Method of making adhesive dental bridges

FIELD: prosthetic dentistry.

SUBSTANCE: strong tooth is prepared, model is cast and doubled. Washing-though space is modeled in the area of defect onto doubled model by means of high-test plaster. Prepared cavities at strong teeth are filled with silicon mass. The mass is polymerized and is subject to cut in such a way that the mass disposes 1-mm lower than occlusion surface does. Mass is polymerized, removed from strong teeth and removed to get a bracket. Non-polymerized layer is applied to cavities and to plaster inside washing-off space in the area of defect to get thickness of 0,2-0,3 mm, cut of half-rope in form of a loop is submerged into the layer and closed. The other part of rope is applied and pressed by bracket. Excess material is removed. Polymerization is performed and intermediate part is formed. Adhesive dental bridge is put off, adjusted and fixed inside mouth's cavity.

EFFECT: improved adhesion force of prosthetic appliance with strong teeth.

2 cl, 3 dwg

 

The invention relates to medicine, namely to prosthodontics.

Adhesive bridges (AMP) to avoid radical dissection of the teeth while achieving reliable fixation of the prosthesis. The indication for the use of AMP are small defects in the anterior and lateral parts of the dentition (one or two teeth) in young patients with large cavity of the tooth. Such prostheses are shown and patients with poor health, suffering from severe cardiovascular diseases. Therefore, it is always urgent search for new options in materials and workmanship for adhesive bridges.

Similar to the proposed method, the author proposes an adhesive bridge. (Enguli. "Fixed prostheses: Theory, clinical and laboratory equipment", Nizhniy Novgorod state medical Academy, Nizhny Novgorod, 2002, str-359).

Adhesive bridge consists of supporting elements-plates and the intermediate part. The latter is a traditional design of an artificial tooth with a veneer of plastic or ceramics. Basic parts of the prosthesis are kind of metal pads on the lingual surface of the teeth. Each plate is maximally covers the lingual surface to the interdental contact points, comes to the occlusal surface of the abutment teeth and is located at a distance of approximately 0.5-1 mm from the gingival. Extent the ü coverage lingual surface of the teeth is dictated by the need to ensure a reliable fixation of the prosthesis subject to a maximum recovery of aesthetics. Introduced into the denture occlusal pad promotes more uniform distribution of chewing pressure between the supporting teeth and reduces the load on the fixing material.

The prosthesis is carried out as follows. Using high-precision impression materials get double prints. The combination of a plaster model in accordance with bounds on the thickness of the lining of wax models supporting elements and the intermediate part of the bridge.

After casting verify the accuracy of manufacture of the first frame on a working model, and then in the mouth, then revet intermediate portion of plastic or ceramics. The finished prosthesis test again in the mouth, Priazovsky the prosthesis is subjected to final polishing or glazing.

Before the strengthening of the prosthesis enamel under the support elements pickle 30-50%phosphoric acid at a depth of 5 μm. For fixing use different composite materials.

Disadvantages of the method is similar:

- the presence of metal in the mouth;

- different coefficients of thermal expansion of metal and composites, leading to cracking of the prosthesis;

poor aesthetics.

The prototype of the proposed method, the author believes adhesive bridge for the recovery of small de the projects (1-2 teeth) tooth row, manufactured using system GlasSpan", made of durable inorganic fibres or woven laces large diameter, aretiranih in a special way for strong connection with organic matrix composite materials. It can be used for manufacturing different designs of extra - and intracanal tires for repair of small defects of the dentition in combination with light-cured composite materials. (Borisenko AV "Composite filling materials. M., "Book plus", 1999, str-168).

For the manufacture of such tires or prosthesis carry out the preparation of the abutment teeth. The length of the prepared excavation measure the required length of the strap. With a brush of his moisten the adhesive, removing excess tool. The cavity is etched, treated with an adhesive system and polimerizuet. At the bottom of the cavities is applied and firmly placed a small amount of the composite. Tools carefully laid prepared the lace in the form of the eight are setprimarykey each tooth within 30-40 seconds. Subsequently carry out layer-by-layer filling the cavities of the composite material. On a strip of lace on the defect of dentition form the layers of the artificial tooth. Then finally process the prosthesis is grinded and polished./p>

Certain disadvantages, in the opinion of the author, the method of prosthetics and used in the manufacture of the AMP system GlasSpan", is that:

insufficient strength of the support elements.

- there is a possibility of occurrence of edge cracks;

- lack of strength of the body of the prosthesis;

the small adhesive force of the support elements with abutments;

- the applied system GlasSpan" is a hard rigid ceramic fiber, it is difficult adaptable to the surface of the teeth;

fiber coated with sizing, which impairs its chemical combination with the adhesive;

- cord "GlasSpan" cannot be cut by melting, as is razvlechenie cord, and he acquires a black color.

To avoid such drawbacks, the author proposes a method of manufacturing adhesive bridges to repair small defects of the dentition using fiberglass "Glassarm". The technical result of the invention is to increase the strength of the prosthesis due to prevent it voids, pores and shells, as well as increasing the strength of adhesion of the prosthesis to the abutment teeth. "Glassarm" is a fiberglass cord-sleeve (TRS 9391-001-0110507207-05) with a diameter of 1.5 mm and the thickness of the weave 8.0±1.0 n/cm, made of cord-grip electrotechnical of glass-fibre brand SHS (TU 5952-027-00204961-01) by roasting the last prospect is the temperature of 600° . "Glossary" consists of 16 interwoven strands. "Glossary non-toxic, chemically inert, has no harmful effect (figure 1).

Permitted for use in dental practice for the manufacture of adhesive bridges and/or splinting pathologically mobile teeth. Manufacturer AMP or tire produced according to the standard technique used in dentistry with the use of fibrous materials.

Manufacturer AMP (2-3) is as follows. Carry out the preparation of the abutment teeth under tabs on class II in black. Cavities are located on the chewing and the contact surfaces of the teeth facing the dentition defect. Remove the impression of a high-strength plaster cast model. Duplicate the model. On the duplicated model simulate the flushing space by applying high-strength gypsum on the alveolar bone in the defect area. To do this, on the vestibular surface of the washing space is reduced to nothing, and on the oral surface is modeled with a height of up to 2 mm, thus the inclined plane. Wash the space necessary for self-cleaning or easy cleaning and hygiene of the prosthesis.

The abutments on the working model isolated vaseline or special insulating silicone varnish.

The prepared cavity in oporn the x teeth fill up most of the silicon, will polimerizuet her and after polymerization, remove and cut off part of the silicone mass facing the occlusal surface, so that it is 1 mm was below the edges of the cavity. Cavity models restore almocera with subsequent polymerization. Polymerized ormocer (pad) is removed from the abutment tooth plaster model and remove the silicone mass.

In the prepared cavity contribute unpolymerized ormocer and distribute it on the bottom of the cavity so that its thickness was 0.2-0.3 mm Layer of unpolymerized ormocer impose and high-strength gypsum wash the area of the defect is also of a thickness of 0.2-0.3 mm by means of melting cut a piece of string "Glassarm" length corresponding to four times the length of the defect, including the abutment teeth. Cord impregnated under vacuum with silane and adhesive and placed four times. In ormocer dipped half cut the cord "Glassarm" in the form of a loop, cover it with a layer of unpolymerized ormocer thickness of 0.2-0.3 mm, this layer is placed second half cut the cord "Glassarm" and also enjoy the unpolymerized ormocers. Placed on top of the previously made the pad and press so that it took its original position, press out excess ormocer removed.

Perform light polymerization ormocer on supports who's teeth and location of the defect on the plaster model. Then simulate the intermediate part with the subsequent polymerization, remove the AMP from the plaster model, conduct additional polymerization of each section of the AMP. The AMP is placed in the furnace, maintaining temperature With 200° and a pressure of 5 ATM.

A pin is stuck AMP on the duplicated model using corrective silicone paste, grind, Polish it and fix in the oral cavity to the abutment teeth composite cement and silicone polishers.

The advantages of the proposed method of manufacturing adhesive bridges is:

- due to the proposed method of manufacturing an adhesive bridge is pressing cut the cord "Glassarm" armature, preventing the formation of voids, pores and sinks in the prosthesis;

- achieved the best connection ormocer with "Glassarm";

- increases the strength of adhesion AMP with abutments;

- with this method of manufacturing AMP fiber material Glassarm is located at a distance of 1 mm from the occlusal surface, i.e. the maximum reinforcing effect;

- optic material is located only in the area stretching;

- prevention of the edge cracks;

- increases the strength of the prosthesis;

- "Glassarm" is reinforced, no upper zamaslivatele layer, so well connected sadhasivam, fiberglass can be cut by means of melting, thanks to the weaving cord Glassarm soft and flexible, allowing you to manipulate them in the manufacture of the SFA.

1. Method of making adhesive bridges including the preparation of the abutment teeth, the modeling of a cord of fibrous material United with the composite material of the intermediate part, the polymerization, the fit and fixation of the prosthesis, characterized in that the cast model, duplicate it, on the model on the location of the defect by applying a high-strength gypsum on the alveolar bone in the area of the defect model wash the space with height on the oral surface to 2 mm and tapering off on the vestibular surface of the prepared cavity isolated abutment teeth filled silicone mass, will polimerizuet, remove and cut facing the occlusal surface of the mass to a depth of 1 mm from occlusal surface, restoring the cavity with almocera with subsequent polymerization, remove polymerized ormocer-trim and remove the silicone mass, in the prepared cavity and high-strength gypsum wash the area of the defect contribute unpolymerized ormocer and distribute thickness of 0.2-0.3 mm, cut off part of the fiber cord with a length corresponding to four on the ine defect, including the abutment teeth, the cord is folded in four, half of piece of cord impregnated with silane and adhesive, folded in the form of a loop, immersed in uromacer, top, place a layer of unpolymerized ormocer thickness of 0.2-0.3 mm and placed second part of the segment of cord fiber material in the form of a loop, closed his ormocers and top, pressing, put custom pickguard, squeezing out the excess ormocer remove, hold the light polymerization ormocer, after modeling and polymerization intermediate part of the conduct additional polymerization of each plot, after which the prosthesis pin is stuck and fixed in the mouth.

2. The method according to claim 1, characterized in that as the cord of the fiber material used fiberglass "Glassarm".



 

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