RU2252729C1 - Method for restoring frontal teeth groups of fully lacking crown part with composite reinforcement pin being applied - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has perforated plate or metal wire network plate. Pin has reinforcing part manufactured as curve plate and fixing part matching root base cavity in shape and fastening member. The reinforcement pin is fixed in root canal with a fastening member manufactured from twisted metal threads passed through fixing part of the pin. The crown tooth part is formed on the reinforcing pin part from composite material.

EFFECT: retained anatomical natural tooth shape and appearance; retained crown part.

Description

The invention relates to medicine, to aesthetic dentistry, to a method for restoration of anterior teeth groups in the complete absence of a crown using a precast reinforcing pin.

State of the art

From publicly available sources of information on the priority date for the application it is known that the reasons for the complete absence of the crown part of the frontal groups of teeth can be: carious damage to the tooth, non-carious damage, traumatic fracture, the consequences of prosthetics with artificial crowns.

To restore the crown of the tooth with a preserved root in dentistry, artificial crowns are used based on stump or pin structures, direct and indirect restorations from light-cured composite materials, additionally reinforced with a variety of pin structures (1-7).

A known method of restoring a damaged tooth using a pin having a head with an expanded area for fixing the crown of the tooth. The disadvantages of this technique are the presence of laboratory stages, the need for precision casting, the presence of an edge gap, the further destruction of hard tooth tissues, periodontal overload, and the duration of treatment (8).

The closest in technical essence is the method of restoration of the missing crown part of the tooth with composite materials using an anchor pin fixed in the tooth root canal with cement (9).

The disadvantages of this method are:

1. low mechanical strength of the structure;

2. The area of contact of the composite with the head of the anchor pin is about 20-30% of the total area of the crown part of the tooth being restored;

3. the head of the anchor pin is located at 1/3 of the height of the crown part of the tooth being restored (in the center), which ensures mechanical strength of the structure only in the cervical region;

4. about 60-70% of the crown of the restored tooth remains without reinforcement, which leads to frequent chips and spallations of the structure.

Given the above disadvantages, the restoration of composite materials in the complete absence of the crown part in the front groups of teeth with the use of anchor pins in clinical practice has not received widespread use.

The objective of the invention is to develop a method of restoration of the front groups of teeth in the complete absence of the crown using a precast reinforcing pin, which eliminates the above disadvantages along with high aesthetics.

EFFECT: simplification of the procedure for restoration of the crown part of the tooth due to the use of a prefabricated reinforcing pin easy to manufacture, while ensuring the corresponding strength, functional and aesthetic characteristics of the restored crown part of the tooth.

The technical result is achieved due to the design features of the pin, one end of which is fixed on the base of the tooth root and in its channel, and the other in the composite layer of the restored crown of the tooth. Thus, the restored crown part is firmly attached to the root of the tooth. Due to the design features of the pin, at the same time as providing a strong connection of the crown part and the root of the tooth, reinforcement of the restored crown part of the tooth is additionally carried out.

The technical result is ensured by the following factors:

1. a reinforcing pin made of a metal plate with perforations or of a metal mesh, in conjunction with a fastening element made of a series of twisted metal threads, is a mechanically strong monolithic structure placed inside a composite material;

2. the implementation of the reinforcing pin with perforations or from a metal mesh not only increases the area of contact with the composite material, but also gives the corresponding strength to the crown of the restored tooth;

3. the implementation of the reinforcing pin with perforations or from a metal mesh helps to reduce the shrinkage of the composite material and leads to an improvement in the marginal fit of the composite to hard tooth tissues;

4. the execution of the fixing part of the pin in a shape that repeats the shape of the cavity, made at the base of the root, provides a uniform distribution of stress on the root with functional loads on the tooth;

5. the implementation of the reinforcing pin with perforations or from a metal mesh helps to reduce the stress (stress) that occurs during the polymerization of a composite material;

6. the implementation of the reinforcing pin with perforations or from a metal mesh provides the prevention of possible complications of chips and spalls after restoration of the crown part;

7. The use of a reinforcing pin increases the durability of the restored tooth.

SUMMARY OF THE INVENTION

The proposed method (see Fig.1-12) involves preliminary endodontic treatment of the tooth. The root canal should be sealed 1/3 of the length of the root and not have periapical changes. The color of the future restoration is determined on the VITA scale. Gum retraction is performed by retraction floss for greater access to the root of the tooth. After retraction of the gums, a cavity is formed at the base of the root.

The reinforcing pin is made of a rectangular metal perforated plate or a rectangular plate made of metal mesh. The reinforcing and fixing parts of the pin are formed from the plate, respectively intended for reinforcing the crown of the tooth and for fixing the pin in the cavity formed on the base of the root. Opposite sides along the length of the plate draw together relative to each other to give the plate a curved shape. Thus, the so-called "stiffener" is formed at the plate, which increases the strength of the reinforcing pin and, in particular, its bending reinforcing part. The width of the part of the curved plate, which is designed to reinforce the crown of the tooth - the reinforcing part of the pin, must correspond to the width of the defect of the crown of the missing tooth. The pin is fixed in the root of the tooth so that the plate is turned with a concavity towards the vestibular surface of the tooth.

From the side opposite the reinforcing part of the pin, the fixing part of the pin is formed. For this, the plate is additionally bent to give it a shape that repeats the shape of a cavity formed on the basis of the root.

The metal threads, which can be, in particular, cut out of the mesh, give a "U" -shaped shape. The free ends of the threads pass through the holes of the fixing part of the pin, preferably in the center, and twist them together, rigidly connecting the fixing part of the pin and the fastening element thus formed. Moreover, the length of the fastening element, as a rule, does not exceed 1/2 the length of the tooth root. The reinforcing part, the fixing part and the fastening element constitute a prefabricated reinforcing pin. Then carry out the fitting of the precast reinforcing pin. After fitting and correction, acidic etching of the root base is performed to create a microrelief (the root canal is closed with cotton wool. The acid is washed off with a water jet while the saliva ejector is working, the cavity is dried with air, adhesive is applied, it is slightly blown with air for uniform distribution. Polymerized by the standard method according to the instructions. Then remove wool from the root canal and the pin are fixed with glass-cement, placing a fastening element in the root canal, and in the formed cavity of the base nya - the fixing part of the pin.

After fixing the pin, they begin the final restoration of the missing crown part of the tooth in accordance with its anatomical shape using composite materials.

The aesthetic effect is achieved after pre-treatment and grinding with standard polishing discs of various thicknesses and grain sizes of the abrasive with diamond burs, and the approximate surfaces are treated with strips. Occlusive editing is carried out under the control of occlusal paper with finishing burs, discs. Remove the retraction thread. Thus, this method allows to increase the structural strength, increase the durability of the restoration with the complete absence of the crown of the tooth along with high aesthetics.

Example

Patient T., 28 years old.

Complaints: aesthetic dissatisfaction, the complete absence of the crown 11.

Anamnesis: According to the patient, the 11th tooth was previously repeatedly treated for complicated caries. About six months ago, 11 was restored using composite materials. Three days ago, the crown part 11 was broken off.

Objective: The condition is satisfactory, external inspection without features. The mucous membrane of the oral cavity is pale pink. Orthognathic bite. There is no crown 11. The percussion of the tooth is painless. There is no change in the periapical tissue x-ray, the root canal is completely filled.

It is recommended to restore the missing crown 11 using a precast reinforcing pin.

Treatment: The color of the future restoration was determined on a VITA scale. Gum retraction was performed with retraction thread. After retraction of the gums, a cavity was formed at the base of the root. The reinforcing pin was made of a rectangular plate made of metal mesh. The reinforcing and fixing parts of the pin were formed from the plate. Opposite sides along the length of the plate brought together relative to each other to give the plate a curved shape. The width of the reinforcing part of the pin corresponded to the width of the defect of the crown part of the missing tooth. From the side opposite the reinforcing part of the pin, its fixing part was formed. For this, the plate was additionally bent to give it a shape that repeats the shape of a cavity formed on the basis of the root.

The metal threads cut from the net were given a “U” shape. The free ends of the threads were passed through the holes of the fixing part of the pin, twisted them together, rigidly connecting with the fixing part of the pin. After fitting and correction of the precast reinforcing mesh pin, acid etching of the root base was performed, while the root canal was closed with cotton. The acid was washed off with a jet of water while the saliva ejector was working, the cavity was dried with air, adhesive was applied, and it was slightly blown with air for uniform distribution. Polymerized by the standard method according to the instructions. Then cotton wool was removed from the root canal and the pin was fixed with glass-resin cement, placing a fastening element in the root canal, and the fixing part of the pin in the formed root base cavity.

After fixing the prefabricated reinforcing pin, they began the final restoration of the missing crown part of the tooth in accordance with its anatomical shape using composite materials.

The aesthetic effect was achieved after pretreatment and grinding with standard polishing discs of various thicknesses and grit sizes, diamond burs, and the approximate surfaces were treated with strips. Occlusive editing was carried out under the control of occlusal paper with finishing burs and discs. The retraction thread was removed. Complications after carrying out the above method were not identified.

Sources of information

1. Galimov I.Yu. // Clinical experience with the use of anchor pins to restore the crown of the tooth. Dentist practitioner. 2001. No1. - S.28-30.

2. George Friedman. Aesthetic treatment using pin repair technique. Clinical Dentistry. 2001. No2. - S. 10-15.

3. Kopeikin V.P. Guide to orthopedic dentistry. M - 1998, p. 496.

4. Nikolaev A.I., Tsepov L.M. // Practical therapeutic dentistry. St. Petersburg - 2001

5. Svetlov A.V., Kozitsina S.I. // Experience with the root pins of the COSMOPOST system. Scientific and practical journal. Institute of Dentistry - 2000. No. 1., - P.28-30.

6. Olesova V.N. // Biomechanical and clinical substantiation of fiberglass-based pin structures. Panorama of orthopedic dentistry. 2000. - P.4-6.

7. Jordan R.E. // Composite filling and facing materials in dentistry. A.V. Borisenko, V.N. Nespryadko. / Kiev - 2001, - С.200.

8. Patent US 5178540 A, 12.01.1993.

9. Nikolishchin A.K. Restoration (restoration) and tooth filling with modern materials and technologies. Poltava - 2001, p. 72-77 - a close analogue.

Claims (1)

A method for restoration of anterior tooth groups in the complete absence of a crown using a precast reinforcing pin, including endodontic tooth treatment, fixing a reinforcing pin in the root canal and cavity previously formed on the base of the root, and forming composite materials on the reinforcing part of the tooth crown in accordance with anatomical shape, while the reinforcing part of the pin is formed in the form of a rectangular metal plate bent along the length, made with perforations whether from the grid, and for forming the latch portion of the pin one end of the plate is shaped corresponding to the shape of the cavity on the basis of the root, and then through the openings and the locking part is passed between a series of twisted metal strands to form the fixing pin member in the root canal of a tooth.

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