Method for improving retention properties of dental bridge having single-side anchorage

FIELD: medical engineering.

SUBSTANCE: method involves producing an opening of diameter reaching 2 mm with diamond or hard alloy bore in adhesive cover after preparing abutment tooth and prosthesis or widening already available perforation also to diameter of 2 mm. The prosthesis is set on the abutment tooth and place is marked for creating and directing pin-canal in the area of cutting one-third of the frontal abutment tooth or in the lateral abutment tooth equator area. The pin-canal direction is to correspond to path for introducing the prosthesis. The pin is screwed-in with screwdriver and holder to a depth of about 2 mm into dentin. The prosthesis is set on the abutment for making control. The pin is filed-off to adhesive cover layer after having fixed the prosthesis on composition cement.

EFFECT: prolonged service life; high functional value.

 

The invention relates to medicine, namely to prosthodontics.

Rastamaniak adhesive bridges with one-sided support (oamp) - is a frequent complication encountered when using this design of prostheses. Frequency drop oamp for two or more years of use of the prosthesis, according to different authors, ranging from 9 to 34.9%. Thus, the problem of increased retention oamp seems relevant.

As a counterpart, the authors propose a method of using a reinforced oamp with vestibular adhesive pad, which is a strip of metal located on the vestibular surface of the abutment tooth and the exhaust from oral adhesive pads, while the vestibular surface of the support tooth disassembled as well as oral: flattens the equator creates a groove (Petrikas O.A. Modern imaging methods to repair defects of dentition (part 1) // New in dentistry. - 1998. - N5. - 102 C.).

The disadvantages of the method, adopted as similar, is the need for additional preparation of the abutment tooth and making new enhanced oamp; violation of the aesthetics of natural teeth.

As a prototype, the authors propose a way to enhance retention oamp using occlusive strip, which is a strip of metal tol the other 0.5 mm, located on the occlusal surface of the abutment tooth and the exhaust from the adhesive pads in two places, covering the mound of the reference tooth in the window. Place for occlusive strips disassembled the fissures of the tooth (Walmsley A.D. Restorative Dentistry. - Edinburgh, 2002. - 208 S.).

The disadvantages of the method, taken as a prototype, is the need for additional preparation of the abutment tooth and making new enhanced oamp; the method is applicable only in the upper jaw.

The authors propose a way to enhance retention oamp when frequent racemetirosine, under adverse conditions, prosthetics (low clinical crown abutment teeth, deep bite), when you have exhausted all conservative ways of strengthening oamp due to the preparation of the reference tooth.

The aim of the invention is to increase the functional value and service life oamp when frequent racemetirosine, when adverse clinical conditions.

This goal is achieved by the use of pins to enhance retention of the prosthesis. Use a pin system BBB, Russia.

When you racemetirosine oamp the method is as follows:

- Impose oamp on the abutment tooth, and evaluate:

stability of the prosthesis, airtight, no caries under the adhesive pad.

- Removing composition is cement excavator with enamel or metal.

- Handle internal surface of the adhesive pads in beskonechnom the device.

- Prepare the abutment teeth: advanced zashlifovyvajut enamel within the reference zone of a spherical diamond head, restore retention points (grooves, the bed occlusal pads, pricesnews groove). The above manipulations are performed in each case restatement.route oamp.

- After preparing the abutment teeth and oamp the authors extend the adhesive pad is selected perforation up to 2 mm in diameter carbide or diamond Bur; in otsutstvie perforations create the hole in the adhesive pad with a diameter up to 2 mm in the Direction of boron should roughly match the route of administration oamp.

- oamp impose on the abutment tooth and outline the place of creation and direction of a pin channel in the cutting-thirds of the anterior abutment tooth or area of the equator side of the supporting tooth.

The little spherical diamond boron pass the tooth enamel to the dentin.

- Create a pin channel in the dentin special drill in a location remote from the pulp of the tooth, the cutting-thirds of the anterior abutment tooth or area of the equator side of the supporting tooth. With direction pin channel must match the route of administration oamp.

- Screwed pin sash lock - holder to a depth of approximately 2 mm into dentin. To enable n the situation oamp the direction of the pin must be the same by introducing a prosthesis (valid slight mismatch in parallelism due to the difference of the diameters of the perforations and the pin).

- Carry out a trial overlay oamp without composite cement and etching of enamel.

- Impose and fix oamp on composite cement.

- Zashlifovyvajut pin to the level of the adhesive pads.

This method provides precise control create a pin channel in the dentin. His most often used in younger patients teeth with a large tooth cavity, hard-to-reach teeth (molars), with limited mouth opening.

Valid different sequence of actions, oamp first fixed composite cement. Then through the perforation, or created onemillimeter the hole in the adhesive pad, if no perforations, create a pin channel and enter the pin. The mismatch between the diameter of the hole and the pin negate it by filling an additional portion of the composite cement. Zashlifovyvajut pin to the level of the adhesive pads.

This method provides the ability to vary the direction of the pin channel, not keeping the parallelism between the pins and route of administration oamp. It is used when the operative field and the access is not limited.

Clinical example 1

Patient O., 22, and/b No. 82624, appealed to the dental clinic with a complaint against recementing oamp resting on the upper left first molar, made 2 years ago about a missing upper left second premolar.

the donkey clinical examination and obtaining the consent of the patient, it was decided to re-record oamp on composite cement with additional reinforcement retention with Pina. The upper left first molar has a bad on-line access and a large cavity of the tooth, so I used the first variant of the method of enhancing retention oamp.

After the preliminary preparation of the abutment tooth and oamp, in the absence of perforations in the adhesive pad, created carbide Burr hole with a diameter of 2 mm, left oamp on the upper left first molar and outlined the place of creation and direction of a pin channel in the region of the equator, the small spherical diamond Burr passed the tooth enamel to the dentin, created a pin channel in the dentin around the equator of the reference tooth, the direction pin of the channel relative to the path of introduction oamp, they screwed pin system BBB sash lock-holder to a depth of approximately 2 mm into dentin, recorded oamp on composite cement ("Micrel"), sollipulli pin to the level of the adhesive pads. Examinations take place after the year showed good functional results.

Clinical example 2

Patient B., aged 26, and a/b No. 79623, appealed to the dental clinic with a complaint against recementing oamp resting on the upper left Central incisor, made 2 years ago about a missing upper right Central incisor.

After clinical examination and obtaining the consent of the patient, it was decided to re-record oamp on composite cement with additional reinforcement retention with p the power pins. The upper left Central incisor has a good on-line access, the cavity is small, so I used the second variant of the method of enhancing retention oamp.

After the preliminary preparation of the abutment tooth and oamp, recorded oamp on composite cement ("Micrel"), through the perforations in the adhesive pad has created a pin channel in the cutting-thirds of the upper left Central incisor, after which the prosthesis is additionally strengthened PTS system BBB, the mismatch between the diameter of the perforation and Pina neutralized composite cement, then sollipulli pin to the level of the adhesive pads. Examinations take place after the year showed good functional results.

The proposed method provides increased retention oamp, increasing the functional value and service life of the prosthesis, there is no need for additional preparation of the abutment tooth and the manufacture oamp reinforced, that is, the method provides time-saving tools; maintains the aesthetics of natural teeth, and can also be used on oamp, replacing both the front and side teeth, the upper and lower jaw.

A way to enhance retention of adhesive bridges with one-sided support, characterized in that after the preparation of the abutment tooth and adhesive bridges with one-sided support, the adhesive nakedc the carbide or diamond Burr to create an opening with a diameter of 2 mm or expand existing perforation also up to 2 mm in diameter, adhesive bridges with one-sided support impose on the abutment tooth and outline the place of creation and direction of a pin channel in the area of cutting-thirds of the anterior abutment tooth or area of the equator side of the supporting teeth are tooth enamel to the dentin, create a pin channel in the dentin in the field of cutting-thirds of the anterior abutment tooth or area of the equator side of the reference tooth and the direction pin channel must match the way the introduction of adhesive bridges with one-sided support, screwed pin sash lock - holder to a depth of approximately 2 mm into dentin, impose adhesive bridges with one-sided support for control abutment and, once it was fixed on the composite cement, zashlifovyvajut pin to the level of the adhesive pads.



 

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FIELD: medical engineering.

SUBSTANCE: method involves producing an opening of diameter reaching 2 mm with diamond or hard alloy bore in adhesive cover after preparing abutment tooth and prosthesis or widening already available perforation also to diameter of 2 mm. The prosthesis is set on the abutment tooth and place is marked for creating and directing pin-canal in the area of cutting one-third of the frontal abutment tooth or in the lateral abutment tooth equator area. The pin-canal direction is to correspond to path for introducing the prosthesis. The pin is screwed-in with screwdriver and holder to a depth of about 2 mm into dentin. The prosthesis is set on the abutment for making control. The pin is filed-off to adhesive cover layer after having fixed the prosthesis on composition cement.

EFFECT: prolonged service life; high functional value.

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