RU2587016C1 - Method for temporary tooth replacement after transdental implantation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to dentistry and use when recovering masticatory efficiency teeth with resected or amputated roots transdental implants. Optical impression of patient's dental arch to causative tooth preparation in preoperative period. Digital image is obtained of replication of positive optical impression. Method includes simulation in computer program CAD/CAM system on formed stump part of individual transdental implant bit having with oral surface processes, located at oral surfaces of teeth, located on both sides of causative tooth with removed from contact with teeth opposite jaw articulatory motions, tuned in a virtual articulator CAD/CAM system. Method includes cutting simulated computer crown of a polymer block with subsequent adhesive fixing time for transdental implant on mounted to adjacent teeth directly after operation.

EFFECT: method enables temporary prosthetics teeth with resected or amputated roots reinforced with transdental implants for period of their osteointegration.

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Description

The invention relates to medicine, namely to dentistry, and can be used to restore the chewing effectiveness of teeth with resected or amputated roots reinforced with transdental implants.

A known method of temporary prosthetics of the teeth during the osseointegration of two-stage dental implants is that temporary implants are inserted in the spaces of two-stage dental implants displaced in the vestibulooral directions, and the bridges based on them are made of a composite so that their chewing surfaces in the vestibule located in one line, inner surfaces facing the center of the alveolar ridge, have fillets in the form of a mucosa the jaw, departing from it by 1.0 mm, and the surfaces adjacent to the mucous membrane of the prosthetic bed at the junction of the crowns have dome-shaped roundings in the form of a gingival papilla, departing from it by 1.0 mm (RF Patent No. 2454967).

The prior art method of endodonto-endoossal implantation, which includes preoperative preparation of the tooth for endodonto-endoossal implantation, preparation of the root canal of the tooth with drills, sequentially increasing the diameter, screwing the endodonto-endoossal implant into the prepared hole in the tooth using a key for manual insertion. To prepare the orthopedic design, a transfer is screwed onto the implant and the impression is taken with an open or closed standard spoon or an individual spoon with a silicone mass, an impression is taken from the oral cavity, while the transfer remains in the mold. An analogue of the implant is placed on the transfer in the mold, filled with super gypsum and a collapsible model is made according to standard technology, an abutment is put directly on the crown of the implant, then a plastic cap, the stump of the prepared tooth is modeled with wax, and the wax composition is traditionally replaced with metal, and together with wax they burn out the plastic cap, fit the finished structure and fix it on the orthopedic cap using laser welding, make a permanent prosthesis. In cases of obstruction of the size of the postoperative bone defect of implant fixation without effort in the bone, an additional ratchet ratchet with reverse is used (RF Patent 2320290 of June 16, 2006).

The disadvantages of this method are the complexity of its implementation, the inaccuracy of manufacturing an individual abutment and high cost.

A known method of transdental implantation is carried out as follows, the crown, mouth and root canal of the tooth, for which resection or amputation of the root is planned, is prepared under the pin-stump insert according to classical technology, the root canal is prepared to the level of the physiological root apex, then into the prepared tooth a transdental implant replica is established, an impression is made of silicone mass, on which a model is cast from gypsum, on the obtained model, wax is simulated the horned part of the transdental implant on top of the replica fixed in the model corresponding to the stump of the prepared tooth, under the fixed orthopedic design and the circular bevel is milled at an angle of 135 degrees around the entire perimeter, then the prototype of the transdental implant made of titanium is fixed instead of the replica with hot wax to the mouth part of the obtained wax structure having an intra-root part in the form of an elongated cylinder with a rough surface and a corrugated intraosseous part, made in the idea of a thread with a rounded end part, the resulting structure is treated with a special anti-reflective powder to obtain an optical impression and converted to a digital format using a CAD / CAM scanner and using a computer program, the diameter of the root section of the implant is simulated with a circular gap between the implant and the root canal walls in 100 microns necessary for the placement of cement on which the implant is fixed, after which the transdental implant is milled from the titanium block, e under local anesthesia, resection or amputation of the root is performed, smoothing of the pointed edges of the root stump, preparation of the walls of the root canal with standard drills used in transdental implantation, glass-ionomer cement is introduced into the root canal on the canal filler and the transdental implant is fixed, the excess cement is removed, the bone marrow is replaced, , the wound is sutured tightly, then after two weeks from the root part, an impression is made and a suit is made governmental crown (RF patent №2521847).

The disadvantages of this method is that the artificial crown is made in the long term after the operation.

The problem to which the invention is directed is the temporary prosthetics of teeth with resected or amputated roots reinforced with transdental implants for the period of their osseointegration.

The technical result of the invention is the manufacture and fixation of a temporary crown-prototype on a tooth with a resected or amputated root, reinforced with a transdental implant with the redistribution of the masticatory load on adjacent teeth.

The technical result is achieved due to the fact that the method of temporary tooth prosthetics after transdental implantation consists in obtaining an optical impression of the patient’s dentition before the preparation of the causative tooth in the preoperative period, digital replication of the received positive image of the optical impression and modeling in the computer program CAD / CAM of the system on of the stump part of the individual transdental implant of the crown, having processes on the oral surface, having running along the oral surfaces of teeth located on both sides of the causative tooth, removing from contact with the teeth of the opposite jaw during articulation movements verified in the virtual articulator of the CAD \ CAM system, the subsequent milling of the simulated computer crown from the polymer block, followed by adhesive fixation of the temporary crown on installed transdental implant and adjacent teeth immediately after surgery.

The manufacture of a temporary crown in the preoperative period using modern CAD / CAM systems will restore the chewing effectiveness of the tooth and the patient’s aesthetics precisely and precisely immediately after the operation to install the transdental implant. The lateral processes of the temporary crown and the removal of the entire structure from the bite when reconstructing articulation relationships can significantly reduce the load on the operated tooth, which ensures osseointegration of the established individual transdental implant.

The method of temporary tooth prosthetics after transdental implantation is as follows:

1. Obtaining an optical impression of the dentition of the patient before the preparation of the causative tooth in the preoperative period.

2. Digital replication of the received positive image of the optical print.

3. Modeling in a computer program CAD / CAM of the system on the formed stump part of an individual transdental implant of a crown having processes on the oral surface located on the oral surfaces of the teeth located on either side of the causative tooth.

4. Removing from contact with the teeth of the opposite jaw during articulation movements verified in a virtual articulator of a CAD / CAM system.

5. Milling a simulated computer crown from a polymer block.

6. Fixation of the temporary crown on the installed transdental implant and next to the teeth.

Claims (1)

A method of temporary tooth prosthetics after transdental implantation consists in obtaining an optical impression of the patient’s dentition before the preparation of the causative tooth in the preoperative period, digitally replicating the received positive image of the optical impression and modeling in the computer program CAD / CAM of the system on the formed stump part of an individual transdental crown implant having from the oral surface, the processes located on the oral surfaces of the teeth located on about on the sides of the causative tooth, removing from contact with the teeth of the opposite jaw during articulation movements verified in the virtual articulator of the CAD / CAM system, subsequent milling of the simulated computer crown from the polymer block, followed by adhesive fixation of the temporary crown to the installed transdental implant and to adjacent teeth immediately after surgery.