First, it is best to do – is to consult a doctor. If it is difficult to (the teeth tend to get sick is not the right time, such as late Friday night, for 2 hours before departure or 31 December at 18.00, which also talks about the benefits of a timely appeal to the dentist ) that:

A. Do not heat the affected area outside! Do not coddle a sore spot in scarves, shawls, do not apply, do not sleep on the patient’s cheek, as per night extra pillow you build any good third party. For the case when a student in a dormitory sleeping on his haunches, leaning against a radiator steam heat, you need to tell jokes in the section, and the consequences – in the horror section. Your humble servant, worked in those days, maxillofacial surgeon, and this is one of the strongest impressions at the time – Essays Online!

Two. Despite the absolute certainty, paragraph 1, point 2 sounds paradoxical, but that is no less true. Warm the affected area in every way from the inside! Hot rinse very useful in exacerbations of practically any dental disease. Moreover, almost indifferent, than you will rinse your teeth, it is important! First of all, rinse should be hot. No, the second-degree burns us to nothing, hospitals, and so has no place. But barely warm the affected area with warm, too little water is useless. Next, rinse should be frequent, at least 5-10 times per day, and the more the better (well, too, within reason ). Rinse once or twice a day will help you as an elephant’s grain. You are tea, coffee and drink it often – is not rinse. In addition, many perceive as a gargle loud gurgling in her throat over the sink or tub under the shy frightened relatives for spitting and spraying the contents all over the bathroom. In fact, we do not treat throat and teeth, and do not need to wet his throat, and hot baths to arrange a tooth. Therefore suggest a nice (as far as dental treatment can be fun) alternative. Take a jar in one hand, in another bowl, sit in front of the TV favorite, we collect the cheek and pyalimsya in the telly. When you feel the cool down, spat into a bowl, took up a new batch, and so on until the complete destruction of the banks or pain . A couple of hours again. I feel that many of the perceived wrong mention of “bank”, “score on the cheek,” etc. It is with deep regret compelled to disappoint you! Rinsing with alcohol, brandy and other strong drinks to the hot rinse is not refer! Those many may argue that they help, what I would say that it helps much always, and from all, especially when nothing hurts. Some even rinse the urine (urinotherapy called) and they say that helps. I do not know, as in other diseases, and from the teeth just does not work. Is what you wrote boiling water. But inflammation of the urogenital system to place themselves at risk to native oral microbes also cousins ​​of the other cavities. A rinse can be any type of herbal chamomile, sage, and oak bark. Even the usual tea and coffee are also suitable (especially at work where a daisy pick especially once ). You can also use a weak solution of potassium permanganate, or baking soda. About soda conversation at all special, because disinfects it better, but frequent use can burn the mucous membranes of the most nowhere, and in periodontitis, which in varying degrees, affected 99% of the residents of St. Petersburg, soda is harmful at all! Therefore, baking soda rinse can be infrequent and not a strong solution, and the best grass!

Three. Now for some help the body. If the inflammation is strong, then do some rinsing difficult. We’ll have to take anything. No, again I’m not about nice. Take necessary pills. The least dangerous – is sulfadimetoksin. It is not an antibiotic and, therefore, has fewer side effects. Sulfadimetoksin take on a very complicated method. On the first day loading dose – 2 tablets in the morning and two in the evening. And then on the 1st morning and evening. Before the complete disappearance of the pack, which is 4 days only. The next product – Biseptol. It says that you will take 1-3 tablets 2 times a day. Written to believe! Fans also newfangled antibiotics suggest you carefully read the instructions in Russian. Under the new legislation, any remedy must be Russian instruction. If not, then you buy something or not, or is there somewhere. I would like to add that all this should be taken after meals. And if you start to drink antibiotics, the rate should be brought to the end! Throwing to take them on the second day after a light relief, you contribute to the development of antibiotic-resistant strains in the body that affect later!

Cendres & Metaux SA, Switzerland are the pioneers in the manufacture of innovative attachments, and focused on the subject. Evaluation of broken attachments, we returned vtechenie the past few years has shown that the usual practice of immobilization device may not function properly. Despite the fact that in many clinical cases, both technically and visually apparent strength of the prosthesis, a detailed analysis showed that, although the immobilization device is based on the milled framework, it can not completely protect the attachment. Some cases have already predetermine failure during the planning stage, for example, insufficient space was available for the proper arrangement of immobilization devices. Other reasons include insufficient or inaccurate milling castings – despite the modern technology of casting, it remains a problem.

Bilateral end prostheses are considered particularly problematic in this respect, since shoulder immobilization cast as an integral part of the ignoble carcass. So fine milled surface can be spoiled by bad pripasovannym casting.

Immobilization device shall include the following features:

Figure 1 is located right on the immobilization device ekstrakoronkovom attachments.

In order to ensure that the attachment and the stabilizer will be a functioning unit, stabilizer (S) and attachment (G) must be connected by cast immobilization arm (U). Lingual side of the mostly distal crown must be milled along the direction of insertion. Cervical final line should be positioned slightly lower than the attachment in order to allow the immobilization device to direct the introduction of the prosthesis / attachment. In order to reproduce the original contours of the tooth as accurately as possible, premaxillary area should be tapered. The slot or button (M) facilitates the removal of the prosthesis to the patient. The stabilizer can vyfrezerovyvatsya, as necessary, or can be used by the finished device (Plasta, Interlock by A.Ceccato, CENDRES & METAUX SA). It must be installed on the opposite side of the attachment. When produced single crowns, 2/3 tubular section (H) of the stabilizer should be in the wall of the crown – if multiple crown or bridge is made multisection, she laid in the interdental space. The stabilizer prevents tilting the attachment and prevents it from twisting.

Due to the complex issues involved, initially eightieth Cendres & Metaux SA began to develop attachment, which would not require time-consuming and costly immobilization device. SG-Attachment was launched in the mid eighties.

Figure 2 SG-Attachment.

SG-Attachment was the first device in the world, containing a primary reference milling. Additional advantages of this design include a plastic insert that is easily activated by a screw, and its small size, enabling him to pripasovyvat even where space is limited. External immobilization device is duplicated and cast technician. Patent Cendres & Metaux SA protects the structural advantages of SG-Attachment. Since the SG-Attachment was very successful, Mini-SG-Attachment was developed and launched in early 1993 is the first attachment, and includes internal and external immobilization device. Its design is also patented.

Figure 3 Mini-SG-Attachment with integrated immobilization device.

Clinical experience acquired with the structural principle of the last 10 years vtechenie, has had a positive effect on the statistics for “our” complaints. Considering that the attachment is mounted correctly and is assessed annually by a dentist, broken Mini-SG-Attachment or patrichnyh parts SG-Attachment can virtually be excluded. The question of why this construction principle can withstand the normal loads that occur in the mouth, and why you can do without the stabilizing immobilization device becomes even more relevant.

At first glance, the aesthetics may seem an area which is not applicable to the diagnosis. Dental appearance is very subjective thing, and not so easily amenable to dissection on the basis of scientific criteria and diagnostic guidelines. Indeed, according to traditional views, you can accurately diagnose pathology and dysfunction. As for appearance, it is, by contrast, seems unstable category, largely dependent on personal tastes as a doctor and patient.
And yet, despite some subjective aesthetic object and the absence of unanimous opinions about what is “beautiful smile” Most dentists agree with the apparent agree that some smiles look better than others. But if so, then, apparently, you can talk about the existence of certain principles, adherence to which can provide tangible assistance to the dentist in diagnosis and planning the cosmetic treatment.

Contemporary and historical perspectives
The emergence of the basic ideas about the role of aesthetic factors in dentistry due to the development and manufacture of orthopedic full dentures. In 20 – 30 years, the theory that the size, shape, color and location of the front teeth can and should be conditional on specific characteristics of the individual, was launched by the leading manufacturers of orthopedic surgeons and supported by the teeth for dentures. Of course, patients with loss of teeth is a unique opportunity to create an aesthetically perfect dentition.
A new era of esthetic dentistry aimed at improving the appearance of a patient with natural teeth, and with toothless jaws sites through the use of full or partial dentures. With such technological innovations as composite and porcelain veneers (lining), dentists were able to change such parameters as color, size, shape and position of the tooth.

Principles of Design

Original starting point in the design of a smile are the central incisors of the upper jaw. In a beautiful smile central incisors should differ by individual size, position and shape of the tooth.
Standard sizes are determined by the central incisor so-called rule of “1 to 16.” The rule states that the ideal height of the central incisor is 1/16 of the distance from the center of an imaginary line drawn between the pupils, to the base of the chin, the perfect is the width of the central incisor is 1/16 of the distance between the center line of the face and malar projection. It should be borne in mind that these are rather relative, and in fact there is no valid, scientifically verified data, how often they occur in nature. And yet, quantified by this method ideal size of the central incisor, this figure can be taken as a starting point for the design of a smile. The simplest device for this is the “Key to the size of the tooth,” or Tool Size Indicator (Dentsply International).
After establishing the ideal size of the central incisors to determine their optimal position. In the calculation should take factors such as phonetics, smile line (number of teeth, which can be seen at a wide smile or lips at rest), as well as the position of the central incisor with the designation of the lower jaw forward.

Design elements of the age

As you know, over time the natural teeth in humans undergoing age-related changes, so the design of front teeth need to take account, among other factors, and age-appropriate.
So, smile at young people is characterized by a long central incisors, which are much longer than the adjacent lateral incisors with them. In the central incisors are often taught in an uneven cutting edge, and rounded inside and outside corners. The color of the teeth in a young person is always lighter than the later periods of his life.
With the aging of the human body and certain changes occur in the teeth. The two main signs of this process snashivaemost and abrasion, which are manifested in shortening of the central incisors. Over time, their length is the same (or nearly the same) as that of the lateral incisors and canines. With the shortening of the central incisors, while their width remains more or less constant, their shape changes from square to square. Wear dulls the edge of the incisive, erases imperfections and thus creates a more acute angles, the edges of crowns, tooth color darkens.

Design elements of the tooth in patients of different gender

Despite a long and ongoing discussion, to this day remains an open question whether there really distinctive “male” and “female” teeth, known in the art as “sexual dimorphism”. Pathologists tend to believe that “sexual dimorphism” in relation to the teeth do not exist. However, informal surveys conducted by dentists, dental technicians and ordinary mortals show that most people believe that certain features still distinguish male from female smile.
The determining factor in this respect is the lateral incisor. Lateral incisor in females is slightly narrowed from the gums, is rectangular-shaped with radiating down the sides, rounded cutting edge. The tooth itself, as a rule, considerably narrower than the central incisor. Male lateral incisor, as a rule, has pronounced features that distinguish it from the lateral incisor of the opposite sex. Usually, the tooth wider at the neck and is shaped like rectangles with a parallel lateral sides (even more square), and the cutting edge of the tooth with a flat. As soon as the width of the upper lateral incisors close in size to the width of the central incisors, all the teeth in a smile look more “masculine.”

Design elements of nature

Historically, that long, sharp fangs used cartoonists and directors of horror films as an attribute of aggressiveness, ferocity and cruelty. Worked out so firmly entrenched stereotypes in the mass consciousness, and the dentist has to take into account this circumstance. From a design standpoint, the shape of the maxillary canines is a reflection of the passive aggressive nature. Aggressive tusk is usually longer than the neighboring teeth, has a pronounced sharpening at the end, when considering the full face is flatter. The characteristic features typical of passive canine, directly opposite the aggressive properties. Typical for the passive canine is the same or even smaller length than the adjacent teeth. It is characterized by more convex and more obtuse, rounded cutting edge.
In cases where the restoration of teeth includes a so-called aesthetic zone (teeth that are visible when smiling), there are substantial advantages in the use of design elements for the formation of a specific individual patient smile. The complexity and scope of the design are determined by the dentist and are an important tool in

treatment planning and discussing it with the patient. After an appropriate history collection should make a drawing smiles and subsequently performs the same role as the blueprint for building a house. The design concept can be replicated in three projections in the form of a model with teeth made (often made of white wax) in accordance with the desired result. Approved as a dentist and the patient, such a model is further used as a template for the preparation of the teeth, temporary crowns and bridges, as well as help for the dental technician in the manufacture of permanent crowns and bridges.
The principles of smile design can be used when working with non-restored teeth before and during the correction of permanent fillings, crowns, bridges and veneers in aesthetic

area for personalization of each case. Minor corrections can be made on an already established fillings and crowns, “as needed” to meet the aesthetic needs of the patient.

Conclusion
Significantly increasing in recent years the requirements of patients to their dental appearance, are a challenge for dentists in their daily work, despite the fact that with regard to the principles of dental aesthetics in the equation of “art and science” are still on the “art”. Moreover, patient perception of beauty is very individual and subjective in nature. And yet, there are very definite aesthetic concepts used in the diagnosis and planning of dental treatment. Factors such as size and position of the central incisors, age, gender, and character of the patient, should be considered when planning the aesthetic treatment and applied to each patient individually.
The design elements described in this article, is not fully reflect all the possible theories and methods of formation of smile design. Moreover, no creation of the dentition (inside or outside the aesthetic zone) can not be considered complete if you do not take into account the factor of occlusion, ie, relationships with the opposite jaw teeth.
In the end, when it comes to beauty, you probably can not be absolutely right or wrong. Each dentist must determine for themselves the elements of design, which he considers most important, and apply them in planning and conducting treatment to the benefit of their patients.

Coloured teeth

The appearance of a tooth “is not that color” always causes the patient to turn to the dentist. Often, after examination of the patient is not waiting for bleaching. There are many causes of tooth discolouration, as well as colors, that they acquire. Normally, the teeth are white, yellowish or bluish tint. Depends on the degree of tooth mineralization. It is believed that the teeth with a yellowish tinge more resistant to external factors. A characteristic feature of the “healthy” is the color shine. Healthy enamel is always shining.
In dentistry, there is impressive in its scope the classification of the causes of color change or discoloration of the teeth. However, it is difficult for the perception of patients, so let’s talk about the specific causes of color change.
Expressed whitish color may be due to the dense plaque, formed as a result of inadequate oral hygiene. Melovidnye spots on the enamel surface is usually a sign of initial caries. Also white spots, especially in children, may be a symptom of enamel hypoplasia. Melovidnye teeth can be a symptom of over-bleaching, prolonged use of baking soda for this purpose.
The appearance of pink color may be due to staining of plaque food dyes, as well as potassium permanganate (“potassium permanganate”) after rinsing. A more rare cause of a syndrome of “pink tooth” when the pulp is proliferation of connective tissue, blood vessels, which shine through the thinned dentin and enamel. Pink teeth may become due to traumatic hemorrhage in a growing tooth, as well as bleeding from the gums.
Teeth with a greenish tinge appear in the defeat of their specific surface fungi. Green staining may occur in contact with the tooth fillings of copper amalgam.
Prolonged use of water containing large quantities of iron salts may lead to the appearance of pronounced bluish tint of the teeth.
Yellow teeth can be caused by exposure to vapors of bromine and iodine, as well as the constant use of strong tea and coffee.
The dark brown rim appears frequently in smokers, especially in cases where oral hygiene is inadequate. Dark brown with black teeth until may appear in the professional contact with the metals (manganese, iron, nickel).
The gray color may be due to poisoning by heavy metals mercury and lead. The appearance of color in the gray color is often associated with devitalization of the tooth pulp removal in the treatment of pulpitis.
There are many reasons for discolored teeth. The severity of the causes of discoloration requires the intervention of a dentist. Identify the causes and conduct of bleach will help to eliminate unpleasant symptoms and prevent its occurrence in the future.

Choose the shape and color

Among other complaints, to which people turn to a dentist, a large proportion are those that are associated with various changes in the enamel surface and shape of the teeth, as well as their color.
The reasons for these changes are quite diverse. We will only say that there are two main groups of such losses: a) arising during the follicular anlage development, ie to teething, and b) arising after the eruption.
A modern and effective ways to treat such disorders of dental hard tissues is the use of so-called veneers.
Veneer – thin enough plate – plate, which is usually made of porcelain or composite materials. The use of veneers can change the shape of the teeth. That is why they are so indispensable in situations where patients complain of gaps between the teeth, chipped enamel, and other abnormalities in the shape and structure of hard tissues of teeth.
From traditional metal crowns veneers favorably with that in the preparation of the teeth worn down to a much lesser extent and, basically, with the labial surface. This eliminates the need for depulpirovaniya teeth that sometimes you have to do with conventional metal-ceramic crowns.
In addition, veneers are a radical and effective method of treatment of the color of tooth enamel. Before the other bleaching agents, which include hydrogen peroxide, chloride and chlorine, veneers have a significant advantage: once by setting them, you do not have to worry about the color of teeth. This, in turn, will help save not only time but money.
But we should not forget that the veneers, as well as other treatment methods have their indications and contraindications for use, so the final decision in the choice of treatment rests with the physician.
As for the color of teeth, the reasons for the change is also very diverse. There is staining of the enamel surface and deep staining of hard tissues of teeth. Surface discoloration of the teeth occur when taking a meal containing much coloring matter, such as strong tea, coffee, a variety of intensely colored soft drinks, some fruit, red wine. In addition, the detrimental effect on the color of teeth, tobacco smoking. The dye penetrates into the grooves, pits, and mikrotreschinki enamel defects and causes of pigmentation and discoloration.
The deep (internal) staining of hard tissues of teeth can be caused by taking certain drugs, high content of fluoride in drinking water, some systemic diseases of the body cavities. In addition, some filling materials over time, changes in color, in this case is different and the color of teeth. Just darken tooth enamel with age.
Depending on the cause of the discoloration, the dentist may suggest one or another way to solve this problem.
Fortunately, modern methods of treatment used in dentistry, can quite effectively to eliminate these drawbacks.

Funds for the same anesthetic effect mainly on the central nervous system and cause inhibition of consciousness. But we can not endorse the use of anesthesia as a radical means of combating the psycho-emotional stress during dental procedures, to which there are a number of important reasons.
The most important – the medical risks of anesthesia, usually outweigh the risks of dental surgery. This is due to the fact that under the influence of drugs for general anesthesia, not only inhibited the reaction to pain, but also a variety of body functions: suppressed protective reflexes (cough, gag), changes the nature of the external and tissue respiration, heart activity, and so on. In addition, for quality of dental treatment is often needed to maintain the patient’s consciousness.
Conduct of anesthesia requires special equipment and trained professionals – physicians, anesthesiologists, that under current conditions increases the cost of dental treatment.
-Can there be complications with local anesthesia?
- Yes, and mostly because for many patients visit to the dentist is still stress. Postponement of the visit to the doctor temporarily relieves fear, but it worsens the condition of the tooth-jaw system and increases the pain, the duration and complexity of the subsequent treatment. “We all come from childhood,” so great importance to have a first experience of the child’s dentist or doctor’s ability to properly assess the health of the patient.
- Often come to accept patients suffering from allergies?
- Alas, the number of people suffering from allergies is growing. That is why dentists of all specialties need to be vigilant in the prevention and trained to treat allergic reactions.
Before treatment the dentist should meticulously examine and reveal the hidden history of predisposition to allergy, and if necessary – and get advice from an allergist, who must give an opinion on the portability of local anesthetics to specific patient.
Let us sum up our conversation, life goes on, and literally every month there are new drugs and tools like computer-syringe. Some of our clinics and offices began to move to the Western way of working “four hands”. But we still have much to be done to integrate new technologies with modern pain management organizational technology. Local anesthesia should be adapted to the specifics of surgical, therapeutic and prosthetic treatment of dental diseases.

During pouring a substance in the solid state (an alloy of attachment) is wetted by molten metal injection precious alloy. Mezhlitsevaya reaction (diffusion) fused elements of the two materials results in a metallic compound as sell gold.

In order to achieve good results pouring the following conditions and evidence must be taken into account:
Only attachments vysokoplavkie alloys, which are not oxidized during the preheating and casting, suitable for pouring, because the alloy can be wetted by the attachment only if the oxide layer is absent.
Attachment must be clean, when included in the modeling of wax. Dirt on the surface can affect the diffusion. Remains of wax must not be present on the functional parts of the attachment.
The temperature of the solid phase attachment should be considerably higher than the melting temperature of the cast alloy, so that the attachment does not become liquid during casting.
Slav attachment and cast alloy must approach each other. Unsuitable alloys can form a low mechanical strength of the phase or low-melting zone (eutektichnoy) interface attachment / cast alloy.
Information on suitable attachment and alloys for pouring can be found in the documentation of CM.
Pouring, in the sense of obtaining metal compounds can be successful only if the attachment is delivered from the preheating temperature injection cylinder to a temperature within the melting zone the cast alloy. This occurs during the casting process. In addition, the volume of molten metal in the attachment must be large enough to raise the temperature of the corresponding parts.
During pouring a thin shell of matrix, such as intrakoronkovymi attachments, vertical gates shall not be located in close proximity to the attachment, because the deformation of the matrix can be triggered by the high thermal radiation from the molten metal.
During the pre-heating or vtechenie casting process can form a gap between the two materials due to various extensions of the packing and alloy attachment. As a result, the molten alloy can zatech between compression and attachments, and form a thin film on the surface of the functional part of the attachment (Fig. 2).
Mechanical correction is hardly possible in such cases, because the precision engineering parts of the attachment certainly very much worse.

As a preventative measure, the thin groove can be scratched with a needle to wax circularly around the attachment. It will be a stop for the alloy at the boundary of the functional part.
Due to a different course of shrinkage of the cast alloy, alloy attachment and investment material mixtures during cooling can accumulate the voltage in the armature, or deformity may occur attachment. This is usually removed during a subsequent heat treatment, such as soldering or firing ceramics.
After pouring cylinder must be cooled to room temperature to prevent stress in the molded object.
Work with the cast-on attachments must be performed carefully, we can not allow the ceramic to come into contact with the alloy attachment (Fig. 3). Because of the different thermal expansion coefficients of the two materials can be triggered by the formation of cracks in ceramics.

In Fig. 1. Clinical crown height diagram 1. The height of the clinical
on a plaster copy of the prepared tooth crowns dental plaster copies

The next point was tapered. The slope of the side surfaces of prepared teeth to their long axis at 4 ° was found in a premolar. The taper of 5 ° was observed in 7 teeth: 2 incisors, 3 canines, 1st Prize-lyara, 1 molar. The taper of 6 ° was observed in 8 teeth: three incisors, one canine, one premolar, 1 molar. The taper of 7 ° was found in 14 teeth: an incisor, 2 canines, premolars, 7 and 4 molars.
Taper at 9 ° occurred in 38 teeth: a canine, premolars, 19, 18 molars. Obliquity of 11 ° was observed in 3 teeth: 2 incisors and one molar. Obliquity of 12 ° was observed in a canine, and taper to 14 ° in 28 teeth: two incisors, canines 3, 6 premolars and 17 molars. Obliquity of 16 ° was found in a molar and obliquity of 18 ° from one another molar (Figure 2, Figure 2).

In Fig. 2. The taper of the prepared Figure 2. Taper
tooth on a plaster model of prepared teeth

Thus, the study of the degree of taper of prepared teeth showed that, firstly, more than half of them (64), as shown in figure 2, are expressed slope side walls (9 and 14 degrees), and, secondly, expressed taper found on the teeth, related both to the front of the group (incisors and canines), and to the side (premolars and molars), indicating a significant deviation from the rules of a cone with dissection of these groups of teeth.
Another factor characterizing the quality of preparation of teeth under the Inter-tallokeramicheskie crown, was to form a ledge. The results of the study plaster copies of prepared teeth showed that the total number of shoulder in 90 ° was observed in 3 teeth, 2 premolars and 1 molar, shoulder at 135 ° occurred in 85 teeth: 7 incisors, canines 10, 30 premolars and 38 molars (Fig. 3). In 12 teeth ledge was absent entirely (Fig. 4): 3 incisors, 1 canine, 3 premolars and molars 5 (Figure 3).

In Fig. 3 ledge in 1350 Fig. 4. The tooth is dissected free of the ledge

Chart 3. Distribution of teeth, with a ledge of prepared and without

Thus, the total number of examined teeth overwhelming majority were dissected from the ledge. At the same time, the 12 teeth ledge completely absent, which should be regarded as a medical error that could cause violations of fixing the prosthesis, the marginal damage and the subsequent development of periodontal inflammation and its development in the caries process bad of fit artificial crown to the tooth hard tissues of the cervix .
In addition to the presence or absence of the ledge we were interested in and its width. Of the total number of teeth examined ledge width of 0.3 mm was found in a premolar and 0.4 mm – in a molar and 0.5 mm – in 60 teeth: 3 incisors, canines 5, 22 premolars and 30 molars, 0.7 mm – 4 teeth at 1 and 3 canine molars, 1 mm – in 18 teeth: two incisors, canines 3, 8 premolars and molars 5 and 1.5 mm – in 4 teeth: 2 incisors, 1 canine and premolar 1 (Figure . 5, 6, 7, Figure 4). Scarps formed along the entire perimeter of the necks of the teeth occurred in 87 teeth: 7 incisors, canines 10, 32 premolars, 38 molars. Second only to the lip and oral surfaces was about 1 molar.
It should be noted that we took into account the prevailing average width of the ledge at each tooth, and the majority of the teeth is varied around this average.

In Fig. 5. The average width of the ledge 0.5 mm Fig. 6. The average width of 1 mm ledge

In Fig. 7 The average width of 1.5 mm of the ledge. Chart 4. The results of measurements of the width
ledge of different groups of teeth

Thus, the results showed that the width of the ledge varies in different limits for different groups of teeth and a pattern corresponding to the accepted rules, we could not be found.
The next stage of the study was to investigate violations of preparation in the form of involuntary formation of undercuts on the lateral surface of the prepared teeth. Based on the total number of examined teeth, undercuts were found in 46 teeth, 4 incisors, 4 canines, 13 premolars and 25 molars (Fig. 8).
A 54 tooth undercut absent: the 6 incisors, canines 7, 22 premolars and 19 molars. Ratio of teeth with and without undercut them is shown in Figure 5.

In Fig. 8. Undercut in pridesnevoy Figure 5. ratio of teeth with
half of the lateral surface of the molars and without undercut
(Arrow)

Thus, evaluating the quality of the preparation of teeth for metal ceramic crowns, we can say that almost half of them discovered a serious flaw – the presence of undercuts, which significantly reduces the quality of artificial teeth for crowns. It should be noted that undercuts may be the direct cause of violations of fit artificial crown to the dental hard tissues with all the ensuing consequences.
One of the factors reflecting the quality of preparation of teeth for metal-ceramic crowns is their anatomical shape. In a study of this feature revealed that the total number of selected plaster copies of prepared teeth in anatomical shape was retained sufficiently in 92 teeth: 8 incisors, canines 8, 33 premolars and 43 molars, ie the vast majority. The absence of the anatomical shape of the tooth after preparation was observed in 8 teeth: 2 incisors, 3 canines, 2 premolars, 1 molar (Figure 6).

In Fig. 9. The relief of chewing Figure 6. The presence or absence of anatomical
surface of the molar tooth shape is stored after preparation
after dissection

Thus, the results showed that the requirement that the inherent anatomical teeth after preparation is performed in most cases. At the same time violation of this requirement in some cases takes place, indicating that low skills of individual physicians who perform this manipulation.
A more detailed assessment of the anatomical shape of prepared teeth showed that about three-quarters of them that have been submitted molars and premolars, ie a group of posterior teeth (79) had the following features in the formation of the occlusal surface. Expressed relief at the chewing surface dissection was created only 22 teeth, 15 premolars and molars 7 (Fig. 9).
In 57 teeth (20 premolars and 37 molars) showed no pronounced relief of occlusal surface (Figure 10, Figure 7).

In Fig. 10. Lack of relief Chart 7. state the relief of chewing
chewing surfaces of posterior surface
molars after preparation

Findings

Thus, the study of pre-selected 100 plaster copies of the prepared teeth showed that in the process of conducting this clinical manipulation of individual errors were made that significantly affect the quality of natural teeth under artificial crowns. Thus, the study of the degree of taper of prepared teeth showed that, firstly, more than half of them (64) have a pronounced slope of the side walls (9 and 14 degrees) and, secondly, the severe taper found on the teeth, related both to the front panel (incisors and canines), and to the side (premolars and molars), which does not comply with generally accepted rules for creating tapered dissection of these groups of teeth.
In the study of the quality of preparation of teeth with a ledge we took into account the prevailing average width of the ledge at each tooth, and the majority of the teeth is varied around this average. It was established that the teeth completely absent from the ledge. The teeth with a ledge width of its varied range of different groups on different teeth, and some patterns corresponding to the generally accepted rules, we could not be found.
Almost half of the prepared teeth discovered a serious flaw – the presence of undercuts, which significantly reduces not only the quality of artificial teeth for crowns, but the entire prosthesis. It should be noted that undercuts may be the direct cause of violations of fit artificial crown to the dental hard tissues with all the ensuing consequences.
Despite the observance of basic rules of playing the anatomical shape of the teeth, after preparation in about half of the defects identified training occlusal posterior teeth, which also has a significant influence on the chewing efficiency of future prosthetic devices, ie its decline.

Perhaps in the future will bring manufacturing technology items not requiring prior precise geometric description of the object being created, but so far it’s impossible.
The first dental design of future automated systems designs were the most time consuming step, requiring a doctor’s serious skills in drawing and geometry. It was necessary to manually enter the coordinates of all the key points at which changes the direction of the grinding unit. Some of the automatic systems still require pre-production prototype by hand the restoration of wax or plastic (so-called intermediate model), followed by its mechanical copying at a ratio of 1:1 (system CELAY, Mikrona Technologic, Sweden) buy essay online.
The development of computer-aided design for all manufacturers of dental CAD / CAM-systems have been designed to simplify and maximize the visual clarity of the process. Modern systems, having received from the scanner digitized information on the relief surface of prosthetic bed, starting to build its image on the screen. After that, a special software offers the doctor the most acceptable variant restoration of the tooth. Some of the modern computer programs can design artificial limbs that are not inferior in its parameters of experienced dental technicians. The degree of intervention required from the operator of CAD / CAM to design the restoration, can vary from minimal customization to a significant change in the structure. Even in the most automated systems, the user typically has the ability to change automatically according to a designed restoration of their preferences. Widely developed three-dimensional animated simulation of future construction. It greatly simplifies and accelerates the process of creating a virtual model of the prosthesis, making it more visible. Your doctor may consider on-screen design on all sides, at different magnifications and make amendments.

Making restoration

When modeling a future restoration is complete, the software converts CAD virtual model of a specific set of commands. They, in turn, passed on the production module CAM, which produces a designed restoration. They received instruction set is converted into a sequence of electrical impulses that control the precision movements make tools.
Early automated systems were made by cutting a tooth-restoration of the finished unit with rotating diamond or carbide burs and discs. This approach, in which the excess construction material removed to create a given shape the prosthesis, called “consuming method” (born subtractive). “Taking” production creates a complete form of a complex configuration is very accurate, but much of the material is wasted. Approximately 90% of the finished unit is removed for a typical dental restoration. As an alternative to “add” (born additive) methods of production are beginning to find application in automated systems. Sometimes referred to as methods of manufacturing a solid-free molding (born solid free-form fabrication). For the first time such techniques have been used in microelectronics for rapid prototyping of parts.
Selective laser sintering – one of the technologies that are used for the manufacture of ceramic or metal dental restorations. An example is the dental system Medifacturing (Bego Medical AG, Germany) and DigiDent (Hint-ELs, Germany). In this method, the computer calculates the trajectory of the tool, as in other existing CAD / CAM-systems. However, the system does not soshlifovyvaet, and the laser beam sinters layer of material moving along the predetermined path inside the tank, filled with layers ceramic or metal powders. Each subsequent layer is soldered to the previous. This technology allows us to produce complex-shaped structures without material loss.
Some CAD / CAM systems combine the “add” and “consuming” approaches. For example in the Procera (Nobel Biocare, Sweden) initially milled increased metal copy of the abutment of the stump (“consuming” method). This increase is calculated as the computer to compensate for shrinkage during sintering of the final restoration. Then the powder is compacted under pressure to stamp the metal matrix, creating an increased restoration (“add” method). After this block is milled out (again, “taking” method) to create the exact contours of the exterior restoration. In conclusion, the increased construction of metal removed from the die and sintered material in order to achieve final hardness and size.
Another option is a combination of “adds” and “consuming” approaches used in the Wol-Ceram (Germany). In the first step the cap “add” method. The essence of the process is the deposition of aluminum oxide crystals from the slurry to the surface of the stump by the electrophoretic dispersion. The operator manually cuts excess material protruding over the edge of the ledge. The outer surface is formed by grinding the restoration (“consuming” approach). The operator then removes the cap from the die-matrix impregnates it with glass and sintered.
An interesting example of “adding” technology – making models of prostheses using three-dimensional printing. CAM-device WaxPro printer (System Pro 50, Cynovad, Canada) acts as an inkjet printer, but instead of ink, he fires a tiny portion of melted wax. Thus, layer by layer and get a wax model of a skeleton or artificial crown. In the future, wax cast reproductions of prosthesis made of metal or pressed ceramic. An improved version of the print module of the system is able to create designs Cynovad not only of wax, but also from composite materials. This significantly extends the capabilities of the system and allows, for example, use it to produce maxillofacial prostheses.
The rapid development of dental computer-aided design and manufacture of prostheses has led to the emergence of a new segment in materials – materials for CAD / CAM-technology.
Scope of dental CAD / CAM-systems is not confined only to the manufacture of dental prostheses. For example, developed several CAD / CAM-systems for use in surgical practice. For example, the SurgiGuide (Materialise, Belgium) is used to make individual surgical templates to facilitate the correct positioning of dental implants during surgery. CAD / CAM-System Nobel Guide software (Nobel Biocare, Sweden) allows us to produce the restoration immediately after implant placement. Both systems use the data obtained by CT scan, a special software CAD, to determine the ideal placement of the restoration, and CAM technology to produce patterns or working models.

Technology-aided design and manufacture of dental prostheses

Theoretical foundations of computer-aided design and manufacture of various objects formed in the 60s and early 70s of the XX century.
To refer to computer-aided design throughout the world is abbreviated as CAD (from the English. Computer-Aided Design), and to refer to systems automation – CAM (from the English. Computer-Aided Manufacturing). Thus, CAD defines the area of ​​geometric modeling of various objects using computer technology. The term CAM, respectively, means the automation solutions of geometric problems in manufacturing technology. This is mainly calculated toolpath. Since these processes are complementary in the literature often found the term CAD / CAM. Integrated CAD / CAM-system – this is the most high-tech products, constantly developing and incorporating the latest knowledge in the field of modeling and processing of materials. Development costs are 400-2000 person-years.
The first theoretical study of the possible use of automated systems for the restoration of decayed teeth were held in 1973, Altschuler and Swinson in 1975, prototypes of dental CAD / CAM systems were first proposed in the mid-1980s, several independent groups of scientists. Anderson R. W. (System RroCERA, 1983), Duret F. and Termoz C. (1985), Moermann W. H. and Brandestini M. (A system of CEREC, 1985), Rekow (system DentiCAD, 1987) are considered the pioneers in this field. Today the world has produced about three dozen different hard-working dental CAD / CAM-systems.
From the beginning, technology was developed in two directions. First – Individual (mini) CAD / CAM-systems to make the restoration within one institution, sometimes even directly in the dental office and in the presence of the patient (CEREC 3, Sirona Dental Systems GmbH, Germany). The main advantage of such systems – efficiency of production of any design. For example, manufacturing a single-layer all-ceramic crown on tooth preparation and the start until after the final crowns using CEREC 3 system takes about 1-1.5 hours. However, to complete the work required the full range of equipment (expensive).
The second area of ​​CAD / CAM-technology – a centralized system. They include the presence of one high-tech manufacturing center, made to order a wide range of designs, and deleted the entire network from a peripheral workstations (eg, RroCERA, Nobel Biocare, Sweden). The centralization of the production process allows dentists to acquire manufacturing industry is not a module. The main disadvantage of such systems – inability to treat a patient during one visit, and costs for delivery of the finished design doctor because production center can sometimes even be in another country.
Despite this diversity, the basic principle of all modern dental CAD / CAM-systems has remained unchanged since the 1980s and involves the following steps:
1. Collecting data on the surface topography prosthetic bed with a special device and convert the received information into a digital format suitable for computer processing.
2. Build a virtual model of the future design of the prosthesis using a computer and with the wishes of the doctor (stage CAD).
3. Direct fabrication of the prosthesis on the basis of data obtained from the device with numerical control of construction materials (stage CAM).
Various dental CAD / CAM-systems differ only in the technological solutions used for these three stages.

Data collection

Systems CAD / CAM-significantly differ from each other in the collection phase. Reading the information about the surface topography and its translation into a digital format by optical or mechanical digital converters (digitizers). The term “optical impression” to describe the optical reading of information from the prosthetic bed was introduced by a French dentist Frank grow stupid (Francois Duret) in 1985 The main difference between the optical impression of the ordinary plane of the object of digital photography is that it is three-dimensional, ie . each point of the surface has a clear position in three mutually perpendicular planes. A device for obtaining an optical impression, as a rule, consists of a light source and photo sensor that converts light reflected from an object into a stream of electrical pulses. Last digitized, ie, encoded as a sequence of digits 0 and 1, and transmitted to the computer for processing. Most optical scanning systems exclusively sensitive to various factors. Thus, a small move the patient during data acquisition leads to a distortion of information and affects the quality of the restoration. In addition, the accuracy of the optical scanning method reflecting significantly affect material properties and the nature of the studied surface (smooth or rough it).
Mechanical scanning system reads information from the contact tip relief, which gradually moves across the surface according to the desired path. Touching the surface, the device is placed on a special map of the spatial coordinates of all points of contact and digitizes them. To ensure accuracy in the scanning process from beginning to end, the slightest deviation is unacceptable scanning the object relative to its original position.
Of the variety of available CAD / CAM-systems so far only two have the potential of the intraoral scanning precision. This system of CEREC 3 (Sirona Dental Systems GmbH, Germany) and the Evolution 4D (D4D Technologies, USA). All other CAD / CAM-systems are equipped with accurate mechanical or optical scanning devices, the size or characteristics of which do not allow the collection of elevation data directly into the mouth of the patient. For the operation of such systems requires the prior receipt of traditional prints impression materials and manufacture of plaster models.

Let’s look at what stage of life, what the priority areas of hygiene and dental disease prevention system.

Prevention of any disease should begin with the first days of life.

Do unborn child is not yet the reaction to light and sound, but there is a strong sucking reflex, which provides food supply for future development and growth of the jaws, face and entire body. Even in the most severe cases of malnutrition in a child’s cheek fat pads remain tight Bichat to sucking his cheeks sank not in the mouth. Breastfeeding a child pushes the jaw forward (in the newborn physiological position of the mandible at rest distal – posterior to the upper jaw), captures the nipple and the movement of the tongue to the throat in the mouth creates a vacuum that the milk came in her mouth. Unfortunately, for many reasons and so many children born after loading function – sucking – is not fulfilling its role as ordained by nature. This is a guaranteed way to the emergence of strains of bite and improper eruption of teeth.
The neonatal period – there is a massive colonization of oral cavity due to:
Dates parents;
licking, often the mother or nurse, fallen out of his mouth child dummies (instead of douse it with boiling water);
clover samples with a spoon before feeding children.

This is repeated every day for many months, and promotes continuous accumulation in the infant’s oral flora, introduced from outside, and, unfortunately, not always healthy. Such situations should be completely excluded, and only these preventive measures will help keep your mouth healthier child:
mouth baby after every meal should be cleaned with a soft terry cloth dampened with warm boiled water;
Use a rubber teething ring stimulates salivation, which in itself clears the oral mucosa and stimulates the eruption of deciduous teeth.
If a child is bottle-fed do not increase in the nipple “hole” does not pour into the baby food. Business directories nipple very carefully calculate the value of the hole (by the way, for water and milk – it is different with different nipples size hole) to a healthy baby could develop sufficient pressure to suction milk from a bottle, to spend the right amount of time (newborn eats 15 – 20 minutes) and do not overeat.

After the first eruption of primary teeth (6-8 months):
Parents themselves are beginning to clean teeth baby toothbrush designed for children up to 2 years (brush has a small atraumatic head, a very soft bristle tips of which shall be rounded and polished).
Use toothpaste during this period is not recommended because it can cause severe retching.
Before and after using the brush should be washed with warm boiled water, not boiling, as it soften synthetic fiber bristles and the brush will not fit.
During this period, children are not able to rinse and spit, so do not even try to give mouth rinse. Liquid or just pour out of his mouth, or a child choke her.

Children between 2-6 years accustomed to holding individual oral hygiene, but under strict regular monitoring by the parents until the age of 8.

Especially important to note that the content of fluoride toothpastes and ingredients in rinses for children, adolescents and adults should be used only in areas where reduced or no fluoride in drinking water. The use of fluoride as the active compound in regions with a high content of fluoride in drinking water can lead to dental fluorosis, and all the negative consequences associated with it.