The way the restoration of posterior teeth

 

(57) Abstract:

The invention relates to medicine, namely to dentistry. The way the restoration of the crown of the teeth of the side groups using light-cured composite material and a reinforcing element in the form of a grid, characterized in that the bottom and formed through the center of the tooth cavity in mediodistal direction do a groove, receding from the lateral and medial walls of the tooth root of 1-2 mm, a width and a depth of 1-2 mm of metal mesh cut out a rectangular piece for forming a reinforcing element corresponding to the length and width of the missing coronal tooth structure and repeating the contours of his restoration site, then reinforcing element pin is stuck in the groove, remove, washed under running water and dried, then in the formed cavity of the tooth contribute adhesive and install in the groove perpendicular to the bottom of the cavity mesh, treated with adhesive, polimerizuet, the groove is filled flowable composite, followed by a layer-by-layer filling the formed cavity of the tooth composite material prior to full recovery of its anatomical shape. The proposed method is it will prevent chipping and bruised restored tooth. 2 C.p. f-crystals.

The invention relates to medicine, namely to dentistry.

It is known that causes tooth decay side groups can be: carious and non-carious disorders of anatomic integrity of the tooth, traumatic atlam.

To restore the anatomical integrity of the coronal part of the tooth with intact root in dentistry used composite (chemical and light curing) restoration/reconstruction, made a direct (in-clinic) (1) and indirect (dental laboratories) (2).

The known method of restoration/reconstruction of a coronal part of the tooth, which consists in the fact that initially define the color of teeth on the next standing and located contralateral to the teeth using a scale of colors VITA, VITA, Germany). Then the tooth dissect with the formation of a cavity under the restoration/renovation II class Bleck. When subgingival location of the bottom of the cavity to hold the retraction of the gums, and then on the restored tooth set contour matrix, providing a snug fit of the gingival margin of the matrix to restore the tooth; etched enamel and dentin, washed and dried the cavity, then in the Zuya each layer, to the full restoration of the anatomical shape of the tooth, followed by finishing the restoration/reconstruction of a coronal part of the tooth (1, 3).

There is a method of restoration of the coronal part of posterior teeth using light-cured composite material and a reinforcing element in the form of a grid (4).

This method is chosen for the prototype.

The disadvantage of this method is the low mechanical strength of the renovation/restoration due to the large chewing pressure and due to the fact that the area of contact of the composite with hard tissues of the prepared tooth is about 25% of the total volume of the tooth crown. Occlusal surface of the restoration/reconstruction during functional loads experienced significant stress and strain of a cyclical nature, which affects the mechanical strength of the restored section of the crown of the tooth and leads to frequent chipped and split.

The objective of the invention is to increase the durability of the restoration of the crown of the tooth, preventing chipping and bruised restored tooth.

This is due to the fact that the bottom and formed through the center of the tooth cavity in mediodistal voltage is -2 mm, of metal mesh cut out a rectangular piece for forming a reinforcing element corresponding to the length and width of the missing coronal tooth structure and repeating the contours of his restoration site, then reinforcing element pin is stuck in the groove, remove, washed under running water and dried, after which the formed cavity of the tooth contribute adhesive and install in the groove perpendicular to the bottom of the cavity mesh, treated with adhesive, polimerizuet, the groove is filled flowable composite, followed by a layer-by-layer filling the formed cavity of the tooth composite material prior to full recovery of its anatomical shape. In deponirovano tooth additionally fixed anchor pin, and on the cervical side of the reinforcing elements form a groove under the head of a pin. All this reinforces the mechanical link between the composite and hard tissues of the tooth and by the portions of the composite, but also helps mitigate the stress-strain state, the redistribution of loads, thereby serves to increase the durability of the restoration, prevention of occurrence of cracks in the area of marginal seal of composite to A tooth enhances the fixation of the composite in the cavity of the tooth. Before restoration moisturize teeth with intact coronal part and determine the suitable color of the composite material on the VITA scale.

The method is as follows. After professional oral hygiene of the patient is taught the rules of personal hygiene and determine the color of teeth on the next standing and located contralateral to the teeth using a scale of colors VITA, VITA, Germany). Tooth dissect form a cavity under the restoration/reconstruction. In accordance with the traditional way of preparation for the filling, in the case of subgingival location of a defect in the crown of the tooth with root, is the retraction of the gums for exposure subgingival area. After gingival retraction thin conical diamond head is treated with a root part, adjacent to the gum.

During the restoration/reconstruction of pulpless tooth on the basis of the root using spherical boron form a semicircular cavity, select the anchor pin on the bottom of a cavity formed through its center in mediodistal direction using, for example, torpedo-shaped boron do a groove, receding from the lateral and medial walls of the tooth root 1-2 mm to prevent lane is a groove first pin is stuck grid of rectangular shape, the corresponding length and width of the missing coronal tooth structure and repeating the contours of his restoration site, and the presence of anchor pins on the cervical side of the grid additionally form the groove under his head; remove the mesh, washed under running water, dried, formed in the cavity of the tooth contribute adhesive and install in the groove perpendicular to the bottom of the cavity mesh, treated with adhesive, polimerizuet, after which the groove is filled flowable composite; then carry out layer-by-layer filling the formed cavity to the full restoration of the anatomical shape of the tooth.

For reinforcement in the quality of the mesh can be used, for example, gold-plated metal mesh stainless steel company "Renfert", of a thickness of 0.2 mm, is designed for reinforcing basic records.

Clinical example No. 1.

Patient S., 29 years. Case history No. 151. Without somatic pathology. Complaints about the “jam” food and complexity of deletion is between 34 and 35 teeth.

Anamnesis: 34 tooth has repeatedly cured about tooth decay. Bite orthognathic, the class I Angle.

Objective: proximal and medial part of the occlusal who Vila periapical changes.

Diagnosis: secondary recurrent caries 34 tooth on class II in Black.

Treatment: purification of the crown 34 of the tooth by mechanical means. To select the color of the future reinforced restoration/reconstruction first watered the patient's teeth with intact coronal part, determined suitable color according to the standard technique (on the North side of the room, noon) on a scale VITA, VITA, Germany).

After isolation of the tooth and gingival retraction boron carbide spherical shape of the subgingival area was dissected dentin to healthy tissue, then formed two grooves Crescent-shaped in vestibuloocular direction using plamiing of boron, the thickness of the dentin, above the roof of the pulp cavity and the cervical area, retreating from the enamel-dentinal border, 1,0-2,0 mm

From plate metal mesh cut out the rectangular piece, which was formed by the reinforcing element. Was prepassivate reinforcing element, so that the edge stress was located in the formed grooves. Tried to the contours of the reinforcing element repeated the contours of the restoration site of the crown 34 of the tooth.

Grooves were subjected to acid etching acid - 3M SCOTCH tooth brush, 15-20 with its washed away by running water while running the saliva ejector, then struck adhesive 3M SINGLE BOND DENTAL ADGESIVE SYSTEM Directory. Dental materials 2001. 3M Dental, page 6) using the applicator, RUB the adhesive hydrated dentin, slightly chill air and made a standard polymerization method.

The grid was degreased, dried, caused an adhesive, polymerizable, then struck a masking agent - 3M TM REIX TM CERAMIC PRIMER (the Directory. Dental materials 2001. 3M DENTAL, page 6) thus, to save aseistant grid.

After preparing a reinforcing element on the two Crescent-shaped grooves inflicted adhesive 3M SINGLE BOND DENTAL ADGESIVE SYSTEM Directory. Dental materials 2001. 3M DENTAL, page 6), using the applicator, in accordance with the recommendations of the manufacturer.

Then, without effort, has established a reinforcing element in the grooves and the last filled flowable composite 3M TM FILTEC FLOW (the Directory. Dental materials 2001. 3M DENTAL, page 3).

After polymerization, the reinforcing element is fixed. For the best pairing of composite with reinforcing element (metal mesh) it is applied in two steps: after applying to the entire surface and then was removed, and the last is by osita - 3M TM FILTEK Z 250 (the Directory. Dental materials 2001. 3M DENTAL, page 4). Each applied layer should not exceed 2.0 mm, to the full restoration of the anatomical shape of the tooth. Deleted the retraction thread and spent finishing the restoration/reconstruction, using circular brushes and pumice remove the dispersion layer of the composite (Engibarov oxygen). The aesthetic effect is achieved after pre-treatment and grinding standard polishing discs - 3M TM SOF-LEX TM (the Directory. Dental materials 2001. 3M Dental, page 8) different thickness and grain size of the abrasive, diamond forests, and the contact surfaces of the strips - 3M TM SOF-LEX TM (the Directory. Dental materials 2001. 3M Dental, page 8). Occlusive editing carried out under the control of occlusal paper finish using burs, disks. Made finishing adviceline with palatal and vestibular surfaces. The final grinding and polishing was performed on the 2nd day after polymerization.

Thus, this method allows you to increase structural strength, durability along with high aesthetics.

Clinical example No. 2.

Patient A., 32 years. History ptx2">History: 16 tooth previously cured about pulpitis. Bite orthognathic, the class I Angle.

Objective: proximal and distal part of the occlusal surfaces 16 of the tooth is destroyed. Tooth fixed, percussion painless. When radioviziograficheskoye survey 16 tooth shows that the canals obturated to the top, changes in periapical tissues no.

Diagnosis: secondary recurrent caries 16 tooth on class II in Black.

Treatment: purification of the crown 16 of the tooth by mechanical means. To select the color of the future reinforced restoration/reconstruction first watered the patient's teeth with intact coronal part, determined suitable color according to the standard technique on a scale VITA, VITA, Germany).

On the bottom of the root of the tooth formed torpedo-shaped diamond Burr two radius (diametrically), vzaimopomoshi each other grooves: one from the medial wall of the tooth root to the head of the anchor pin, the other from the head of the anchor pin to the lateral walls of the root of the tooth, receding from the lateral and medial walls of the root, on average, 1-2 mm in order to prevent perforation of the walls of the tooth. The depth of the grooves formed taking into account konsolidasi tooth root, in the medium to the main thread.

On the net make the groove under the head of the anchor pin, and the grid should have two "legs", which are recorded in the two slots. The width of the grid already, on average, 3-4 mm coronal part of the restored tooth. The body length of the grid comes to dentinal enamel tooth connection. Then fixed anchor post into the canal of the tooth. Then degreased mesh, washed with water, dried, caused an adhesive, produced the polymerization, and then struck a masking agent - 3M TM RTLIX TM CERAMIC PRIMER (the Directory. Dental materials 2001. 3M Dental, page 11), while preserving aseistant grid.

Grooves were subjected to acid etching acid - 3M SCOTCH-BOND ETCHANT GEL (Catalog. Dental materials 2001. 3M DENTAL, page 6) to create a surface. The acid was applied on the tooth and the crown anchor pin with a brush, 15-20, with its washed away by running water while running the saliva ejector, then struck adhesive 3M TM SINGLE BOND DENTAL ADHESIVE SYSTEM (the Directory. Dental materials 2001. 3M DENTAL, page 6) using the applicator, RUB the adhesive hydrated dentin, slightly chill air made the standard polymerization method.

The grooves were filled flowable composite 3M TM FILTEK TM FLOW (the Directory. Dental materialmay part of the tooth-composite - 3M TM FILTEK TM Z 250 (the Directory. Dental materials 2001. 3M Dental, page 3), bringing a new layer (no more than 2 mm) to the full restoration of the anatomical shape of the tooth, polimerizuet each layer of material. To improve the grinding and subsequent polishing with the aid of the circular brushes and pumice have deleted the dispersion layer of the composite (Engibarov oxygen), then to achieve the aesthetic effect of processed and polished standard polishing discs - 3M TM SOF-LEX TM (the Directory. Dental materials 2001. 3M DENTAL, page 8). Occlusive editing carried out under the control of occlusal paper finish using burs, disks. Made finishing adviceline with palatal and vestibular surfaces, removing retraction thread. The final grinding and polishing was performed on the 2nd day after polymerization.

Thus, this method allows you to increase the strength and durability of the design, along with high aesthetic qualities.

Sources of information

1. Petrikas A. J. Surgical and restorative dentistry. - Tver, 1997. - S. 120-135.

2. Kopeikin Century. N. Guide prosthetic dentistry. - M., 2001. - S. 156-168.

3. Borowski E. C., Barysheva Y. D. 565889 A1, 20.10.1993.

1. The way the restoration of the crown of the teeth of the side groups using light-cured composite material and a reinforcing element in the form of a grid, characterized in that the bottom and formed through the center of the tooth cavity in mediodistal direction do a groove, receding from the lateral and medial walls of the tooth root of 1-2 mm, a width and a depth of 1-2 mm of metal mesh cut out a rectangular piece for forming a reinforcing element corresponding to the length and width of the missing coronal tooth structure and repeating the contours of his restoration site, then reinforcing element pin is stuck in the groove, remove, washed under running water and dried, then in the formed cavity of the tooth contribute adhesive and install in the groove perpendicular to the bottom of the cavity mesh, treated with adhesive, polimerizuet, the groove is filled flowable composite, followed by a layer-by-layer filling the formed cavity of the tooth composite material prior to full recovery of its anatomical shape.

2. The method according to p. 1, characterized in that deponirovano tooth additionally fixed anchor pin, and on the cervical side of armir what vracia moisturize teeth with intact coronal part and determine the suitable color of the composite material on the VITA scale.



 

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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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