ORTHOAPNEA
®El método de trabajo en laboratorio para la rea- lización de la prótesis intraoral preconizada es el siguiente:
• Se preparan los modelos para hacer las plan- chas de vacío.
• Se hacen las planchas superior e inferior en la máquina vacío o presión.
• Una vez enfriada, recortamos la plancha, como si de una férula de descarga se tratase. • Articulamos el modelo con la mordida cons- tructiva en un articulador simple de bisagra o charnela.
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• Empezamos el proceso por el maxilar inferior para que nos de el plano del superior. • Ponemos la plancha realizada al modelo, se -
llando con cera los bordes para que el acrílico no sobrepase los límites.
• Unimos la parte rígida con adhesivo especial que hace de agente de unión plástico-resina, después de secar procedemos a cargar el acrí- lico, con el método habitual en ortodoncia, dejando un plano ideal equilibrado con un grosor de altura aproximado de 1.3 mm de caninos a segundos molares.
• En el repasado hay que dejar los cuellos fes- toneados en la placa.
• Para realizar la placa superior hay que subir la DV (dimensión vertical) creando un espacio suficiente para el dispositivo.
• Preparamos el inferior poniendo plástico adhesivo en cinta a modo de separador de resinas, a los planos inferiores caras oclusa- les para que nos de un plano guía para el su - perior.
• Sellaremos con cera los márgenes de la placa al igual que el inferior.
• Procedemos a cargar el acrílico del maxilar superior, teniendo en cuenta en hacer sólo pistas de caninos a molares.
• Una vez cargada la resina, articulamos con el inferior supervisando si desliza bien el plano superior con el inferior.
• El repasado sigue el mismo procedimiento de la placa inferior.
• Con las dos placas repasadas, empezamos a preparar el modelo inferior insertando la barra inferior de 1.5 mm, que sirve de guía de desliza miento lateral para el dispositivo ortho- apnea.
• Usar, para el inferior, la barra totalmente redon- da, que no tiene zona de desmontaje en supe- rior e inferior, solo para casos especiales. • El recorrido libre de la barra para el dispositivo
es de canino a canino. La barra debe ser ins-
talada teniendo en cuenta la altura del dispo- sitivo y según el registro del avance realizado en la clínica, de tal modo que coincida ideal- mente con el emplazamiento ideal en la placa superior.
• Una vez bloqueado el dispositivo en el maxilar inferior, marcamos y posicionamos la barra en el modelo superior dejando la barra prepara- da para su instalación.
Orthoapnea®
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OrthoApnea. Roncopatía y Apnea Obstructiva
• La barra superior, específica en anulación y dimensiones, es la que dispone de una zona de desmontaje del dispositivo.
• Se debe preparar la placa dejando la barra libre de la zona de canino a canino para el mo - vimiento del dispositivo.
• Ambas barras y superficies de deslizamiento deben quedar equilibradas y en el mismo pla- no, elevando el conjunto de la mínima DV, siem- pre que el clínico no indique lo contrario. • En el caso de realización de placas especiales,
como son las de ortodoncia, disclusión forza- da, blanqueamiento, sobre implantes con pró-
tesis removible, sobre desdentados y demás posibilidades, seguir el proceso adecuado de cada especialidad (Fig. 16).
Visto lo que antecede, el descrito dispositivo in - traoral de avance mandibular regulable, aplicable para evitar el ronquido y la apnea del sueño, repre- senta, una estructura innovadora de características estructurales y constitutivas desconocidas hasta aho- ra para tal fin, razones que unidas a su utilidad prác- tica, le dotan de fundamento suficiente para ser refe- rencia terapéutica en los tratamientos del SAHS y la roncopatía por medio de prótesis intraorales (Fig. 17).
Figura 16. Figura 17.
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Ilustre Consejo General deColegios de Protésicos Dentales de España