U.S. patent application number 11/202608 was filed with the patent office on 2005-12-08 for dental prosthesis fabrication and placement system and associated methods.
Invention is credited to Harlan, Laurence.
Application Number | 20050272010 11/202608 |
Document ID | / |
Family ID | 32712739 |
Filed Date | 2005-12-08 |
United States Patent
Application |
20050272010 |
Kind Code |
A1 |
Harlan, Laurence |
December 8, 2005 |
Dental prosthesis fabrication and placement system and associated
methods
Abstract
A dental prosthesis fabrication and placement method is adapted
for completion in one appointment. The dental prosthesis, such as a
crown or short-span bridge, is a prefabricated composite shell that
is modified by the addition of composite material and cured on-site
to form a custom-modified device.
Inventors: |
Harlan, Laurence; (Chagrin
Falls, OH) |
Correspondence
Address: |
JACQUELINE E. HARTT, PH.D
ALLEN, DYER, DOPPELT, MILBRATH & GILCHRIST, P.A.
P.O. BOX 3791
ORLANDO
FL
32802-3791
US
|
Family ID: |
32712739 |
Appl. No.: |
11/202608 |
Filed: |
August 12, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11202608 |
Aug 12, 2005 |
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10349460 |
Jan 22, 2003 |
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6935862 |
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Current U.S.
Class: |
433/218 |
Current CPC
Class: |
A61C 13/0003 20130101;
A61C 5/77 20170201 |
Class at
Publication: |
433/218 |
International
Class: |
A61C 005/08 |
Claims
What is claimed is:
1. A method for fabricating a dental prosthesis comprising the
steps of: placing a prefabricated prosthesis shell over a tooth;
trimming the shell to achieve desired seating on the tooth and
optimal occlusion; removing the shell from the tooth; adding an
uncured composite material to an interior space of the shell;
positioning the shell over the tooth; partially curing the
composite material in situ; removing the shell from the tooth; and
fully curing the composite material.
2. The method recited in claim 1, further comprising the steps of:
making a model of a mouth of the patient; preparing a tooth in the
model mouth corresponding to the tooth for which the prosthesis is
intended; and prefabricating the prosthesis shell commensurate with
the prepared model tooth.
3. The method recited in claim 2, wherein the prefabricating step
comprises reflecting at least one mouth conformation parameter
selected from a group consisting of bite registration, occlusion,
contour, gingival finish line, and interproximal contacts.
4. The method recited in claim 1, wherein the shell has a thickness
measured between an external surface and the interior surface in a
range of 0.3-1.5 mm.
5. The method recited in claim 1, wherein the shell comprises a
polyacrylic glass composite.
6. The method recited in claim 1, wherein the shell is selected
from a plurality of premanufactured crown shells.
7. The method recited in claim 1, wherein the shell is selected
from a group consisting of a single crown shell and a short-span
bridge.
8. The method recited in claim 1, further comprising the step,
prior to the placing step, of preparing the tooth with at least one
of a shoulder and a prominent chamfer gingival margin.
9. The method recited in claim 8, wherein the preparing step
further comprises removing extant amalgam and bases from the
tooth.
10. The method recited in claim 8, wherein the preparing step
further comprises eliminating any extant undercuts in the
tooth.
11. The method recited in claim 1, further comprising the steps,
following the placing and the trimming steps, and prior to the
uncured composite material adding step, of: examining the fit of
the shell to ensure correct interproximal contacts; and if the fit
is incomplete, relieving the interproximal contacts, gingival
margins, and an internal aspect of the shell as determined by the
fit examining step.
12. The method recited in claim 1, wherein the adding step
comprises adding soft uncured composite material to a level of
approximately half-full.
13. The method recited in claim 1, wherein the uncured composite
material comprises a substantially same material as the
prefabricated prosthesis shell.
14. The method recited in claim 1, further comprising the step of,
following the shell removing step, of modifying the shell as
desired to achieve an optimal conformation, by filling any voids
with uncured composite material, again positioning the shell over
the tooth, and again partially curing the composite material in
situ.
15. The method recited in claim 1, further comprising the step of,
following the shell removing step, of modifying the shell as
desired to achieve an optimal conformation, by correcting for
insufficient interproximal contacts by bonding additional composite
material to an external surface of the shell.
16. The method recited in claim 1, further comprising the step of
trimming the fully light shell to establish desired contours and to
eliminate any gingival margin overhang.
17. A method of fabricating a dental prosthesis comprising the
steps of: trimming a prefabricated prosthesis shell to achieve
desired seating on a tooth and optimal occlusion; adding an uncured
composite material to an interior space of the shell; partially
curing the composite material; modifying the shell as desired to
achieve optimal conformation by filling any voids with uncured
composite material and again partially curing the composite
material in situ; and fully curing the composite material.
18. The method recited in claim 17, wherein the shell comprises a
polyacrylic glass composite.
19. The method recited in claim 17, wherein the shell is selected
from a plurality of premanufactured crown shells.
20. The method recited in claim 17, wherein the shell is selected
from a group consisting of a single crown shell and a short-span
bridge.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application claims priority to Ser. No. 10/349,460,
filed Jan. 22, 2003, entitled "Dental Prosthesis Fabrication and
Placement System and Associated Methods," the contents of which are
incorporated hereinto by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to systems and methods for
performing a dental procedure, and, more particularly, to such
systems and methods forfabricating and placing a dental crown or
bridge.
[0004] 2. Description of Related Art
[0005] The fabrication and placement of dental prostheses such as
crowns and bridges typically requires at least two visits to the
dentist's office to complete. At the first visit, the placement
site in the patient's mouth is prepared, and a mold is made from
which a permanent prosthesis is to be constructed. A temporary
prosthesis is inserted into the site, awaiting the fabrication of
the permanent device, which is usually performed at a remote
location from the dentist's office. At a second visit, the
permanent prosthesis is affixed into the site.
SUMMARY OF THE INVENTION
[0006] The present invention is directed to a dental prosthesis
fabrication and placement system and associated methods that can be
completed in one visit. The dental prosthesis, which may comprise,
for example, a crown or short-span bridge, is a prefabricated
composite shell that is modified by the addition of composite
material and cured on-site to form a custom-modified device.
[0007] The method of the invention, which is for fabricating and
placing a dental prosthesis, comprises the steps of placing a
prefabricated prosthesis shell over a tooth that has a surface that
has been prepared for prosthesis placement and trimming the shell
to achieve desired seating on the tooth and optimal occlusion. The
shell is then removed from the tooth, and the tooth's prepared
surface is painted with a separating medium. An interior surface of
the shell is painted with a bonding agent, and an uncured composite
material is added to the shell's interior space.
[0008] Next the shell is positioned over the tooth, and the
composite material is partially light cured in situ. The shell is
removed from the tooth and modified as desired to achieve optimal
conformation. Any added composite is then fully light cured, and
the shell is affixed to the tooth.
[0009] The features that characterize the invention, both as to
organization and method of operation, together with further objects
and advantages thereof, will be better understood from the
following description used in conjunction with the accompanying
drawing. It is to be expressly understood that the drawing is for
the purpose of illustration and description and is not intended as
a definition of the limits of the invention. These and other
objects attained, and advantages offered, by the present invention
will become more fully apparent as the description that now follows
is read in conjunction with the accompanying drawing.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is a side view of a model of the patient's mouth.
[0011] FIG. 2 is a side view of the model with the respective tooth
prepared.
[0012] FIG. 3 is a side view of the model with a shell crown placed
therein.
[0013] FIGS. 4A-4C are views of the shell crown: FIG. 4A, a side
view; FIG. 4B, an occlusal view; and FIG. 4C, an internal view.
[0014] FIG. 5 is a side view of the mouth with the tooth to be
crowned prepared.
[0015] FIG. 6 is a side view of the shell crown placed over the
prepared tooth.
[0016] FIG. 7 is a side view of the shell crown having added
material.
[0017] FIG. 8 is a side view of the finished crown bonded to the
tooth.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0018] A description of the preferred embodiments of the present
invention will now be presented with reference to FIGS. 1-8.
[0019] The method of the present invention in a preferred
embodiment comprises the steps of making a study model 10 of the
patient's mouth (FIG. 1), comprising, for example, stone. This may
be accomplished at an appointment prior to the prosthesis-placement
appointment. Additional information that should be gathered include
bite registrations and shade data. Using the study model 10 and
additional information, the selected tooth 11 (or teeth) is
prepared on the model in advance (FIG. 2) for fitting a custom
shell restoration 12 thereto. The custom shell restoration 12
should be prepared to accurately reflect parameters such as color,
as well as conformational parameters such as occlusion, proper
contours, estimated gingival finish line, and interproximal
contacts (FIGS. 3 and 4A-4C), and has in a preferred embodiment a
minimum thickness of 0.3 mm and a preferred thickness of 1.0-1.5
mm.
[0020] The shell 12 may comprise, for example, a polyacrylic glass
composite such as manufactured by Ceramco, Inc. (division of
Dentsply International), under the name Cristobol. This material is
not intended as a limitation, and other composite compounds
exhibiting appropriate handling and wear characteristics, such as
Sculpture, BelleGlass, AtrGlass, and Targis, may be substituted by
one of skill in the art without departing from the spirit of the
present invention. Such materials are processed or polymerized by
various combinations of light activation, heat, pressure, and
vacuum.
[0021] In an alternative embodiment for a single crown, a kit is
provided comprising a variety of standardized size and shade
premanufactured crown shells.
[0022] At the treatment appointment the patient is anesthetized,
and the tooth 13 (teeth) to be treated is prepared by a method as
known in the art, including preparing the tooth 13 with a shoulder
or prominent chamfer gingival margin. In a preferred embodiment old
amalgam and bases are removed. Also in a preferred embodiment, the
present technique is not used for single crowns posterior to the
first molar and for bridges posterior to the second bicuspid. A
bridge should preferably span no more than three teeth. Preferably
all undercuts present in the prepared tooth 13 (teeth) are
eliminated using an appropriate buildup or filler material.
Hemostasis of the surrounding gingival tissue 14 is preferred.
Gingival retraction cord should be trimmed and placed completely
into the sulcus to achieve both retraction and hemostasis.
[0023] A backup system for making a temporary crown should
preferably be in place should the procedure of the present
invention not be successful.
[0024] Next the prefabricated crown or bridge shell 12 is placed
over the prepared tooth 13 (or teeth) and trimmed to seat
completely on the prepared tooth 13 (teeth) and to achieve optimal
occlusion. The shell 12 should fit passively, yet completely, and
should be checked to ensure that there are correct interproximal
contacts. If the shell 12 does not fit completely, the tooth 13,
the interproximal contacts, the gingival margins, and the internal
aspect 15 of the shell 12 should be relieved as needed. If
interproximal contacts are insufficient, they can be corrected
later.
[0025] The shell 12 is removed from the mouth, the prepared
surfaces of the tooth 13 (teeth) are painted with a separating
medium, such as a thin coating of water-soluble lubricant. The
internal aspect 15 of the shell 12 should be cleaned, etched and
silinated if necessary, and painted with the appropriate bonding
agent or adhesive. The interior 17 of the shell 12 should be filled
approximately halfway, with a lining of soft uncured composite 16
placed over the adhesive (e.g., modeling compound and primer).
Although it is preferable to use the same material for the direct
reline as was used to construct the shell 12, the composite shell
12 is compatible with standard composites used in the art of
posterior dental restorations.
[0026] The partially filled shell 12 is placed over the prepared
tooth 13 (teeth) to establish the proper occlusion, and the gross
excess composite that may establish undercuts with the adjacent
teeth is removed. The composite 16 is light cured from the buccal,
lingual, and occlusal aspects for no more than several seconds,
typically approximately 5-10 seconds. The shell 12 is removed and
inspected for the presence of voids, which are filled with small
additions of uncured composite, and is again pressed into place
over the prepared tooth 13 (teeth) and light cured.
[0027] This process is repeated as many times as necessary to
develop a fully adaptive internal aspect with complete gingival
integrity. If there are insufficient interproximal contacts, they
may be modified in the same manner by bonding additional material
to the external surface of the shell 12. Once the addition of
material to the shell 12 has been completed, the modified shell 12
should be sufficiently polymerized to optionally harden the entire
prosthesis by light curing for 6-10 minutes, preferably in a light
curing oven.
[0028] Next the shell 12 is trimmed to establish proper contours
and to eliminate any gingival margin overhangs. The occlusion
should be checked and refined as needed, and the external surface
should be polished using an instrument such as, but not intended to
be limited to, diamond, carbide, and silicone polishing
instruments.
[0029] A radiograph may be exposed to verify the accuracy of the
fit. Prior to cementation, the internal aspect 15 of the shell is
then microetched, silinated, and coated with an appropriate bonding
agent. The prepared tooth 13 should be cleaned to remove all the
separating medium, acid etched, usually with buffered phosphoric
acid, and coated with the appropriate bonding agent. The retraction
cord should be removed, and the crown 12 should be cemented with a
dual-cure composite luting cement to achieve a fully bonded,
single-appointment final restoration.
[0030] It should be noted that the laboratory-processed shell 12 is
likely to be polymerized significantly more than the reline portion
of the crown 16. It is this well-polymerized, most durable portion
of the shell 12 that covers most of the tooth, thereby protecting
stress areas and providing for minimal occlusal wear. The weakest
area is the gingival margin, which should, at the very least, be as
durable and provide the same integrity as the best direct composite
restoration.
[0031] In the foregoing description, certain terms have been used
for brevity, clarity, and understanding, but no unnecessary
limitations are to be implied therefrom beyond the requirements of
the prior art, because such words are used for description purposes
herein and are intended to be broadly construed. Moreover, the
embodiments of the system and methods illustrated and described
herein are by way of example, and the scope of the invention is not
limited to the exact details thereof.
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