Bonding and treatment methods for dental prostheses

Abstract

The present invention relates to a new method for bonding dental prostheses that suppresses excessive polymerization shrinkage of the photopolymerizable adhesive, prevents bonding defects of dental prostheses, and enables reliable treatment with high patient satisfaction. The method includes the steps of: applying a photopolymerizable adhesive to the inner surface of the dental prosthesis; placing the dental prosthesis on the tooth to be treated and attaching it to the tooth under pressure; removing excess photopolymerizable adhesive from the edges of the dental prosthesis with a brush; and curing the photopolymerizable adhesive by irradiating it with visible light. The curing step includes a primary curing process in which the central portion of the dental prosthesis is irradiated for a first hour with visible light in the active wavelength band range of the photopolymerization initiator contained in the photopolymerizable adhesive, gradually increasing the intensity from a first to a second level; and a secondary curing process in which the central portion of the dental prosthesis is irradiated for a second hour with visible light in the active wavelength band range of the photopolymerization initiator contained in the photopolymerizable adhesive at a third level.

Description

[Technical Field]

[0001] The present invention relates to a bonding and treatment method for dental prostheses, and more specifically, to a new method of bonding and treatment for dental prostheses that enables the bonding and treatment of highly reliable prostheses without the occurrence of bonding defects. [Background technology]

[0002] When tooth enamel is damaged, orthodontic treatment is performed to reconstruct the damaged enamel, protect the tooth from external stimuli, and restore its aesthetics. In orthodontic treatment, the most efficient aesthetic prosthetic is laminate.

[0003] When performing laminate veneer procedures, typically about 0.5 to 1.2 mm of tooth structure is removed. However, in order to prioritize tooth preservation, a procedure using ultra-thin dental prostheses is being performed that minimizes the amount of tooth structure removed to about 0.1 to 0.2 mm. Figure 1 is a cross-sectional view comparing the amount of tooth structure removed during procedures using ultra-thin dental prostheses and conventional dental prostheses.

[0004] On the other hand, when performing such dental prostheses, a dental photopolymerizable adhesive called resin cement is used to attach the prosthesis to the tooth. Such photopolymerizable adhesives contain a photopolymerization initiator and a polymerizable monomer so that they polymerize and harden when exposed to a light source in the visible light range that is harmless to the human body. Generally, methacrylate monomers are used as polymerizable monomers, and campoquinone (CQ), an aromatic carbonyl compound, is used as the photopolymerization initiator.

[0005] Furthermore, during the placement of dental prostheses, a photopolymerizable adhesive is applied to the prosthesis, and a photocuring unit is used to irradiate it with visible light in the wavelength range that activates the photopolymerization initiator, curing the adhesive and attaching the dental prosthesis. However, when the photopolymerizable adhesive hardens, polymerization shrinkage occurs, and conventionally, visible light at 2000 mW / cm² is used. 2The light-curable adhesive was cured by irradiating it with a fairly strong intensity. Consequently, excessive polymerization shrinkage occurred in the light-curable adhesive, causing the dental prosthesis to spread at the tooth margin. This can lead to food getting trapped between the prosthesis and bleeding, which can induce tooth discoloration. In some cases, the dental prosthesis may shift or fall out, and tooth hypersensitivity may also occur.

[0006] On the other hand, ultra-thin dental prostheses have an extremely thin thickness, and the shade (color) of the light-curing adhesive used during the procedure is visible through the ultra-thin dental prosthesis. As a result, the shade of the ultra-thin dental prosthesis ultimately reflects the shade of the light-curing adhesive.

[0007] Because the shade of the light-curing adhesive affects the final shade achieved, there is a risk that the shade intended by the technician during the lamination process may not be correctly realized, making it difficult to provide a satisfactory treatment to the patient. [Prior art documents] [Patent Documents]

[0008] [Patent Document 1] Korean Published Patent Publication No. 10-2017-0119430 [Patent Document 2] Korean Registered Patent Publication No. 10-1743374 [Patent Document 3] Korean Registered Patent Publication No. 10-2030734 [Overview of the project] [Problems that the invention aims to solve]

[0009] This invention has been made in view of the above-mentioned problems, and provides a new method for bonding and performing dental prostheses that suppresses excessive polymerization shrinkage of light-polymerizable adhesives, prevents poor bonding of dental prostheses, and enables the practitioner to achieve the shade intended by the practitioner, thereby enabling highly reliable treatment with high patient satisfaction. [Means for solving the problem]

[0010] A method for bonding a dental prosthesis to a patient's prepped tooth is provided, comprising the steps of: applying a photopolymerizable adhesive to the inner surface of the dental prosthesis; placing the dental prosthesis on the tooth and attaching it to the tooth by applying pressure; removing excess photopolymerizable adhesive from the edges of the dental prosthesis with a brush; and curing the photopolymerizable adhesive by irradiating it with visible light, wherein the curing step comprises a primary curing process in which the central portion of the dental prosthesis is irradiated for a first hour with visible light in the active wavelength band region of the photopolymerization initiator contained in the photopolymerizable adhesive, gradually increasing the intensity from a first to a second intensity; and a secondary curing process in which the visible light in the active wavelength band region of the photopolymerization initiator contained in the photopolymerizable adhesive is irradiated at a third intensity for a second hour.

[0011] According to another feature of the present invention, the third strength is greater than the second strength.

[0012] According to another feature of the present invention, the first intensity is 200-300 mW / cm². 2 The second intensity is 500 mW / cm². 2 The aforementioned first time is 1 to 2.5 seconds.

[0013] According to another feature of the present invention, the third intensity is 600-1200 mW / cm². 2 The aforementioned second time is 0.5 to 1.4 seconds.

[0014] According to another feature of the present invention, between the step of applying the adhesive and the step of pressing and attaching the dental prosthesis to the treated tooth, a step of inserting and arranging dental floss between the treated tooth and the adjacent tooth is added, and between the primary curing process and the secondary curing process, a dental floss process of removing the photo-curable adhesive that has flowed between the treated tooth and the adjacent tooth by pulling out the dental floss is further added.

[0015] According to another feature of the present invention, in the primary curing process, spot bonding with a diameter of 1 to 5 mm is formed in the central portion of the dental prosthesis.

[0016] According to another feature of the present invention, before the step of applying the photo-curable adhesive, steps of preparing a plurality of photo-curable adhesives having different shades and a plurality of test glycerins having the same shade as the photo-curable adhesive, applying the test glycerin to the dental prosthesis, and visually confirming the shade in which the shade of the test glycerin is reflected in the shade of the dental prosthesis by placing the dental prosthesis on the treated tooth of the patient, and when the shade in which the shade of the test glycerin is reflected in the shade of the dental prosthesis in the shade test step is suitable for the shade of the natural tooth of the subject, determining the shade of the test glycerin used in the shade test step as the shade of the photo-curable adhesive are added.

Advantages of the Invention

[0017] The present invention having the above-described configuration cures the photo-curable adhesive in various processes to attach the dental prosthesis, thereby preventing the photo-curable adhesive from excessively polymerizing and shrinking. Therefore, the problems caused by the excessive polymerization shrinkage of the conventional photo-curable adhesive are solved.

[0018] Particularly, in the primary curing process, with the central part of the dental prosthesis spot-bonded and the dental prosthesis temporarily fixed, it becomes easier to remove excess adhesive protruding outside the dental prosthesis with dental floss, and the mounting state of the dental prosthesis becomes clean. Also, there is no problem of the proximal parts between teeth being adhered by the adhesive. Therefore, a satisfactory dental prosthesis can be applied to the patient.

[0019] Also, by simulating the shade finally achieved after the treatment using test glycerin and determining the shade of the photo-polymerizable adhesive used for bonding the dental prosthesis, a shade suitable for the patient's natural teeth can be easily expressed, enabling an even more satisfactory treatment.

Brief Description of the Drawings

[0020] [Figure 1] It is a cross-sectional view comparing the amount of tooth removal during the application of the ultra-thin dental prosthesis and the normal dental prosthesis. [Figure 2] It is a photograph of the ultra-thin dental prosthesis manufactured in a preferred embodiment of the present invention. [Figure 3] It is a perspective view of the photo-polymerizer used in the above embodiment.

Modes for Carrying Out the Invention

[0021] Hereinafter, the present invention will be specifically described. In a preferred embodiment of the present invention, it is exemplified as being applied when the present invention attaches an ultra-thin dental prosthesis with minimal tooth removal. Considering the overall treatment system to which the present invention is applied, it is as follows.

[0022] (1) Manufacturing steps of the ultra-thin dental prosthesis 1. 3D scanning operation - Scan the patient's oral cavity with a 3D scanner to obtain the patient's oral cavity information. 2. Tooth design operation - Based on the patient's oral information obtained from 3D scans, we design oral models and ultra-thin dental prostheses. 3. Output of the oral cavity model - A 3D printer is used to output an oral cavity model. 4. Primary milling of dental prostheses -Using a CAD / CAM system, the bulk block is milled to form an ultra-thin dental prosthesis, and the dental prosthesis is subjected to primary processing. 5. Secondary manual work on dental prostheses -Dental technicians perform secondary processing on primary processed dental prostheses by hand, and this manual process allows for the manufacture of thinner, more natural-looking, ultra-thin dental prostheses. 6. Reproduction of gloss and texture -The ultra-thin dental prosthesis, which has undergone secondary processing, is glazed (polished) to reproduce a luster and texture similar to that of natural teeth. Figure 2 is an example photograph of an ultra-thin dental prosthesis manufactured in this manner.

[0023] (2) Photopolymerization adhesive application step A photopolymerizable adhesive is applied to the manufactured ultra-thin dental prosthesis. The photopolymerizable adhesive used contains a methacrylate monomer and campoquinone (CQ) as a photopolymerization initiator.

[0024] (3) Insert dental floss on both sides of the tooth being treated. The patient's tooth to be treated is prepped, and dental floss is inserted between the prepped tooth and the adjacent teeth.

[0025] (4) Steps for placing dental prostheses The dental prosthesis to which the light-curing adhesive has been applied in the previous step is placed on the patient's tooth to be treated, i.e., the tooth that has been prepped, and the dental prosthesis is attached to the tooth by gently pressing it with the hand. This causes the light-curing adhesive applied to the dental prosthesis to spill out onto the edges of the prosthesis.

[0026] (5) Remove any light-curing adhesive that has spilled outside the dental prosthesis using a brush. In the above step, remove any excess light-curing adhesive that has spilled out of the dental prosthesis using a brush.

[0027] (6) Photopolymerization adhesive curing step The photopolymerizable adhesive is cured using a photopolymerizer that irradiates it with visible light in the active wavelength range of camphorquinone, a photopolymerization initiator contained in the aforementioned photopolymerizable adhesive. The photopolymerizable adhesive is cured, i.e., hardened, in a variety of stages to prevent excessive polymerization shrinkage. Figure 3 is a perspective view of the photopolymerizer used in this embodiment.

[0028] Specifically, the process is divided into: a primary curing process in which light is gradually increased from the first to the second intensity for the first hour on the central part of the dental prosthesis; a dental flossing process in which the light-curing adhesive that has flowed between the dental prosthesis and the adjacent teeth is removed using dental floss; a secondary curing process in which light is irradiated at a third intensity, higher than the second intensity, for two hours; an additional dental flossing process in which the light-curing adhesive that has spilled onto the edges of the dental prosthesis during the secondary curing process is removed using dental floss; and a tertiary curing process in which light is irradiated at a fourth intensity to completely cure the light-curing adhesive. A more detailed examination of each process is as follows.

[0029] 1. Primary curing process (spot and soft curing process) In this process, for the first hour, the light (visible light) is gradually increased from the first intensity to the second intensity, irradiating only the central portion of the dental prosthesis. In this process, because only the central portion of the dental prosthesis is irradiated with light, the light-curable adhesive at the edges of the dental prosthesis does not harden, and only the light-curable adhesive in the central portion of the dental prosthesis hardens, resulting in a temporary fixed state where only the central portion of the dental prosthesis is spot-bonded to the patient's tooth. Preferably, to ensure that only the central portion of the dental prosthesis is effectively spot-bonded, a light guide tip 12 with a diameter of 1 to 3 mm is connected to the light curing unit 10 and light is irradiated, as shown in Figure 3.

[0030] Preferably, in this process, the first intensity is set to 200-300 mW / cm². 2Set the second intensity to 500 mW / cm 2 and irradiate light for 1 to 2.5 seconds. That is, over 1 to 2.5 seconds, the light intensity is increased gradually from 200 mW / cm 2 to 500 mW / cm 2 or the light intensity is increased gradually from 300 mW / cm 2 to 500 mW / cm 2 and irradiate light. In this process, since light with a relatively low intensity of about 200 - 500 mW / cm 2 is irradiated, the photocurable adhesive cures softly.

[0031] If the photocurable adhesive for attaching a dental prosthesis cures entirely at once, excessive polymerization shrinkage of the photocurable adhesive is induced. Due to such excessive shrinkage force, the dental prosthesis spreads at the edge of the tooth, food may be trapped during this period, bleeding may occur, not only causing tooth discoloration, but in some cases, problems such as the dental prosthesis shifting or falling off may occur.

[0032] In contrast, in this process, only the central part of the dental prosthesis is spot - bonded with light of relatively low intensity, so excessive polymerization shrinkage of the photocurable adhesive is prevented. Therefore, there is no risk of problems caused by excessive polymerization shrinkage of the adhesive as described above.

[0033] On the other hand, in this process, if the dental prosthesis is spot - bonded in an overly narrow area, the dental prosthesis may not be properly fixed, so there is a risk that the dental prosthesis may flow or fall off during the adhesive removal process described later. If it is spot - bonded in an overly wide area, there is a risk that the adhesive cannot be properly removed during the adhesive removal process described later. Preferably, in this process, as a result of experimenting with the spot - bonding area according to the light irradiation time, results as shown in Table 1 were obtained.

[0034]

Table 1

[0035] Experiments have shown that, considering the stable temporary fixation of the dental prosthesis and the effective removal of the adhesive using dental floss, it is preferable for the spot bonding to be formed with a diameter of 1 to 5 mm, and particularly preferable for the spot bonding to be formed with a diameter of 3 mm. Therefore, most preferably, in this process, a 3 mm diameter light guide tip is connected to the light curing unit and the light intensity is set to 300 mW / cm for 2 seconds. 2 From 500 mW / cm 2 The irradiation is applied while gradually increasing the intensity to form a spot bond with a diameter of 3 mm.

[0036] On the other hand, preferably, the light curing unit is set to a primary curing mode in which the light intensity and time are adjusted so that such a primary curing process is carried out, and further, secondary curing modes and tertiary curing modes are also set in which the light intensity and time are adjusted so that secondary curing and tertiary curing processes are carried out. When the light curing unit is set to modes in which each curing process is carried out in this way, each curing process can be easily carried out regardless of the skill level of the operator, thereby reducing the dependence on the operator's skill level.

[0037] 2. The Dental Flossing Process As mentioned above, although the photopolymerizable adhesive that has spilled outside the dental prosthesis is removed with a brush during the prosthesis placement step, it is difficult to remove the photopolymerizable adhesive that has flowed into the contact area between the treated tooth and the adjacent tooth using a brush. Therefore, in this process, the photopolymerizable adhesive that has flowed into the contact area between the treated tooth and the adjacent tooth is removed by pulling the dental floss, which has been inserted between the teeth, to prevent the contact from becoming clogged. On the other hand, if the dental floss is inserted from the outside of the tooth towards the gum to remove the adhesive, there is a risk of inserting the dental floss too far and damaging the patient's gums. Therefore, it is preferable to insert the dental floss in advance and remove the adhesive by pulling the dental floss out of the tooth.

[0038] During the initial curing process, only the central portion of the dental prosthesis is spot-bonded, temporarily fixing it in place. Therefore, the dental prosthesis does not move during this process and maintains its initial position. Consequently, not only does the dental prosthesis not shift position, but because the excess adhesive has not yet hardened, removing the adhesive is easy, and in particular, the adhesive at the contact points can be cleanly removed.

[0039] 3.Secondary curing process During this process, the second intensity (500 mW / cm²) was applied for the second hour. 2 ) Light irradiation at a third intensity higher than ), specifically 600-1200 mW / cm² for 0.5-1.4 seconds. 2 By irradiating the dental prosthesis with high-intensity light, the photopolymerizable adhesive is polymerized to about half its original strength. Preferably, 1200 mW / cm² per second. 2 Shine light at this intensity.

[0040] 4. Additional dental flossing steps During the secondary hardening process, adhesive may seep out onto the edges of the dental prosthesis, so use dental floss to remove the adhesive that has seeped into the contact area. Since the adhesive is about half polymerized, it is possible to remove the excess adhesive. Insert dental floss between the treated tooth and the adjacent tooth and remove it by moving it in and out. In some cases, as mentioned above, it is also possible to insert dental floss between the treated tooth and the adjacent tooth beforehand and pull the dental floss out of the tooth to perform the work.

[0041] 5.Third hardening process In this process, visible light is irradiated at a fourth intensity to completely photopolymerize and cure the photopolymerizable adhesive, specifically at 1000-2000 mW / cm². 2 The entire dental prosthesis is irradiated with light of this intensity to finally harden it. Preferably, 2000 mW / cm² for 3 to 5 seconds. 2 Irradiate with light at this intensity.

[0042] The present invention, having the configuration described above, prevents excessive polymerization shrinkage of the light-polymerizable adhesive by curing the adhesive in multiple steps. Therefore, problems such as spreading between the tooth and the dental prosthesis, tooth discoloration, and detachment or displacement of the dental prosthesis, which occur with conventional light-polymerizable adhesives due to excessive polymerization shrinkage, do not occur, and highly reliable dental prosthesis procedures can be performed. In particular, since the central part of the dental prosthesis is spot-bonded during the primary curing process to temporarily fix the dental prosthesis, dental flossing is performed to remove the adhesive that has flowed into the contact between the treated tooth and the adjacent tooth. As a result, the adhesive that has spilled outside the dental prosthesis is cleanly removed, and the problem of the proximal area between teeth becoming bonded with adhesive and the contact becoming clogged does not occur.

[0043] The following describes other embodiments of the present invention, but the same configurations and effects as those described above will not be explained.

[0044] In another embodiment of the present invention, a shade test and shade determination step is further added, in which the shade of the tooth is tested using test glycerin and the shade of the light-curable adhesive to be used during the procedure is determined, prior to the application step of the light-curable adhesive.

[0045] To that end, test glycerin is prepared. Multiple samples of this test glycerin are prepared, each having the same shade as the photopolymerizable adhesive. The test glycerin is a mixture of glycerin and pigment.

[0046] The prepared test glycerin is applied to the dental prosthesis, and the prosthesis is temporarily placed on the patient's tooth. Because the dental prosthesis is ultra-thin, the shade of the test glycerin is visible through the prosthesis, and the final visible shade is the result of the test glycerin shade being reflected in the shade of the dental prosthesis.

[0047] In this way, the shade of the dental prosthesis is checked by reflecting the shade of the test glycerin. If the checked shade is suitable for the shade of the patient's natural teeth, the shade of the test glycerin used is determined to be the shade of the light-curing adhesive used when curing the dental prosthesis, as described later. Here, "if the checked shade is suitable for the shade of the patient's natural teeth" means that the shade checked through the test not only matches the shade of the patient's natural teeth, but is also similar to the shade of the patient's natural teeth, and the treated tooth harmonizes with the patient's natural teeth.

[0048] In particular, after the placement of a dental prosthesis, the shade of the prosthesis reflects the shade of the test glycerin, resulting in a wider range of shades than those available in the bulk block used to manufacture the prosthesis. This has the advantage of allowing for a more accurate representation of the shade that best suits the patient's natural teeth.

[0049] On the other hand, if the shade of the dental prosthesis, which reflects the shade of the test glycerin, is not suitable for the patient's natural teeth, the test glycerin is wiped off and the shade of the light-curing adhesive is determined by testing with test glycerin of a different shade.

[0050] By using test glycerin in this way to simulate the final shade achieved after the procedure and determining the shade of the light-curing adhesive to be used, it is possible to easily achieve a shade that is suitable for the patient's natural teeth. Furthermore, since the shade of the light-curing adhesive is reflected in the shade of the dental prosthesis to express the final shade, it is possible to express a number of shade types equal to the number of shade types of the light-curing adhesive multiplied by the number of shade types of the bulk block used to manufacture the dental prosthesis. Therefore, it is possible to express a shade that is even more accurately suited to the shade of the patient's natural teeth, thereby providing the patient with a more satisfying treatment.

[0051] Although specific parts of the present invention have been described in detail above, it will be clear to those with ordinary skill in the art that this specific description is merely a preferred embodiment and does not limit the scope of the invention. Therefore, the substantial scope of the invention is defined by the appended claims and their equivalents.

Claims

1. A method for bonding a dental prosthesis to a patient's prepped tooth to be treated, The steps include applying a light-curing adhesive to the inner surface of the dental prosthesis, The steps include: placing the dental prosthesis on the tooth to be treated and attaching it to the tooth by applying pressure; The steps include removing excess light-curing adhesive from the edges of the dental prosthesis with a brush, The process includes a curing step of curing the photopolymerizable adhesive by irradiating it with visible light, The curing step is, A primary curing process is performed by irradiating the central portion of the dental prosthesis for a first hour while gradually increasing the intensity of visible light in the active wavelength range of the photopolymerization initiator contained in the photopolymerizable adhesive from a first intensity to a second intensity. A method for bonding dental prostheses, characterized by comprising a secondary curing step of irradiating the photopolymerizable adhesive with visible light in the active wavelength range of the photopolymerization initiator at a third intensity for two hours.

2. The bonding method for dental prostheses according to claim 1, characterized in that the third strength is greater than the second strength.

3. The first intensity is 200-300 mW / cm². ２ The second intensity is 500 mW / cm². ２ The bonding method for dental prostheses according to claim 1, characterized in that the first time is 1 to 2.5 seconds.

4. The third intensity is 600 to 1200 mW / cm². ２ The bonding method for dental prostheses according to claim 3, characterized in that the second time is 0.5 to 1.4 seconds.

5. Between the step of applying the adhesive and the step of applying pressure to attach the dental prosthesis to the tooth to be treated, An additional step is added: inserting dental floss between the tooth to be treated and the adjacent teeth. The bonding method for a dental prosthesis according to claim 1, further comprising a dental flossing step between the primary curing step and the secondary curing step, in which the dental floss is withdrawn to remove the light-curable adhesive that has flowed between the tooth to be treated and the adjacent tooth.

6. The method for bonding a dental prosthesis according to claim 1, characterized in that, in the primary hardening process, spot bonding with a diameter of 1 to 5 mm is formed in the central portion of the dental prosthesis.

7. A method for determining the shade of a light-curing adhesive during the procedure of dental prostheses, The steps include preparing multiple photopolymerizable adhesives having different shades from each other, and multiple test glycerins having the same shade as these photopolymerizable adhesives, A shade test step involves applying the test glycerin to the dental prosthesis, placing the dental prosthesis on the patient's tooth to be treated, and visually confirming the shade of the dental prosthesis in which the shade of the test glycerin is reflected. A method for determining the shade of a light-polymerizable adhesive during the procedure of a dental prosthesis, comprising: a shade test step, in which the shade of the dental prosthesis reflects the shade of the test glycerin, and if the shade is suitable for the shade of the patient's natural teeth, the shade of the test glycerin used in the shade test step is determined to be the shade of the light-polymerizable adhesive.

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