RU2333734C1 - Stump inlay for restoration of anatomic shape of coronal part of multi-rooted tooth residual fragment - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular prosthetic dentistry and dental surgery for bridgework of multi-rooted teeth with two or three ablated roots and can be used for restoration of anatomic shape and function of separate teeth, as well as for dental restoration by removable and nonremovable structures of dentures with extracoronal retainer. The stump inlay for restoration of anatomic shape of coronal part of multi-rooted tooth residual fragment after root resection is made in a shape of split conic frustum. From the side of its larger side there are orifices for protuberance of endodonto-endosseous implant placed on non-parallel root canal of tooth and connected with inlay by means of glass-ionomer cement. The orifices for endodonto-endosseous implant are made in each part of split conic frustum, and the number of its parts corresponds to the number of resected roots. One part of the inlay is made so that it slides along the contact area and surfaces of one or two other parts while installing on the endodonto-endosseous implant.

EFFECT: restoration and strengthening of multi-rooted tooth structure with ablated non-parallel roots and broken coronal part.

1 dwg

Description

The invention relates to medicine, in particular to orthopedic and surgical dentistry for prosthetics of multi-root teeth with two or three (in the case of a three-root tooth) amputated (resected) roots, and can be used to restore the anatomical shape and function of individual teeth, as well as to replace dentition defects with removable and non-removable prosthesis structures with supporting elements on the implant.

As a result of surgical treatment of periodontitis, amputation (resection) of the majority of the affected roots of multirooted teeth is carried out, the remaining stump of which is subsequently covered with an orthopedic structure or artificial crown in the postoperative period. However, it is not always possible to use a tooth stump as a support for various types of orthopedic structures, especially in molars of the upper jaw. After amputation of two or three palatine roots in the molars of the upper jaw, the functioning of the remaining fragment of the tooth depends on how these roots or root are inclined with respect to the vertical axis of the tooth and the alveolar ridge. Mismatch of large vertical loads with the axial direction of the roots leads to dislocation of the tooth over time.

A well-known stump tab for restoring a three-channel tooth after endodontic treatment with non-parallel canals, containing a crown part made together with tabs for insertion into two channels parallel to each other, the third tab in the root is made in the form of a standard anchor pin inserted into a toothpaste prepared for it the channel through the formed hole in the crown part (RU 50812 U1, 01/27/2006).

Known stump tab containing the crown part, made in the form of a truncated cone and the root cone part, while the crown part is made with two longitudinal holes in which two buccal pins are placed, the dimensions of which correspond to the buccal canals of the root (RU 53143 U1, 05/10/2006) .

Known crown for restoration of a multi-channel tooth with non-parallel channels, made with a cult insert, the crown is made at the same time with bushings threaded on the inner surface and retention points on the outer chewing surface of the crown has holes for introducing pins through them, and the bushings are made in anatomical shape channels and have a length of 1/3 of the corresponding tooth channel (RU 2280419 C1, 07.27.2006).

Known cult tabs cannot be used in cases of amputated (resected) roots of multirooted teeth.

Known cast stump pin tab to restore the functioning of the remaining fragment of the tooth, containing the cult part and the pin part, one of the pins of which is made with the ability to move in the cult part of the tab, while the pin has a constant diameter throughout, and its working section is made in the form of a row consecutively truncated cones facing a large base towards the tooth cavity, and has a rounded end (Patent RU 2098040 C1, 12/10/1997).

The disadvantage of this stump insert is that it does not fully restore the biomechanics of a multi-rooted tooth during chewing load, since the apical part is not firmly fixed in the jaw bone.

The technical result of the invention is to restore and strengthen the structure of a multi-rooted tooth with amputated (resected) non-parallel roots and a destroyed crown part.

The technical result is achieved due to the fact that the stump tab for restoring the anatomical shape of the crown part of the remaining fragment of the multi-root tooth after resection of the root is made in the form of a collapsible truncated cone, and from the side of its larger base there are closed openings for the protruding parts of the endodontic-endoossal implant (EEI), located in non-parallel root canals of the tooth and connected to the tab by means of glass ionomer cement, while the holes under the EEI are made in each part truncated cone, and the number of its parts corresponds to the number of resected tooth roots, and one part is made with the possibility of sliding along its contact surface of the surfaces of one or two other parts when installing them on EEI.

The invention is illustrated in the drawing.

1 - stump tab

2 - closed (deaf) holes

3 - amputated roots

4 - root canals

5 - endodonto-endoossal implant (EEI)

The stump tab for restoring the anatomical shape of the crown of the remaining fragment of the multi-root tooth after root resection is made in the form of a collapsible truncated cone 1. On the end surface from the side of its larger base there are closed (deaf) holes 2 for the protruding parts of the EEI 5. The number of holes corresponds to the number of amputated roots 3 multi-rooted teeth. EEIs are located in the non-parallel root canals of the 4 teeth and are connected to the insert by means of glass ionomer cement by installing a cast insert on the protruding parts of the EEI. The holes under the EEI are made in each part of the collapsible truncated cone, and the number of its parts corresponds to the number of resected tooth roots. The first main part is made with the possibility of sliding on its contact surface of the congruent (mating) surfaces of the second or two other parts when installing them on the EEI. The contact surface of the first main part of the tab can be made at an acute angle or at a right angle to the larger base of the tab cone.

The proposed tab is set as follows. In the preoperative period, a bed is formed on the retained tooth in the root canals for EEI. The channels of the tooth root are expanded to a diameter corresponding to the diameter of the EEI rods and form a platform for the future stump. Then, a bed for the intraosseous part of the implant with a depth of not more than 5 mm is formed through the root canal of the tooth. The directing analogue of EEI is introduced into the root canal of the tooth, an impression is taken and a working model is made. On a working model, a tooth stump is prepared from wax and transferred to metal. On the same working model, a temporary removable mouthguard is made of colorless plastic with a guide hole for forming a bed by EEI. The stump of the tooth and temporary removable mouthguards are fitted before surgery. After resection of the roots of the teeth or their apices and, if necessary, additional formation of a bed under the EEI, the metal stump and EEI are fixed, made, for example, of the VT1-00 titanium alloy used in dental implantology. The protruding part of the pin should exceed the size of the crowns of adjacent teeth. Fixing cement is introduced into the root canals of the tooth using a channel filler. EEI is introduced through the channel until it stops, then the implant is fixed with a fixing key in the bone tissue, and then the stump is fixed on glass ionomer cement. Excess cement trapped in the hole is removed, the surgical field is irrigated with a solution of antiseptics. The trepanation hole is closed, the wound is sutured.

The tooth stump is covered with a pre-prepared provisional crown, while excluding the presence of contact points with the teeth antagonists during the formation of the bone structure around the EEI, with the subsequent replacement of the temporary crown with a permanent one.

Claims (1)

A stump insert for restoring the anatomical shape of the crown part of the remaining fragment of a multi-root tooth after root resection, characterized in that it is made in the form of a collapsible truncated cone, and on the side of its larger base there are closed openings for the protruding parts of the endodontic-endoossal implant located in non-parallel root canals teeth and connected to the tab by means of glass ionomer cement, while the holes for the endodontic-endoossal implant are made in each part molecular weight of the truncated cone, and the number corresponds to the number of its parts rezertsirovannyh tooth roots, wherein one part is slidable in its turn the contact surfaces of one or two other parts when mounted on endodonto-endosseous implant.