GB2503009A

GB2503009A - Dental Bridge

Info

Publication number: GB2503009A
Application number: GB1210531.8A
Authority: GB
Inventors: Steven Robertson
Original assignee: Individual
Current assignee: Individual
Priority date: 2012-06-14
Filing date: 2012-06-14
Publication date: 2013-12-18
Also published as: GB201210531D0

Abstract

A dental bridge system 38 comprises spaced apart natural teeth 40, 42, each having a natural crown (52) and a root. At least one of the natural teeth (40, 42) is canted so as to present a sloping occlusal surface (44) on the crown. A pontic 12 is interposed between the said neighbouring natural teeth and a bridge element 14 bonds the pontic 12 to the neighbouring natural teeth. The bridge element 14 extends as an onlay, at least in part, onto the neighbouring sloping occlusal surface. Preferably it tapers in a converging direction, away from the pontic 12, so that the bridge element 14 provides the neighbouring said natural tooth 42 with a reoriented occlusal surface (68). The reoriented occlusal surface is preferably a relevelling of the sloping occlusal surface, whereby a patient's dentition or bite can be corrected. A dental bridge 10 for use in such a system and a method of using a dental bridge 10 to repair a patient's dentition or bite are also provided.

Description

I

Improvements In Or Relating To A Dental Bridge The present invention relates to a dental bridge system, a dental bridge for use in such a system, and to a method of using a dental bridge to repair a patient's dentition or bite.

Dental bridges are well known and come in various forms, such as a traditional fixed bridge, a Maryland bridge, and a cantilever bndge. The most common form is a traditional fixed bndge which comprises two porcelain crowns anchored to prepared neighbouring support teeth, a pontic interposed between the porcelain crowns, and bio-compatible metal framework which interconnects the porcelain crowns and the politic across their rear or lingual faces. The natural crowns of the neighbouring support teeth are ground away to form an abutment post for receiving the porcelain crowns, and as such a substantial amount of preparation and discomfort on the part of the patient is required prior to the fitting of the bridge.

The Maryland bndge dispenses with the need for the porcelain crowns and can be utilised providing the neighbouring support teeth are suitably healthy and strongly rooted. The pontic is foimed with metal framework across its rear or lingual surface, and the framework is bonded to the adjacent lingual surfaces of the neighbouring support teeth using a dental adhesive.

The cantilever bridge can be of the traditional variety or of the Maryland variety, but is really only appropriate for areas of lower stress, such as the lower front teeth. A cantilever bridge is required when there is only one suitable supporting tooth present on a side of an empty gap. The pontic is anchored to one or more of the natural teeth extending from one side of the pontic.

The problem associated with the traditional fixed bridge is that the fitting process is relatively long winded and arduous for the patient. The natural crowns of the neighbouring support teeth must be ground down to form an abutment post for receiving the artificial crown thereon. The artificial crowns and the pontic have to be formed, and then interconnected by metal framework. Fitment then has to take place using a temporary cement to allow checking for comfort and alignment. Once bedding in has taken place and any adjustments implemented, the crowns with attached bridge can be permanently fixed in place using a permanent cement.

The Maryland bridge simplifies a number of these proNems in terms of reduced preparation time, but in turn cannot deal with an uneven or offset dentition or bite caused by the natural support teeth tilting over time into the gap left by the removal of the intermediate tooth.

The present invention seeks to provide a solution to these problems.

According to a first aspect of the invention, there is provided a dental bridge system comprising spaced apart natural teeth having a natural crown and a root, at least one of the natural teeth being canted, the canted natural tooth having a sloping occlusal surface on the crown, a pontic interposed between the said neighbouring natural teeth, and an bndge element which bonds the pontic to the neighbouring natural teeth, characterised by the bridge dement being at least in part an onlay extending onto the neighbouring sloping occlusal surface and away from the pontic, so that the bridge element provides the neighbouring said natural tooth with a reoriented occlusal surface.

Preferable and/or optional features of the first aspect of the invention are set forth in claims 2 to 11, inclusive.

According to a second aspect of the invention, there is provided a dental bridge for use in a dental bridge system in accordance with the first aspect of the invention, the dental bridge comprising a pontic and an bndge element being at least in part an onlay for spanning onto a sloping occlusal surface of a neighbouring canted natural tooth, the bridge element extending away from the pontic so that, in use, the said sloping occlusal surface is reoriented.

Preferable andlor optional features of the second aspect of the invention are set forth in claims 14 to 18, inclusive.

According to a third aspect of the invention, there is provided a method of using a dental bridge to repair a patient's dentition. the method comprising the steps of: a] locating a pontic between two spaced apart natural teeth having a natural crown and a root, at least one of the natural teeth being canted; and b] bonding the pontic to the sloping occlusal surface of the canted neighbouring natural tooth using a dental adhesive, wherein the dental adhesive forms an bridge element extending at least in part as an onlay from a proximal edge of the occiusal surface adjacent to the pontic towards a distal edge, so that the proximal surface is built up to or substantially to a level of the distal cdgc.

Preferable and/or optional features of the third aspect of the invention are set forth in claims 21 to 27, inclusive.

The invention will now be more particularly described, by way of example only, with reference to the accompanying drawings, in which: Figure 1 shows a side elevational view of one embodiment of a dental bridge, in accordance with the second aspect of the invention; Figure 2 shows the dental bridge of Figure 1 when in use and forming part of a dental bridge system in accordance with the first aspect of the invention; Figure 3 shows a cast of a paticnt's lower gum and teeth, viewed from the buckle or facial side, whereby a canted second molar can be seen, a first molar has been lost, and a second premolar is now unsupported and starting to drift; Figure 4 is similar to Figure 3, but showing a cast of the patient's upper gum and teeth on the lower teeth and forming the patient's dentition; Figure 5 is similar to Figure 4, but taken from the lingual side; Figure 6 is a plan view of the dental bridge of Figure 1, applied to the lower teeth shown in Figure 3; Figure 7 is a perspective view from above and to the lingual side of the dental bridge of Figure 1, shown applied in Figure 6; Figure 8 is a side elevational view from the buckle or facial side of the dental bridge applied as in Figure 6; Figure 9 is a side elevational view similar to Figure 8, but from the lingual side; and Figure 10 is a side elevational view from the buckle or facial side, similar to Figure 8, but including the cast of the upper gum and teeth to show the improved dentition.

Referring firstly to Figure 1 of the drawings, there is shown one embodiment of a dental bridge 10 which comprises a pontic 12 and an adhesive bridge 14. The potitic 12 is preferably a molar or premolar, but the invention is also applicable to an incisor and canine. The pontic 12 also may be adapted for location in a patient's upper or lower jaw, although preferably location is in the lower jaw which is typically subjected to less stress during use.

The adhesive bridge 14 forms two opposing mesial and distal bridge portions i6, 18 being at least in part respective onlays and which extend from the mesial and distal surfaces 20, 22 of the pontic 12, respectively. A base 24 of the bridge portions 16, 18 may also extend from the lingual or inwardly facing surface 26 of the pontic 12.

Each bridge portion 16, 18 defines in part first and second bridge occlusal surfaces 28, which are adjacent to the pontic occlusal surface 32 and generally coplanar therewith.

A lower surface 34 of each bridge portion 16, 18 also tapers generally upwardly from the respective mesial and distal surfaces 20, 22 of the pontic 12 to a distal free end 36 thereof.

Preferably, the distal free end 36 of each bridge portion 16, 18 is defined by the intersection of the respective bridge occlusal surface 28, 30 and its lower surface 34.

However, in the case of natural tooth damage, the taper may be truncated at the distal free end 36. fit both cases, the bridge portions 16, 18 are substantially wedge-shaped in a crown-to-root plane of the pontic 12 extending through the mesial and distal surfaces 20, 22.

Preferably, the adhesive bridge is formed from a dental adhesive, being a fibre-reinforced natural tooth-coloured resin.

A dental bridge system 38 can thus be provided which utilises the dental bridge 10 described above and two neighbouring natural teeth 40, 42 which are spaced apart by the omission of the natural tooth being replaced by the pontic 12. The said system 38 relies on the canting or tilting of at least one of the neighbouring teeth 42, due to the gap left by the missing tooth. As such, generally the neighbouring natural teeth 40, 42 will bc molars or a molar and a prcrnolar, and thc pontic 12 will bc a molar or a prcmolar. In the example of the dental bridge system 38 shown in Figure 2, the neighbounng natural teeth 40, 42 are the first premolar and the first molar of the lower jaw, and the pontic 12 is the second premolar.

The pontic 12 locates in the space between the neighbouring natural teeth 40, 42. At least one of the teeth 42, in this case being the first molar, is canted or tilted in the mesial direction to present a sloping occlusal surface 44 towards the pontic 12. The distal bridge portion 18 extends from the distal surface 22 of the pontic 12 onto the sloping occlusal surface 44 of the canted first molar 42. The wedge-shaped taper of the distal bridge portion 18 converges in the mesial-distal direction in substantiafly two mutually perpendicular planes. The upper mesial edge 46 of the canted first molar 42 is thus effectively raised back to or substantially to its original level by the distal bridge portion 18. Due also to the substantially level bridge occlusal surface 30 of the distal bridge portion 18. the or substantially the entire occlusal surface 44 of the first molar 42 is relevelled without having to reposition the entire natural tooth 42. See the raised mesial edge 48 in Figure 8.

By forming the distal bridge portion 18 of the dental adhesive, little or no preparation of the neighbouring natural tooth 40, 42 is required for bonding to take place. Addifionally.

the bridge occlusal surface 30 of the distal bridge portion 18 can be contoured to match or substantially match the contounng of the portion of the natural occlusal surface 44 which it overlies.

Similarly, the mesial bridge portion 16 spans between the pontic 12 and the neighbouring natural first premolar 40. The first premolar 40 may be canted, tilted, upright or substantially upright, and this positioning affects the degree of tapering of the mesial bridge portion 16. Even if the tapering is not as great as that of the distal bridge portion i8, the distal bridge portion 18 can hold the pontic i2 suitably rigidly, acting as a primary supporting locator, with the mesial bridge portion 1 6 forming a secondary supporting locator.

The mesial bridge portion 16, as with the distal bridge portion 18, forms at least in part the occiusal surface 50 of the neighbouring natural tooth 40.

Such a dental bridge system 38 therefore utilises two spaced part natural teeth 40, 42 having a root and crown 52 and at least one of which is caffled, and a pontic 12 which is interposed therebetween. The mesial and distal bridge portions 16, 18 extend onto the neighbouring occiusal surfaces 44, 50. Due to the tapering of the mesial and distal bridge portions 16, 18 in two substantially mutually perpendicular directions, the sloping occiusal surface 44 of the neighbouring natural tooth 42 is relevelled. As a result of this reorientation, the patient's dentition or bite can be locally reformed or corrected.

In use, a dental cast 54 is taken of the patient's lower and upper teeth and gums 56, 58 in the normal manner, and the existing dentition can be checked. As can be seen in Figures 3 to 5. the second premolar of the lower jaw is missing, the neighbouuring first molar 42 in the row of teeth, due to the lack of support of the second premolar has tilted into the gap 60 vacated by the second premolar. The first prernolar 40 is also unsupported and will likely also tilt in due course.

The pontic 12 is formed by a dental lab in a normal manner, and in this case may be rootless. Once the pontic 12 is located in the gap 60 between the two neighbouring natural teeth 40, 42, as shown in Figures 6 to 8, the adhesive bridge 14 is applied without or substantially without preparation of the neighbouring rooted natural teeth 40, 42. The mesial bridge portion 16 is attached to the mesial surface 20 of the pontic 12.

spans between the pontic 1 2 and the cl-own 62 of the first prernolar 40, and tapers upwardly as it reaches and overlies at least pail of the occhisal surface 50 of the first premolar 40. The bridge occlusal surface 28 of the mesial bridge portion 16 as an onlay builds up at least part of the upper dista' edge 64 of the first premolar 40, thereby not only supporting the pontic 12 at its mesial side, but also relevdlling the occlusa surface of the first premolar 40.

The distal bridge portion 18 is attached to the distal surface 22 of the politic 12, spans between the politic 12 and the crown 66 of the first molar 42, and again tapers upwardly as it reaches and overlies at least part of the sloping occlusal surface 44 of the first molar 42. This supports the pontic 12 at its distal side and importantly, due to the generally level bridge occlusal surface 30 and the upwardly sloping lower surface 34, as an onlay builds up the mesial edge 46 of the sloping occlusal surface 44 of the canted first molar 42.

The bridge occiusal surfaces 28, 30 of the mesial and distal bndge portions 16, 18 form at least in part reoriented occlusal surfaces 68 of the natural teeth 40, 42, and are profiled to match or substantially match the occlusal surfaces 44, 50 of the neighbouring natural teeth 40, 42. During application of the adhesive bridge 14, the patient's dentition or bite can be reformed by analysing the seating of the upper jaw on the lower jaw, as shown in Figures 9 and 10. The mesial and distal bridge portions 16, 18 can be built up accordingly, thereby not only supporting the pontic 12 but also reorienting and relevelling the original occlusal surfaces 44, 50 of the first molar 42 and the first premolar 40, as necessity dictates.

Although an adhesive bridge is described above and is particularly convenient in the current situation, any suitable bridge element can be provided. For example, it is envisaged that the bridge element could be formed using a CAD modelling system from a suitable bio-compatible dental metal, such as titanium, ceramic or other material. CNC machining or laser cutting methods could be used to form the bridge element from the solid material, instead of using the described adhesive.

In the event that one of the neighbouring natural teeth is in a substantially normal orientation, in other words, not being particularly canted or tilted, then that natural tooth may be prepared to accept the bndge element extending from the adjacent side of the pontic. To this end, the said natural tooth may have a channel or recess formed in its occlusal surface whereby the bridge element can be received therein as a recessed or inlaying onlay so as to be at least substantially flush with the respective occlusal surface.

In this way, the pontic is supportable from both sides by oppositely extending bridge elements which extend onto the adjacent natural teeth at or through the occlusal surfaces.

Although preferably tapering in a converging direction away from the pontic, the adhesive bridge may not need to taper depending on the structure of the neighbouring natural teeth.

Additionally, although in the above described embodiments only a single pontic is utilised, two or more pontics can be connected together with each end pontic being connected to an adjacent natural tooth in the row via the above described overlying adhesive bridges.

It is thus possible to provide a dental bridge system which utilises a pontic, neighbouring natural support teeth, at least one of which is canted or tilted, and an adhesive bridge which extends from the pontic onto an occlusal surface of the neighbouring support teeth. It is also possible, by utilising a neighbouring natural tooth which presents a sloping occlusal surface towards the pontic, to locally rectify a patient's dentition or bite.

The embodiments described above are provided by way of examples only, and vanous other modifications will be apparent to persons skilled in the field without departing from the scope of the invention as defined by the appended claims.

Claims

Claims 1. A dental bridge system comprising spaced-apart natural teeth having a natural crown and a root, at least one of the natural teeth being canted, the canted natural tooth having a sloping occiusal surface on the crown, a pontic interposed between the said neighbouring natural teeth, and a bridge element which connects the pontic to the neighbouring natural teeth. characterised by the bridge element being at least in part an onlay extending onto the neighbouring sloping occlusal surface and away from the pontic, so that the bridge element provides the neighbouring said natural tooth with a reoriented occlusal surface.
2. A dental bridge system as claimed in claim 1, wherein the bndge element is an adhesive bridge.
3. A dental bridge system as claimed in claim 1 or claim 2, wherein the bridge element tapers in a converging direction away from the pontic.
4. A dental bridge system as claimed in claim 3, wherein the tapering of the bridge element is in two mutually perpendicular directions.
5. A dental bridge system as claimed in any one of c'aims 1 to 4, wherein the sloping occlusal surface slopes towards the pontic.
6. A dental bridge system as claimed in any one of claims 1 to 5, wherein both natural teeth are canted towards the pontic, so as to each provide said sloping occlusal surface.
7. A dental bridge system as claimed in any one of claims 1 to 6, wherein the sloping occlusal surface of the natural crown is at least substantially unprepared.
8. A dental bridge system as claimed in any one of claims 1 to 7, wherein the adhesive is a fibre-reinforced natural tooth-coloured resin.
9. A dental bridge system as claimed in any one of claims 1 to 8, wherein the said reorientation of the occlusal surface is at least substantially a relevelling.
10. A dental bridge system as claimed in any one of claims I to 9, wherein each natural tooth is one of a molar and a premolar.
11. A dental bridge system as claimed in any one of daims I to 10, wherein the pontic is one of a molar and a premolar.
12. A dental bridge system substantially as hereinbefore described with reference to the accompanying drawings.
13. A dental bridge for use in a dental bridge system as claimed in any one of the preceding claims, the dental bridge comprising a politic and a bridge element being at least in part an onlay for spanning onto a sloping occlusal surface of a neighbouring canted natural tooth, the bridge element extending away from the ponfic so that, in use, the said sloping occiusal surface is reoriented.
14. A dental bridge system as claimed in claim 13, wherein the bridge element is an adhesive bridge.
15. A dental bridge as claimed in claim 13 or claim 14, wherein the bridge element tapers in a converging direction away from the pontic.
16. A dental bridge as claimed in claim 15, wherein the tapering of the bridge element is dimensioned to in use at least substantially relevel the said sloping occlusal surface.
17. A dental bridge as claimed in any one of claims 13 to 16, wherein the bridge element is at least in part substantially wedged shaped.
18. A dental bridge as claimed in any one of claims 13 to 17, wherein an upper surface of the bridge element is shaped to at least in part substantially match a sloping occlusal surface of a neighbouring natural tooth which the bridge element will at least in part overlie. ii
19. A dental bridge substantially as hereinbefore described with reference to the accompanying drawings.
20. A method of using a dental bridge to repair a patient's dentition or bite, the method comprising the steps of: a] locating a pontic between two spaced-apart natural teeth having a natural crown and a root, at least one of the natural teeth being canted; and b] bonding the pontic to the sloping occlusal surface of the canted neighbouring natural tooth using a dental adhesive, wherein the dental adhesive fonns a bridge element extending at least in part as an onlay from a proximal edge of the occlusal surface adjacent to the pontic towards a distal edge, so that the proximal surface is built up to or substantially to a level of the distal edge.
21. A dental bridge system as claimed in claim 20, wherein the bridge element is an adhesive bndge.
22. A method as claimed in claim 20 or claim 21, wherein the bndge element tapers in a converging direction away from the ponfic.
23. A method as claimed in claim 22, wherein the tapering of the bridge element is in two mutually perpendic&ar directions.
24. A method as claimed in any one of claims 20 to 23, wherein, in step a], the natural crown is at least substantially unprepared.
25. A method as claimed in claim any one of claims 18 to 21. wherein the pontic is rootless.
26. A method as claimed in any one of claims 20 to 25, wherein each natural tooth is one of a molar and a premolar.
27. A method as claimed in any one of claims 20 to 26, wherein the pontic is one of a molar and a premolar.