JP2018134280A - Method for preventing inflammation due to surplus dental cement and inflammation prevention sheet for use in the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide means that can conveniently and reliably prevent surplus dental cement in the cement-retaining from invading gingival crevice in dental implant therapy.SOLUTION: An inflammation prevention sheet 4 has a circular hole with a diameter being slightly smaller than the diameter of an abutment base and comprises a rubber-made or plastic-made stretchable thin sheet. An abutment 3 is inserted into the circular hole 5 of the sheet, and the sheet 4 is set so as to cover the whole periodontal part of a tooth for the therapy target. Subsequently, a crown 8 is covered on the abutment 3 and bonded with dental cement, and the surplus dental cement protruding from a margin part is deposited on the inflammation prevention sheet 4 and removed.SELECTED DRAWING: Figure 1

Description

The present invention relates to a method for preventing periodontal inflammation caused by excess cement protruding from the end of a crown when adhering a crown to an abutment (abutment) in dental implant treatment, and an anti-inflammatory sheet used therefor About.

In recent years, dental implant treatment has become widespread. Dental implant treatment is a treatment method in which an artificial tooth root is embedded in a jawbone from which a tooth has fallen and an artificial tooth is fixed thereon. Implant treatment requires surgery and has the disadvantage of high treatment costs. However, it has a better appearance than a denture base and has a good chewing response, and therefore the needs of patients are increasing.

FIG. 5 is a schematic cross-sectional view of an implanted tooth. Usually, in dental implant treatment, a metal (especially titanium) artificial tooth root 2 called a fixture is first screwed into the alveolar bone 1 of the jaw and then an abutment 3 as a support connecting member is screwed onto the fixture. Then, the abutment 3 and the crown are joined by covering the dental superstructure (hereinafter referred to as “crown” or “crown”).

As a method for joining the abutment and the crown, a method of screwing (screw retain) and a method of adhering with a dental cement layer 11 as shown in FIG. 5 (cement retain) are mainly used. Among them, cement retainer has become the mainstream of dental crown joint because of the appearance of treated teeth, ease of occlusal adjustment, low cost, and the like.

However, in recent years, in cement retain, the harmfulness of surplus dental cement that protrudes from the root of the crown has become a problem. This is a problem that excessive dental cement enters the gingival sulcus (periodontal pocket) and is difficult to remove, causing inflammation in the periodontal region. When this inflammation progresses, in extreme cases, it may cause troubles such as dropping of the implant.

Cement retainin is a method commonly used in crown restoration of natural teeth other than implant treatment. However, in the restoration of natural teeth, the harmfulness of surplus dental cement is rarely a problem. This is considered to be due to the difference in the state of the gingival sulcus between the implant tooth and the natural tooth (Non-patent Document 1).

It is considered that the fixture made of titanium has low adhesion to the internal tissue of the gingival sulcus compared to natural teeth, and the gingival sulcus tends to be deep. Therefore, excessive dental cement penetrates to the deep part of the gingival sulcus and makes it difficult to remove it. This residual cement is considered to be a hotbed for inflammation-causing bacteria and causing inflammation of the periodontal region. Thus, inflammation of the periodontal region due to excess dental cement is one of the risk factors for implant treatment, and the fundamental solution has not been obtained.

Takanori Suzuki; Journal of Japan Dental Research Institute, Vol. 20, no. 4,235-240, 2014

As described above, in the case of natural tooth cement retainer, the gingival sulcus is not so deep, so the excess dental cement that protrudes from the joint (margin) of the crown and abutment (abutment) is used for dental search. It can be removed relatively easily with a needle or scaler. However, in the case of implant retain cement retainer, since the gingival sulcus is deep, it is very difficult to remove excess dental cement.

If you try to scrape the excess cement with a stainless steel probe forcibly, the surface of the abutment may be crushed to promote the growth of periodontal disease bacteria, and the scaler will remove excess cement in the deep gingival crevice. It is also difficult. Further, whether or not the excess cement enters the gingival sulcus depends on the position of the margin portion. If the margin is slightly above the gingival margin, the excess cement is less likely to penetrate deep into the gingival sulcus, but if the margin is at the same level or below the gingival margin, the excess cement is easily gingival. It goes into the deep part of the groove.

From the viewpoint of reducing the damage of excess cement, it is desirable that the margin portion is higher than the gingival margin, but the margin portion is easily visible, which is not preferable from the viewpoint of aesthetics. Therefore, even if the margin portion is below the gingival margin, if there is a method capable of preventing the surplus cement from entering the gingival crevice, the above problem can be solved at once. However, no such means has yet been found.

Therefore, the present invention provides a novel means for preventing the surplus cement that protrudes from the margin portion from entering the gingival sulcus during cement retain in dental implant treatment, and thus, the periodontal portion of the surplus dental cement. The problem is to drastically solve the problem of inflammation.

In order to solve the above problems, the method for preventing inflammation by the surplus dental cement of the present invention,
In dental implant treatment in which a fixture is embedded in the jawbone, an abutment is bonded to the jawbone, a crown is put on the abutment, and both are bonded with dental cement.
After joining the abutment to the fixture,
An anti-inflammatory sheet made of a stretchable thin sheet made of rubber or plastic having a hole whose diameter is slightly smaller than the diameter of the abutment base, the abutment is inserted into the hole, and the sheet is treated. Set to cover the entire periodontal region of the tooth,
Next, the abutment is covered with the crown, and both are bonded with dental cement,
Thereafter, the anti-inflammatory sheet to which excess dental cement sticking out from the root of the crown is attached is removed.

In the above-mentioned inflammation prevention method, it is desirable to remove the inflammation prevention sheet to which excess dental cement is adhered before the cement is hardened. The hole is preferably a circular hole.

The inflammation prevention sheet of the present invention is an inflammation prevention sheet used in the above-described inflammation prevention method, and is a rubber or plastic stretchable thin sheet having a hole whose diameter is slightly smaller than the diameter of the abutment base. It is characterized by.

The inflammation prevention sheet preferably has a thickness of 0.05 to 1.0 mm.
Moreover, it is preferable that said inflammation prevention sheet consists of a water-repellent silicone resin or fluorine resin. The hole is preferably a circular hole, and it is desirable to color the sheet in advance in red, blue, green or the like. This is because the sheet is easily visualized.

According to the present invention, in dental implant treatment, it has become possible to reliably prevent surplus cement that protrudes from the margin during cement retention from entering the gingival sulcus with simple means. This has made it possible to drastically solve the problem of periodontal inflammation caused by excess dental cement in dental implant treatment.

Hereinafter, preferred embodiments of the present invention will be described. FIG. 1 is an explanatory diagram of the work procedure of the inflammation prevention method of the present invention. As shown in FIG. 1 (a), a fixture 2 is embedded in the alveolar bone 1, and an abutment 3 is screwed to the fixture 2. After that, as shown in FIG. 1 (b), the abutment 3 is inserted into the circular hole 5 provided in the center of the inflammation prevention sheet 4, and the inflammation prevention sheet 4 is placed on the upper part of the gingiva 6, particularly in the gingival groove 7. Set to cover the entire circumference.

At this time, the diameter of the circular hole 5 is slightly smaller than the diameter of the abutment base 3a. Further, since the inflammation prevention sheet 4 is stretchable, a bent portion 5a is formed at the edge of the circular hole 5, and this portion fastens the abutment base 3a, so that the inflammation prevention sheet 4 is in close contact with the abutment base 3a. .

Next, as shown in FIG. 1 (c), the crown 8 is placed on the abutment 3 and bonded with dental cement. That is, dental cement is applied in advance to the inner periphery of the crown 8 and / or the outer periphery of the abutment 3, and the crown 8 is put on the abutment 3. At this time, surplus cement protrudes from the joint (margin portion) between the crown 8 and the abutment 3.

Since the margin portion is above the bent portion 5a of the circular hole, the excess cement that protrudes flows on the surface of the inflammation prevention sheet 4, and the excess cement layer 9 is formed. Further, since the inflammation preventing sheet 4 is in close contact with the abutment 3, it is possible to prevent the excessive cement from entering the gingival sulcus 7.

Next, as shown in FIG. 1 (d), when the end of the inflammation prevention sheet 4 is picked and pulled up (with tweezers or the like), the circular hole 5 is enlarged, and the inflammation prevention sheet 4 is a portion where the diameter of the crown 8 is large. To go through.
In addition, since the anti-inflammatory sheet 4 is made of a water-repellent material in which the surplus cement layer 9 is difficult to adhere (easy to peel off), the surplus cement layer 9 peels off as the anti-inflammatory sheet 4 is deformed. -It breaks and can be easily removed. Thereby, it can prevent reliably that an excessive cement enters into the gingival crevice 7.

The first key point of the inflammation prevention method of the present invention is that a circular hole is provided near the center of the inflammation prevention sheet 4 and the abutment 3 is inserted through this to cover the periodontal region. It was to be able to cover easily and reliably.

The second key point is that an elastic material is used for the anti-inflammatory sheet 4, and the diameter of the circular hole 5 is made slightly smaller than the diameter of the abutment base 3a, whereby the edge 5a of the circular hole 5 is obtained. This means that the abutment base 3a is tightened, and it is possible to reliably prevent the excess cement from leaking through the gap between the two.

2A and 2B are diagrams showing the shape of the anti-inflammatory sheet used in the examples of the present invention. FIG. 2A is a plan view and FIG. 2B is a side view. This inflammation prevention sheet 4 was square, the side length L was 10 mm, and the diameter d of the circular hole was 3.5 mm. The sheet thickness (t) was 0.2 mm.

However, the anti-inflammatory sheet of the present invention is not limited to a square sheet, and may be various shapes such as a rectangle, an ellipse, and the like. The dimensions need not be limited to the above values. In short, an appropriate size may be selected in consideration of the width of the gingival portion to be covered. The hole is not limited to a circle, and may have various shapes such as ☆ and ◇. The diameter d of the hole is not necessarily limited to the above value, and the diameter of the abutment base 3a is taken into consideration. Choose one. Alternatively, it is conceivable to prepare a large number of anti-inflammatory sheets having different diameters d, and select and use those having an appropriate diameter at the treatment site.

The sheet thickness t need not be limited to the above value, but is preferably in the range of 0.05 to 1.0 mm. If t is less than 0.05 mm, there is a risk of breaking in the middle of setting. If t exceeds 1.0 mm, the flexibility is insufficient and handling becomes difficult.

The material of the anti-inflammatory sheet is preferably water-repellent, for example, a silicone resin type or a fluororesin type. This is because it is easy to peel off excess dental cement adhering to the sheet. In this example, a silicone resin-based stretchable sheet was used. Incidentally, the tensile strength (tensile breaking stress) of this sheet was 5.1 N, and the breaking elongation was 59.3%.

FIG. 3 is an explanatory diagram of a method of using the anti-inflammatory sheet when adjacent teeth are close to each other. In this case, as shown in FIG. 3A, when the abutment 3 is inserted into the circular hole 5 of the inflammation prevention sheet 4 and the inflammation prevention sheet 4 is set, the adjacent teeth 10 are obstructive. Become. However, there is no problem if the edge of the anti-inflammatory sheet 4 is bent upward along the side surface of the adjacent tooth 10.

In this state, as shown in FIG. 3 (b), if the crown 8 is put on the abutment 3, there is almost no gap between the adjacent teeth 10. Therefore, the surplus cement does not protrude in this direction, and most of it protrudes in the other direction (front and rear and the opposite side). Therefore, there is no particular problem in removing the inflammation prevention sheet 4.

When the gap between the tooth 8 of the crown 8 and the adjacent tooth 10 is particularly small and the inflammation prevention sheet 4 cannot be pulled upward, a part of the inflammation prevention sheet 4 is cut and sandwiched between the gaps. If the sheet is pulled forward, it can be removed without problems. Although FIG. 3 shows the case where the adjacent teeth are only on one side, it has been confirmed that there is no problem even if they are on both sides.

Since the anti-inflammatory sheet of the present invention is extremely small and lightweight, there is a problem that it is easily dissipated during handling. Therefore, in manufacturing, transporting, and storing the sheet, it is desirable to use a collective sheet. FIGS. 4A and 4B are diagrams showing examples of the shape of the aggregated sheet of the inflammation prevention sheet of the present invention. FIG. 4A shows a case of one row of sheets, and FIG.

If this aggregate sheet is cut at the broken line portion, an isolated sheet is obtained. Since this sheet is made of thin rubber or plastics, it can be easily cut with scissors or a knife at the treatment site.
Furthermore, a thin sheet of silicone resin or fluorine resin is usually transparent or translucent, and its position is difficult to identify when set on a gum. Therefore, it is desirable to color the sheet in red, blue, green or the like in advance.

It is explanatory drawing of the work procedure of the inflammation prevention method of this invention. It is a figure which shows the shape of the inflammation prevention sheet used in the Example of this invention. It is explanatory drawing of the usage method of the inflammation prevention sheet when the next tooth | gear is adjoining. It is a figure which shows the example of the shape of the assembly | stacking type | mold sheet | seat of the inflammation prevention sheet of this invention. It is a cross-sectional schematic diagram of the implanted tooth.

1: Alveolar bone 2: Fixture 3: Abutment 3a: Abutment base 4: Inflammation prevention sheet 5: Circular hole 5a: Bent part of circular hole 6: Gingival part 7: Gingival groove 8: Crown 9: Excess cement Layer 10: Adjacent tooth 11: Dental cement layer

Claims (7)

In dental implant treatment in which a fixture is embedded in the jawbone, an abutment is joined thereto, a crown is put on the abutment and bonded with dental cement,
After joining the abutment to the fixture,
An anti-inflammatory sheet made of a rubber or plastic stretchable sheet having a hole slightly smaller than the diameter of the abutment, the abutment being inserted into the hole, and the sheet is a periodontal portion of a tooth to be treated Set to cover the whole,
Put the crown on the abutment and bond them with dental cement,
A method for preventing inflammation caused by excess dental cement, comprising removing the inflammation-preventing sheet to which excess dental cement protruding from the root of the crown is adhered. 2. The method for preventing inflammation according to claim 1, wherein the removal of the inflammation preventing sheet to which excess dental cement is adhered is performed before the cement is hardened. Inflammation prevention to prevent inflammation caused by excess dental cement used for dental implant treatment where a fixture is embedded in the jawbone, an abutment is bonded to the jawbone, a crown is put on the abutment, and both are bonded with dental cement A sheet,
Rubber and / or plastic expansion and contraction that has a hole slightly smaller than the diameter of the abutment and is set to cover the entire periodontal portion of the tooth to be treated by inserting the abutment through the hole An anti-inflammatory sheet characterized by being a possible sheet. The inflammation prevention sheet according to claim 3, wherein the thickness of the sheet is 0.05 to 1.0 mm. The inflammation prevention sheet according to claim 3 or 4, wherein the sheet comprises a water-repellent silicone resin or fluorine resin. The inflammation prevention sheet according to any one of claims 3 to 5, wherein the shape of the hole is any one of a circle, ☆, and ◇. It is colored, The inflammation prevention sheet in any one of Claim 3 to 6 characterized by the above-mentioned.

Images