RU2425652C2 - Method of fixation of dental prostheses on implants - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine and is intended for fixation of dental prostheses on implants. Implants are installed. After screwing out from implant of gum shaper, impression abutment is screwed into it. Impression is made. Combined model with implant analogue and screwed into it abutment is cast. Abutment is screwed out of the model and bent by means of vice or two dental crampons at angle, necessary for prosthesis manufacturing.

EFFECT: method makes it possible to increase quality of dental prosthesis fixation by individual abutment fitting for each implant.

3 dwg

Description

The invention relates to medicine, namely to dentistry, and can be used to fix dentures on implants.

State of the art

Dental implant systems are widely used to replace damaged or lost natural teeth. In such systems, the implant is placed in the jaw of the patient, replacing the root of the natural tooth. Then, an abutment structure (abutment is a support or a heel), consisting of one or several parts, can be attached to the implant to build up the skeleton for the part of the denture protruding from the bone tissue, through the soft tissue of the gum and into the patient's oral cavity. Ultimately, a prosthesis or crown may be placed on the abutment.

The finished prosthesis must be sized and shaped in such a way as to fit the patient’s remaining teeth in a functional and aesthetic way. To this end, the dental technician must select the appropriate prosthesis for a particular patient using the model of the jaw of this patient, and this model includes an implant and, possibly, the structure of the abutment. To provide such a model, the so-called working simulation methods are used.

One of the types of such modeling techniques is the so-called “pick-up” (“capture”) method.

U.S. Patent 6,068,478 (Grande et al.) Describes an impression system that includes an impression cap for transferring an end portion of an implant protruding from a human tissue structure located in the human body, including possibly suprastructures, to a working model. The outward-facing end of the implant has a clipped contour on its outer side, and the impression cap has a geometry complementary to the clipped contour and is capable of engaging with it. The trimmed contour is formed either by narrowing the cone-shaped implant towards the implant bed, or by a recess near the end of the implant.

International patent WO 99/29255 (Morgan) discloses an imprint of an abutment having a head portion containing a retention means, such as an annular groove.

European patent EP 0190670 (Lustig) discloses a prefabricated abutment that can be used in combination with a prefabricated sleeve-shaped cap that telescopically corresponds to a pin.

There is a traditional method of manufacturing bridges skeletons, which consists in the manufacture of a plaster model, on the basis of which the prosthesis frame is formed (Orthopedic dentistry. Textbook. Edited by V.N. Kopeikin, M., 2001).

A known method of processing a prosthesis with cement-screw fixation, comprising the operation of placing and connecting at least one abutment having a first hole for a screw, with an implant using a screw; providing a crown having at least one second screw hole made correspondingly to the first screw hole; and fixing the crown and abutment by placing dental cement between the abutment and the crown, including also removing the screw through the second screw hole, separating the fixed crown and abutment from the implant, removing the remaining cement and polishing the crown edge (RF patent for the invention No. 2313308, A61C 8 / 00).

A known method of fixing dentures on implants, including installing implants, radiography of their position after engraftment, installing abutments inside the implants, taking impressions followed by removal of the abutments and inserting them into the mold, installing copies of the implants on the threaded parts of the abutments, manufacturing a combined model, modeling a permanent framework the prosthesis and fitting it to the abutments, followed by coating the frame and installing it in the oral cavity, installing the combined model in pa the allelemeter and the determination of the abutment parallelism, which is eliminated by processing on a milling and parallelometric machine, then the model of the permanent prosthesis frame in the articulator is modeled and the fitting is carried out on the processed abutments, in which threaded holes are made through the frame, then the ceramic or composite coating is applied to the frame, and they are fixed with screws in the cavity mouth and install the prosthesis with screws, the heads of which are coated with a composite coating (RF patent for the invention No. 2176488, А61С 8/00) - PROTOTYPE.

The objective of the invention is to improve the quality of fixation of dentures by individually fitting abutments for each implant.

To solve this problem, we propose a method of fixing dentures on implants, including installing implants, radiography of their position after engraftment, installing abutments inside implants, taking impressions followed by removal of abutments and placing them in an impression, installing copies of implants on the threaded parts of the abutments, making a combined model , modeling the framework of a permanent prosthesis and fitting it to abutments, installation in the oral cavity, installation of a combined model, determination of abutment configurations, elimination of abutment defects by machining on a milling machine, modeling of a permanent denture framework in the articulator and fitting onto machined abutments in which threaded holes are made through the framework, applying ceramic or composite coatings to the framework, fixing with screws in the oral cavity and installing the prosthesis with fixation with screws, the heads of which are coated with a composite coating, characterized in that after screwing the gum former out of the implant, a blind is screwed into it abutment-screw shot cast abutment are bent by means of two clutches or dental Crampon angle needed to manufacture the prosthesis.

The method is implemented as follows.

Usually, when fixing dentures on implants, a bone bed is prepared, formed and the intraosseous part of the implant is placed. To prevent tissue from growing into the internal threaded channel, a plug is screwed. After two to three months on the lower jaw and after 4-6 months on the upper jaw, the location of the intraosseous part of the implant is determined. Unscrew the cap and screw in the gingiva former, which, after about three weeks, is replaced by a support head (abutment). After 2-4 weeks, a crown is attached to the abutment.

Since it is not always possible to place the implant parallel to natural teeth or parallel to adjacent implants, the implant is placed where bone tissue allows, taking into account the individual topographic and anatomical features of the patient.

After twisting the gingiva former, the abutment is screwed into the implant, which in the proposed method is an impression and working abutment.

The impression is removed using the sandwich method, the abutment is unscrewed and inserted into the impression, a mark is preliminarily placed on the vestibular surface of the abutment.

The abutment is taken from the impression and screwed into the implant analog, inserted again into the impression and the collapsible model is cast from the super gypsum. The collapsible model is opened and, having unscrewed the abutment from the model, is screwed back into the implant analog, and then the abutment is bent using a vice or two dental crampons at an angle necessary for the manufacture of prostheses.

A denture fixed by the proposed method fits tightly on the abutments, while there is no mobility of the prosthesis in the lateral directions, as well as under compression on the jaw. Such fixation of the prosthesis leads to a uniform distribution of the load on the implants.

The proposed method does not use screws for fixing dentures, because implants have an internal thread for fixing the abutment, and the abutment has an external thread.

Bending of the abutment allows you to achieve parallel placement of the implant in relation to natural teeth or in relation to implants standing next to the implant.

Figure 1 shows the implementation of the method.

Figure 2 shows the location of the implants in the alveolar bone.

Figure 3 shows the location of the implants in the alveolar bone with a curved abutment in the milling apparatus.

The drawings show: 1, 2, 3 - bone, 4, 5 - implant, 6 - abutment, 7 - alveolar bone.

Famous titanium nickelide implants with a memory shape have a superstructure - an abutment. The superstructure has the shape of a cylinder, and when the implant is inclined, it is also installed obliquely. In this case, they first resort to bending the superstructure to the desired angle of inclination, and then milling it.

In those cases when the superstructure is unable to achieve parallelism by milling the superstructure, they also resort to its bending, followed by milling and modeling of the prosthesis frames on implants.

Claims (1)

A method of fixing dentures on implants, including installing implants, radiography of their position after engraftment, installing abutments inside the implants, taking impressions followed by removal of the abutments and installing them in an impression, installing copies of implants on the threaded parts of the abutments, manufacturing a combined model, modeling a permanent framework the prosthesis and its fitting on the abutments, installation in the oral cavity, casting, casting of the combined model, determining the configuration of the abutments, eliminated e defects of abutments by processing on a milling machine, modeling the framework of a permanent denture in the articulator and fitting onto machined abutments in which threaded holes are made through the framework, applying ceramic or composite coatings to the framework, fixing with screws in the oral cavity and installing the prosthesis with screw fixation, the heads of which are coated with a composite coating, characterized in that after unscrewing the healing abutment from the implant, the impression abutment is screwed into it, the impression is taken, from pour the combined model with the implant analog and the abutment screwed into it, unscrew the abutment from the model and bend it using a vise or two dental crowns at an angle necessary for making the prosthesis.

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