Method for repairing dental row having two failing lateral teeth and completely or partially failing crown parts of supporting teeth by applying reinforcing net-beam bridge prosthesis

FIELD: medicine.

SUBSTANCE: method involves forming supporting platforms on supporting teeth for fixing bridge prosthesis beams and repairing supporting teeth crown parts and crowns of teeth under substitution corresponding to their anatomical shape. The supporting platform having completely lacking crown portion is formed at the level of crown part equator by filling cavity layer-by-layer with microfilled composite material, the cavity being built by walls reinforced with gold-plated metal net and restored in advance using macrofilled composite material to the tubercles level, and by producing slit on aproximal wall surface on the same side with the defect. The supporting platform is formed on tooth having partially lacking crown portion as grooves produced at the equator level on vestibular and oral crown part surface restored in advance using macrofilled composite material and reinforced with net carcass fixed on bearing tooth stump. Supporting beam parts are shaped to conform with the shape of the supporting platforms contact surfaces and grooves shape. Gold-plated metal net is mounted on bearing parts of the beams. The net is preliminarily given M-shaped form and the beams are additionally attached to the beams and the beams are fixed to each other using thin metal threads. The grooves are as deep as the net carcass location depth.

EFFECT: high strength, reliability, prolonged service life; restored dental row integrity.

 

The invention relates to dentistry, and in particular to prosthetic posterior teeth bridges.

The prior art solution included defects of the dentition by the RF patent №2155555 using bridges. The prosthesis beam structure made by the laboratory method, and then fixed in the oral cavity of the patient in the pre-formed cavities of the abutment teeth.

The prior art method of restoring the dentition with the loss of one or two teeth with the use of the bridge by the RF patent №2160568. The famous bridge is made in the form of a beam structure, the middle part which is fixed inside an artificial tooth. Bridge is fixed on the abutment teeth through the ends of the beams protruding from both sides of the artificial tooth. The use is known of the bridge is shown at the height of the coronal part of both abutment teeth not less than 6 mm. otherwise, according to the description of the patent RF №2160568 the patient is another way to restore the dentition. Adhesive bridge is made Autonomous laboratory method using pre-made casts of the upper and lower jaws. After trying on and fitting the prosthesis is fixed in the oral cavity of the patient on the abutment teeth edges the main material.

Known methods of substitution included defects of the dentition with the use of dentures is shown at a healthy periodontium and high intact crowns of the abutment teeth.

Typically, these favorable clinical conditions for prosthetics are rare. In the case of defects of a coronal parts of the abutment teeth, the application of the known bridges or completely contraindicated or will not provide high strength and durability functioning of the restored dentition when it was restored.

Since all bridges in varying degrees overload abutment teeth, functional overload of the abutment teeth with pathological changes of the periodontium in the case of restoring the dentition can lead to their destruction and the need for re-replacement for over a substantial length of dentition defect. Increase the length of the defect of dentition, as a rule, is a contraindication to the use of fixed dentures.

To avoid functional overload of the abutment teeth, in particular, with pathological changes of the periodontium, and increase the strength of bridges in the practice of prosthetics increase the number of teeth, whereby the prosthesis is fixed in the oral cavity of the patient. For more the x abutment teeth, adjacent to abutments with defects, form additional reference cavity (grounds) for fixation of the prosthesis. This increases the number of teeth affected by traumatic exposure dissection.

The purpose of the invention is to develop a method to restore dentition in the absence of lateral teeth and if there are significant defects in the crown portions of the teeth bordering the lateral teeth, with minimal traumatic impact.

When implementing the inventive method restores the functional and aesthetic properties of an edge of teeth with periodontal defects. As a result, they become functionally suitable for use as a reference when fixing bridges. The strength requirement applicable to bridge prosthesis when the prosthesis missing teeth, is provided in the claimed invention at the expense of three-dimensional reinforcement coronal parts of the abutment teeth gold-plated metal mesh, and also due to the characteristics of the formation in the coronal parts of the sites that perform so that the prosthesis was based including on the net. When the claimed method of fixation of the bridge increases the strength of the restored dentition to the perception of functional loads.

This W the problem is solved by reinforcement coronal parts of the abutment teeth and crowns of posterior teeth. The use of reinforcing plated metal mesh eliminates the appearance of chips from exposure to masticatory loads.

The restoration of the coronal parts of the abutment teeth, the formation of the bridge and restore the crowns of posterior teeth directly in the mouth of the patient allows to account for individual anatomical features of the patient's dentition.

Thus, the restoration of the dentition of the claimed method allows to eliminate the defect of considerable length (two abutment teeth and two lateral teeth), to restore the functional properties of the abutment teeth, to ensure the durability of the bridge without additional supporting teeth and without additional traumatic impact on these teeth.

Technical result achieved when implementing the inventive method is the simplification and reduction in procedure time restore dentition in the absence of the two lateral teeth, and fully and partially missing coronal parts of the abutment teeth, ensuring high strength and durability of the functioning of the restored dentition and each of the restored teeth.

The essence of the invention.

The restoration of the dentition begins with the formation of the relevant reference sites in the abutment teeth with polnostyu partially missing coronal parts.

Mechanically surfaces of the teeth adjacent to the defect, clean toothbrushes using toothpastes and determine a suitable color according to the standard scale VITA.

1. The first clinical phase is the restoration of the abutment tooth with completely missing the crown part. The restoration is performed with the use of reinforcing mesh to strengthen the restored coronal part of the tooth. Reinforcement of coronal tooth structure, including the surface of the root, provides a uniform perception of functional loads, prevents mechanical damage (e.g., chips) on the outer surface of the tooth crown.

The restoration of the coronal portion of the abutment tooth is preceded by a pre-endodontic treatment of the tooth. Root canals should be filled to the top and should not have periapical changes.

Perform the retraction of the gums, and then on the basis of the root form a Cup-shaped cavity, the surface of which is subjected to acid etching. After thorough rinsing with water, the surface is dried, put double-tassel adhesive and polimerizuet.

Next, using microfilariae composite material, designed to restore chewing teeth groups, form stink the missing coronal portion of the abutment tooth to the top of the bumps in accordance with the anatomical shape of the tooth. After polymerization is conducted occlusive editing.

For the reinforcement cavity formed by the restored walls of the coronal portion of the abutment tooth, use gold plated metal grid.

The grid shape, the shape of the inner surface of the cavity, so that the outer surface of the mesh tightly to the inner surface of the formed cavity, including the tubercles. Hold the fitting and correction of the shape and size of reinforcing mesh. On a contact surface of the cavity and reinforcing mesh after adhesive processing and curing a thin layer is applied composite cement. Next, the grid is installed in the cavity of the abutment tooth, pressing it to the surface of the root and to the surface of a cavity formed by walls. The restored wall of the crown portion fixed in the cavity of the crown part with cement mesh are reinforced artificial enamel layer. This layer will polimerizuet from the outside and from the inside surface to harden.

Then proceed to the formation of a platform for placing and fixing the abutment ends of the beams adhesive grid-beam prosthesis.

For this purpose, flowable or microfilaraemia composite layers which fill reinforced mesh cavity to ur is VNA the equator of the tooth, and conduct polymerization.

On the approximal surface of the abutment tooth with sides dissect part of the wall, forming a slot on the depth of the level bumps up to the level of the equator. Thus, the ground of one of the abutment teeth formed at the level of the equator of a coronal portion of the abutment tooth plane of the layer microfilariae composite material, the inner surface restored to the level curves of reinforced walls of the tooth crown, and the slot is made on the approximal tooth wall side of the defect to the level of the equator.

The aesthetic effect of the restored walls is achieved after pre-treatment and grinding standard polishing disks of different thickness and grain size of the abrasive, diamond dental drill. The correction is performed under the control of the occlusal paper finish using burs and discs. Produce final adviceline.

Thus, a simultaneous restoration of completely missing coronal part of one of the abutment teeth and the formation of a platform for fixing the bridge.

The restoration of the second abutment tooth with partially missing coronal part is performed with the use of a reinforcing wire frame. Missing coronal part of the tooth is restored with ochitamae anatomic form.

Conduct preparation of demineralized tissue preserved stump anchor tooth, and then form a retention points on the cult for a solid fixation of the reinforcing metal frame.

To make this frame Golden metal grid in the shape of a square with stopper and beaked forceps shape, the shape of the surface of the stump of the tooth. After fitting the excess mesh is removed and re fitting, ensuring full compliance with the size and shape of the reinforcing wire frame shaped stump of a tooth.

After acid etching stump anchor tooth conduct thorough rinsing with water. Stump dried by air, apply the adhesive and polimerizuet. On the stump anchor tooth and the frame put the adhesive. Perform the air purge for uniform distribution of the adhesive layer and the polymerization in a standard way. Then on the tooth stump and the inner surface of the reinforcing grid frame is applied photocurable glass-ionomer cement. The frame is mounted on the tooth stump, fix and carry out polymerization. Then hold the restoration of partially missing coronal portion of the abutment tooth microfilariae composite material in accordance with the anatomical shape of the restored tooth.

To achieve the aesthetic effect of the reset is issued by the crown part of the tooth is polished standard polishing disks of different thickness and grain size of the abrasive, diamond dental drill after pre-processing. The correction is performed under the control of the occlusal paper finish using burs and discs. Produce final adviceline.

After recovery of the second abutment tooth with partially missing coronal part with the use of a reinforcing wire frame at the level of the equator with vestibular and oral surfaces of the crown portion to form the grooves. The depth of the groove is such that when the formation is removed not only artificial enamel layer of the crown part, but the part of the mesh reinforcing mesh frame. Thus, the depth of the groove is chosen from the condition that, when fixing the bridge on the second abutment tooth beams rested on the contact surface of the groove, the width of which is not less than the sum of the thicknesses of artificial enamel layer of the restored crown of the tooth at the level of the equator and the grid frame. Support beams on the net strengthens the construction of the bridge, and hence the restored dentition to avoid functional overload.

After the formation of foothold in one of the abutment teeth and the formation of grooves on the level of the equator on a restored crown of a portion of another anchor tooth initiate the formation of a reinforcing grid-beam bridges.

2. The laboratory phase of zaklyuche is to receive the impression and getting cast working model of high-strength gypsum, and in the manufacture of the orthodontic wire of the two beams intended for fixation of the prosthesis on the abutment teeth on the vestibular and oral surfaces.

The beam is composed of a carrier and two support parts. One of the support parts each of the beam, where the beam is fixed in the pre-formed groove, formed in accordance with the size and shape of the groove, in particular, by flattening beams and additional bending. Another basic part of each of the beams bend in the shape of the contact surface of the supporting point of the supporting tooth. Make the fitting and adjustment of beams on a plaster model of the abutment teeth.

3. The second clinical stage begins with the fitting beams formed on the abutment teeth in the oral cavity of the patient. After trying carry out the fixation of the beams on the abutment teeth.

The abutment teeth and beams after acid etching is covered with adhesive and conduct polymerization. Next, the beam is fixed on the abutment teeth with cement. First fix the beam on the oral surface, and then on the vestibular surface. For aesthetic beams cover the masking agent and conducting the polymerization. After fixing beams spend the final restoration on the abutment tooth with completely missing the crown part. The cavity formed is restored to the level of Ogarkov reinforced walls, fill microfilament composite material, restore the bumps and spend occlusive editing. To the formation of a coronal parts missing posterior teeth start two days after complete polymerization of the restored coronal parts of the abutment teeth.

4. The final clinical stage consists in forming reinforced crowns of posterior teeth.

This gold plated metal grid of rectangular shape whose length is no more than the length of the replaced defective dentition, gives M-shaped.

Grid set on load-bearing parts of the beams so that its free edge facing toward the alveolar ridge. Next, correction and fitting mesh and proceed to its mechanical fixing to the supporting parts of the beams. To do this, use a thin metal filament, by means of which the grid is rigidly fastened to beams. In addition, to impart strength and rigidity to the frame of the bridge formed bearing portions of the beams and the M-shaped grid bearing of the beams is additionally fixed between a thin metal threads.

Formed by the above method grid-beam frame along with the bearing function of the restoring posterior teeth performs the function of three-dimensional reinforcement of their restored with crowns. In the Les of forming a reinforcing grid-beam frame started to restore the missing posterior teeth in accordance with their anatomical form.

To do this, use microfilaraemia composite material, which form the washing space, next, form the vestibular and then oral surface missing crowns of posterior teeth. This creates a reinforced "shuttering" of microfilaraemia composite and M-shaped grid. The cavity formed by the inner surface of the M-shaped grid, fill flowable composite material, and conducting polymerization, creating an artificial antinomy layer.

Then proceed to the formation of chewing tubercles posterior teeth using microfilariae composite material. Thus, the reinforcing grid-beam bridge is a mechanically rigid monoblock, consisting of a grid-beam frame, immured in microfilaraemia and microfilaraemia composite material.

To improve the grinding and subsequent polishing with the aid of the circular brushes and pumice to remove the dispersion layer of the composite, inhibited by oxygen.

The aesthetic effect is achieved after pre-treatment and grinding standard polishing disks of different thickness and grain size of the abrasive.

Occlusive editing is performed under the control of the occlusal paper finish using burs, disks. Produce the finish of the second adviceline with oral, vestibular and chewing surfaces. The final grinding and polishing is performed on the 2nd day after polymerization.

Thus, this method allows you to restore the integrity of the dentition with full and partial defect of a coronal portion of the abutment teeth with the use of a reinforcing grid-beam bridges.

The way to restore dentition in the absence of the two lateral teeth and full and partial absence of a coronal parts of the abutment teeth with the use of a reinforcing grid-beam bridges, including the formation of reference sites on the abutment teeth for fixing the beams of the prosthesis, forming the frame of the prosthesis and the restoration of the coronal parts of the abutment teeth and crowns of teeth being replaced in accordance with their anatomical form, and the reference area of the tooth, completely missing the crown part is formed at the level of the equator of a coronal part by layer-by-layer filling microfilament the composite material of the cavity formed by the pre-restored microfilament composite material to the level of tubercles walls, reinforced gold-plated metal grid, and perform by defect the slots in the approximal surface of the wall and the base area of the tooth with partially missing coronal calufornia in the form of grooves, done at the level of the equator on the vestibular and oral surfaces of the crown part, previously restored microfilament composite material and reinforced by a grid frame, fixed on the cult of the abutment tooth, with reference to the parts of the beam shape corresponding to the shape of the contact surfaces of the reference sites and the form of grooves, and bearing parts of the beams set gold plated metal grid, which is pre-attached M-shaped, with a grid attached to the beams, and beams fixed to each other via a thin metal threads and grooves perform at a depth of placement of the grid frame.



 

Same patents:

FIELD: medicine.

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Bridge // 2185128
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FIELD: medicine.

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