RU209996U1 - TORPEDO-SHAPED DENTAL BURN FOR VERTICAL PREPARATION - Google Patents

Abstract

The utility model relates to medicine, in particular to dentistry, and can be used for sparing preparation of soft tissues surrounding the tooth in the subgingival region. The dental bur contains a shank, a working part and a smooth rod. The novelty of the device is as follows: the working part of the bur contains an active surface, which occupies 2/3 of its area, covered with diamond chips, and a passive surface, also an inert rounded tip, the length of which is 1/3 of the area of the bur. The purpose of the utility model is to reduce the risk of complications during and after the preparation of teeth for artificial crowns, as well as to reduce the amount of working time on the hard tissues of the tooth and orthopedic preparation in general. This goal is achieved by calibrating a torpedo-shaped bur with an inert working part. Going under the gum by 0.3 mm, the marginal periodontium is not injured, while the parallelism of the walls of the hard tissues of the tooth is observed due to the shape of the bur.

Description

The utility model relates to medicine, in particular to dentistry, and can be used for gentle preparation of soft tissues surrounding the tooth in the subgingival region.

To date, the standard in our country is considered to be the preparation of hard tissues with a ledge. However, in order to achieve the correct ledge shape, expensive optics and a considerable amount of time are required to reproduce it on the tooth stump. In addition, this type of preparation means a large amount of hard tissue removal, which subsequently leads to corresponding complications. To reduce the risk of complications during and after grinding of hard tooth tissues, there is a vertical preparation technique that is actively practiced abroad. This method involves preparation without any visible margins (it helps to reduce working time both on the tooth tissues and with the patient himself), in the subgingival region and placing the margin of the restoration more coronally in relation to the preparation margin. This technique requires strict adherence to the parallelism of the hard tissues of the tooth during their grinding, and since the border of the restoration enters the subgingival region, it is necessary to create atraumatic conditions for the surrounding soft tissues. In order to achieve these goals, we offer a modified torpedo-shaped dental bur designed for the vertical preparation technique.

A dental bur is known (RU 79415 U1, publ. 01/10/2009), which includes a reverse-conical shape of the working part facing the smooth rod with an angle of 30-70 degrees to the axis of the bur. This model is used in dentistry to form conical surfaces on adjacent teeth during their splinting. The disadvantage of this device is that the bur parameters are not pre-calibrated, therefore, the bur cannot guarantee the exact amount of hard tissue removed from the tooth surfaces.

As the closest analogue, a dental combined bur was chosen (RU 169953 U1, publ. 04/07/2017), consisting of a working part with an active surface covered with diamond grit, a passive surface located at the end of the working part and not covered with diamond grit. The modification of the bur is as follows: the active surface of the working part, located between the shank and the tapering end of the active working part, is covered with coarse-grained diamond grit, and the tapering end of the active working part of the bur, conjugated with the passive surface, is covered with fine-grained diamond grit. The disadvantages of this device include the following: this bur is designed only for the preparation technique with a shoulder, which means a large amount of abrasion of the hard tissues of the tooth and a significant time investment for the formation of a quality shoulder stump. In addition, the inert head has a small extent, based on the data of the drawing, therefore, its presence does not exclude traumatization of the marginal periodontium.

The purpose of the utility model is to eliminate the shortcomings of the prototype. EFFECT: reduction of the time of contact of the cutting tool with the hard tissues of the tooth, reduction of the time of work with the patient himself during the preparation of teeth for orthopedic structures, immediate impressions. The above results are achieved by controlling the required volume of tissue grinding from various surfaces of the teeth when choosing the path of restoration insertion, by maintaining the parallelism of the walls of the tooth stump, which make it possible to create a ferrule effect due to a minimal reduction in the hard tissues of the tooth, and also make it possible to exclude traumatization of the marginal periodontium and obtain high aesthetic effect.

The task is solved by changing the design of the torpedo-shaped dental bur - the shape of the bur remains the same, the following parameters undergo changes: the length of the inert part will be 1/3 of the total area of the bur and will be represented by a smooth rod with an inert rounded tip, the thickness of the bur is 0.5 mm , and the length of the active part of the bur covered with spiral-shaped diamond chips (tornado) will be 2/3 of the bur area.

In addition, the proposed torpedo-shaped dental bur for vertical preparation of hard tissues of teeth for artificial crowns, which eliminates the stage of "ledge formation", thereby reducing not only the amount of removal of hard tissues of the tooth, but also helps to reduce the working time on the hard tissues of the tooth, excluding the possibility their overheating.

The claimed technical solution allows to reduce the amount of removal of hard tissues of the teeth; facilitates the modeling of the required tooth profile; allows you to gradually reduce the hard tissues of the tooth from its surfaces during preparation, thanks to the regulation of the process and the uniform distribution of pressure over all areas of the tooth stump during preparation.

In FIG. 6 shows a torpedo-shaped dental bur for vertical preparation of teeth for artificial crowns, contains a working part (Fig. 6.1), 0.5 mm thick, a passive part (Fig. 6.2), which is 1/3 of the total area of the bur, and an active part, covered with diamond chips of a spiral shape (tornado) (Fig. 6.3), which is 2/3 of the boron area. The bur design also includes a steel shank (Fig. 6.5), designed to hold the bur in the dental handpiece, and soldering (Fig. 6.4), which connects the shank and the working part of the bur.

The proposed device works as follows

The design of the torpedo-shaped dental bur for vertical preparation makes it possible to atraumatically go under the gum by 0.3 mm and form grooves for attaching a future orthopedic structure, an artificial crown, keeping the walls of the stump parallel, and precisely control the removal of hard tissues from the tooth. The formation of a tooth stump in this way reduces the risk of complications during and after preparation; also, due to the creation of micro ledges in the subgingival region and the formation of parallelism of the walls of the hard tissues of the tooth due to calibrated bur parameters, reliable fixation of the orthopedic structure is ensured.

The structural elements listed above are made as follows: the base frame of the bur is made of medical steel, partial sputtering with diamond chips of a spiral shape (tornado) with a size of 5 nm is present on the working part, with the exception of the end third and the end-shaped section of the tool, which is a section of polished steel.

The torpedo-shaped bur described above for vertical preparation for artificial crowns of teeth is used at the stages of preparation of hard tissues of the tooth from the vestibular, lingual and contact surfaces. Due to its shape and pre-calibrated parameters, the bur contributes to the precise removal of hard tissues from the tooth and to maintaining the parallelism of the walls during the preparation. Due to the long inert surface, entering the subgingival area, the possibility of traumatizing the marginal periodontium is excluded.

Examples of a specific performance are given in the form of an extract from the medical history.

Example No. 1 of a specific application is given in the form of an extract from a medical history

Patient P., 28 years old, came to the clinic of orthopedic dentistry with complaints about the absence of teeth in the lower jaw, tooth decay 3.4.

Objectively: the oral mucosa is without visible pathology, the end defect of the dentition of the lower jaw on the left, the equator of tooth 3.4 is not pronounced, the occlusal and vestibular surfaces of the tooth are partially restored with composite fillings of unsatisfactory quality. The marginal fit of the seals is broken. No pathological abnormalities of tooth 3.4 were revealed on the radiograph. EOD tooth 3.4 10 μA.

The main clinical diagnosis: Partial loss of teeth 2nd class according to Kennedy, defect of hard tissues of the tooth 3.4.

Orthopedic treatment plan: Restoration of tooth 3.4 with an artificial metal-ceramic crown, restoration of the integrity of the dentition of the lower jaw with a removable plate prosthesis with clasp fixation.

Treatment: Upon completion of the examination and approval of the treatment plan, a silicone key was received for the manufacture of a provisional crown. Under local infiltration anesthesia, tooth 3.4 was atraumatically prepared for a metal-ceramic crown using the newly proposed tornado-type bur with a non-aggressive torpedo-shaped tip. A straight ledge was formed at the level with the gingival margin with a width of 0.8 mm. A silicone impression was obtained with C-silicone "Speedex" on the day of preparation and without the use of retraction threads due to the absence of bleeding of the marginal periodontium and its deformation due to burr trauma, which could cause distortion of the impression (Fig. 1). With the help of c-silicone mass, the position of the central occlusion was fixed, an impression of the teeth of the antagonists was obtained, and a temporary crown of tooth 3.4 was made and fixed. Further, at the stages of dental rehabilitation, the defect of hard tissues of tooth 3.4 and partial loss of teeth of the lower jaw were restored in accordance with the clinical protocols of the Ministry of Health of the Russian Federation for this pathology.

At the scheduled examination after 6 months, no complications of treatment were detected.

Example No. 2 of a specific application is given in the form of an extract from the medical history

Patient K., 38 years old, came to the dental clinic with complaints about the absence of teeth in the lower jaw, tooth decay 4.4.

Objectively: the oral mucosa is without visible pathology, there are no teeth of the lower jaw: 3.6, 4.6, 4.7, 4.8. The mesial, occlusal and distal surfaces of tooth 4.5 were restored with a filling of satisfactory quality from a composite material using an anchor titanium pin. Index of destruction of the occlusal surface of the tooth according to Milikevich 0.6.

Diagnosis: Partial loss of teeth of the lower jaw, class 2, subclass 3 according to Kennedy, a defect in the hard tissues of the tooth 4.5.

Treatment plan: Restoration of tooth 4.5 with a metal-ceramic crown, restoration of the integrity of the dentition of the lower jaw with a removable arch prosthesis with clamp fixation.

Treatment: On the first visit, a silicone key was received for making a provisional crown. Under local infiltration anesthesia, tooth 4.5 was atraumatically prepared for a metal-ceramic crown using the newly proposed tornado-type bur with a non-aggressive torpedo-shaped tip. A straight ledge was formed at the level with the gingival margin with a width of 0.6 mm. A silicone impression was obtained with C-silicone "Speedex" on the day of preparation and without the use of retraction threads due to the absence of bleeding of the marginal periodontium and its deformation due to burr trauma, which could cause distortion of the impression (Fig. 2). With the help of c-silicone mass, the position of the central occlusion was fixed, an impression of the teeth of the antagonists was obtained, and a temporary crown of tooth 4.5 was made and fixed. Further, at the stages of dental rehabilitation, a defect in the hard tissues of tooth 4.5 and partial loss of teeth in the lower jaw were restored in accordance with the clinical protocols of the Ministry of Health of the Russian Federation for this pathology.

At the scheduled examination after 6 months, no complications of treatment were detected.

Example No. 3 of a specific application is given in the form of an extract from the medical history

Patient E., 44 years old. He complained about the absence of teeth, their destruction. Objectively: the oral mucosa is without visible pathology, teeth of the upper jaw are missing: 1.6, 1.5, 1.4, 2.4, 2.5. Tooth 1.2 - restored with multiple fillings. Teeth 1.1, 2.1 are significantly destroyed, the roots are preserved, the tissues of the roots are light and dense. On the radiograph, the root canals of teeth 1.2,1.1, 2.1 are filled homogeneously, up to the tops. No changes were found in the periapical tissues.

Diagnosis: Partial loss of teeth of the upper jaw, class 3 according to Kennedy, defect of hard tissues of teeth 1.2, 1.1, 2.1

Treatment plan: Restoration of the stumps of teeth 1.1., 2.1 with stump pin tabs. Restoration of the integrity of the dentition of the upper jaw with a ceramic-metal bridge supported by teeth 1.7, 1.3, 1.2, 1.1, 2.1, 2.2, 2.3, 2.6.

Treatment: On the first and second visits, teeth 1.1, 2.1 were restored with cast pin tabs, anatomical impressions were taken for the manufacture of provisional bridges. On the third visit, under local infiltration anesthesia, teeth 1.7, 1.3, 1.2, 1.1, 2.1, 2.2, 2.3, 2.6. prepared for metal-ceramic crowns. At the same time, teeth 1.2, 1.1, 2.1, 2.2 were prepared according to the classical method using retraction of the gingival margin with epinephrine-impregnated threads. For teeth 1.7, 1.3, 2.3, 2.6, a newly proposed “tornado” type bur with a non-aggressive torpedo-shaped tip without retraction of the marginal gingival margin was used. On all abutment teeth, a straight ledge with a bevel of 45 degrees is formed at the level of the gingival margin with a width of 0.5-0.8 mm. Fixed temporary bridges. On the fourth visit, 3 days after the preparation, after the removal of temporary structures, the state of the gingival margin in the area of the prepared teeth was assessed (Fig. 3). Puffiness and hyperemia of the gingival margin is noted in the area of teeth prepared in the traditional way using retraction threads - in the area of teeth 1.2, 1.1, 2.1, 2.2, which does not allow obtaining a precision impression. The condition of the marginal periodontal margin in the area of teeth 1.7, 1.3, 2.3, 2.6 is satisfactory. On the seventh day after the preparation (5th visit), there was no difference in the state of the gingival margin on the abutment teeth; a working and auxiliary impression was obtained with c-silicone. Further, at the 6th and subsequent visits, the restoration of defects in the hard tissues of the teeth and partial loss of the teeth of the upper jaw was carried out in accordance with the clinical protocols of the Ministry of Health of the Russian Federation for this pathology.

At the scheduled examination after 6 months, no complications of treatment were detected.

Example No. 4 of a specific application is given in the form of an extract from the medical history

Patient Sh., 47 years old, came to the dental clinic with complaints of missing teeth in the upper jaw, increased sensitivity from hot on the fangs of the upper jaw.

Objectively: The oral mucosa is without visible pathology, teeth of the upper jaw are missing: 1.8, 1.6, 1.5, 1.4, 2.4, 2.5, 2.6, 2.7, 2.8. On teeth 1.3, 2.3 - wedge-shaped defects of the cervical area. The bottom of the defects is pigmented, dense.

Diagnosis: Partial loss of the teeth of the upper jaw, class 2, subclass 3 according to Kennedy, defect in the hard tissues of the tooth 1.3, 2.3.

Treatment plan: Restoration of teeth 1.3, 2.3 with artificial zirconium dioxide crowns, restoration of the integrity of the dentition of the upper jaw with a removable arch prosthesis with clasp fixation.

Treatment: On the first visit, impressions of the upper and lower jaws were obtained for the manufacture of temporary crowns 1.3, 2.3. On the second visit, under local infiltration anesthesia, teeth 1.3 and 2.3 were prepared for zirconia crowns. 1.3 - atraumatically, using the newly proposed "tornado" type bur with a non-aggressive torpedo-shaped tip, 2.3 - according to the traditional method. A straight ledge was formed at the level with the gingival margin with a width of 0.6 mm. When examining the stump of tooth 1.3 (Fig. 4), prepared by the proposed boron, no injury to the gingival margin, bleeding or deformation of the marginal periodontium was found. It is possible to take a working impression on the day of preparation. When examining tooth 2.3 (Fig. 5), prepared by the traditional method, bleeding and trauma to the gingival margin were revealed, which is unacceptable when taking a working impression. Temporary crowns of teeth 1.3, 2.3 are temporarily fixed. The patient is scheduled for impressions in a week. On the third visit, a silicone impression was obtained with Speedex C-silicone. With the help of c-silicone mass, the position of the central occlusion was fixed, and an impression of the teeth of the antagonists was obtained. When evaluating the working impression, no differences were found in the imprint of teeth 1.3, 2.3. Further, at the stages of dental rehabilitation, the restoration of defects in the hard tissues of teeth 1.3 and 2.3 and the partial loss of teeth in the upper jaw were performed in accordance with the clinical protocols of the Ministry of Health of the Russian Federation for this pathology. By applying the proposed technique on both teeth, it would be possible to reduce the time spent by a week.

At the scheduled examination after 6 months, no complications of treatment were detected.

Claims (1)

A torpedo-shaped dental bur for vertical preparation, containing a shank, a working part and a smooth rod, which is coated with diamond grit, characterized in that the working part of the bur contains an active surface, occupying 2/3 of its area, in the form of spraying a spiral shape with diamond grit, and a passive surface, inert rounded tip, occupying 1/3 of the area of the drill, the thickness of the working part of the drill is 0.5 mm.

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