RU2253402C2 - Method for restoring/restructuring crown part defects with metal reinforcement net carcass being applied - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves carrying out odontopreparation, forming cylindrical tooth stump to gingival level, forming a projecting part on this place and fixing net carcass on the stump followed by crown part restoration using composite material. When forming stump, occlusion surface is filed off by 0.9-1.2 mm and additional retention zones like 0.2-0.3 mm deep horizontal grooves are formed on the aproximal surfaces. The carcass is produced from gold-plated metal wire net having 0.4 mm large meshes to fit the stump. Before being fixed, the net carcass is treated twice with masking agent leaving meshes open. Final crown part restoration follows with anatomical tooth shape being taken into account.

EFFECT: fully restored anatomical tooth shape; high strength of tooth walls; long service life; high esthetic quality.

Description

The invention relates to medicine, namely to dentistry, to the method of restoration / reconstruction of defects of the crown of the teeth using a metal mesh-reinforcing frame.

The causes of defects in tooth crowns are: caries and its complications, increased abrasion of hard tooth tissues, acute and chronic injuries, hypoplasia, enamel and dentin cracks, wedge-shaped defects (5, 6, 8).

The nature and extent of the medical intervention depends on the degree of damage and the prescription of the process. As therapeutic agents for defects in the crown of the tooth, dentures are mainly used: inlays and artificial crowns (2, 4, 7).

The closest in technical essence, taken as a prototype are all-ceramic crowns and bridges (1).

Disadvantages of all-ceramic crowns.

1. A complex, multi-stage manufacturing process.

2. High probability of thermal burn of the pulp.

3. The impossibility of prosthetics with low clinical crowns.

4. The need for tooth removal in case of tilt.

5. The inability to use with malocclusion (deep incisal overlap).

6. The inability to use in people with periodontal disease, bruxism, epilepsy.

7. The complexity of odontopreparation (creating a step, the taper of the walls).

8. The need to manufacture a temporary (provisional) crown on the prepared tooth.

9. Duration of manufacture (requires several visits).

10. Penetration of fixing cement into the gingival fissure.

11. Increased tooth abrasion of antagonists due to the more pronounced hardness of ceramics in comparison with tooth enamel.

12. Frequent chips.

13. Possible de-alignment of crowns.

14. With endodontic treatment, the need to remove the crown.

15. High cost.

The aim of this invention is: restoration of the anatomical shape, functions and appearance of a damaged tooth, prevention of chips and chips, increase the durability of the crown of the tooth.

Advantages of the method of restoration / reconstruction of defects in the crown of teeth using a metal mesh-reinforcing framework - ISAC:

1. A gentle method of preparation.

2. The defect is restored in one visit.

3. Lack of laboratory steps.

4. Low cost.

5. The ease of construction.

6. The durability of the design.

7. A simple way to restore the cortical part of the tooth.

8. The mesh-reinforcing frame is fixed on glass ionomer cement of double cure, which provides a full fixation of the structure.

9. If endodontic intervention is necessary, it is possible to create access by perforation without removing the structure.

10. The mesh-reinforcing frame, combined with glass ionomer cement and composite material, forms a single monoblock that ensures structural strength.

11. A simplified and immediate method of manufacturing a mesh-reinforcing frame.

12. The mesh-reinforcing frame provides reliable mechanical retention of the restored materials.

13. Mesh-reinforcing frame provides high structural strength.

14. Lightweight robust design.

15. Excludes the casting process of the frame.

16. Accelerates the recovery period of the defect.

17. Reduces time costs.

18. Increases the economic effect.

19. The cellular structure of the mesh-reinforcing frame provides a solid connection of the portions of the composite with each other and prevents chips and chips.

20. Good biocompatibility of the mesh-reinforcing framework with the surrounding tooth tissues and with the composite.

21. Double adhesive and camouflage treatment not only improves the bond strength of the mesh-reinforcing frame with the composite, but also eliminates the color change of the structure.

22. Robust construction, since the mesh-reinforcing frame provides reinforcement of the structure.

23. The mesh-reinforcing frame in combination with modern adhesive composite materials creates a monoblock - a multilayer reinforced structure, without its inherent weak boundaries between the layers, which ensures the reliability and efficiency of the structure.

24. The effectiveness of modeling the crown of the tooth.

25. The cellular structure of the mesh-reinforcing frame provides a high aesthetic effect.

26. The cellular structure of the mesh-reinforcing framework ensures the naturalness of the restoration.

27. The mesh-reinforcing framework is fully adapted to the anatomy of the tooth stump.

28. The ability to create access, through perforation, without violating the integrity of the structure if necessary, endodontic intervention.

29. A gold-plated mesh frame provides a shade similar to dentin.

30. The yellow color of the metal mesh in the composite layer is less visible and looks more natural and provides a natural appearance of the crown.

31. Gold-plated mesh frame is not only aesthetic, but also compatible with composite and tooth tissues.

Stages of production of ISAC.

1. Determination of the color of the crown.

2. Anesthesia.

3. Odontopreparation.

4. Production and fitting of MSAK.

5. Preparation of ISAA for fixation.

6. Preparation of tooth stump for fixation.

7. Fixation of ISAC.

8. Restoration of the anatomical shape of the tooth.

Crown Color Definition

Mechanically, the surface of the teeth adjacent to the defect is cleaned with toothbrushes using toothpastes and a suitable color is determined according to the generally accepted VITA scale. Gum retraction is performed with retraction thread.

Anesthesia

To create a favorable and painless work, anesthesia is performed.

Odontopreparation

After the onset of anesthesia, intermittent preparation is carried out with a water-cooled turbine drill to prevent inflammation of the pulp tissue.

First, the tooth is separated by flame-shaped and cylindrical burs to create parallel walls and form a ledge of the tooth stump at the level of the gums. Next, the occlusal surface of 0.9-1.2 mm is ground with abrasive tools. The preparation is completed by removal of tissues from the oral and vestibular surfaces protruding above the level of the neck of the tooth, and the tooth stump is given a cylindrical shape. Then, retention points are formed on the proximal surfaces to improve the fixation of MASK.

Production and fitting of a metal mesh-reinforcing frame MSAC.

A 2 × 2 cm square is cut out of the metal mesh, using a plugger and beak-shaped forceps, a mesh frame is formed and fitting is carried out. Then, the excess is cut off with scissors and repeated fitting is carried out. Then achieve full compliance in height, width and shape of the tooth stump. Next, prepare to fix the ISAA. Preparation for fixing the mesh-reinforcing frame of the ISAC.

The mesh reinforcing frame is coated with adhesive. Further, the adhesive is slightly flushed with air for uniform distribution and polymerized by the standard method. The adhesive is then applied with a second layer, which is distributed and polymerized.

To improve the aesthetics of the structure, a masking agent is applied to the mesh-reinforcing frame, which is distributed evenly with a thin layer by a stream of air, leaving the mesh cells open. Then polymerized for 30 seconds. Then a masking agent is applied with a second layer, which is also distributed and polymerized.

Preparation of the tooth stump for fixation of the metal mesh-reinforcing frame of the ISAA.

The tooth stump is treated. The etching gel is applied to the tooth stump for 30 seconds, then washed off with a stream of water while the saliva ejector is running, air-dried, and adhesive is applied. Further, the adhesive is slightly flushed with air for uniform distribution and polymerized by the standard method. The adhesive is then applied with a second layer, also distributed and polymerized. After that, SIC (glass ionomer cement) is applied to the retention points of the tooth stump and to the inner surface of the MSCA, then the frame is fixed to the tooth stump and polymerization is carried out. Next, the restoration / reconstruction of the cortical part of the tooth is carried out with composite materials according to the instructions.

The aesthetic effect is achieved after pretreatment and grinding with standard polishing discs of various thicknesses and grit sizes, diamond burs, and the approximate surfaces are treated with strips. Correction is performed under the control of occlusal paper with finishing burs and discs. Finishing is done.

Thus, this method allows for restoration / reconstruction in case of defects in the crown of the tooth using a metal mesh-reinforcing framework and to achieve long-term restoration of the tooth along with high aesthetics.

Clinical example:

Sick, 34 years old.

Complaints: aesthetic dissatisfaction with 14 teeth.

Anamnesis: Earlier, 14 tooth was treated for complicated caries, four years ago a metal crown was made. Three weeks ago, the crown was unsealed.

Objectively: The crown of the tooth is destroyed by 1/2. The results of the x-ray: the channels are sealed to the apex, periapecal changes are not observed.

Diagnosis: crown defect 14.

Treatment: Mechanically, the surfaces of the teeth adjacent to the defect are cleaned with toothbrushes using toothpastes and a suitable color is determined according to the generally accepted VITA scale. Gum retraction is performed with retraction thread.

To create a favorable and painless work, anesthesia is performed. After the onset of anesthesia, intermittent preparation is carried out with a water-cooled turbine drill. First, the tooth is separated by flame-shaped and cylindrical burs to create parallel walls and form a ledge of the tooth stump at the level of the gums. Next, the occlusal surface of 0.9-1.2 mm is ground with abrasive tools. The preparation is completed by removal of tissues from the oral and vestibular surfaces protruding above the level of the neck of the tooth, and the tooth stump is given a cylindrical shape. Then, retention points are formed on the proximal surfaces to improve the fixation of MASK.

For the formation of the mesh frame, use a gold-plated metal mesh with a thickness of 0.4 mm firm "Renfert". The metal mesh is designed to strengthen plastic prostheses (Catalog. Products for dental technicians 2001-2002, pp. 102-103). A square 2 × 2 cm is cut from the grid, the corners and edges of which are cut with scissors, and a circle shape is achieved. Then, with the help of a plug-in, the circles are cup-shaped and try on a tooth stump. Then, with crampon and beak-shaped forceps, a mesh framework is formed so that it matches the contours of the tooth stump.

The mesh-reinforcing framework is coated with 3M ^TM SINGLE BOND DENTAL ADHESIVE SYSTEM adhesive (Catalog. Dental materials 2001. 3 M Dental, p. 6). Further, the adhesive is slightly flushed with air for uniform distribution and polymerized by the standard method. The adhesive is then applied with a second layer and polymerized.

To improve the aesthetics of the design on the grid-applied reinforcing frame masking agent - 3M ^{TM TM} RelyX CERAMIC PRIMER (. Dental materials Catalog 2001. 3 M Dental, p.11), which is a thin layer uniformly distribute the air stream leaving the open grid cell. Then polymerized for 30 seconds. Then a masking agent is applied with a second layer, which is also distributed and polymerized. The etching gel is applied to the tooth stump for 15 seconds - 3M SCOTCHBOND ETCHANT GEL (Catalog. Dental materials 2001. ЗМ Dental, page 6), then washed with a jet of water while the saliva ejector is working, dried with air, and applied with adhesive. Further, the adhesive is slightly flushed with air for uniform distribution and polymerized by the standard method. The adhesive is then applied with a second layer, also distributed and polymerized. After that, glass ionomer cement SIC - 3M SCOTCHBOND ETCHANT GEL is applied to the retention points of the tooth stump and to the inner surface of the MSCA (Catalog. Dental materials 2001. 3M Dental, p.6).

Then fix the frame on the tooth stump and carry out the polymerization. Next, the restoration of the crown part of the tooth is carried out according to the traditional method for chewing groups of teeth 3M ™ FILTEK ™ Z-250. Universal restoration material (Catalog. Dental materials 2001. 3M Dental, p.2).

The aesthetic effect is achieved after pretreatment and grinding with standard 3M ™ SOF-LEX ™ polishing discs (Catalog. Dental Materials 2001. 3 M Dental, p. 8) of various thicknesses and grain sizes, diamond burs, and the approximate surfaces are treated with strips. Correction is performed under the control of occlusal paper with finishing burs and discs. Finishing is done.

Thus, this method allows the restoration / reconstruction of a tooth crown defect using a metal mesh-reinforcing framework. There were no complications after the restoration / reconstruction by the above method.

Sources of information

1. Kristian W. New all-ceramic crowns and bridges - evaluation criteria // Quintessence. 1993-1994, No. 6-32. Prototype.

2. Abolmasov NG, Orthopedic dentistry, Moscow, MEDpress - inform., 2002, p.211-219.

3. Aparin VV, Prevention of complications when using ceramic-metal prostheses // Journal “Dentistry”. 1981, No. 2, p. 34-36.

4. Unknown GV, Long-term results of prosthetics with tabs // Journal "Dentistry", 1990, No. 6, p. 63-64.

5. Borisenko A.V. and others. Composite filling and facing materials in dentists. Kiev: 2001, p. 200.

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

7. Ryakhovsky AN, Edge fit - as a criterion for the quality of prosthetics with fixed prostheses // Journal “Dental Technician”, No. 3, 2000, p. 15-17.

8. Jordan R.E. // Composite filling and facing materials in dentistry. A.V. Borisenko, V.N. Not without reason. / Kiev, 2001, p. 200.

9. Iohn A. In - Ceram technology for the manufacture of all-ceramic bridges // Quintessence. 1993-1994, p. 39-74.

Claims (1)

The method of restoration of the crown part of the tooth using a mesh-reinforcing framework, including odontopreparation, the formation of a tooth stump of a cylindrical shape to the level of the gums, the formation of a protrusion at this level and fixation of a metal mesh frame on the stump with the subsequent restoration of the crown part with a composite material, and when forming the stump, the occlusal surface polished on 0.9-1.2 mm, and on its approximate surfaces retention points are additionally formed in the form of horizontal grooves of the deep bina 0.2-0.3 mm, while the frame is formed from a gold-plated metal mesh with 0.4 mm cells in accordance with the stump shape, before fixing, a masking agent is applied to the mesh frame twice, leaving the cells open, and the subsequent final restoration of the crown carried out in accordance with the anatomical shape of the tooth.