Method for substituting failing foretooth with combined reinforced adhesive bridge prosthesis from titanium or titanium nickelide

FIELD: medical engineering.

SUBSTANCE: method involves producing two horizontal grooves on oral surfaces of each bearing tooth becoming vertical grooves on opposite contact surfaces of the bearing teeth. Groove depth is not larger than enamel thickness. Prosthesis carcass is formed in patient oral cavity comprising parallel beams preliminarily mounted in the grooves and manufactured from flattened wires, and porous plate rigidly attached to the bearing beams part by means of metal threads and additionally fixed in vertical grooves of the bearing teeth. The beams and plate are manufactured from titanium or titanium nickelide. Rest and bearing beam portions are mated as stiffening ribs. Shape is given to plate in correspondence to crown tooth part outlines in the plane the plate is placed. The crown part is formed with composite materials in accordance to anatomical tooth shape and anatomical peculiarities of dental row under reconstruction.

EFFECT: long service life; high esthetic quality.

3 dwg

 

The invention relates to dentistry, and in particular to methods of prosthetics patients with partial loss of the front teeth bridges.

The prior art method prosthesis with partial loss of teeth on the patent of Russian Federation №2146505 by preparation of the abutment teeth and attach a prosthesis. A distinctive feature of this method is that the inside of the prosthesis is fixed thread extending from approximal sides and the envelope abutment teeth in the form of loops, the free ends of which pass through tunnels formed by oral prosthesis surface. The thread is placed in the grooves previously formed on the perimeter surface of the abutment teeth, tightly covers the abutment teeth and closes with a filling material.

There is also known a method of restoring the dentition by the RF patent №2160568 (as seems to be the closest to the claimed invention). When implementing the known method is used bridge girder design, the middle of which is fixed inside an artificial tooth, and the speakers on both sides of the ends of the beam structure are designed for mounting on the abutment teeth adhesive material. And beam construction is the supporting frame of the artificial tooth, and for fixing the prosthesis to the abutment teeth f reroute cavity at the level of the fixation support of the prosthesis elements.

From the practice of prosthetics known that bridges have good functional properties. Using them is a complete restoration of chewing function, they keep well established occlusal relationships. These properties are provided appropriate orientation and fixation of the bridge relative to the restored dentition.

In the known method for these purposes provide additional orientation of the upper surface of the beam structure in parallel approximalely plane working surfaces of the abutment teeth, additional alignment levels and ensuring the parallelism of the supporting elements in accordance with the level and orientation of sites cavities formed in the respective abutment teeth, additional fitting and the fitting of adhesive bridges, as well as a preliminary adjustment of the bite.

In contrast to the known, in the present method of replacement of a missing anterior tooth functional quality porous reinforcing-plate girder adhesive motevideo prosthesis provided by a fundamentally different method.

The formation of the adhesive of the bridge and its correction with respect to the tooth row is carried out directly in the mouth in accordance with the levels, anatomizes the second form, the size and orientation of the abutment teeth and the teeth of the antagonists. However, preliminary fitting and adjustment on the plaster model are only beams made of titanium or nickelide titanium wire. In the inventive method, the bridge is fixed to the abutment teeth by means of two beams placed parallel to each other and parallel to the occlusal surface of the abutment teeth. Through the use of two parallel beams, bonded porous titanium or nickelide titanium plate shape corresponding to the shape of the tooth crown, precise orientation, replaced front of the tooth relative to the dentition of the patient, taking into account individual peculiarities of this series. To a solution of the same problem sent and the form of the beams. Due to the flattening of the wire prevents the rotation of the beams relative to their longitudinal axis during fixation on the abutment teeth. The inventive shape of the beams provides a gentle method of preparation of the abutment teeth, since the depth of the groove made by the oral surfaces of the abutment teeth for positioning and fixing beams does not exceed the thickness of the enamel layer of the abutment teeth.

In addition, in comparison with the known bridge-like prosthesis, the prosthesis used in the present method, has more W the resource design (basic technical requirement, requirements for bridges dentures) due to the rigid bonding of porous titanium or nickelide titanium plates and parallel beams, and by fixing the plate in a vertical grooves made on facing to each other of the contact surfaces of the abutment teeth. Additional fixation of the titanium plate or nickelide titanium in the vertical grooves of the abutment teeth allows the use of the claimed method in the case of use as abutment teeth, performing different functions, in this regard, perceiving different direction chewing load. By performing the intermediate part of the frame of the prosthesis in the form of fixed beams and vertical grooves titanium or nickelide titanium plates eliminates the mobility of the abutment teeth. To provide an even distribution of functional load on the artificial crown replaced tooth on the abutment teeth. Thus, the increased strength of the prosthesis, carry out the claimed method, in comparison with the known method.

When replacing a front tooth of particular importance for the patient acquires the aesthetics of prosthetics. Use in the claimed method of titanium or nickelide titanium porous plate allows you to form a crown replaced tooth directly in the oral cavity of the patient according the its anatomical characteristics, as well as anatomical features of the dentition. Using titanium or nickelide titanium porous plate reinforced coronal part of the restored tooth, which contributes to its hardening.

Typically, the prosthesis included defects of the anterior dentition using permanent dentures appropriate after 5-6 months after removal of the front teeth, as soon as the alveolar ridge. Otherwise, due to the atrophy of the alveolar crest between the body of the prosthesis and a crest, you may receive the slit and, as a consequence, the speech. The application of the inventive method shown in this case. The specified defect can be eliminated by the restoration of the coronal part of the replaced tooth composite materials without violating the integrity of the prosthesis.

Technical result achieved during the implementation of the claimed invention is to improve durability, reliability and aesthetics of the restoration of the dentition, as well as in the recovery of phonetic features, as well as in the reduction stage of replacement of a missing anterior tooth.

The essence of the invention.

1. Clinical stage.

On the abutment teeth from the oral surface are formed two horizontal groove depth within the thickness of the enamel, which become n the approximal surfaces of the abutment teeth in the future are connected with vertical grooves, made from a defect on the contact surfaces of the abutment teeth also on the depth within the thickness of the enamel.

Grooves formed respectively for fixing the upper and lower reinforcing beams and for the fixation of porous titanium or nickelide titanium plates. After forming the grooves receive the prints, cast a working model of a high-strength gypsum.

2. Laboratory stage, which consists in the manufacture of reinforcing beams from titanium or nickelide titanium wire. Wire tapers. Flattening allows to ensure a gentle method of preparation of the abutment teeth with proper fixation strength of beams. Reinforcing beams are made so that they are without voltage was set into a formed on the abutment teeth grooves. Beams advanced Flex so that their intermediate supporting part was facing vertical grooves. During the transition from the reference to the bearing of the beam formed by bending in the form of ribs. Next, carry out the fitting and adjustment of the formed titanium beams on the basis of impression plaster model.

Then hold the fitting and correction reinforcing beams directly into the oral cavity of the patient. When installing beams should stress be placed in horizontal slots in parallel relation to each other.

3. The second clinical stage consisting in formation of a combined reinforced adhesive bridges directly in the oral cavity of the patient.

Mechanically surfaces of the teeth adjacent the defect, clean toothbrushes using a polishing pastes and determine a suitable color according to the standard scale VITA. Make the fitting and correction reinforcing beams and porous titanium or nickelide titanium plates on the abutment teeth in the mouth.

In the horizontal grooves of the abutment teeth is fixed to the reinforcing beams using glass ionomers cement.

Porous titanium or nickelide titanium plate installed in the formed vertical grooves of the abutment teeth. Oral surface of the porous titanium or nickelide titanium plates must touch the vestibular surface of the supporting part armorous the beams. After trying on a porous plate mechanically using a thin metal thread is rigidly fixed to beams and cover masking agent, while maintaining its overall porosity. Thus form a porous reinforcing-plate girder frame made of titanium or nickelide titanium, then proceed to the final restoration of the tooth crown with the use of composite materials in accordance with its anatomical shape and anatomical features of the restored dentition. After the restoration of conduct occlusive editing under the control of occlusal paper. The aesthetic effect is achieved after pre-processing, polishing and grinding.

Thus, the claimed method allows for gentle method of preparation of the abutment teeth to restore dentition defect and phonetic function.

The sequence of carrying out the proposed method provides higher accuracy, strength, durability and aesthetics of the restoration of the dentition with the elimination of the defect front tooth.

The way to replace a missing front tooth with a combined reinforced adhesive bridges made of titanium or nickelide titanium, including the formation by oral surfaces kadogos abutment teeth two horizontal grooves, moving in the vertical grooves of the opposite contact surfaces of the abutment teeth, and the depth of the grooves is not more than the thickness of the enamel and the formation in the oral cavity of the patient frame of the prosthesis, consisting of pre-recorded in the grooves of the parallel beams, made of flattened wire, and a porous plate firmly attached to the bearing part of the beams by means of metal thread and optionally locked in the vertical grooves of the abutment teeth, with beams and plate made of titanium or titanium nickelide, bearing and bearing parts of the beam are interfaced with the formation of the ribs and the plate shape in accordance with the contours of the tooth crown in the plane of the placement plate and the crown part is formed of a composite material in accordance with the anatomical shape of the tooth, as well as anatomical features of the restored dentition.



 

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FIELD: medicine.

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

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Bridge // 2185128
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