RU2268678C2 - Reinforcing net-adhesive pin and method of its manufacture - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: reinforcing net-adhesive pin can be used in dental practice for restoration of front groups of teeth. Reinforcing net-adhesive pin is made of rectangular metal net with thickness of meshes of 0,4 mm. Part of pin placed in crown part of tooth has width to correspond to width of defect of crown part of tooth. Height of the pin is 1 mm shorter than its crown part. Part of pin placed in tooth's root channel is made in form of connected and twisted vertical wires of net. Wires have lengths to be 1-2 mm longer than length of root's channel. Passage from crown part of pin to its root part is made in form of oval-shaped neck formed of vertical wires of net. Neck follows the shape of cavity formed onto base of root. Restored defects of crown part of front groups of teeth have longer life and keep high elasticity. Pin can be manufactured during operation of restoration.

EFFECT: reduced time of restoration procedure.

2 cl

Description

The invention relates to medicine, namely to the pins used in dentistry during restoration of the front teeth.

It is known from the prior art to use various types of artificial crowns in the case when defects in the hard tissues of the tooth crown cannot be replaced by filling or using tabs.

To restore the destroyed crown part of the tooth, artificial crowns are used with support on pin structures, direct and indirect restorations made of composite materials (1-2, 4-9).

In recent years, to restore the destroyed coronal part of the teeth, anchor pins have been widely used.

Anchor pins are structural elements that are fixedly fixed (cemented) in the root canal of the tooth and serve to additionally fix the restoration elements. Conventionally, the anchor pins consist of two parts - the root and crown. A screw thread or horizontal grooves can be applied to the root portion for better retention. The crown part, as a rule, is an elongated rectangle, at the corners of which cuts are made. With the help of special holders, fixed on these cuts, the pin is inserted into the root canal and removed from it. Anchor pins are made of steel, gold and titanium alloys. The appearance of composite materials allowed the direct (intraoral) restoration method to restore significant defects of the tooth crown in combination with standard anchor pins of one design or another.

Using anchor pins, both single-rooted and multi-rooted teeth can be restored.

The closest in technical essence is the method of restoring a completely missing crown part of the anterior teeth using anchor pins, known from the "Guide to Orthopedic Dentistry" V.P. Kopeikina, M .: Medicine, 1993, p. 143, 157, 181 - ( 3).

Disadvantages of using anchor pins:

1) accompaniment of vertical root fractures;

2) excessive expansion of the root canal, which leads to a decrease in the mechanical strength of the root;

3) excessive load on the root;

4) the occurrence of the effect of the "wedge" in the apical part of the tooth under load;

5) the occurrence of a wedging effect on the root wall;

6) the possibility of corrosion of metal root pins made of base alloys, which can lead to a fracture of the tooth with its subsequent loss;

7) when fixing the pins, large internal stresses can occur, leading to destruction of the root, since retention is carried out only due to the root filling material;

8) the metal pin is less ductile.

To eliminate the above disadvantages in the restoration of defects of the anterior teeth groups is possible in the case of the application of the inventive reinforcing mesh-adhesive pin (ASASH).

ASASH is an alternative to the known metal and non-metal pins, the use of which for restoration with the direct method of the partially or completely missing crown part of the tooth, especially in the frontal groups of teeth, is problematic due to the narrow root canals and thin bark part, in particular, in the lower incisors.

In this regard, only the use of the claimed ASASH will allow the restoration of the missing crown of the tooth in cases:

- the inability to repair the defect of the root and crown parts of the tooth using standard pins;

- Anomalies in the position of the front groups of teeth in adults, when for some reason it is impossible to correct them by the orthodontic method;

- pathological abrasion of the hard tissue of the front lower teeth;

- thin tooth crowns;

- narrow root canals with a slight curvature.

The technical result achieved is to simplify the design of the ASASH and the method of its manufacture, while providing an increase in the durability of the restored defects of the crown of the anterior teeth groups along with high aesthetics and shortening the duration of the restoration procedure due to the possibility of manufacturing a pin directly during the restoration.

The technical result is achieved through the manufacture of a pin from a durable easily formed material - a metal mesh:

- simplifies the manufacture of the pin;

- an easy, strong design is formed;

- achieved a low manufacturing cost;

- the width and height of the crown part of the pin and the dimensions of the root part of the pin are formed during the restoration in accordance with the dimensions of the tooth defect and the root canal.

In this case, the use of ASASH ensures the durability of the restoration:

1) due to the gentle preparation method when expanding the root canal in badly damaged teeth with thin walls;

2) by providing reliable mechanical retention of the restored materials;

3) due to the mesh structure of the mesh, which provides a strong connection of the portions of the composite with each other and prevents chips and chips.

The use of the claimed ASASH for restoration of the crown part of the front teeth groups allows you to:

1) reduce the period of repair of the defect;

2) restore the defect in one visit;

3) to improve the strength of the joint of the pin with the composite due to the double adhesive and camouflage treatment of the pin, to exclude a change in the color of the structure in both the crown and root part of the tooth;

4) to increase the strength of the restoration, since, starting from the cutting edge of the restored crown of the tooth to the apical part of the root, the pin provides reinforcement for the restored tooth, excluding chips and spalls;

5) to create a multilayer reinforced structure through the use of a metal mesh in combination with modern composite, without its inherent weak boundaries between the layers;

6) increase the efficiency of modeling the crown of the tooth;

7) expand the modeling capabilities of the crown part of an absent tooth of complex design;

8) to restore the crown-root part of the tooth in the simplest way;

9) restore the thin walls of the crown of the tooth, especially in the lower central incisors, due to the thickness of the crown of the ASACH 0.2-0.4 mm;

10) to restore the stump and crown part of the tooth, which is impossible using indirect tabs;

11) reinforce 95% of the crown of the restored tooth;

12) to make the in-channel part of the ASASH, exactly repeating the shape of the prepared channel;

13) the ability to introduce the root part of the ASASH into the curved channel due to its flexibility;

14) free entry and tight fit to the tissues of the abutment tooth of the root part of the ASASH;

15) adjustment of the length and thickness of the root part of the ASASH;

16) giving the root part of the ASASH - cylindrical, conical, conical - cylindrical shape;

17) fully adapt ASAS to the anatomy of the root and crown parts of the tooth;

18) reduction of the wedging load on the root wall in the case of using conical - cylindrical ASASh form;

19) easy and quick removal of ASAS if necessary, repeated endodontic treatment.

SUMMARY OF THE INVENTION

For the manufacture of reinforcing mesh - adhesive pin using a stainless steel metal mesh with small cells with a thickness of 0.4 mm company "Renfert".

The grid with the help of scissors is cut out in a rectangular shape, which is conditionally divided into two parts:

- crown;

- root.

To form the crown, the mesh using scissors is cut so that the width of the mesh corresponds to the width of the defect of the restored crown of the tooth, and the height of the crown of the mesh is cut shorter by 1 mm from the length of the crown of the restored tooth to ensure transparency of the cutting edge.

The root part of the grid is left 1-2 mm longer than the length of the root canal, since when twisting the wires, the length of the root part is shortened.

Horizontal wires are removed from the root, while maintaining vertical. The side wires are brought closer to the center in such a way that the root part of the pin acquires a triangular shape, the base of which is the neck of the pin.

To form a cylindrical shape of the root part of the pin, the area of transition of the crown part to the root (in the horizontal direction) is fixed with crampon forceps, and with the help of a clamp, the free ends of the vertical wires of the root part are fixed. The clamp is rotated clockwise and as a result of twisting the wires form the root part of the ASASH, which takes on a cylindrical shape.

The root part of the ASASH is presented in the form of vertical wires twisted together in a bundle, which passes into the crown part of the pin through an oval neck that repeats the shape of the root base.

Thus, the formed ASASH consists of the following parts:

- crown part in the form of a rectangular grid;

- an oval neck formed of vertical wires in the form of a transition from the crown part of the pin to its root part;

- and the root part in the form of vertical wires twisted together to form a cylindrical shape.

After the manufacture of the pin, the length of the root part with the help of scissors is shortened to the desired size, taking into account the length of the root canal of the restored tooth. If you reduce the number of vertical side wires, you can adjust the thickness of the root pin. If the length of the root wires is left the same, then after twisting, the root part of the pin acquires a cylindrical shape, and if the side wires are cut shorter than the central ones, then after twisting the root part of the pin acquires a conical shape.

Before fixing ASASH in the root canal of the tooth produce its fitting. The length of the root part of the ASASH should correspond to the length of the root canal of the restored tooth. The pin neck should have an oval shape and be placed without tension in oval shaped grooves preformed at the root base.

The restoration method for defects in the crown of the anterior tooth groups using ASASH includes:

1) preparation of the tooth for restoration;

2) individual manufacture of ASASH;

3) fitting ASASH;

4) fixation of ASASH;

5) the final restoration of the defect using composite materials.

ASASH is fixed using glass ionomer cement (Catalog. Dental Materials, 2001. 3M Dental, p. 11) by a standard method.

After fixation of ASASH, 3M ™ SINGLE BOND DENTAL ADHESIVE SYSTEM adhesive is applied to the crown part (Catalog. Dental materials, 2001. 3 M Dental, p. 6). Rubbing the adhesive, lightly blow with air, re-apply the adhesive and re-blow with air. Polymerized by a standard method for 10 s. The crown part of the pin is then covered with a camouflage agent and 3M ™ RelyX ™ CERAMIC PRIMER is polymerized (Catalog. Dental materials, 2001. 3 M Dental, p. 11).

Next, the final restoration of the tooth is carried out with a composite material for the front groups of teeth - 3M ^tm FILTEK ^tm (Catalog. Dental materials, 2001. 3 M Dental, p. 3). The first portion of the composite material is applied to the mesh and removed to improve the adhesive ability of the material. First, the tooth contour is restored using the macrophile R-60-3M ^ТМ SOF-LEX ^ТМ (Catalog. Dental materials, 2001. 3 M Dental, p. 4). Then, the opaque and enamel layers of the composite are applied in layers to the mesh, first on the oral, then on the vestibular surface, and directed polymerization is carried out from the vestibular and oral sides.

To improve grinding and subsequent polishing with circular brushes and pumice, the dispersion layer of the composite is removed. The aesthetic effect is achieved after pretreatment and grinding with standard polishing discs of various thicknesses and grain sizes of the tooth abrasive - 3M ™ FILTEK ™ A110 (Catalog. Dental materials, 2001. 3 M Dental, page 3), diamond burs, and proximal surfaces with strips - 3M ™ SOF-LEX ™ ((Catalog. Dental materials, 2001. 3 M Dental, p. 8).

Occlusive editing is carried out under the control of occlusal paper with finishing burs and discs.

Finishing is performed from the palatine and vestibular surfaces, the rubber dam and retraction thread are removed.

Final grinding and polishing is carried out on the 2nd day after polymerization. The treatment by this method allows to increase the durability of the restoration.

Information sources

1. Galimov I.Yu. Clinical experience with the use of anchor pins to restore the crown of the tooth. Dental practice, M., 2001, No. 1, pp. 28-30.

2. George Friedman. Aesthetic treatment using a pin repair technique. Clinical Dentistry. M., 2001, No. 2, pp. 10-15.

3. Kopeikin V.P. Guide to orthopedic dentistry. M .: Medicine, 1993, p. 143, 157, 181. PROTOTYPE.

4. Kopeikin V.P. Guide to orthopedic dentistry. M.: Medicine, 1998, p. 496.

5. Kopeikin V.P. Orthopedic dentistry. Second Edition. Augmented. M .: Medicine, signed in print March 15, 2001, p. 171-174.

6. Nikolaev A.I. and other Practical therapeutic dentistry. - St. Petersburg: 2001, p. 33-34.

7. Nikoloshin A.K. Restoration (restoration) and tooth filling with modern materials and technologies. Poltava, 2001, pp. 72-77.

8. Olesova V.N. Biomechanical and clinical rationale for fiberglass-based pin structures. Panorama of orthopedic dentists. M .: Medicine, 2000. p. 4-6.

9. Svetlov A.V. Experience with root pins of the CJSMOPOST system. Scientific and practical journal. Institute of Dentistry. - 2000, No. 1, pp. 28-30.

Claims (2)

1. A reinforcing mesh-adhesive pin made of a rectangular metal mesh with cells of a thickness of 0.4 mm, and the part of the pin placed in the crown of the tooth has a width corresponding to the width of the defect of the crown of the tooth, and a height of 1 mm less than the length of its crown parts, and the part of the pin placed in the root canal of the tooth is made in the form of connected and twisted together vertical wire mesh, the length of which is 1-2 mm longer than the length of the root channel, while the transition from the crown part of the pin to its root part flax in the form of an oval-shaped neck, formed from vertical mesh wires. 2. A method of manufacturing a reinforcing mesh-adhesive pin according to claim 1, comprising forming from the metal mesh the crown part of the pin in the form of a rectangle, the width of which is selected from the condition that the width of the defect of the crown part of the tooth corresponds to a height of 1 mm less than the length of its crown part, and forming from the grid with previously removed horizontal wires the root of the tooth in the form of connected and twisted together vertical wires, the length of which is 1-2 mm longer than the length of the root canal, while the transition about t of the crown part of the pin to its root part is formed in the form of an oval neck that repeats the shape of the cavity formed on the basis of the root.

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