Restoration of defects of teeth tabs in Armenia
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Armenia, Yerevan
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Description
At partial defects of koronkovy part of tooth when the index of destruction of an okklyuzionny surface (IROPZ) makes less than 0,6 (60%) application of microartificial limbs is shown.
Now classification of tooth microartificial limbs depending on their design was widely adopted (inlay, onlay, overlay, pinlay, veneer).
- Inlay - the microartificial limb which is settling down in solid fabrics of a crown of tooth.
- Onlay-the microartificial limb which is settling down inside in the depth of fabrics, but at the same time is available the okklyuzionny slip protecting tooth walls from changes at action of direct loading.
- Overlay - the microartificial limb covering 4 of 5 free walls of tooth.
- Pinlay - the microartificial limb strengthened in tooth by means of pins (macro - or micropins).
- Veneer — the microartificial limb covering a vestibular surface of frontal teeth. Also other approaches to classification of microartificial limbs are known.
- The restoring microartificial limbs — normalize the chewing pressure put upon okolozubny fabrics through tooth.
- The loading microartificial limbs — are used for restoration of partial defects of tooth alignments as a support for bridge-like artificial limbs and load in addition basic teeth.
- The distributing microartificial limbs - redistribute chewing pressure at a shinirovaniye zubov.00.56
There is also a classification of microartificial limbs depending on constructional material of which they are made.
- Metal
- from a kobalto-chrome alloy
- from a silver-palladium alloy
- from gold alloys
- from alloys of the titan
- Composite
- Ceramic
- Combined
- metalcomposite
- ceramic-metal
At the choice of a design of a microartificial limb not only the extent of defect of solid fabrics, but also a condition of walls of a crown, their density, existence of macrocracks, color, and also a condition of a pulp of tooth is considered. Tabs are applied generally in the field of painters and premolyar. Introduction in stomatology of seals practically made of esthetic composite materials irrelevant application of tabs in foreteeth where vinira are applied generally.
Advantages of tabs in comparison with a seal are the possibility of recovery of anatomy and function of interdental contact point and their durability at restoration of this zone at chewing teeth. Preparation of teeth under various designs of microartificial limbs (inlay, onlay, overlay, venire) has the features depending on the choice of constructional material and manufacturing techniques of a microartificial limb. So, at preparation of tooth under a ceramic tab there should not be sites where the size of a cavity would be less than 1,5 mm since the ceramic tab with konstrutivny elements of the smaller sizes can not sustain chewing pressure. At preparation of a cavity under a metal tab it is allowed to form thinner retentsionny elements. The zone of connection of tooth and a tab also has the features: at preparation under a metal tab the edge of a cavity is mown, the fold is created, and the tab will have the "peak" protecting enamel edge. At preparation under a ceramic tab it is necessary to form edge of a cavity so that the edge of a ceramic tab was rather massive, had no thin elements, otherwise chips are possible. It is necessary to observe also the standard principles of formation of geometry of a cavity and to prepare within safety zones. At production of ceramic tabs by their milling from standard blocks it is necessary to avoid formation of undercuts taking into account the mill area of work. In the course of preparation of frontal teeth under vinira minimum admissible volume of removal of fabrics providing durability a vinira makes in the field of a cutting edge 1 mm, the equator of 0,7 mm, a neck of 0,5 mm. And the cutting edge is blocked with formation of a ledge from the palatal party, it is desirable above okklyuzionny contact with tooth antagonist. For improvement of fixing of a vinir preparation of approksimalny surfaces of teeth with removal of seals is recommended.
Now the next ways are applied: a direct way of a modeling of a tab - in an oral cavity of the patient, indirect - on the plaster working model and computer - with application of the latest technologies. The direct way assumes physiological separation by means of wedging and use of matrixes for registration of approksimalny surfaces. Apply to a modeling wax, the self-hardening and light-cured plastic.
Prints are removed silicone, polyester or vinilksiloksanovy masses. The preference should be given to removal of a print with simultaneous drawing two mass of various viscosity. It provides the maximum compliance of working plaster model of a situation in an oral cavity. It is necessary to make folding working plaster models for high-quality modeling of interdental contact points. Realization of technology of computer milling requires a computer mold which is received with application of an intra oral digital video camera.
Generally apply metal tabs from a gold alloy to chewing group of teeth, ceramic tabs and ceramic-metal tabs. Metal tabs traditionally make by molding. Generally apply the following technologies to production of tselnokeramichesky tabs: roasting of porcelain on fire-resistant models, molding pressing, computer and copy milling. For production of the loading tabs the preference should be given to technology of use of completely baked framework from dioxide of the zirconium revetted with ceramics in a design of a bridge-like artificial limb. At small defects of an okklyuzionny surface use of standard ceramic tabs is possible. The most perspective technology of receiving ceramic-metal tabs is use of the metal frameworks made by a galvanoplasty method. Alternative methods of receiving microartificial limbs are light polymerization and thermal pneumopolymerization of composites. The Istirayemost of composite artificial limbs is as close as possible to an istirayemost of natural teeth in comparison with other constructional materials. However it is necessary to recognize that separate shortcomings of the heliocomposite seals established on chewing group of teeth are inherent in these microartificial limbs.
Metal and ceramic-metal tabs are fixed traditionally on cements, ceramic artificial limbs - by means of adhesive equipment with use of composites of double hardening. The adhesive equipment is of especially great importance when fixing vinir.
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Restoration of defects of teeth tabs in Armenia