Dental prosthesis bonding and procedure method

Abstract

The present invention relates to a novel dental prosthesis bonding method that suppresses excessive polymerization shrinkage of a photopolymerizable bonding agent to prevent bonding failure of a dental prosthesis, thereby enabling a reliable procedure with high patient satisfaction. The method comprises: a step of applying a photopolymerizable bonding agent to the inner surface of a dental prosthesis; a step of placing the dental prosthesis on a tooth to be treated and pressing and attaching same to the tooth to be treated; a step of removing the photopolymerizable bonding agent protruding from the edge of the dental prosthesis by using a brush; and a curing step of curing the photopolymerizable bonding agent by irradiating same with visible light, wherein the curing step comprises: a primary curing step in which visible light in an activation wavelength range of a photopolymerization initiator contained in the photocurable bonding agent is emitted to the central portion of the dental prosthesis for a first time while the intensity thereof is gradually increased from a first intensity to a second intensity; and a secondary curing step in which visible light in the activation wavelength range of the photopolymerization initiator contained in the photocurable bonding agent is emitted at a third intensity for a second time.

Description

Dental prosthesis bonding and treatment method

[0001] The present invention relates to a method for bonding and operating a dental prosthesis, and more particularly, to a new method for bonding and operating a dental prosthesis that enables bonding and operating a highly reliable prosthesis without causing bonding failure of the dental prosthesis.

[0002] When the tooth enamel is damaged, orthodontic treatment is performed to rebuild the damaged enamel, protect the tooth from external stimuli, and provide aesthetics. The most effective aesthetic prosthesis in orthodontic treatment is laminate.

[0003] When performing a laminate procedure, teeth are typically removed by approximately 0.5 to 1.2 mm, but with an emphasis on tooth preservation, ultra-thin dental prosthetics are being used, minimizing the amount of tooth removal to approximately 0.1 to 0.2 mm. Figure 1 is a cross-sectional view comparing the amount of tooth removal when performing an ultra-thin dental prosthesis and a conventional dental prosthesis.

[0004] Meanwhile, when performing dental prosthetics, a dental photopolymerizable bonding agent called resin cement is used to attach the dental prosthesis to the teeth. This photopolymerizable bonding agent contains a photopolymerization initiator and a polymerizable monomer so that it can be polymerized and cured by a light source in the visible light range that is harmless to the human body. Generally, a methacrylate monomer is used as the polymerizable monomer, and camphorquinone (CQ), an aromatic carbonyl compound, is used as the photopolymerization initiator.

[0005] And when performing dental prosthesis treatment, a photopolymerizable bonding agent is applied to the dental prosthesis, and a light curing device is used to cure the bonding agent by irradiating it with visible light in the wavelength range that activates the photopolymerization initiator, thereby attaching the dental prosthesis. However, when the photopolymerizable bonding agent hardens, polymerization shrinkage occurs, and conventionally, visible light of 2000 mW / cm is used. 2The photopolymerizable bonding agent was cured by irradiating with a fairly strong intensity. Therefore, excessive polymerization shrinkage of the photopolymerizable bonding agent occurs, causing the dental prosthesis to separate at the edge of the teeth, causing food to get caught in the gap or bleeding, which not only causes tooth discoloration, but in some cases, causes the dental prosthesis to become misaligned or fall out, and can also cause tooth hypersensitivity.

[0006] Meanwhile, since the ultra-thin dental prosthesis has a considerably thin thickness, the shade (color) of the photopolymerizable bonding agent used during the procedure is visible through the ultra-thin dental prosthesis, so ultimately, a shade that reflects the shade of the photopolymerizable adhesive is realized in the shade of the ultra-thin dental prosthesis.

[0007] In this way, since the shade of the photopolymerizable adhesive affects the shade that is ultimately realized, there is a concern that the shade intended by the practitioner may not be properly realized during the lamination procedure, and thus, it may be difficult to provide a satisfactory procedure to the patient.

[0008] [Prior Art Literature]

[0009] [Patent Document]

[0010] Republic of Korea Patent Publication No. 10-2017-0119430 (October 27, 2017)

[0011] Republic of Korea Patent No. 10-1743374 (May 29, 2017)

[0012] Republic of Korea Patent No. 10-2030734 (October 2, 2019)

[0013] The present invention has been proposed in consideration of the above-mentioned problems, and provides a new method for bonding and treating a dental prosthesis, which suppresses excessive polymerization shrinkage of a photopolymerizable bonding agent, prevents bonding failure of a dental prosthesis, and enables the shade intended by the practitioner to be implemented, thereby enabling reliable treatment with high satisfaction of the patient.

[0014] According to a feature of the present invention, a method for bonding a dental prosthesis to a patient's prepared tooth for surgery is provided, comprising the steps of applying a photopolymerizable bonding agent to the inner surface of the dental prosthesis, placing the dental prosthesis on the tooth for surgery and attaching it to the tooth for surgery by applying pressure, removing the photopolymerizable bonding agent protruding from the edge of the dental prosthesis with a brush, and curing the photopolymerizable bonding agent by irradiating visible light to harden the photopolymerizable bonding agent, wherein the curing step comprises a first curing step of irradiating the central portion of the dental prosthesis with visible light in an active wavelength range of a photopolymerization initiator contained in the photopolymerizable bonding agent while gradually increasing the intensity from a first to a second intensity for a first hour, and a second curing step of irradiating the central portion of the dental prosthesis with visible light in an active wavelength range of a photopolymerization initiator contained in the photopolymerizable bonding agent at a third intensity for a second hour.

[0015] According to another feature of the present invention, the third century is greater than the second century.

[0016] According to another feature of the present invention, the first intensity is 200 to 300 mW / cm 2 And the second century is 500mW / cm 2 , and the first time is 1 to 2.5 seconds.

[0017] According to another feature of the present invention, the third century is 600 to 1200 mW / cm 2 And the second time is 0.5 to 1.4 seconds.

[0018] According to another feature of the present invention, between the step of applying the bonding agent and the step of applying pressure to attach the dental prosthesis to the tooth to be treated, a step of placing dental floss between the tooth to be treated and the adjacent tooth is added, and between the first curing process and the second curing process, a dental floss process of removing the photopolymerizable bonding agent that has entered between the tooth to be treated and the adjacent tooth while pulling out the dental floss is further added.

[0019] According to another feature of the present invention, in the first curing process, a spot bonding having a diameter of 1 to 5 mm is formed in the central portion of the dental prosthesis.

[0020] According to another feature of the present invention, before the step of applying the photopolymerizable bonding agent, a step of preparing a plurality of photopolymerizable bonding agents having different shades and a plurality of test glycerins having the same shade as the photopolymerizable bonding agents is added, a shade test step of applying the test glycerin to a dental prosthesis and placing the dental prosthesis on a patient's tooth to be operated on, and visually confirming a shade in which the shade of the dental prosthesis is reflected by the shade of the test glycerin, and a step of determining the shade of the test glycerin used in the shade test step as the shade of the photopolymerizable bonding agent when the shade in which the shade of the dental prosthesis is reflected by the shade of the patient's natural tooth in the shade test step matches the shade of the patient's natural tooth are added.

[0021] The present invention, having the above-described configuration, prevents excessive polymerization shrinkage of the photopolymerizable bonding agent by curing the photopolymerizable bonding agent in multiple steps to attach the dental prosthesis. Accordingly, the problem of excessive polymerization shrinkage of conventional photopolymerizable bonding agents is resolved.

[0022] In particular, during the first curing process, the central part of the dental prosthesis is spot bonded to temporarily fix the dental prosthesis, and the excess bonding agent protruding from the dental prosthesis can be easily removed with dental floss, so the dental prosthesis is attached neatly. In addition, there is no problem of the proximal area between the teeth being stuck by the bonding agent. Therefore, a satisfactory dental prosthesis can be performed on the patient.

[0023] In addition, by simulating the final shade implemented after the procedure using test glycerin and determining the shade of the photopolymerizable bonding agent to be used when bonding the dental prosthesis, it is possible to easily create a shade that matches the natural teeth of the patient, thereby enabling a more satisfactory procedure.

[0024] Figure 1 is a cross-sectional view comparing the amount of tooth removal during the procedure of an ultra-thin dental prosthesis and a conventional dental prosthesis.

[0025] Figure 2 is a photograph of an ultra-thin dental prosthesis manufactured in a preferred embodiment of the present invention.

[0026] Figure 3 is a perspective view of the light curing device used in the above embodiment.

[0027] Hereinafter, the present invention will be described in detail.

[0028] In a preferred embodiment of the present invention, the present invention is applied to a case where an ultra-thin dental prosthesis is attached by minimally removing teeth, and the overall treatment system to which the present invention is applied is as follows.

[0029] (1) Ultra-thin dental prosthesis manufacturing stage

[0030] ① Scanning task

[0031] - Obtain information about the patient's oral cavity by scanning the patient's oral cavity in 3D with a scanner.

[0032] ② Tooth design work

[0033] - Design an oral model and ultra-thin dental prosthesis based on the patient's oral information obtained through 3D scanning.

[0034] ③ Output oral model

[0035] - Print an oral model using a 3D printer.

[0036] ④ Primary milling of dental prosthesis

[0037] - The dental prosthesis is first processed by milling a bulk block to form an ultra-thin dental prosthesis using a CAD / CAM system.

[0038] ⑤ Secondary manual work on dental prosthesis

[0039] - The dental technician manually processes the primary processed dental prosthesis for the second time. Through manual processing, a thinner and more natural ultra-thin dental prosthesis is manufactured.

[0040] ⑥ Reproduction of gloss and texture

[0041] - The ultra-thin dental prosthesis that has undergone secondary processing is glazed (polished) to reproduce the gloss and texture similar to natural teeth. Figure 2 is an example photograph of an ultra-thin dental prosthesis manufactured in this manner.

[0042] (2) Photopolymerizable bonding agent application step

[0043] A photopolymerizable bonding agent is applied to the manufactured ultra-thin dental prosthesis. The photopolymerizable bonding agent used contains a methacrylate monomer and camphorquinone (CQ) as a photopolymerization initiator.

[0044] (3) Step of inserting dental floss on both sides of the patient's teeth to be treated

[0045] The patient's teeth to be treated are prepared in advance, and dental floss is inserted between the prepared teeth and the adjacent teeth.

[0046] (4) Dental prosthesis placement stage

[0047] A dental prosthesis to which a photopolymerizable bonding agent has been applied in the above step is placed on the patient's tooth to be treated, i.e., the prepared tooth, and the dental prosthesis is gently pressed against the tooth to be treated by hand to attach it.

[0048] In this way, the photopolymerizable bonding agent applied to the dental prosthesis protrudes out to the edge of the dental prosthesis.

[0049] (5) Step of removing the photopolymerizable bonding agent protruding from the outside of the dental prosthesis using a brush.

[0050] In the above step, the excess photopolymerizable bonding agent protruding from the outside of the dental prosthesis is removed using a brush.

[0051] (6) Photopolymerizable bonding agent curing step

[0052] The photopolymerizable bonding agent is cured using a photopolymerization device that irradiates visible light of the active wavelength range of camphorquinone, a photopolymerization initiator contained in the above photopolymerizable bonding agent. To prevent excessive polymerization shrinkage of the photopolymerizable bonding agent, the photopolymerizable bonding agent is cured, i.e., hardened, in several steps. Fig. 3 is a perspective view of the photopolymerization device used in this embodiment.

[0053] Specifically, it is divided into a first curing process in which light is gradually increased from the first intensity to the second intensity for one hour to the central part of the dental prosthesis; a flossing process in which light is used to remove the photopolymerizable bonding agent that has entered between the dental prosthesis and the adjacent teeth; a second curing process in which light is used at a third intensity that is higher than the second intensity for two hours; an additional flossing process in which light is used to remove the photopolymerizable bonding agent that has protruded to the edge of the dental prosthesis during the second curing process; and a third curing process in which light is used at a fourth intensity to completely harden the photopolymerizable bonding agent. A more detailed look at each process is as follows.

[0054] ① 1st curing process (spot and soft curing process)

[0055] In this process, light (visible light) is gradually increased from the first intensity to the second intensity for the first hour, and light is irradiated only to the central part of the dental prosthesis. Since light is irradiated only to the central part of the dental prosthesis in this process, the photopolymerizable bonding agent at the edge of the dental prosthesis is not cured, and only the photopolymerizable bonding agent at the central part of the dental prosthesis is cured, so that only the central part of the dental prosthesis is temporarily fixed by being spot-bonded to the patient's teeth. Preferably, as shown in Fig. 3, a light guide tip (12) having a diameter of 1 to 3 mm is connected to a light curing device (10) and light is irradiated so that only the central part of the dental prosthesis is effectively spot-bonded.

[0056] Preferably, the first century in this process is 200-300 mW / cm 2 and the second century is 500 mW / cm 2 Adjust the intensity to irradiate the light for 1 to 2.5 seconds. That is, the light intensity is 200 W / cm over 1 to 2.5 seconds. 2 at 500mW / cm 2 Gradually increase the light intensity to 300 W / cm over 1 to 2.5 seconds. 2 at 500mW / cm 2 The light is irradiated while gradually increasing the intensity. In this process, 200~500mW / cm 2 Because the light is irradiated with relatively low light intensity, the photopolymerizable bonding agent is softly cured.

[0057] If the photopolymerizable bonding agent for attaching a dental prosthesis is cured all at once, excessive polymerization shrinkage of the photopolymerizable bonding agent is induced, and this excessive shrinkage force causes the dental prosthesis to spread apart at the edge of the teeth, causing food to get caught in between or bleeding to occur, which not only causes tooth discoloration, but in some cases, the dental prosthesis to become misaligned or fall off.

[0058] In contrast, in this process, since only the central portion of the dental prosthesis is spanbonded with light of relatively low light intensity, excessive polymerization shrinkage of the photocurable bonding agent is prevented, and therefore, there is no concern that problems due to excessive polymerization shrinkage of the bonding agent as described above will occur.

[0059] Meanwhile, if spot bonding is performed over an excessively narrow area of ​​the dental prosthesis during this process, the dental prosthesis may not be properly fixed, which may cause the dental prosthesis to flow or fall off during the bonding agent preparation process described later. In addition, if spot bonding is performed over an excessively wide area, there is a concern that the bonding agent may not be properly prepared during the bonding agent preparation process described later. Preferably, the results of testing the spot bonding area according to the light irradiation time during this process are as shown in Table 1.

[0060] 0.5 seconds 1 second 1.5 seconds 2 seconds 2.5 seconds 3 seconds Almost no polymerization 1 mm 2 mm 3 mm 5 mm 7 mm

[0061] * Light intensity: 300~500mW / cm 2 * Light guide tip diameter: 3mm

[0062] According to the experiment, considering the stable temporary fixation of the dental prosthesis and the effective removal of the bonding agent using dental floss, it is desirable that the diameter of the spot bonding be formed as 1 to 5 mm, and it is particularly desirable that the diameter of the spot bonding be 3 mm. Therefore, most preferably, in this process, a light guide tip with a diameter of 3 mm is connected to the light curing machine and the light intensity is 300 W / cm for 2 seconds. 2 at 500mW / cm 2 By gradually increasing the temperature, spot bonding with a diameter of 3 mm is formed.

[0063] Meanwhile, preferably, a first curing mode in which the light intensity and time are controlled is set so that the first curing process is performed in the light curing device, and a second curing mode and a third curing mode in which the light intensity and time are controlled so that the second and third curing processes are performed are also set. When the modes in which each curing process is performed are set in the light curing device in this way, each curing process can be easily performed regardless of the skill level of the operator, thereby reducing dependence on the skill level of the operator.

[0064] ② Flossing process

[0065] As mentioned above, during the dental prosthesis placement step, the light-curable bonding agent that has protruded outside the dental prosthesis is removed with a brush, but it is difficult to remove the light-curable bonding agent that has entered between the tooth to be operated on and the adjacent tooth (contact) using a brush. Therefore, in this process, the light-curable bonding agent that has entered between the tooth to be operated on and the adjacent tooth (contact) is removed while pulling out the dental floss inserted between the teeth to prevent the contact from being blocked. On the other hand, if the dental floss is inserted from the outside of the tooth toward the gum to remove the bonding agent, the dental floss may be over-inserted, which may damage the patient's gums. Therefore, it is preferable to insert the dental floss in advance and then remove the bonding agent while pulling the dental floss out of the tooth.

[0066] In the above first curing process, only the central part of the dental prosthesis is spot bonded, so the dental prosthesis is temporarily fixed, so the dental prosthesis does not move during this process and maintains its initial position. Therefore, not only does the position of the dental prosthesis not change, but the bonding agent that protrudes is not hardened, so it is easy to remove the bonding agent, and in particular, the bonding agent in the contact area is cleanly removed.

[0067] ③ Second curing process

[0068] In this course, the second intensity (500 mW / cm) for the second hour 2) is irradiated with light at a higher intensity than the third century, specifically 600-1200 mW / cm for 0.5-1.4 seconds. 2 Irradiate the entire dental prosthesis with light of a certain intensity to polymerize the photopolymerizable bonding agent to about half. Preferably, 1200 mW / cm for 1 second. 2 The light is examined with the light intensity of .

[0069] ④ Additional flossing process

[0070] During the secondary curing process, bonding agent may protrude from the edges of the dental prosthesis. Therefore, use dental floss to remove any excess bonding agent that has entered the contact area. Since the bonding agent is semi-polymerized, removal is possible. The floss is inserted between the tooth to be treated and the adjacent tooth, and is then moved back and forth to remove the excess. In some cases, as described above, it is also possible to pre-insert the floss between the tooth to be treated and the adjacent tooth, then pull the floss out from the tooth.

[0071] ⑤ 3rd curing process

[0072] In this process, the photopolymerizable bonding agent is completely photopolymerized and hardened by irradiating it with visible light at the fourth intensity, specifically 1000 to 2000 mW / cm 2 The dental prosthesis is finally cured by irradiating the entire dental prosthesis with light of the century. Preferably, 2000 mW / cm for 3 to 5 seconds. 2 It is investigated by century.

[0073]

[0074] The present invention, having the above-described configuration, prevents excessive polymerization shrinkage of the photopolymerizable bonding agent by dividing the curing into several steps. Therefore, problems such as gapping between the teeth and the dental prosthesis, tooth discoloration, and loss or misalignment of the dental prosthesis due to excessive polymerization shrinkage of the conventional photopolymerizable bonding agent do not occur, and reliable dental prosthesis treatment can be performed. In particular, in the first curing process, the central part of the dental prosthesis is temporarily fixed by spot bonding the dental prosthesis, and then flossing is performed to remove the bonding agent that has entered the contact between the tooth to be operated and the adjacent tooth. Therefore, the bonding agent that has protruded out of the dental prosthesis is cleanly removed, and the problem of the proximal part between the teeth being stuck by the bonding agent and blocking the contact does not occur.

[0075] Below, another embodiment of the present invention is described, but description of the same configuration and effect as the above-described embodiment is omitted.

[0076] In another embodiment of the present invention, a shade test and shade determination step is further added to determine the shade of the photopolymerizable bonding agent to be used during the procedure by testing the shade of the tooth using test glycerin before the photopolymerizable bonding agent application step.

[0077] For this purpose, test glycerin is prepared. Multiple test glycerins are prepared with the same shade as the photopolymerizable bonding agent. Test glycerin is glycerin mixed with pigment.

[0078] The prepared test glycerin is applied to the dental prosthesis, and the dental prosthesis is temporarily placed on the patient's teeth. Since the dental prosthesis is ultra-thin, the shade of the test glycerin is visible through the dental prosthesis, so the shade of the dental prosthesis is reflected in the shade of the test glycerin, resulting in the final shade.

[0079] In this way, the shade of the dental prosthesis is confirmed by reflecting the shade of the test glycerin, and if the confirmed shade matches the shade of the natural teeth of the subject, the shade of the test glycerin used is determined as the shade of the photopolymerizable bonding agent to be used when curing the dental prosthesis, which will be described later. Here, "if the confirmed shade matches the shade of the natural teeth of the subject" means that the shade confirmed through the test not only matches the shade of the natural teeth of the subject, but is also similar to the shade of the natural teeth of the subject, so that the treated teeth are in harmony with the natural teeth of the subject.

[0080] In particular, after the dental prosthesis procedure, the shade of the dental prosthesis is reflected in the shade of the test glycerin, so that a wider variety of shades can be produced than the shade types of the bulk block used to manufacture the dental prosthesis, and thus, it has the advantage of being able to produce a shade that matches the natural teeth of the patient more accurately.

[0081] Meanwhile, if the shade of the test glycerin reflected in the shade of the dental prosthesis does not match the natural teeth of the patient, the test glycerin is wiped off and a test is performed with a test glycerin of a different shade to determine the shade of the photopolymerizable bonding agent.

[0082] In this way, by simulating the final shade realized after the procedure using test glycerin and determining the shade of the photopolymerizable bonding agent to be used and proceeding with the procedure, it is possible to easily realize a shade that matches the natural teeth of the patient. In addition, since the shade of the photopolymerizable adhesive is reflected in the shade of the dental prosthesis to produce the final shade, as many shades can be produced as the shade types of the bulk block used to manufacture the dental prosthesis multiplied by the shade types of the photopolymerizable bonding agent. Therefore, it is possible to produce a shade that matches the shade of the patient's natural teeth more accurately, so it is possible to provide the patient with a more satisfactory procedure.

[0083] While specific aspects of the present invention have been described in detail above, it should be apparent to those skilled in the art that these specific descriptions are merely preferred embodiments and do not limit the scope of the present invention. Therefore, the substantial scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A method for bonding a dental prosthesis to a patient's prepared dental prosthesis, A step of applying a photopolymerizable bonding agent to the inner surface of a dental prosthesis; A step of placing a dental prosthesis on the tooth to be treated and attaching it to the tooth to be treated by applying pressure; A step of removing the photopolymerizable bonding agent protruding from the edge of the dental prosthesis using a brush; and It includes a curing step of hardening the photopolymerizable bonding agent by irradiating it with visible light, The above curing step is, A first curing process in which the central portion of the dental prosthesis is irradiated with visible light in the active wavelength range of the photopolymerization initiator contained in the photopolymerizable bonding agent for a first hour while gradually increasing the visible light from the first to the second intensity; and A bonding method for a dental prosthesis, characterized in that it includes a second curing process of irradiating the photopolymerization initiator contained in the photopolymerization bonding agent with visible light in the active wavelength range at a third intensity for a second hour.

2. In paragraph 1, A bonding method for a dental prosthesis, characterized in that the third century is greater than the second century.

3. In paragraph 1, The above first century is 200~300mW / cm 2 And the second century is 500mW / cm 2 A bonding method for a dental prosthesis, characterized in that the first time is 1 to 2.5 seconds.

4. In paragraph 3, The above 3rd century is 600~1200mW / cm 2 A bonding method for a dental prosthesis, characterized in that the second time is 0.5 to 1.4 seconds.

5. In paragraph 1, Between the step of applying the above bonding agent and the step of applying pressure to attach the dental prosthesis to the tooth to be treated, A step is added to place dental floss between the teeth to be treated and the adjacent teeth. A bonding method for a dental prosthesis, characterized in that a flossing process is further added between the first curing process and the second curing process to remove the photopolymerizable bonding agent that has entered between the dental floss and the adjacent tooth while pulling out the dental floss.

6. In paragraph 1, A bonding method for a dental prosthesis, characterized in that a spot bonding having a diameter of 1 to 5 mm is formed in the central portion of the dental prosthesis during the first curing process.

7. A method for determining the shade of a photopolymerizable bonding agent when performing dental prosthesis treatment. A step of preparing a plurality of photopolymerizable bonding agents having different shades and a plurality of test glycerins having the same shade as the photopolymerizable bonding agents; A shade test step in which the test glycerin is applied to the dental prosthesis and the dental prosthesis is placed on the patient's surgical tooth, and the shade of the test glycerin is reflected in the shade of the dental prosthesis and visually confirmed; and A method for determining the shade of a photopolymerizable bonding agent during dental prosthesis treatment, characterized in that it includes a step of determining the shade of the test glycerin used in the shade test step as the shade of the photopolymerizable bonding agent when the shade of the dental prosthesis reflected in the shade test step matches the shade of the natural teeth of the subject.

Images