{"id":1095,"date":"2023-11-17T02:54:48","date_gmt":"2023-11-17T01:54:48","guid":{"rendered":"https:\/\/drkittel.pl\/?p=1095"},"modified":"2023-11-20T12:47:36","modified_gmt":"2023-11-20T11:47:36","slug":"protetyka-cyfrowa-od-a-do-z","status":"publish","type":"post","link":"https:\/\/drkittel.pl\/en\/protetyka-cyfrowa-od-a-do-z\/","title":{"rendered":"Digital prosthetics from A to Z"},"content":{"rendered":"

Nowoczesna protetyka stomatologicznej jest dziedzin\u0105 zdigitalizowan\u0105. Protetyka cyfrowa oznacza zastosowanie technologii\u00a0 cyfrowych praktycznie na ka\u017cdym etapie leczenia protetycznego, pocz\u0105wszy od cyfrowych zdj\u0119\u0107 3D, umo\u017cliwiaj\u0105cych ocen\u0119 stanu z\u0119b\u00f3w i ich po\u0142o\u017cenia w ko\u015bci, przez cyfrow\u0105 analiz\u0119 okluzji, po projektowanie i drukowanie uzupe\u0142nie\u0144 protetycznych. Jednak cyfrowo nie zawsze oznacza bezb\u0142\u0119dnie.<\/strong><\/p>\n

Protetyka stomatologiczna to dzia\u0142 stomatologii, kt\u00f3ry zajmuje si\u0119 odtwarzaniem prawid\u0142owego zgryzu za pomoc\u0105 uzupe\u0142nie\u0144 sta\u0142ych: koron, lic\u00f3wek i most\u00f3w lub ruchomych \u2013 protez. Protetyk stomatologiczny pomaga r\u00f3wnie\u017c w sytuacjach, kiedy pacjenci chc\u0105 po prostu nada\u0107 swoim z\u0119bom bardziej estetyczny wygl\u0105d.<\/p>\n

Protetyka cyfrowa XXI wieku<\/h2>\n

Wsp\u00f3\u0142czesne leczenie protetyczne opiera si\u0119 na podej\u015bciu holistycznym. Oznacza to, \u017ce pod\u0142o\u017cem protetycznym, czyli punktem odniesienia w pracy protetyka, jest ca\u0142y uk\u0142ad stomatognatyczny pacjenta, a nie pojedynczy ubytek. Odtwarzaj\u0105c z\u0105b lekarz bierze wi\u0119c pod uwag\u0119 nie tylko stan i po\u0142o\u017cenie pozosta\u0142ych z\u0119b\u00f3w i to jak ze sob\u0105 kontaktuj\u0105, ale r\u00f3wnie\u017c morfologi\u0119 twarzy, tor oddechowy czy po\u0142o\u017cenie kr\u0119gos\u0142upa. Co wi\u0119cej, pod\u0142o\u017ce to musi by\u0107 odpowiednio przygotowane. Oznacza to wygojone dzi\u0105s\u0142a, wyleczone z pr\u00f3chnicy i stan\u00f3w zapalnych oraz oczyszczone z kamienia z\u0119by.
\nDrug\u0105 istotn\u0105 cech\u0105 nowoczesnej protetyki stomatologicznej jest jej digitalizacja. Techniki cyfrowe s\u0105 stosowane praktycznie na ka\u017cdym etapie leczenia protetycznego. Zaczynamy od cyfrowych zdj\u0119\u0107 3D, umo\u017cliwiaj\u0105cych ocen\u0119 stanu z\u0119b\u00f3w i ich po\u0142o\u017cenia w ko\u015bci. Nast\u0119pnie cyfrowo analizujemy okluzj\u0119, a na ko\u0144cu projektujemy i drukujemy uzupe\u0142nienia protetyczne. Nowoczesne gabinety stomatologiczne i laboratoria protetyczne pracuj\u0105 w pe\u0142ni zdigitalizowany spos\u00f3b. Jednak nie we wszystkim cyfryzacja wyr\u0119czy lekarza i technika dentystycznego, o czym napisz\u0119 w dalszej cz\u0119\u015bci tekstu.<\/p>\n

Digital prosthetics \u2013 from the analysis of occlusion to the placement of restorations in the patient's oral cavity<\/h2>\n

Najcz\u0119\u015bciej wykonywanymi uzupe\u0142nieniami protetycznymi s\u0105\u00a0 korony protetyczne.<\/a> S\u0105 one osadzane pojedynczo lub w formie most\u00f3w na naturalnych korzeniach z\u0119b\u00f3w b\u0105d\u017a implantach. W klinice Dr Kittel uzupe\u0142nieniem pierwszego wyboru s\u0105 pe\u0142nokonturowe korony cyfrowe wykonywane z tlenku cyrkonu, o kt\u00f3rych wi\u0119cej pisa\u0142am tutaj<\/a>. Dzi\u0119ki eliminacji nietransparentnego metalu z podbudowy stosowanej w koronach porcelanowych, ten rodzaj uzupe\u0142nienia gwarantuje estetyk\u0119 na najwy\u017cszym poziomie. Jako\u015b\u0107 koron protetycznych ma niebagatelne znaczenie dla sukcesu ca\u0142ego leczenia, bo to w\u0142a\u015bnie korony pe\u0142ni\u0105 niejako funkcj\u0119 ortezy dla staw\u00f3w skroniowo-\u017cuchwowych. Z\u0119by s\u0105 tu tylko podparciem. Na przyk\u0142adzie koron \u201efull contour\u201d om\u00f3wi\u0119 jak przebiega cyfrowe leczenie protetyczne.<\/p>\n

1. Digital prosthetic treatment planning<\/h3>\n

The first stage of a prosthodontist's work is to recognize the problem and make a diagnosis. Already at this stage, in addition to the clinical examination, the doctor has digital tools at his disposal, such as digital radiological examinations and an intraoral scanner. In most cases, the scanner replaces existing analog (plaster) impressions. The device uses a beam of light that transfers the image of hard and soft tissues from the patient's oral cavity to a computer language. The image obtained in this way can be enlarged and rotated. The undoubted advantage of digital scanning is its accuracy, which remains unchanged throughout the entire work process in the office and prosthetic laboratory. However, digital does not always mean error-free. It turns out that we cannot rely 100 percent on technology in all cases. In the case of large, full-arch works or complete edentulism (dentures), it is better to rely on traditional impressions, as the scanner may have difficulties in correctly registering all fragments of the mucous membrane.<\/p>\n

2. Digital smile visualization<\/h3>\n

Digital technology also allows us to pre-design the smile and visualize the patient's face after treatment, i.e. plan the aesthetics before the treatment begins. Virtual design takes into account both the patient's expectations and the existing occlusal conditions. Visualization of the final effect of treatment at this stage allows for its proper planning (including, for example, determining whether orthodontic treatment is justified).<\/p>\n

3. Digital occlusion analysis and design (CAD phase)<\/h3>\n

Oczekiwana estetyka z\u0119b\u00f3w zawsze musi i\u015b\u0107 w parze z prawid\u0142ow\u0105 funkcjonalno\u015bci\u0105. Wiedz\u0105c ju\u017c jaki efekt chcemy osi\u0105gn\u0105\u0107 i jakim sposobem, przyst\u0119pujemy do cyfrowej weryfikacji okluzji. Okluzja to inaczej kontakty pomi\u0119dzy g\u00f3rnymi i dolnymi z\u0119bami. Nieprawid\u0142owa okluzja (zwarcie z\u0119b\u00f3w) mo\u017ce skutkowa\u0107 b\u00f3lem, a nawet problemami z \u017cuciem pokarm\u00f3w i m\u00f3wieniem. Dlatego przy odbudowie protetycznej kluczowe jest jej w\u0142a\u015bciwe zaprojektowanie. Z pomoc\u0105 przychodzi tu specjalne oprogramowanie, do kt\u00f3rego trafiaj\u0105 pliki z wykonanymi wcze\u015bniej cyfrowo skanami wewn\u0105trzustnymi. Projektowanie obejmuje m.in. ustalenie k\u0105ta osadzenia przysz\u0142ych koron na z\u0119bach, kt\u00f3re b\u0119d\u0105 ich filarami i wyznaczenie zasi\u0119gu granic preparacji, czyli oszlifowania z\u0119b\u00f3w. Wykonany w ten spos\u00f3b projekt jest analizowany w wirtualnym artykulatorze. Dzia\u0142a on na podobnych zasadach do artykulator manualny. Symulacja odwzorowuje naturalne ruchy \u017cuchwy wzgl\u0119dem szcz\u0119ki, w tym ruchy boczne, doprzednie, tzw. prowadzenie k\u0142owe czy sieczne. Zwarcie mo\u017cna dowolnie podnie\u015b\u0107 lub obni\u017cy\u0107 dostosowuj\u0105c je do warunk\u00f3w anatomicznych pacjenta. Wszystko po to, by przysz\u0142e korony nie powodowa\u0142y dyskomfortu czy dysfunkcji w stawach skroniowo-\u017cuchwowych oraz nie wymaga\u0142y znacz\u0105cych korekt po ich wydrukowaniu.<\/p>\n

Based on the initial virtual design, the so-called mockup \u2013 an individual 3D design placed on the patient's teeth or \"virtually tried on\". Analog mock-up allows you to \"try on\" new teeth at a stage when it is still possible to make changes to the design. After the patient's acceptance, the doctor starts preparing the teeth for future crowns, and the laboratory starts working on the final restorations.<\/p>\n

4. Preparation of teeth for crowns<\/h3>\n

Preparation of teeth for crowns involves preparing them for permanent placement of prosthetic restorations. The teeth must be properly ground to provide support for the crowns. It includes the incisal edges, occlusal surface, proximal, labial, palatal and cervical surfaces. Modern digital technologies that we use when designing crowns mean that tooth grinding is reduced to a minimum. The preparation should be carried out in a way that ensures perfect marginal tightness and good adhesion of the crown.<\/p>\n

5. Crown milling (CAM phase)<\/h3>\n

In the prosthetic laboratory, the individual, digital design of the crowns goes to a milling machine that cuts the restorations from special ceramic blocks. Modern CAM technologies enable machine-made crowns with an appropriate texture, occlusal surface and excellent marginal tightness. After milling, the crowns are ready for characterization, which is done manually. Dental technicians work to ensure that the appearance of crowns is as close to natural as possible, imitating the natural dynamics of light by selecting appropriate paints and glazes. At this stage, artificial intelligence cannot replace human artistry.<\/p>\n

6. Cementation of crowns<\/h3>\n

Ready-made prosthetic crowns are sent from the laboratory to the office, where the prosthodontist cements (i.e. permanently embeds) them on pillars (prepared teeth) or on implants. The entire process ends with digital and analog occlusion verification, and necessary corrections are made if necessary.<\/p>\n

The use of digital techniques for analysis, design and production of prosthetic works allows for a radical shortening of the treatment process and makes it more predictable and precise. In the past, we somehow adapted our prosthetic work to occlusal conditions, but today we can influence these conditions. Teeth grinding, i.e. interference with their living structure, has been limited to a minimum. The precision of the design and printing of crowns affects the comfort and durability of their use. The technology uses an image that is understandable to the patient. Finally, technology standardizes processes and significantly reduces the risk of human errors, although, as I mentioned earlier, it can make mistakes itself, which is why the participation of a doctor and a dental technician is necessary in the entire process.<\/p>","protected":false},"excerpt":{"rendered":"

Nowoczesna protetyka stomatologicznej jest dziedzin\u0105 zdigitalizowan\u0105. Protetyka cyfrowa oznacza zastosowanie […]<\/p>\n","protected":false},"author":1,"featured_media":1096,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"ppma_author":[20],"class_list":["post-1095","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stomatologia"],"yoast_head":"\nProtetyka cyfrowa od A do Z - Digital Dentistry & Medicine<\/title>\n<meta name=\"description\" content=\"Protetyka cyfrowa to zastosowanie technologii cyfrowych w leczeniu protetycznym z\u0119b\u00f3w. 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