordance with a first variant may be used as follows. After fitting of the device in a cavity of mouth, the patient is trained on peculiarities of treatment with it. The device is activated through every 10-14 days. By activation of a metal wire palatal power element (34) disposed between plates (33) and springs (32) connecting plates (33) with fastening elements of lateral segments (31) the growth of bone tissues of median palatine suture and alveolar process is achieved.

A device for correction of the form of upper jaw in accordance with a second variant may be used as follows. After fitting of the device in a cavity of the mouth, the patient is trained on peculiarities of treatment with it. The device is activated through every 10-14 days. By activation in sagittal and transversal directions of a palatal power element (45) disposed between plates (44) and springs (43) disposed between plates (44) and fastening elements (41) of lateral segments, as well as, springs (46) disposed between a palatal power element (45) and a fastening element (42) of a frontal segment the growth of bone tissues of median palatine suture and alveolar process is achieved.

A device for correction of the form of upper jaw in accordance with a third variant is used as follows. After fitting of the device in a cavity of mouth, the patient is trained on peculiarities of treatment with it. The device is activated through every 10-14 days. By activation in sagittal and transversal directions of springs (57) disposed between plates (56), springs (55) disposed between plates (56) and a palatal arch (54), springs (53) connecting fastening elements (51) and (52) with a palatal arch (54), as well as, a

of bone tissues of median palatine suture and alveolar process is achieved.

The presence of zones of growth, mounting of plates above and below convex parts of the palatal fornix (in the case of a double fundus of the cupula of palate), and influence of plates on them allow to correct the form of a palate (see, Fig. 6).

Proceeding from the clinical indications second and third variants of the device may be applied in the case of malocclusion treatment.

Example

A patient of 14 years old with complaints to cosmetic defect has been addressed. Objectively: nose breathlessness, constriction of top teeth line, cross bite, deep double fundus of the palatal fornix. The first variant of the device for correction of the form of upper jaw has made and fitted in the cavity of patient's mouth. The patient has received the necessary recommendations on treatment with the device. After 3 months, the increase of transversal dimensions of dental alveolar process in the area of fourth teeth on 9mm and in the area of sixth teeth on 5mm has registered. The dental alveolar arch has corrected. The form of the cupula of palate (its geometry) has corrected. The depth of the palatal fornix in the area of the sixth teeth has decreased on 3 mm. The devices were taken off after 3 months from the beginning of the retention period, at the same time, during the retention period the device was applied within 1.5 months round the clock and within 1.5 months - only at night.

STIMULATION OF GROWTH OF MISSING TISSUES OF JAW DEFECTS

It is well-known that the bone tissues possess significant regenerative abilities. At traumas in places of fractures and bruises the bone tissue gets properties to regenerate and produce immature tissues (bone calluses). Proceeding from the above-stated, a task was put to develop a method of treatment and a device, which envisage to stimulate intensive growth of tissues through periodical micro-traumatization of defect's edges.

As shown in Fig. 9 and Fig. 10 devices for stimulation of growth of missing tissues of jaw may consist of fastening elements of teeth of lateral (61) and frontal (62) segments, which are realized in the form of metal wireframes. Fastening elements of lateral teeth segments (61) have crosspieces (63), (64), respectively disposed in interdental spaces and intertubercular recesses of teeth in sagittal and/or transversal directions on masticatory surfaces of teeth. Teeth fastening elements (61) and (62) are

^■ έo'kfilfcli^yfffafini'ililiVch (6) through orthodontic springs (65). The lingual arch (66) in its turn is connected with a palatal plate (69) closing missing tissues of defects and an optional alveolar plate (70), respectively through springs (67) and (68). In the case of a defect of alveolar process a traumatizing plate (70) may be provided with artificial teeth (71) as shown in Fig. 10.

A device for stimulation of growth of missing tissues may be used as follows.

Conditions for transferring the influence of muscle forces (at joining of teeth) to the device are created by periodic activation in a frontal direction of crosspieces (64), which are inherent parts of teeth fastening elements(61) and disposed on a masticatory surfaces of teeth. As a result, plates (69), (70) are set in vibratory motions and, consequently, micro-traumatization of edges of missing tissues of palatal and alveolar process defects is occurred. After every 20-25 days, a space for neoformations of tissues is freed by periodical correction of working surfaces of plates (69), (70). Correction of dental alveolar arch is achieved by activation of springs (65) and lingual arch (66).

Micro-traumatization of edges of missing tissues of defects and creation of free spaces for neoformations of tissues promote intensive growth of missing tissues and filling of defects of jaw.

The method and device may be used in the case of correction of defects of missing tissues of both upper and lower jaws' alveolar processes. The method may be realized by other appliances too, where vibratory motion is provided by a separate functional unit inserted into an appliance and ensuring low-frequency vibrations.

Example: A patient of 11 years old with complaints to cosmetic defect and masticatory problem has addressed to the clinic. Objectively: malocclusion of class III by Angle, sagittal-transversal decrease of upper jaw dimensions. A cleft of the hard palate in size of 2x2 cm, postoperative scars on hard palate and upper lip (uranoplasty and cheiloplasty). A low position of the palatal cupula as also present. A device, in accordance with a variant depicted in Fig. 9, has made and fitted in the cavity of patient's mouth. At each 20-25 ^th day, a lingual arch (66) and springs (67) were activated in sagittal and transversal directions, crosspieces (64) which are inherent parts of teeth fastening elements (61 ) and disposed on a masticatory surfaces of teeth were simultaneously activated in a frontal direction too. Correction of dental alveolar arch in sagittal-transversal directions was achieved by activation of springs (65) and lingual arch (66). A mode of micro-traumatization and irritation of edges of missing

^■ tϊslfeStj'isH ^' Sl^alatii'liWii ensured by activation of crosspieces (64) of teeth fastening elements (61) in a frontal direction. Furthermore, raising and formation of palatal cupula were realized due to non-uniform activation of springs (67). A dental alveolar arch was normalized after 5 months from the beginning of treatment. A cleft was completely closed after 7 months from the beginning of treatment. The edges of soft tissues were refreshed and sewed. As a result of treatment, the increase of transversal and sagittal dimensions of dental alveolar process in the region of the first bicuspids on 9 mm, and in the region of median palatine suture from sixth to first teeth - on 6 mm was also achieved. The device was taken off after 4 months from the beginning of the retention period.

CORRECTION OF THE FORM OF THE DENTAL ALVEOLAR ARCH

It is well known that a tissue of alveolar process is a viscous-elastic medium. The tissues of alveolar process (more precisely, periodontium) relatively well tolerate vertical loadings and much worse - horizontal. At the application of forward and rotary forces to a crown of tooth, depending on their value and position of points of their application, the axes of rotation of teeth may be disposed within the range of crowns of teeth (see, Fig. 11), and roots of teeth too (see, Fig. 12).

In the result of influences of forward and rotary forces on teeth, a squeezing of tissues of alveolar process by roots of teeth in horizontal direction occurs that results in its elastic deformation and movement of a tooth. The periodic removal of the device results in partial return of a tooth to an initial position (see, Fig. 13). Changes of directions of forward - rotary forces taking place at the act of chewing promote intensive alternating change of zones of squeezing and tension of the alveolar process (see, Figures 14, 15). The repeated removals of influences of forward and rotary forces from the teeth between periodic activations of the device, which are combined with an intensive alternating change of zones of squeezing and tension of the alveolar process at the chewing act, stimulate intensive growth of a bone tissue of alveolar process. Moreover, the frequent removals of the device or its active elements from a cavity of mouth reduce influences of elements of fastening metal wireframes on teeth that push out the latter from an alveolar socket, increase forces of masticatory muscles on separate teeth at the chewing act, and consequently, prevent a loosening of separate teeth.

The efficiency of treatment by a proposed method was controlled by periodic measurement of transversal dimensions of a dental arch and an alveolar process of the

φatrøWb? 'The measurements were performed between buccal tubercles of 4 ^th teeth and mesial-buccal tops of 6 ^th teeth, as well as, points disposed below the latter on 10 mm. The carried out investigations have shown that in the result of use of the proposed method and devices the increases of the dimensions of dental arches and alveolar processes of both jaws are occurred, with an average intensity of 2 mm / months. Movements of teeth with a similar intensity by other methods of forward - rotary influence on teeth usually result in denudation of roots of teeth (because of scarcity of bone tissue of an alveolar socket).

In the case of small height of crowns of primary and permanent teeth and their not apparent equator, the method may be realized by devices with the combined details of fastening elements. As variants of embodiment of the mentioned fastening elements may be fixed parts, in the form of fastening units, which are directly glued on separate teeth or fixed on orthodontic rings, on which metal wireframes, clasping dentition's separate segments are fixed by a maximum simplified process of removal and mounting of a device. The removal of exerted forces on teeth is carried out by a withdrawal of the device or its active elements from a cavity of mouth.

EXAMPLES

A patient of 18 years old with the complaints related to cosmetic defect has addressed to clinic. Objectively: deep overbite, constriction of both dental alveolar arches, overcrowding and rotation of incisors of both jaws. The devices for correction of the form of dental alveolar arches have made and fitted in the cavity of patient's mouth. The first activation of devices was carried out after 3 days of their fitting. Subsequent activations were carried out after every 20-25 days. The patient was recommended to remove a device at least once a day, during a food assumption. After 3 months from the beginning of treatment, the increase of alveolar processes in the area of 4 ^th teeth was achieved, on the upper jaw on 5mm, and on the lower jaw on 6mm. The relation of dentitions and positions of teeth were normalized. For securing the results of treatment, the permanent bearing of the device in the course of 1.5 months and its removal during a food assumption, and its subsequent night bearing in the course of 2 months was recommended. The control inspections were carried out in each month, and after 4 months from the termination of a retention period the inspection has shown steady results of orthodontic treatment (see, Fig. 16)

A patient of 21 years old with the complaints to cosmetic defect has addressed to clinic. Objectively: a deep overbite, constriction of both dental alveolar arches,

oVefcfoWWng ¹ alM ^;l1 rotation of incisors of both jaws and protrusion of upper central incisors. The devices for correction of the form of dental alveolar arches have made and fitted in the cavity of patient's mouth. The first activation of devices was carried out after 3 days of their fitting. Subsequent activations were carried out after every 20-25 days. The patient was recommended to remove a device at least once a day, during a food assumption. After 4 months from the beginning of treatment, the increase of alveolar processes in the area of 4 ^th teeth was achieved, on the upper jaw on 6mm, and on the lower jaw on 7mm. The relation of dentitions and positions of teeth were normalized. For securing the results of treatment, the permanent bearing of the device in the course of 2 months and its removal during a food assumption, and its subsequent night bearing in the course of 2 months was recommended. The control inspections were carried out in each month, and after 3 months from the termination of a retention period the inspection has shown steady results of orthodontic treatment (see, Fig. 17). The method was also successfully used as a treatment of periodontosis.

While the above is a complete description of the preferred embodiment of the present invention, it is possible to use various alternatives, modifications and equivalents. Therefore, the scope of the present invention should be determined not with reference to the above description but should, instead, be determined with reference to the appended claims, along with their full scope of equivalents. In the claims that follow, the indefinite article "A", or "An" refers to a quantity of one or more of the item following the article, except where expressly stated otherwise. Any feature, whether preferred or not may be combined with any other feature, whether preferred or not. The appended claims are not to be interpreted as including means-plus-function or step-plus-function limitations, unless such a limitation is explicitly recited in a given claim using the phrase "means for" or "step for."