RU2253399C1 - Method for restoring lateral incisors having defects covering 2/3 of crown part with wire reinforcement being applied - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves reinforcing crown part defect with wave-shaped wires. The wires are taken in advance from gold-coated metal network, Ѕ tooth root length long wire portion is twisted and fixed in the canal. Free ends of the wires are distributed along vestibular surface of tooth cutting edge and bent towards vestibular tooth surface 1-1.5 mm below the cutting edge. Free ends of the wires are fixed in oval tooth cavity on the vestibular tooth surface side. Artificial enamel layer is produced from macrofilled composite material anatomically matching in shape the incisor crown part, fixing the wave-shaped wires in composite material. Artificial dentine is produced from microfilled composite material.

EFFECT: high strength of incisor walls; long service life under chewing loading.

Description

The invention relates to medicine, namely to dentistry, and can be used in the restoration of lateral incisors with defects of 2/3 of the crown using wire reinforcement.

From publicly available sources of information on the priority date for the application it is known that the causes of a defect in the crown part of the lateral incisors can be: carious tooth damage, non-carious lesion, traumatic fracture, consequences of prosthetics with ceramic-metal crowns.

To restore the crown part 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 (1-9).

The prior art (EPO No. 056589 A1, 1993) known a method of restoring the crown of the tooth by applying material for fillings and a reinforcing element made in the form of a bracket. It seems that the known method is the closest in technical essence to the claimed one (10).

The disadvantages of this method are manifested:

1) in the complex technological manufacture of the reinforcing element, due to the complex spatial configuration of the bracket (the presence of a welded or solid centerpiece and transverse teeth, etc.);

2) the need for the manufacture of several sizes of brackets and the use of only a certain standard size;

3) in a limited area of reinforcement of the restored tooth surface, determined by the geometric dimensions of the bracket and its configuration;

4) in the presence of different strength characteristics of the zones of the restored part of the tooth;

5) in the occurrence of additional zones of increased tension due to the formation in the tooth body of elements for attaching the bracket;

6) subject to paragraphs 4 and 5, in an increased likelihood of chipping of the filling material from the walls of the restored tooth.

The objective of the invention is to develop an easy-to-implement method for the restoration of side incisors, including reinforcing the restored walls with easy-to-manufacture means - wave-shaped wires, in which the above disadvantages would be completely eliminated.

The use of wave-like wires for reinforcing the walls of the lateral incisors during their restoration allows the restoration of incisors in one visit to the patient.

Achievable during the implementation of the claimed invention, the technical result consists in increasing the strength of the restored walls of the cutters, due to volume reinforcement with wave-like wires, and in increasing their durability during the perception of chewing loads.

The technical result is ensured by the following factors:

1) due to the wave-like shape of the wires that increase the retention of the composite materials used in tooth restoration, chips and chips of the restored walls are excluded;

2) due to the placement of wave-like reinforcing wires in a composite medium, it increases the contact area with the composite and the reinforcement efficiency increases;

3) through the use of gold-plated metal wires, the corresponding color of artificial dentin is achieved;

4) due to the use of wave-like wires, the shrinkage of the composite material is reduced and the marginal fit of the composite to the hard tissues of the tooth is improved;

5) due to the flexibility, wave-like wires are formed in accordance with the shape of the restored cutter, which ensures uniform distribution of stress on the root under functional loads on the tooth;

6) due to the flexibility of wave-like wires, the crown of the tooth is reinforced even in cases of root channel curvature;

7) due to the flexibility of wave-like wires, the elimination of a tooth defect occurs in one visit, since the manufacture, fitting and fixing of the wires is carried out directly during the restoration.

SUMMARY OF THE INVENTION

The proposed method involves preliminary endodontic treatment of a 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 with retraction thread for greater access to the cervical part of the tooth crown. After gum retraction, an oval cavity is formed on the preserved crown of the tooth.

Then carry out the next stage of restoration - reinforcing the crown of the tooth with wires. For this, wave-shaped wires previously removed from a gold-plated metal mesh are used. In this case, the required wire length is defined as the sum of the length of the root canal of the tooth and the doubled height of the crown of the tooth.

The wires are collected in a bundle, drawing closer to each other, and with the help of clamps are twisted from one of the ends. The length of the twisted part of the wires is not more than 1/2 the length of this channel. The diameter of the fixing part of the wires is formed corresponding to the diameter of the root canal. If necessary, the diameter of the fixing part can be adjusted in accordance with the size of the diameter of the root canal.

Thus, the fixing part of the wire bundle is formed, which is designed to fix the wires in the root canal of the tooth. Due to the flexibility of the wires, the formed fixing part also has flexibility, which makes it possible to install the fixing part even in the root channel with curvatures.

Next, the correction and fitting of this fixing part. In this case, the free ends of the wires are distributed in a “fan” order along the cutting edge of the tooth, at approximately equal distance from each other. Using cement, the fixing part is fixed in the root canal and the restoration of the crown part of the tooth is started.

The distributed wires are bent towards the vestibular surface of the tooth so that the bend is 1-1.5 mm below the cutting edge of the tooth. The free ends of the wires are placed in a previously formed cavity of the crown of the tooth. Due to the elasticity, the ends of the wires are fixed in the cavity from the side of the vestibular surface of the tooth.

An artificial enamel layer is formed from a mechanically durable (macrophilic) composite on the oral surface of the tooth in accordance with the anatomical shape of the tooth. In this case, the “fan-shaped” distributed wires are located in the composite enamel layer and repeat in shape the oral surface of the crown of the tooth. The space of the crown of the tooth, formed by curved wires, is filled with a microfilled composite, forming artificial dentin.

An artificial enamel layer is formed from the macrophilic composite on the side of the vestibular surface of the coronal part.

Thus, the restored crown of the tooth consists of an artificial enamel layer reinforced with curved wave-like wires and artificial dentin.

Restored by the claimed method, the tooth is able to absorb chewing loads. Due to the reinforcement with wave-like wires, the strength of its walls increases, chips and spalls of the walls are excluded.

List of references

1. Borovsky EV and other therapeutic dentistry. M .: Medicine, 1997. - S.163-168, 177-178, 196.

2. 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.

3. Griban A.M. Elimination of traumatic defects of crowns of the frontal group of teeth with composite materials using parapulpar pins. Dentistry Republican interdepartmental collection of the Ministry of Health of the Ukrainian SSR, 1988. - P.106-109.

4. George Friedman. // Aesthetic treatment using a pin recovery technique. Clinical Dentistry. 2001. No2. a. - S. 10-15.

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

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

7. 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. - S.28-30.

8. Olesova VN, // Biomechanical and clinical justification of the pin structures based on fiberglass. Panama orthopedic dentistry. 2000. - P.4-6.

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

10. Application for patent EPO No. 0565899 A1, cl. A 61 C 5/00, 1993 - a close analogue.

Claims (1)

A method for restoration of lateral incisors with defects of 2/3 of the crown of the tooth using reinforcing wires, including preliminary endodontic treatment of the tooth, gum retraction and the formation of an oval cavity on the preserved crown of the tooth, fixation in the root canal of undulating wires previously extracted from a gilded metal mesh and twisted between each other along the length of no more than 1/2 the length of the root canal, the distribution of free wires along the cutting tooth and the bending of the free ends towards the vestibular of the tooth is 1-1.5 mm below the cutting edge, and the placement of the free ends of the wires in the oval cavity of the tooth from the side of the vestibular surface, and the fixation of the wires placed in the crown of the tooth in an artificial enamel layer formed in accordance with the anatomical shape of the crown a cutter made of macrophilic composite material, and the formation in the space between the wires of artificial dentin made of microfillated composite material.