Method for restoring frontal teeth groups of fully lacking crown part with composite reinforcement pin being applied

FIELD: medical engineering.

SUBSTANCE: device has perforated plate or metal wire network plate. Pin has reinforcing part manufactured as curve plate and fixing part matching root base cavity in shape and fastening member. The reinforcement pin is fixed in root canal with a fastening member manufactured from twisted metal threads passed through fixing part of the pin. The crown tooth part is formed on the reinforcing pin part from composite material.

EFFECT: retained anatomical natural tooth shape and appearance; retained crown part.

 

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 precast reinforcing pin.

The level of technology

From publicly available sources of information at the priority date of the application it is known that the total absence of a coronal part of the frontal teeth groups can be: a carious tooth, non-carious lesion, traumatic atlam, the effects prosthetics artificial crowns.

To restore the crown of the tooth with intact root in dentistry used artificial crowns based on the core or pin tumbler construction, direct and indirect restorations of light-cured composite material, optionally reinforced by a variety of helical structures (1-7).

A known method of restoring a damaged tooth with a pin having a head with extended area for fixation of a tooth crown. The disadvantages of this technique is the availability of laboratory stages, the need for accurate casting, the presence of the edge gap, the further destruction of hard tooth tissues, overload of the periodontium, the duration of treatment (8).

The closest in technical essence is a way of restoration of the missing crown of the tooth composite material is aalami using anchor pin, fixed in the root canal of the tooth cement (9).

The disadvantages of the known method are:

1. the low mechanical strength of the structure;

2. the area of contact of the composite with the cylinder anchor pin is about 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 area;

4. about 60-70% of the coronal part of the restored tooth remains without reinforcement, which leads to frequent splits and split design.

Considering the above drawbacks, the restoration of composite materials in the complete absence of a coronal part of the front groups of teeth with the use of anchor pins in clinical practice is not widely used.

The objective of the invention is to develop a means of restoration of front teeth groups in the complete absence of a coronal part of using precast reinforcing pin, ensuring elimination of the above disadvantages, along with high aesthetic qualities.

Effect: simplified procedure for the restoration of the coronal part of the tooth through the use of simple in manufacturing prefabricated reinforcing pin while ensuring that matched the existing strength, functional and aesthetic characteristics of a restored crown of the tooth.

The technical result is achieved due to the design features of the pin, one end of which is fixed on the basis of the tooth root and in its channel, and the other in the layer composite restored crown of the tooth. Thus, restored the crown part is firmly fastened to a tooth root. Due to the design features of the pin while providing a durable connection coronal and root of the tooth additionally, reinforcement restored crown of the tooth.

The technical result is ensured by the following factors:

1. the reinforcing pin is made of metal plate with perforations or of metal mesh, in connection with the fastening element made of several twisted between a metal thread, is a mechanically strong monolithic structure, placed inside a composite material;

2. performing a reinforcing pin with perforations or of metal mesh not only increases the area of contact with the composite material, but also gives adequate strength to the coronal part of the restored tooth;

3. performing a reinforcing pin with perforations or of metal mesh ways which helps to reduce shrinkage of the composite material and leads to improved marginal seal of composite to the tooth hard tissues;

4. perform the locking of the pin shape, the shape of the cavity made in the base of the root, provides uniform distribution of voltage at the root of the functional loads on the tooth;

5. performing a reinforcing pin with perforations or of metal mesh helps to reduce stress (stress), which occurs during polymerization of composite material;

6. performing a reinforcing pin with perforations or of metal mesh ensures the prevention of possible complications chips and bruised after the restoration of the crown part;

7. the use of reinforcing pin increases the longevity of the restored tooth.

The invention

The proposed method (see figure 1-12) assumes that endodontic treatment of the tooth. The root canal should be filled about 1/3 of the length of the root and not have periapical changes. Determines the color of the future restoration on the VITA scale. Is retraction of gingival retraction thread for more access to the root of the tooth. After the retraction of the gums at the base of the root form a cavity.

A reinforcing pin is made from a rectangular metal perforated plate or a rectangular plate made of metal mesh. Of the plate to form a reinforcing and locking of the pin,designed respectively for the reinforcement of the tooth crown to secure the pin in the cavity, formed on the basis of the root. The opposite side along the length of the plate closer relative to each other to impart a curved plate shape. Thus, the plate is formed a so-called "ribs"that increases the strength of the reinforcing pin and, in particular, its reinforcing part at the bend. The width of the curved part of the plate, which is used for reinforcing the crown part of the tooth reinforcing portion of the pin must match the width of the defect coronal part of the missing tooth. The pin is fixed in the root of the tooth so that the plate facing the concavity in the side of the vestibular surface of the tooth.

The side opposite to the reinforcing of the pin, forming the locking portion of the pin. The Flex plate is additionally to give it a shape, the shape of the cavity formed on the basis of the root.

Metal threads, which can be, in particular, a cut from the grid, add "U"-shaped. The free ends of the filaments are passed through the fixing holes of the pin, preferably in the center, and twisted them together, rigidly connecting the locking portion of the pin and formed thus the fastening element. The length of the fastening element, as a rule, does not exceed 1/2 of the length of the tooth root. A reinforcing part, the locking part and e is the element mounting are prefabricated reinforcing pin. Then carry out the fitting of prefabricated reinforcing pin. After fitting and correction produce acid pickling the base of the root to create microrelief (root canal is closed with cotton wool. Acid wash running water while running the saliva ejector, the cavity is dried by air, apply the adhesive, lightly blow air for even distribution. Will polimerizuet standard method according to the instructions. Next, remove the cotton from the root canal and the pin is fixed with the help stacionarnogo cement, placing in the root canal of the fastening element and formed in the cavity of the base of the root - fixing of the pin.

After fixing pin proceed to final restoration of the missing coronal tooth structure in accordance with its anatomical shape with the use of composite materials.

The aesthetic effect is achieved after pre-treatment and grinding standard polishing disks of different thickness and grain size of the diamond abrasive forests, and approximal surfaces of the strips. Occlusive editing is performed under the control of the occlusal paper finish using burs, disks. Remove the retraction thread. Thus, this method allows you to increase structural strength, increase longevity of the restoration at what alnum the absence of a coronal part of the tooth along with high aesthetics.

Example

Patient T., 28 years.

Complaint: on the aesthetic dissatisfaction, the complete absence of a coronal part 11.

History: according to the patient, 11 tooth has repeatedly cured about complicated caries. About six months ago was renovated 11 using composite materials. Three days ago happened atlam coronal part 11.

Objectively: the patient is in satisfactory Condition, the external examination without features. The mucous membrane of the mouth pale pink color. Bite orthognathic. No coronal part 11. Percussion of the tooth is painless. At the sighting of the radiograph in the periapical tissues changes not, the root canal was sealed completely.

Recommended to restore the missing coronal part 11 with the use of prefabricated reinforcing pin.

Treatment: determine the color of the future restoration on the VITA scale. Made the retraction of the gingival retraction thread. After the retraction of the gums at the base of the root formed cavity. A reinforcing pin made of a rectangular plate made of metal mesh. Of the plate shaped reinforcing and locking of the pin. The opposite side along the length of the plate is aligned relative to each other to impart a curved plate shape. The width of the reinforcing portion of the pin corresponded to the width of the de is known coronal part of the missing tooth. The side opposite to the reinforcing of the pin, formed its fixing part. This plate was curved more to give it a shape, the shape of the cavity formed on the basis of the root.

Metallic threads will be cut out of the mesh, attached "U"-shaped. The free ends of the filaments were passed through the fixing holes of the pin, twisted them together, rigidly connecting with the locking part of the pin. After fitting and adjustment of prefabricated reinforcing grid pin made of acid etching the base of the root, and the root canal was closed with cotton wool. Acid washed with running water while running the saliva ejector, the cavity was dried by air, applied the adhesive, lightly blew air for even distribution. He polymerizable standard method according to the instructions. Next, remove the cotton from the root canal and the pin was recorded using stacionarnogo cement, placing in the root canal of the fastening element and formed in the cavity of the base of the root - fixing of the pin.

After fixing precast reinforcing pin proceeded to the final restoration of the missing coronal tooth structure in accordance with its anatomical shape with the use of composite materials.

The aesthetic effect was achieved after pre-treatment and is lipovci standard polishing disks of different thickness and grain size of the abrasive, diamond forests, and approximal surfaces were treated with coils. Occlusive editing carried out under the control of occlusal paper finish using burs, disks. Deleted the retraction thread. Complications after carrying out the above method was not found.

Sources of information

1. Galimov IU //Clinical experience with anchoring pegs to restore the crown of the tooth. Dentist practices. 2001. No. 1. - P.28-30.

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

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

4. Nikolaev A.I., Tsepov L.M. //Practical therapeutic dentistry. St. Petersburg - 2001

5. Svetlov AV, kosicina SR //Experience with root pins system COSMOPOST. Scientific and practical journal. Institute of dentistry in 2000. No. 1., - P.28-30.

6. Olesov NR. //Biomechanical and clinical rationale pin structures on fiberglass. Panorama of prosthetic dentistry. 2000. - P.4-6.

7. Jordan R.E. //Composite filling and lining materials in dentistry. Averina, Vinesparc. /Kyiv - 2001, - S.

8. Patent US 5178540 And 12.01.1993.

9. Nikolishin A.K. Recovery (restoration) and the fillings are modern mate what materials and technologies. Poltava - 2001, p.72-77 - close equivalent.

The way the restoration of the front teeth groups in the complete absence of a coronal part of using precast reinforcing pin including endodontic treatment of the tooth, the fixation of the reinforcing dowel pin in the root canal and cavity previously formed on the basis of the root, and the formation of composite materials in reinforcing portion of the pin of the tooth crown in accordance with its anatomical shape, thus reinforcing the portion of the pin is formed as a curved along the length of the rectangular metal plate made with perforations or mesh and for forming the locking portion of the pin on one end of a plate shape corresponding to the shape of the cavity at the base of the root, and then through the holes of the fixing parts missing and rolled between a number of metal filaments for the formation of the element mounting pin in the root canal of a tooth.



 

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