The method of restoring a tooth with missing coronal part and perforation of the root in the area of the bifurcation with the use of reinforcing mesh ring

 

(57) Abstract:

The invention relates to medicine, namely to the field of dentistry, and can be used to restore the tooth with missing coronal part and perforation of the root in the area of the bifurcation. The technical result of the invention consists in the complete restoration of root perforations due to repeated placement osteosclerosis material. The method includes forming the walls of the crown part, the restoration of the perforation of the root by repeated application of granules “Callahan and the final restoration of the crown part. Wall form after the pre-endodontic treatment of root canals and preparation of the surviving walls of the coronal part of the gum formation carried out in stages up to the equator and to the occlusal surface, with an intermediate gingivectomies damaged tissues of the root to form a wall using a composite material and fixed in the cavity of the tooth ring is made of fine gold mesh with a thickness of 0.4 mm, the outside surface of which corresponds to the inner side surface of the cavity formed of the tooth, and the diameter of the hole number is raised to medicine, namely dentistry: how to restore the tooth with missing completely the crown part and the presence of a perforation of the root in the area of the bifurcation.

In clinical practice, there are perforation of the root in the area of the bifurcation from chewing groups of teeth with complete absence of the crown part, the reason of which is dental caries and its complications.

From publicly available information sources it is known that when the perforations of the root in the area of the bifurcation disturbed function of the tooth, which makes it impossible to use it as a support for the prosthesis. Due to the presence of microorganisms, their toxins and destructive inflammatory process in the periodontal such teeth are a potential nidus of chronic odontogenic intoxication. Sustainable clinical symptoms of periodontitis and the destruction of bone in the area of the perforation of the bottom of a coronal cavity are a direct indication for surgical treatment of such patients (koronadalenos separation, hemisection on the teeth of the lower jaw). But traditional surgical methods for the treatment of chronic destructive forms of periodontitis resulting from perforations, also not always successful. The development of postoperative Pospolita who t their functionality, which leads to the removal of these teeth[2, 3, 4, 7, 8, 9].

After tooth extraction spend prosthetics different structures (bridges): soldered, cast, ceramic-metal, metal-ceramic, based on the implant.

In the prior art (EPO No. 0565889 A1) known way to restore the crown of the tooth by applying a material for seals and a reinforcing element made in the form of brackets [1]. Seems to be a well-known method is the most similar techniques with the claimed method.

The disadvantages of this method are:

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 produce staple 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 walls of the cavity;

4. lack of access to the root of the tooth if necessary endodontic is 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 with the restored tooth.

The objective of the invention is to provide a method of restoring a tooth, whereby missing coronal part of the tooth is restored in conjunction with the restoration of root perforations in the area of the bifurcation perform additional reinforcement of the crown restored tooth through the use of the grid ring to create a monolithic structure. The application of the inventive method eliminates the above disadvantages. In addition, the use of the grid ring to form a cavity access the root of the tooth and thus to ensure full recovery of root perforations due to repeated placement osteosclerosis material, and the recovery process perforations of the root is the most comfortable for the patient.

The advantages of the invention consist also in the following:

1. treatment of inflammation and preservation of the tooth;

2. recovery options is the duty to regulate removal of tooth pulp of the abutment teeth;

5. does not require laboratory stages;

6. allows you to restore the crown part of the tooth is the most simple way;

7. reinforcing mesh ring is represented as a matrix on which to build the missing coronal part of the tooth;

8. it increases the mechanical strength of the design, reduces the shrinkage of the composite material, resulting in improved marginal seal of composite to the tooth hard tissues;

9. counteracts stress, which occurs during polymerization and reduce polymerization stress;

10. provides reliable mechanical retention restored materials;

11. provides high structural strength;

12. perforated mesh shape reduces the voltage formed on the walls of the tooth crown and promotes uniform distribution of pressure, which occurs when functional loads on the tooth;

13. in combination with modern adhesive systems creates a one-piece, multi-layered reinforced construction without its inherent weak boundaries between layers, which ensures reliability and efficiency of the design;

14. grid ring - binder MetroSet chipped and split;

15. processing grid adhesive and masking agent eliminates discoloration of the design of the tooth crown;

16. the efficiency of the simulation of a coronal part of a tooth.

17. visual and x-ray control upon the occurrence of pathological changes of hard tissues after restoration.

18. keep the access to the root portion of a tooth for endodontic treatment.

The essence of the invention.

This method assumes that endodontic treatment. Root canals should be filled to the physiological holes and should have no periapical changes.

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 controlling x-rays have infiltration anesthesia and dissect preserved walls of the coronal part of the tooth at the gum. 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. The cavity is dried without the RNO and again blow air. Within 10 will polimerizuet standard method.

Composite material designed to restore chewing teeth groups, form the walls of a coronal part of the tooth thickness 1,5-2 mm to the equator. Spend gingivectomy with excision softened and demineralized tissues of the root in the area of bifurcation and medical treatment of the wound.

Then restore the walls of the tooth crown to the occlusal surface before contact with teeth-antagonists (to prevent the effect Popov-Godone). For reinforcement of the coronal part of the restored tooth using fine-mesh gilded mesh with a thickness of 0.4 mm using stopper create a shape that mirrors the inner surface of the restoring of the tooth cavity. Get a bowl, cut out the bottom, receiving the form of a ring. Thus form a reinforcing grid ring.

Grid reinforcement ring is removed after fitting of the cavity of the tooth and cover with two layers of adhesive, polimerizuet individually. The cavity of the tooth is dried by air, apply the adhesive. Lightly blow air to distribute, causing the adhesive again and again blow air is armirovannoj cavity of the tooth using a flowable composite.

Thus, reinforcing mesh ring allows you not only to strengthen the thin walls of a coronal part of the restored tooth, but to continue the treatment of perforation of a root in the area of the bifurcation.

For repair of root perforation in the area of the bifurcation use “Callahan-L” in the granules, which impose the wound. As Callalan-L-biocomposite material based on highly pure hydroxyapatite, collagen and medicines used for the treatment of diseases associated with abnormal bone tissue, has a strong osteogenic and anti-inflammatory properties, greatly enhanced reparative processes in the damaged tissues, promoting faster healing of bone wounds and restoration of bone structure, is provided by the prolonged action of the contained drug. High microbial activity of the material is retained 16-20 days, during which there is a uniform allocation of antibiotics in the bone cavity; has high biocompatibility, does not cause rejection[5, 6, 7].

After applying “Collana-L” in the area of bifurcation and the base of the root of the tooth to leave the bandage on IU the Asti bifurcation of the root, add “Callahan-L” and leave the bandage.

After full recovery of root perforation in the area of the bifurcation proceed to final restoration of the tooth crown. Remove temporary bandage and carry out the restoration of the coronal part of the tooth restoration using the system for posterior teeth according to the instructions of the manufacturer. Before polishing and controlling the polymerization is conducted occlusive editing. The final grinding and polishing is performed on the 2nd day after polymerization. Next, the patient is under medical supervision.

Thus, this method allows you to achieve preservation of the tooth, increasing the longevity of the restoration of the missing coronal tooth structure.

Example.

Patient S. 54,

Complaints: in the absence of a coronal part of the tooth 36, difficulty chewing of food.

The development of this disease: previously 36 were under metal-ceramic prosthesis.

Transferred and associated diseases: peptic ulcer 12 duodenal ulcer.

External examination: the configuration of the face is not changed; the lymph nodes are painless, not increased.

Objective: referovanou and inflamed gums.

On the radiograph: in the area of the bifurcation of the roots 36 has a perforation, and the rarefaction of bone tissue; miconia partition destroyed by 1/2, root canals filled to the top, periapical changes are not observed.

DS: localized chronic periodontitis in the area of the bifurcation of the roots of the tooth 36 of moderate severity.

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 controlling x-rays have infiltration anesthesia and dissect preserved walls of the coronal part of the tooth at the gum. Then hold the acid etching acid. 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. The cavity is dried by air, apply the adhesive, slightly air to distribute, put again and again rinsed with air. Within 10 will polimerizuet standard method.

Composite material designed to restore chewing teeth groups, form the walls of a coronal part of the tooth thickness of 1.5-2 eutalloy surface. The method of polymerization can reduce polymerization shrinkage, improve the marginal seal directed.

Spend gingivectomy with excision softened and demineralized tissues of the root in the area of bifurcation and medical treatment of the wound.

To restore the perforation in the area of the bifurcation of the root is used “Callahan-L” in the granules, which impose the wound.

Then restore the walls of the tooth crown to the occlusal surface before contact with teeth-antagonists. For reinforcement of the coronal part of the restored tooth using fine-mesh gilded mesh with a thickness of 0.4 mm using stopper create a shape that mirrors the inner surface of the restoring of the tooth cavity. Get a bowl, cut out the bottom, receiving the form of a ring. This ring is used as a reinforcing element, which allows not only to strengthen thin restored walls of the tooth crown, but to continue the treatment of perforation of a root in the area of the bifurcation.

The grid ring is removed after fitting of the cavity of the tooth and cover with two layers of adhesive, polimerizuet individually. The cavity is dried and again blow air. Within 10 will polimerizuet standard method. Put flowable composite reinforcing structure and the inner wall of the tooth, fix the ring on the inner surface of the restored crown of the tooth.

After applying “Kalapana-L” in the area of bifurcation and the base of the root of the tooth to leave the bandage on for a month.

After a month under the control of the x-rays to determine the degree of recovery of the perforation in the area of the bifurcation of the root, add “Callahan-L” and leave the bandage.

After the complete restoration of the perforation in the area of the bifurcation of the roots proceed to final restoration of the tooth crown. Remove temporary bandage and carry out the dissection of the inner surface of the crown part of the tooth. The cavity is dried by air, apply the adhesive. Lightly blow air to distribute, put again and again rinsed with air. Within 10 will polimerizuet standard method. Then hold the restoration of the coronal part of the tooth restoration using the system for posterior teeth according to the instructions of the manufacturer. Before polishing and controlling the polymerization is conducted occlusive editing. Windows is NT taken on the dispensary account: every three months to inspect the oral cavity, professional cleaning and polishing of the teeth. The treatment used in this method saves the tooth, prevent chipped and split. Complications after the restoration by the above method was not found.

Sources of information

1. Patent application EPO No. 0565899 And 61 With 5/00, 1993 - close equivalent.

2. Abolmasov. N. G., Abolmasov N. N., Bychkov Century A. Prosthetic dentistry. Moscow. 2002. - S. 211-219.

3. Shargorodsky A., Inflammatory diseases of maxillofacial area and neck. Moscow. 1985. - S. 133.

4. Bazhanov N. N. Dentistry. Moscow. 1984. - S. 113.

5. Dunaev M. C., Bochkarev, N. With. Application of bioactive composite drug “Callahan-L”//. Journal of dentistry. 1998. No. 6.

6. Langues A. And, Demidenko F. I. Application of material “Callahan-L” in the practice of oral and maxillofacial surgery.// Journal of dentistry 1997. No. 3.

7. Nikitin, A. A., I. Kazantsev A. Studies in research and the clinic biocomposite material “Callahan-L”//. Russian dental journal 2001. No. 3.

8. Pekker R. J. Diseases of the teeth and oral cavity. Moscow. 1980. - S. 39-40.

9. Starobin I. M. oral Surgery outpatient physician. Moscow. 1977. - S. 75-77.

 

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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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