The way of restoration of the masticatory teeth groups in the complete absence of a coronal part with the use of reinforcing mesh ring

 

The invention relates to the field of dentistry and can be used in the restoration completely destroyed coronal part of the tooth. The technical result is the preservation of the tooth, increasing its durability together with high aesthetics. The way of restoration of the masticatory teeth groups in the complete absence of a coronal part with the use of reinforcing mesh rings, in which the reinforcing mesh ring is placed between the restored using microfilariae composite enamel layer and dentin of microfilaraemia composite. The outer side surface of the ring form the response of the inner surface of the cavity of the restored tooth. The ring is fixed in the cavity of the tooth using a fluid composite. Restored the crown part is a monoblock multi-layered reinforced construction, anatomical form, function and appearance appropriate to the natural tooth. If necessary endodontic treatment is provided access to the root portion of the tooth. 5 Il.

The invention relates to medicine, namely to the dentist, and can be used to restore anatomical form and functionala absence of a coronal portion of the teeth is dental caries and its complications.

Level of technology:

From publicly available sources known to use for recovering the missing coronal part of the chewing teeth groups with intact root of artificial crowns, direct and indirect methods of restoration with the use of composite materials(1, 2, 3, 4).

Using well-known techniques associated with:

1) excessive expansion of the root canal;

2) additional loads on the root transmitted vertically through the pin on the wall of the tooth root;

3) the stress concentration at the base of the root canal due to the conical shape of the pin;

4) the emergence of the so-called effect of the wedge, which occurs in the apical part of the tooth under load and may be the cause of the split root;

5) corrosion of metal pins of non-precious alloys, which leads to root fracture with subsequent tooth loss;

6) implementation of retention only at the expense of root filling material, therefore, when the fixing pins may have a greater internal stress, resulting in the destruction of the root;

7) the emergence of allergies due to the use of metal pins;

8), a significant increase in the probability of fracture of the root.

In clinical practice, very often E. removal of the root defect restore using bridges, made soldered, cast, ceramic-metal, metal-ceramic with the implant.

The disadvantages of these methods are:

1) preparation of abutment teeth intact;

2) trauma to the cervical area of the gums during dissection;

3) tight fit metal frame to the gum leads to long-term compression of tissues, blood circulation disorders and the development of inflammation in the gums;

4) poor control over the formation of defects of hard tissues under the denture;

5) due to solder the frame of these prostheses has low strength,

6) lack of exact simulation of the occlusal surface of the abutment crowns and intermediate part due to the timing of production, which makes them less effective in functional terms;

7) due to the three types of metal: crown, solder and body, distinguished due to ligious components and having a different structure, the conditions for the occurrence of galvanic currents and output from alloys of trace elements chromium, Nickel, iron and others; sensitivity to skin and ions of various metals, and the use of such prostheses may be one of the complications is the engine, intolerance or allergic reaccelerate for fillings and a reinforcing element, made in the form of bracket (5). Seems to be a well-known method is the most similar techniques with the claimed method.

The disadvantage of this method is:

1) complex technological manufacturing a reinforcing element, due to the spatial configuration of the bracket (weld or seamless gutter and lateral teeth, and so on);

2) the need to fabricate brackets several sizes and the use of only a certain size;

3) limited area of reinforcement recovered cavity of the tooth, due to the geometrical dimensions of the bracket (in particular, its width), the reinforcement of the opposite cavity wall;

4) lack of access to the root of the tooth if necessary endodontic treatment;

5) having different strength characteristics of the areas restored part;

6) the occurrence of the additional zones of higher naprjazhennosti caused by the formation in the body of the tooth elements for fastening the bracket;

7) subject to paragraphs 4 and 5, the probability chips filling material of the restored tooth.

The objective of the invention is to provide a method of restoration of the masticatory teeth groups in the complete absence of a coronal part with the use of the technical results: eliminates the above disadvantages, ensured preservation of the tooth is restored to its anatomical form, function and appearance, as well as due to the formation of the cavity by means of net ring access to the root of the tooth if necessary andadoption treatment.

In addition, the application of the inventive method:

1) increase the strength characteristics of the restored part due to the reinforcement of the entire lateral surface of the cavity of the restored tooth;

8) is simplified manufacturing technology reinforcing element with parameters corresponding to the parameters recovered cavity;

9) may use different structural characteristics of composite materials, without compromising the strength characteristics;

10) through the use of a reinforcing ring, in particular, of gilded mesh decreases the shrinkage of the composite material, resulting in improved marginal seal of composite to the tooth hard tissues, increases the counter voltage that occurs during polymerization, and reduced polymerization stress, ensures reliable mechanical retention restored materials, evenly distributed pressure, which occurs when functionaljava design, without its inherent weak boundaries between layers, which prevents chips and split ensures the reliability and efficiency of the design.

The invention is:

This method involves the pre-endodontic treatment of the tooth. Root canals should be filled to the physiological holes and should have no periapical changes.

Missing coronal part of the tooth is restored with regard to anatomical structure, form, function and biomechanical features of the tooth. The tooth is covered mechanically durable enamel, which is the dentin. The mechanical strength of the dentin is lower than that of enamel. Given the above features, when the full recovery of the missing coronal tooth structure, form:

- artificial enamel layer;

- artificial dentin.

For artificial enamel layer apply:

1) mechanically strong microfilaraemia composite;

2) reinforcing element.

For artificial dentin apply:

1) microfilaraemia composite, which has a mechanical strength lower than that of microfilaraemia composite.

Mechanically toothbrushes using toothpastes clean the surface of teeth that are next to define wall of a coronal part of the tooth at the gum. In subsequent spend dissection of the base of the root portion of the tooth, forming a bowl-shaped cavity. Next, using a thin spherical boron with the inner surface of the Cup-shaped cavity at the gum to form a groove (Fig.1, 2).

Then hold the acid etching acid to create a surface. The acid is applied with a brush, on average, 15-20, then wash off with running water while running the saliva ejector and the vacuum cleaner.

After acid etching of the shaped cavity is dried by air, apply the adhesive. Then he gently blow air to distribute, put again and again rinsed with air. Within 10 will polimerizuet standard method.

Microfilaraemia composite material, designed to restore chewing groups of teeth, shape of the roller and placed within the formed groove, polimerizuet. Then restore the walls of a coronal part of the tooth thickness of 1-1 .2 mm to occlusal contact with the teeth-antagonists. Formed wall will polimerizuet with both outer and inner surfaces, to ensure full polymerization of the composite [Fig.3].

For the reinforcement of the walls of the coronal part of the restored tooth vnutrenniy surface restored cavity of the tooth. Receive reinforcement design of Cup-shaped form, cut out the bottom, receiving the form of a ring. This form of reinforcement design allows not only to strengthen thin restored walls of the tooth crown, but in the future, if necessary, to carry out endodontic intervention. Grid ring after the fitting is removed from the cavity of the tooth and cover with two layers of adhesive, polimerizuet individually. The formed cavity is dried by the air and cause the adhesive. Lightly blow air to distribute, put again and again rinsed with air. Within 10 will polimerizuet standard method. Put flowable composite reinforcing structure and the inner wall of the tooth, fixed “grid ring on the inner surface restored cavity of the tooth (Fig.4).

For the formation of dentin formed in the tooth cavity fill microfilament composite material, the strength of which is less than the strength microfilariae composite enamel layer. Tubercles restored mechanically durable microfilament composite.

Before polishing and controlling the polymerization is conducted occlusive editing. Okonchatelnoe to achieve preservation of the tooth, increase the durability together with high aesthetics.

Clinical example

Patient I., 42 years old, appealed to the dentist with complaints about the complete destruction of the crown 46 of the tooth. With words, 46 tooth was previously cured about complicated caries.

External examination without features. Bite orthognathic. The oral mucous membrane is pale pink in color.

Objectively: the crown 46 of the tooth completely destroyed. Percussion is painless. On the radiograph 46 tooth periapical no changes, the channels are sealed to the tops.

Treatment: mechanically toothbrushes using toothpastes clean the surface of teeth, which are located near the defect, and determine their color according to the standard scale VITA. After the control radiographs dissect preserved walls of the coronal part of the tooth at the gum. In subsequent spend dissection of the base of the root portion of the tooth, forming a bowl-shaped cavity. Using a thin spherical boron with the inner surface of the Cup-shaped cavity at the gum form the groove. Spend the acid etching acid to create a surface. The acid is applied with a brush, on average, 15-20, then wash off with running water while running clinoatacamite distribution, put again and again rinsed with air. Within 10 will polimerizuet standard method. Microfilaraemia composite material, designed to restore chewing groups of teeth, shape of the roller and placed within the formed groove, polimerizuet. Restore the walls of a coronal part of the tooth thickness of 1-1 .2 mm to occlusal contact with the teeth-antagonists. Formed wall will polimerizuet with both outer and inner surfaces, to ensure full polymerization of the composite. For the reinforcement of the walls of the coronal part of the restored tooth using fine-mesh gilded mesh, thickness of 0.2-0.4 mm using stopper create a shape that mirrors the inner surface of the restoring of the tooth cavity. Receive reinforcement design of Cup-shaped form, cut out the bottom, receiving the form of a ring. Grid ring after the fitting is removed from the cavity of the tooth and cover with two layers of adhesive, polimerizuet individually. The formed cavity is dried by the air and cause the adhesive. Lightly blow air to distribute, put again and again rinsed with air. Within 10 seconds will polimerizuet standard method. Nae is on the inner surface of the restored tooth cavity. For the formation of dentin formed in the tooth cavity fill microfilament composite material. Tubercles restored mechanically durable microfilament composite.

Before polishing and controlling the polymerization is conducted occlusive editing. The final grinding and polishing is performed on the 2nd day after polymerization.

The treatment in this way allows you to increase longevity of the restoration. Complications after restoration by the above method have been identified.

Bibliography

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

2. Nikolaev, A. I., Tsepov L. M. Practical therapeutic stomatology St. Petersburg - 2001,

3. Svetlov, A. C., Kozlov, S. I., Peter Dukart. Experience with root pins system Cosmopost // Institute of dentistry. March 2000

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

5. Patent application EPO No. 0565889 A1, CL And 61 With 5/00. 1993 - close analogue.

Claims

The way of restoration of the masticatory teeth groups in the complete absence of a coronal part of using arecom anatomical structure, form, function and biomechanical features of the tooth, including the formation of the enamel layer of the walls of the coronal part and its reinforcement through rings, made of fine gold mesh with a thickness of 0.2-0.4 mm, the formation of dentin and the final restoration of the crown part, and an enamel layer formed from microfilariae composite material, which is in the form of a roller mounted in a groove made at the level of the gums in a Cup-shaped cavity, the pre-formed at the base of the root portion of the tooth, with subsequent restoration of the walls of the coronal part of the thickness of 1-1,2 mm to the occlusal surface of the tooth, the repaired part will polimerizuet with outer and inner sides, carry out the fixing ring, the outer surface of which corresponds to the inner surface of the restored crown of the tooth and the size of the hole of the ring from the root chosen from a condition of access to the root, and the formation of dentin using microfilariae composite material, the strength of which is less than the strength microfilariae composite enamel layer, and the bumps restored mechanically strong microfilament composite, before the polishers is the study conducted on the 2nd day after polymerization.

 

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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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