RU2299039C1 - Method for restoring lateral teeth in totally lacking dental coronal part and perforated root cases in bifurcation or trifurcation zone and naked interradicular septum - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves applying endodontic treatment to root canals, forming cavities in each of canals with depth not exceeding 1/2 - 1/3 times length of the corresponding canal after having prepared demineralized tissues of cervical root one-third with preparation surface relief being preserved and forming destroyed root walls from macrofilled composite to gingiva level with following immobilization of roots separated due to perforation by means of at least one preliminary generated reinforcing immobilization wire pin fixed by means of glass ionomer cement in root canal cavities to be joined, on a root base surface and on naked interradicular septum surface not more than by 1/3 of its height. Intracanal parts are formed as interlaced gilt metal wires and bent relative to intermediate supracanal pin parts according to fixing canals direction. The intermediate supracanal part manufactured from same not interlaced wires repeats root base surface relief and naked interradicular septum surface relief. At least one coronal part cavity walls pin is formed after fixation from macrofilled composite to occlusion surface level with formed coronal cavity being subsequently reinforced to equator level by means of coronal carcass produced from gilt metal mesh fixed by means of glass ionomer cement in coronal cavity and by means of three additional pins on the root base. The bifurcation or trifurcation zone and interradicular septum is closed with glass ionomer cement. The intraradicular parts of additional pins are placed in canal cavities through perforated openings in coronal carcass by means of glass ionomer cement together with preliminary fixed intracanal parts of immobilization wire pin. Fixed coronal carcass cavity is filled with microfilled composite, and then damping a cavity on equator level and coronal part walls from equator to occlusion surface are reinforced by means of the second coronal net carcass fixed with glass ionomer cement. The second coronal net carcass cavity is filled to occlusion surface level with microfilled composite composite. Tubercles are restored from macrofilled composite.

EFFECT: enabled stability and strength of perforated root; simplified lateral teeth repair; reduced risk of traumatic complications.

10 cl

Description

The invention relates to medicine and can be used for prosthetics of the posterior teeth by the method of reinforcing dentistry.

The invention is aimed at preserving a root in which the hard tissues of the cervical third are destroyed and the bifurcation or trifurcation region is perforated, and the use of such a root for restoration of the lateral tooth and restoration of its full function.

The inventive method of restoration is shown in the case of eliminating the combined defect of the crown and root parts of the lateral tooth, namely when:

- complete destruction of the crown part below the level of the gums;

- destruction of the hard tissues of the cervical third of the root with partial preservation of the walls of the root;

- root perforation in the area of bifurcation or trifurcation with exposure not more than 1/3 of the height of the interroot septum (the interroot septum is not destroyed). With such a defect, the preserved root part is weakened due to the destruction of the hard tissues of the cervical third of the root.

The roots of the preserved root part are separated by perforation in the area of bifurcation or trifurcation.

The roots are united only by the thinned preserved walls of the cervical third of the root.

Thus, the possibility of prosthetics of the lateral tooth with a reinforced composite crown is complicated with a weakened and fragmented root revealing the interroot septum.

The main task in the restoration of such teeth is to restore and strengthen the root and its use for subsequent restoration of the crown.

State of the art

As a rule, when restoring teeth with lesions in the area of bifurcation or trifurcation, surgical methods of treatment are used. In particular, the method of coronary-radicular separation of the tooth according to patent RU No. 2103941. To restore the function of a multi-rooted tooth, the crown is cut in the projection of the bifurcation into fragments using the patented method, and then the fragments are fixed with each other using a monolithic solid cast structure consisting of two combined independent crowns having a common occlusal surface and equator. The one-piece construction has stabilizer pins that mate with the grooves of independent cult pin tabs that restore roots, due to which the cervical edge of the structure is kept at a predetermined level and does not injure the gum.

As follows from the prior art, a contraindication to the use of pin structures is the destruction of the root by more than 1/4 of its length or a defect in any of the root walls equal to or greater than 1/4 of the root value. Because of the danger of a fracture of the root or its walls on the basis of such a root, it is not possible to form a traditional shock-absorbing cavity that ensures the retention of an artificial crown on the basis of the root.

In the case of applying the known method and known means to eliminate the combined defect of the lateral tooth, either the tooth restoration will not be carried out, or the strength of the restoration will not be ensured.

In the presence of the above combined defect, the application of the known method is also impractical because of its increased invasiveness, because of the complexity of the implementation and the likelihood of postoperative complications.

Thus, in the case of applying the known method, the goal of preserving a weakened root, disconnected by perforation in the area of bifurcation or trifurcation, and the use of such a root for "high-quality" tooth restoration will not be achieved.

The restoration of the lateral teeth of the claimed method completely eliminates the negative consequences of surgical intervention according to the patented method, preserves the weakened root, separated by perforation, as a support for the restoration of the reinforced composite crown.

The claimed method is carried out in stages, starting with increasing strength and stabilizing the preserved part of the root.

This problem is solved with the help of reinforcing immobilizing wire pins, composite materials and glass ionomer cement.

The reinforcing immobilizing wire pin is made of 0.6 mm thick wires, which are released from the gold-plated metal mesh used in dentistry.

The pin has two intra-channel parts and an intermediate super-channel part.

Intracanal parts are fixed in the cavities of the canals of the united roots.

The intracanal portions are formed by weaving the wires and are bent with respect to the intermediate portion in accordance with the direction of the fixation channel.

The intermediate supercanal part consists of the same, but not interwoven wires.

During fixation, the wires of the supercanal part repeat the relief of the root base and the surface relief of the exposed interroot septum.

Depending on the clinical situation, one, or two, or three immobilizing pins are used.

In particular, during restoration of the lower chewing groups of teeth, two or three pins are made to immobilize the mesial and distal roots with perforation in the bifurcation region.

In particular, when restoring the upper chewing groups of teeth, two or three pins are made to immobilize the buccal and palatine roots with perforation in the trifurcation region.

The use of immobilizing pins allows you to:

to prepare the surface of the preserved root part in a gentle mode, in which the relief of the preparation surface is maintained, and only demineralized hard tissues of the cervical third of the root are removed;

maintain a complete inter-root septum, exposed no more than 1/3 of the height;

immobilize disconnected roots;

exclude the possibility of a fracture of the walls of the cervical third of the root;

stabilize the root due to its fixation in relation to a stable inter-root septum;

reinforce the root base surface and the surface of the exposed interroot septum;

redistribute the functional load along the entire surface of the reinforcement, including directly to the interroot partition;

to provide hardening and stabilization of weakened roots regardless of the anatomy of the channels (their diameter, curvature, length);

to carry out the restoration of the crown part of the lateral tooth on the basis of the immobilized root using a reinforcing mesh crown-root frame.

The mesh of the crown-root frame reinforces the walls of the crown of the tooth and the base of the root.

As a result, the crown and root parts of the restored tooth are mechanically fastened together, ensuring the solidity and strength of the restoration.

The inventive method is simple to implement and can be implemented on an outpatient basis in one visit.

The technical result achieved during the implementation of the method is to ensure the stability and strength of the root with perforation of the bifurcation or trifurcation region, as well as to simplify the procedure for restoration of lateral teeth and reduce its invasiveness.

SUMMARY OF THE INVENTION

The inventive method is aimed at eliminating the combined defect of the lateral tooth, including the complete destruction of the crown part, the destruction of the hard tissues of the cervical third of the root with perforation in the bifurcation or trifurcation region and exposing the interroot septum no more than 1/3 of the height.

Perforation in the area of bifurcation or trifurcation destroys the natural connection between the roots.

As a result, the roots of the preserved root part of the tooth are united only by the preserved thin walls of the cervical third of the root.

Due to the fragmentation of the roots and a significant loss of hard tissues, the preserved root part is weakened.

The main task in eliminating the combined defect of the claimed method is:

in the immobilization of disparate root perforation;

in restoring and reinforcing a bifurcation or trifurcation region;

in creating a design that would provide a strong mechanical connection between the crown and root parts of the restored tooth.

This method involves preliminary endodontic treatment. Root canals should be sealed to the apex and should not have periapical changes.

Mechanically, toothbrushes using toothpastes clean the surface of the teeth that are next to the defect and determine their color according to the generally accepted VITA scale.

Conduct a control x-ray. After the control radiographs, they begin to restore the destroyed walls of the cervical third of the root. For this purpose, demineralized tissues of the cervical third of the root are prepared, including the region of bifurcations or trifurcations, while maintaining the relief of the preparation surface.

In the root canals form cavities with a depth of not more than 1 / 3-1 / 2 of the root length, depending on the clinical situation.

An acid etching of the base of the cervical third of the root and cavities formed in the channels is carried out to create a microrelief.

The acid is applied with a brush for an average of 15-20 seconds, then the acid is washed off with a stream of water and the etched surfaces are dried with air.

After acid etching and adhesive treatment using macro profiled composite rollers, the walls of the cervical third of the root are formed with a thickness of 1.5-2 mm to the level of the gums, with the formation of the root cavity.

Then proceed to the manufacture of at least one reinforcing immobilizing wire pin to immobilize weakened disconnected roots of the preserved root part of the tooth.

For the manufacture of a reinforcing immobilizing wire pin using a gold-plated metal mesh with a thickness of 0.6 mm

Wire is released from the mesh.

A number of wires, the number of which is selected taking into account the smallest diameter of the root canal, is bent in half and twisted.

In this way, one of the intra-channel parts of the pin is formed, the length of which is not more than the depth of the previously formed channel cavity of the corresponding root.

Having formed one of the interlaced inter-channel parts of the pin, the wires are left unbound. This is an intermediate supercanal part of the pin, the length of which is not less than the distance between the channels of the immobilized roots, including the length of the exposed surface by no more than 1/3 of the height of the interroot septum.

And then the wires are again intertwined, forming the second intra-channel part of the pin, which is fixed in the channel of another root. The length of this part of the pin is also chosen no more than the depth of the cavity formed in the channel of the corresponding root.

The intertwined intra-channel parts of the pin are bent with respect to the supra-channel intermediate part, taking into account the direction of their fixation channels.

The reinforcing immobilizing wire pin thus formed consists of two intra-channel parts in the form of interwoven wires and a super-channel intermediate part of the same, but non-interwoven wires.

Reinforcing immobilizing wire pins are made taking into account the anatomical and topographic features of the posterior teeth.

During root perforation in the region of lower molar bifurcation, one or two immobilizing pins are made to immobilize the mesial and distal roots, depending on the clinical situation.

In the case of using one immobilizing pin, its intracanal parts are fixed in the channel of the distal root and in one of the channels of the mesial root.

In the case of using two immobilizing wire pins, one pin is fixed respectively in the channel of the distal root and in the mesial-buccal channel of the mesial root, and the other in the channel of the distal root and in the mesial-lingual channel of the mesial root.

Thus, each immobilizing wire pin with one intracanal part is fixed in the canal of the distal root (the largest channel), and the second intracanal part is fixed in the mesial-buccal and mesial-lingual channels of the mesial root.

When the root is perforated in the area of trifurcation of the upper molars, one or two immobilizing wire pins are also made to immobilize the buccal and palatine roots, which are installed in the same way.

In the case of using two pins, one pin is fixed respectively in the palatine root canal and in the mesial-buccal canal of the buccal root, and the other in the palatine root canal and in the distal-buccal canal of the buccal root.

Thus, each immobilizing wire pin with one intracanal part is fixed in the palatine root canal (the largest canal), and the second intracanal part is respectively in the mesial-buccal and distal-buccal canals of the buccal root.

In the case of using three immobilizing pins, their intracanal parts are fixed in pairs in the cavities of the channels of the combined roots.

Carry out the fitting of the pins. Depending on the clinical situation, the pins are installed alternately in the cavities formed in the channels of the corresponding roots in the above order.

The pins must be installed without voltage.

The intertwined intracanal parts of the pins should be located in the formed cavity of the channels, and the intermediate supercanal parts should be in the form of distributed wires on the surface of the base of the cervical third of the root and on the surface of the exposed interroot septum, repeating the relief of the surfaces.

After fitting and correction, the pins are removed.

The cavity of the channels is filled with glass ionomer cement, glass ionomer cement is applied to the surface of the cervical third of the root base and to the exposed surface of the interroot septum. At least one pin is installed, placing its intertwined intracanal parts in the cavity cavities of the corresponding roots (in the above order, taking into account the anatomical and topographic features of the lateral tooth). After placement of the intra-channel parts in the wire channels of the over-channel intermediate part of the pin, they are adjacent to the surface of the root base and the exposed surface of the interroot septum, repeating their relief. In the case of using two or three immobilizing wire pins, each subsequent pin is appropriately set.

Thus, with the help of pins, the roots of a multi-root tooth separated by perforation are immobilized, the root base and the surface of the exposed interroot partition are reinforced.

As a result, the roots of a multi-root tooth are not only connected to each other, but also fixed in relation to the inter-root septum.

The roots are interconnected using reinforced glass-ionomer cement.

Then proceed to the restoration of the destroyed walls of the crown of the tooth.

The walls of the coronal part with a thickness of 1.5-2 mm to the level of the occlusal surface are formed from the macrophilized composite.

The restored walls of the coronal part of the tooth form a common coronal-root cavity with the previously formed root cavity.

The formed crown-root cavity is reinforced with a mesh crown-root frame.

The manufacture of a mesh crown-root frame.

The reinforcing mesh crown-root frame is formed from a fine-mesh gilded metal mesh 0.4 mm thick.

Using a plug-in, the grid is shaped in accordance with the surface shape of the coronal-root cavity. The formed reinforcing mesh crown-root frame is tried on and, after fitting and correction, it is removed from the crown-root cavity.

An adhesive is applied to the inner surface of the coronal-root cavity, slightly blown with air for even distribution, the adhesive is applied again, again blown with air and polymerized by a standard method.

The reinforcing mesh crown-root frame is fixed in the crown-root cavity using glass ionomer cement after adhesive treatment of the inner surface of the crown-root cavity.

Glass ionomer cement covers the perforation in the bifurcation or trifurcation region and the interroot septum.

A fixed mesh crown-root frame strengthens the walls of the crown part of the restored tooth and additionally reinforces the root base. Using a mesh crown-root frame, the crown of the tooth is mechanically connected to the root base with the formation of a monolithic structure.

After fixation, the cavity of the reinforcing mesh crown-root frame is filled to the gingival level with glass-ionomer cement, and then filled with microfiled composite to the level of the occlusal surface.

Thus, the crown of the tooth is restored taking into account the anatomical structure.

Tubercles form from a macrophilic composite.

Before polishing and control polymerization, occlusal editing is performed.

The final grinding and polishing is carried out on the 2nd day after polymerization.

Considering the fact that, due to the destruction of the hard tissues of the cervical third of the root and root perforation in the bifurcation or trifurcation region, the preserved root part of the tooth is weakened and fragmented, additional fixation of the crown-root frame to the root is required to ensure the strength of the restoration depending on the clinical situation.

When implementing a variant of the method with additional fixation of the crown-root frame on the root, three additional pins are used. The use of additional pins allows you to create a monolithic structure with additional mechanical connection of the restored crown of the tooth with its root part.

In particular, during the restoration of the upper molars, three twisted or twisted wire pins preformed from wires released from a gold-plated metal mesh are used for additional fixation of the crown-root frame.

Each of the pins form an intra-root part. To form the inner root portion of the twisted pin, at least two wires are bent in half and intertwined, starting from the bend. To form the inner root portion of the twisted pin, at least two wires are twisted together. The length of the root portion of the pin is not more than the depth of the cavity of the corresponding fixation channel.

The root parts of twisted or twisted wire pins should be installed without stress in the cavities of the fixation channels.

The twisted or twisted intra-root part of the pin passes into the non-bound wires of its root part, intended to form a wire head on the inner surface of the bottom of the crown-root frame. The length of the wires remaining unbound, choose at least the size of the depth of the cavity of the corresponding fixation channel.

In particular, during the restoration of the lower molars, two twisted or two twisted wire pins previously formed in the manner described above and one flat mesh pin are used to additionally fix the crown-root frame. A mesh flat pin is formed from a gold-plated metal mesh. The grid is bent in half. Moreover, the width and length of the resulting mesh rectangle is selected, respectively, no more than the size of the distal root canal in the buccal-lingual direction and at least twice the depth of the distal root canal cavity.

Then form the root portion of the flat mesh pin. For this, corners are cut along the length of the grid rectangle on both sides. The length of the slice is not more than the size of the depth of the cavity of the canal of the distal root.

The formed intra-root part of the flat mesh pin should be placed without tension in the cavity of the distal root canal in the buccal-lingual direction, and its root part in the form of an uncut part of the mesh rectangle.

When implementing a variant of the method with additional fixation of the crown-root frame, the intra-root parts of the additional pins are fixed in the cavities of the corresponding channels together with the intra-channel parts of the previously fixed immobilizing wire pins.

Depending on the diameter of the channel cavities, for the purpose of free placement of the pins in the channel cavities, the intra-root parts of the twisted or twisted pins and the internal channels of the immobilizing pins can be pre-flattened to give them a flat shape.

Thus, when implementing a variant of the method with additional fixation of the crown-root frame, at least one immobilizing wire pin is formed simultaneously, as indicated in option 1, and three additional pins.

After the formation of all the necessary pins, they are tried on.

Depending on the clinical situation, immobilizing pins are installed in the channel cavities according to the scheme indicated in option 1, and additional pins are installed according to the scheme indicated in the description of option 2 above.

If necessary, adjust the shape and size of the pins. Then the pins are removed from the cavity of the channels.

Then, plugs are formed from the polypropylene tube. The length and diameter of the plugs are selected, respectively, no more than the length and diameter of the formed twisted or twisted wire pins. To replace the flat mesh pin, the polypropylene tube is cut lengthwise, resulting in a rectangle. The rectangle of the polypropylene tube is cut in accordance with the dimensions of the formed flat mesh pin.

Carry out the fitting of the immobilizing pins together with the plugs. The plugs must be installed without voltage in the cavities of the respective channels. After fitting, the immobilizing pins and plugs are removed.

Then, using glass ionomer cement, immobilizing wire pins are fixed according to option 1, installing in the cavities of the corresponding channels simultaneously with the in-channel parts of the immobilizing pins and plugs.

Prior to the final curing of the glass ionomer cement, the plugs are removed from the channel cavities. Thus, in the previously formed cavity of the channels with the help of plugs form a space for fixing additional pins - cavities for additional pins.

Then proceed to the restoration of the destroyed walls of the crown of the tooth.

The walls of the coronal part with a thickness of 1.5-2 mm to the level of the occlusal surface are formed from the macrophilized composite.

The restored walls of the coronal part of the tooth form a common coronal-root cavity with the previously formed root cavity.

The formed crown-root cavity is reinforced with a mesh crown-root frame.

A reinforcing mesh crown-root frame is formed, it is tested and fixed with glass ionomer cement according to option 1. Moreover, before the adhesive treatment of the inner surface of the crown-root cavity, the newly formed cavities for additional pins are covered with cotton.

After fixing the reinforcing mesh crown-root frame, its bottom root part is prepared in the projection of the cavities for additional pins. Through the perforations, the cotton wool is removed from the cavities for additional pins.

Re-try additional pins designed to fix the crown-root frame on the root.

The intra-root parts of the additional pins should be placed in the respective cavity of the channels without voltage.

If necessary, the surface of the cavity of the channels formed by means of plugs can be further prepared. Thus, their dimensions can be adjusted for the free installation of additional pins.

In the manufacture of additional twisted or twisted pins with tapered intra-root parts for the manufacture of caps, the polypropylene tube is pre-cut lengthwise, and then, from the resulting polypropylene rectangle, the intra-root part of the cap is cut in accordance with the intra-root parts of the additional pins.

After fitting, the additional pins are removed.

The cavities for the additional pins are filled with glass ionomer cement and the additional pins are finally fixed.

The intra-root parts of the additional pins fixed in the cavities of the canals are deepened at the level of the surface of the bottom root part of the crown-root frame. In the root cavity of the coronal-root frame above its inner surface are the root parts of the additional pins, respectively, in the form of free wires for twisted or twisted pins or in the form of a mesh for a flat pin.

Using the root parts of the additional pins, the crown-root frame is fixed on the root.

In particular, during the restoration of the upper molars, a layer of glass ionomer cement is applied to the inner surface of the root cavity of the fixed crown-root frame, the free wires of the root part of the pins are distributed over the inner surface of the frame and fixed.

In particular, during restoration of the lower molars, after fixing the wires of the root part of two intertwined and / or twisted pins on the inner surface of the root cavity of the fixed crown-root frame, the root part of the mesh flat pin is bent with respect to the center of the root cavity of the crown-root frame and fixed using wires or wires and mesh root part of the additional pins.

After fixing the reinforcing mesh crown-root frame with additional pins, the restoration of the lateral teeth is carried out in accordance with option 1.

The results of the restoration of the lateral teeth of the claimed method show its high efficiency and the possibility of widespread use in the practice of prosthetics.

Claims (10)

1. The method of restoration of the posterior teeth in the complete absence of the crown part with root perforation in the area of bifurcation or trifurcation and with exposing the interroot septum, including endodontic treatment of the root canals, the formation of cavities in each of the channels with a depth of no more than 1 / 2-1 / 3 of the length of the corresponding channel after the preparation of demineralized tissues of the cervical third of the root while maintaining the relief of the preparation surface and the formation of the destroyed walls of the root from the macrophilic composite to the level of the gums, followed by mobilization of roots separated by perforation by means of at least one preformed reinforcing immobilizing wire pin, fixed with glass ionomer cement, respectively, in the cavity cavities of the combined roots, on the surface of the root base and on the surface of the interroot septum, exposed no more than 1/3 of its height, intracanal parts which are formed in the form of intertwined metal gilded wires and bent in relation to the intermediate supercanal hour and the pin in accordance with the direction of the channels of their fixation, and its intermediate supercanal part of the same non-interwoven wires repeats the relief of the surface of the root base and the surface relief of the exposed interroot septum, the formation after fixing of at least one core wall of the coronal part from the macro profiled composite to the level of the occlusal surfaces with subsequent reinforcement of the formed coronal-root cavity by means of a coronal-root frame preformed from metal gilded mesh, which is fixed in the coronal-root cavity with glass ionomer cement, while the area of bifurcation or trifurcation and the inter-root septum are closed with glass ionomer cement, and then the cavity of the fixed crown-root frame is filled with glass ionomer cement to the gingival level and microfilmed composite surface to the level of the microfilmed composite surface to the level of and restore tubercles from macrophilic composite. 2. The method according to claim 1, comprising immobilizing the roots, separated by perforation in the bifurcation or trifurcation region, by means of two reinforcing immobilizing wire pins, one of the intra-channel parts of the second pin being placed together with the intra-channel part of the previously installed pin in the cavity of the canal of the distal or palatine root, and the other intracanal part of the second pin is placed in the cavity of the free channel of the mesial or buccal root, respectively. 3. The method according to claim 1, comprising immobilizing the roots, separated by perforation in the bifurcation or trifurcation region, by means of three reinforcing immobilizing wire pins, the intra-channel parts of which are pairwise placed in the channel cavities of the combined roots. 4. The method of restoration of the posterior teeth in the complete absence of the crown part with root perforation in the bifurcation or trifurcation region and with exposing the inter-root septum, including endodontic treatment of the root canals, the formation of cavities in each channel with a depth of no more than 1/2 - 1/3 of the length of the corresponding channel after the preparation of demineralized tissues of the cervical third of the root while maintaining the relief of the preparation surface and the formation of the destroyed walls of the root from the macrophilic composite to the level of the gums, followed by by mobilization of roots separated by perforation by means of at least one preformed reinforcing immobilizing wire pin fixed with glass ionomer cement respectively in the cavity cavities of the combined roots, on the surface of the root base and on the surface of the interroot septum, exposed to no more than 1/3 of its height, intracanal parts which are formed in the form of intertwined metal gilded wires and bent with respect to the intermediate supercanal part ty of the pin in accordance with the direction of the channels of their fixation, and its intermediate supercanal part - of the same unwoven wires - repeats the relief of the surface of the root base and the surface relief of the exposed interroot septum, the formation of at least one pin of the walls of the crown part from the macrophilic composite to the level of the occlusal surface, followed by reinforcing the formed coronal-root cavity by means of a coronal-root frame previously formed from gilded grid, which is fixed with glass ionomer cement in the crown-root cavity and with the help of three additional pins on the root base, while the region of bifurcation or trifurcation and the inter-root septum are closed with glass ionomer cement, and the intra-root parts of the additional pins are placed through the perforations of the crown-root in the cavities of the channels of the combined roots in place of the previously installed stubs and fixed with glass ionomer cement together with previously fixed intracanal parts of the immobilizing wire pin, and then the cavity of the fixed crown-root frame is filled with glass-ionomer cement to the level of the gums and microfiled composite to the level of the occlusal surface and the tubercles from the macrophilic composite are restored. 5. The method according to claim 4, comprising immobilizing the roots, separated by perforation in the bifurcation or trifurcation region, by means of two reinforcing immobilizing wire pins, one of the intra-channel parts of the second pin being placed together with the intra-channel part of the previously installed pin in the cavity of the canal of the distal or palatine root, and the other intracanal part of the second pin is placed in the cavity of the free channel of the mesial or buccal root, respectively. 6. The method according to claim 4, comprising immobilizing the roots, separated by perforation in the bifurcation or trifurcation region, by means of three reinforcing immobilizing wire pins, the intrachannel parts of which are pairwise placed in the channel cavities of the joined roots. 7. The method according to claim 4, including the formation of additional pins of metal gold-plated wires, the inner root part of which is made in the form of weaving or twisting wires. 8. The method according to claim 4, including the formation of two additional pins of metal gold-plated wires, the inner root part of which is made in the form of weaving or twisting the wires, and the formation of a flat pin in the form of a rectangle of a double layer of a metal gilded mesh, the inner root part of which is made with cut two sides along the length of the rectangle with corners, and the width of the rectangle is not more than the size of the channel of the distal root in the buccal-lingual direction, and the length of the cut is not more than the size of the depth olosti distal root canal. 9. The method according to any one of paragraphs.5, 6, 7 and 8, including additional flattening of the intra-channel parts of the reinforcing immobilizing wire pins and the intra-root parts of additional intertwined or twisted pins to give them a flat shape. 10. The method according to claim 9, including the formation of plugs from a polypropylene tube in accordance with the size and shape of the root parts of the additional pins.