CA2199532A1 - Method for installing a permanent bridge between a pair of abutment teeth - Google Patents

Method for installing a permanent bridge between a pair of abutment teeth

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Publication number
CA2199532A1
CA2199532A1 CA 2199532 CA2199532A CA2199532A1 CA 2199532 A1 CA2199532 A1 CA 2199532A1 CA 2199532 CA2199532 CA 2199532 CA 2199532 A CA2199532 A CA 2199532A CA 2199532 A1 CA2199532 A1 CA 2199532A1
Authority
CA
Canada
Prior art keywords
infrastructure
bridge
abutment teeth
wings
resistant composite
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA 2199532
Other languages
French (fr)
Inventor
Guy Deom
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Deom Design Inc
Original Assignee
Deom Design Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Deom Design Inc filed Critical Deom Design Inc
Priority to CA 2199532 priority Critical patent/CA2199532A1/en
Publication of CA2199532A1 publication Critical patent/CA2199532A1/en
Abandoned legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00Dental prostheses; Making same
    • A61C13/225Fastening prostheses in the mouth
    • A61C13/26Dentures without palates; Partial dentures, e.g. bridges

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

A method for installing a permanent bridge over a gincival crest between a pair of abutment teeth posterior to the canines, comprising a) providing a rigid infrastructure having two wings, the infrastructure being sized to extend in between and inside the abutment teeth; b) processing the abutment teeth to form retentive dental cavities large enough to receive the wings of the infrastructure;
c) applying a resistant composite to the bottom of the infrastructure, curing the resistant composite that is so applied so as to fix the resistant composite to the infrastructure and thus to form a bridge, processing the bridge to remove imperfections and placing each of the wings of the infrastructure into the corresponding cavity to ensure that the so formed bridge fits over the gingival crest;
d) fixing the wings of the infrastructure embedded into the formed bridge to the dental cavities of the abutment teeth by means of an adhesive; and e) filling the occlusal part of the bridge with an additional resistant composite and finishing the bridge to give the bridge the contours of a real tooth.

Description

CA 02199~32 1997-0~-01 METHOD FOR INSTALLING A PERMANENT BRIDGE BETWEEN
A PAIR OF ABUTMENT TEETH

a) Field of the invention The present invention relates to a method for installing a permanent bridge between a pair of abutment teeth posterior to the canines.
b) Brief descriPtion of the prior art In dentistry, there exists a number of well known methods for installing bridgework. These methods are efficient but characterized by high cost, destruction of existing biological material, the necessity of obtaining 15 impressions of the affected area, and treatment that requires several extended visits to the dentist. Therefore, there is a need for a method of installing a dental bridge that overcomes the problems of the existing methods of installing bridgework.

The object of the present invention is to provide a method by which a dental bridge may be installed in a manner that:
- is very economical as compared to the conventional 25 methods;
- requires only one visit to the dentist;
- does not require impression and lab processing; and - does not require destruction of any existing biological material, thereby avoiding posts and/or root canal treatments and/or wall 30 cutting.
In accordance with the invention, this object is achieved with a method for installing a permanent bridge over a gincival crest between a pair of abutment teeth posterior to the canines, which comprises the steps of:

CA 02199~32 1997-0~-01 ._ 2 a) providing a rigid infrastructure having two wings, said infrastructure being sized to extend in between and inside the coronal part of the abutment teeth;
b) processing the abutment teeth to form dental cavities large 5enough to receive the wings of the infrastructure;
c) applying a resistant composite to the bottom of the infrastructure, curing the resistant composite that is so applied so as to fix the resistant composite to the infrastructure and thus form a bridge, processing said bridge to remove imperfections and placing each of said wings of the 10infrastructure into the corresponding cavity to ensure that the formed bridge fits over the gincival crest;
d) fixing the wings of the infrastructure embedded into the bridge to the dental cavities of the abutment teeth by means of an adhesive;
e) filling the occlusal part of the bridge with an additional 15resistant composite and finishing the bridge to give said bridge the contours of a real tooth.
The method according to the invention is particularly well adapted for use when the abutment teeth (molars or prepolars) have fillings present, which face towards the infrastructure of the bridge to be installed.
20In such a case, the method according to the invention comprises the basic steps of:
(a) providing a rigid infrastructure having opposite wings, the infrastructure being long enough to extend in between and over part of the abutment teeth;
25(b) removing fillings from the abutment teeth to leave slightly retentive dental cavities;
(c) applying a resistant composite to the infrastructure from successive angles until a bridge is formed, and inspecting the bridge thus formed to remove imperfections;
30(d) affixing the wings of the infrastructure to the dental cavities;
and (e) applying additional resistant composite to the occlusal portion of the bridge and finishing the bridge until it resembles a tooth.

CA 02199~32 1997-0~-01 The method according to the invention makes use of an infrastructure whose size and shape depend on the position and shape of the abutment teeth. This infrastructure can be selected among three types of infrastructures that can be sold as a kit, depending on which tooth is to be 5 replaced (molar or premolar).

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be better understood upon reading the following 10 detailed and non-restrictive description of it, made with reference to the accompanying drawings in which:
Figure 1 is a lateral view in transcoronal transparency of a molar infrastructure of the universal type for use in the method according to the invention, the illustrated infrastructure being shown in installed position;
Figure 2 is an overhead "occlusal" transcoronal view of the molar infrastructure shown in Figure 1;
Figure 3 is a lateral view in transcoronal transparency of a molar infrastructure of precontoured type, shown in installed position;
Figure 4 is an overhead "occlusal" transcoronal view of the molar infrastructure shown in Figure 3;
Figure 5 is a lateral view in transcoronal transparency of a premolar infrastructure, shown in installed position;
Figure 6 is an overhead "occlusal" transcoronal view of the premolar infrastructure, shown in Figure 5;
Figure 7 is a lateral view of a premolar infrastructure, having one wing inserted into an opening made in an adjacent premolar;
Figure 8 is a lateral view of a infrastructure having one wing installed in a dental cavity made in the occlusal part of an adjacent tooth and another wing installed in a dental cavity in the form of an opening made in one side of the other adjacent tooth; and Figure 9 is a perspective view of a bridge prepared in according with the invention, just before it is fixed to the adjacent teeth.

CA 02199~32 1997-0~-01 ~ 1 99532 DETAILED DESCRIPTION OF THE INVENTION

As briefly disclosed hereinabove, the method according to the invention comprises five basic steps. Each of these steps will now be described in greater detail.

Step (a): Drovidina a riaid inrta:~lructure The first step of the method according to the invention consists of providing a rigid infrastructure 1 which has two wings 3, 5 and is long 10 enough to extend in between and inside the coronal part of the abutment teeth T,T' between which the permanent bridge must be installed.
As aforesaid, the bridge is intended to be used in replacement situation posterior to canines. Thus, it is intended to be installed between premolars or molars provided that such teeth have fillings that face towards 15 the infrastructure to be installed. Indeed, the method according to the invention is not desirable when one or both abutment teeth is or are intact. In such a case, the primary choice should preferably be a butterfly or Maryland bridge or, if money and receptive bone is no object, an implant. The adjacent teeth should also not be of different extreme levels due to a malocclusion.
The infrastructure 1 is in the form of an elongated bar made of a strong biocompatible metallic alloy ~BIOSIL F, INTERNATIONAL STANDARD
ISO 6871). Its actual shape and size depend on position where it is intended to be installed.
In most situations involving molar teeth, use can be made of a 25 molar infrastructure 1 of the "universal" type, as shown in Figures 1 and 2.
This universal molar infrastructure preferably has the following dimensions:
length L - about 23 mm central thickness T -- about 2 mm wing thickness t = about 1 mm width W = about 3 mm In some very specific situations involving molar teeth, use can be made of a molar infrastructure 1 of precontoured shape, as shown in Figures CA 02199~32 1997-0~-01 3 and 4. This precontoured molar infrastructure preferably has the following dimensions:
length L = about 23 mm central thickness T = about 3 mm wing thickness t = about 1.5 mm cental width W = about 6 mm wing width w = about 3 mm In situations involving premolar infrastructure teeth, use can be made of a premolar infrastructure 1 as shown in Figures 5 and 6. This premolar 10 infrastructure preferably has the following dimensions:
length L = about 1 9 mm central thickness T = about 2.75 mm wing thickness t = about 1.25 width W = about 2 mm In some other situations, it is also possible to use such a bridge to replace first premolars in quadrants using a premolar infrastructure. One of the essential conditions for this option is to have a significant filling on thedistal of the canine which is retentive, and large enough to be able to insert apremolar infrastructure. For this option, the second premolar should also have 20 a mesial-occlusal or mesial-occlusal-distal filling.
Of course, in use, one must choose amongst the three types of infrastructure disclosed hereinabove, the one that is the best adapted for the particular bridge to be installed. Such a choice can be made after the abutment teeth T,T' have been processed as will be described hereinafter (see step ~b)), 25 and thus are provided with dental cavities C,C' adapted to receive the wings 3,5 of the infrastructure 1.
If the wings 3,5 of the selected infrastructure 1 are too long and/or too large and do not move down to the bottom of the dental cavities C,C', the size of these wings can be modified with a balloon-shaped bur (not 30 shown), until they may properly be seated. In use, if is preferable to leave 1.5 to 2 mm free at the occlusal in order to maximize aesthetics by hiding the infrastructure. It is also preferable to etch the modified infrastructure 1 witha sand-jet apparatus like the one sold under the trademark MICRO-ETCHER."

CA 02199~32 1997-0~-01 Step (b): Processin~ the abutment teeth to form dental cavities The second step of the method according to the invention consists of removing the composite or amalgam fillings from the abutment 5 teeth T,T' and then processing the teeth in order to form therein dental cavities C,C' of a sufficient size to accommodate the wings of the infrastructure chosen in step (a). The tooth processing may include cutting portions of the occlusal parts of the teeth, but one must always remember that it is preferable to modify the infrastructure in specific situations rather than being aggressive10 by cutting unnecessarily intact tooth structure.
In situations where only one of the abutment teeth has a filling, the other abutment tooth should be processed in order to form therein the requested cavity in which the corresponding wing of the infrastructure may rest. In some particular situations like the one shown in Fig. 8, one may create15 an opening C" in the side of the tooth facing the gincival crest in order to receive one of wings of the infrastructure 1. Of course, this opening must be large enough to allow the wing of the infrastructure to be inserted therein.
In all cases, in order to ensure that the bridge does not become loose and/or fall out, the dental cavities C,C' should be made slightly retentive, 20 as is shown in Fig. 7.

Step (c): aPPlvinq comPosite to the Pontic The third step of the method according to the invention consists of applying a resistant composite 7 to the infrastructure 1, curing this resistant 25 composite that is so applied so as to fix the composite to the infrastructureand thus to form a bridge, processing the bridge to remove imperfections and placing each of the wings 35 of the infrastructure 1 into the corresponding cavities C,C' to ensure that the so formed bridge fits over the gincival crest.
This step actually corresponds to the preparation of the 30 underneath part of the bridge. The rough bridge that is so obtained is illustrated in Fig. 9.
The resistant composite that can be used in this step is known and commonly available. By way of example, reference can be made to the CA 02199~32 1997-0~-01 21 ~532 highly resistant composites sold under the trademarks Z100, HERCULITE, SPECTRUM or GLACIER.
Preferably, prior to the application of the resistant composite to the infrastructure, a layer of primer-adhesive can be applied with a brush to the same and cured according to the manufacturer's specifications.
Preferably also, prior to the application of the resistant composite to the pontic, an opaquer can be applied to the occlusal surface of the infrastructure to hide the metallic aspect of the infrastructure and enhance theaesthetic appearance of the bridge. To verify that any excess of so applied 10 opaquer has not altered the fit of the infrastructure and does not hinder insertion of the infrastructure into the bottoms of the dental cavities, the infrastructure can be reinserted into the dental cavities.
In practice, a first amount of resistant composite can be applied to the first gingival portion of the infrastructure while the same is hand-held.15 Care must be taken not to apply composite to the portions of the infrastructure that will be close to the abutment teeth T,T'.
The infrastructure to which the composite has been so applied forms a pontic that can be positioned again with the dental cavities C,C' and pressed therein with a pair of tweezers to make it sure that the bridge fits.
In such a position, an additional amount of resistant composite can be applied to the buccal and lingual sides of the infrastructure. The same can be removed again and a further quantities of composite can be applied to its underside to make it sure that there is a slight excess of composite on the buccal and lingual sides.
After further reinsertion and removal of the pontic, the gingivomesial and gingivodistal angles under the pontic can be filled in with the same resistant composite, thereby creating the requested rough bridge (see Fig. 9).
The so created rough bridge is then positioned firmly against the 30 bottom of the dental cavities C,C' and a wax carver can be passed over the mesial, distal and abutment tooth joint to ensure that no composite material has fallen under the retentive part of the tooth.

CA 02199~32 1997-0~-01 21 ~532 After it has been verified that no resistant composite remains under the retentive gingivoaxial part of the abutment teeth T,T', the composite is cured. The bridge is then removed and examined. The resistant composite that has been added to the pontic should be in the form of a saddle closely 5 fitted to the gums and close to the gingival ridge. Of course, any visible imperfections (bumps, bubbles,...) should be corrected.
Preferably, the bridge that has been so prepared should be reinserted in the dental cavities C,C' and an attempt should be made to pass dental floss through the sides of the gum cavity near the abutment teeth. If 10 there is difficulty in passing dental floss through, the underneath portion of the near the abutment teeth should be polished until dental floss can easily be passed through, thereby allowing for proper oral hygiene techniques to be employed .
It is worth mentioning that, normally, it is up to a dental 15 technician to fabricate the requested bridge from impressions taken by a dentist. In accordance with the invention, it is the dentist who manufactures the bridge, and more especially the part of the bridge that is underneath the pontic.

20 Step (d): fixing the bridqe The fourth step of the method according to the invention consists of fixing the bridge prepared in step (ej in the dental cavities C,C'.
Preferably, prior to inserting the wings 3,5 projecting from the bridges into the dental cavities C,C', said cavities can be prepared so as to be25 as secure as possible, by acid-etching treatment and application of a glass ionomer liner/base. Similarly, tissues which come into contact with the bottom of the bridge may be treated to remain healthy. In practice, the dental cavitiesC,C' should be prepared as securely as the situation warrants with care taken to avoid contamination. If the cavity preparation is a medial-occlusal-distal, a30 clear plastic matrix should be used, as usual, rehabilitation of cavities in such situations .
Then, a fine layer of a known adhesive 9 (see Fig. 7) like the dual-cure composite sold under the trademark VARIO-LINK or any other dual CA 02199~32 1997-0~-01 21 99~32 '_ g cure composite, should be applied and cured beneath the wings of the bridge.
As aforesaid, the dual-cure composite 9 used as an adhesive can be mixed and spread over the bottom of the dental cavities C,C'. Then, each wing 3,5 of the bridge is inserted into the dental cavities C,C' and adjusted 5 rapidly so as to be seated properly. The seating of the bridge is accomplishedby means of the automatic hold of the dual-cure composite. Excess dual-cure composite at the external-gingival angles that flows out when the is "pushed"
into the bottom of the dental cavities, should be removed by means of a wax carver or round periodontal probe. Hardening of the dual-cure composite may 10 be accelerated by curing from the occlusal surface.

Step (el: finishing the occlusal Portion of tooth The fifth and last step of the method according to the invention consists of finishing the occlusal portion of the tooth.
To do so, an additional amount of resistant composite 7 can be added to the top of the wings 3,5 of the bridge in the dental cavities of the abutment teeth T,T' (see Fig. 7). The occlusal of the teeth can then be sculptured and fine finished.
Finally, the occlusal part of the pontic can also be filled in with 20 the same resistant composite, sculptured and fine finished.
When sculpturing and fine finishing the occlusal portion, the following precautions should be taken relative to occlusion and morphology.
Canine guidance should be enhanced and balancing contacts avoided on the pontics'lingual or palatal cuspid; the cuspids of the teeth should be sculptured25 rounder than is customary; and the should not be made to large in the buccal- lingual region.
A number of advantages accrue from the method according to the invention.
First of all, the biological cost is minimal since the pulp and nerve 30 tissue are conserved, dentin within the root canal is preserved, the buccal and lingual enamel are preserved and no wall cutting is required.
Secondly, the method according to the invention is very economical as compared to the methods associated with traditional bridges CA 02199~32 1997-0~-01 2 i 9q532 ~ 10 and implants which require several visits to the dentist's office and dental impressions that give rise to associated laboratory costs.
Thirdly, the method according to the invention is faster than the traditional methods of installing bridgework because the bridge can be installed5 during one visit, thereby reducing the chairside time for the patient.
Additionally, the root canal treatment associated with many methods of installing bridgework is unnecessary.
Fourthly, the precision of adaptation afforded by this method is very good.
Fifthly, the bridge that is created is easy to repair. Chips, dents, and other damage may be repaired by reapplying composite to the affected area.
While the present invention has been described in great detail, it will be understood that obvious modifications may become apparent to those 15 of ordinary skill in the art.

Claims (20)

1. A method for installing a permanent bridge over a gincival crest between a pair of abutment teeth posterior to the canines, comprising:
a) providing a rigid infrastructure having two wings, said infrastructure being sized to extend in between and inside the abutment teeth;
b) processing the abutment teeth to form retentive dental cavities large enough to receive the wings of the infrastructure;
c) applying a resistant composite to the bottom of the infrastructure, curing the resistant composite that is so applied so as to fix the resistant composite to the infrastructure and thus to form a bridge, processing said bridge to remove imperfections and placing each of said wings of the infrastructure into the corresponding cavity to ensure that the so formed bridgefits over the gingival crest;
d) fixing the wings of the infrastructure embedded into the formed bridge to the dental cavities of the abutment teeth by means of an adhesive; and e) filling the occlusal part of the bridge with an additional resistant composite and finishing the bridge to give said bridge the contours of a real tooth.
2. The method of claim 1 wherein the infrastructure provided in step a) is a universal molar infrastructure.
3. The method of claim 1 wherein the infrastructure provided in step a) is a precontoured molar infrastructure.
4. The method of claim 1 wherein the infrastructure provided in step a) is a premolar infrastructure.
5. The method of claim 1 wherein step a) also comprises modifying the wings of the infrastructure with a balloon-shaped bur.
6. The method of claim 1 wherein step b) comprises removing filings from said abutment teeth and cutting portions of the occlusal parts of said teeth to define the retentive dental cavities in which the wings of the infrastructure may rest.
7. The method of claim 1 wherein step b) comprises creating an opening in one side of one of said abutment teeth facing the gingival crest, said opening being large enough to allow one of the wings of the infrastructure to be inserted therein.
8. The method of claim 1 wherein prior to carrying out step c), a layer of primer adhesive is applied to the infrastructure.
9. The method of claim 1 wherein prior to carrying out step c), a layer of opaquer is applied to the occlusal surface of the infrastructure to maximize aesthetics.
10. The method of claim 1 wherein prior to carrying out step d), the bridge is removed, dental floss is inserted through the sides of the gumcavity and the bridge is reinserted to make sure that dental floss may pass in between the bridge and the abutment teeth once the installation is complete.
11. The method of claim 1 wherein prior to carrying out step d), a fine layer of adhesive is cured on the side of the bridge that comes into contact with the gincival crest.
12. The method of claim 6, wherein:
prior to carrying out step c), a layer of primer adhesive is applied to the and a layer of opaquer is applied to the occlusal surface of the to maximize aesthetics; and
13 prior to carrying out step d), the bridge is removed, dental floss is inserted through the sides of the gum cavity and the bridge is reinserted to make sure that dental floss may pass in between the bridge and the abutment teeth once the installation is complete.

13. The method of claim 12 wherein the infrastructure provided in step a) is a universal molar infrastructure.
14. The method of claim 12 wherein the infrastructure provided in step a) is a precontoured molar infrastructure.
15. The method of claim 12 wherein the infrastructure provided in step a) is a premolar infrastructure.
16. The method of claim 7, wherein:
prior to carrying out step c), a layer of primer adhesive is applied to the infrastructure and a layer of opaquer is applied to the occlusal surface of the infrastructure to maximize aesthetics; and prior to carrying out step d), the bridge is removed, dental floss is inserted through the sides of the gum cavity and the bridge is reinserted to make sure that dental floss may pass in between the bridge and the abutment teeth once the installation is complete.
17. The method of claim 16 wherein the infrastructure provided in step a) is a universal infrastructure.
18. The method of claim 16 wherein the infrastructure provided in step a) is a precontoured molar infrastructure.
19. The method of claim 16 wherein the infrastructure provided in step a) is a premolar infrastructure.
20. A method for installing a permanent bridge in a gingival crest between a pair of abutment teeth posterior to the canines, comprising:
(a) providing a rigid infrastructure having opposite wings, the infrastructure being long enough to extend in between and over part of the abutment teeth;
(b) removing fillings from the abutment teeth to leave slightly retentive dental cavities;
(c) applying composite to the infrastructure from successive angles until a bridge is formed, and inspecting the bridge thus formed to remove imperfections;
(d) affixing the wings of the infrastructure to the dental cavities;
and (e) applying an additional resistant composite to the occlusal portion of the bridge, and finishing the bridge until it resembles a tooth.
CA 2199532 1997-03-07 1997-03-07 Method for installing a permanent bridge between a pair of abutment teeth Abandoned CA2199532A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA 2199532 CA2199532A1 (en) 1997-03-07 1997-03-07 Method for installing a permanent bridge between a pair of abutment teeth

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CA 2199532 CA2199532A1 (en) 1997-03-07 1997-03-07 Method for installing a permanent bridge between a pair of abutment teeth

Publications (1)

Publication Number Publication Date
CA2199532A1 true CA2199532A1 (en) 1998-09-07

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA 2199532 Abandoned CA2199532A1 (en) 1997-03-07 1997-03-07 Method for installing a permanent bridge between a pair of abutment teeth

Country Status (1)

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CA (1) CA2199532A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1023877A3 (en) * 1999-01-26 2001-05-09 Eastflex Corp. Improved intracoronally supported pontic

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1023877A3 (en) * 1999-01-26 2001-05-09 Eastflex Corp. Improved intracoronally supported pontic

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