Anchor pin for restoring teeth after endodontic treatment

FIELD: medical engineering.

SUBSTANCE: device has non-aggressive tip and grooves on external surface. Conic cavity is coaxial with the pin. The conic cavity has insert stump protruding above pin head part. Cavity wall and insert are threaded. The grooves pass through pin body to 3/4 of its length in plane passing through pin center. The protruding insert portion has retention points.

EFFECT: high strength, sealed, stable cosmetic results; exactly repeated tooth root canal shaped.

1 dwg

 

The present invention relates to medicine, namely to prosthetic dentistry and can be used to restore the crown of the tooth after endodontic treatment.

The restoration of teeth after endodontic treatment is an integral part of successful treatment of teeth with regard to complicated caries and has three objectives: the elimination of cosmetic disorders, recovery of lost functions, creating tightness previously filled channel.

It is known that deportirovanniy tooth, unlike intact, very fragile and often changed in color due to a certain extent the loss of the main structure of the tooth is dentine - internal moisture. Enamel, devoid of dentin, is also very fragile and, as a result of masticatory load, often get. This raises the danger of a deep fracture of the crown, which usually runs from the medial to the distal wall and ends deep under the gums. When such fractures inevitably surgical treatment (removal of a tooth or hemisection).

Prevention of deep fracture of the coronal part of the tooth restoration after endodontic treatment, when completely destroyed, Odon or two approximal wall to introduction into the root canal additional support, pin and grinding W is therefore bumps or, better, the entire chewing surface of the tooth. So removed the chewing surface restored with composite materials light-cured or tabs online or overlay.

Known in the dental screw posts, possess great strength and stability, but have poor retention, as to the tissues of the tooth and restorative material, have high blood pressure when setting, as well as higher functional pressure. Due to the redistribution of masticatory pressure from crown to root through the pin there is a risk of crack initiation and fracture of the root. This is facilitated by the following points; the screwing of the pin, the diameter of the pin is larger than the diameter of the channel, the aggressiveness of the screw cutting and the top of the pin, etc. Treatment of crack and/or split root surgical removal of the tooth. (Ngirolata, Abs, Vasickova, A.at-Hakim. "Prosthetic dentistry". Smolensk, 2000, str.)

All known dental anchor pins are round in shape, and most of the roots of the oval, which can lead to excessive expansion of the channel, the thinning of the walls of the root, either due to the small diameter of the pin to a lack of stability and retention. Analysis of the obtained results the parameters of the root canal and its walls have teeth in the upper and lower persons who stay showed the vast majority of them, except the front incisors of the upper jaw, the anterior-posterior diameter prevails over mesio-distal. (Ngirolata, Abs, Vasickova, A.at-Hakim. "Prosthetic dentistry". Smolensk, 2000, str.) In such situations, often resort to the production of individual cult tab. Preparation of the channel under the tab requires the removal of all pagnutti in the structure of the tooth, which can lead to undue thinning of the walls of the root. Need additional visits, preferably making crowns require the participation of the dental technician (casting in the laboratory), as well as additional material consumption (removing the mold channel), which makes the construction much more expensive.

Analogue of the invention are individually manufactured cult tabs representing individually cast from a metal tab exactly prepared the bed of the channel and formed the tooth stump. (Ngirolata, Abs, Vasickova, A.at-Hakim. "Prosthetic dentistry". Smolensk. 2000, str.)

Disadvantages:

1. Cult tab is unsightly and should be in most cases covered with a crown.

2. Requires casting in the laboratory, attracting a dental technician, and additional supplies, which increases the number is in the visits and the cost of treatment.

3. The undercut in the tooth structure must be removed, which may lead to undue thinning of the walls of the root and subsequent crack or split.

4. The wedging effect, which occurs in the apical part of the tooth under functional stress can also cause a split tooth root.

5. The retention is rather weak, as in passive pins.

Known passive anchor pins, taken by the authors for the prototype. The prototype is a conical pin or pin having parallel walls and grooves for mechanical retention, the end part has a non-corrosive top (.Hellwig, J.Klimek, T.Attin.: Einfuhrung in die Zahnerhaltung 1999, str, Ngirolata, Abs, Vasickova, A.at-Hakim. "Prosthetic dentistry". Smolensk, 2000 str)

Disadvantages:

1. This pin has insufficient fitted with fixing and restorative material and tooth tissues, which can lead to loss of the whole structure or part thereof.

2. Due to insufficient retention pin has a low stability.

3. Lack of retention may result in microbacteria, depressurization of the canal and endodontic treatment.

4. The pin has a round shape, when setting in the oval channel requires excessive thinning of the walls of the root, which can lead to the Ascoli root. In the case of small diameter of the pin is broken stabilization and reduced retention.

The above disadvantages have prompted the authors to develop the anchor pin so that when endodontic treatment in one visit, to undertake a complete restoration of the tooth crown; the maximum mimic the anatomical shape of the root canal of the tooth, when the front-rear size of the root prevails over mesio-distal, allowing you to create tight obturation of oval channel and not have a functional pressure on the walls of the root, but possessing sufficient strength and stability.

Objectives: Improving the quality and increasing the lifetime of the restored tooth after endodontic treatment, the increase in stability of the structure.

The essence of the invention is the anchor pin to restore the crown of the tooth after endodontic treatment with non-corrosive top and grooves on the external surface, characterized in that along the center of the pin is made conical chamber which is provided with a cult insert, protruding above the head part of the pin, the wall of the cavity and the insert is threaded, and the grooves are made through through the body of the pin on3/4its length in the plane passing through the center of the pin, and the protruding portion of the insert has a retention points.

For l is chego perception of the pin shown in the drawing, where: 1 - anchor pin; 2 - through the slots through the body of the pin on3/4its length; 3 - conical cavity; 4 - screwed-core portion of the pin; 5 - inner thread of the pin; 6 - outer thread stump; 7 - protruding portion of the insert retention points.

The pin set as follows.

After the endodontic treatment prepare previously filled channel on its anatomical shape (oval). Then pickle prepared canal and the remaining tooth structure. Demineralize gel wash off after 40 seconds, the canal is dried. Next, adhesive is applied to the system and polimerizuet her. In the channel make with the help of Canaanites a dual-cured material. Then make the setting pin (1), passively without twisting and pressure, so that the grooves of the pin (2) was located in mesio-distal direction. After seasoned pause 30 sec (the time for penetration of the material into the cavity of the pin through the slots (2)) is produced by screwing in (on the thread (6, 5)) in the conical cavity (3), the core insert (4), which pushes the wall of the pin (1), thereby stabilizing it in the channel. The excess of the fixation material, when turning, extend through the slots (2) up. The material is polymerized using a standard source of polymerization. Then at a set pin (1), the protruding part (7) is ooltewah insert (4) and saved the tooth tissues produce restoration of the tooth crown according to the usual method.

Restoration of the tooth crown with the application of the proposed pin was tested in 100 patients, 50 patients formed the control group, the treatment which is performed with the use of passive anchor pins Unimetric.

In 22% of patients in the control group, the treatment of which produced a standard anchor pins, 3 months after the restoration was observed various changes, including: 4 patients (8%) loss of the pin stump with, in 2 patients (4%) produced by tooth removal due to the split of the root, in 5 patients (10%) identified aesthetic disorders associated with insufficient adhesion of the restorative material and the pin.

Patients for which the restoration was carried out using the pin, after 3 months no changes detected.

At the control examination after 12 months after restoration in 5 (10%) patients of the control group showed slightly painful percussion, due to water leakage. 4 (8%) patients in the control x-rays increased width of the periodontal gap. In 18% of patients showed loss of the pin on the stump.

After 12 months, at the control examination, the patients of the main group loss of the pin stump with was not observed in the control x-rays increase the width of the periodontal gap is not detected. One patient immediately is up positive percussion, what we think associated with chronic omega periodontitis in history.

Example:

Patient A., aged 35, has filed complaints on the aesthetic disadvantage in the area 15 of the tooth associated with the violation of the integrity of the crown. As well as periodic pain when eating cold and hot food.

After endodontic treatment, the preparation of the previously filled channel on anatomical shape (the ratio of the buccal-palatal size to mesio-distal 1:3, oval shape) using the expansions of suitable length and diameter. The pin is picked up by the length and diameter of the prepared bed.

Then protravel prepared canal and the remaining tooth structure. Demineralize the gel was washed in 40 seconds and dried. Next caused the adhesive system and polymerizable her. In the channel made with the help of Canaanites a dual-cure (Duo Cement). Then made a statement of the pin, passively without twisting and pressure. After seasoned pause 30 sec (the time for penetration of the material into the cavity of the pin, the tension on the walls of the channel), produced screwing the core parts to complete stabilization of the pin in the channel. The material was polymerizable using a standard source of polymerization. Then at a set pin, cult part and saved the tissues of the tooth has been restored with crowns, the new part of the tooth photopolymer composite Venus.

Patient 12 months after treatment, the clinical picture was favorable. Not mentioned aesthetic disturbances, changes in periapical tissues, the strength and stability of the structure has not changed.

The proposed pin allows you to: per visit now to get a solid, hermetic design with good cosmetic effect, replicating the anatomical shape of the root canal of the tooth. Additional mechanical connection of the pin with fixing material and tooth tissues, due to the grooves in the walls of the pin, and the hollow space in the center. Rasimas part improves the stabilization and retention of the pin. Analyzing the survey results, we can conclude that the proposed pin easy to use, well tolerated, has no side effects and contraindications for use. The data obtained allow us to recommend the proposed anchor pin for the restoration of the coronal part of the tooth after endodontic treatment in a broad dental practice.

Anchor pin to restore the crown of the tooth after endodontic treatment with non-corrosive top and grooves on the external surface, characterized in that along the center of the pin is made conical chamber which is provided with a cult insert, protruding above goal the main part of the pin, the wall of the cavity and the insert is threaded, and the grooves are made through through the body of the pin onits length in the plane passing through the center of the pin, and the protruding portion of the insert has a retention points.



 

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