RU2276592C1 - Method of making prosthetic appliances of teeth - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method includes restoration of lost fragments of crown part of tooth, preparation of support teeth for which the prosthetic appliances are made, getting of tooth row print, making of prosthetic appliance and final cementing of prosthetic appliance onto strong teeth. After lost fragments of crown part of tooth are restored, metal precision cap is made to follow the mould of prepared tooth. Marginal part of the cap has minimal thickness to prevent of getting of bench. Small hole is made in top part to force excess cement off. The cap is fixed by cement onto prepared tooth to prove screening and reinforcement of crown part and fragments of naked root. Tooth row print is got after cap is cemented onto tooth.

EFFECT: better screening and reinforcement of tooth to be restored; prolonged and reliable closing-down and fixation of prosthetic appliance on strong tooth.

Description

The invention relates to medicine, namely to orthopedic dentistry.

One of the main areas of orthopedic dentistry is the treatment of defects in hard tissues of the tooth crown - restoration of the crown by means of prosthetics in order to prevent further tooth decay or relapse of the disease. The restoration of the crown helps to prevent further destruction and the loss of many teeth over time, which in turn avoids serious morphological and functional disorders of various parts of the dentition.

The therapeutic effect in prosthetics of crown defects is expressed in eliminating the violation of the act of chewing and speech, normalizing the function of the temporomandibular joint, and restoring aesthetic norms.

As therapeutic agents for defects in the crown of the tooth, mainly two types of prostheses are used: inlays and artificial crowns.

As a prototype of the proposed method, the authors propose a method of dental prosthetics with the restoration of lost fragments of the crown of the tooth by making cast metal stump inserts. // Kopeikin V.N., Mirgazizova M.Z., "Orthopedic dentistry", M., "Medicine", 1988, pp. 142-150 //.

The method consists in the following: the preparation of prosthetic supporting teeth with the creation of a ledge on the marginal part of the tooth, obtaining an impression of the dentition, the manufacture of the prosthesis and its final cementation on the patient's teeth.

However, the proposed method of prosthetics cannot guarantee a long and reliable degree of preservation of the prepared teeth, because prosthetics restored by cast cult inlays of the teeth represent a combination of tooth dentin and metal, having completely different physical and mechanical properties, and, accordingly, adhesive properties with respect to fixing cement, which over time leads to depressurization of the prosthesis in the marginal zone and damage to the supporting tooth. In addition, a relatively coarse cast metal frame that does not pretend to be precision cannot guarantee the long-term preservation of prepared teeth after cementing.

The authors propose a method of dental prosthetics, the technical result of which is the shielding and reinforcement of the restored prosthetic tooth, which provides long-term, reliable preservation and fixation of the prosthesis on the supporting tooth. The method increases the mechanical reliability and the degree of preservation of the prepared abutment teeth with the creation of a highly adhesive surface for guaranteed cementation of the finished metal-ceramic, all-ceramic and any other bridge or single crown.

Prosthetics is carried out as follows: after restoration according to the prototype method, the lost fragments of the crown of the tooth are cast with cast tabs and they take a cast of the prepared teeth and control the quality of the tooth treatment, i.e. parallelism of their walls. After that, metal precision caps are made from the cast of the prepared tooth using the method of electroforming. The cap must be resilient. The elasticity is determined by the wall thickness and the alloy used. The marginal part of the cap has a minimum thickness to prevent the creation of a step in the root part, the thickness of the crown part varies depending on the clinical picture from 0.08 to 0.30 mm. The necessary elasticity with a minimum cap wall thickness is ensured by the use of alloyed steel-based alloys. It is not practical to make thicker-walled caps from such hard alloys. The cap is treated in a sandblasting machine both from the inside and from the outside to increase the adhesive properties with respect to the fixing cement, after which the outer side of the marginal part of the cap is coated with gilding or titanium nitrite (damask steel), which increases the overall elasticity of the cap and makes it possible to manufacture more thin-walled caps, a gold-plated coating or a titanium nitrite coating is polished. Due to the elasticity of the precision cap during cementation on the prepared teeth, fixing cement creates temporary stress in them, which contributes to the process of increased diffusion of cement with the tissues of the prepared tooth.

The precision cap follows the shape and contour of the prepared tooth so precisely that during its fixation, excess cement, displaced from the marginal zone, can damage the gum pocket tissue. To prevent this at the time of cementing, it is recommended to make a small hole in the upper part of the cap to displace excess cement.

The manufactured precision caps are fixed with cement on the prepared tooth so that it screens both its crown part and fragments of the bare root, and it is necessary that the marginal surface of the cap, which screens the bare root fragment and comes into direct contact with the gingival pathological pocket, be polished for free washing of a pocket and preservation of gingival and porcelain coloring. The step on the prepared tooth is formed at the usual subgingival or gingival level, taking into account the general aesthetics, thus the boundary of the marginal fit of the cap is much deeper than the fit of the ceramic-metal crown.

In some cases, the use of precision caps makes it possible not to create a step during the preparation of teeth.

On single teeth, it is possible to apply the porcelain directly to the precision cap.

After cementing the cap, a cast of the dentition or a single-standing tooth is taken to begin work on the manufacture of a ceramic-metal prosthesis.

The obvious advantages of the proposed method of prosthetics are:

- the precision thin-walled cap practically does not change the contour of the prepared tooth, does not create an artificial ledge in the marginal area, which can interfere with the tooth hygiene procedure at the periodontal border;

- the cap almost does not increase the volume of the prepared tooth, so the procedure for preparing the teeth is almost unchanged and does not create difficulties for the orthopedic surgeon;

- if necessary, thickening of the walls of the crown part of the cap is possible;

- shielding of prosthetic teeth at the stage of their preparation almost completes the process of their final conservation;

- fragmentary depressurization of a ceramic-metal or all-ceramic prosthesis in the marginal region does not in any way entail damage to the prosthetic tooth during prolonged use of the prosthesis.

Claims (1)

A method of dental prosthetics, including the restoration of lost fragments of the crown of the tooth, the preparation of the prosthetic abutment teeth, obtaining an impression of the dentition, the manufacture of the prosthesis and its final cementation on the abutment teeth, characterized in that after the restoration of the lost fragments of the crown of the tooth, a metal precision is made of the prepared tooth cap, the marginal part of which has a minimum thickness to prevent the creation of a ledge, and in the upper part is made a small hole for displacing excess cement, fix it with cement on the prepared tooth to provide shielding and reinforcement of the crown and fragments of the exposed root, and the impression of the dentition is obtained after cementing the cap on the tooth.