The way the restoration of the front teeth groups in the complete absence of a coronal part of using gold plated reinforcement mesh

 

(57) Abstract:

The invention relates to medicine, aesthetic dentistry, to method restorations in the anterior teeth groups in the complete absence of a coronal part of using gold plated reinforcing mesh. The purpose of the invention is the prevention of chipping and bruised, increase longevity of the restoration in the complete absence of a coronal part of the front teeth groups, along with high aesthetic qualities. The way the restoration of the front teeth groups in the complete absence of a coronal part of using gold plated reinforcing mesh includes the definition of the corresponding color on the VITA scale, filling one-third of the root canal, the formation on the basis of the root cavity and two diametrically opposite grooves made in mesiodistal direction, a depth of 1-2 mm, fixation anchor post into the root canal and fixation gold plated grid with two P-shaped protrusions respectively in the groove of the head of the pin and the groove base of the root. The head of the pin optional clamp for fixing the grid, the formation of the oral and vestibular surface of the crown part by layering opaque and enamel layers of the composite in accordance with the anatomical shape of the political dentistry, method restorations in the anterior teeth groups in the complete absence of a coronal part of using gold plated reinforcing mesh. The total absence of a coronal part of the front groups of teeth are caries, non-carious lesions, trauma.

For reconstruction of the coronal part of the dental apply artificial crowns supported on a pin structure, direct and indirect restorations made of composite materials (2-5, 7-9).

The closest in technical essence is taken as the prototype of the method of making cast inlay cores in the oral cavity [1].

The disadvantages of the known methods:

1. the cavity in the root canal should be of sufficient depth to a root part of the tab, at least, was equal to the supragingival part;

2. a rather lengthy dissection;

3. wedging action when the load;

4. the lack of elasticity (different physical properties tabs and hard tissues of the root);

5. the ideal clinical conditions: wide, long and straight root;

6. the direct method does not guarantee sufficient precision manufacturing tab due to shrinkage and deformation plastmassovoi results or racemetirosine, or to the destruction of the root;

8. the corrosion of metal root of the pin causes sweating tooth;

9. weak fixation (passive);

10. high cost;

11. more complex and time-consuming procedure of production;

12. the need for dental laboratory;

13. a longer treatment time.

The purpose of this invention is to increase the longevity of restorations in the anterior teeth groups in the complete absence of a coronal part of, along with high aesthetic qualities.

The advantage of this method restorations in the anterior teeth groups in the complete absence of a coronal part of using gold plated reinforcing mesh:

1. gold plated mesh provides perfect shade stump, similar to dentin;

2. yellow metal mesh layer of the composite is less illuminated, looks more natural and provides a natural view of the restored crown of the tooth;

3. coronal part of the restored tooth using gold plated reinforcing metal mesh and composite has excellent adaptation to the remaining tooth structure;

4. missing coronal cajetsia the mental state of the patient;

5. restoration is quick and predictable;

6. reinforced composite, adhesive anchor pin and glass ionomers cement form a monoblock (multilayer structure without its inherent weak boundaries between themselves) and provide a strong grip with the remaining tooth structure;

6. gold plated mesh and anchor pin are not only aesthetic, but also compatible with composite and tooth tissues;

7. the many colors of the composite contribute to the achievement of the maximum aesthetic result in the restoration;

8. gold plated mesh is not only a mechanical link between the anchor pin, composite, hard tissues of the tooth, but also by portions of the composite;

9. gold plated mesh and anchor pin are connected together by mechanical means, are represented as a single durable mechanical reinforcing structure, embedded in a composite material;

10. gold plated mesh not only increases the area of contact with the composite, but also provides 95% reinforcement coronal part of the restored tooth;

11. gold plated mesh JV hard tooth tissues;

12. gold plated mesh is connected with the base of the tooth root and crown anchor pin that allows you to evenly distribute the stress on the root in functional loads;

13. gold plated mesh helps to reduce stress (stress), which occurs during polymerization;

14. gold plated mesh ensures the prevention of possible complications chips and bruised after restoration and increases the longevity of the restored tooth.

The way the restoration of the front teeth groups in the complete absence of a coronal part of using gold plated reinforcing mesh is as follows.

Preparing the tooth for restoration.

Mechanically the surface of the teeth, which are located near the defect, clean toothbrushes using toothpastes and determine a suitable color according to the standard scale VITA. After filling verhushechku thirds of the root canal restored tooth produce retraction of gingival retraction thread for more access to the root of the tooth. After gingival retraction thin conical diamond head is treated with a root part, adjacent to the gum.

On the basis removed after fitting. In the center of the base of the root, in mesio-distal direction, with torpedo-shaped boron are formed two radius (diametrically), vzaimopomoshi each other groove, one from the medial wall of the tooth root to the root canal, the other from the root canal to the lateral walls of the root of the tooth, receding from the lateral and medial walls of the tooth root on average 1-2 mm in order to prevent perforation of the walls of the tooth root. The depth of the groove is formed taking into account konsolidasi tooth root, on average it is equal to 1-2 mm.

Fixation of the anchor pin.

Before fixing the anchor pin is the etching of the base of the root, and the root canal is closed with cotton wool to prevent the ingress of acid. Formed semicircular cavity and grooves is subjected to acid etching acid-3M SCOTCHBOND ETCHANT GEL (Catalog. Dental materials. 2001. 3M Dental, page 6) to create a surface. The acid is applied with a brush on average 15-20 seconds, washed away by running water while running the saliva ejector. Next, the wool is removed from the root canal and is fixed anchor pin using C. I. C. (glass ionomers cement. The catalogue. Dental materials. 2001. 3M Dental, p. 11th groove, when the fixing pin one of the grooves of the head must be positioned in alignment with the groove formed on the basis of the root. Vestibular and palatal surfaces of the head anchor pin ground 1 to 2 mm to ensure aesthetics.

Preparation of gold-plated reinforcing mesh for reinforcing the root and crown of the tooth.

As a reinforcing element, use gold plated grid with a small cell thickness of 0.4 mm firm "Renfert" (USA). The mesh is intended to strengthen the plastic dentures (the Directory. Products for dental technicians. 2001-2002, page 102 and 103).

The grid is selected so that the length and width of the grid corresponded to the length and width of the missing coronal tooth structure, that is, the net has a rectangular shape.

The grid is conventionally divided into three parts: the cutting surface, the body, the cervical surface.

On the cervical surface of the mesh with scissors are the two prongs of the U-shape. The width of the tabs should match the width of the grooves formed on the basis of the root, and the distance between the tabs should match the width of the head of the anchor pin.

Fitting gold plated reinforcing mesh.

the intermediate part between the projections must be in the groove of the head of the anchor pin. On the approximal surfaces of the mesh width should be 1 mm, and the cutting surface should be shorter by at least 1-2 mm of the edge of the restored tooth to ensure transparency of the cutting edge after the restoration.

After trying on the net is rinsed under running tap water, air dried, then applied two layers of adhesive and polimerizuet.

Final restoration of the missing coronal tooth structure using gold plated reinforcing mesh.

Produce isolation of a destroyed tooth from the liquid environment of the oral cavity by using a cofferdam [5].

After fixation pin as in the semicircular cavity and the groove (formed on the basis of the root), and the cylinder anchor pin cause the adhesive (the Directory. Dental materials. 2001. 3M Dental, page 6) MTM SINGLE BOND DENTAL ADHESIVE SYSTEM using the applicator. Rubbing the adhesive, lightly blow air; re-applied adhesive and re-purge the air. Within 10 sec will polimerizuet standard method. Using macrophilia composite (the Directory. Dental materials. 2001. 3M Dental, page 4) form the curb height of 1.5-2.0 mm at the level of the gums around the perimeter of the formed cavity.

The slots fill flowable to metallicheskaya grid in the groove so to the cervical two tabs into the notch formed in the cavity of the cervical part of the root (without voltage), and an intermediate portion between the tabs into the groove in the head of the anchor pin. Before polymerization of the cylinder anchor pin (in the groove which is located grid) mechanically compacted, and then polymerization is carried out.

Thus, the net, which replaces the missing coronal part of the tooth is connected with the root of the tooth in two ways: adhesive (using the cervical ridges) and mechanical [intermediate part of the grid (between the lugs) is connected with the cylinder anchor pin].

Then hold the final restoration of the tooth crown with composite materials for front teeth groups-MTM FILTEKTM.

The first portion of the composite material is applied to the grid and remove it to improve the adhesive ability of the material. First restores the contour of the tooth using macrofile R-60-MTM SOF-LEX TM (the Directory. Dental materials. 2001. 3M Dental, page 4). Then applied in layers opaque and enamel layers of the composite grid, first on the oral and vestibular surface (conduct directed polymerization with vestibular and oral sides).as the layer of composite (Engibarov oxygen). The aesthetic effect is achieved after pre-treatment and grinding standard polishing discs-MTM SOF-LEX TM (the Directory. Dental materials. 2001. 3M Dental, page 8) different thickness and grain size of the abrasive, diamond forests, and approximal surfaces of the strip-MTM SOF-LEX TM (the Directory. Dental materials. 2001. 3M Dental, page 8). Occlusive editing is performed under the control of the occlusal paper finish using burs, disks. Produce final adviceline with palatal and vestibular surfaces, remove the cofferdam and retraction thread. The final grinding and polishing are conducted on the 2nd day after polymerization. Thus, this method allows you to increase structural strength, increase longevity of the restoration in the complete absence of a coronal part of the tooth, along with high aesthetic qualities.

Example

Patient M 36 years.

Complaints: the complete destruction of the crown part, on the aesthetic dissatisfaction 21.

Anamnesis: 21 previously repeatedly cured about complicated caries. Objectively: the crown 21 of the tooth completely destroyed. Percussion is painless. On the radiograph 21 tooth ASS="ptx2">

Treatment. Mechanically surfaces of the teeth adjacent the defect, clean toothbrushes using toothpastes and determine a suitable color according to the standard scale VITA. Produce retraction of gingival retraction thread for more access to the root of the tooth. After gingival retraction thin conical diamond head is treated with a root part, adjacent to the gum.

On the basis of the root using spherical boron form a semi-circular cavity. Pick up the anchor pin, which is removed after fitting. In the center of the base of the root in mesio-distal direction with torpedo-shaped boron form two radial (diametrically), vzaimopomoshi each other groove: one from the medial wall of the tooth root to the root canal, the other from the root canal to the lateral walls of the root of the tooth, receding from the lateral and medial walls of the tooth root on average 1-2 mm in order to prevent perforation of the walls of the tooth root.

Before fixing the anchor pin produce etching of the base of the root, and the root canal is closed with cotton wool (to prevent ingress of acid). Formed semicircular cavity and grooves is subjected to acid etching for the ri working the saliva ejector. Next, the wool is removed from the root canal and produce a fixation anchor pin using C. I. C. (glass ionomers cement) according to standard methods. When fixing anchor pin groove of the head is placed in alignment with the groove formed on the basis of the root. Vestibulary and palatal surface of the anchor pin is polished at 1-2 mm.

As a reinforcing element, use gold plated grid with a small cell thickness of 0.4 mm firm "Renfert ".

The grid is selected so that the length and width of the grid corresponded to the length and width of the missing coronal tooth structure, that is, the net has a rectangular shape.

On the cervical surface of the mesh with scissors to create two prongs of the U-shape. The width of the protrusions corresponds to the width of the grooves formed on the basis of the root, and the distance between the projections corresponds to the width of the head of the anchor pin.

After trying on a grid washed under running tap water, air dried; then apply the adhesive will polimerizuet.

Before the final restoration of the tooth crown are insulated from the liquid environment of the oral cavity with the help of the cofferdam.

After fixation pin as in semicircular palestinia. Rubbing the adhesive, lightly blow air, re-applied adhesive and re-purge the air. Within 10 sec will polimerizuet standard method.

The slots fill flowable composite and simultaneously set a metal grid in the groove so that prisiazhnye two lug into the groove in the base of the root (without voltage), and an intermediate portion between the tabs into the groove in the head of the anchor pin. Before polymerization of the cylinder anchor pin (in the groove of which is a metal mesh) mechanically compressed, and then carry out the polymerization.

Then hold the final restoration of the tooth crown composite material for anterior teeth groups.

The first portion of the composite material is applied on the restored surface mesh and remove it to improve the adhesive ability of the material. First restore the contours of the tooth using macrofile. Then applied in layers opaque and enamel layers of the composite metal grid, first oral and then on the vestibular surface. To improve the grinding and subsequent polishing with the aid of the circular brushes and pumice to remove the dispersion layer Comandante polishing disks of different thickness and grain size of the abrasive, diamond forests, and approximal surfaces treated with coils. Occlusive editing is performed under the control of the occlusal paper finish using burs and discs. Produce the finish of svetotenjei with palatal and vestibular surfaces, remove the cofferdam and retraction thread. The final grinding and polishing are conducted on the 2nd day after polymerization. The treatment in this way allows you to increase structural strength, increase longevity of the restoration. Complications after the restoration in the complete absence of a coronal part of a tooth above method was not found.

Sources of information

1. Shcherbakov, M. C., Trutenko VP //Method of making cast inlay cores in the mouth. Dental technician. 2002. No. 1. - C. 11. The PROTOTYPE.

2. Galimov I. Y. //Clinical experience with anchoring pegs to restore the crown of the tooth. Dentist practices. 2001. No. 1. - S. 28-30.

3. George Friedman. //Aesthetic treatment using recovery methods on the pin. Clinical dentistry. 2001. No. 2. - S. 10-15.

4. Kopeikin VP Guide prosthetic dentistry. M - 1998 S. 496.

5. Neither is ISIN A. K. //Restore (restoration) and the fillings are modern materials and technologies. Poltava. 2001, - S. 72-77.

7. Svetlov, A. C., kosicina S. I. //Experience with root pins system COSMOPOST. Scientific and practical journal. Institute of dentistry. - 2000. No. 1. - S. 28-30.

8. Olesov Century. N. // Biomechanical and clinical rationale pin design on fiberglass. Panorama of prosthetic dentistry. 2000. - S. 4-6.

9. Jordan R. E. // Composite filling and lining materials in dentistry. A. C. Borisenko, V. N. Desprado. / Kyiv. - 2001 - S. 200.

The way the restoration of the front teeth groups in the complete absence of a coronal part of using gold plated mesh reinforcement, including determination of the appropriate colour on the VITA scale, filling one-third of the root canal, the formation on the basis of the root cavity and two diametrically opposite grooves made in mesiodistal the direction of depth of 1-2 mm, fixation anchor post into the root canal and fixation gold plated grid with two P-shaped protrusions respectively in the groove of the head of the pin and the groove base of the root, the head of the pin optional clamp for fixing the grid, the formation of the composite in accordance with the anatomical shape of the tooth with subsequent grinding and polishing.

 

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