RU191117U1 - DEVICE FOR CONTINUOUS MEASUREMENT OF THICKNESS OF OVERPULPED DENTIN - Google Patents

Abstract

The utility model is intended for use in orthopedic and therapeutic dentistry in order to protect tooth pulp from inflammatory reactions. The technical result of the utility model is to create a high-precision device for measuring the thickness of hard tissues of teeth during continuous odontopreparation. The device is based on a new method of processing the signal received from the measurement output circuit, equipped with an automatic calibration system, consists of elements that perform self-diagnosis, uses digital signal processing, uses dental carbide boron as a measuring electrode, has greater reliability and stability due to fewer elements in the measuring circuit. During the treatment of patients using this device, there were no cases of undesirable effects.

Description

The utility model is intended for use in orthopedic and therapeutic dentistry in order to protect tooth pulp from inflammatory reactions. In the process of preparing a living tooth for fixed constructions or in the treatment of caries, a lot of factors act on the tooth pulp such as heat, vibration, etc. [Ahmad I. Aesthetics of indirect restoration / Irfan Ahmad; Per. from English - M .: MEDpress - inform, 2009. - 232 p.]. Also, during the preparation process, the dentist can damage the pulp of the tooth by excessive grinding of the hard tissues of the tooth. In order to protect the pulp of the tooth, it is recommended that the thickness of the suprapulpar dentin is kept at least 1 mm. [Arutyunov S.D., Lebedenko I.Yu. Odontopreparation under orthopedic designs of dentures. / M .: Practical medicine; 2007]. The dentist can use radiography and computed tomography to control the thickness of supra-pulp dentine. However, when radiography is obtained two-dimensional image that does not allow to determine the thickness of all the walls surrounding the pulp. Computed tomography allows you to get a three-dimensional image of the tooth, but the use of this technique to control the thickness of the preparation is impossible, because This technique has a high radiation dose. [Lebedenko I.Yu., Kalivrajiyana E.S. Orthopedic Dentistry / M .: GEOTAR-Media; 2016], [Rusakova S.I., Titarchuk L.V., Titarchuk V.V. A review of methods for assessing the thickness of suprapulpural hard tissues for planning and performing the operation of odontopreparation of vital teeth / Tver Medical Journal. 2017; 1: 25-28].

The closest known analogues for the purpose is a device for measuring the thickness of hard tissues of vital teeth (patent for a utility model of the Russian Federation No. 48759, IPC АСС 19/04), containing active and passive electrodes, a power source, a recording and indication unit, which consists of a stabilizer mode, signal conditioner and calibration unit, first, second and third threshold recorders, first second and third color indicators, while the mode stabilizer is connected to a passive electrode, the input of the signal conditioner is Inonii through calibration block with the active electrode, the outputs of the first, second and third threshold recorders connected respectively to the first inputs of the second and third color indicators.

The disadvantages of the known device are:

the possibility of carrying out only a layered preparation with measurements between the stages of preparation, which reduces the accuracy of the preparation and increases the time of odontoparision

the use of alternating current with a frequency of 500 Hz to measure the thickness can cause pain in the patient, as well as adversely affect the pulp

the use of a complex expensive and fully analog measuring circuit with low reliability without digital devices, without self-diagnostics, without automated calibration and without software signal processing

low measurement frequency limited by the frequency of the measuring current

low accuracy of dentin thickness measurement

lack of dentin thickness readings in millimeters and the need for interpretation by the dentist

the lack of indicators beyond visual ones, which increases the risk of errors in the interpretation of the instrument by the dentist

the inability of the device to work with a moving bur

The above device is poorly adapted to limit the depth of grinding of vital teeth during the preparation process.

The technical result of the utility model is the creation of a device of high accuracy for measuring the thickness of hard tissues of teeth with continuous odontopreparation.

The device allows you to measure the thickness of the dentin with an accuracy of 10 times more than the analog device with a frequency of not less than 10 times more than that of the analog and limited only by the capabilities of the microcontroller with continuous preparation; display the dentin thickness in millimeters in real time on a digital display using a moving dental hard-alloy or fine-grained diamond boron as an active electrode with compensation of boron resistance, automatic calibration, self-diagnosis, compensation of noise and bounce arising in the patient circuit between the active and passive electrode when maximum simplicity of the measuring circuit and maximum reliability of the entire device. At the same time, the device, unlike the analogue, performs direct current measurement and, as a result, has significantly less effect on the pulp of the vital tooth during operation.

The technical result is achieved due to the fact that the device is based on a new method of processing the signal received from the output of the measuring circuit, is equipped with an automatic calibration system, consists of elements that perform self-diagnosis, uses digital signal processing, uses dental carbide boron as a measuring electrode, has a large reliability and stability due to fewer elements in the measuring circuit.

In FIG. 1 is a structural diagram of a device for measuring dentin thickness during continuous preparation.

The device contains a passive electrode 1, an active electrode 2, a display 6, a main module 3, which contains an exemplary resistor 4, a charger 7, a power supply, which is a rechargeable battery 8, a boost voltage converter 9, a reference voltage source 10, an audible warning device 16, a microcontroller 5 containing an analog-to-digital converter (ADC) 11, a software filter for interference and bounce 12, a software compensator for the electrical resistance of boron 13, a software unit for calculating the measurement results 14, p serial port 15. The software compensator for the electrical resistance of boron is a software converter that measures the resistance value of the dental tip and boron, in the process of measuring this value from the final resistance measured by the device so that the resistance of the boron does not affect the measurement results. Charger 7 is connected to a power source (battery) 8 connected to a step-up voltage converter 9 connected to a source a reference voltage 10 connected to the active electrode 1 and the microcontroller 5. The ADC 11 of the microcontroller is connected to the passive electrode, as well as the reference resistor, while the data from the ADC 11 are sequentially supplied to the program filter of interference and bounce 12, the compensator of the electrical resistance of the bur, block calculation of measurement results 14, serial port 15, display 6. An audible warning device is connected to the discrete output of the microcontroller, activated by the result of a logical operation of the result calculation unit 14. The measurement display 6 is also connected to a voltage step-up converter 9, performing the display power supply 6.

Applied a device for measuring the thickness of dentin with continuous preparation as follows.

Before starting the preparation, the passive electrode is placed in the under-tooth space close to the tooth being machined, the active electrode of the device is attached to the metal body of the dental tip, carbide boron or fine-grained diamond boron is installed in the collet of the tip, thereby creating an active electrode and display 6 located in a separate housing in a place convenient for the dentist, after which you can proceed to the preparation. Continuous preparation is carried out by conventional methods, with wetting of the working area by means of built-in air-water cooling, using a saliva ejector, as well as cofferdam, roberdam and other methods that isolate the prepared tooth.

During the preparation process, the electrical resistance between the active and passive electrodes in contact with the patient’s tooth and lip, respectively, is measured continuously using direct current. An electric current flows between these points, causing a voltage drop across the model resistor 4. Due to the boron moving and the electrical contact being unstable, and the carbide boron has its own electrical resistance, which requires correction, measured 5000 times per second ADC 11, the voltage is processed by the filter 12 and a compensator 13, after which it is interpreted as the thickness of the dentin in millimeters with an accuracy of 0.1 mm by the unit for calculating the results of measurements 14, which then transfers the data to the follower port and on the display, and also makes the decision to activate an audible warning device to warn the dentist about the dangerously small thickness of dentin at this point. Based on the characteristics of a particular medical case, the dentist adapts, in real time, the preparation strategy. The voltage converter 9 ensures the stability of the device parameters when the voltage of the battery 8 is changed, the reference voltage source 10 provides the voltage stability when the ambient temperature changes or the voltage instability at the output of the voltage converter 9, the interference filter and bounce 12 ensures the stability of the device in the presence of induced interference in the measuring circuit and with the bounce of the rotating bur on the cut material of the tooth. Self-diagnostic tools built into the microcontroller ensure continued stable operation of the device in the event of a software error. A smaller number of additional tools used in the preparation is provided by the fact that the active electrode simultaneously acts as a tool for preparation.

The simplicity of the measuring circuit and the software implementation of the key elements of the device can significantly reduce the cost of the device, as well as easily integrate it into other medical devices that use microcontrollers, for example, modern electrodotometers or apex locators.

Clinical studies of the claimed model were carried out in dental clinics of Ryazan. Orthopedic treatment was performed for 35 patients (of which 21 men and 14 women) aged 20 to 70 years.

The application of the claimed model is illustrated by the following examples:

Example 1

04/08/2017 I visit. Patient D., 46 years old. I went to the dental clinic with a complaint about a violation of the integrity of the dentition.

Medical history: tooth 2.5 was removed due to the destruction of the crown of the tooth more than 1 year ago.

Anamnesis of life: Botkin's disease and other specific infections denied.

Objective research data: the mucous membrane in the area of the missing tooth 2.5 and adjacent teeth 2.4 and 2.6 are pale pink. On the occlusal surface of the tooth 2.6 there is a seal IROPZ - 0.4. Tooth 2.4 is intact.

Dental formula:

Orthognathic bite.

Diagnosis: partial adentia.

Treatment: An auxiliary two-layer impression was obtained using the Hydrorise A-silicone mass. Under infiltration anesthesia of a 2% solution of Ultracaine, preparation of teeth 2.4, 2.6 was prepared under ceramic-metal crowns with the formation of a circular subgingival ledge. For control during the preparation process, the developed patented device was used. The preparation of the teeth was completed with a thickness of suprapulpar dentin of 1.2 mm. Also, for comparative control of the dentin thickness at the end of the preparation, the EndoEst-3D apparatus (Geosoft) was used in the mode of measuring the thickness of the suprapulparine dentin, which showed the value of the thickness of the supraulparine dentin at 1.2 mm. Teeth 2.4, 2.6 are treated with 3% sodium hypochlorite solution. A working two-layer impression was made from the Hydrorise A-silicone mass from the upper jaw, an auxiliary impression from the Speedex C-silicone mass from the lower jaw. The registration of central occlusion. Color determination and fabrication of temporary plastic crowns using Luxatemp automix plus A2 color material in a direct manner, for teeth 2.4, 2.6, which were fixed using Repin temporary cement.

Recommended: next visit after 14 days.

04/16/2017 II visit: no complaints.

Objectively: the plastic crowns on the teeth 2.4, 2.6 without defects, the gums in the teeth 2.4, 2.5, 2.6 are pale pink, tightened, there is no bleeding when probing.

Treatment: fitting of the metal frame of the artificial crown on the stump of teeth 2.4, 2.6. The color of the ceramic mass was determined using the standard “Vita” coloring - A2. The teeth were treated with 3% sodium hypochlorite solution. Installation of temporary plastic crowns for teeth 2.4, 2.6, which are fixed with temporary cement “Repin”.

Recommended: next visit after 7 days.

04/24/2017 III visit: no complaints.

Objectively: the plastic crowns on the teeth 2.4, 2.6 without defects, the gums in the teeth 2.4, 2.5, 2.6 are pale pink, tightened, there is no bleeding when probing.

Treatment: the artificial metal-ceramic construction of teeth 2.4, 2.5, 2.6 was checked in the oral cavity. Artificial crowns restore interdental contact points and occlusal contacts with antagonist teeth. The tooth stumps were treated with a 3% sodium hypochlorite solution. A temporary fixation of permanent artificial crowns was carried out using temporary Repin cement.

Recommended: next visit after 7 days.

October 3, 2016 IV visit: no complaints.

Objectively: ceramic-metal crowns on teeth without defects, gums in the tooth area 2.4, 2.6 pale pink, densified, no bleeding when probing.

Treatment: the design of the ceramic-metal prosthesis in the oral cavity was checked. Color and shape satisfy the patient. The tooth stumps were treated with a 3% sodium hypochlorite solution. The artificial crowns were permanently fixed with the help of glass ionomer cement “Fuji ope”.

Recommended: next visit after 6 months.

Control:

No complaints were reported 6 months after treatment.

There were no complaints 12 months after treatment.

Example 2

06/14/2017 I visit. Patient A., 32 years old. I went to the dental clinic with a complaint of a violation of the aesthetic defect and violation of the integrity of the dentition.

Medical history: Medical history: tooth 3.2 was removed due to traumatic injury 4 months ago.

Anamnesis of life: Botkin's disease and other specific infections denied.

Objective research data: the mucous membrane in the area of the missing tooth 3.2 and adjacent teeth 3.1 and 3.3 are pale pink. On the medial surface of the tooth 3.1 there is a filling of IROPZ - 0.3 and on the distal surface of the tooth 3.3 there is a filling of IROPZ - 0.2.

Dental formula:

Straight bite.

Diagnosis: partial adentia.

Treatment: An auxiliary two-layer impression was obtained using the Hydrorise A-silicone mass. Under infiltration anesthesia of a 4% solution of Ubistesin, preparation of teeth 3.1 and 3.3 was performed under ceramic-metal crowns with the formation of a circular subgingival ledge. To control during the preparation process, a developed device was used. The preparation of the teeth was completed with a thickness of suprapulpular dentin of 1 mm. Also, for comparative control of the dentin thickness, at the end of the preparation, the EndoEst-3D device (Geosoft) was used in the mode of measuring the thickness of suprapulparine dentin, which showed a thickness of supra-pulp dentine of 1 mm. Teeth 3.1, 3.3 are treated with 3% sodium hypochlorite solution. A working two-layer impression of the Hydrorise A-silicone mass from the lower jaw was obtained, an auxiliary impression of the Speedex C-silicone mass from the upper jaw. The registration of central occlusion. Color determination and temporary plastic crowns made with Luxatemp automix plus material, color A3.5, in the direct manner, for teeth 3.1, 3.3 which are fixed using Tempofix temporary cement.

Recommended: next visit after 14 days.

06/30/2017 II visit: no complaints. After the odontopreparation procedure, the patient noted the presence of pain in the teeth 3.1, 3.3. After the installation of temporary crowns, the patient noticed a significant improvement - the absence of pain in the tooth area 3.1, 3.3.

Objectively: the plastic crowns on the teeth 3.1, 3.3 without defects, the gums in the teeth 3.1, 3.2, 3.3 are pale pink, densified, there is no bleeding when probing.

Treatment: fitting of the metal frame of the artificial crown on the stump of teeth 3.1, 3.3. The color of the ceramic mass was determined using the standard color “Vita” - A3.5. The teeth were treated with 3% sodium hypochlorite solution. Installation of temporary plastic crowns for teeth 3.1, 3.3, which are fixed with temporary cement “Tempofiks.

Recommended: next visit after 7 days.

07/07/2017 III visit: no complaints. Lack of pain in the area of the prepared teeth.

Objectively: the plastic crowns on the teeth 3.1, 3.3 without defects, the gums in the teeth 3.1, 3.2, 3.3 are pale pink, densified, there is no bleeding when probing.

Treatment: the artificial metal-ceramic construction of teeth 3.1, 3.3 in the oral cavity was checked. Artificial crowns restore interdental contact points and occlusal contacts with antagonist teeth. The tooth stumps were treated with a 3% sodium hypochlorite solution. A temporary fixation of permanent artificial crowns was carried out using the temporary Tempofix.

Recommended: next visit after 7 days.

07/15/2017 IV visit: no complaints.

Objectively: the ceramic-metal construction on the teeth 3.1, 3.3 without defects, the gums in the teeth 3.1, 3.2, 3.3 are pale pink, densified, there is no bleeding when probing.

Treatment: the design of artificial ceramic-metal constructions of teeth 3.1, 3.2, 3.3 in the oral cavity was checked. Color and shape satisfy the patient. The tooth stumps were treated with a 3% sodium hypochlorite solution. The artificial crowns were permanently fixed using the Fugi Plus glass ionomer cement.

Recommended: next visit after 6 months.

Control:

No complaints were reported 6 months after treatment.

There were no complaints 12 months after treatment.

Example 3

March 6, 2018, I visit. Patient G., 35 years old. I went to the dental clinic with a complaint of short-term pain in the tooth area 2.6 from all types of irritants, tooth decay.

Anamnesis of the disease: the presence of pain in the tooth 2.6 more than 1 month.

Anamnesis of life: Botkin's disease and other specific infections denied.

Objective research data: on the occlusal surface of the tooth 2.6 there is a deep carious cavity, Class 1 according to Black, sounding along the entire bottom is moderately painful, the bottom of the carious cavity is dense, pigmented, the reaction to cold is painful, passes after removal of the irritant, EDI - 11 μA

Dental formula:

Orthognathic bite.

Data from additional studies: on the x-ray of the tooth 2.6, a filling is determined in the area of the tooth crown 2.6, the pulp cavity and periodontium are intact.

Diagnosis: Tooth 2.6. - deep caries

Treatment:

Under the infiltration anesthesia of a 2% solution of Ultracaine, a carious cavity of the tooth was prepared 2.6. For control during the preparation process, the developed patented device was used. The preparation of the teeth was completed with a 1.6 mm thickness of suprapulpar dentin. The carious cavity was formed and treated with medication. Vitremer insulating gasket (3m Espe), permanent seal Filtek z250 (3m Espe). Grinding and polishing of a permanent seal.

Recommended: next visit after 6 months.

Control:

No complaints were reported 6 months after treatment.

There were no complaints 12 months after treatment.

During the treatment, not a single case of undesirable effects was detected.

Claims (4)

1. A device for measuring the thickness of supra-pulp dentine, including a power source, active and passive electrodes, characterized by the presence of a charger, a main module with an exemplary resistor, a display, a voltage converter, a voltage reference, an audible warning device, a microcontroller containing an analog-to-digital converter, software filter for interference and bounce, software compensator for electrical resistance of boron, software unit for calculating measurement results. 2. The device according to p. 1, characterized in that the fastening of the active electrode is made to the metal body of the dental handpiece, and the measurement is carried out in the process of odontopreparation through carbide or diamond fine-grained boron. 3. The device according to claim 1, characterized in that the contact of the active electrode with dentin is compensated by a software filter of interference and bounce. 4. The device according to claim 1, characterized in that the measurement result is displayed on the display, and with a dangerously small thickness of the dentin, an audible alarm is activated.

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