Buguruslan, Orenburg, Russian Federation
Thing. A new substantiated method of orthopedic treatment of patients with complete destruction of the crown of the tooth is described, objective results of its use are given, and an economic analysis of its use is carried out in comparison with the traditional method of treatment of such patients. The goal is to create a device for restoring the missing clinical crown of premolars and its clinical, laboratory and economic justification. Methodology. During the study, orthopedic treatment of 20 patients with complete destruction of the crown of the tooth was carried out. A clinical assessment of the effectiveness of treatment using targeted radiography, occlusion and quality of life of patients was conducted using the OHIP-14 RU questionnaire. The compressive strength of ceramic coatings was studied for 10 samples of our device and 10 samples with a traditional ceramic-metal crown. The economic effect of our proposed method is analyzed in comparison with the traditional one. Results. 1 month after the treatment, a favorable outcome was observed in all patients on targeted radiographs; during occlusionography, 10 % of patients showed slight premature contacts in lateral occlusion, which were eliminated by selective grinding. 95 % of patients rated the quality of life as good, 5 % ― unsatisfactory. Safety margin of ceramic coating on samples of our device was 2.4 times higher than on samples of a traditional device. The economic efficiency of the traditional method in comparison with the one we proposed below has a ratio of 1:1.35, respectively. To restore one missing clinical tooth crown, the difference in cost between these methods is 21.2 %, or 1536 rubles. Conclusions. The results of the study allow us to recommend our proposed device for active use in practical dentistry in the treatment of patients with complete destruction of the clinical crown of premolars.
destruction of the crown part of premolars, stump pin insert, ceramic-metal crown, economic efficiency, orthopedic treatment
1. Artemova, A. V. (2014). Otsenka effektivnosti lecheniya patsiyentov s obshirnoy poterey tverdykh tkaney zubov [Evaluation of the effectiveness of treatment of patients with extensive loss of hard dental tissues]. Byulleten' meditsinskikh Internet-konferentsiy [Bulletin of medical Internet conferences], 5, 762–763. (In Russ.)
2. Venatovskaya, N. V., Pudovkina, E. A., Suetenkov, D. E. (2011). Protezirovaniye defektov tverdykh tkaney zubov i zubnykh ryadov kak profilaktika zubochelyustnykh anomaliy u detey: ot neobkhodimosti k vozmozhnosti [Prosthetics of defects in hard tissues of teeth and dentition as prevention of dental anomalies in children: from necessity to possibility]. Saratovskiy nauchno-meditsinskiy zhurnal [Saratov scientific medical journal], 1, 226–230. (In Russ.)
3. Gazhva, S. I., Teterin, A. I., Alekseev, M. K. (2018). Teoreticheskiye aspekty vosstanovleniya razrushennykh zubov posle endodonticheskogo lecheniya [Theoretical aspects of restoration of destroyed teeth after endodontic treatment]. Sbornik nauchnykh trudov, posvyashchennyy 30-letiyu stomatologicheskogo fakul'teta Privolzhskogo issledovatel'skogo meditsinskogo universiteta [Collection of scientific papers dedicated to the 30th anniversary of the dental faculty of the Volga research medical University], 361–365. (In Russ.)
4. Ivanova, V. I., Makarova, E. S., Nikonorov, M. K. (2019). Klinicheskiye sluchai, pokazyvayushchiye preimushchestva restavratsiy keramicheskimi vkladkami nad kompozitnymi plombami [Clinical cases showing the advantages of restoration with ceramic tabs over composite fillings]. Problemy stomatologii [Actual problems in dentistry], 15, 1, 104–108. (In Russ.)
5. Kojaev, M. F., Vorobyova, M. V., Nevzorov, A. Yu. (2016). Effektivnost' ispol'zovaniya vkladok pri defektakh tverdykh tkaney zubov [Effectiveness of the use of tabs for defects in hard dental tissues]. Byulleten' meditsinskikh Internet-konferentsiy [Bulletin of medical Internet conferences], 6, 1091. (In Russ.)
6. Komlev, S. S. (2014). Metody profilaktiki oslozhneniy, voznikayushchikh posle protezirovaniya kul'tevymi shtiftovymi vkladkami [Methods of prevention of complications arising after prosthetics with stump pin tabs]. Mezhdunarodnyy nauchno-issledovatel'skiy zhurnal [International scientific research journal], 3 (34), 86–87. (In Russ.)
7. Lutsk, I. K., Novak, N. V. (2016). Esteticheskaya restavratsiya zuba pri znachitel'nom razrushenii koronkovoy chasti [Esthetic restoration of the tooth with significant destruction of the crown part]. Dental Magazine [Dental Magazine], 1, 18–22. (In Russ.)
8. Ohanyan, A. I., Tsalikova, N. A., Salamov, M. Ya., Grishkina, M. G. (2016). Primeneniye shtiftovykh kul'tevykh konstruktsiy iz dioksida tsirkoniya dlya vosstanovleniya koronkovoy chastey zubov v razlichnykh uchastkakh zubnogo ryada [Application of pin stump structures made of zirconium dioxide for restoration of crown parts of teeth in various areas of the dental row]. Rossiyskaya stomatologiya [Russian dentistry], 1, 24–27. (In Russ.)
9. Razakov, D. Kh., Arutyunov, E. I., Narbekov, R. R., Narbekova, E. R. (2018). Reaktsiya tkaney parodonta na manipulyatsii pri ortopedicheskom lechenii zubov s polnym otsutstviyem koronkovoy chasti zuba [Reaction of periodontal tissues to manipulations in orthopedic treatment of teeth with complete absence of the crown part of the tooth]. Byulleten' meditsinskikh Internet-konferentsiy [Bulletin of medical Internet conferences], 7, 295. (In Russ.)
10. Saburov, S. K. (2016). Chastota vstrechayemosti i oslozhneniy v ortopedicheskoy stomatologii pri protezirovanii nes"yemnymi konstruktsiyami bol'nykh s obshchesomaticheskoy patologiyey [Frequency of occurrence and complications in orthopedic dentistry during prosthetics with fixed structures of patients with General somatic pathology]. Vestnik Avitsenny [Avicenna Bulletin], 3, 77–80. (In Russ.)
11. Khudaleeva, K. A., Kuftyrev, D. A. (2017). Laboratornoye obosnovaniye podgotovki kul'tey opornykh zubov i vybora fiksiruyushchego materiala pri nizkikh klinicheskikh koronkakh [Laboratory substantiation of the preparation of support teeth stumps and the choice of fixing material for low clinical crowns]. Smolenskiy meditsinskiy al'manakh [Smolensk medical almanac], 1, 28–34. (In Russ.)
12. Shuraev, A. A., Badrutdinov, M. M. (2017). Vkladki dlya izgotovleniya anatomicheskoy formy zubov kak al'ternativa plombirovochnym kompozitam [Tabs for manufacturing anatomic forms of teeth as an alternative to filling composites]. Byulleten' meditsinskikh Interenet-konferentsiy [Bulletin of medical Internet conferences], 9, 1461–1465. (In Russ.)
13. Abdulrazzak, S. S., Sulaiman, E., Atiya, B. K., Jamaludin, M. (2014). Effect of ferrule height and glass fibre post length on fracture resistance and failure mode of endodontically treated teeth. Australian Endodontic Journal, 4, 81–86.
14. Arcangelo, C. D. (2010). Fracture resistance and deflection of pulpless anterior teeth restored with composite or porcelain veneers. J. Endod, 1, 153–156.
15. Dietschi, D., Spreafico, R. (2015). Evidence-based concepts and procedures for bonded inlays and onlays. Part I. Historical perspectives and clinical rationale for a biosubstitutive approach. Int J Esthet Dent, 10 (2), 210–227.
16. Juloski, J., Apicella, D., Ferrari, M. (2014). The effect of ferrule height on stress distribution within a tooth restored with fibre posts and ceramic crown: a finite element analysis. Dental Materials, 3, 1304–1315.
17. Kainose, K., Nakajima, M., Foxton, R. (2015). Stress distribution in root filled teeth restored with various post and core techniques: effect of post length and crown height. International Endodontic Journal, 4, 1023–1032.
18. Kalay, T. S., Yildirim, T., Ulker, M. (2016). Effects of different cusp coverage restorations on the fracture resistance of endodontically treated maxillary premolars. J Prosthet Dent, 116 (1), 404–410.
19. Lazari, P. C., De Carvalho, M. A., Del Bel Cury, A. A., Magne, P. (2018). Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material. Journal of Prosthetic Dentistry, 119 (5), 769–776.
20. Maroli, A., Hoelcher, K. A., Reginato, V. F. (2017). Biomechanical behavior of teeth without remaining coronal structure restored with different post designs and materials. Mater Sci Eng C Mater Biol Appl, 76, 839–844.
21. Ng, C. C., Dumbrigue, H. B., Al‐Bayat, M. I. (2006). Influence of remaining coronal tooth structure location on the fracture resistance of restored endodontically treated anterior teeth. Journal of Prosthetic Dentistry, 9, 290–296.
22. Rocca, G. T., Rizcalla, N., Krejci, I., Dietschi, D. (2015). Evidence-based concepts and procedures for bonded inlays and onlays. Part II. Guidelines for cavity preparation and restoration fabrication. Int J Esthet Dent, 10 (3), 392–413.
23. Shuman, I. (2007). Excellence in class II direct composite restorations. Dent. Today, 26 (4), 102–105.
24. Von Stein-Lausnitz, M., Bruhnke, M. (2018). Direct restoration of endodontically treated maxillary central incisors: post or no post at all? Clin. Oral Investig, 23 (1), 381–389.
25. Zhang, Y. Y., Peng, M. D., Wang, Y. N., Li, Q. (2015). The effects of ferrule configuration on the anti‐fracture ability of fiber post‐restored teeth. Journal of Dentistry, 4, 117–125.
