I.G. Massarsky, N.N. Abolmasov, I.A. Adayeva, V.K. Kovalkov, A.A. Solovyev, E.A. Statenina
Clinical and laboratory substantiation of the method used to prepare pulpless teeth for prosthetics
State Budget Educational Establishment of Higher Professional Education «Smolensk State Medical University» of Russian Ministry of Public Health, Smolensk, Russian Federation
Abstract.
This article presents the data from laboratory and clinical studies. Using the method of Vickers modified by S.M.Remizov we conducted a research of dentin microhardness of extracted due to medical indications intact and pulpless teeth, canals of which were obturated in vivo with gutta-percha pins by the method of lateral condensation with one paste (zincoxide evgenol) and with the help of resorcinol-formalin method. The result showed a significant reduction in the hardness of dentin of pulpless teeth, especially when the sealing of canals had been performed with the use of zincoxide evgenol paste. In the course of the laboratory study we determined a reliable decrease in the permeability of the dentinal tubules on coating the inner walls of the tooth cavity and root canals after their drilling for the post stump inlay. For studying the firmness of the system «tooth-post stump inlay-cast crown» six mathematical models were designed with varying degree of the coronal portion destruction (the complete destruction and 1/2), the shape of the cervical part (ledge 135°, ledge 90°, without any ledge), the method of finite element analysis was applied. The dependence of ultimate construction firmness on the ledge type, the degree of stump destruction and the angle of inclination in vestibulooral or mesiodistal direction was established. On the basis of laboratory data the method to prepare teeth for fixed constructions with the application of surface sealant was developed. A clinical study was also conducted, it involved 100 patients with defects of hard tissues of the teeth and dentitions. 50 patients who made up the main group, underwent the treatment with the use of surface sealant, 50 patients out of the control group received the treatment without the use of surface sealant. As a result of clinical studies a low rate of complications and a better marginal seal of artificial crowns compared to the control group were identified.
Key words: dentin microhardness, surface sealant, finite element analysis, preparation of the oral cavity for prosthetics.
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