МЕТОД ИЗГОТОВЛЕНИЯ ЗУБНЫХ ПРОТЕЗОВ ИЗ ТЕРМОПЛАСТОВ

Комлев С.С.

Кандидат медицинских наук,

ГБОУ ВПО Самарский Государственный Медицинский Университет Минздрава России

МЕТОД ИЗГОТОВЛЕНИЯ ЗУБНЫХ ПРОТЕЗОВ ИЗ ТЕРМОПЛАСТОВ

Аннотация

На кафедре ортопедической стоматологии СамГМУ при частичном отсутствии зубов на челюстях используют современные методы ортопедического лечения пациентов. Нами было предположено, что введение в конструкцию протеза из термопласта опорно-удерживающих кламмеров, позволит равномерно распределить нагрузку на опорные зубы, получить возможность стабилизации по плоскости, а также повысить фиксацию протеза.

Ключевые слова: зубной протез, термопласт, элемент бюгельного протеза.

Komlev S. S.

MD,

Samara State Medical University

METHOD OF MAKING DENTURES OF THERMOPLASTICS

Abstract

At the Chair of Orthopedic Dentistry SamSMU we use modern methods of treating patients with partial absence of teeth. We have supposed that introduction retaining clasps into construction of thermoplastic prosthesis allows to allocate evenly the load on bearing teeth as well as make possible stabilization on a plane and improve fixation of prosthesis.

Keywords: denture, thermoplastic, element of clasp prosthesis.

Partial absence of teeth is one of the most common diagnosis in the clinic of orthopedic dentistry [1, 4]. Removable prosthetics if widely used for replacement of dentition deformity. One of the most topical medical and social problems of orthopedic dentistry is improving  methods of optimal recovery of function in case of arising deformities in dentoalveolar system as a result of loss of teeth.

At the Chair of Orthopedic Dentistry SamSMU we use modern methods of treating patients with partial absence of teeth.

Acrylic plastics which technological features do not require expensive equipment are most widely used in making of orthopedic constructions. However, according to many authors, acrylic plastics, despite of numerous advantages have some significant drawbacks: for example, some orthopedic construction can cause toxic and allergic reactions and making acrylic prostheses often involves the use of retaining clasps [2, 3]. Thermoplastics can be used for making partial dentures. Among the positive features of thermoplastic prostheses we can note flexibility, elasticity, such prostheses do not require preparation of bearing teeth, highly esthetic. The indications for making thermoplastic prostheses are: partial absence of teeth – bounded defects, free-end defects, combined defects due to Kennedy classification, allergic reactions to acrylic prostheses. Prostheses are held only by dent-alveolar clasps or bandages, which are clasps of retaining type. We have supposed that introduction retaining clasps into construction of thermoplastic prosthesis allows to allocate evenly the load on bearing teeth as well as make possible stabilization on a plane and improve fixation of prosthesis [5].

The aim of our work: to strengthen the frame of thermoplastic prosthesis as well as improve fixation and stabilization by introducing in thermoplastic the molten frame with retaining clasps. Making these prostheses is carried out in following way. We gather impressions by two-layer two-step method using silicone mass (C-silicone A-silicone, Speedex, Zetaplus, polyesters). Definition of central occlusion. Definition of color and shape of artificial teeth. In dental laboratory production of models made of super plaster is made, boundaries of prosthesis are marked and boundaries of molten frame. The model is studied in parallelometer. Molten frame with clasps is modeled of wax. Then, we duplicate the model in a conventional way. The picture of molten frame is transferred to the refractory model, the sprues-feeding system is placed and metal is replaced by wax in a standard technology. After that, the part of frame which will be in the thick of thermoplastic is processed in the sander and clasp part is grinded and polished. Then, the basis of prosthesis is modeled on the super plaster model, into which a molten frame is introduced. Setting of artificial teeth is carried out. Thereafter, the dentist checks the wax construction on the model and in the oral cavity. Then, replacing of wax by thermoplastic take place in the laboratory. We gypsum model with wax construction into the bottom of cuvette, then set wax sprues diameter of 5 mm. Then cuvette is closed and filled with wax. Thermoplastic material Perflex t-crystal was used for making prostheses, which is used for all types of removable dentures. After evaporation of the wax, cuvette is opened and holes for retention are drilled in acrylic teeth. The teeth are set on a plaster bed. Then the injection oven (Smart 101) is switched on and the temperature of 280 degrees is set. At this time, both halves of cuvette are placed in hot water of 100 degrees, then the cuvette is dried, plaster in area of prosthesis is lubricated with separating varnish. The cuvette is closed by 4 screws and placed in thermal press. When the program finishes, it is cooled at room temperature. The gathered prosthesis is taken out of cuvette and is processed using diamond cutters, rubber discs, tissue and hair brushes using polish pastes. This prosthesis has flexibility, strength, and at the same time improve fixation and stabilization of prosthesis by using retaining clasps. Molten frames which are located in the thick of thermoplastic on the oral side on the right and on the left. Fixation is reached by using molten retaining clasps and occlusal patches.

The orthopedic treatment of 47 patients with partial absence of teeth using traditional methods (10 patients) using proposed method (37 patients) was conducted at the department of orthopedic dentistry at the Chair of Orthopedic Dentistry SamSMU. The results of prosthetic patients showed that while using thermoplastic partial dentures we can evenly distribute load on bearing teeth, stabilize on a plane and improve fixation of prosthesis by introducing molten frames with retaining clasps. Patients adapt to such prostheses within 2-3 weeks. The observation was conducted in 1, 3, 6, 12 months, the results are considerable.

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