Factors defining the selection of the design of the prosthesis. Burel defestities

The use of various fastening systems depending on the type of dentition defect. Since the main indication for global dentures is the magnitude and topography of dentition defects, various classifications are proposed. The most common and convenient is the classification of Kennedy.

The most complex for treatment with global prostheses are defects I and II classes. The difficulties of the design are associated with the fixation and correctness of the distribution of chewing load between the teeth and the mucous membrane of the prosthetic bed. An important condition at the same time is the method of comprising clammers with a basis, which depends on the degree of adherence to the mucous membrane and the state of the periodontal of the reference teeth.

I class in Kennedy: two-way terminal defect. Most of the chewing teeth are missing. Therefore, in order not to cause the overloading of the remaining teeth, it is advisable to the chewing pressure to distribute between them using a multi-sized continuous clamber. The latter improves the fixation of the prosthesis, makes its stronger design, prevents the distal part of the distal part, which is especially important when taking a viscous write. In addition, in the absence of another 1-2 front teeth, they can be refunded with artificial teeth with strengthening on a continuous cast clammer.
Due to the fact that when I grade I, there are no distal supports on Kennedy, and a large chewing pressure drops on artificial teeth, a method for connecting clummers with a prosthesis basis is of particular importance. With bilateral end defects and large atrophy of alveolar processes in the distal departments, apply the first and second type of clammer is inappropriate.
With a stable (rigid) compound, even if there is a continuous clamber, the remaining natural teeth are experiencing a significant load. Therefore, in these cases, the labile is shown, that is, a movable connection of the clammers with a basis or semi albyl.

Class II on Kennedy: One-sided terminal dental defect. The replacement of such defects by gluable prostheses is relatively difficult. Unfortunately, many dentists go along the least resistance line and make a console prosthesis with a mesial support, and after a very short period of time it is necessary to solve the question of the use of the removable design, but in more difficult conditions.
If there is such a defect, it is best to apply a burealed prosthesis with one-two-dimensional support-keeper clammer for teeth, adjacent to a defect or cake clammers of Jackson, Bonville, Reikhelmann in a dental side of the opposite side.

The Bonville clumer is a biscuit clammer with occlusive lining in fissors in contact teeth and is used for one-sided end defects with an arrangement in a continuous dental row between the molars.

Rechelman's cluminum is transverse, with an occlusal overlay in the form of a crossbar above the entire chewing surface connecting two shoulders (vestibular and oral). The indications are the same as for the Bonville clammer, but the reference tooth coating with a metal crown is required.

The Jackson clammer is a cake, a wire, bent, consists of a shoulder located in the interdental contact areas of adjacent teeth and from the roast side of the forming ring covering the vestibular surface of the supporting tooth. Often this ring from the vestibular side is cut for the convenience of activating the clammer. It is used in a continuous dental row and the presence of space for the location of the cake of the clammer without increasing the height of the bite (intervalolar height).

Continuous (multi-sized) The clumer is a compound of the shoulders of several clums into a single whole and, located orally or vestibularly, adjacent to each natural teuba in the hydraulic area or equator. In the mobility of the front teeth of the lower jaw and their slope, this clammer is orally, located on the pagan surface, gives the teeth to the frontal stabilization and prevents the displacement in the oral direction.
When the continuous clammer is located, the teeth are orally and vestibularly included in it are combined into a single unit, and the clummer has resistance to the horizontal forces acting on it.

What is Burel prosthetics?

A distinctive feature of the BEGEL is a comfortable wearing, which is achieved due to the reduced volume and the thickness of the base

- This is one of the types of removable structures, the basis of which is a metal arc with plastic fragments fixed on it, imitating gums, and artificial teeth.

The Puegen is called metal arc, repeating the shape of the jaw. The appointment of the prosthesis is to restore the teeth, both in the upper and lower row.

In addition to the metal base and imitating fragments, the design has fixing elements that provide a durable arc mount in the oral cavity.

The orthopedic product is a decent alternative to a removable lamellar and flexible nylon prosthesis.

A distinctive feature of the BEGEL is a comfortable wearing, which is achieved due to the reduced volume and the thickness of the base.

The basis of the bureaucratic design performs at the same time several functions:

connects artificial fragments of gums and teeth;
gives a prosthesis support;
stabilizes the position in the oral cavity.

When prosthetized the lower row of the arc is located on the part of the tongue (in the middle point between the bottom of the mouth and the level of the edge of the gums). The arc parameters are regulated (are made narrower or wide) so as not to create discomfort to the bridle of the language.

The prosthesis for the upper dentition has a sky jumper. It connects saddot dots of the design and adjusts the chewing load, as close as possible to the physiological.

Varieties and design features

There are several varieties of bureaucratic type prostheses, the difference between which lies in the method of fixation:

On clamps - The design includes metal hooks that provide fixation of the product to the supporting teeth simultaneously on both sides. When installing the stratification of support teeth is not carried out.
Attachmen - The product has microcams that ensure reliable fastening. Due to the low dimensions, the clamps are almost invisible. When chewing, the load is distributed mainly on the reference units.
On telescopic crowns - The prosthesis is fixed with special telescopes. These products are considered the most reliable, but the cost is very high, which is explained by the complex manufacturing technology and virtuosity of calculations. Before installing the structure, it is necessary to calculate the supporting teeth, the coating of them with metal and conducting polishing. Only highly qualified specialists will be able to fulfill efficiently (the interaction of the dentist and dental technology).
Shining - The arc of the prosthesis exactly repeats the shape of the teeth, which ensures reliable fixation of units. This factor determines the cases where the installation of the prosthesis is appropriate, namely, the mobility of the teeth.

On telescopic crowns Attachmen On clamps Shining

Types of locks, castle mounts

Upper jaws are produced in several versions that differ in the main form:

ring;
horseshoe;
in the form of a transverse strip.

Designs with clamps are considered the most common.

Varieties of this group differ in the holding elements:

Clummers Roucha Externally similar to T-shaped processes, which depart from the arc of the frame and are placed in recesses. Products provide good fixation, but the process of their placement is quite complicated.
Clames Bonville Represent a group of cake structures. Crossing the occlusal surface across, they are placed on the vestibular and oral part of the cutter (molar). It is appropriate to use in cases where there is a slot between the teeth. The clummer completely fills it out, which eliminates the accumulation of food residues.
CLAMMERS REHELMANA They are distinguished by the transverse construction and the presence of an occlusal overlay in the form of a special partition.
Continuous clammer - The design is represented from several bonded units among themselves. The product is placed orally or vestibularly. The peculiarity lies in the dense adjacent of each link to natural teeth, which ensures solid fixation.
Ambraid clammers - In essence, this is a type of bonville clames, but the two elements included in the design are directed in opposite sides. Products perform a stabilizing function, so often used to shining.

Continuous clammer Ambrazulic clammer CLAMMER BONVILA Clummer Roucha Clame Rarhelman

What parameters is the variety?

To solve problems with loosening teeth, the covert prosthesis will be more suitable

Each type has a number of advantages, but the most reliable is considered to be cast design, so when choosing a type of fastening, preference is worth paying to a whole product.

To solve problems with loose teeth, the covered prosthesis will be more suitable.

Its design is designed in such a way that natural teeth are fixed in natural position.

With long-term exposure of the links per unit, the cervix strengthen the neck in Dentine. The same products are recommended in the presence of incorrect bite. Stabilizing the quality of the arc allow you to achieve a defect correction with long wearing.

The lock design is chosen in partial loss of teeth when several units are missing in a row. A clammer is appropriate to apply when there are support teeth, which will redistribute the load on them during chewing.

Types of bureaucratic prostheses

Dental prostheses are classified according to various features, including the type of material that is used in the process of producing an orthopedic product:

Types of Prostheses of Burel Type
Name	Description
Motoless (Quadrotti)	The main element of the prosthesis is made of polymeric material, which makes it possible to use the design of allergies.
Metal-containing	For the manufacture of prostheses, various dental alloys are used: titanium, chromocobalt, goldstand.
Plastics	The base consists of acetal. Such a product is distinguished by light weight and convenient wearing.
Metal ceramics	In the process of manufacturing a prosthetic, a metal combination with ceramics is used. This improves the aesthetic qualities of the orthopedic design.

Types of elements

The supporting details are the following types:

solid - pour out metal alloy:
composite - connected from several parts using soldering;
individual - the wire elements are first harvested, which are subsequently soldered among themselves into a single design.

Types of fasteners

All orthopedic prostheses in dentistry are divided into groups:

removable;
unbalanced;
partially removable.

Burel structures refer to the third group, as the removal is carried out only to perform hygienic procedures. Patients easily cope with this task with one hand movement. Delete the prosthesis for the night there is no need.

When firing food, emotional conversations and manifestations of joy (laughter) to worry about the reliability of fixation is not necessary. The prosthesis is firmly held by fasteners.

Burel prosthesis when disposal

In the absence of a large amount of teeth in a number of patients, the installation of a burealed prosthesis on implants is recommended.

In prosthetics, the teeth often identifies problems with soft tissues (periodontitis, periodontal).

In the process of progression of inflammation of the gums, blushes and swells, a clearance is formed between it and the teeth.

In this case, a decision on the installation of a pinning structure, which tightens the units, preventing them out.

In the absence of a large amount of teeth in a row, the patient is recommended to install a burealed prosthesis on implants.

Initially, implants are implanted into those places of the gums, where the support of the prosthetic structure is needed (with the complete absence of units, 4 implants are required, in other cases 2 pcs.).

The operation is carried out using local anesthetic. After healing soft tissues, the prosthesis is installed. For these purposes, the most suitable options are structures on attachments or beam fasteners.

On the upper jaw

Prostheses for the upper jaws are made of openwork casting when using durable medical alloys

Burel prosthetics of the upper row is performed in the absence of one or more teeth.

If there is not a single tooth, 4 implants are implanted. The prosthetic structure at the location of the artificial teeth is fixed to the jaw, and the arc itself to the sky.

Among all types of global products are popular with the restoration of the upper jaw, attachments and covert prostheses use.

The clamps correspond to the functional needs, but significantly lose in aesthetics. Therefore, they are rarely used for the top row.

Prostheses for the upper jaw are made of openwork casting when using durable medical alloys.

The connecting element (packer) does not overlap the entire surface of the sky, which makes the process of addiction to rapid and comfortable. The peculiarity of the prosthetics of the upper jaw is a more complex technique for performing work.

Burel prosthetics of the lower jaw is carried out easier. The design of the prosthesis looks easier, it does not have a sky part. The whole load takes the support teeth to which the product is fixed. All types of global prostheses are suitable for restoring the lower dentition.

Advantages and disadvantages

Experts allocate the following advantages of bureaucratic type prostheses:

uniform distribution of chewing load throughout the jaw;
aesthetics, which is achieved due to the design of the design with tiny locks;
comfortable wearing, which provide small sizes of metal frame;
strength and reliability (metal arc can withstand regular and severe loads, unlike polymer analogs).

The disadvantages of global structures may not be manifested if the preparatory work on the installation of a prosthesis and measurements are made at a high level. Most of the appeals of patients with complaints are associated with errors of the calculation of the dentist.

As for the most prosthesis, then, despite its strength, sometimes there are cases of damage to the locks. Such a defect is not subject to repair, you have to replace the whole design.

Also attributed the high cost of the product, but it is quite justified. The process of casting a metal arc involves the use of high-tech technology requiring high accuracy.

This ensures the strength and reliability of the prosthesis, from here and a long service life, which fully pays off with a comfortable wearing.

Prices

The cost of the burealed prosthesis is represented by a wide price range, which is explained by several factors:

An important role in pricing is played by the regional factor, the status of the clinic and the qualification of the dentist.

Middle Plots for the Bureel Prosthesis (for 1 Jaw):

cLAMMER - 30 000-35 000 r. ;
cutting - 45 000 r. ;
on locks - 62 000-65 000 r. ;
on telescopic crowns - 65 000 r.

Contraindications

There are restrictions on the installation of global prostheses.

They relate to such cases:

if a patient has a deep bite;
in the presence of pathological processes in soft tissues and on the oral mucosa;
when there are no support teeth or if low;
with severe jaw atrophy;
with high location of the fastening of the bridle of the language;
if there are inflammatory processes in the mouth;
when the bottom of the mouth is shallow;
with non-danguable mucosa in the field of missing teeth.

The contraindication to the setting of the arcuate design is the presence of allergies to one of the components used during the production process, for example, for metal.

The orthopedist during inspection may postpone prosthetics for such reasons:

due to pregnancy;
if the patient uses narcotic substances;
in the period of passing the patient with the use of radiation therapy.

The installation of prostheses of all species becomes impossible in the following health disorders:

if psychic disorders are diagnosed in the patient;
diabetes;
in the presence of problems with respiratory organs flowing in acute form;
oncology;
the aggravation of diseases of the cardiovascular system.

Care, repair and service life

The process of care of the prosthesis of a secular type is simple, but requires regular attention.

Throughout the day, bacteria accumulates in the oral cavity, which leads to the development of inflammation of the mucous membrane and the formation of an unpleasant odor.

In the night hours, salivation decreases, as a result of which it appears on the teeth and design.

Get rid of complications will help timely cleaning of the mouth with the use of special means: toothpaste and brush, dental filament, rinse balm.

In order for the surfaces of the prosthesis, it was ahead of time, acquire pastes better than a soft action (not aggressive). Once every six months should be contacted to a specialist with the aim of professional cleansing the oral cavity, especially coffee fans, because the drink changes the color of artificial teeth (yellow).

In the process of socks, the prosthesis may break. Causes are different, but all of them provoked by a sharp mechanical effect on the design. The ability to repair depends on the seriousness of the breakdown of the product.

The main types of breakdowns include:

bummer of metal fasteners;
fractional formation in any place of construction;
disconnecting artificial teeth;
cleaning of the lock part;
fracture of the prosthesis into two parts.

The service life of the prosthesis during proper care is 5-10 years.

What prosthesis is better burel or nylon?

Both types of prostheses deserve attention, but the nylon design is considered more modern. This is due to a number of factors: ease, comfortable adaptation in the mouth and simple wearing, lack of problems with ridicuing soft tissues with individual nodes.

Yes, and nylon care is easier than with a metal option. Although the chewing load better distributes a paper type product.

If we consider the main preferential characteristics of nylon prostheses, then they outweigh metal counterparts in the following indicators:

hypoallergenicity;
flexibility, elasticity;
low probability of breakage;
material transparency increases aesthetics.

There are also not a lot of minuses of prostheses from nylon, but they are weighty. For example, to repair the broken product is already impossible. Yes, and the price of new "biting".

Ministry of Health of the Moscow Region
State budgetary educational institution

secondary vocational education of the Moscow region
"Moscow Regional Medical College No. 1"

Specialty: 060203 "Orthopedic dentistry"

Graduation qualifying (thesis) work

Kalchenko Maxim Olegovich

Principles of Planning Design Burel Prostheses

Head
Ph.D. A.G. Everyvandyan.

Moscow 2014.

Introduction ..................................................................................3

Theoretical Justification of the problem .......................................... ..7

Chapter 1. Features of burealed prostheses .......................13

1.1. Burel prostheses ............................................................... 13

1.2 Composite parts of burealed prostheses .................................... ..16

1.3. Varieties of designs of global prostheses ......................24

Chapter 2. Concept of parallelometry .................................... ..26

2.1. Pollometry .................................................................27

2.2. Errors at parallelometry ...............................................................

2.3. Methods of manufacturing the framework of burealed prostheses .................. 34

Conclusion ........................................................................... 37.

Conclusion ........................................................................................ 41.

References ..................................................................................... 44

Introduction

Partial lack of teeth is one of the most common diseases: according to the World Health Organization, it suffers to 75% of the population in various regions of the globe.

In our country, in the overall structure of the provision of medical care in therapeutic and preventive institutions of the dental profile, this disease ranges from 40 to 75% and is found in all age groups of patients.

Partial secondary adenatia directly affects the quality of the patient's life. It causes a violation, up to a complete loss, the vital function of the body - feeding food, which affects the processes of digestion and admission to the body of the necessary nutrients, and also often causes the development of diseases of the gastrointestinal tract of an inflammatory nature.

No less serious are the consequences of the partial absence of teeth for the social status of patients: violations of articulation and diction are affected by the patient's communicative abilities, these violations, simultaneously with changes in appearance due to the loss of teeth and developing atrophy of chewing muscles, may determine changes in psycho-emotional state, up to psyche violations.

The late restoration of the integrity of the dentitions during their partial absence determines the development of such functional disorders, as the overloading of the periodontal of the remaining teeth, the development of pathological heralds, disorders of biomechanics of the dental system.

A late or poor-quality treatment of partial secondary adventure leads to the development of such diseases of the dental system, as periodontal diseases, in a remote run - to the complete loss of teeth - complete secondary adventure of both jaws. The incidence of perodont in the age group of 35-44 years is 86%.

These diseases in untimely and poor-quality treatment may lead to spontaneous loss of teeth due to pathological processes in the tissues of the periodontal of inflammatory or dystrophic nature, to the removal of non-treating teeth or their roots with deep caries, pulpitis and periodontitis.

The main sign of partial adventure is considered the absence of a dental one from one to fifteen teeth on one of the jaws.

The clinical picture is characterized by the absence of one or more teeth in the presence of one or more natural teeth or their roots. The manifestations of the partial absence of teeth depend on the topography of defects and the number of missing teeth and differ in variety.

A feature of this pathology is the absence of painful syndrome patients. In the absence of one or two, and sometimes several teeth patients often do not feel discomfort and do not turn to the doctor.

With a significant absence of side teeth, the "spare" of soft tissues of cheeks, lips.

In the absence of even one frontal tooth, a violation of diction may be observed on the upper and / or lower jaw.

Partial lack of teeth on both jaws without preserving antagonation pairs of teeth in each functionally oriented group of teeth leads to a decrease in the height of the lower person, often to the development of angular heilitis ("snaps"), the pathology of the temporal-lower jaw joint, a change in the configuration of a person expressed nasal and chin folds, omitting the angles of the mouth.

Partial absence of chewing teeth deteriorates violations of chewing function, patients complain about poor fiercing food.

Sometimes significant partial adency is accompanied by the usual sublit or dislocation of the temporomandibular joint. After the loss or removal of teeth, atrophy of periodontal ligaments occurs at the corresponding areas of the jaws, at the loss of more than two teeth, atrophy of the alveolar processes themselves is gradually developed, progressing over time.

This pathology is an irreversible process. The restoration of the integrity of the dental rows is possible only by orthopedic treatment methods with non-removable and / or removable structures of dentures.

RELEVANCE

Currently, one of the actual problems of orthopedic dentistry is the prosthetics of defects of dentitions using burealed prostheses. A competent assessment of the clinical situation underlies the right choice of the rational design of the future bureaucratic prosthesis.

Functional, technological and structural features of a burealed prosthesis, determine the high accuracy of the manufacture of the framework with the supporting elements, which are provided by the use of special methods for the preparation of the working model in the parallelometer to study and mark up the reliefs of the prosthetic field on working models.

PURPOSE OF THE STUDY

Identifying the main factors to create the optimal design of global prostheses.

OBJECT OF STUDY

Design of a global prosthesis.

THING

Principles of planning the design of global prostheses.

PRACTICAL SIGNIFICANCE

Development and implementation of new designs of burealed prostheses.

Theoretical Justification of the problem

The problems of dentition defects can be solved by very different approaches at certain stages of execution. For patients, the main purpose of prosthetics is the restoration of chewing function and aesthetics. A removable denture made according to an individual treatment plan significantly affects the improvement of the quality of the patient's life. At the same time, the aesthetic aspects and the dynamics of the chewing function should be taken into account. The denture complies with these high requirements when observed:

Restored chewing function
Sturdy fixation, easy introduction and elimination
Aesthetic species
Impeccable phonetics
Minimum pressure on the fabric in psychologically acceptable boundaries
Good hygiene, simple care
Impeccable, accurate technical performance
Biologically compatible materials
Good functionality guarantee

During the consultation, it is necessary to find out whether the clammer design of the global prosthesis is responsible by the ideas, wishes and capabilities of the patient. During the long-term application, the clammer burealed prosthesis has proven itself in a variety of modifications around the world. With a proper diagnosis, planning and design, the clammer bakel prosthesis is a completely acceptable functional solution. Excellent qualities of modern cobaltchromic alloys and the right manufacturer guarantee high-quality prosthetics. The elegant design of the bureaucratic prosthesis is usually unchanged without problems in the dental system. Due to the stability of the form, the Burel Prosthesis frame connects reliably to the saddles of the terminal defects, gives a good support and fixation at the expense of the clamps. Tissue tolerance of cobaltchromic alloys - provided that correct readings and proper processing - is estimated as excellent. Comparatively low thermal conductivity and small proportion increases the comfortability of the prosthesis.

Actual problems, including failures in the manufacture and use of global prostheses, are linked today less than the technological processes. They appear rather due to uncertainty in determining the testimony and choosing a design. Modern instruments and materials, instructions for their application and maintenance are much simplified by the manufacture, but do not solve planning and design issues. And although the responsibility for solving these two tasks is primarily a dentist, but he and dental technician should be together to look for an individual solution for each patient. Only on the basis of clear and specific data of the dental technician can accurately accomplish the design planned by a orthoper and ensure a good end result.

The creation of a flawless frame of the glukel prosthesis is a difficult task even for experienced dental technicians, qualified by other works, if the classic clammer prosthesis departed to the background. One who today is intensively engaged in global prosthetics technology has a wide range of design opportunities. However, the intensive development of skills of skill is equally important. Planning and making structures corresponding to the desires of the patient and the functional necessity should be carried out by the joint efforts of the dentist and the dental technology.

As a rule, most patients want to have a dental prosthesis, which, first of all, meets their aesthetic ideas. Functional aspects often have only secondary meaning or remainless. Therefore, the manufacture of a functionally immaculate denture, but taking into account the wishes of the patient during the planning, is responsible for the dentist.

Between the simplest global prosthesis with clames and a technically complex combined prosthetic, there are huge differences in terms of functionality, aesthetics and comfort. The patient needs to be informed about the technical and financial alternatives for each suitable for him, prosthesis. During the consultation, the advantages and disadvantages of certain prosthetics capabilities should be considered, the issues of the choice of material, as well as all financial conditions are stipulated. A thorough discussion of various types of prosthetics significantly helps in choosing a solution. A question arises in front of the patient: to save on costs in this case or refuse other needs. It is important that he understands what advantages has a more expensive prosthesis. The patient should also be clear that the speech here is not only about the restoration of the defect of the tooth row or chewing function. Additional costs it should be considered as an investment in his own health and quality of life. But a simple, inexpensive variant of the prosthesis also guarantees the recovery of the chewing function. The implementation of wishes for aesthetics and the convenience of a prosthesis requires additional work. New high-quality biocompatible materials and modern technologies help create an amazing cosmetic effect. If the patient sees that his individuality only wins from a natural appearance, it will be more located to invest in a denture. For obvious reasons, especially in young patients with characteristic pronounced dentition defects, there is a huge antipathy to removable structures. It is necessary to take into account the associated fear that grows up to mental problems. Experience shows that this circle of patients is only with great difficulty getting used to partial, removable prosthesis. When searching and selecting individual solutions, it is recommended to use such easily accessible aids such as visual models, brochures, directories, videos. These benefits, except, clearly inform the patient and about very high labor costs of both the dentist and the dental technique.

With all the remarkable features that exist in modern dentistry, it is impossible to forget that patients can not always or want to have an expensive prosthesis. Sometimes their financial position allows you to choose only the simplest designs. Consequently, the dentist should create a functional denture with the help of simple means, but using modern scientific achievements.

The physiologically justified and financially advantageous is the clammer bakel prosthesis from the cobaltchromic alloy with cast support-holding clammers. The position of the design and the type of supporting elements depends substantially on the location of the remaining natural teeth. Crowns on supporting teeth are made only with extreme necessity, for example, due to insufficient retention. With defects of the tooth row in the front area, it is almost impossible to avoid visible elements of the clammer. In situations with a small number of supporting teeth or with their unfavorable location, a large metal basis is required. Such, from a functional point of view, inevitable restrictions should be clarified to the patient before the start of prosthetics.

But in the manufacture of an inexpensive prosthesis, the location of the clamps should not be determined arbitrarily or just on the eye. With an insufficient depth of submution, the risk is durable and reliable landing of the prosthesis. In turn, too much greater depth of submution will overload the support teeth and complicate the input and removal of the prosthesis. Without accurate measurement of the model, the flawless functionality of a partially valve prosthesis is provided and may cause prosthetics failure. Conclusion: A professionally made by a clammer prosthesis is an externally simple, but quite adequate choice.

In the center of all dental treatment and prosthetics is the patient's health. The dentist's doctor and on the dental technique falls, thus, a big responsibility: a dentist is responsible for the overall work, including the correct diagnosis and treatment, dental technician - for the flawless technical manufacture of the prosthesis. In accordance with the diversity of modern technologies, a dentist is obliged to use the full potential and technical capabilities of the laboratory. The patient must be sure that the laboratory has all the necessary conditions for performing quality work.

Not only tested, reliable technologies and high-quality materials affect the quality of dental work. The rational organization of labor is very important, as well as accurate planning, the use of accumulated experience and, which is important, close interaction of the doctor, dental technique and the patient.

Healthy dental periodonts is an important condition for prosthetics. Anamnesis, the study of the general condition of the patient and the diagnosis is based on the basis of each orthopedic planning. Before proceeding with the final selection of the design of the prosthesis, the patient must be prepared for prosthetics, i.e. removed teeth not subject to treatment; Caries therapy was carried out, etc. Surface examination of the patient and the rush start of the manufacture of prostheses often leave many problems not identified. The consequence of such an infallible examination will be dissatisfied, complaining of patients whose condition is deteriorating after prosthetics.

Chapter 1. Features of Burel Prostheses

1.1. Burel prostheses

Burel prosthesis is a variety of partial removable prostheses. The name of the prostheses occurred from the German word Bugel, which means "arc". A burealed prosthesis consists of a metal frame, which includes supporting devices, arcs and artificial teeth. The frame of the prosthesis on the lower jaw is the sub-surround arc, and on the top - the sky plate.

The advantages of global prostheses compared to lamellar:

Allows you to use not only guy for your support, but also teeth
Compactity
Strength
A short period of addiction
High aesthetics (when using locks)
Best fixation and stabilization

Disadvantages of global prostheses compared to lamellar:

Insufficient aesthetics (when using clums in the frontal department)
Possible overload of reference teeth (especially when using locks)
The presence of metal (in the manufacture of cast bakels)
Complexity planning
Complexity of manufacture
High price

Features: Burel dentures are as close as possible to the type of natural teeth in color, size and shape. Unlike partial removable lamelte prostheses, glukels breaks less tactile, flavoring, temperature sensitivity and clarity of speech. In addition, they have high chewing efficiency. This type of prosthetics is recommended in the absence of three nearby teeth and distal molars.

Burel dentures vary by the type of their attachment to the teeth:

Fixed using clamps

The fixation of such prostheses is carried out with the help of special hooks that have a different shape, and are manufactured individually for each supporting tooth. The use of clums allows you to achieve a dense felting of the prosthesis without damage to the enamel. The disadvantage of this type of bureaucratic prosthesis is the visibility of the clamps when smile.

Called by Attachments

Attachment is a locking fastening that consists of two elements included in one another. The first part of the castle is located on the artificial teeth of the prosthesis, the second is on the patient's teeth. Unlike clammers, castle mounts are more aesthetic, they provide better fixation and comfort when removing and putting on a prosthesis. According to the method of fastening the attachments to a natural tooth distinguish: intricate, intraconenery, extraction, intercourse, etc.

Fixed with telescopic crowns

Fastening on crowns is considered the most aesthetic and expensive type of construction. The technology - a crown is put on the patient's gaining tooth, for which, with the help of a hollow crown, the entire bureaucratic design is fixed. Thus, one part of the crown is included in another, providing reliable fixation.

Prosthetics by glittering prostheses

Orthopedic treatment by global prosthesis requires several visits to the doctor's orthopedist doctor. For beginnings, support teeth are prepared: they are treated, enamel and, if necessary, covered with crowns. Then the casts are removed, which are sent to the laboratory. The next visit is carried out fitting. The prosthesis should be suitable in shape and size, in case of discomfort, its correction is required. The final stage will be already fitting and obtaining the finished design.

Care

The service life of the bureaucratic prostheses is more than five years with proper and careful care. Prostheses are recommended to rinse with water after each meal and twice a day to brush with a toothbrush and other special means. Once in 6 months, it is necessary to come to the dentist orthopedist on a prophylactic inspection with carrying out the remnation of the prosthesis.

1.2 Composite parts of burealed prostheses

The main elements of relying dentures:

The supporting clammer.
Arc.
Basis with artificial teeth.

According to the technology of manufacturing the framework of a bureaucratic prosthesis, arc opaled prostheses can be divided into:

Separate elements bent from wire using standard arcs and then paved.
Separate elements cast from metal, and then paired.
Solid.
Casting with removal from the model or in the combined models.
Casting on a refractory model.
Casting through a plastic composition.

Claiming Claimers

The clummers are the most common way to strengthen the bureaucratic prostheses. They are obtained by casting or bending from wire (stainless steel, gold-based alloys). The form of the clamber varies from the function performed by them (support, retention, etc.) to retention it to the tooth. The correct location of the clammer on the coronal part of the tooth is based on the rational use of their form. The line passing through the most convex part of the tooth crown is called the equator. The horizontal equator line shares the tooth crown into two parts: occlusive and retention (gingival), which is located below the equator line. On the occlusal part, the support elements of the clammers are located, and on the retention - deterrent.

Three kinds of clamps distinguish:

Holding.
Reference.
Combined (reference)

The prosthesis fixed with the help of holding clammers, the vertical load sends, i.e. Moves towards the mucous membrane and immersed in it. As a result, the pressure is transmitted to the mucous membrane. When using supporting clums, the pressure is transmitted mainly to the support teeth, and partially on the mucous membrane of the prosthetic bed.

Composite elements of the supporting clammer:

Shoulders Club - parts adjacent to the coronal surface of the tooth concerning it. Allocate the retention and inpatient parts of the shoulder.
Body the clammer is a fixed part, located above the equator of the support tooth.
Exchange CLAMMER - Part of the body of the clammer turning into the prosthesis basis.
Overfusion overlay - Located on the chewing surface of the tooth. It protects the prosthesis from diving into the mucous membrane and transfers the supporting tooth a vertical load, restores occlusion contact with the antagonist, restores the height of low crowns of the teeth.

The fixation of the prosthesis can be like due to the careful design of the baseline, and due to the correct selection of the type of clammer for each support tooth.

For the first time the clummer for fixing prostheses applied Monton. Currently, there are many varieties of the designs of the supporting clammers. Therefore, proposed in 1969. NEY systematization is very important in their study and application. The authors studied the fact that the clamp fracture always occurs at the place of its exit from the prosthesis basis, and offered the body of the clammer and the top of his shoulder to do thick. This rigid part of the clammer, located above the mid-level line, should cover a tooth on 3/4 crowns.

The system of clamps of the company is represented by the 5th types of clamps. The selection of this or that type of clammer depends on many conditions, the main of which is the location of the center line.

The first group includes two subgroups of clamps with shoulders heading into the retention zone by occlusion, i.e. From the lining. Most of them are relatively rigid clammer systems. The first group make up bilent and typural clammers.

The second group includes clammers with shoulders guide to the holding zone from the gum. They are called rod clammers. They belong to spring (elastic) systems of clamps.

The third group includes combined clammers consisting mainly of the shoulders of the first and second groups, as well as combinations of rigid elements from the occlusion and wire shoulder.

Mainly in the Burel prosthetics are used by a system of a system that includes 5 clums:

Type I type - Consists of an occlusal overlay with two shoulders. The whole support portion is shown with a lining, as well as body and part of the shoulders. The tip of the shoulder (reminds the form of horns) thinner and enters into the subcompetification of the tooth, but the brighter is pronounced the tooth, the thinner and in short, the part that holds and springs. Such clamemers are used with dental series defects, in which the support teeth are not converted (tilted) in one direction or another and well-expressed in the equators on both sides.
Clammer II type - it is considered a split or split. Such clamemers consist of two shoulders T-shaped and an occlusal lining. The clammer is used in cases where the landline is not located in the place where it is typically located. Very well fixed the prosthesis with the end defect and with the slopes of the teeth in the medial side. The length of the processes is adjusted the spring property of the shoulders.
Clammer III type - called combined. It consists of two shoulders, one of which is taken from the type I clammer I and the type II clammer shoulder. It is used when the dentition defect is both included and end. At the same time, the interaced line is in different places, on different surfaces. This happens when the tooth is tilted into the vestibular (front) side.
CLAMMER IV type - non-Profit Clameconsisting of one shoulder. A blockage block attachment joins a bureaucratic prosthesis frame, which goes vertically from the distal side of the tooth, while the pad is located with the medial side of the tooth. Used in such prostheses, which replace the terminal defect, with short, conical forms of supporting teeth and oral slopes of fangs and premolars (small indigenous teeth).
Clammer V type (ring) . Consist from the longest shoulder and two linings, which are located on the chewing surface. To strengthen the shoulder design make a jumper that goes parallel to the shoulder. It is manufactured for single-standing gears teeth (large indigenous), inclined in the medial side.

Base of global prostheses.

The basis represents an element of a removable prosthesis, carrying artificial teeth and branches from metal parts of a resting prosthesis. The basis is strengthened on the support teeth through the connecting elements and relies on the alveolar process.

Currently, gold and cobaltchromic alloys, as well as various plastics, are used for the manufacture of bases.
The advantages of the base from the cobaltchromic alloy over gold is that the first has a small proportion, and before plastic in high strength. When carrying out the maintenance of the base: the advantage is preserved behind the plastic.

Baseful functions:

Holding artificial teeth.
Transmission of load from applied pressure.
Ensuring resistance to offset forces.

The form and sizes of the basis depend not only on the presence of teeth and the anatomical conditions of the oral cavity, but also from functional and preventive tasks. The more natural teeth perceives chewing pressure and the more they can be loaded, the less the area is required for the prosthesis basis.
The advantages of global prostheses over removable lamellar are as follows: have a smaller size, therefore the patient is adapted faster to them; do not cause a feeling of a foreign body; Do not violate taste and temperature sensitivity.

In supporting removable prostheses, standard artificial teeth from plastics and porcelain are used. However, it is possible to use metal teeth, cast along with a prosthesis frame.

When setting artificial teeth in partially removable prostheses, it is necessary to comply with the laws of statics and dynamics, i.e. The teeth are located in the middle of the alveolar crest. It is also necessary to take into account the interlimoolar ratios.

Connection frame with a base with a basis can be:

Tough - It is advisable to use when a rejected removable prosthesis is installed with a sufficient amount of supporting teeth and well-preserved alveolar processes and mucosa with a small uniform elasticity.
Spring Fastening - it is achieved by introducing one or more springs. The spring compound is shown when it is necessary to reduce the load on the support teeth by increasing the functional load on the tissue of the jaw comb. This is necessary with a small number of supporting teeth or when the support teeth are not sustainable.
Hinged joints - Designed for the rational distribution of chewing load on the mucous membrane and periodont.

With distally limited defects (3 and 4 classes), the vertical load is transmitted mainly to the support teeth, so the size of the basis can be reduced in order not to interfere with the movements of the language.

With a well-preserved alveolar process, artificial teeth on the adhesive are made to replace defects of the dentition of the 4th grade dentition.

The boundaries of the base of the prosthesis with freely finishing saddles should be extended, especially on the lower jaw with a significant length of defects. The boundaries of the prosthesis of the lower jaw are installed for a complete removable prosthesis, i.e. within the neutral zone. The distal boundary of the prosthesis basis on the lower jaw takes place on the victualwolar beat. This is necessary to prevent the displacement displacement in the distal direction and reduce the pressure on the mucous membrane.

On the upper jaw, there is no need to expand the boundaries of the basis with a large and medium height of the alveolar process, and the location of the support area does not have a significant value.

The preparation of dentition is composed of the following main events:

Alignment of the occlusal surface.
Restoration of bite height.
Replacement of small dental defects with bridges with bridges.

Preparation of support teeth is as follows:

Preparation of space for occlusal linings.
Immobilization is not sustainable or excessively loaded teeth.

Changes in contours of support teeth. A burealex prosthesis must be considered not as a combination of clammers, arcs and bases, but as a single complex, which must be designed as functionally integer.
1.3. Varieties of bureaucratic prostheses

Solving the issue of the choice of the design of the prosthesis, the type and location of the clammer is adopted in the process of the clinical survey of the oral cavity of the patient.

The diversity of the designs of global prostheses is first and foremost the type of defect, then the flexibility of the mucous membrane, the number of supporting teeth, the type of prosthesis, etc.

Designs of global prostheses based on Kennedy classification:

1 class.

A distinctive feature of the bureaucratic prostheses with this defect is the presence of two, freely ended saddles, rigidly interconnected by the arc. The saddle of the prosthesis from the medial side is based on the teeth through the clammers or castle compounds, and on their free ends are on the mucous membrane of the alveolar process.

An example of such a design can serve as a prosthesis with two characters of the accoronic arc; A continuous oral clummer can be introduced into the design, the load crusher in case of periodontal tissue disease.

Grade 2.

With the defects of this class, glukel prostheses have a freely ended saddle, fixed from the medial side on the supporting teeth and lying on the alveolar's mucous membrane. The saddle is combined with a metal arc with clames that are reinforced on the side teeth of the opposite side of the dentition. The fixation of the prosthetic can be carried out using a two-decker an accoron clammer, a reverse rear valve, or a double trial clammer.

Grade 3.

Burel prostheses with 3 class defects have included seats with double-sided fixation on support teeth. Two-way prostheses are used for large defects when the manufacture of non-removable prostheses is impossible. The clummers located on the healthy side of the dentition must be rigid, fixed on a large number of teeth (at least 2 teeth). When there is a power prevalence of the opposite tooth row, the vertical load on the support teeth should be reduced by spring compounds, the creation of support for a larger amount of teeth, expanding the area of \u200b\u200bthe basis of the base of the base, reduction of the oclyuzion surface of the dentition. It is especially important not to overload a single standing dust tooth.

4th grade.

Burel prostheses for grade 4 defects have one saddle, lying ahead of the support teeth. Production of prostheses with these defects requires a hard compound of the clamer with a saddle. Since the clum line can be the axis of rotation of the prosthesis, it is necessary to prevent the clummers to prevent rotation movements to position on all remaining teeth. To reduce the rotational torque, extensive bases, ring clammers or rear-action clummers are used.

a - first class
b - second class
in - Third Class
m - fourth grade

Chapter 2. Concept of parallelometry

In a removable prosthetic in each case, the shoulders of clamps should be located on the surface of the tooth, respectively, vertical and horizontal equator. If the number of clamps is greater than two, the choice of stabilizing and the retention features of the clammer is determined on the basis of a single, common for all surfaces of the teeth of the clinical equator, which in the special literature it was called the "path of introducing a prosthesis". To objectivate a single, general clinical equator, a device was created - a parallelometer.

The plane of the base of the device and the horizontal part of the movable part of the rack are parallel to each other, so any diagnostic rod, fixed with it, perpendicular to the base of the parallelometer. A table for fastening the model has a moving stand with a locking device, which allows you to give the model any position relative to the diagnostic metal rod and other tools. Consequently, the parallelometer is a device for determining parallel and in one plane of points on an infinite number of horizontal surfaces of teeth, alveolar processes of jaws with a certain specified position of the model with respect to the diagnostic rod (vertical). Practically significant are the five positions of the model in relation to the vertical diagnostic rod.

horizontal - zero tilt: the axis of the diagnostic rod is perpendicular to the occlusal plane of chewing teeth;
rear when the rear dentition of the dentition is lowered;
front when the front of the dentition is omitted;
left when the model is tilted to the left;
right when the model is tilted to the right.

The effect of tilt tooth on the position of the equator on the crown and changing the line of the review on each tooth when the diagnostic model is tilted illustrates a diagram with an ovoid body. Changing the position of the model relative to the diagnostic rod, it is possible to change the position of the equator, the area of \u200b\u200bocclusal and gingival surfaces selected by the teeth support in order to provide the necessary depth of retention, reasonable, from the point of view of fixation and aesthetics, the arrangement of the shoulder of the clammer in accordance with the design chosen by them (the latter dictated Analysis of the clinical condition of crowns of supporting teeth, periodontal and its x-ray assessment, type of bite). Replacing the diagnostic metal rod on the stylus, outline the surfaces of the teeth in the model found and installed on the table. As a result, the view is obtained - the graphic image of the points lying in different planes on all the surfaces of the teeth at a given (defined) axis of the introduction of the prosthesis, which was called parallelography. This line of the review is the zone of the greatest bulge of each tooth in a single axis of administration of the prosthesis. In a diagram with an ovoid body, it can be seen that this line of the greatest bulge may not coincide (which most often happens) with anatomical formation on the crown of the teeth - an anatomical equator.

Depending on the inclination of the model, the view line will be located differently on the support teeth both by the defect and the vestibular and oral sides.

Distinguish 5 options for passing a line of view on the surface of the tooth.

First option - From the side of the defect, the line of the review is approaching the gingival part, and from the side of the one-standing medial tooth - to the occlusal part of the tooth. As a result, I and IV quadrants have a large area than II and III.

Second option - From the side of the defect, the line of the review approaches an occlusive, and from the side of a nearby medial tooth - to the gingival part of the tooth. As a result, the I quadrant area is reduced to a minimum or practically no.

Third option - sharply diagonal passage of the review line, resulting in areas I and IV quadrants become minimal.

Fourth option - approximation of the line of the review to the occlusal part over the entire length of the vestibular or oral surface of the tooth. It occurs when the tooth is tilted in the appropriate side. Practically I and II quadrants are absent.

Fifth option - approximation of the survey line to the gingival part over the entire length of the vestibular or oral surface of the tooth. It occurs when the tooth is tilted, respectively, in the opposite direction, with the conical shape of the tooth crown. Virtually III and IV quadrants have a minimal area or absent. Listed options for passing the line of the review will vary depending on the position of the model, i.e. the chosen axis of the prosthesis is only in the fifth variant, provided that the line of the review and with the vestibular, and from the oral side passes close to the gantry edge (with the conical shape of the crown) . To improve the reference conditions, it is necessary to make an artificial crown for the chosen type of clammer. If you add that under parallelometry, we determine the undercut zones near the teeth and in the field of alveolar processes, creating insulation to avoid the formation of "seizures" of the basic part of the prostheses in order to unhindered their introduction, it becomes apparent that parallelometry and parallelography should be applied in almost the treatment with all the designs of the dental Prostheses with multiple diverse fixation elements.

The path of administration and removal of the prosthesis, as well as the common line for all supporting teeth, with respect to which the elements of the support-retaining clamber will be located, are determined using a special device - a parallelometer.

The parallelometer is a device for determining the greatest convexity of the teeth on the models of the jaws, identifying the relative parallelism of the surfaces of two or more teeth or other parts of the jaw, for example, the alveolar process

The device has a flat base on which a rack with a bracket is fixed at right angles. The bracket is moving in vertical and horizontal directions. The shoulder of the bracket correlates with a rack at an angle of 90 °. On the shoulder of the bracket there is a clamping device for interchangeable tools. This device allows you to move the tools vertically.

There are three methods for identifying the path of administration of the prosthesis:

Arbitrary.
Method for determining the average tilt of long axes of support teeth.
Method of choice.

Method of arbitrary orientation of the model in the parallelometer

The model on the table of the parallelometer is installed so that the occlusal plane of the teeth is perpendicular to the griffel rod. After fixing the position of the model on the table of the parallelometer, the stylus is supplied to each supporting tooth and outlined the viewing line. With this method, the parallelometry of the passage may not coincide with the anatomical equator of the tooth, since its position will depend on the natural inclination of the teeth. Therefore, on separate reference teeth, the conditions for the location of the clamps will be unfavorable.

This parallelometry method is shown only with parallelism of vertical axes of teeth, their insignificant slope and minimum number of clamps.

Method for detecting medium tilt long axes of supporting teeth

The edges of the socket model are cut by achieving their parallelism. Then the vertical axis of one support tooth is found, the analyzing rod must coincide with the long axis of the tooth, the direction of which is transferred to the side surface of the base. Then the vertical axis of the 2nd support tooth is determined, located on the same side and transfer it to the side surface of the base. Then the average approximate axis of supporting teeth is found. In the same way, the average axis of the teeth on the other side of the dentition of the model is determined. The obtained "average" is transferred to the free edge of the base and between them determine the "middle" of all supporting teeth.

On the found "medium" set a table with a model in a parallelometer. An analytical rod is replaced with graphite and on each reference teeth outline the range. This method does not take into account the aesthetic requirements of the location of the clamps.

Selection method

The model on the table of the parallelometer is installed so that the occlusal plane of the teeth is perpendicular to the griffel rod. The latter is summarized to each teuba in turn and study the magnitude of the support and holding zones. The model is studied under different slopes, choosing one that provides a better holding zone on all supporting teeth.

After the airline lines are indicated and the path of administration of the prosthesis is determined, the arc location, the support-holding clammers, a continuous clamber, clawing processes, is studied. Then the model draw a frame of a future prosthesis.

When determining the path of administration and removal of the prosthesis, it is most advisable to proceed from the topography of dentition defects:

in the absence of teeth in the distal departments (I class on Kennedy) or in the front (IV class), the slope of the model should be carried out in the direction of the defect;
with the simultaneous presence of two or more defects in the front and side departments of the dentition, the model is tilted towards the defect in the area of \u200b\u200bwhich one is possible and the lesser stability of the prosthesis;
with a unilateral defect and presence of distal support (III class), the model is advisable to tilt towards a more stable tooth to create the most favorable conditions for fixing;
with a defect IV class, the best fixation provides the front slope of the model, and the rear is advisable only from aesthetic considerations.

2.2. Errors with parallelometry

Ignorance of parallelometry leads to undesirable results:

complex fitting frame;
improper definition of the clum zone;
fifty of the vestibular part of the clammer;
the topography of the reference and retention zones is incorrectly estimated.

Complex fitting frame

It occurs due to the fact that the model was insulation was carried out, i.e. Insulation sites have substitutions, and then the teeth prepared under the clamps are not dialed in parallel. This makes it difficult to find the path of administration of the prosthesis.

If the path of administration of the prosthesis is not defined, the clamps cannot clearly perform their functions. The insulation zone should be "0" for all supporting teeth.

Incorrect definition of the clammer zone

Incorrect definition of the clum zone, as a rule, leads to the fact that the clummer breaks down during operation, or the frame is fixed to the support teeth with a large voltage.

The parallelometry gives a clear picture of the location of the clammer, since the clammer zone is measured from 0 to 25 microns. The clummer must be evenly thinned, then it works like a "whip" - 1/3 of the clammer should participate in the work.

If the parallelometry is carried out correctly, the Burel Prosthesis framework does not cause any difficulty.

Fifteen of the vestibular part of the supporting clammer

This problem occurs due to improper location of the clammer. Many techniques are drawn by the model on the peephole, and therefore the clummeer is placed as bent. With this location of the clammer, the working time is very close to the occlusal overlay. And, as a result, that part of the clammer works, where the maximum thickness, i.e. The elasticity of the clammer is "0". Sooner or later, the fatigue of the material comes, and the clummer will break away at that point where the maximum load occurs.

Improper assessment of the topography of the support zone of the clammer.

The most typical error is complete or partial location of the continuous clammer on the teeth of the lateral group in the retention area.

2.3. Methods of manufacturing burealed prostheses

Soldering frames should be considered only in historical terms, since this method has a number of flaws:

Insufficient adjacent of clums to the surface of the teeth;
Electrolysis spike places, which leads to a breakdown of a prosthesis;
Inability to manufacture complex structures
Manufacturing of a solid frame of a burealed prosthesis:

BUT. Making a solid frame when casting it without a model.

After receiving the cast, the model is cast from high-strength autoclave gypsum. Using the parallelometer, the model is studied to determine the location of the clammers. Then the drawing of the future prosthesis is applied on the model. With the help of standard wax blanks, the framework of the prosthesis is simulated. Having completed modeling, the model of the prosthesis attaches the sprues with wax balls, remove the wax basis from the model and carefully failed with a march with a mixture of ethylSilicate. The marginal mixture is applied 2-3 times and sprinkled with quartz sand of a large grinding. According to the solidification of the mixture, the wax blank is packaged into the casting cuvette with a refractory mass.

The cuvette is installed on the electric stove, the wax is paid, and then in the muffle furnace, in which the wax is burned at 800-1200 degrees and prepare the cuvette to the fill with the metal. Metal is poured in the machine with centrifugal force. The cuvette is cooled in air, removed the prosthesis, grind and polished. Finish the manufacture of prosthesis with dentation.

B. Production of a solid frame when casting it on a refractory model.

After getting the cast, the model from high-strength autoclave gypsum is cast. The model is studied in a parallelometer. Prepare a model for duplication, for this all retention places in the teeth are filled with Moliar. The model in a special collapsible cuvette is poured with a heated hydrocoleloid mass. After cooling, the mass of the cuvette is retrieved by the model. In the middle of the cast, a metal hollow cone is installed, then a model of refractory mass is cast. From the cast is separated by hydrocoleloid mass.

The faceted model is dried in a muffle furnace at a temperature of 200 degrees. Signing the model in a special solution, produce modeling from the wax frame of the prosthesis. Install the sprues so that they formed the cone.

Cuvette walls are folded asbestos. The cuvette is heated to 1,200 degrees and filled with molten metal. From the cooled cuvette, the frame is removed, which is grinning and polished.

Conclusion

The use of theoretical knowledge in practice

During the advancement of the internship, we conducted a survey and treatment of patients with partial secondary adventure, which were manufactured by Burel Prostheses. 19 patients aged from 38 to 67 years old were accepted for treatment. Of these, 6 men and 13 women.

The patient survey was carried out according to the following scheme:

Survey of the patient.
Preparation of the oral cavity.
Justification of the diagnosis.
Justification of the treatment plan.
Design definition prosthesis.

In each case, the following manipulations were performed:

The preparation of support teeth.
Receipt of writing.
Casting of plaster or supergips models.
Application on the model drawing model and the location of the supporting elements.
Determination of the central relationship of the jaws.
Supanching of a burealed cake in the oral cavity.
Check formulation of artificial teeth.
Verification of the design of the prosthesis.
Prosthesis.

Solving the issue of the choice of the design of the prosthesis, the type and location of the clammer was taken in the process of clinical examination of the oral cavity of the patient and analyzing diagnostic models. It was made of 19 burealed prostheses, of which 7 on the upper jaw and 12 on the lower one.

In all 14 people, fixation was carried out with the help of supporting clammers (cast), and in 5 combination of holding (bent) with supporting and holding clamps (cast). The framework of all 19 prostheses are made by casting on a refractory model.

The distribution of patients in groups, taking into account the localization of the defect, was carried out on the basis of the Keny classification.

1 class. This type of defect met in 6 patients. In 4 patients, the prosthesis relies on the teeth by means of 2 accker clums. And in 2 cases, a continuous oral clummer was included in the design.

Grade 2. With the defects of this class, there was a one-way terminal defect. In 2 patients, the prosthetic fixation was carried out using an accoron clammer, and in the 2nd reverse rear valve, in the 1 - double three-track clammer.

Grade 3. In 4 patients, the supporting clammer were used in combination with holding. This was associated with the presence of intact teeth and the impossibility of using the supporting clammers.

4th grade. With this type of defect on treatment there was 1 patient. In the design of the prosthesis, a continuous clummer was applied. To prevent rotational movements, the continuous clummeter is located on all the remaining teeth.

After planning the design, the prosthesis has begun to prepare the oral cavity for the bureaucratic prosthetics. To estimate the state of the periodonta tissues, a radiographic study was carried out.

Supported teeth with defects caused by carious and noncaryry processes were covered with crowns. In intact teeth, space for occlusal linings was obtained by deepening natural fissures, followed by remineralizing therapy. It is mainly for the manufacture of global prostheses, the casts were removed alginate masses, followed by their casting from supergips.

In second visit, central occlusion was determined. Special attention paid to an accurate fitting of wax rollers in the height of the bite, the density of their adjacent to each other and the alveolar process. After that, fixed in the position of the central occlusion.

In the third visit, the carcass of the burealed prosthesis was supplied in the oral cavity. They paid attention to the arc location, as far as it lags behind the mucous membrane, as the reference-holding elements are located.

In the fourth visit, they checked the arrangement of the teeth, the shape and boundaries of the bases.

In the fifth visit, the bureauca prosthesis was handed over to the patient, clarified how to use it correctly. If necessary, conducted correction. Control inspections were conducted during the first three weeks. During the inspections, it turned out how patient feels, whether there are complaints, discomfort, as the adaptation process occurs. If necessary, a prosthesis correction was performed.

Thus, as a result of analyzing the data of clinical examination of patients after prosthetics during the month, it was revealed that:

Patients 1 groups have observed the greatest percentage of treatment (an average of 38.65%). Complaints of the patients were functional (poor fixation in biting or chewing food, pain during conversation and food), phonetic and psychological nature. Particular attention was paid to pain syndrome, determining the nature of pain, its localization and degree. After the correction, the volume and frequency of complaints decreased. In 3-4, visiting patients were absent.

In the 2 group, complaints of a functional and phonetic nature were also present. After 2-3 correlations of complaints in patients disappeared.

In the 3rd group, a functional complaint was absent, but there were phonetic and psychological on the presence of a foreign body. But with a large length of the defect, complaints were joined related to the overload of supporting teeth, since more pressure is transmitted to them than on the mucous membrane.

In the 4th group, the patient allocated complaints of a phonetic and aesthetic nature (the visibility of the clamps). After the corrections and these recommendations, the state improved.

Comparative data of clinical observations with literary.

Basically, our clinical observations coincide with literary data.

The boundaries of testimony during prosthetics by glittering prosthesis are caused by the amount and location of the teeth, the features of the bite, the state of the mucous membrane and alveolar processes, localization of defects in the dental arc.

Output

The planning of the design of the burealed prosthesis is:

in determining the route of administration and removal of the prosthesis;
in the markup of the model for finding the most convenient location of the clinical equator on the supporting teeth and the corresponding position of the clammer;
in determining the position of the arc in the sky and the alveolar leakage of the lower jaw and other elements of the prosthesis (multi-sized clamps, branches, processes, etc.).

All this in general allows you to apply a drawing of the frame of a future prosthesis on the model.

When planning a fixing system of a removable prosthesis, two main goals are being pursued:

create a reliable fastening of a prosthesis during chewing and speech;
provide such a fastening of a prosthesis, in which it would have the smallest effect on the support teeth and the mucous membrane covering the toothless alveolar processes.

Of particular importance in solving these tasks, a clear idea of \u200b\u200bthe biomechanics of the removable prosthesis is acquired, the effects of forces shifting the prosthesis: gravity, chewing pressure and thrust force.

The gravity of the gravity of the prosthesis on the lower jaw is neutralized by supporting teeth, alveolar processes with a mucous membrane covering. In this case, it contributes to the retention of a prosthesis on the jaw. On the upper jaw, this force makes it difficult to fasten the prosthesis and under certain conditions violates its stability. This is especially pronounced with bilateral end defects, when the basis of a prosthesis, devoid of distal support, can be asstected or tipped under the action of gravity.

Chewing pressure also contributes to the displacement of the prosthesis. Under the action of adhesive food, the prosthesis can be separated from the prosthetic bed as the upper and lower jaw. It enhances the overturning moment due to the severity of the prosthesis. Its rotation occurs around the clum line. Under the action of chewing pressure, the prosthesis is exposed to spatial movement in three planes - vertical, sagittal and transverzal. Depending on the selected fixation method, the offset of the prosthesis may prevail in any one plane. Its movement in other planes is usually less pronounced, but almost always takes place. This makes the character of a prosthesis under the action of chewing pressure so difficult that it requires a detailed consideration under different clinical conditions, depending on the type of removable prosthesis, the method of its fixation, the magnitude and topography of defects of the dentition, the nature and the amount of atrophy of the toothless alveolar process, etc.

Thus, the preservation of supporting teeth and the prevention of their functional overload during a clammer fixation is an important problem. One way to solve it is the correct location of the clammer line.

All the supporting clammers, their elements should be located strictly naturally in relation to the clinical equator - the greatest perimeter of the tooth, taking into account its inclination. The clinical equator coincides with the anatomical equator only with a strictly vertical location of the longitudinal axis of the tooth. Usually, due to the physiological inclination of the teeth, the line of anatomical equator does not coincide with the clinical. If the tooth is inclined orally, then the line of the clinical equator on the paternal side is shifted to an occlusal surface, and the vestibular is lowered to the gingival edge.

It is important to determine the general clinical equator line of the dentition, which is also called the clinical equator, the protethic equator, the circuit height, the guide line, the overall overview line. E.I. Gavrilov was given a name that became commonly used - the rigid line (distinction).

The center line divides the surface of the tooth on the support (occlusive) and holding (retention, gingival). It cannot be called the Equator, because It does not coincide with him and, unlike it, it changes the position due to the tilt of the tooth: it approaches the chewing surface on the side of the inclination, and on the opposite - it is removed from it. The midwater line is detected by parallelometry and serves as a reference to the location of the shoulder parts of the supporting clammer.

When planning the design of the global prosthesis, the type of bite is of great importance. Thus, with a deep, as well as a deep traumatic bite in the design of the prosthesis, a multis-screen clummer with shining elements will not be included, which will interfere with the closure of the teeth and the preservation of the usual intervalolar height. In patients with such a bite, it is necessary to find out the possibility of increasing the intelvelaolar height, and only after that, in the presence of indications, a cast palatal strip can be applied, restoring cut-tube contact.

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"New in dentistry" - M.- 1999. No. 3
Lazarev A., Ginger T. Technology for the manufacture of telescopic fasteners // Dental technician. M. 2002.
Kopeikin V.N., Knubovets Ya.S., Kurland V.Yu. and others. Unit technique. - M: Medicine, 1978.
Pizetsky M.I. Prosthetics by glittering prostheses. - Moscow: Medicine, 1985.
Gavrilov E.B. The theory and clinic of prosthetics by partial removable prostheses. Edition 2nd. M.: Medicine, 1973
Reagree A.B. The use of removable dentures with a friction-pin telescopic fixation system 1999.

The manufacture of a burealed prosthesis is starting with a detailed estimate of each case. The use of the diagnostic model improves planning efficiency.

The planning of the design of the burealed prosthesis is:

1) in determining the route of administration and removal of the prosthesis;

2) in the markup of the model for finding the most convenient location of the clinical equator on the support teeth and the corresponding position of the clammer;

3) in determining the position of the arc in the sky and the alveolar leakage of the lower jaw and other elements of the prosthesis (multi-sized clamps, branches, processes, etc.).

All this in general allows you to apply a drawing of the frame of a future prosthesis on the model.

When planning a fixing system of a removable prosthesis, two main goals are being pursued:

1) create a reliable fastening of the prosthesis during chewing and speech;

2) Ensure such a fastening of a prosthesis, in which it would have the smallest effect on the support teeth and the mucous membrane covering the toothless alveolar processes.

All supporting clammers, their elements should be located strictly naturally in relation to the clinical equatorome to the perimeter of the tooth, taking into account its inclination. The clinical equator coincides with the anatomical equator only with a strictly vertical location of the longitudinal axis of the tooth. Usually, due to the physiological inclination of the teeth, the line of anatomical equator does not coincide with the clinical. If the tooth is inclined orally, then the line of the clinical equator on the paternal side is shifted to an occlusal surface, and the vestibular is lowered to the gingival edge.

Pollometry

The path of administration and removal of the prosthesis, as well as the common line for all supporting teeth, with respect to which the elements of the support-retaining clamber will be located, are determined using a parallelometer.

Parallelometer It is a device for determining the greatest convexity of teeth on the models of the jaws, identifying the relative parallelism of the surfaces of two or more teeth or other parts of the jaw, for example, an alveolar process.

Parallelometers

The tool kit includes:

Flat analyzer for determining the most favorable position of the overall overview (mid-level line), and consequently, the positions of the clamps that ensure the unhindered introduction of a prosthesis and its good fixation;

The pin in which the chiffi is fixed to the outline of the line;

Pottracy pins: Calibers? 1, 2 and 3; They differ in the diameter of the measuring disk: disk? 1 - 0.25 ml, disc? 2 - 0.5 ml, disc? 3 - 0.75 ml (with their help determine the position of the ends of the holder of the clammers on the support teeth);

Pot-knives for removing excess wax after filling of sublinks.

The kit includes a table to secure models. The platform of the table is hinged with the base, which allows you to tilt the models and to bring them to the tools at different angles.

At the base of all the designs of parallelometers lies the same principle: with any displacement, the vertical rod is always parallel to its original position. This allows you to find a point on the teeth located on parallel vertical planes.

The magnitude of the reference and stabilizing and retention zones on the teeth depends on the position of the overall overview (partial) line or clinical equator, which, in turn, depends on the tilt of the model during parallelometry.

Basic rules of parallelometry:

1) the parallelometer makes it possible to determine the design of the burealed prosthesis;

2) the total clammer (partial) line, despite the fact that it is bent, should be in general parallel to the occlusal plane;

3) the prosthesis when fixing it in the oral cavity should transmit chewing pressure along the axis of the tooth;

4) The prosthesis should be designed so that it is rationally distributed the chewing pressure of between the remaining teeth and alveolar process.

Known three parallelometry methods: arbitrary, method of determining the average inclination of the longitudinal axes of the reference teeth (Novak method), the method of inclination of the model (method of choice or "logical" method).

Arbitrary method. The model, cast from high-strength plaster, is installed on the table of the parallelometer so that the occlusal plane of the teeth is perpendicular to the rod of the griffel. Then, the parallelometer trap and the overall overview line or clinical equator are supplied to each supporting tooth. The line under this method of parallelometry may not coincide with the anatomical equator, because Its position will depend on the natural tilt of the tooth, therefore, on separate teeth, the conditions for the location of the clammers may be less favorable. This parallelometry method is shown only with parallelism of vertical axes of teeth, a minor slope of them and the minimum number of clamps.

Method for detecting medium tilt long axes of supporting teeth. The edges of the socle model cut into so that they are parallel to each other. The model is strengthened on the table of the parallelometer, after which they find the vertical axis of one of the support teeth. The table with the model is installed so that the analyzing terminal of the parallelometer coincides with the long axis of the tooth. The direction of the latter is drawn on the side surface of the socket model. Next, the vertical axis of the second reference tooth is determined on the same side of the dentition, and are also transferred to the lateral surface of the model. Then the resulting lines are connected by parallel horizontal lines, after dividing horizontal lines in half, the average estimated axis of supporting teeth is obtained. In the same way, the average axis of the teeth on the other side of the model is determined. The obtained average axes with the help of the analyzing terminal of the parallelometer are transferred to the free edge of the model base, and the average axis of all supporting teeth is determined. Then the table with the model is finally installed in the parallelometer. An analytical rod is changed to graphite and outline overview line on each reference tooth. When drawing, the end of the graphite rod should be located at the level of the neck of the tooth. The lack of a method is the duration, difficulty and probabilities of the error in determining the overall overview (inter-second) line.

Selection method. The model is strengthened on the table of the parallelometer. Then the table is installed so that the occlusal surface of the model of the model was perpendicular to the analyzing rod (zero tilt). The latter is submitted to each supporting tooth in turn and determine the presence and magnitude of the reference and stabilizing and holding zones. It may turn out that on one or several teeth there are good conditions for the location of the elements of the clammer, and on others - unsatisfactory. Then the model must be considered under a different inclination angle. Of several probable slopes, choose such that provides the best holding zone on all supporting teeth.

There are four main types of tilt model.: front, rear, right side and left side.

When designing a global prosthesis, this method allows us to take into account the requirements of aesthetics and the optimal degree of clummers. So, if the supporting clammers must be placed on the group visible when the teeth, it is advisable to bring the line of view to the neck of the supporting teeth for reasons of aesthetics. For this apply the rear slope of the model, that is, the model is tilted back. The lateral slope of the model is chosen for the uniform distribution of the degree of retention on the support teeth of both half of the jaw.

For example, if, with a horizontal position of the model, it turns out that on the left side teeth, the line of the review is located in the pending surface along the necks of the teeth (due to the tongue inclination of the teeth), then it is advisable to tilt the model to the left to "raise" the overview line. The degree of lateral inclination of the model is determined by the adequacy of the retention zone on the right side teeth.

Securing the mobile table and the model placed on it in the selected position, the vertical pin with the blade is caused by a common overview line.

Summing up the stylus to each teuba so that its lower edge is and moved along the level of the gum edge, draw the line on the vestibular, oral and the approximal surfaces of all teeth. After removing the model with a table with a parallelometer stand, a thin marker or a soft pencil, the resulting general equator line is reduced and proceed to planning the design of the clamps and apply the drawing of the future frame of the prosthesis.

The overall clinical equator intersect only the retention parts of the clamps. To determine the location of the retention part in the parallelometer there is a special stem with a ledge - the degree of retention (calibrations 1, 2 and 3). The rod is strengthened in the shoulder of the parallelometer and install it so that it concerns the clinical equator. At this moment, the reset of the rod concerns the point of the tooth below the clinical equator. After holding a rod for a tooth, a notch is obtained, which indicates the line of the retention part, i.e. The point where the end of the holding clamber should be located: at a 1st degree of retention - by 0.25 mm below the clinical equator, at 2nd - by 0.5 mm and at 3rd - by 0.75 mm.

The location of the clinical equator line on the crown after the parallelometry, its attitude towards the occlusal and gingival parts of the crown determine the need to choose for each tooth of a particular type of supporting clammer. The choice of the form of the clammer depends on the topography of the clinical equator and the area of \u200b\u200bocclusal and gingival parts.

When planning the design of the arc prosthesis, the position of the support teeth in the dentition should also be taken into account. The displacement of the teeth into the medial, distal, flip or pagan side makes it difficult to create their parallelism by stalking of solid tissues, because It is fraught with the opening of the cavity of the tooth or thermal damage to the pulp. In such cases, doctors often resort to their depug. Experience shows that the depugtation of teeth in order to create their parallelism when applying an arc prosthesis at present should be considered an extremely extreme measure. The correct choice of the design of the supporting elements after studying the models in the parallelometer sharply reduces the testimony to the deputation of the teeth and coating them with crowns.

Special conditions arise with a significant vestibular inclination of the front group of the teeth, when in the design of the prosthetic bus, it is necessary to include pinch elements. The latter is sometimes impossible to apply due to the disorders of the aesthetics or the danger of the imperisions of the prosthesis. A favorable condition for the location of clawing processes is the presence of three and diastheats. It is equally impossible to plan an arc prosthesis under the pagan slope of the lower front teeth.

When planning a design of a bureaucrat Of great importance is the type of bite. Thus, with a deep, as well as a deep traumatic bite in the design of the prosthesis, it is impossible to include a multi-zero clummer with pinching elements that will interfere with the closure of the teeth and the preservation of the usual intervalolar height. In patients with such a bite, it is necessary to find out the possibility of increasing the intelvelaolar height, and only after that, in the presence of indications, a cast palatal strip can be applied, restoring cut-tube contact.

Introduction

UURS.

on the topic:

"Burel prosthetics"

Completed: Student 433 groups

Dyshekov Asker Muhamedovich

Stavropol, 2014.

Introduction .................................................................................... 3

1. Choosing a design .................................................................. .4

2. Selection of the arc location (BEGEL) .......................................... .... 6

3. Stages of manufacture. Militant Burel Prosthesis Frame ... ....... 7

4. Obtaining a refractory model .............................................................. ... 9

5. Putting the teeth and the manufacture of Bases of the Burel Prosthesis .......... ..11

Conclusion .............................................................................. 12.

Literature .............................................................................. ..13

Burel dentures relate to removable prostheses. This is the design of replacing therapeutic devices, allowing to fully restore biting and chewing food, while the pressure is distributed between the remaining teeth and the mucous membrane with the tight fabric toothless sections of the alveolar process.

Therefore, the chewing efficiency of such prostheses is close to the effectiveness of their teeth, global prostheses are used to prosthetize extensive dental defects, end defects, as well as for prosthetics during periodontitis.

The variants of the designs of the bureaucratic prostheses are many, they depend on the topography of defects of dental rows. The main feature of these types of prostheses is a metal frame and a basis with artificial teeth.

The metal frame consists of an arc (arc of the German - Bureau), sites for fixing the basis and clummers of the supporting type.

Compared to lamelted prosthesis, global prostheses are much more compact, comfortable, reliable.

The planning of the design of the arc prosthesis is, firstly, in determining the path of administration and removal of the prosthesis, finding the most convenient location of the separation line on the supporting teeth and in accordance with it - the position of the clamps;

Secondly, in establishing the boundaries of the base, the position of the arc in the sky and the alveolar part of the lower jaw;

Thirdly, in the choice of the design of the support-holder of the frame elements (clums, branches, processes, continuous clammer, indirect locksters, etc.) All this in general allows you to apply a drawing of the frame of the future arc prosthesis on the model.

Before proceeding with the planning of the design of the prosthesis, the diagnostic model of the jaw on the impression obtained by alginate masses is cast.

The model is cast from high strength plaster, dried and cut off so that its base should be quite thick, at least at least 1.5 cm. The side walls are made parallel to each other and perpendicular base. The prepared model is studied in a parallelometer.

Parallelometer The device for determining the relative parallelism of the surfaces of two or more teeth or other parts of the jaw, for example, the alveolar crest. A lot of parallelometer designs are proposed, but they are based on the same principle, namely: when mixed, the vertical rod is always parallel to its original position. This allows you to find a point on the teeth located on parallel vertical planes. The parallelometer is equipped with a set of rods: analyzing, rods with discs Difference diameter for measuring sublinks, graphite rod to delineate the separation line, blade for removing excess wax.

Ways of administration and removal of the prosthesis. By administration, the movement of the prosthesis from the initial contact of its locking elements with the front teeth to the tissues of the prosthetic bed, after which the occlusal linings are installed in their lodges, and the basis is accurately located on the surface of the prosthetic bed.

The path of removal of the prosthesis is defined as its movement in the opposite direction, i.e., from the moment of separation of the basis from the mucous membrane of the prosthetic bed to the complete loss of contact of the support and retaining elements with supporting teeth.

There are several ways to introduce a prosthesis, but you should choose the most convenient. The best way to introduce and remove the prosthesis should be considered the one when the prosthet is easily superimposed and is removed by meeting a minimum interference, which cannot be excluded, and at the same time providing the same retention on each tooth. The route of administration depends on the location of the clamps, and the last, naturally affects the aesthetics. Therefore, it is necessary to find such a solution in which there will be less noticeable clams and the form of the anterior teeth will be preserved. Considering the activities of aesthetics, sometimes you have to sacrifice other qualities for example fixation.

Perhaps countless paths of administration of the prosthesis. All of them can be reduced to five options: 1) vertical, but there must be good retention, as viscous food can dismiss the disobedness of the teeth; 2) the vertical right (the movement is slightly right away from the true vertical); 3) vertical left; 4) vertical rear; 5) Vertical front.

The choice of the route of administration is not random, but is determined by certain circumstances.

These include interference with the insertion and removal, torture the teeth and the alveolar niche. It is necessary to choose this path at which there will be less interference, and the topography and lines of the dividing is most convenient for the location of the clamps. It is necessary to take into account the fixation of the prosthesis during the function. It is necessary that the clammers on the premoires are not noticeable, and the latter would have appropriate and color.

The study of the model of the jaw in the parallelometer puts its task to identify the separation line of the tooth, i.e. the line separating the surface into two parts: an occlusive (reference) and retention (holding or receiving), and thereby simultaneously determine the path of administration of the prosthesis. Between the separation line and the desalted edge is undercutting, that is, a zone that essentially allows the springing part of the clammer to ensure the retention of the prosthesis.

The definition of the separation line of the supporting teeth helps to properly distribute the same elements and at the same time find the most convenient path of administration of the prosthesis.

Other articles

Prosthetics with the complete absence of teeth. Part 5. Functional prints and their classification.

Partial removable dentures. Burel prostheses.

Burel prosthesis. Principles for receiving an impression for a global prosthesis.

Supancy of the wax pattern of a denture.

Problems arising during prosthetics Immediat -Protez.

Prosthetics with Immediat Provense. Indications for the immediat of the prosthesis.

What is Burel prosthetics?

Varieties and design features

Types of locks, castle mounts

What parameters is the variety?

Types of bureaucratic prostheses

Types of elements

Types of fasteners

Burel prosthesis when disposal

On the upper jaw

Advantages and disadvantages

Prices

Contraindications

Care, repair and service life

What prosthesis is better burel or nylon?

Graduation qualifying (thesis) work

Principles of Planning Design Burel Prostheses

Introduction

RELEVANCE

PURPOSE OF THE STUDY

OBJECT OF STUDY

THING

PRACTICAL SIGNIFICANCE

Theoretical Justification of the problem

Chapter 1. Features of Burel Prostheses

1.1. Burel prostheses

1.2 Composite parts of burealed prostheses

Chapter 2. Concept of parallelometry

2.2. Errors with parallelometry

2.3. Methods of manufacturing burealed prostheses

Conclusion

Output

Bibliography

The planning of the design of the burealed prosthesis is:

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