RU46176U1 - BRIDGE - Google Patents

Abstract

The proposed utility model relates to the field of medicine, namely to dentistry to bridges and can be used in orthopedics for prosthetics of included defects of small dentitions in the lateral section. The proposed bridge makes it possible to reduce trauma during the preparation of hard tooth tissues, to preserve the individual relief of the occlusal surface of the abutment teeth, the interalveolar distance and the occlusal relationship. To do this, in a bridge containing two supporting elements in the form of half-crowns and an intermediate part, each half-crown is made with an open chewing surface formed by two pins located on the proximal sides, connected by a transverse beam located in the longitudinal fissure.

Description

The proposed utility model relates to the field of medicine, namely to dentistry to bridges and can be used in orthopedics for prosthetics of included defects of small dentitions in the lateral section.

Prosthetics with included defects in the dentition is one of the urgent tasks of orthopedic dentistry.

If an included defect of short length occurs, the patient makes complaints related to a violation of aesthetics (especially with loss of premolars). Functional complaints are often absent. However, an objective examination shows that most organs of the dento-maxillary system are involved in the pathological process of dysfunction: teeth move, chewing efficiency decreases, uneven chewing load gradually leads to facial asymmetry due to hypertrophy of the chewing muscles of the healthy side.

All these factors indicate the need for prosthetics for patients even with defects included, such as the absence of 1 tooth.

Most often, bridges with supporting elements in the form of full crowns are used. All the advantages of prosthetics based on full crowns are obvious: replacement of an aesthetic defect, prevention of the above complications. But we must not forget about the negative sides.

Firstly, there is a need to prepare abutment teeth, in which a significant amount of hard tooth tissue is ground.

Secondly, during aesthetic prosthetics with bridges (metal-ceramic, metal-acrylic, all-ceramic), sometimes, as a preparation for further orthopedic treatment, it is necessary to depulite the abutment teeth, which increases the risk of complications due to endodontic treatment.

Thirdly, the occlusal surface of the abutment teeth is completely polished and, as a result, during the prosthetics, individual individual alveolar distance may be lost, teeth may be moved towards antagonists, and the individual relief of the masticatory surface will be lost.

Moreover, if the teeth limiting the defect are intact, then the patient often refuses prosthetics, having learned about the need for significant preparation of these teeth.

The most common type of support element for prosthetics with bridges is a full crown (A.S. Scherbakov, V.N. Trezubov, E.N. Gavrilov, E.N. Zhulev. Orthopedic dentistry. St. Petersburg - Foliant, 1997, p. 110-122). It covers the entire crown of the tooth.

However, the known analogue has the following disadvantages. Firstly, there is a need to prepare abutment teeth, in which a significant amount of hard tissue is ground off from the entire surface of the crown of the tooth. Secondly, during prosthetics with aesthetic types of bridges (metal-ceramic, metal-acrylic, all-ceramic), sometimes, as a preparation for further orthopedic treatment, it is necessary to depulite the abutment teeth, which increases the risk of complications due to endodontic treatment. Thirdly, the occlusal surface of the abutment teeth is completely polished and, as a result, during the prosthetics, individual individual alveolar distance may be lost, teeth may be moved towards antagonists, and the individual relief of the masticatory surface will be lost. Moreover, if the teeth limiting the defect are intact, then the patient often refuses prosthetics, having learned about the need for significant preparation of these teeth.

For the prototype of the proposed utility model, a well-known bridge is selected containing supporting elements made in the form of half-crowns and an intermediate part (B. Boyanov, T. Khristozov. Microprosthetics. Sofia - Medicine and Culture, 1962, p. 175-180). A semicircle is an orthopedic construction that acts as a supporting element in bridges, covering the palatine (lingual) half of the tooth. This element provides a fairly reliable fixation of bridges, preserves the aesthetics of supporting teeth.

However, for the use of a semi-crown, it is necessary to prepare the chewing surface, which inevitably entails a change in the existing occlusal relationships; the preparation of the internal tubercles of vital chewing teeth is associated with a certain risk, since there is the possibility of damage to the horns of the pulp; during a conversation, the lingual (palatine) tubercle of the chewing teeth covered with a metal semicircle is clearly visible and creates an unfavorable aesthetic

the effect; when preparing a half-crown of the palatine tubercles of the lateral group of teeth, a possible loss of lateral protection of the temporomandibular joint (TMJ) and, as a result, the development of Kosten syndrome is possible.

The objective of the proposed utility model is to reduce trauma during the preparation of hard tooth tissues, preservation of the individual relief of the occlusal surface of the abutment teeth, interalveolar distance and occlusal relationships.

The problem is solved in that in the known bridge, containing two supporting elements in the form of half-crowns and an intermediate part, each half-crown is made with an open chewing surface formed by two pins located on the proximal sides connected by a transverse beam located in the longitudinal fissure.

The proposed utility model meets the criteria of "novelty" and "inventive step", since in the process of conducting patent information research, no sources of information were found discrediting the novelty of the proposed utility model, as well as technical solutions with essential features of the proposed device.

The proposed utility model when used allows to obtain the following positive effect

1. Significantly reduces the volume of preparation of the abutment teeth, which reduces the risk of mechanical and thermal damage to the pulp of the tooth.

2. The need for preliminary depulpation of supporting teeth disappears, and, as a result, the possibility of complications due to endodontic treatment disappears.

3. The occlusal surface is prepared in a very small volume, which allows the individual interalveolar distance and the individual relief of the chewing surface to be preserved during the prosthetics process.

4. Maintaining contact between the abutment teeth and their antagonists avoids the movement of abutment teeth during prosthetics.

5. The occlusal relationship of the abutment teeth with the antagonist teeth is preserved during various functional movements of the lower jaw.

The proposed utility model is illustrated in the drawing. Figure 1 shows the proposed bridge 1 containing support elements 2 made in the form of half-crowns and an intermediate part 3. Each half-crown 2 is made with an open chewing surface 4, which form

two pins 5 located on the approximate sides connected by a horizontal beam 6 located in the longitudinal fissure.

The intermediate part of the proposed bridge can be made as metal cast, as well as metal acrylic or cermet.

The proposed device operates as follows.

The stages of prosthetics with a metal-ceramic bridge prosthesis are given.

Clinical 1: receive alginate impressions from the upper and lower jaw. Fixing the position of the central occlusion using a silicone or wax occludogram. Production of diagnostic models of jaws from super gypsum and their gypsum plastering. The study of occlusal relationships, occlusal contacts in the central, lateral, anterior occlusions. The study of targeted x-rays of the abutment teeth in order to determine the size of the pulp chamber and the volume of preparation. Phantom preparation of supporting teeth on diagnostic models.

Clinical 2: after anesthesia, the gums of the supporting teeth are retracted with a retraction floss, receive occlusal fingerprints using carbon paper in the central occlusion position. The abutment teeth are prepared under the proposed bridge with an open chewing surface:

1. Prepare the palatine (lingual) surface with approaching the approximate with the creation of a ledge at the level of the gums.

2. A longitudinal groove is prepared in accordance with the longitudinal fissure of the tooth, moreover, care should be taken to ensure that the occlusion prints do not fall into the preparation zone.

3. Prepare longitudinal guide grooves on the approximate surfaces of the abutment teeth.

The preparation is conducted with a cone-shaped bur with a rounded apex.

After preparation, biphasic two-stage silicone impressions from the upper and lower jaw are obtained, the position of the central occlusion is recorded using a silicone or wax occludogram, and the prepared teeth are coated with fluoride varnish.

3 laboratory; prints make the working and auxiliary models of super gypsum, fix them in the articulator. A bridge framework is modeled under the control of an occlusal relationship. The casting of the metal frame (cobalt-chromium or nickel-chrome alloy) is carried out either by a lost wax model or by a refractory model. After casting, check

landing of the frame on the model, carry out fitting of the frame (if required). Work is transferred to the clinic.

4 clinical: check the skeleton of the bridge in the oral cavity using silicone corrective paste. Verification and correction of central and functional occlusion is carried out using carbon paper. The color of the cladding is determined.

5 laboratory: apply the lining to the intermediate part of the bridge.

6 clinical: check the bridge in the oral cavity. Check and correct central and functional occlusion. Color correction (if required).

7 laboratory: glazing of ceramic cladding, polishing of metal parts of the bridge.

Clinical 8: fixation of a glazed and polished bridge with a double cured cement in the oral cavity is carried out. Remove excess cement. Finishing polishing of metal contact with tooth tissues.

An example of a specific performance is given in the form of an extract from a medical history

Patient O., 23 years old, turned to the NGMA Orthopedic Dentistry Clinic with complaints of an aesthetic defect in the upper jaw on the right, difficulty chewing food.

Anamnesis of the disease: the patient removed a 15 tooth due to an exacerbation of chronic granulomatous periodontitis b months ago.

Objectively: the bite is orthognathic, there is no asymmetry of the face, the mucous membrane is pale pink, moistened moderately. On the upper jaw, an included defect in the lateral region on the right (15 tooth missing). 14 and 16 teeth are intact, coronal parts are well defined. Deformation of the dentition was not detected.

Diagnosis: unilateral included defect of the upper jaw (Kennedy grade 4).

Treatment plan:

1. prosthetics of the upper jaw with a ceramic-metal bridge prosthesis based on 14 and 16 teeth. The supporting elements of the bridge are made in the form of semi-crowns with an open chewing surface.

Treatment:

1. Obtaining alginate impressions from the upper and lower jaw. Fixing the position of central occlusion using a silicone occludogram (Occlufast). Production of diagnostic models of jaws from super gypsum and

gypsum them into the articulator. The study of occlusal relationships, occlusal contacts in the central, lateral, anterior occlusions. The study of targeted x-ray images of 14 and 16 teeth in order to determine the size of the pulp chamber and the volume of preparation. Phantom preparation of 14 and 16 teeth on diagnostic models.

2. An infiltration anesthesia was performed on the upper jaw in the region of 14 and 16 teeth. Gum retraction of 14 and 16 teeth with retraction floss was performed. Using carbon paper, occlusal imprints were obtained on the upper jaw in the position of central occlusion. 14 and 16 teeth were prepared under a semi-crown with an open chewing surface with the creation of a ledge at the level of the gums. Two-phase two-stage silicone impressions from the upper and lower jaw (Silagum) were obtained. Fixing the position of central occlusion using a silicone occludogram (Occlufast). Coating 14 and 16 teeth with fluoride varnish (Bifluorid 12).

3. Checking the skeleton of the bridge in the oral cavity using silicone corrective paste (Speedex). Verification and correction of central and functional occlusion using carbon paper. Determination of the color of ceramic cladding: the main shade is A3, the enamel layer is D2.

4. Verification of the bridge in the oral cavity. Verification and correction of central and functional occlusion.

5. Fixation of the glazed and polished bridge using double cured cement (Nexus 2) in the oral cavity. Removing excess cement. Finishing polishing of metal contact with tooth tissues.

Claims (1)

A bridge prosthesis containing two supporting elements in the form of half-crowns and an intermediate part, characterized in that each half-crown is made with an open chewing surface formed by two pins located on the proximal sides, connected by a transverse beam located in the longitudinal fissure.