Method for restoring single-rooted premolars by applying reinforcing beam-and-net structure

FIELD: medicine.

SUBSTANCE: method involves applying endodontic treatment of root, forming cylindrical cavity in root canal and shock-absorbing cavity on its base, forming reinforcement pin and ring-shaped crown carcass from gold-coated metal gauze. Root pin part is fixed in root canal after having restored artificial enamel layer from macrofilled composite material in correspondence with single-root premolar anatomical structure and fixing reinforcing carcass on internal surface formed by enamel layer. The tubular root part has longitudinal slit and free gauze wires at the end. The pin part above the root made as free gauze wires in the root part is fixed on the shock-absorbing root cavity surface. The root portion of the pin is formed in conformance with canal cavity shape. Root part length and length of part above the root is selected no to be less than 1/3 of root canal length and not less than less than double-length of the shock-absorbing root base cavity. Crown cavity is layer-by-layer filled with macrofilled composite material. Chewing surface tubercles is restored from macrofilled composite material corresponding to anatomical tooth shape.

EFFECT: retained tooth root as base for making prosthesis ; high strength and stability of the pin and repaired tooth; simplified pin design.

 

The invention relates to dentistry, and in particular to methods for the recovery of single-rooted premolars, destroyed below the gums.

The choice of method will restore the crown of the tooth depends on its group membership, and the degree of destruction of its coronal part

To restore masticatory teeth the complete destruction of the coronal part of the tooth due to caries, trauma, pathological abrasion of hard tooth tissues used pin design, the main locking element which is the root pin.

The prior art method of prosthetics lost crown of the tooth with the use of root pin tooth, consisting of a root and head parts and the hollow root lock (patent RU 2095031). When restoring a tooth in a known manner on the pre-aligned with the base of the tooth root around the entrance to the root canal to form a circular groove, the diameter and depth of which corresponds to the depth and the height of the end surface of the root lock. Introduction into the root canal root part of the dental structure is produced simultaneously with the placement of the root lock landing on the ledge.

In the prior art it is known prosthetics lost crown of the tooth pin tab on the Pat is the EN 2031639. Pin stump tab also consists of the crown part, the root part and the support element.

When restoring a tooth using tabs develop root canal under the size of the root part. Then perform boarding deepening around the entrance to the root canal to the size of the support element. Further sterilized tab and complete the introduction at the landing place in the root canal using a fixing material. After the installation tab in the root produce simulation, fabrication and fitting of artificial crowns on the crown part of the tab.

Thus, in the first and second cases, to restore the tooth sophisticated by design pin design, errors in the production of which significantly affect the accuracy and strength of the restored tooth. In addition, a rather lengthy dissection of hard tissues preserved root for the purpose of enhancing the sustainability of the peg, and restored tooth limits the possibility of applying known solutions ideal clinical conditions.

In the ideal case, the root pin must pass the chewing pressure on the root through the support site, and its internal part should be strengthened passively and reduce unwanted hcpa the op perate at the apical part of the root due to the elasticity.

In the case of using the known helical structures, including the above, when the destruction of the tooth below the gum implementation of endodontic treatment and peripheral preparation of the root portion of the tooth is problematic due to insufficient thickness (less than 1 mm of dentin remaining root. The use of traditional measures of stabilization of the pin and the crown part of the tooth relative to the base of the root, such as channels, retention openings of 1.5 mm or retention areas on the surface of the root canal, it is impossible because of the danger of damaging the integrity of the walls of the root.

In addition, this mass destruction of dentin of the root compared to the weight recorded in the root canal of the traditional pin may be so insignificant that holds the efforts of the walls of the root canal will not be enough to ensure the sustainability of the pin.

In the case of using the known structures are likely to occur under the action functional loads micro-movements of the pin in the root canal, resulting in the walls of the root and/or restored tooth can also be destroyed.

Analysis of clinical situations in prosthetic dentistry, allows us to state that the application of known means to restore the tooth with a fracture below the gum will not provide the expected stable the spine and durability of its operation for the above reasons, therefore, as a rule, are removed.

The claimed solution is aimed at creating a restore method premolar in the case of fracture below the gum, the implementation of which were completely eliminated the disadvantages of tooth restoration with the use of known helical structures.

Technical result achieved when implementing the inventive method, is to preserve the tooth root, destroyed below the gums, as the basis for the prosthesis to increase the strength and stability of the pin and the restored tooth, to simplify the design of the pin and method of restoring a tooth.

The technical result is achieved by reinforcing the greatest possible surface of the root canal and the crown part of the restored tooth plated metal mesh, which is directly in the process of implementation of the method form a pin grid structure consisting of a wire frame in the form of a ring and mesh tubular pin. The frame and the pin is fixed in the respective cavities of the tooth and additionally fastened to each other, forming a stable reinforcing mesh helical structure.

The advantages of the construction should include a simple constructive solution, the ability to adjust the shape and size of the pin and frame in accordance with the atomic features of the restored tooth.

The root part of the grid pin has a tubular shape with a longitudinal slot and with loose wires at one end, is placed in the channel from the apical part of the root.

The root of the requested pin is firmly fixed in the root canal, connecting with the roughness of the channel in a single structure. Due to these design features of the root portion of the pin eliminates the stress of the pin on the root tissue, but at the expense of free wires root portion of the pin is provided the maximum depth of the reinforcing channel. The walls of the root canal parts are more durable, resulting in a substantial increase in the strength of the restored tooth. Due to the elasticity of the pin grid after posting a root canal takes the form corresponding to the shape of the channel, and the diameter corresponds to.

The root portion of the pin enters nadkarni in the form of free wire mesh its root part.

In the process of recovery available wire head of the pin are distributed on the surface of the cushioning cavity of the root, as well as on the surface of the tooth crown, a pre-reinforced wire frame in the form of a ring. Fixed on the surface of the cushioning cavity wire head of the pin exclude the occurrence of m is of rodigari pin in the root canal, increase thus its resistance, and hence the stability of the restored crown of the tooth in relation to the root.

In addition, the implementation of the claimed method allows you to:

1. to ensure high mechanical connection coronal part of the restored tooth with the base of the root;

2. to create a unit with reinforced walls of the tooth crown, stainless steel pin and glass ionomers cement (multilayer structure without its inherent weak boundaries)that provides the reliability and durability of the recovery.

3. to reduce the shrinkage of the composite material and to improve the marginal seal of composite to the tooth hard tissues;

4. to reduce the tension (stress), which occurs during polymerization of composite materials,

5. to ensure the prevention of possible complications, chips and bruised after restoration;

6. to bring about the restoration of the tooth crown direct way for one visit, significantly reducing the time required to implement recovery procedures.

The essence of the invention.

The inventive method involves pre-endodontic treatment of the tooth. The root canal should be filled to the top and should not have periapical changes. After gingival retraction dissect the base of the root, remove the demineralized tissue is simultaneously form the cushioning cavity on the surface of the root. To increase the area of contact between the composite material to the tooth tissue on the inner surface of the cushioning cavity shape retention points. The depth of preparation chosen preserved hard tissues of the root.

In the root canal to form a cylindrical cavity for fixing the pin to a depth of not less than 1/3 the length of this channel. Then we proceed to manufacture a reinforcing grid pin. To do this, use gold plated metal grid of rectangular shape. One of the sides of a rectangular grid on the minimum length of the perimeter side surface of the root canal, and the length of another side of the rectangular grid is not less than the amount of 1/3 of the length of the root canal and double depth formed depreciation cavity. The grid gives a tubular shape, connecting its opposite sides so that the diameter of the tubular form corresponded to the diameter of the formed cylindrical cavity of the channel. From the apical part of the root of the root portion of the pin is released from the transverse wires. Formed in the root portion of the pin is a mesh tubular surface, turning into available wire mesh. Carry out the fitting of the pin in the root canal and the correction of its size. The pin should stress be placed in the cavity of the channel. After fitting and adjustment step is removed from the cavity. The root canal is closed with cotton wool. Spend the acid etching the surface of the cushioning cavity of the root and after thorough rinsing water is applied the adhesive and conduct polymerization. Then proceed to the formation of artificial enamel layer head part of the tooth with the use of mechanically strong microfilariae composite material, designed to restore posterior teeth, in accordance with the anatomical structure and shape of the restored tooth. From gold plated metal mesh mechanically form a frame in the form of a ring whose shape corresponds to the inner surface of the crown part of the tooth formed by the restored enamel layer. After fitting and correction frame is removed from the cavity and subjected to adhesive treatment followed by the application of a masking agent, while maintaining end-to-end porosity grid cell, then hold polymerization. On the inner surface of the crown part of the tooth after acid etching and processing the adhesive is applied photocurable glass-ionomer cement and simultaneously set the grid frame. Conduct directed polymerization. Grid frame fixed in the cavity of the tooth crown, reinforces the artificial enamel layer. Then proceed to install grid pin in the root canal. From ravago channel remove the cotton wool and spend re-fitting of the pin and its correction. After fitting of the part of the pin which is located above the base of the root, remove the cross wires up to the base of the root, thus forming nadkarni of the pin in the form of free wires of the grid. The root portion of the pin is fixed in the cylindrical cavity of the root canal with cement. Next available wire head of the pin alternately Flex and simultaneously pressed against the surface of the depreciation of the cavity of the root. After fixing pin the base of the root filled glass ionomers cements and proceed to final restoration of the tooth crown with regard to its anatomical structure. Microfilament composite layers reinforced fill the cavity of the tooth crown and carry out polymerization, and the tubercles restore using microfilariae composite material.

Before polishing and controlling the polymerization is conducted occlusive editing.

The way to restore single-rooted premolars using a reinforcing grid of pin tumbler construction, including endodontic treatment of the tooth, forming a cylindrical cavity in the root canal and cushioning cavity, the formation of the plated metal mesh reinforcing pin and the crown of the carcass in the form of a ring, and the Le recovery in accordance with the anatomical structure of single-rooted premolar artificial enamel layer of microfilaraemia composite material and fixing the reinforcing frame on the inner surface coronal cavity formed by the enamel layer is fixed in the root canal, the root portion of the pin having a tubular shape with a longitudinal slot and free the wire mesh on the end, and nadkarni of the pin, made in the form of free wire mesh its root portion, is fixed on the surface of the cushioning cavity of the root, with the root portion of the pin is formed in accordance with the diameter of the cavity of the channel, and the length of the root and head parts chose not less than 1/3 the length of the root canal and not less than twice the depth of the cushioning cavity of the base root of a coronal cavity in layers fill microfilament composite material, and the tubercles chewing surfaces restore from microfilariae composite material in accordance with the anatomical shape of the tooth.



 

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The invention relates to medicine, namely to the dentist, and can be used for restorations in the anterior teeth groups with reinforcing mesh-adhesive pin
The invention relates to medicine, namely to prosthetic dentistry and can be used in the prosthesis with complete or partial destruction of the tooth crown
The invention relates to medicine, namely to the dentist, and may be applicable to prosthetic splint the tooth with an artificial stump of metal

Pivot stump inlay // 2250090

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