SU1577779A1 - Method of producing fixed cermet prosthesis with use of implanted metal supports - Google Patents

Abstract

The invention relates to dentistry. The purpose of the invention is to reduce trauma to the gum tissue. The model used in the work, made a combination. The elements of the prosthesis supported by the implants are made thin-walled. The metal framework of the prosthesis is made solid-cast and ceramics is applied to the latter.

Description

The invention relates to medicine, in particular to dentistry, and is intended for use in the practice of dental clinics for prosthetics using implanted metal supports.

The aim of the invention is to reduce gum tissue trauma.

The essence of the method lies in the fact that the prosthetic jaw model is made as a combined one, a thin-walled crown is included in the implant, which is included in a solid cast metal bridge-like prosthesis, manufactured as a metal-ceramic one.

Example. A patient with a diagnosis of a dental defect was diagnosed, the last 4 teeth were missing on the lower jaw on the right (0000432II12345678), an implant of KHS alloy was implanted in the region of the seventh tooth on the right 71. After two months, the state of the gum was evaluated - inflammation, complaints Remarks of the patient, the implant mobility in the vestibular-oral direction was up to 0.5 mm, which, in the opinion of, for example, American implants, corresponds to the norm. Based on the foregoing, implantation is intended to be successful and proceeded to prosthetics.

When prosthetics at all stages used coferdam. The abutment tooth is premol; the right tooth is prepared before the operation, since the postoperative period is characterized by increased sensitivity.

On the first visit of the patient (after the operation) with the help of the impression material "Cielast-03, an impression was taken from the lower jaw, then the impression was transferred to the laboratory, where a combined collapsible model was made, which allows to extract the tooth models from the dental model In the implant and pre-prepared tooth-premol 4, standard xiphoidal shanks are fixed, which are fixed with pins through the impression. Next, a combined model of two layers of gypsum was fabricated: the dental series and the alveolar process of the high strength type Superch. plaster, on top - medical plaster.

For a strong mechanical adhesion of the super-gypsum followed by a layer

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Medical gypsum in the non-hardened super-gypsum installed clips in the area of defects of dental rows and teeth on which no crowns could be made. After the plaster had hardened onto the ends of the liners, the wax balls were reinforced with a diameter of up to 2 mm, the liners were smeared with petroleum jelly for subsequent easy ejection of the liner with the tooth stump model from the combined model. Then the mold was filled with a solution of medical gypsum on a vibrating table.

After the plaster hardened, the model was freed from the impression. Oriented along the axis of the tooth stump, in the basement part, with a cutter, drilled holes to wax balls, which are a guideline to accurately determine the location of the shanks, then with a jigsaw sawed out a tooth stump model to the border of two gypsum media. Lightly tapping the shank pushed the models 4) and the implant, determined the boundaries of the tooth neck along the depth of the gingival slit. A shank with a tooth stump model should be freely installed in the correct position in the jaw model, while not changing the position in the tooth row, because during the modeling of the wax composition, ceramic cladding and final fitting of the prosthesis on the jaw model, the dental technician should have accurate guidelines on the ratio of abutment teeth with adjacent teeth and antagonists.

In order to obtain an accurate framework, it is necessary to take into account the shrinkage of the alloy, which is compensated for by the use of a special compensating varnish and compensating polymer caps.

The model of 41 prepared twice was treated with a special varnish. The first layer of lacquer was applied on the stump and part of the model of the stump of the tooth below the neck by 2-3 mm, the second layer of varnish only on the stump of the tooth, not income to its neck 0.5 mm.

After the varnish has completely dried, they proceed to the formation of polymeric caps, which are made from a Kodent film, which is an amorphous undirected lavsan with a high degree of ashlessness and well shaped on the tooth stump model. To do this, the first film with a thickness of 0.1 mm, which serves to compensate for the shrinkage of the metal, and the second film with a thickness of 0.6 mm, which serves to impart hardness to the simulated wax composition and prevent its deformation during removal, together, heated over the burner flame in a special holder and pressed in a special silicone mass “Keramoplast, while the thin plate should be turned to the tooth stump model.

The thin cap was shortened 2-3 mm above the tooth neck and put in place,

0

after which these missing 2-3 mm were poured

special casting wax “Formodent.

Over the thin cap set

thick cap, trimmed 1 mm higher

of the tooth neck, and proceeded to the modeling of the crown 41, for which they used a set of "Modevaks, consisting of three types of waxes: red (low hardness) - to simulate the cervical area: green (solid) to simulate crowns: blue (medium hardness) for modeling the intermediate part of a prosthesis, modeling according to a conventional technique. After modeling the wax crown on 41, they started modeling a thin-walled crown on an implant model, for which a 0.1 mm thick film was heated over a burner flame in a special holder and pressed into a special ceramic mass, Keramoplast, the cap was shortened 2-3 mm above the implant neck and started modeling a thin-walled crown, for which they modeled the cervical area with red wax, put green wax on top of the cap and gave an approximate “anatomical shape”

5 teeth, then a compensation lacquer was applied, after the lacquer had dried, they warmed over the burner flame a compensation film 0.6 mm thick and pressed into the “Keramoplast. The cap is trimmed 1 mm above the neck of the implant. From it extracted thin

0 a cap and a wax, a thick cap, hollow, installed on the implant stump, forming the cervical area with red wax. Then modeled the intermediate part of the wax composition in the form of a tooth stump. Between the intermediate part of the bridge prosthesis and the alveolar ridge there should be a gap of 1.5-2.0 mm, for which the alveolar ridge of the intermediate part was compressed with a bugel base wax.

After the end of the simulation, a gating system was installed. A sprue made from molded wax “Voskolit-2, with a diameter of 2-3 mm and a length of 5-6 mm on chewing surfaces was attached to each casting unit, connecting the sprues with a wax feeder with a diameter of 3-4 mm from

5 of the same wax. Then the wax composition together with the gating system was carefully removed from the model so that there was no deformation of the composition, they were re-installed on the model and sent to the foundry.

By the method of flaskless casting, the wax was transferred to the metal – alloy KHS, in high-quality furnaces. The metal frame was modified and fitted on the model.

On the second visit of the patient, the skeleton was fitted in the mouth, the color of the pottery was selected. In the laboratory, a metal frame was covered with ceramics. At the third visit of the patient, the frame covered with ceramics was put in the mouth, matching color and adhesion to the gum. The laboratory carried out the final stage - the glazing of the bridge structure, before passing the prosthesis to the clinic, carefully checking the ceramic coating of the prosthesis, the state of the surface and the color matching. At the fourth visit, the metal-ceramic bridge was temporarily strengthened with Relin. A week later, having done so in the absence of complications, the bridge was cemented with composite cement “Evikrol.

Claims (1)

Invention Formula A method of manufacturing a fixed metal-ceramic prosthesis using implanted metal supports by removing the impression of the jaw with protruding implants, making a model according to which the caps are made on the protruding parts of the implant, followed by forming, manufacturing and fixing the fixed prosthesis, characterized in that , in order to reduce gum tissue trauma, model d five 0 the combination caps are made of ashless plastic implants on the caps, a wax model of a thin-walled 0.5-0.6 mm crown is formed on the caps, while in the process of forming a wax composition of the prosthesis, the implant models are covered with compensatory varnish and thin-walled ashless caps plastics with a thickness of 0.1 mm; wax is created from the anatomical shape of a tooth on a thin-walled implant cap; a wax model of the tooth is coated with a compensating varnish and a cap of ashless plastic with a thickness of 0.5-0, 6 mm, wax and thin-walled cap are removed from the latter, the latter is put on the implant model and the wax body is simulated in the form of stumps of missing teeth and together with the crowns of the prepared teeth are formed a single wax prosthesis composition, and after the one-piece metal bridge prosthesis is made fitting, covered with ceramics and fixed to the protruding parts of the implant.