JP2010269034A - Dental prosthesis substitute - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a dental prosthesis substitute which is used as a substitute in order to aesthetically protect the state wherein a tooth is lost. <P>SOLUTION: This dental prosthesis substitute has a combination constitution of a tooth-like section which is arranged at the area where the tooth is lost, and a fixing section which fixes the tooth-like section by contact while covering one or both of the side surface of the adjacent tooth or the gingiva, and performs the protection of the tooth-lost area with aesthetic property, and the prevention of disturbance after the implanting of the dental implant. When the CAD/CAM method is used, a more accurate prosthesis substitute can be formed by forming the prosthesis substitute by representing the shapes of tooth-lost section and the surroundings in data, and forming the prosthesis substitute conforming to the data. Thus, the dental prosthesis substitute suits the lost area, and the fixing property can be increased. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a dental prosthetic substitute that protects a site where a tooth has been lost by extraction or the like, and aesthetically protects a dental implant implantation site such as an artificial tooth root.

There is a need for substitutes that can protect tooth loss immediately after tooth extraction caused by dental caries treatment, accidents, illness, and tooth extraction, and that have aesthetics that compensate for the unnatural appearance.
On the other hand, if swinging occurs on the artificial root immediately after planting, the artificial root after planting becomes unstable and may fall out, so the root can not be rocked for a while and can be kept quiet. Such ingenuity is necessary.
Japanese Utility Model Publication No. 59-122109 discloses a bridge denture that is used by adhering to an adjacent tooth. However, since the denture is bonded and fixed only on the side surface, impact, disturbance, and rocking due to mastication are applied to the denture. When added, it is questionable whether a stable denture can be maintained.
Japanese Patent Application Laid-Open No. 2000-287998 discloses a partial denture using a rubber elastic body that can be engaged with an undercut portion of an adjacent tooth and an underzone of a gingiva without using a metal clasp.

JP 2000-287998 A Japanese Utility Model Publication No.59-122109

Sato et al., P27-28, DE, No. 160, 2007

The configuration shown in Japanese Patent Application Laid-Open No. 2000-287998 requires a configuration as a denture having an engagement property that does not shift due to a collision with a counter tooth by chewing. A rubber elastic body having such a rigidity that it can be securely fixed together is required, and it has not yet been disclosed that protection at the time of tooth extraction or implant implantation is taken into consideration.
There has not yet been proposed a prosthetic substitute that can sufficiently protect a wound site immediately after extraction, after implant implantation, after extraction, and the like.

In view of the above, as a result of intensive research, the present invention is based on a new point of view that protects immediately after tooth extraction or at the time of artificial root implantation, and teeth adjacent to one or more provisional tooth shape portions arranged at a site where the tooth has been lost. Alternatively, the combination of the fixing portions that fix one or both of the gingiva in contact with each other protects a site lost due to the operation such as tooth extraction, and realizes a prosthetic substitute with denture-like substituteability.
In addition, the present invention is easy to handle, can prevent early bone healing by performing treatment immediately after tooth extraction, etc., and the shape of the prosthetic substitute is suitable for the condition in the oral cavity and has aesthetics. .
In addition, the bone stabilization period is short, and it is possible to advance the timing of implanting, or to speed up the installation of the partial denture. Protect and realize early fixation.
Since the fixing part in the present invention is a shape that fits the lost tooth part, the surrounding gingiva, and the adjacent teeth, it is easy to attach and detach, but because the fixing property is high, in a stable mounting state, External disturbances, especially chewing disturbances and rocking can be suppressed so as not to be applied to the wound after surgery, and a resting state can be maintained.
In addition, the present invention protects the damaged part from rocking caused by mastication or the like, so that it is possible to maintain a resting state so as to leave the clot accumulated in the tooth extraction part that is closely related to the amount of bone formation. Can be prevented.

Furthermore, the present invention makes it possible to protect the implant immediately after implantation, which is important for long-term fixation of the implant, from impacts caused by mastication and other swings.
The present invention improves the fixability by allowing the fixing portion to properly contact the adjacent tooth, gingiva, and loss site. This proper contact may include sealing between the fixed part and the adjacent teeth, gums and site of loss. In the case of sealing, it can be expected that foreign matters such as food residue will be prevented from entering, and that a stable state can be expected by reducing the number of removals for cleaning after mounting. Note that the presence or absence of sealing and the degree of sealing may be appropriately adjusted according to the situation in the oral cavity used.
Further, this appropriate contact can be realized by, for example, CAD / CAM, RP (rapid prototype) method or a common method.
The present invention can deal with not only the loss of one tooth but also the loss of a plurality of teeth and the provision of a plurality of implants by using a plurality of provisional tooth shapes.
The temporary tooth-shaped part and the fixing part in the present invention may be formed of the same material, or different materials may be used.

Specifically, it is formed by integral molding using a hard resin or a composite material of ceramic and resin. Or tentative tooth shape part is feldspar, other ceramics and the following resin composite, fixing part is polyurethane, acrylic, silicone, nylon resin, polycarbonate resin, heat polymerized resin, other thermal polymerization Resin or photopolymerization resin, even if it is composed of two or more materials using a soft resin such as a composite resin material that forms a more complete polymerization state by thermal polymerization after photopolymerization Good. As the fixing part, a soft polyamide resin or the like introduced in a local denture (Sato et al., P27-28, DE, No. 160, 2007) or the like can be used.
Furthermore, it is possible to improve the strength and aesthetics by making the layers of the gingival contact surface and the adjacent tooth contact surface selectively different from each other by stacking three or four layers or more. .

Although it is preferable that this invention does not contact a counter tooth as a protective device, Furthermore, the shape which does not contact a wound part may be sufficient. The “not in contact” is not only a state in which no contact is made, but also a range in which the masticatory force is not transmitted to the protective equipment, and may include a state in which the contact is apparent.
You may arrange the nonwoven fabric impregnated with antibiotics, the gauze, and other porous members on the contact surface with a wound part.
In addition, since the force applied to the fixed part (denture base) is smaller than that of the denture (partial denture) because there is no meshing with the mating teeth, the present invention can be effectively operated only by contact with the gingiva. There is also.

The present invention is a prosthetic substitute that protects a site lost by a treatment such as immediately after tooth extraction and also has a denture-like substituteability.
It is easy to handle, prevents bone retraction by treatment immediately after extraction, etc., and allows early healing, and the shape of the prosthetic substitute is suitable for the condition in the oral cavity and has aesthetics.
In addition, the period during which the bone is stabilized is short, and the timing for implanting can be advanced or the attachment of the partial denture can be accelerated.
In addition, after the implant is set up, the implant is protected from disturbance applied to the upper portion of the implant by simple mounting, thereby realizing early fixation.
Since the present invention can protect the wound part after tooth extraction and the implant immediately after implantation by simply attaching it, the rest of the wound part can be achieved with a simple operation. In addition, the present invention can be configured to be in close contact with the gingiva around the wound part and the adjacent teeth depending on the case, so that it can be stably used without detachment for removing the food residue. Moreover, since the shape is a temporary tooth shape, further aesthetics can be improved by adjusting the shape, coloring, or material.

It is a figure explaining one Example of this invention. It is a figure explaining the Example of this invention. It is a figure explaining the other Example of this invention.

The present invention is applied continuously, for example, during a period from extraction to fixation of the implant, applied after extraction, until healing of the wound, and thereafter, until the denture is attached, or implant implantation. Later, it is applied during the period of protecting the treatment site.
The present invention, after extraction, is placed in a fixed portion that comes into contact with adjacent teeth and gingiva to form a fixed state, and is accommodated in the wound site space after extraction, and has a temporary size that does not contact at least the counter teeth The prosthetic substitute which formed the tooth shape integrally is illustrated.
The method for producing the prosthetic substitute is not particularly limited. For example, a heat- and photo-curable resin is poured into a concave model obtained by taking a shape such as an impression of a tooth loss site and cured. An example is a manufacturing method in which a fixed part (denture base) of a tooth loss site is formed, and an existing artificial tooth having an approximate or the same form is selected and bonded and connected thereto as necessary.
Alternatively, a concave tooth shape is directly formed on a temporary tooth-shaped portion on a concave model obtained by taking a shape such as an impression of the shape of a tooth loss portion, and hard on a concave portion that is a tooth-shaped portion. A method or resin prepared by pouring a soft curing resin or inserting a pre-made artificial tooth and pouring a soft curing resin over the portion corresponding to the fixing portion and polymerizing and curing with heat and light in advance. Examples thereof include a method of making a solid or bowl-like shape by press-fitting the resin that has become the bowl-like shape and curing it as necessary.

In addition, when using CAD / CAM, an impression is taken from the periphery of the tooth loss site, a convex model is formed by pouring a hardener such as gypsum into this impression, and the surface shape is a contact method using a probe, Moire method, conoscope, stereo photography, other measurement methods such as laser beam, infrared ray, visible light, etc., non-contact method such as triangulation method is used to form 3D shape measurement data. The concave model data is created by adding the concave data of the tooth shape portion determined in advance or formed by selecting the approximate shape data from the database. Based on the concave model data, a prefabricated block is processed to form a concave model.
The concave model may be formed of a resin having transparency, translucency or heat resistance, or other resin, or may be formed of gypsum excellent in heatability. Description of other specifications These materials may also be applied to a model that can be used as a mold.
A dental prosthetic substitute of the present invention may be formed by pouring a composite material of curable resin, resin and ceramic into the concave model and curing it with light or heat.
Alternatively, a dental prosthesis substitute may be manufactured by forming three-dimensional convex model data using the above-described computer and cutting an existing block based on the convex model data. In addition, such a concave or convex model is not prepared, and the shape of the tooth loss site is measured directly by using a non-contact probe or the like using the triangulation method in the oral cavity, and is further matched or approximated on the database. Tooth shape data may be selected, and this selection data may be added to tooth loss site data to form prosthetic substitute shape data.
Further, for example, it may be directly manufactured by a RP (rapid prototype) modeling method disclosed in JP-A-2-46820, JP-A-2001-157686, or the like, or a concave model is formed. However, an indirect prosthetic substitute may be manufactured by pouring a curable resin into it.
The present invention is preferably a substitute that can be prosthetic at a relatively early stage at the time of tooth extraction and implant implantation, and the fixed portion is formed from the non-contact measuring means for the shape of the gingival surface and the shape of the adjacent tooth, Next, the tooth shape is formed.

The provisional tooth shape data may be versatile, and the tooth shape may be formed using existing data.
If the missing tooth remains, its surface shape may be measured, and the tooth shape may be formed based on the measurement data. Data obtained by computer processing of prediction information from the adjacent tooth is used as the tooth shape. It may be reflected in

In addition, regarding the defect after extraction, if the amount of blood clot is small and sufficient bone formation is not expected, or if there is insufficient bone for implant implantation, the bone resorbability and osteogenic properties as biomaterials Bone that is insufficient by filling granules, powder, and prosthetic shaped materials with excellent α-tricalcium phosphate ceramics and covering the filled parts with GORE-TEX sheets, collagen sheets, biodegradable polymer sheets, etc. In some cases, it may be possible to achieve early formation.
Moreover, in order to adjust the amount of the alveolar bone when the subsequent denture is mounted or when the implant is implanted, the mounting environment may be adjusted by the filling.
After the filling, the tooth loss site and the implant implantation site may be protected by mounting the prosthetic substitute according to the present invention.

At the time of implant implantation, the present invention can protect the extraction site only by attaching it to the extraction site, and early healing is expected, so that the upper portion of the implant can be accommodated in the temporary tooth shape portion. By forming a space in which the side surface does not contact the surroundings, stable and early fixation can be realized without giving impact or rocking by mastication to the upper part of the implant.
The space may be formed by forming a hole having a necessary diameter and depth from the bottom, or by drilling a hole penetrating vertically.

The present invention may be mounted for a tentative period until the denture is mounted after the tooth loss part has been healed by extraction or after the implanted implant has become stable. The temporary replacement is until the lost state is recovered and may not depend on the condition of the wound.
In addition, the present invention can be applied as a so-called bridge or continuous crown form for a plurality of teeth in the tooth loss state due to tooth extraction and implant placement, and can be temporarily replaced.

An embodiment of the present invention will be described in detail with reference to the drawings.
11 is a tooth-shaped part, and the tooth-shaped part 11 is preferably formed using a hard material. For example, calcium phosphate-based ceramics, alumina, zirconia, calcium phosphate-based glass ceramics, composite resin material, resin-added type It may be formed from natural minerals such as glass ionomer cement and feldspar, and in some cases, pre-made artificial teeth that are similar or similar in size and shape to the application site are selected and used. You may do it.
Reference numeral 12 denotes a fixing portion, and the fixing portion 12 is preferably formed of a material that contacts and fixes adjacent teeth and gums, but is integrally formed of the same material as the tooth-shaped portion. Specific materials include polyurethane, acrylic, silicone, nylon resin, polycarbonate resin, heat polymerized resin such as heat polymerized resin, photopolymerization resin, or both photopolymerization and thermal polymerization. The resin which has the composite property which performs is illustrated.
As for the contact part of the fixing | fixed part 12 and a biological body, it is desirable to contact so that the prosthetic substitute 10 may not slip | deviate.

The fixing portion 12 can be further improved in fixing force by contact-connecting with a part of the adjacent tooth, but there may be a case where sufficient fixing can be achieved even when contact-connecting only to the gingiva.
The connection between the tooth-shaped part 11 and the fixing part 12 may be made of the same material and integrally formed. In this case, a transparent curable resin or a composite resin with ceramics is selected and filled into a mold, cured by light or heat and molded, and each surface is appropriately colored by an ink jet printer. May be. Alternatively, the above-described separate materials may be poured into a mold and cured by light or heat to combine them.
The tooth-shaped part 11 and the fixing part 12 may be obtained by integrally processing an existing block by CAD / CAM.
Further, when the tooth-shaped part 11 is a pre-made artificial tooth, or when the tooth-shaped part 11 is prepared using the above-described hard member, the tooth-shaped part 11 and the fixing part 12 are bonded with an adhesive in these cases. It may be.

  Reference numerals 13 and 14 denote adjacent tooth contact surfaces, which are parts that come into contact with each other so as to surround the side surfaces and the opposing surfaces of the adjacent teeth. The bonding area is preferably wide, but is preferably adjusted so that it does not swing at least. The area is appropriately selected according to the degree of fixation. Note that an adhesive such as a resin adhesive or cement for temporary bonding may be applied to the contact surface between the fixing portion 12 and the adjacent tooth.

Reference numeral 15 denotes a tooth loss site contact surface, which preferably has the same shape as that of the tooth injury site 16, but does not necessarily have to be contacted, and a therapeutic agent such as an antibiotic may be applied or impregnated. .
Although 16 shows a tooth damage site | part and shows the state by which the gingiva has already been stitched | sutured, it may not necessarily be after suturing.

Next, the operation of the embodiment shown in FIG. 1 will be described. FIG. 1D shows the prosthetic substitute 10 shown in FIGS. 1A to 1C in a cross-sectional view taken along line xx ′.
FIG. 1 (d) shows a state in which the prosthetic substitute 10 is to be mounted between the adjacent teeth 17 and 18. FIG. 1 (e) shows the state after mounting.
The tooth loss part contact surface 15 of the prosthetic substitute 10 and the tooth damage part 16 are in uniform contact, the adjacent tooth contact surface 13 and the side surface of the adjacent tooth 17, the adjacent tooth contact surface 14 and the side surface of the adjacent tooth 18 Are uniformly attached and fixedly attached as a whole. It is preferable that the tooth shape part 11 sets the space | interval with the opposing tooth 1T with the predetermined | prescribed difference value 19. FIG.
The difference value 19 should just be a grade which is not contacted at least, for example, 0.5 mm-about 1.5 mm are illustrated.

2 (a) is a perspective view of FIG. 1 (d), and FIG. 2 (b) is a perspective view of FIG. 1 (e).
FIG.2 (c) is a perspective view at the time of applying this invention to two tooth loss sites.
201 is a fixed part, and 202 and 203 are temporary tooth-shaped parts. The shapes of the tooth shape portion 202 and the tooth shape portion 203 may be aesthetically different, may be pre-formed shapes, or may be the same shape.
The configuration of fitting and mounting on the gingiva 206 and the adjacent teeth 204 and 205 in the fixing unit 201 may be the same as that shown in FIG.
Further, the present invention can be applied even in the case of two or more lost sites, and can take the same shape as a so-called bridge or bridge.

Next, another embodiment of the present invention will be described in detail with reference to FIG.
This example is an example for use after implanting an implant.
Parts having the same configurations as those in FIGS. 1 and 2 are denoted by the same reference numerals.
Reference numeral 31 denotes a temporary tooth-shaped portion, which may be formed of the same material as that shown in FIG. 1, or may be a material that does not hinder the formation of the protective space 32.
Reference numeral 32 denotes a protective space, which is formed by a through-hole, a non-penetrating cylindrical or prismatic hole, or the like.
The diameter may be at least larger than the diameter of the implant, and the height is preferably such that it does not touch the implant upper part 34. The protective space 32 may be formed by a doctor or a person related to the treatment by performing a perforation process in accordance with the planting state of the implant before and after the treatment. There may be.
As described above, the protective space 32 does not necessarily have to be a through-hole as long as it does not come into contact with the upper part of the tooth root. 36 is a lid in the case of a through-hole. The lid 36 may be a dissimilar material such as resin or rubber. Moreover, it does not necessarily need to be a hole shape, and may be a space that can accommodate at least the upper portion of the implant.

  As in FIG. 1, the placement contact surface 33 of the prosthetic substitute 30 and the implantation surface 35 on the gingiva 1N are uniformly contacted, and the adjacent tooth contact surface 13 and the side surfaces of the adjacent teeth 17 and adjacent teeth The contact surface 14 and the side surface of the adjacent tooth 18 are uniformly contacted, and the gingiva 1N and the fixing portion 12 are contacted uniformly. In this case, it is preferable that the protective space 32 and the implant upper part 34 are not in contact with each other. A state in which the prosthetic substitute 30 is mounted is shown in FIG. FIG. 3B is a partial cross-sectional view.

The implant upper part 34 shows the upper part of the one-piece type artificial tooth root here, but the necessity of preventing disturbance even if it does not protrude into the oral cavity at the time of implantation like the two-piece type, treatment It may be included in the scope of the present invention because of the necessity of later rest.
In the present embodiment, the state after implant implantation is shown, but it may be used from the state before implant implantation.
In some cases, the protective space 32 may be formed in advance, and the protective space 32 may be formed depending on the state after planting.
Furthermore, as shown in FIG. 1 (e), the present invention provides a prosthetic substitute 10 according to the embodiment mounted on the lost part, and is previously provided as an artificial tooth root embedding site at the upper part of the tooth-shaped part 11 or by implant implantation. A surgical stent method may be used in which a hole is formed from a site set at the time of surgery (for example, the implantation site (imp2) in FIG. 2B) and the hole is opened as it is to the inside of the alveolar bone (1G shown in FIG. 1).
In this case, conventionally, a troublesome positioning process that has been performed using an X-ray CT before implanting an artificial tooth root can be realized with a simple operation.
Further, if a drilling process for increasing the diameter of the tooth-shaped portion 11 is performed, the state shown in FIG. 3B can be formed, and the upper root of the tooth can be protected more reasonably.

When extracting a tooth, when a tooth is lost, or when performing artificial root treatment, if there is a gap that needs to be filled from the outside, or if a gap is created, a filler is added to the gap. It may be filled and subjected to a shaping or filling process.
Examples of fillers to be filled and applied to gaps and cuts on alveolar bone include granular and powdered hydroxyapatite, calcium phosphate compounds such as α or β type tricalcium phosphate, and other biocompatible materials. . In particular, an α-tricalcium phosphate ceramic material excellent in bone resorption ability and new bone formation ability is preferably used. In addition, hemostatic materials may be added when bleeding is high.
When using granular or powder fillers, the filled part is a biocompatible film, such as biodegradable polymers such as polylactic acid, membranes such as collagen that are finally absorbed into the body, GORETECH It may be covered with an affinity material such as Su (trademark) film or CG (trademark) film.

Further, it may be a filler having the same shape as the gap.
In addition, there is no gap to be filled with the filler, but the tooth loss part contact surface applies a pre-formed shape, so if it is necessary to reshape or if bone formation due to clot is insufficient after extraction, In some cases, a filler is filled.
The present invention works particularly effectively for temporary and temporary use from tooth loss due to tooth extraction and other causes to the installation of dentures or the implantation of implants. Until the planting condition is satisfied, it may include several months or more, and depending on the condition, it may be a semi-permanent use for protection.

  The present invention is expected to be applicable in the dental field because esthetics, bone formation promotion, and the like are achieved at sites requiring protection and rest, such as when extracting teeth, artificial roots, and other dental implants.

DESCRIPTION OF SYMBOLS 10 Prosthetic substitute 11 Tooth shape part 12 Fixing part 13 Adjacent tooth contact surface 14 Adjacent tooth contact surface 15 Tooth damage site contact surface

Claims (9)

  A dental prosthesis substitute comprising a fixing portion that is fixed in contact with one or both of one or a plurality of tooth-shaped portions and one or both of adjacent teeth or gums arranged at a site where a tooth is lost.   The dental prosthetic substitute according to claim 1, wherein a space in which the upper portion of the implant can be inserted in a non-contact state is formed in the tooth shape portion. The dental prosthetic substitute according to claim 2, wherein the space is a through-hole penetrating vertically.   The dental prosthetic substitute according to claim 1, comprising a plurality of the tooth-shaped portions and the fixing portions applied to a plurality of lost teeth.   The dental prosthetic substitute according to claim 1, wherein the tooth-shaped part is in a non-contact state with the opposing tooth.   The dental prosthesis substitute according to claim 1, wherein the fixing portion is formed of a soft resin material.   The dental portion according to claim 1, wherein the tooth shape portion is colored with an aesthetic property similar to a tooth, and a portion that contacts the gingiva at the fixing portion is colored with an aesthetic property similar to a gingiva. A prosthetic substitute.   The dental prosthetic substitute according to claim 1, wherein the fixing portion is formed based on information obtained by measuring the tooth loss site and the shape of the adjacent tooth by CAD / CAM in a non-contact and contact manner. object.   Dental prosthesis provided with a calcium phosphate compound applicable to the hard tissue part to be replenished, a filler selected from other ceramics, and a molding filling means formed of a biocompatible film that covers the part to which the filler is applied as necessary Substitute.

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