CC BY
18MEDICAL SCIENCES
СРАВНИТЕЛЬНАЯ ХАРАКТЕРИСТИКА ЧАСТИЧНЫХ СЪЕМНЫХ ПРОТЕЗОВ С КЛАММЕРНОЙ И ТЕЛЕСКОПИЧЕСКОЙ СИСТЕМОЙ ФИКСАЦИИ
Багиров А.А.
Доктор философии по медицине. Ассистент Кафедра Ортопедической стоматологии. Азербайджанский Медицинский Университет.
Баку, Азербайджан Гусейнова Ч.Б. Доктор философии по медицине. Ассистент Кафедра Ортопедической стоматологии. Азербайджанский Медицинский Университет.
Баку, Азербайджан Абдулазимова Г.Н. Кафедра Ортопедической стоматологии. Ассистент Азербайджанский Медицинский Университет
Баку, Азербайджан
COMPARATIVE CHARACTERISTICS OF PARTIAL REMOVABLE DENTURES WITH CLASP
AND TELESCOPIC FIXATION SYSTEMS
Bagirov A.,
Doctor of Philosophy in Medicine, I Azerbaijan Medical University, Department of Orthopedic Dentistry
Baku, Azerbaijan Huseynova Ch., Doctor of Philosophy in Medicine, I Azerbaijan Medical University, Department of Orthopedic Dentistry
Baku, Azerbaijan Abdulazimova G. Azerbaijan Medical University, Department of Orthopedic Dentistry I Baku, Azerbaijan DOI: 10.5281/zenodo.7275962
Аннотация
Результаты исследования показали, что при использовании кламмерной фиксации атрофические изменения в пародонте возникали в более ранние сроки и имели более тяжелую степень, чем при использовании конструкций протезов, перекрывающих корни зубов и фиксированные с помощью телескопических коронок. Покрывные конструкции съемных протезов с фиксацией на телескопических коронках являются более прогностически благоприятными для сохранения тканей пародонта, нежели кламмерная фиксация.
Abstract
The results of the study showed that when using clamp fixation, atrophic changes in the periodontium occurred earlier and were more severe than when using prosthesis structures that overlap the roots of the teeth and fixed with telescopic crowns. More prognostically favorable for the preservation of periodontal tissues than clasp fixation.
Ключевые слова: съемный протез, кламмерная фиксация, телескопические коронки.
Keywords: removable prosthesis, clasp fixation, telescopic crowns.
Of all removable dentures, the prosthesis on telescopic crowns is the most reliable. Telescopic prosthe-ses got this name due to the fact that the docking of the components of the structure has the principle of the structure of a telescope (one crown is fixed on the tooth, the other is put on the first one along with the prosthesis). Implants.[1,2]
The telescopic prosthesis has very Important advantages, over other removable prostheses, it is more aesthetic, compared to prostheses with a clasp fixation
system (it has no clasps), it can be repaired after the removal of the abutment tooth, without redoing the entire prosthesis [3]. The telescopic prosthesis is conditionally removable, that is, it has the advantages of both removable and non-removable prostheses, it can be used for periodontitis without fear that if teeth are lost, it must be redone, so it also performs a splinting function [4].
It is known that the absence of teeth causes a violation of chewing, speech function, disproportion of the
parameters of the facial skeleton, disrupts social adaptation, and changes the nature of nutrition [5].
The purpose of our study was to evaluate in a comparative aspect the long-term results of prosthetics in patients with partial loss of teeth with removable dentures with clasp fixation and with a telescopic fixation system.
Purpose of the study. 1 Evaluate the clinical efficacy of removable partial dentures with a telescopic fixation system. 2 Conduct a comparative analysis of partial removable dentures with a clasp and telescopic fixation system in the dynamics of 1-2 years. 3 To give practical recommendations for orthopedic treatment of patients with partial loss of teeth with different fixation systems. We examined and performed orthopedic treatment followed by dynamic observation of 54 patients of the main group and the comparison group (33 people) aged 38 to 75 years. The main group, in turn, was divided into two subgroups according to the number of teeth remaining in the oral cavity: subgroup I - patients with single teeth in the upper and lower jaws (39 people aged 51-75 years); Subgroup II - patients with more than 3-4 teeth in the oral cavity on the upper and lower jaws (15 people aged 38-50 years). The comparison group included patients previously prosthetic with partial removable dentures with a clasp fixation system (32 people aged 41-75 years). At the same time, 120 prosthetic units were made in total. The assessment of the clinical effectiveness of partial removable dentures with a telescopic fixation system was carried out at the macro level. This is the degree of fixation of prostheses, their stability during functional tests, determining the marginal fit to the mucosa of the alveolar process, the state of the gingival margin of the supporting caps under the base of the removable prosthesis and determining the decrease in the volume of tissues of the prosthetic bed under the base of partial removable dentures with a telescopic fixation system. Dynamics changes in the volume of tissues under the bases of removable dentures were studied in a known manner. With the help of removable dentures, casts were taken in the position of central occlusion under slight bite pressure, using corrective material. The size of the volume of the impression separated from the base of the prosthesis was equal to the degree of tissue atrophy under the base of the prosthesis. Silicone materials are durable, do not shrink for a long time, and therefore the measurements taken on them are accurate. Clinical studies were carried out before prosthetics, 1-2 years after orthopedic treatment. Observation of patients of subgroup I showed that the prostheses are in good condition: there are no chips, cracks. An assessment of the fixation of partial removable dentures in this subgroup showed that in patients with single teeth, the retention of the prosthesis after 1 year was maintained due to the tight fit of the artificial tooth scale and the inner surface of the prosthesis base.
In 6 patients after 2 years, there was a deterioration in the fixation of the prosthesis during the function or the functional tests we conducted. Intraoral micro-basing with fast-hardening plastic in the area of the support caps refined the fit boundary and restored the lost fixa-
tion. In the same subgroup, the assessment of the marginal fit of the prosthesis to the alveolar mucosa showed that the edge of partial dentures retains a tight fit after 1-2 years. This is explained by the fact that the manufacture of removable dentures has always been carried out through the fitting of individual spoons, regardless of the number of remaining teeth. Thus, the edge of the prosthesis was made individually with functional Herbst tests. When analyzing the state of the gingival margin of the supporting caps under the basis of a removable prosthesis, we did not find significant differences in the time of wearing prostheses. Retraction of the gums, its inflammation was not detected.
All patients in whom the edge of the cap did not sink more than 0.2 mm did not complain of a violation of chewing, speech function.
Analysis of the clinical efficacy of partial removable dentures of the II subgroup was carried out according to the same parameters. A year after the orthopedic treatment, the efficiency indicators were significantly higher than in subgroup I, which is explained by the large number of remaining teeth used as supporting and holding the prosthesis on prosthetic field. Aesthetics indicators in patients of subgroups I and II are almost the same and do not depend on the number of remaining teeth. A large dependence was determined by the position of the abutment teeth in the dental arch and the type of bite. The most favorable conditions for an aesthetic setting are a straight and orthognostic bite and upright, parallel abutment teeth. In subgroup II, four patients had spalling of the vestibular scales. This complication is explained by the lack of space for their placement due to the more vestibular inclination of the abutment teeth, which subsequently determined a relative contraindication for the appointment of telescopic caps. In the comparison group, in patients with partial removable dentures with a clasp system of subjective fixations, the indicators were identical, but one of the main indicators was missing - this is an aesthetic factor.
The clasp, located on the front te"th, 'specially on the upper jaw, when talking, smiling, determined the removable construction, which significantly influenced the mood of patients, their wishes to replace the clasp fixation system with more aesthetic ones. Currently, the number of patients who want to improve the cosmetic results of prosthetics with removable partial dentures is increasing, regardless of age and gender.
In addition to the degree of fixation of the prosthe-ses, the state of the gingival margin of the supporting caps and aesthetic assessment, we studied the dynamics of the decrease in the volume of tissues under the bases of the prostheses, depending on the fixation elements (telescopic crown or holding clasp) and the time of wearing prostheses.
The dynamics of changes in the volume of tissues of the prosthetic bed under partial removable dentures with different systems of fixation on the abutment teeth shows that the atrophic processes of the tissues of the prosthetic bed do not stop. We noted a decrease in the volume of tissues of the prosthetic bed under the bases of partial removable dentures with a clasp fixation system by 1.2-2 times compared with the group where fixation was carried out using a telescopic crown. This is
due to the fact that the telescopic system has a support-retaining function and the distribution of the masticatory load is carried out both on the periodontium of the abutment teeth and on the mucous membrane of the prosthetic bed, causing less atrophy of the prosthetic bed than the retaining clasp, which does not prevent vertical loads during function, which contributes to a greater immersion of the prosthesis on the prosthetic bed, causing atrophy of the alveolar process and underlying tissues.
Thus, the results of determining the degree of atrophy of the tissues of the prosthetic bed show that, regardless of the methods of fixation, progressive atrophy occurs in all patients, but with the use of a telescopic fixation system, atrophy slows down by 1.2-2 times compared with the group with a clasp fixation system. And again the principle of facilitating the restoration of partial dentures with a telescope comes into play, since traditional relining eliminates the inconsistency of the prosthesis with the tissues of the prosthetic bed, while maintaining the functional value of the prosthesis and, most importantly, aesthetics. Therefore, the proposed orthopedic treatment of patients with partial removable dentures with a telescopic fixation system, confirmed by the results of dynamic observation, allows us to recommend it for further widespread use in clinical practice.
References
1. Naumovich S.A., Parhamovich S.N., Pashuk An.P. Instrukcija Metody primenenija teleskopicheskih sistem s silikonovym kol'com i metallicheskim cilindricheskim sterzhnem dlja fiksacii s#emnyh zub-nyh protezov. MZ RB Minsk 2013.
2. Pashuk An.P. Sila, uderzhivajushhaja ko-nusovidnye koronki «Aktual'nye voprosy terapevtich-eskoj, ortopedicheskoj, hirurgicheskoj stomatologii, stomatologii detskogo vozrasta i ortodontii». Materialy 8- oj mezhd. Nauchno-praktich. konferencii po stoma-tologii-2009, -S.147
3. Pashuk An.P. Metod fiksacii teleskopicheskih koronok BGMU: 90 let v avangarde medicinskoj nauki i praktiki: sb.nauch.tr. / BGMU; redkol.: A.V. Sikorskij [i dr.]. - Minsk: GU RNMB, 2011. - T.2 - S. 129.
4. Pashuk An.P. Kratkaja sravnitel'naja harakteris-tika fiksirujushhih sistem pri chastichnom s#jomnom protezirovanii. Proizvodstvennoprakticheskoe izdanie «Innovacii v stomatologii» materialy 6 s#ezda stomatologov Belarusi (Minsk, 25-26.10.2012) / Otv. Za vypusk A.V. Glinnik. - Minsk: F-l 1 OAO «Krasnaja zvezda», 2012. - s.195-198.
5. Prakticheskaja gerontostomatologija i geriatrija / M.L. Zakson, G.D. Ovruckij, M.I. Pjaseckij, A.M. Solncev. Kiev: Zdorov'e, 1993.
ВКЛАД ОТЕЧЕСТВЕННЫХ ХИРУРГОВ В СТАНОВЛЕНИЕ И РАЗВИТИЕ ЧЕЛЮСТНО-
ЛИЦЕВОЙ ХИРУРГИИ В РОССИИ
Кравчук Е.В.
ассистент кафедры управления в здравоохранении Воронежского государственного медицинского университета им. Н.Н. Бурденко
Сарычева И.Н.
доцент кафедры управления в здравоохранении Воронежского государственного медицинского университета им. Н.Н. Бурденко
CONTRIBUTION OF DOMESTIC SURGEONS TO THE FORMATION AND DEVELOPMENT OF
MAXILLOFACIAL SURGERY IN RUSSIA
Kravchuk E.,
assistant of the department of management in healthcare Voronezh State Medical University named after N.N. Burdenko
Sarycheva I.
associate professor of the department of management in healthcare Voronezh State Medical University
named after N.N. Burdenko DOI: 10.5281/zenodo.7275964
Аннотация
В статье рассматривается влияние отечественной хирургии на становление и развитие челюстно-лицевой хирургии в России с начала XIX до середины ХХ веков. Освещены первые упоминания об официально опубликованных и зарегистрированных сведениях в печати, касающиеся каких-либо разделов челюстно-лицевой хирургии в России начала XIX века. В статье показан большой интерес отечественных хирургов к проблемам диагностики и лечения заболеваний лица и шеи уже с первого десятилетия XIX столетия. Отражены события Первой Мировой и гражданской войн, которые послужили значительным толчком к развитию челюстно-лицевой хирур гии в России. Показана активизация медицинской общественности, известных хирургов и дантистов-энтузиастов в организации челюстных госпиталей и подготовке специалистов по челюстно-лицевой хирургии.В статье рассматривается стремительное разви тие медицины и хирургии в частности после окончания гражданской войны, создание медицинских факультетов, хирургических кафедр и реформы стоматологического образования. Освещены многотомные руководства по общей хирургии с разделами посвященными хирургии лица, полости рта и
