Patent ID: 6792952
Filing Date: 2004-09-21
Classification: A61B,A61C,A61F

Abstract:
A method for treating maxilla/cranial base to mandibular axis discrepancies in the temporomandibular joints of a patient comprising (a) fitting an orthotic to the maxillary teeth of the patient so as to allow full coverage of all the maxillary teeth, wherein the orthotic has an anterior ramp to provide anterior guidance of the patient's mandible in excursive movements by contact of the superior surface of the anterior mandibular teeth of the patient with a posterior surface of the anterior ramp of the orthotic so as to allow for complete disclusion of the posterior mandibular teeth of the patient from the orthotic during eccentric jaw movements which over time deprograms the temporomandibular joints of the patient into a stable condylar position by stabilizing the condyles in their corresponding glenoid fossa sockets in the maxilla/cranial base;(b) determining alignment of the mandible to the maxilla/cranial base in the temporomandibular joints of the patient after each condyle has been stabilized in its corresponding glenoid fossa socket by the orthotic; (c) constructing a model of an upper dental arch of the patient with a base, which is parallel on all sides to the upper dental arch model and is delineated with horizontal and vertical reference lines, and a model of a lower dental arch of the patient with a base; (d) mounting the base of the upper dental arch to an upper plate with mounting stone of an artificial jaw simulator and mounting the base of the lower dental arch to a lower plate with mounting stone of the artificial jaw simulator such that the true axis of rotation of the temporomandibular joints of the patient with the temporomandibular joints in the stable condylar position has been maintained and wherein the sides of each base are parallel and confluent to the artificial jaw simulator mounting plates; (e) determining on the artificial jaw simulator mounted with the upper and lower dental arch models an amount of maxillary bone to be removed from the patient's maxilla in a surgical procedure wherein the maxilla is cut along a transverse plane superior to the maxillary teeth to separate the maxilla into an upper and a lower part which is sufficient to allow a jaw position in the patient when the upper and lower parts are joined after the amount of maxillary bone has been removed wherein the maxillary and mandibular teeth of the patient are re-approximated into a position coincidental to the stabilized jaw joint position with a functional bite wherein the anterior maxillary teeth provide anterior guidance of the mandible in excursive movements by contact of the lingual surface of the anterior maxillary teeth with the superior surface of the mandibular anterior teeth while allowing complete disclusion of the posterior maxillary and mandibular teeth during eccentric jaw movements and which at the same time maintains the temporomandibular joints in the stable condylar position; (f) constructing a surgical stint of the functional bite in which the temporomandibular joints are in the stable condylar position to act as a guide for relating the maxilla to the mandible during the surgical procedure for removing the amount of maxillary bone from the patient determined in step (e); (g) fitting the surgical stint into the mouth of the patient and performing the surgical procedure for removing the amount of maxillary bone from the patient's maxilla determined in step (e); and (h) immobilizing the patient's jaw following the surgical procedure with the surgical stint fitted to the patient's teeth so as to maintain the functional bite wherein the temporomandibular joints are in the stable condylar position and fixating the patient's mouth shut for a time sufficient for the upper and lower parts of the maxilla to heal, which treats the cranial base to the mandibular axis discrepancies in the temporomandibular joints.