Сучасні технології та конструкційні особливості адгезивних мостоподібних протезів

Abstract

У статті наведені сучасні погляди на ортопедичне лікування невеликих дефектів зубних рядів адгезивними мостоподібними протезами, представлені інноваційні технології їх виготовлення, матеріали, армуючі елементи, мінімально інвазивні підходи до препарування опорних зубів, підкреслені суттєві переваги, висока естетичність та функціональність таких протезів. Визначені також основні невирішені проблеми та окреслені перспективні шляхи оптимізації конструкції адгезивних мостоподібних протезів.

В статье приведены современные взгляды на ортопедическое лечение небольших дефектов зубных рядов адгезивными мостовидными протезами, представлены инновационные технологии их изготовления, материалы, армирующие элементы, минимально инвазивные подходы к препарированию опорных зубов, подчеркнуты существенные преимущества, высокая эстетичность и функциональность таких протезов. Определены также основные нерешенные проблемы и обозначены перспективные пути оптимизации конструкции адгезивных мостовидных протезов.

The paper presents the current views on the orthopedic treatment of small defects of dentition with resin bonded bridges. Dentition defects of small length in the frontal or lateral areas in patients of different ages are quite commonly observed. Currently, several methods for such defects replacing can be proposed. The concept of minimal invasiveness in treatment and prosthetics of hard dental tissues is intensively developing. The modern technologies and materials make it possible to provide teeth rehabilitation including restoration of their anatomical, functional and aesthetic characteristics, which is a convincing alternative to more complex and expensive orthopedic constructions. Resin bonded bridges (RBB) are highly aesthetic designs providing the most sparing treatment of abutment hard tissues, biomechanical restoration of the dentition function and have low production cost. Currently, there is no protocol for dental care of patients with small included dentition defects in case of RBB application. The world dental market presents a lot of reinforcing elements for RBB, which can be divided into metal and fiber according to material used. Fiberglass is considered to be the most promising group of reinforcing elements. The issues on determination of the optimal fiber element laying, their number, and the need for its application remain unsolved in RBB manufacturing by direct method. The results of RBB strength evaluation without reinforcement and with reinforcement of various elements in different variants were presented. Sparing treatment of the abutment teeth, in particular, minimal preparation degree is one of the RBB advantages. But no unified view on the optimal design of the retention elements for RBB fixation on the abutment teeth has been suggested. One of the approaches presented the inlay MOD for premolars and inlay MO for molars as the strongest retainers. Other variants for providing the increase in construction strength included additional retention cuts in the area of final fiber segments. The results obtained have determined that the resin bonded bridges with reinforced fiber elements can possess certain durability. Perhaps, the duration of their application without complications will change the attitude to RBB as the temporary structures. The systematization of data obtained and formation of investigation approach for the most effective RBB construction should be carried out to improve the quality of orthopedic treatment in case of dentition defects. The solution of mentioned problems will provide the further development of differentiated approaches and will suggest the optimal constructions for resin bonded bridges considering specific clinical case as well as application of certain reinforcing elements and restoration materials.