RU2602033C1 - Fixed denture - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to dentistry, and can be used to replace a small length defect of a dental arch. Fixed denture is made using computed-aided milling with further individualization with ceramic mass and dyes and consists of an intermediate part in the shape of the absent tooth and support and retaining elements in the form of inlays and onlays, their shape corresponds to missing hard tissues of teeth, limiting the denture defect. Support and retaining elements of the denture have additional retention elements in the shape of a length-way half of a cone with a base that is 2 mm in diameter, facing the gingival edge of the tooth at the distance of 1.5 mm, and are located on the approximal surfaces of abutment teeth.

EFFECT: technical result is production of aesthetic precise ceramic structure of fixed denture to replace a denture defect of dental arch with minimal invasive dissection of abutment teeth.

1 cl, 2 dwg

Description

The invention relates to medicine, and in particular to dentistry, and can be used to replace small length dentitions. Known adhesive bridge prosthesis, consisting of a bridge with vertical supports and an artificial tooth, which is installed on the bridge. The supports can be made L-shaped with oppositely directed ends (RF Patent No. 21545419).

The prosthesis can be used for partial, secondary adentia of the dentition. The invention allows for the restoration and repair of the prosthesis directly in the patient’s oral cavity in a hospital, since preparation of supporting teeth is required.

A bridge is known for replacing small included dentition defects having a titanium nickelide carrier plate having a shape memory effect installed in the grooves of the abutment teeth. The plate has a semicircular end surface. The tooth mounted on the plate has a longitudinal groove. The grooves in the abutment teeth are formed vertically from their contact surface and do not reach 1.0-1.5 mm to the neck of the tooth. The width of the longitudinal groove is 10% greater than the thickness of the supporting element in the form of a plate (RF Patent No. 2200503).

A known method of installing a fixed denture, including processing the denture and its subsequent fixation on the abutment teeth by at least two rod clasps, the ends of which are fixed in opposite holes made on the medial surfaces of the abutment teeth, characterized in that this method characterizes the installation of an artificial tooth on rod clamps with its subsequent fixing using a self-hardening composition (RF Patent No. 2099021 from 12/20/1997).

A known method of prosthetics of small included defects of the dentition in the lateral region, which consists in the preparation of abutment teeth, taking impressions, casting the working and auxiliary models, the manufacture of the prosthesis. The prosthesis is fixed by filling in the undercut zones formed by the lateral surfaces of the prosthesis and abutment with adhesive material using a wax matrix mounted on the bed to preserve the wash space (RF Patent No. 2268021).

The invention allows, due to the increase in the area of glued surfaces, to ensure reliable fixation of the bridge in the oral cavity.

A known method of manufacturing an adhesive bridge, which consists in preparing the abutment teeth by cleaning them from plaque, making cuts, treating them with acid and filling with a fluid-flowing composite, fixing the fixing system; facing the future prosthesis with composite materials, characterized in that the prosthesis is made directly in the oral cavity in the area of the dentition defect; in the abutment teeth, cuts are made parallel to the axis of the tooth, into which the fiberglass is installed in the form of strips, having the fiber directional vector perpendicular to the tooth axis, forming a fiberglass fastening system, where counter-directed fibers on the surfaces of adjacent fiberglass strips are intertwined with each other; then the fastening system is filled with a fluid composite or resin; the tooth is restored with a condensable composite; perform the final modeling of the prosthesis with a microhybrid preparation and post-boarding (Patent RU 2250089).

A method of manufacturing fixed dentures includes the preparation of surfaces of the abutment teeth by forming in each of them along the line of the anatomical equator of the cavity located on the side facing the defect of the dentition, and fixing them with composite material of the tabs of the artificial tooth. The cavity is made with a through depth of 1.5-2.0 mm, a width of 2.0 mm and a height of at least 2.0 mm. Effect: the ability to maintain an individual relief of the chewing surface of the abutment teeth (Patent RU 2255705).

Known methods for repairing dentition defects with combined bridges based on tabs formed on occlusal surfaces of teeth defining a defect (EN Zhulev, SD Arutyunov, I.Yu. Lebedenko. “Designing fixed dentures using tabs”. Publishing house of the Novosibirsk State Medical Academy N.Novgorod. 2005, pp. 56-102).

Known bridge prosthesis on the tabs, which is made of ceramics based on zirconium dioxide (CAD / CAM technology). The main difference between such a prosthesis and ceramic bridges is that in this case the abutment teeth are not completely grinded on all sides. On the chewing surfaces of the abutment teeth, indentations are made under the tabs, which will serve as the supports of this bridge. The finished bridge is fixed on the abutment teeth (http://24stoma.ru/mostovidnye-protezy.html).

This method is selected for the prototype.

The problem to which the invention is directed is to repair a dentition defect with a minimally invasive orthopedic design with high aesthetic characteristics.

The technical result of the invention is the manufacture of an aesthetic, precision ceramic design for a fixed denture to replace a dentition defect with minimally invasive preparation of abutment teeth.

The technical result is achieved by the fact that the fixed denture is made by computer milling followed by individualization with ceramic mass and dyes, consists of an intermediate part in the form of an absent tooth with supporting and retaining elements in the form of tabs-overlays, in shape corresponding to missing hard tooth tissues that limit the defect dentition and having additional retention elements in the form of a longitudinal half of the cone with a base with a diameter of 2 mm, facing the gingival margin, dulling 1.5 mm from it, located on the approximate surfaces of the abutment teeth.

Compliance with the rules of biological expediency in the preparation of teeth provides minimally invasive preparation, but does not provide mechanical retention of a fixed denture based on tabs. In practical health care, the indicated problem is solved by the use of double-cured composite cements for fixing the prosthesis. However, it is worth noting that the protocol for the use of such tools provides for the use of chemical etching of hard tissues with acids, which can lead to inflammation of the neurovascular bundle of the tooth.

In the proposed method, the above problems are solved by additional retention elements in the form of a longitudinal half of the cone. The shape of the cavity in the form of a cone provides mechanical retention and causes the horizontal introduction of the prosthesis, which is not familiar to the traditional vertical route of administration. Due to mechanical retention, it is possible to use glass-ionomer cement to fix the obtained prostheses, the protocol for the use of which does not imply chemical etching of the enamel. The proposed structural material with the possibility of individualization provides the aesthetics of a fixed denture made by computer milling.

A fixed denture is illustrated by drawings, where in FIG. 1 and in FIG. 2:

1. Teeth limiting the defect.

2. Marginal gums.

3. Additional retention elements.

4. Fixed denture.

The method of replacing a defect in dentitions of short length using the proposed non-removable denture is as follows:

1. Anesthesia

2. Removal by preparation from abutment teeth limiting the defect (1) of previously existing fillings, restorations, carious cavities, preserving healthy hard dental tissues as much as possible.

3. Formation of retention grooves on the distal from the defect proximal surfaces in the form of a longitudinal half of a cone with a base 2 mm in diameter facing the marginal gum (2), 1.5 mm departing from it, passing to the intraoral and chewing surfaces of the tooth.

4. Obtaining an optical impression.

5. Digital modeling of the design of the bridge of a fixed denture (4) with support on tabs repeating in their form the missing hard tissues of the abutment teeth (1) with additional retention elements (3) in the form of a longitudinal half of a cone with a base with a diameter of 2 mm, facing to the gingival margin (2), departing from it by 1.5 mm, located on the approximate surfaces of the abutment teeth.

6. Verification of articulation movements in a computer ariculator with reduction of the digital model of the prosthesis in places of contact with the hard tissues of the tooth by 20 microns, to ensure the optimal thickness of the cement film.

7. Milling the resulting digital model of a prosthesis made of zirconia.

8. Synthesis of the prosthesis (4).

9. Individualization of the resulting design (4)

10. Fixing a fixed denture (4) in the oral cavity to glass ionomer cement.

Claims (1)

The fixed denture is made by computer milling followed by individualization with ceramic mass and dyes, consists of an intermediate part in the form of an absent tooth and supporting-retaining elements in the form of tabs-overlays, in shape corresponding to missing hard tissues of the teeth, limiting the dentition defect and having additional retention elements in the form of a longitudinal half of the cone with a base with a diameter of 2 mm facing the gingival margin, departing from it 1.5 mm, located on the approximation lnyh abutment teeth surfaces.

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