Method grid-anchor reinforcement of composite materials in the restoration of completely missing coronal part of the front teeth groups

 

(57) Abstract:

The invention relates to medicine, aesthetic dentistry, to the way grid-anchor reinforcement of composite materials in the restoration of completely missing coronal part of the front teeth groups. Method grid-anchor reinforcement of composite materials in the restoration of completely missing coronal part of the front group of teeth includes a fixation anchor post into the root canal and in the cavity, the pre-formed on the basis of the root, the fixation of metal mesh in the groove of the head of the pin and the diametrically opposite grooves made on the basis of the root in mesiodistal direction, and the subsequent formation of the composite materials of the tooth crown in accordance with its anatomical shape. From the cervical surface of the tooth in mesh form two U-shaped protrusion, the distance between which corresponds to the width of the head of the anchor pin, and the grid size chosen not more than the height and width of the crown part. The technical result - prevent chipping and bruised, increase longevity of the restoration in the complete absence of a coronal part of the front teeth groups along with vsetecka-anchor reinforcement of composite materials in the complete absence of a coronal part of the front groups of teeth.

It is known that the obvious reason of the absence of a coronal part of the front groups of teeth are caries, non-carious lesions, trauma: otlon coronal part of the tooth.

For reconstruction of a coronal part of a tooth when stored root in dentistry used artificial crowns supported on a pin structure, direct and indirect restorations made of composite material, optionally reinforced glass ionomers cements, composites, chemical curing and a variety of pin structures (1-4, 6-7).

The prior art method of recovery of a coronal part of a tooth, in which the reinforcing element of the composite material is used, the cylinder anchor pin (1).

The disadvantages of the known methods are:

1) low mechanical strength of the structure;

2) the area of contact of the composite with the "head" anchor pin is only 20-30% of the total area of the coronal part of the restored tooth;

3) the cylinder anchor pin is located at the level of 1/3 of the height of the coronal part of the restored tooth (center), which provides mechanical strength to the structure in the cervical OEM chips and split composite.

In connection with the foregoing restoration in the complete absence of a coronal part of the front groups of teeth with the use of anchor pins has not gained wide clinical application.

The purpose of this invention is to prevent chipping and bruised, increase longevity of the restoration/reconstruction of a coronal part of the tooth along with high aesthetics.

The advantage of grid-anchor way reinforcement of composite materials in the complete absence of a coronal part of the front teeth groups:

1) metal mesh is not only a mechanical link between the anchor pin, composite, hard tissues of the tooth, but also by portions of the composite;

2) metal mesh and anchor pin are connected together by mechanical means, are represented as a single durable mechanical reinforcing structure, embedded in a composite material;

3) metal mesh not only increases the area of contact with the composite, but also provides 95% reinforcement coronal part of the restored tooth;

4) metal mesh helps to reduce shrinkage of the composite material and leads to superior the m root of the tooth and with the cylinder anchor pin, that allows you to evenly distribute the stress on the root in functional loads;

6) metal mesh helps to reduce stress (stress), which occurs during polymerization;

7) metal mesh ensures the prevention of possible complications chips and bruised after restoration/reconstruction;

8) increases the durability vostanovlenija tooth;

9) high aesthetics.

Grid-anchor way reinforcement of composite materials in the complete absence of a coronal part of the front teeth groups is as follows.

Preparing the tooth for restoration

Mechanically the surface of the teeth adjacent the defect, clean toothbrushes using toothpastes and determine a suitable color according to the standard scale VITA. After sealing the apical third of the root canal restored tooth is retraction of the gingival retraction thread for more access to the root of the tooth. After gingival retraction thin conical diamond head processed root portion adjacent to the gum.

On the basis of the root using spherical boron is formed polycrystalline direction, using torpedoing boron is formed by 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. The depth of the groove is formed taking into account consultati tooth root, on average it is equal to 1-2 mm.

Fixation anchor pin

Before fixate 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 -3 M SCOTCHBOND ETCHANT GEL (Dental materials. The catalogue. 2001. ZM Dental, S. 6) to create a surface. The acid is applied with a brush, on average, 15-20, 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. Dental materials. The catalogue. 2001, 3M Dental, S. 11) according to standard methods. Given the circumstances, that the head unapolagetic in one line with the groove formed on the basis of the root.

Vestibular and palatal surfaces of the head anchor pin ground 1 to 2 mm for the provision of aesthetics.

Preparation of the metallic mesh for reinforcement of the root and crown of the tooth

As a reinforcing element using a metal grid with small cells made of stainless steel with a thickness of 0.4 mm firm "Renfert" (USA). The metal mesh is intended to strengthen the plastic dentures (Products for dental technicians: Directory. 2001-2002, S. 102-103).

The metal grid is selected so that the length and width of the grid corresponded to the length and width of the missing coronal tooth structure.

The metal grid are divided into three parts:

1) the cutting surface;

2) body:

3) the cervical surface.

On the cervical surface of the mesh with scissors creates two prongs of the U-shape. The width of the protrusions must correspond to 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 metal mesh

The cervical two tabs no voltage must be logged in grooves formed based on rosemaling surfaces 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 a metal grid washed under running tap water, air dried, then applied two coats of adhesive, polimerizuet and subsequently put masking agent - 3M RelyX CERAMIC PRIMER (Dental materials: a Catalogue. 2001, 3 M Dental, S. (3) thus, to save aseistant grid.

Final restoration of the missing korkovoi part of the tooth with the use of metal mesh

Isolation 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 applied adhesive (Dental materials: a Catalogue. 2001, 3 M Dental, S. 6) 3M SINGLE BOND DENTAL ADHESIVE SYSTEM using the applicator. Rubbing the adhesive, lightly blow air; re-applied adhesive and re-purge the air. Within 10 will polimerizuet standard method.

Using macrophilia composite (Dental materials: a Catalogue. 2001, 3 M Dental, S. 4), is formed curb height of 1.5-2.0 mm at the level of the gums around Perim materials: Directory. 2001, 3 M Dental, S. 3) and simultaneously installed wire mesh in the groove so that 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 polymerizate the cylinder anchor pin (in the groove of which is a metal mesh) mechanically compressed companymy spires, and then polymerization is carried out.

Thus, a metal grid, 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);

- 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 composite for anterior teeth groups - 3M FILTEK.

The first portion of the composite material is applied on a metal grid and remove it to improve the adhesive ability of the material. First restores the contour of the tooth using macrofile R-60 - 3M SOF-LEX (Dental materials: a Catalogue. 2001, 3 M Dental, S. 4). Then apply in layers conduct directed polymerization with vestibular and oral sides) because setprimarykey composite material shrinks in the direction of the directional light (the technique of directed polymerization can reduce polymerization shrinkage, improve the regional seal). To improve the grinding and subsequent polishing with the aid of the circular brushes and pumice to remove the dispersion layer of the composite (Engibarov oxygen). The aesthetic effect is achieved after pre-treatment and grinding standard polishing discs - 3M SOF-LEX (Dental materials: a Catalogue. 2001, 3 M Dental, S. 8) different thickness and grain size of the abrasive, diamond forests, and approximal surfaces of the strips - 3M SOF-LEX (Dental materials: a Catalogue. 2001, 3 M Dental, S. 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 is performed on the second day after polymerization. Thus, this method allows you to increase structural strength, increase longevity of the restoration/reconstruction in the complete absence of a coronal what kind of dissatisfaction, the complete destruction of the crown part 12.

History: according to patient 12 tooth has repeatedly cured about complicated caries.

External examination without features, the mucous membrane of the mouth is not changed. Bite orthognathic.

Objectively: the crown 12 of the tooth completely destroyed. Percussion is painless. On the radiograph 12 tooth periapical no changes, the channel is sealed to the top.

Diagnosis: complete absence of the crown part 12.

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. Center the base of the root in mesiodistal direction using torpedoing boron form two radial (diametrically), vzaimopomoshi each other groove: one from the BA, 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 fixate anchor pin produce 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 to create a surface. The acid is applied with a brush, on average, 15-20, after wash with running water while running the saliva ejector. Next, the wool is removed from the root canal and produce a fixation anchor pin using C. I. C. (steklovarennyh cement) according to standard methods. When fixing anchor pin groove of the head is placed in one line with the groove formed on the basis of the root. Vestibular and palatal surface of the anchor pin is polished at 1-2 mm.

As a reinforcing element using a metal grid with small cells made of stainless steel with a thickness of 0.4 mm firm "Renfert ".

The metal 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 Ave is the duty to regulate 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 metal grid washed under running tap water, air dried; then apply the adhesive will polimerizuet and subsequently put masking agent in such a way as to preserve aseistant grid.

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 the semicircular cavity and the groove (formed on the basis of the root), and the cylinder anchor pin cause the adhesive applicator. Rubbing the adhesive, lightly blow air, re-applied adhesive and re-purge the air. Within 10 will polimerizuet standard method. The slots fill flowable composite and simultaneously set a metal grid in the groove so that the cervical two tabs into the notch 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.

The first portion of the composite material is applied on the restored surface (metal grid) and remove it to improve the adhesive ability of the material. First restore the contour of the tooth using macrofile. Then applied in layers opaque and enamel layers of the composite metal grid, first on the oral and vestibular surface (conduct directed polymerization with vestibular and oral surfaces). To improve the grinding and subsequent polishing with the aid of the circular brushes and pumice to remove the dispersion layer of the composite (Engibarov oxygen). The aesthetic effect is achieved after the pre-treatment and grinding standard 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, disks. Produce the finish of svetotenjei with palatal and vestibular surfaces, remove the cofferdam and retraction thread. The final grinding and polishing is performed on the second day after polymerization. The treatment in this way allows you to increase stre is/reconstruction in the complete absence of a coronal part of a tooth above method was not found.

Sources of information

1. Galimov I. Y. Clinical experience with anchoring pegs for vosstanovleniya coronal part of the tooth / Dental practices, 2001, No. 1, S. 28-30 prototype.

2. George Friedman. Aesthetic Leonie using methodology vosstanovleniya on the pin./ Clinical dentistry, 2001, No. 2, S. 10-15.

3. Kopeikin VP Guide prosthetic dentistry. - M., 1998, S. 496.

4. Nikolaev, A. I., Tsepov L. M. Practical therapeutic dentistry. SPb, 2001.

5. Nikolishin A. K. Recovery (restoration) and the fillings are modern materials and technologies. - Poltava: 2001, S. 72-77.

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

7. Olesov Century. N. Biomechanical and clinical rationale pin tumbler construction, fiberglass./ Panorama prosthetic dentistry, 2000, S. 4-6.

8. Jordan R. E. Composite filling and lining materials in dentistry. A. Borisenko, V. N. Desprado. - Kiev: 2001, S. 200.

Method grid-anchor reinforcement of composite materials in the restoration of a fully otsutstvuem the seat reservation formed on the basis of the root, fixing a metal grid in the groove of the head of the pin and the diametrically opposite grooves made on the basis of the root in mesiodistal direction, and the subsequent formation of the composite materials of the tooth crown in accordance with its anatomical shape, and from the cervical surface of the tooth in mesh form two U-shaped protrusion, the distance between which corresponds to the width of the head of the anchor pin, and the grid size chosen not more than the height and width of the crown part.

 

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