The method of tooth restoration in the oral cavity

 

(57) Abstract:

The invention relates to the field of dentistry and can be used for sealing and aesthetic restoration of teeth directly in the mouth in the presence of age-related changes in hard dental tissues. How is that make modeling of anatomical shape of the tooth in the received sequence. Form predentin and the tooth cavity by applying creative light yellow color on bandhuvu system. Then substitution dentin of the tooth enamel mass with shades on the Vita scale C3 or C4. After that sequentially form the oral and vestibular petals actually dentin layer of opaque mass with shades on the Vita scale AA or OA,5. Enamel mass with a shade in accordance with the main color of the patient's teeth form pricesnew area of the tooth crown with vestibular and oral part. The surface structure of the tooth and the cutting edge of approximal tooth surfaces form a transparent or enamel mass with a touch on the Vita scale C2. Each formed structural layer of the tooth control in transmitted light on the lack of teleopathy on the border of layer separation. Technical result achieved by the natural; accounting for age-related changes in tooth tissues. 1 C.p. f-crystals.

The invention relates to dentistry and can be used for fillings and for aesthetic restoration of teeth directly in the mouth in the presence of age-related changes in hard dental tissues.

There is a method of filling cavities, including cleaning the surface of the teeth from plaque, the choice of the shade of the restorative material, closest to the main color of the tooth, preparation, reproduction of the contours of the teeth through the introduction of retraction fibres or matrix, if the defect is adjacent to the gingival edge, and isolation of the cofferdam, the cavity preparation and application of bondagegay system, application of the composite of the selected hue, remove the matrix, or threads, correction of the cutting edge, modeling the shape of the tooth finishing, surface restoration and finishing adviceline - quality control of the restoration when the brightness of the light, exceeding the brightness of the natural light is not less than twice (Therapeutic stomatology, E. C. Borovsky, Y. D. Barysheva, Y. M. Maximov, and others /edited by Professor E. Borovsky Century , 2nd ed., M: (LLC) Medical Information Agency, 1997, pp. 184-187).

Under the defect of hard tooth tissues take into account only the basic tone of the tooth, while the natural color of the tooth is the sum of the shades of the structural layers of hard tooth tissues. It is not possible to accurately reproduce the color of aging of the teeth, the color of which is determined by age-related changes in hard dental tissues. In addition, the accuracy in the determination of the base color of the tooth is reduced due to the individuality of colour perception. As a result, there is a method allows to obtain only approximate color restoration that does not allow you to recreate the colours lost in the pathological process of hard tissue of the tooth closest to natural.

Closest to the present invention is a method of tooth restoration in the oral cavity, including cleaning the surface of the teeth from plaque, the choice of the shade of the restorative material, closest to the color of the tooth preparation, surface preparation, application bondagegay system on the prepared surface, applying a layer of Apacer or photocurable glass-ionomer cement (if necessary), applying the selected color composite, the creation of a transparent cutting edge (if indicated), finishing surface restoration and finishing adviceline (Therapeutic stomatology, E. C. Borovsky, Y. D. the second Agency, 1997, pp. 184-187).

In the closest to the proposed method, before applying a composite material of a selected color form the inner part of the tooth from the layer of Apacer or photocurable glass-ionomer cement. This creates some depth of color and brings it closer to the natural. However, this does not take into account age-related changes in hard dental tissues, which determines its color, because the approach in all cases is the same: for restoration using composite material with a color close to the base color of the tooth. In addition, as in the method-analogue, the accuracy in the determination of the base color of the tooth is reduced due to the individuality of colour perception. The method also does not take into account the specific structure of the tooth surface, affecting the refraction of light rays, forming reflected from the tooth surface luminous flux. In the known method in the restoration of lost due to the pathological process of tooth hard tissues does not allow you to recreate the most close to the natural teeth color.

Thus, identified in the patent search methods of tooth restoration in the oral cavity when the implementation does not allow to achieve technical resulti tooth color, regardless of individual colour, closest to the natural color of the teeth of the patient and taking into account age-related changes in tooth tissues.

The present invention solves the problem of creating a method of tooth restoration in the oral cavity, which allows to achieve the technical result consists in the possibility of recreating lost in the pathological process of dental hard tissues with color, regardless of individual colour, closest to the natural color of the teeth of the patient and taking into account age-related changes in tooth tissues.

The essence of the invention lies in the fact that in the means of restoration of teeth in the oral cavity, including cleaning the surface of the teeth from plaque, identifying the main color of the tooth preparation, drawing on the prepared surface bondagegay system, modeling of anatomical shape of the tooth by means of composite materials and the control adviceline formed tooth, modeling of anatomical shape of the tooth is produced in the following sequence: form the most opaque zone predentin and the tooth cavity by applying creative light yellow color to b the th mass with shades on the Vita scale C3 or C4, while choosing the more grey and more transparent tone than their own dentin formed surface is colored creativity, the color of creativity choose from light brown to dark brown depending on the color of dentin adjacent tooth or teeth antagonists, after this form of oral petal actually dentin to enamel-dentinal border with mandatory simulation of coronal part of mamelodi, which on an edge of creativity, the surface put a layer of opaque mass thickness from 0.5 to 1 mm with shades on the Vita scale AA or OA,5, then depending on the color of dentin adjacent teeth of the same opaque mass and the same shade layer from 0.5 to 1 mm is formed vestibular petal actually dentin, then enamel mass, with a touch on the Vita scale selected in accordance with the main color of the patient's tooth, form pricesnew area of the tooth crown with vestibular and oral side, why put two coats of enamel weight, and for the outer layer in the shade of the enamel mass take more bright, when applying the enamel mass thickness of the inner layer is gradually reduced from pricesnews part in the direction of the cutting edge from 1.5-2 mm to zero, the outer layer of the enamel mass on the layer of enamel increases in the direction of the coronal part of mamaloni from zero up to 2-2,5 mm, then form the surface structure of the artificial tooth and the cutting edge of approximal tooth surfaces of a transparent material or enamel mass with shade on a scale Vita C2, which is applied to a thickness of from zero to 1.5-2 mm increase from pricesnews part in the direction of the cutting edge, in addition, after the formation of each structural layer of the tooth control in transmitted light no teleopathy on the border of layer separation. In addition, after the formation of oral petal actually dentin in the presence of the patient's tooth abrasion surface with vestibular side to the coronal part of mamelodi tint creativity, while choosing shades from light brown to dark brown color.

The technical result is achieved in the following way. The color of a natural tooth in the first place is determined by the structure and location of the hard tissues of the tooth. The color of the natural tooth is affected by all the changes happening in its tissues. For example, obsestvennoe enamel causes increase its transparency and reduction of matte shades. Structural tissue layers have a clear color border, due to their difference in structure. In the proposed method, restaurats what I am observing the following sequence: form the most opaque zone predentin and the cavity, then substitution dentin of the tooth, then oral petal actually dentin to enamel-dentinal border with mandatory simulation of coronal part of mamelodi, then vestibular petal actually dentin, then pricesnew area of the tooth crown with vestibular and oral part, and then forming the surface structure of the artificial tooth and the cutting edge of the approximal surfaces. Each structural layer to form a certain thickness, and color hue. As a result, due to the fact that in the proposed method, the restoration of defects of dental hard tissues is accomplished by the sequential recovery of each structural layer of the tooth, it is possible to recreate lost in the pathological process of dental hard tissues with the color closest to the natural color of the teeth of the patient taking into account age-related changes that occur in the tissues of the tooth. In addition, restoration of tooth hard tissues given the complex structure of dentin allows to provide the relative opacity of dentin and create color depth, i.e., to simulate the selective scattering of light, which is determined by a complex structure of dentin.

The accuracy of the ODA is the human eye and brain. Colour perception is very individual. This causes a difference in people's ability to distinguish shades of color, although color vision was normal.

The proposed method allows you to restore the hard tissues of the tooth with the color closest to the natural color of the teeth of the patient, taking into account age-related changes in tooth tissues, and regardless of individual colour perception. This is explained in the following. It is known that the aging of the teeth, the dentin, as living tissue, can form secondary dentin. The color of this secondary dentin transparent grey. In older people the number of transparent secondary dentin increased, which makes the aging teeth darker and grayer. Dark dentin is formed and in areas of high abrasion of the teeth, especially on the cutting edge of the anterior region.

The inventors experimentally obtained set of conditions to form the desired color of the tooth with regard to age-related changes in solid tissues and with the effect as close to the natural color of the teeth, namely, the application of creative light yellow color on bandhuvu system for the formation of the most opaque areas of predentin and the cavity of a tooth; for creation is Vita C3 or C4, creativity, from light brown to dark brown, and opaque mass with shades on the Vita scale AA or OA,5. Due to the fact that the proposed colors of restoration materials chosen with consideration of the natural physiological changes in tissues of the tooth, leading to change their color, and hence alter the color of the tooth as a whole, the proposed method can automatically be taken into account when restoration changes in aging tissues of the tooth. This, in turn, eliminates the influence of individuality colour when choosing shades of composite material for forming the structural layer of the tooth that provides color restoration, as close as possible to the natural, adds depth and spaciousness to the color of the tooth.

Thus, the proposed method can automatically account for the color change of the tooth due to natural physiological changes in aging tissues of the tooth, by using the proposed color scheme and the proposed sequence of formation of the lost tooth structure allows not only to recreate the tooth with a color as close to natural, but to give the color depth and layering. In Rina each structural layer of the restoring of hard tooth tissues obtained experimentally. It is known that for transparent objects, such as restoration materials and teeth, color saturation depends on the thickness: the thicker the material is, the richer it seems the color. Due to the fact that the thickness of each structural layer in the proposed method specified in the range, it is possible, by varying the thickness, change the color saturation of the structural layer, achieving color mixing. The boundaries of the range of variation of the layer thickness is selected so that when the variation is provided by the possibility of obtaining the result color restoration, close to the natural. In addition, due to the presence of the range of variation of the thickness of the layer of composite material allows accurate adjustment of the color of the tooth where the enamel layer is very clear and comes through strongly the color of the dentin. In this case, the color of the dentin should be more saturated, i.e., the layer of composite material must be thicker, otherwise the restored part of the tooth will have an unnatural grey shade.

In the proposed method, when forming the substitution of dentin on the edge of creativity, the surface is applied with a layer thickness of 0.5-1 mm of the enamel mass with Otten is armirovannye surface tint creativity, the color of creativity choose from light brown to dark brown, depending on the color of dentin adjacent tooth or teeth antagonists, after this form of oral petal actually dentin to enamel-dentinal border with mandatory simulation of coronal part of mamelodi, which on an edge of creativity, the surface put a layer of opaque mass thickness from 0.5 to 1 mm with shades on the Vita scale AA or OA,5, then depending on the color of dentin adjacent teeth of the same opaque mass and the same shade layer from 0.5 to 1 mm is formed vestibular petal actually dentin. Except that after the formation of oral petal actually dentin in the presence of the patient's tooth abrasion surface with vestibular side to the coronal part of mamelodi tint creativity, while choosing shades from light brown to dark brown. Due to the fact that in the proposed method for the formation of substitution dentin set not only the sequence of formation of the structural layers of the tooth, but also the range of shades of composite material for each structural layer substitution of dentin and recommendations on the choice of a particular hue, and Otta the om occurred in them age-related changes, there is the possibility of obtaining the result color restoration, closest to the natural color of the teeth of the patient, taking into account age-related changes in tooth tissues, and regardless of individual colour perception. The operation of coloring the respective surfaces of creativity, i.e., its shading, gives eventually the color depth restoration. The same is provided and a selection of more gray and more transparent tone enamel mass during the formation of the substitution of dentin. All this gives the restored tooth a natural appearance.

Another important factor affecting the formation of the color of the tooth, is the distribution of the enamel layer. Transparency and properties of the enamel have a great influence on the color of the tooth. Simultaneously, the reflection color of the dentin. The thickness and color of the enamel layer define how the dentin will refract and reflect incident light. The region of the cutting edge has a thicker layer of enamel that is why it seems more transparent. In the cervical area of the tooth enamel thinner. Therefore, the color of the underlying dentin expressed more clearly. This feature in the proposed method, take into account due to the fact that pricesnew region cornkittee with the main color of the patient's tooth. When this is applied two coats of enamel weight, and for the outer layer in the shade of the enamel mass take in more light, when applying the enamel mass thickness of the inner layer is gradually reduced from pricesnews part in the direction of the cutting edge from 1.5-2 mm to zero, the outer layer of the enamel mass is brought to built the coronal part of mamelodi dentin or more cover her, when the thickness of the outer enamel layer increases in the direction of the coronal part of mamaloni from zero up to 2-2,5 mm

Of particular importance for accurate color reproduction is the reproduction of the structure of the tooth surface. For example, the front teeth are ribs, grooves, roughness, which affects the reflection of the incident light. In the proposed method, to form the surface structure of the artificial tooth and the cutting edge of approximal tooth surfaces of a transparent material or enamel mass with shade on a scale Vita C2, which is applied to a thickness of from zero to 1.5-2 mm, increasing the layer from pricesnews part towards the cutting edge.

The distribution of the enamel mass during the restoration of pricesnews the area of the tooth crown with vestibular and oral part, and a transparent or enamel mass during playback page is Amy basically the color of the tooth, since, as was shown above, the thickness and color of the enamel layer determine how the dentin will refract and reflect incident light. Use for the inner layer of the enamel mass with a darker shade provides color depth. The distribution of the enamel mass allows to take into account the color differences between the tool and the cervical areas of the teeth, as the main color of the tooth varies from the cervical area in the direction towards the cutting edge.

In addition, the natural color is achieved in the proposed method, due to the fact that after the formation of each structural layer of the tooth control in transmitted light no teleopathy on the border of layer separation. The basis of the method of control is the method of transillumination (Therapeutic dentistry. /Under the editorship of Professor Borowski, E. C., M: (LLC) Medical Information Agency, 1998, page 110). In accordance with the known method transillumination through the investigated object, pass a beam of light and appreciate tenebrioninae. In dentistry the transillumination method used for the diagnosis of caries, pulpitis, detection of subgingival dental plaque, cracks in the enamel of the tooth, as well as for supervising the preparation of the cavities chracter shadow: geometrical sizes, definition, boundaries, etc., make the appropriate conclusions.

Unlike well-known in the proposed method, the authors use the transillumination method for dental restoration in an oral cavity as a means of control, by allowing detection teleopathy restored between structural layers to identify areas of the absence of color mixing and variation of the thickness of the layer of composite material, by eliminating teleopathy between layers of composite materials, to achieve color mixing. Stepwise control in transmitted light of each structural layer allows you to restore the hard tissues of the tooth with regard to its anatomical features and ultimately to get the color of a restoration, as close as possible to the natural color of the tooth, since the main color of the tooth is formed by the combination of the colors of all the structural layers of the tooth, and the thickness of the layer determines the intensity, transparency and brightness. The tooth is not perceived as a single standing and integral fits into the overall picture of the dentition without disturbing its integrity.

Pre-cleaning the surface of the teeth from plaque ensures the reliability of the results determine the primary color memory is of the tooth, this also adds further credibility color restoration, because after the preparation of the dentin can be overdried and his colour changed. The tooth preparation enables you to straighten a damaged tooth surface, to clean it from RAID to natural color, which is also further provides natural color restoration. Drawing on the prepared surface bondagegay system due to its binding ability provides reliable adhesion of the composite material with hard tissues of the tooth. In addition, bandegua system has additional properties: completely removes oily layer on the contact surface and at the same time dicalcium surface layer of dentin, returning to the dentin thereby its true color, which in the present invention is used to produce natural color restoration. Modeling of anatomical shape of the tooth by means of composite materials, due to their physical properties and the variety of shades, makes it possible to reconstruct the shape and color features of an artificial tooth with the formation of a strong spatial structure in a relatively short period of time. Control adviceline formed is the Eney than twice, - provides the ability to compare the obtained color restoration with the main tone of the tooth defined previously. All of the above together also allows you to create color restored part of the tooth that is closest to the natural color of the tooth.

Thus, due to the fact that in the proposed method, the restoration of teeth in the mouth is carried out taking into account the structural structure of the tooth, by successive restoration of each structural layer of the tooth, the use of composites with shades, typical of teeth with age-related changes, using techniques that mimic the color depth, the ability to achieve color mixing by controlling the availability of teleopathy at the interface of layers of composite materials, implementation of the proposed method ensures the achievement of the technical result consists in the possibility of recreating lost in the pathological process of dental hard tissues with color, regardless of individual colour, closest to the natural color of the teeth of the patient, and taking into account age-related changes in tooth tissues.

The method of tooth restoration in the oral cavity osushestvlyaetsya on the prepared surface bandhuvu system. Then simulate the anatomical shape of the tooth by means of composite materials. Modeling of anatomical shape of the tooth is produced in the following sequence: form the most opaque zone predentin and the tooth cavity by applying creative light yellow color on bandhuvu system. Then form substitution dentin of the tooth. For this purpose, the layer thickness of 0.5-1 mm is applied enamel mass with shades on the Vita scale C3 or C4. While choosing the more grey and more transparent tone than their own dentin. The generated surface is colored creativity. Color creativity choose from light brown to dark brown depending on the color of dentin adjacent tooth or teeth antagonists. After this form of oral petal actually dentin to enamel-dentinal border with mandatory simulation of coronal part of mamelodi, which on an edge of creativity, the surface put a layer of opaque mass thickness from 0.5 to 1 mm with shades on the Vita scale AA or OA,5. Then depending on the color of dentin adjacent teeth of the same opaque mass and the same shade layer from 0.5 to 1 mm is formed vestibular petal actually dentin. After this enamel mass with a touch on the Vita scale, in Blarney and oral sides. To do this, put two coats of enamel weight, and for the outer layer in the shade of the enamel mass take lighter. When applying the enamel mass thickness of the inner layer is gradually reduced from pricesnews part in the direction of the cutting edge from 1.5-2 mm to zero. The outer layer of the enamel mass is brought to built the coronal part of mamelodi dentin or more overlap. When the thickness of the outer enamel layer increases in the direction of the coronal part of mamaloni from zero up to 2-2,5 mm then form the surface structure of the artificial tooth and the cutting edge of approximal tooth surfaces of a transparent material or enamel mass with shade on a scale Vita C2, which is applied to a thickness of from zero to 1.5-2 mm, increasing from pricesnews part towards the cutting edge. After the formation of each structural layer of the tooth control in transmitted light no teleopathy on the border of layer separation. Except that after the formation of oral petal actually dentin, when a patient has a tooth abrasion, the surface with the vestibular side to the coronal part of mamelodi tint creativity, while choosing shades from light brown to dark brown. After soversheni the tx2">

For beam forming transmitted light and to control adviceline can be used with incandescent lamp. The level of illumination should not exceed 1500 Lux, because otherwise the teeth color will appear lighter. To reduce the impact on the determination of the color of teeth colour of the walls and interior of the doctor's office, you should avoid saturated, flashy colors. The ideal is a combination of neutral colored walls with fluorescent lights the brightness level. Best results are spontaneous definition of primary color during the first examination of the patient. Individual parts of the tooth can be distracting. To avoid this, it is recommended to study the tooth no more than 10-20 seconds. When studying the structure of the tooth inspection should be done with palatal side and side cutting edges for obtaining the most accurate information. When the color of the enamel mass for the formation of pricesnews the area of the tooth crown with vestibular and oral sides and to determine the distribution transparent layer on the surface of the tooth, the tooth can be seen through from the inside. Monitoring of the restoration is also carried out by scanning lamp inside. The final stage of restoration is slipout saved.

Example. Patient K. , 54 years old, came with complaints of violation of aesthetic standards associated with changing the color of the front teeth of the upper jaw. The color change of the tooth occurred gradually. The tooth previously cured about complicated caries.

Objectively: the patient is in satisfactory Condition, the external examination without features. On the medial contact surface 11 is changed in color seal. Visually and sensing there has been a violation of territorial adhesion to tooth tissue. Tooth tissues are also changed in color due to transmission through the pigmented enamel dentin. Percussion of the tooth is painless. On sighting the radiograph in periapical tissues no changes, the root canal was sealed completely.

Treatment:

Spent the tooth preparation to determine the color by holding professional tooth cleaning using a toothpaste that does not contain fluoride.

Chose the brightness and the dominant primary color (A3,5) in conditions as close as possible to the ideal, according to accepted in the world practice the technique.

Studied the structure of tooth tissues with palatal side of the cutting edge, and in transmitted light determined the distribution of the degrees of opacity of dentin, the border of the enamel-dentinal connection.

He studied the details of the surface structure of the tooth, and the plot abrasion of enamel on the cutting edge with exposed dentin.

Conducted a sketch of the thickness of the layers, blend materials of different brightness and opacity.

Removed the seal that held the preparation of hard tooth tissues.

Simulated tooth cavity glass ionomers cement.

Caused the adhesive system onto the prepared surface.

Imitated the most opaque area of the tooth (predentin) creative light yellow color.

Simulated substitution dentin tone C4 layer of about 1 mm

Simulated oral petal actually dentin to enamel-dentinal border opaque mass of color OA,5 thickness of about 0.5 mm

To simulate the changed color of the dentin produced the embellishment of the vestibular surface of oral petal to the cutting edge of the brown creative.

Imitated vestibular petal actually dentin to enamel-dentinal border of the same opaque mass of color OA,5 thickness of about 0.5.

Regained the lost part of a tooth crown is turned to the gums, as the vestibular to the cutting edge, replacing the layer of pulp A3 from 0 to 1.5 mm Layers of different masses superimposed one upon the other, and the thickness of a lighter tone increased, and the darker tone was decreased.

Build cutting edge, approximal surfaces and cutting edges made a lot of shade C2 thickness from 0 to 0.5 mm

Conducted a thorough sanding and polishing with saving the recovered surface features.

After the formation of each structural layer of the tooth is controlled by transmitted light no teleopathy on the border of layer separation. Shortcomings were eliminated by varying the thickness of the layer of composite material.

Control adviceline tooth showed that the restored tooth is not perceived as a single standing and integral fits into the overall picture of the dentition without disturbing its integrity.

1. The method of dental restoration in an oral cavity, comprising cleaning the surface of the teeth from plaque, identifying the main color of the tooth preparation, drawing on the prepared surface bondagegay system, modeling of anatomical shape of the tooth by means of composite materials and the control adviceline sledovatelnot: form the most opaque zone predentin and the tooth cavity by applying creative light yellow color on bandhuvu system, then form substitution dentin of the tooth, for which the layer thickness of 0.5-1 mm, is applied enamel mass with shades on the Vita scale C3 or C4, while choosing a more grey and more transparent tone than their own dentin formed surface is colored creativity, the color of creativity choose from light brown to dark brown, depending on the color of dentin adjacent tooth or teeth antagonists, after this form of oral petal actually dentin to enamel-dentinal border with mandatory simulation of coronal part of mamelodi, why on colored creativity surface put a layer of opaque mass thickness from 0.5 to 1 mm with shades on the Vita scale AA or OA,5, depending on the color of dentin adjacent teeth, then the same opaque mass and the same shade layer from 0.5 to 1 mm is formed vestibular petal actually dentin, then enamel mass, with a touch on the Vita scale selected in accordance with the main color of the patient's teeth, form pricesnew area of the tooth crown with vestibular or oral side, why put two coats of enamel mass, and for the outer layer in the shade of the enamel mass take in more light, when applying the enamel mass thickness is iny layer of the enamel mass is brought to built the coronal part of mamelodi dentin or more cover her when the thickness of the outer enamel layer increases in the direction of the coronal part of mamaloni from zero up to 2-2,5 mm, and then form the surface structure of the artificial tooth and the cutting edge of approximal tooth surfaces of a transparent material or enamel mass with shade on a scale Vita C2, which is applied to a thickness of from zero to 1.5-2 mm, increasing from pricesnews part in the direction of the cutting edge, in addition, after the formation of each structural layer of the tooth control in transmitted light no teleopathy on the border of layer separation.

2. The method of tooth restoration under item 1, characterized in that after the formation of oral petal actually dentin, when a patient has a tooth abrasion, the surface with the vestibular side to the coronal part of mamelodi tint creativity, while choosing shades from light brown to dark brown.

 

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