RU2708030C1 - Method for movable teeth immobilization - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to orthopedic dentistry, and is intended for stabilization of movable teeth caused by periodontium diseases. Method for immobilizing movable teeth involves virtual 3D scanning of patient's dental arch by an intraoral scanner, styling on a virtual model of the denture with an oral surface of a splint with thickness of 0.5 mm in a shape corresponding to the oral surface of the teeth in the lower part, repeating the contours of the cervical line, deviating therefrom by 2 mm, and not reaching 2 mm cutting edge, having with tooth surface of conical shape corresponding to interdental spaces, and on the surface of the splint facing the oral cavity, processes in the form of an arc-positioner, changing over to the vestibular tooth surface, wherein the end of the arc facing the vestibular tooth surface has a platform corresponding to the vestibular tooth surface and adjoins the tooth densely, and in the attachment point of the arc to the oral surface of the splint there is a tapered narrowing, wherein the number of arcs of positioners in the splint at a rate of two teeth – one arc-positioner, subsequent printing of the virtual splint model into a physical form by additive technology from polymethyl methacrylate, accurate fixation by means of arcs of positioners of polymer splint on causative teeth by dental composite with observance of protocol of adhesive fixation, cutting off by dental cutter of arches-positioners in place of cone-shaped contractions in place of attachment of arches with oral surface of splint, grinding and polishing of splint.

EFFECT: method provides immobilization of movable teeth with a splint differing by high accuracy of adjoining, identical to a clinical picture in the oral cavity, minimized by clinical stages of its manufacturing, high accuracy of positioning on the causative teeth and reduced time of fixation of the splint.

1 cl, 1 dwg

Description

The invention relates to medicine, namely to orthopedic dentistry, and is intended to stabilize moving teeth that arose as a result of periodontal diseases.

A method for splinting teeth is known from the prior art which is carried out as follows: professional oral hygiene is carried out using an ultrasonic tip and an intraoral sandblasting apparatus with soda-containing powder, then the surface of the teeth is polished with rubber bands, a fluorine-containing preparation is applied to it, and a digital impression of the teeth is obtained using a digital module. rows of the patient and the bite register to compare them in the simulation program, after receiving the digital ott ska on the digital model starts modeling the future tire, the contour of the future tire is drawn on the lingual surfaces of the teeth to be splinted in the program, departing from the margin of the marginal gum by a distance of less than 1 mm depending on the individual characteristics of the patient, after applying the contour, its thickness is 0.2 mm, the program automatically simulates the surface of the tire, completely repeating the contours of the anatomical features of the teeth, also the program automatically sets the gap between the structure and the surface of the teeth for fixing of the material, then within a few minutes the milling machine cuts out an exact copy of the digital model obtained from the polyurethane block, after polishing and fitting in the oral cavity, the structure is fixed on the double-cured composite cement according to the manufacturer’s instructions (RF Patent for invention No. 2464952 of 05.19.2011 )

A known method for splinting teeth is as follows: the patient receives an impression of the dentition with an alginate impression mass and gypsum models are made, the usual closure of the teeth is fixed with a silicone registrar, the obtained models are plastered into the articulator, and the depth of the subsequent preparation of the splinted teeth is calculated using the previously obtained x-ray image of the skull in lateral projection from the lingual side, in the depth of the tooth cavity, the obtained models are scanned and digitized from shaving by means of CAD / CAM systems, on the virtual model, the boundaries of the future tire are drawn on the lingual surface of the teeth, and the subsequent layer of the composite material necessary for fixing the reinforcing tape is modeled, the thickness of the composite material is calculated based on the depth of preparation, the thickness of the reinforcing tape and the recommendations of the companies of its manufacturers obtained by computer simulation, the model of the dentition is made by computer milling or laser sintering, according to the obtained model a transparent mouthguard is poured by thermal vacuum pressing, then in the oral cavity from the lingual surface of the teeth to be bonded, a bed is formed with a thickness as previously determined on the x-ray, into which the reinforcing tape is laid, then a light-cured composite material is applied and fixed with a previously pressed mouthguard so that the composite material fills the existing groove in the mouthguard, previously designed along the future tire border, after which the composite material is otkryvayut until complete polymerization and grinding m and polishing the resulting tire (Patent №2554206 from 04.01.2014).

A known method of splinting teeth with the possibility of replacing defects in the dentition consists in conducting professional hygiene of the patient’s oral cavity with periodontal diseases, obtaining an optical impression of the clinical situation of the patient’s oral cavity, recognizing this impression in the computer program CAD \ CAM system, modeling on the obtained image of a dental splint, which located on the lingual or palatine surfaces of all existing teeth, overlapping the clinical equators of teeth by 1 mm, so that its lower gr the anise passes 1.5 mm away from the marginal gingival margin and incorporates artificial tooth facets; in the absence of natural teeth, the artificial facets are connected with the splint in one piece and fit snugly to the clinical equators of the teeth, limiting the defect by point contact, and then simulated on a computer the dental splint is milled from a monolithic block of zirconium oxide, polished, polished and fixed in the patient's oral cavity on double-cured dental cement, in case of subsequent tooth loss on a saved computer model without re-admitting the patient, the extracted teeth are replaced with artificial facets and the changed design is milled, grinded, polished and fixed in the oral cavity with double-cured dental cement (Patent No. 2601654 of 06/04/14).

The prior art method for splinting teeth with the possibility of replacing defects in the dentition consists in conducting professional hygiene of the patient’s oral cavity with periodontal diseases, obtaining an optical impression of the patient’s dentition, recognition of this impression in the CAD / CAM system computer program, modeling on the obtained image of the tooth splint, which is located on the lingual or palatal surfaces of all teeth having mobility in the vestibulooral or medial distal direction, overlapping by 2 mm clinical equators of teeth, so that its lower border runs along the gingival border, in teeth with mobility in two or more directions, the splint is located on the vestibular surface, repeating the morphology of the crown of a natural tooth, and has a thickness of 0.5 mm, after which The tooth splint simulated on a computer is milled from a monolithic block of zirconium oxide, after which the vestibular surfaces of the splint are individualized to fit the existing teeth by applying ceramic mass and dyes, followed by glazing and fixed in the patient's mouth on the dental cement dual curing, in the case of subsequent loss of teeth having a mobility in two or more directions, the vestibular surface of the tire remains and serves as a missing tooth (Patent №2579743 from 27.10.2014). All of the above methods have one significant drawback, namely, the complexity and inaccuracy of positioning the tire on the patient’s dentition during its fixation.

The objective of the invention is directed to the immobilization of mobile teeth in patients with periodontal diseases.

The technical result of the invention is the immobilization of mobile teeth with a splint, which is characterized by a high accuracy of fit, an identical clinical picture in the oral cavity, minimized clinical stages of its manufacture, high accuracy of positioning on causal teeth and a reduction in tire fixation time. The technical result consists in the fact that the method of immobilization of movable teeth consists in virtual 3D scanning of the patient’s dentition with an intraoral scanner, modeling on the virtual model of the dentition with an oral surface of the tire with a thickness of 0.5 mm in the shape of the corresponding oral surface of the teeth in the lower part repeating the contours of the cervical line departing from it by 2 mm and not reaching the cutting edge of 2 mm, having conical protrusions on the contact surface with the tooth corresponding to the interdental spaces, and on the In the case of the tire facing the oral cavity, processes in the form of a positioner arc that goes to the vestibular surface of the teeth, while the end of the arc facing the vestibular surface of the teeth has a platform corresponding to the vestibular surface of the tooth and fits snugly, and in the place where the arch is attached to the oral surface of the tire its cone-shaped narrowing, while the number of arc positioners in the tire at the rate of two teeth is one arc positioner, then printing the virtual model of the tire into physical form using additive technology made of polymethylmethacrylate, precise fixation with the help of arc positioners, a polymer tire on causal teeth with a dental composite in compliance with the adhesive fixation protocol, cutting out the arc positioners with a dental cutter at the place of cone-shaped narrowing at the place where the arches are attached to the oral surface of the tire, grinding and polishing the tire.

The use in the proposed method of scanning the dentition, and not the use of a physical impression, eliminates the inaccuracies in the manufacture of the immobilizing splint that can occur when the teeth are pressured by their movement, as well as deformations of the impression material. The manufacture of a tire in the proposed method using modern dental additive technologies from a polymer provides high accuracy of adherence to hard tissues of the tooth, identical to the clinical situation in the oral cavity and the possibility of using an adhesive fixation protocol. And the presence in the tire structure of arc positioners removed after fixation ensures high accuracy of its positioning on causative teeth and a reduction in the time of its fixation in the clinic.

The method of immobilization of movable teeth is illustrated in the drawing, where:

1. The dentition of the patient

2. Immobilizing tire

3. Arc positioner

4. The end of the positioner arc, facing the vestibular surface of the teeth

5. The end of the arc positioner, facing the oral surface of the tire Immobilization of teeth using the proposed method is as follows:

1. Conducting professional oral hygiene.

2. 3D scanning of the dentition (1) of the patient with an intraoral scanner.

3. Modeling on a virtual model of the dentition (1) from the oral surface of the tire (2) with a thickness of 0.5 mm in the shape of the corresponding oral surface of the teeth in the lower part, repeating the contours of the cervical line 2 mm from it and not reaching the cutting edge of 2 mm having conical protrusions on the contact surface with the tooth corresponding to the interdental spaces, and on the surface of the tire (2) facing the oral cavity processes in the form of an arc positioner (3), passing to the vestibular surface of the teeth, with the end of the arc facing the vestibule the surface of the teeth (4) has a platform corresponding to the vestibular surface of the tooth and fits snugly to it, and at the point of attachment of the arch from the oral surface of the tire (5) there is its cone-shaped narrowing.

4. Printing a virtual tire model (2) through additive technology of polymethyl methacrylate.

5. Fixation with the help of arc positioners (3), polymer bus (2) on causal teeth with a dental composite in compliance with the adhesive fixation protocol.

6. Sawing of the positioner arches (3) with a dental milling cutter (3) at the place of cone-shaped narrowing at the place of arch fixation from the oral surface of the tire (5).

7. Grinding and polishing tires.

Claims (1)

A method for immobilizing movable teeth consists in virtual 3D scanning of a patient’s dentition with an intraoral scanner, modeling on a virtual model of the dentition with an oral surface of a 0.5 mm thick tire in the shape corresponding to the oral surface of the teeth in the lower part, repeating the contours of the cervical line, departing from it by 2 mm, and not reaching a cutting edge of 2 mm, having conical protrusions on the contact surface with the tooth corresponding to the interdental spaces, and on the surface of the tire facing the oral cavity from the remains in the form of an arc-positioner, passing to the vestibular surface of the teeth, while the end of the arc facing the vestibular surface of the teeth has a platform corresponding to the vestibular surface of the tooth and is adjacent to it, and in the place of attachment of the arch with the oral surface of the tire there is its cone-shaped narrowing, while the number of arc positioners in the tire at the rate of two teeth - one arc positioner, subsequent printing of the virtual model of the tire into physical form using additive technology of polymethylmethacrylate, precise fixation using dental arches of the polymer tire on causal teeth with a dental composite in compliance with the adhesive fixation protocol, cutting out the dental positioners with a dental cutter at the place of cone-shaped narrowing at the site of attachment of the arches with the oral surface of the tire, grinding and polishing the tire.

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