Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/20—Methods or devices for soldering, casting, moulding or melting
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/0003—Making bridge-work, inlays, implants or the like
  • A61C13/0006—Production methods
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C5/00—Filling or capping teeth
  • A61C5/70—Tooth crowns; Making thereof
  • A61C5/77—Methods or devices for making crowns
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/0003—Making bridge-work, inlays, implants or the like
  • A61C13/0022—Blanks or green, unfinished dental restoration parts
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/08—Artificial teeth; Making same
  • A61C13/087—Artificial resin teeth

Definitions

• the invention relates to a method for manufacturing a composite block for the manufacture of a dental prosthesis and to a method for manufacturing a dental prosthesis.
• the invention also relates to a composite block and a dental prosthesis obtained or likely to have been obtained by such methods.
• Composite blocks made by curing a composite paste that is to say comprising a particulate filler, conventionally made of ceramic material or glass, and a resin, conventionally a mixture of monomers, are known.
• this paste is shaped and then cured. After solidification, the resin forms a binder phase, or "matrix", which binds the particles.
• the composite block obtained is then machined to the shape of the desired prosthesis, conventionally by "computer-aided design and machining” or CAD-CAM (Computer Aided Design - Computer Aided Machining).
• the 3M Paradigm M2100 block from 3M is an example of a composite block manufactured in this way.
• An object of the invention is to provide a novel method for improving the properties of dental prostheses, in particular by increasing their mechanical strength and their chemical stability.
• this object is achieved by means of a method of manufacturing a dental prosthesis, this method comprising the following steps:
• step b) the curing is carried out, at least partially, preferably completely, under a pressure greater than 500 bar.
• a method according to the invention makes it possible to manufacture, in a simple manner, composite blocks having a very high mechanical strength.
• the inventor explains the performance obtained by the fact that the pressure applied in step b) makes it possible to create a stress able to compensate for the shrinkage during the hardening of the resin. This results in a decrease in the number of defects.
• the invention also relates to a solid composite mass, a composite block and a dental prosthesis obtained after a step b), a step c) or a step d), respectively, of a method according to invention or may have been manufactured at the end of such steps.
• cervical prosthesis generally means any piece intended to be placed on the teeth of a patient for the purpose of restoring all or part of it in its natural form.
• the dental prostheses manufactured according to the invention may be, for example, peripheral scapes or crowns that are placed on the stump of a natural tooth, or prostheses generally referred to as "inlay” and “onlay” which are intended to reconstruct a partial alteration of a tooth by filling the cavity resulting from the loss of substance of the tooth by a piece of the same shape made by the prosthetist, or even bridges which are prostheses which simultaneously bear on the remaining portions of at least two teeth possibly compensating for one or more of the missing teeth.
• the term “pressure” refers to the high pressure mentioned above and applied to step b). By default, the "pressure” does not refer to "atmospheric pressure”.
• a dental prosthesis according to the invention may be manufactured by a process comprising the steps a) to d) above:
• a paste is prepared by mixing a particulate filler and a resin capable of forming, by curing, a binder phase.
• the particulate filler preferably represents more than 60%, more than 70%, or even more than 80% and or less than 90% of the mass of the pulp.
• the resin and the particulate filler together account for more than 90%, more than 95%, more than 98%, more than 99%, even substantially 100% of the mass of the pulp.
• the particulate fillers and resins currently used to make dental prostheses, particularly by injection, can be implemented.
• the particulate filler comprises, or even consists of, particles made of a material chosen from a metal oxide in the form of glass-ceramic, glass, or crystalline ceramic such as silica, quartz, alumina or mullite, or by a mixture of such particles.
• the particulate filler comprises, or consists of, particles made of a material chosen from a glass of barium aluminosilicate, a glass containing ytterbium fluoride, albite, a mieatetrafluorosilicate, a lithium disilicate, apatite, quartz, MgAkO-i spinel, mullite and zircon, or by a mixture of such particles.
• Particles of the particulate filler may have undergone a silane treatment intended to increase the wettability of their surface by the resin in the liquid state, and in particular to make this surface more hydrophobic.
• this silanation treatment comprises silanization using an alkoxysilane, a halosilane, preferably 3-methacryloxypyropyltrimethoxysilane.
• the particles are dried, preferably at a temperature between 100X and 200 ° C, typically for several hours.
• the silane treatment may for example be carried out in accordance with the process described in US 5,869,548.
• the nature of the resin is not limiting.
• the resin is chemo-polymerizable, heat-curing, or thermoplastic.
• the resin may in particular be chosen from polymerizable resins, especially those described in US Pat. No. 5,869,548, US Pat. No. 5,843,348 and EP 0 701 808.
• the resin is chosen from the following list:
• a monomer resin that is chemopolymerizable or thermopolymerizable preferably a vinylester or acrylic resin.
• the resin may in particular be chosen from the group formed by 2-hydroxyethyl methacrylate, CAS 868-77-9 (HEMA),
• Tetraethylene glycol dimethacrylate CAS 109-17-1 (TEGDMA), 2 5 2-bis- (4- (2-hydroxy ⁇ 3 ⁇ mayÎhacryloyloxy-propoxy) phenyl) propaKe s CAS 1565-94-2 (BIS GMA), 1, 6-Ws (methacryloxy-2alkyl) xylcarbonylamino) -2,4,4-trimethylhexane urethane, (UDMA) CAS 72869-86-4, ethylene glycol dimethacrylate (EGDMA), diethylene glycol > 1-dimethacrylate (DEGDMA), the
• thermoplastic resin in particular chosen from saturated polyesters, and in particular polyethylene terephthalate (PET) and poly (1,4-butyiene terephthalate), CAS 24968-12-5 (PBT), Polycarbonates Poly (bisphenol A carbonate) , CAS 25037-45-0 (PC), bisphenol A-carbonate, and polyamides.
• dibenzoylperoxide CAS 94-36-0 Methyl Ethyl Ketone Peroxide, CAS 1338-23-4, Di-tert-amyl peroxide, CAS 10508-09-5, Di-tert.- butylperoxide, CAS 110- ⁇ 5-4, or Cumene Hydroperoxide, CAS 80-15-9.
• DMA dimethylaniline
• PEA diemylaniline
• DMPT dimethylparallouline
• the dough may also comprise, in a conventional manner, additives facilitating the control of its curing, for example a catalyst and or an accelerator.
• the total mass content of additives is less than 2% of the mass of the dough.
• the dough is shaped, for example in the form of a "brick", a plate, in particular a disk.
• the maximum thickness of a plate according to the invention is preferably less than 30 mm, preferably less than 20 mm, preferably less than 15 mm, and / or greater than 5 mm, greater than 8 mm.
• step b) the paste prepared in step a) is cured so as to form a solid composite mass.
• the temperature and the holding time at this temperature the chemical nature of the resin, and in particular monomers.
• the resin is conventionally polymerized at ambient pressure.
• the retraction resulting from a polymerization at ambient temperature can conventionally lead to a decrease in the volume occupied by the resin of between 6% and 15% of its initial volume. This retraction leads to appearance of defects generally having a size between 35 and 100 microns.
• the paste is subjected to a high pressure, greater than 500 bar, at least until a portion, and preferably all, of this paste has hardened.
• the high pressure makes it possible to compensate, at least partially, the retraction. This results in a very high homogeneity, an increase in density and a reduction in number and size of defects, or even disappearance of defects.
• the mechanical strength is considerably improved.
• the pressure is preferably greater than 600 bar, preferably greater than 800 bar, greater than 1000 bar, greater than 2000 bar, or even greater than 3000 bar, or even greater than 4000 bar.
• the pressure is less than 5000 bar, preferably less than 4000 bar. In a preferred embodiment, the pressure is between 2000 and 3000 bar.
• the pressure is determined so as to produce a decrease in the volume of the dough greater than or equal to that which, at atmospheric pressure, would result from the shrinkage resulting from the curing of the resin.
• the pressure can be set in the following manner, depending on the shrinkage measured at 20 ° C.
• the pressure is exerted isostatically, or "urriaxial". All known methods of pressurization can be used.
• the pressure must be exerted on the paste while the resin is still at least partly, preferably completely, in the liquid state and until it has at least partially hardened.
• all of the resin is cured, preferably polymerized, to more than 30% by weight, preferably more than 50% by weight, preferably more than 80% by weight, preferably more than 99% by weight. in bulk, preferably substantially 100% by weight, before returning to atmospheric pressure.
• the pressure is kept substantially constant until all of the resin has cured.
• the polymerization can be chemical. Preferably, the polymerization is thermal.
• C preferably below 160 ° C, preferably below 150 ° C.
• the polymerization is preferably carried out at a temperature between 60 and 160 ° C, preferably between 60 and 150 ° C.
• the polymerization is preferably carried out at a temperature of between 150 and 220 ° C, preferably between 150 and 200 ° C, preferably between 160 and 200 ° C.
• the maintenance of the temperature and / or pressure preferably lasts more than 0.25 hours, preferably more than 0.5 and / or less than 2 hours, preferably less than 0.75 hours.
• the application of a high pressure at a temperature greater than 150 ° C., preferably greater than 160 ° C. and preferably less than 220 ° C., preferably less than 200 ° C. advantageously makes it possible to open the double bonds.
• the pressure is kept substantially constant, the pressure variation being preferably less than 20%, preferably less than 10%.
• the pressure is kept substantially constant until the resin is polymerized to more than 30% by weight, preferably more than 50% by weight, preferably more than 80% by weight, preferably more than 80% by weight. from 99% by weight, preferably to substantially 100% by weight.
• a single pressurizing operation without return to ambient pressure is carried out to cure the resin.
• the return to ambient pressure is carried out only after cooling of the cured composite mass, preferably to room temperature.
• the solid composite mass may be subjected to a heat treatment suitable for perfecting the polymerization, for example at a temperature between 150 and 180 ° C.
• the solid composite mass results from a thermopolymerization under pressure of the paste.
• the solid composite mass obtained at the end of step b), according to the invention has a hardness greater than 100 Vickers, preferably greater than 120 Vickers, or even greater than 140 Vickers.
• the solid composite mass obtained at the end of step b) has a Young's elastic modulus greater than 5 GPa, measured according to the ISO 10477 standard and / or a three-point flexural modulus, measured according to the ISO standard. 6,872, greater than 100 MPa, preferably greater than 150 MPa, or even greater than 200 MPa.
• steps b) and c) Preferably, no intermediate step is applied between steps b) and c).
• the solid composite mass is cut to form one or more composite blocks adapted to the machines used for the following steps.
• the solid composite mass may be in the form of a plate, preferably of substantially constant thickness.
• the solid composite mass is in the form of a rod.
• the section of this wand may be square, or rectangular, or circular.
• the solid composite mass has at least one planar face.
• the solid composite mass has a convex shape.
• the solid composite mass has at least two parallel faces.
• the smallest dimension of the solid composite mass is preferably less than 30 mm, preferably less than 20 mm, preferably less than 15 mm, and / or preferably greater than 5 mm.
• the largest dimension, or even each dimension, of the solid composite mass is preferably greater than 15 mm, preferably greater than 50 mm, preferably greater than 100 mm.
• the volume of the solid composite mass is preferably greater than 20000 mm 3 , preferably greater than 50000 mm 3 , preferably greater than 100000 mm 3 .
• the solid composite mass can be cut in a plurality of composite blocks, preferably in at least two composite blocks, into at least three composite blocks, preferably into at least five composite blocks, preferably into at least ten composite blocks. preferably in at least twenty composite blocks.
• all the composite blocks from the same solid composite mass are substantially identical.
• the solid composite mass results from pressure thermopolymerization of the paste prepared in step a), and is then cut into at least three composite blocks.
• a composite block has a convex shape.
• a composite block preferably has at least one planar surface, this surface may for example have streaks resulting from a cutting operation by sawing.
• a composite block does not have the shape of a tooth obtained by molding.
• a composite block is preferably of parallelepipedal shape, preferably of cubic form. It can be cylindrical or prismatic.
• the smallest dimension, or even each dimension of a composite block is greater than 5 mm, preferably greater than 10 mm, preferably greater than 20 mm, and preferably less than 40 mm, preferably less than 30 mm.
• the volume of a composite block is preferably greater than 125 mm ", preferably greater than 1000 mm, preferably greater than 5000 mm J, preferably higher than 10000 mm 3, or and preferably less than 100 000 mm 3, of
• step c) is carried out in such a way that the composite block or blocks obtained can be machined by a CAD-CAM device, in particular by a machining device such as the CELAY system of the company. Mikrona or CEREC 3 from the company SIRONA If necessary, one or more organs can be integrated in a composite block to maintain it by such devices.
• the cutting device makes it possible to form a plurality of composite blocks, for example all of identical shape, for example all of the shape of a cube.
• it makes it possible to form, for example in several operations, composite blocks of identical shape by cutting a plurality of composite masses of various dimensions.
• one of the faces of a composite block is bonded to a metal part, this metal part comprising a rod intended to be fixed in a mandrel of the CAD-CAM device, the rod having a flat part for locating and orienting the block composite,
• the composite block is machined so as to form a dental prosthesis.
• the machining of a dental prosthesis is preferably adapted for the prosthesis to adapt to the tooth or teeth to be treated and or to restore and / or reconstruct a patient
• the ratio of the amount of material removed from the composite block by machining on that of the composite block before machining, to form a dental prosthesis is preferably greater than 10%, preferably greater than 30%, preferably greater than 50%, preferably greater than 70%, and / or preferably less than 90%, preferably less than 80%.
• the composite block according to the invention can be made integral with other parts, for example a metal base.
• steps a), b) and c) can be repeated identically, preferably so as to obtain at the end of step c), composite blocks of calibrated dimensions.
• Steps a), b) and c) can for example be performed in one place, for example in workshops of a factory.
• One or more composite blocks may be packaged, then routed to a place where it is (are) machined) as described in step d). This place may be for example the workshop of a dental technician with a machining device to perform step d).
• the particulate filler is a mixture consisting, for 80% by weight, of a barium aluminosilicate glass powder having a particle size of between 0.1 and 5 microns, the 100% complement being a silica powder. colloidal whose particle size is between 20 and 50 rianometers.
• the resin has the following composition, in percentages by weight
• the paste is obtained by mixing 75% by weight of the particulate filler and 25% by weight of the resin.
• the particulate filler is a mixture consisting, for 70% by weight, of a quartz powder 3 ⁇ 3 ⁇ 4 whose particle size is between 0.1 and 2 microns, the 100% complement being a colloidal silica powder whose size particles is between 5 and 75 nanometers.
• This particulate filler was subjected to a silane treatment identical to that of Example 1.
• the resin has the following composition, in percentages by weight:
• the paste is obtained by mixing 80% by weight of the particulate filler and 20% by weight of the resin.
• the paste thus obtained is then cured under a pressure of 1000 bar, by thermopolymerization at 80 ° C for two hours.
• the particulate filler is a mixture consisting, for 50% by weight, of an albite glass ceramic powder NaAISsOg, the particle size of which is approximately 10 ⁇ m, for 20% by weight, of a glass powder of barium akuninosilicate having a particle size of between 0.4 and 1 ⁇ , the 100% complement being a colloidal silica powder having a particle size of between 50 and 100 nanometers.
• This particulate filler was subjected to silanation treatment identical to that of Example 1.
• the resin has the following composition, in percentages by weight:
• the paste is obtained by mixing 70% by weight of the particulate filler and 30% by weight of the resin.
• the paste thus obtained is then cured under a pressure of 2000 bar, by thermopolymerization at 130 ° C for 0.5 hour.
• the particulate filler is a mixture consisting, for 70 by weight, of a glass powder of barium duminosilicate having a particle size of about 1 ⁇ m, for 10% by weight, of a fluoride powder.
• Ytterbium YDF3 whose particle size is about 3 microns, the 100% complement being a colloidal silica powder whose particle size is between 20 and 50 nanometers.
• This particulate filler was subjected to silanation treatment identical to that of Example 1.
• the resin has the following composition, in percentages by weight:
• the paste is obtained by mixing 60% by weight of the particulate filler and 40% by weight of the resin.
• the paste thus obtained is then cured under a pressure of 3000 bar, by mermopolymensation at 180 ° C. for 1.5 hours.
• the particulate filler is a mixture consisting, for 80% by weight, of an alumina powder whose particle size is between 0.3 and 5 ⁇ m, the 100% complement being a colloidal silica powder whose size particles is between
• This particulate filler was subjected to a silanation treatment identical to that of Example 1.
• the resin is a UDMA resin
• the paste is obtained by mixing 90% by weight of the particulate filler and 10% by weight of the resin.
• the particulate filler is a mixture consisting, for 60% by weight, of a mullite powder whose particle size is between 1 and 10 ⁇ m, for 20% by weight, of a silica powder whose particle size is between 0.1 and 1 ⁇ m, the 100% complement being a colloidal silica powder whose particle size is between 20 and 50 nanometers.
• This particulate filler was subjected to a silane treatment identical to that of Example 1.
• the resin has the following composition, in percentages by weight:
• the paste is obtained by mixing 75% by weight of the particulate filler and 25% by weight of the resin.
• the paste thus obtained is then cured under a pressure of 3000 bar, by thermopolymerization at 60 ° C for 2 hours.
• the particulate filler is a mixture consisting, for 60% by weight, of a powder of vitroceramic particles of fluoro tetra mica silicate, the particle size of which is between 1 and 5 ⁇ m, and for 20% by weight of a powder. of zentonium silicate whose particle size is between 0.1 and 0.5 ⁇ , the 100% complement being a colloidal silica powder.
• This particulate filler was subjected to silanation treatment identical to that of Example 1.
• the resin has the following composition, in percentages by weight:
• ME P 1% The paste is obtained by mixing 70% by weight of the particulate filler and 30% by weight of the resin.
• the paste thus obtained is then cured under a pressure of 2500 bar, by thermopolymerization at 90 ° C for 1 hour.
• the invention provides a method for making composite blocks and mechanically strong prostheses. These composite blocks are also very chemically stable, have improved optical properties and are easier to machine than prior composite blocks.
• the invention is not limited by the chemical nature of the dough or by the shape of the solid mass.

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

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• 2010
  • 2010-11-19 FR FR1059519A patent/FR2967568B1/fr active Active
• 2011
  • 2011-11-18 US US13/988,403 patent/US20130277873A1/en not_active Abandoned
  • 2011-11-18 CN CN201180065421.7A patent/CN103313677B/zh active Active
  • 2011-11-18 JP JP2013539388A patent/JP2014506139A/ja active Pending
  • 2011-11-18 EP EP11796820.6A patent/EP2640308A1/de not_active Withdrawn
  • 2011-11-18 WO PCT/IB2011/055178 patent/WO2012066507A1/fr active Application Filing

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