RU2250089C1 - Method for manufacturing adhesive dental bridge - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: method involves cleaning abutment teeth from deposit using diamond drill. Saw cuts are made in the abutment teeth in parallel to dental axis. The cuts are treated with acid and adhesive system and filled with fluid composite material. Glass fiber material is cut in advance in strips and set into the saw cuts arranging directivity vector in perpendicular to dental axis building in this way fastening system from fiber glass where oppositely directed fibers are interwoven with each other. Then the fastening system is filled with the fluid composite material or resin. Stump is repaired with condensed composite. Final prosthesis modeling is carried out using micro-hybrid material. Post-bonding is carried out using arbitrary protector material.

EFFECT: high retention capability; uniform chewing load distribution.

3 cl, 3 dwg

Description

The invention relates to medicine, in particular to orthopedic, therapeutic dentistry. This method of manufacturing an adhesive bridge (hereinafter referred to as the AMP) can be used in the manufacture of the AMP directly in the oral cavity in the area of a dentition defect without the participation of a technical laboratory during one visit.

Known methods for the manufacture of fixed AMPs, which consist of obtaining impressions, casting models, manufacturing a metal frame, an intermediate part and fixing the prosthesis using a composite material that is glued to the supporting teeth. The supporting elements of the AMP are modified occlusal plates and molded clasps. Fixation of prostheses is carried out using adhesive bases or composite materials (see Scherbakov A.S., Petrikas O.A. Prosthetics with partial loss of teeth by adhesive bridge prostheses. Medical abstract journal. Section XII, No. 11, 1988).

The disadvantage of such prostheses is that fixing with an adhesive base does not always withstand chewing load. In 19% of cases, this leads to the loss of prostheses during the first year of using them. Also, such prostheses cannot be made when the abutment of the supporting teeth, which limits their use (patent RU 2148386 C1).

Also known is a method of prosthetics of a small defect in the dentition, which consists in:

in the preparation of one of the supporting teeth under an artificial crown; determining the boundary of the additional supporting element on the second supporting tooth; imprinting; castings of the working and auxiliary models;

the manufacture of an artificial tooth with a crown - on one of the supporting teeth and an additional supporting element in the form of an occlusal lining - on the second tooth; fixing the crown with cement, and the second supporting element with composite plastic (ed. St. No. 1799572).

The disadvantage of this method of prosthetics is the need to grind one of the supporting teeth under an artificial crown, in addition, the fastening of such a prosthesis is very unstable, since it is fixed cantilever and is not protected from lateral and vertical loads.

The closest is a method of manufacturing a metal-ceramic AMP, which consists in the preparation of abutment teeth, impression taking, casting of the working and auxiliary models, and the manufacture of a prosthesis.

The prosthesis is fixed by filling the zones of ponutrinium formed by the lateral surfaces of the prosthesis and abutment teeth with adhesive material so as to preserve the washing space (patent RU 2148386 C1).

The disadvantages of this method are that:

- grinding of the lingual or palatal surface of the teeth is necessary;

- a prosthesis made under technical conditions has an easy route of administration and accordingly does not have sufficient mechanical retention;

- ROCATEK composite and metal bonding technology has discredited itself during the operation of prostheses, which indicates a poor connection between the metal elements of the prosthesis and tooth tissues.

The essence of the proposed method is that before starting work, the abutment teeth are cleaned of plaque with a diamond bur; make cuts in the abutment teeth parallel to the axis of the tooth; the cuts are treated with an acid and an adhesive system, filled with a fluid composite; fiberglass, cut in advance by strips, is installed in cuts, positioning the fiber directional vector perpendicular to the axis of the tooth (a fiberglass fixing system is formed, where counter-directed fibers on the surfaces of adjacent fiberglass strips are intertwined). After that, the fastening system is filled with a fluid composite or resin. Using a condensable composite, stump repair is performed. The final modeling of the prosthesis can be done with any microhybrid preparation. The post bonding technique is performed with an arbitrarily selected tread.

In the lateral departments during prosthetics of molars and premolars, cuts on the supporting teeth are also made parallel to the axis of the tooth (if necessary, they can be made from two to four).

For the manufacture of AMP of the front teeth, one or two cuts is sufficient.

All work is carried out by direct method without using a technical laboratory for one visit to a doctor.

The technical result obtained by using the proposed method is as follows:

a high degree of retention and an even distribution of the masticatory load on the abutment teeth is achieved (when using the proposed method of AMP fixation, it can withstand the load several times higher than when using all previously known methods) due to the chemical binding of the prosthesis fixing system to the tooth tissues and the location of the fixing system along the axis supporting teeth. This is due to the distribution of chewing load along the axis of the abutment teeth, and not along the slopes of the palatine or lingual surfaces of the abutment teeth, as with standard technology;

preservation without large damage to the teeth, between which the prosthesis is installed (small cuts are made on these teeth, which are immediately closed with chemical materials equivalent to filling materials), the lingual and palatal surfaces of the teeth are preserved;

more reliable fixation of AMP due to the fact that between the tissues of the tooth and the fastening system a bond has formed at the chemical level;

aesthetic properties of the prosthesis are improved due to the lack of metal elements of the prosthesis;

the speed of manufacture of the prosthesis and the lack of attachment to the technical laboratory allows expanding the capabilities of therapists and orthopedists.

Figure 1, 2, 3 shows the step-by-step manufacturing of the lower incisor prosthesis, where Figure 1 is the cuts for the support system, Figure 2 is the installed mounting system, Figure 3 is the final view of the prosthesis.

Example. Before starting work, the abutment teeth are cleaned of plaque using professional pastes and brushes or Air-flow.

Diamond cuts make cuts in the abutment teeth parallel to the axis of the tooth. The propyls are treated with 32% phosphoric acid for 15 s, washed off with a water-air spray. Throughout the manufacture of AMPs using the direct method, a light curing lamp is used. The cuts are treated with an adhesive system. The saw cuts are filled with a fluid composite, and a Fibro-kor fiberglass fixing system is installed so that the opposing fibers of the Fibre Kor strips intertwine with each other. After that, the fastening system is filled with a fluid composite or resin. After that, Alert condensed composite is used to restore the stump.

The final modeling of the prosthesis can be done with any microhybrid preparation.

The post bonding technique is performed with an arbitrarily selected tread.

The method has been tested clinically.

Claims (3)

1. A method of manufacturing an adhesive bridge, which consists in preparing the abutment teeth by cleaning them from plaque, making cuts, treating them with acid and filling with a fluid-flowing composite, fixing the fastening system; facing the future prosthesis with composite materials, characterized in that the prosthesis is made directly in the oral cavity in the area of the dentition defect; in the abutment teeth, cuts are made parallel to the axis of the tooth, into which the fiberglass is installed in the form of strips, having the fiber directional vector perpendicular to the tooth axis, forming a fiberglass fastening system, where counter-directed fibers on the surfaces of adjacent fiberglass strips are intertwined with each other; then the fastening system is filled with a fluid composite or resin; the tooth is restored with a condensable composite; perform the final modeling of the prosthesis with a microhybrid preparation and post-boarding. 2. The method according to claim 1, characterized in that for the manufacture of AMP when prosthetics of molars and premolars in the lateral parts of the abutment teeth, two to four cuts are performed. 3. The method according to claim 1, characterized in that for the manufacture of AMP of the front teeth on the supporting teeth, one or two cuts are made.

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