COMPARATIVE CHARACTERISTICS OF THE QUALITY OF EDENTULOUS PROSTHETICS LOWER JAW WITH REMOVABLE LAMELLAR AND REMOVABLE DENTURES WITH SUPPORTED BY IMPLANTS. Текст научной статьи по специальности «Клиническая медицина»

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MEDICAL SCIENCES / «ШУШМУМ-ШУГМаУ» #10(133), 2022

УДК 616.31

Панахов Назим Адиль ог.,

Доктор медицинских наук, профессор A-зербайджанский медицинский университет, Кафедра ортопедической стоматологии, г.Баку,

Азербайджан Тагиев Азад Исмаил ог, Кандидат медицинских наук доцент A зербайджанский медицинский университет, Кафедра ортопедической стоматологии, г.Баку, Азербайджан

Алиева ЭльмираРамиз кызы Доктор философии в области медицины.Доцент A-зербайджанский медицинский университет, Кафедра ортопедической стоматологии, г.Баку,Азербайджан

Мехмани Ильхам Гасанага ог., Доктор философии в области медицины A-зербайджанский медицинский университет, Кафедра ортопедической стоматологии,ассистент

г.Баку.Азербайджан Бабаев Эльмар Эльман ог., Доктор философии в области медицины A-зербайджанский медицинский университет. Кафедра ортопедической стоматологии,асси-

стент. г. Баку Азербайджан Ашрафов Давуд Сергеевич

A-зербайджанский медицинский университет Кафедра ортопедической стоматологии,ассистент

г. Баку,Азербайджан DOI: 10.24412/2520-6990-2022-10133-12-15 СРАВНИТЕЛЬНАЯ ХАРАКТЕРИСТИКА КАЧЕСТВА ПРОТЕЗИРОВАНИЯ БЕЗЗУБОЙ НИЖНЕЙ ЧЕЛЮСТИ СЪЕМНЫМИ ПЛАСТИНЧАТЫМИ И СЪЕМНЫМИ ПРОТЕЗАМИ С

ОПОРОЙ НА ИМПЛАНТАТЫ.

Panahov Nazim Adil,

Azerbaijan Medical University,Department of Orthopedic Dentistry

Baku,Azerbaijan Doctor of Medical Scinces,professor Tagiyev Azad Ismail, Candidate of Medical Sciences, Associate Professor Azerbaijan Medical University,Department of Orthopedic Dentistry

Baku, Azerbaijan Aliyeva Elmira Ramiz, Doctor of Philosophy in Medicine, Associate Professor Azerbaijan Medical University,Department of Orthopedic Dentistry

Baku, Azerbaijan Mehmani Ilham Gasanaga, Azerbaijan Medical University,Department of Orthopedic Dentistry

Baku, Azerbaijan Doctor of Philosophy in Medicine, assistant Babayev Elmar Elman,

Azerbaijan Medical University, Department of Orthopedic Dentistry,

Baku,Azerbaijan Doctor of Philosophy in Medicine, assistant Ashrafov Davud Sergeevich Azerbaijan Medical University, Department of Orthopedic Dentistry

Baku, Azerbaijan assistant

COMPARATIVE CHARACTERISTICS OF THE QUALITY OF EDENTULOUS PROSTHETICS LOWER JAW WITH REMOVABLE LAMELLAR AND REMOVABLE DENTURES WITH

SUPPORTED BY IMPLANTS.

Abstract.

The article presents the results of the survey in the long term prosthetics in 80 patients aged 55 to 73 years with a complete absence teeth on the lower jaw, of which 52 were made "classic" complete removable dentures, and 28 - removable dentures based on intraosseous implants with installed bol-abutments. Revealed significant superiority of implant-supported prosthetics in terms of indicators ofquality of life, fixation ofprostheses, as well

as functional efficiency. However, when using implants a large degree of atrophy of the alveolar part was registered in distal mandible. The results obtained point to the need for further research, in particular by examining stress- train states, in order to develop an algorithm determination of indications for various types ofprosthetics in patients with complete absence of teeth in the lower jaw.

Аннотация.

В статье представлены результаты обследования в отдаленные сроки протезирования 80 больных в возрасте от 55 до 73 лет с полным отсутствием зубов на нижней челюсти, из которых 52 были изготовлены «классические» полные съемные протезы, а 28 - съемные протезы с опорой на внутрикостные имплантаты с установленными бол-абатментами. Выявлено значительное превосходство протезирования с опорой на имплантаты по показателям качества жизни, фиксации протезов, а также функциональной эффективности. Вместе с тем, при использовании имплантатов зарегистрировано большая степень атрофии альвеолярной части в дистальных отделах нижней челюсти . Полученные результаты указывают на необходимость дальнейших исследований, в частности путем изучения напряженно-деформированных состояний, с целью разработки алгоритма определения показаний к различного вида протезированию больных с полным отсутствием зубов на нижней челюсти.

Keywords: complete edentulous mandible, the level of quality of life, the effectiveness of treatment.

Ключевые слова: полная адентия нижней челюсти, уровень качества жизни, эффективность лечения.

The complete absence of teeth dominates in its destructive consequences for the dentoalveolar system among all dental diseases. One of the pressing problems of modern dentistry is the restoration of functional and aesthetic parameters dentoalveolar system with complete loss of teeth. Still the most common treatment for complete edentulous mandible it remains to manufacture complete removable lamellar dentures. Naturally, that most patients are not satisfied with the quality of such treatment and the use of adhesives and other mechanical methods of fixation does not increase "quality of life[1]. Every year the number of requests to orthopedic dentistry clinics for patients in need of high-quality fixation of removable dentures. It has a huge impact on the quality of life and social adaptation of a person. In the modern world more and more attention is paid to a healthy lifestyle and healthy appearance plays an important role. Loss of teeth not only leads to functional changes, changes in appearance, but also violates psychological status of a person. At the same time, the restoration of the dentition ineffective dentures leads to deterioration psychological status, low self-esteem.

The complete absence of teeth has a significant upward trend prevalence among the population and needs to be improved methods of prosthetics.[2]

The purpose of the work. Conduct a comparative clinical and functional study of the effectiveness of orthopedic treatment of patients with complete the absence of teeth in the lower jaw, which enjoyed complete removable dentures and removable dentures supported by implants. Complete loss of teeth has a significant impact on physiological and social parameters of human life, so this problem requires the closest attention. The relevance of the topic presented research is based on the significant prevalence of complete absence of teeth among the population, as well as its growth associated with pronounced demographic shift towards an increase in the number of old people. As practice has shown, the effectiveness of a complete removable prosthetics remain inadequate. According to WHO (2018) 20-26% patients do not use fabricated complete remov-

able dentures according to various reasons, but most often due to unsatisfactory fixation, especially on the lower jaw. The most progressive solution to the problem of prosthetics for patients with missing teeth is the use of implants. The best performance is noted pros-thetics with removable dentures supported by implants, in particular to improve their fixation on edentulous jaws [3]. However, main obstacle to the continuous use of intraosseous implants in the complete absence of teeth is widely common among the elderly, a distinct atrophy of the alveolar process and reduced bone mineral density caused by involutive processes in the body [4]. It is especially difficult to repeat prosthetics, accompanied by atrophy of the alveolar process and mechanical compression of the mucosa of the prosthetic bed, which is produced rigid bases of prostheses [5]. In this regard, in our opinion, a certain of scientific interest is the study of the nature of atrophic changes in the alveolar part of the edentulous lower jaw, occurring during the use of the traditional design of a removable prosthesis and a removable prosthesis with fixation on implants [6]. Comparative clinical and functional study of the effectiveness of orthopedic treatment of patients with complete absence of teeth in the lower jaw, who used complete dentures and removable dentures with supported by implants.

Materials and research methods. As part of the presented work a survey of 80 patients with a complete absence of teeth on the lower jaws, of which 58 (72.5%) were made "classic" complete removable dentures, while the rest22 (27.5%) have removable dentures with resting on intraosseous implants located in the projection of the canines, with the installation of bolts. Observations were carried out over a long period of time. prosthetics, which averaged 2-3 years. Among the surveyed slightly dominated by women (63.75%). The age of the patients ranged from 55 up to 73 years old. For an objective analysis of the results of prosthetics, we firstly, the quality of fixation of removable dentures was assessed [7], in-secondly, indicators of chewing efficiency were determined according to the method Ru-binov [8.9]. To determine the area of inflammation zones, the method of visual examination was used, the

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of the prosthetic bed. All these shortcomings did not prevent patients from using prostheses, although created some discomfort. This is clearly seen from Table 1.

average total area was calculated zones of inflammation of the mucosa of the prosthetic bed.

Results and its discussion. We have found complaints about certain difficulties when using prostheses. Mostly complaints reduced to poor fixation of prostheses, mobility during chewing and injury to the mucosa

Table 1

Comparative characteristics of the quality of the comfort of using prostheses in depending on the type of

Вид Протеза Comfort level

good satisfartory bad

Complete removable plate prosthesis man. 19 б (3i,57%) 10 (52,63%) 3 15.8%)

woman 33 8 (24.2%) 18 (54.54) 7 (21.26%)

Всего 52 i4 (2б.9%) 28 (53.8%) 10 (19,3%)

Removable with implant support man 10 7 (70%) 3 (30%) 0

woman 18 i0 (55.55%) 7 (38.88%) 1 (5.57%)

total 28 i7 (60.71%) 10 (35.71 1 (3.58%)

Table 2

Comparative characteristics of fixation of removable dentures in patients with complete absence of teeth _in the lower jaw, depending on the type prosthetics._

Вид Протеза Fixation

good satisfactory bad

Complete removable plate prosthesis man 19 0 11 (57.9%) 8 (42.1%)

woman 33 0 25 (75.7%) 8 (24.3%)

Всего 52 0 36 (69.24%) 16 (30.76%)

Removable with implant support man 10 7 (70%) 3 (30%0 0

woman 18 11 (61.1%) 7 (38.9%) 0

total 28 18 (64,28%) 10 (35.72%) 0

As a result of the survey, we see that the standard of living in patients who used complete removable dentures, corresponded to unsatisfactory in 19.3% of cases against 3.5% of patients who implant-supported removable dentures were fabricated.

It should be noted that the state of the mucous membrane of the prosthetic bed in patients with different types of removable structures are not significantly varied. At the same time, the prevalence of lesions of the prosthetic mucosa the bed varied depending on the type of prosthetics. In patients with with complete removable dentures, a generalized character prevailed inflammation, and in implant-supported prosthetics, inflammatory phenomena were more localized around the abutments. At study of the parameters of the residual bone tissue of the alveolar part lower edentulous jaws, an opposite picture was observed. So, when using the traditional design of a complete removable prosthesis a significantly lower degree of preservation was established on the lower jaw bone tissue in the frontal area compared with prosthetics on implants. The use of additional fixation of removable dentures on implants provide greater functional efficiency and greater patient satisfaction with results prosthetics, however, does not prevent the progression atrophy of the tissues of the prosthetic bed, even vice versa. Fixed large the degree of atrophy in the distal mandible when using implants leads to a significant deterioration in the anatomical topographic conditions of the prosthetic bed for repeated prosthetics. In our opinion, in this situation, we can assume the action plastic bases of a removable prosthesis on the distal parts of the lower jaws on the principle of the console. Thus, the hydrostatic pressure

in mucosa exceeds the critical values that cause the development bone atrophy. Hence the need for further studies to study the effect of dentures based on implants on the tissues of the prosthetic bed, in particular by evaluating stress-strain states using the finite elements, which will be the subject of our further research. On our In our opinion, the obtained results will allow us to develop an algorithm for determining indications of various types of prosthetics in patients with a complete absence teeth in the lower jaw.

References:

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2. Алимский А.В., Вусатый B.C., Прикулс В.Ф. Медико-социальные и организационные аспекты современной геронтостоматологии// Российский стоматологический журнал. -М.,-2004.- №2.- С.38-40.

3. Bayramov Y.i., Cafarov F.i.,Oliyeva R.Q. Suni protez konstruksiyalarinin orqanizmin fizioloji xususiyyatlarina tasiri. Azarbaycan Respublikasi Sahiyya Nazirliyi,V.Axundov adina Milli Elmi-Tadqiqat Tibbi Profilaktika institutunun elmi asarlari, I cild, Baki 2007. s.122-124

4. Борисова Е.Н., Минаков В.Д. Анализ факторов, способствующих полной утрате зубов у лиц пожилого возраста//Мат. конф. «Современные вопросы стоматологии». - Ижевск, 2000. - С. 278283.

5. Воронов А.П., Лебеденко И.Ю., Воронов И.А. Ортопедическое лечение больных с полным

отсутствием зубов - М.: МЕД-пресс-информ, 2009.c-334.

6. Джон Ф.Хобкек ,Роджер Ь.Уотсон,Ллойд Дж.Дж.Сизн.Руководство по дентальной импланто-логии.М.МЕДпресс-информ 2007.

7. Копейкин В.Н., Миргазизов М.З. Ортопедическая стоматология: Учебник - Изд. 2-е доп. - М.: Медицина, 2001. -624 с.

8. Полные съемные протезы с опорой на внутрикостных имплантатах / И. В. Малкарова, Н.

С. Каплан, С. М. Каплан, Х. Р. Тигранян // Здоровье и образование в ХХ1 веке. - 2016. - Т. 18, № 2. - С. 255-257

9. Lyndon F. Cooper DDS, PHD, Kuang-Han Chang, DDS, Ingeborg De Kok, DDS современное лечение вторичной полной адентии нижней челюсти. Панорама ортопедической стоматологии 2012 №3 с.18-25.

Носиров Шавкат Баходирович,

врач

Республиканской кожно-венерологической клинической больницы.

г. Ташкент,

Шертаев Мухаметамин Маметжанович

к.м.н. доцент медицинской биологии. Ташкентский Педиатрический Медицинский Институт. г. Ташкент.

СОВРЕМЕННЫЙ взгляд на проблему кожных проявлении аутоиммунных

ЗАБОЛЕВАНИЙ

Nosirov Shavkat Bakhodirovich,

doctor

Republican Dermatovenerological Clinical Hospital.

Tashkent,

Shertaev Mukhametamin Mametzhanovich

PhD Associate Professor of Medical Biology.

Tashkent Pediatric Medical Institute. Tashkent city.

MODERN VIEW ON THE PROBLEM OF SKIN MANIFESTATIONS OF AUTOIMMUNE DISEASES

Abstract.

The article includes data from the literature analysis on aspects of skin manifestations of autoimmune diseases, which are of great importance for physicians, especially for the skin of venereologists, and remains an open question.

Аннотация.

В статье включены данные литературного анализа по аспектам кожных проявлений аутоиммунных заболеваний, которые имеют важное значение у медиков особенно у кож венерологов и остается открытым вопросом.

Ключевые слова: иммунорегуляция, кожа, анализ, аспект, население.

Keywords: immunoregulation, skin, analysis, aspect, population.

Проблема аутоиммунных заболеваний до сих Системная красная волчанка является одной из

пор является актуальной несмотря на развитие ме- актуальных медико-социальных проблем. Отече-дицины. Развитие этих болезней связывают с де- ственными авторами отмечено, что в Российской фектами иммунорегуляции, утратой аутотолерант- Федерации, как и во всем мире, с середины 80-х го-ности и активацией ауто-реактивных Т- и В-лимфо- дов XX века наблюдается рост заболеваемости цитов, приводящими к возникновению СКВ. Статистические данные показали, что распро-воспалительной реакции в собственных тканях ор- страненность СКВ составляет от 48 до 250 случаев ганизма. Разрабатывается также теория генетиче- на 100 тыс. населения, а ежегодная первичная забо-ской предрасположенности к аутоиммунным бо- леваемость около 50-70 случаев на 1 млн. человек в лезням, обсуждается триггерная роль микроорга- год. При этом многие исследователи отмечают уве-низмов в развитии аутоиммунных процессов, личение заболеваемости у мужчин, изменение ха-высказывается мнение относительно важной роли рактера течения СКВ за счет хронизации процесса микрохимеризма в возникновении этой патологии. с уменьшением подострых и острых форм болезни.

Как отмечено многочисленными авторами ли- Поражение кожи при СКВ нередко имеет пер-

тературных источников, что перечень аутоиммун- востепенное диагностическое значение, несмотря ных заболеваний достаточно обширен. Классиче- на то, что кожные проявления очень разнообразны. ским примером является системная красная вол- Патогномоничным кожным проявлением болезни чанка (СКВ).