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MEDICAL SCIENCES / «ШУШМУМ-ШУГМак» #27»)), 2022
УДК 616.31
Arkhmammadov Asif Moyla
Doctor of Philosophy in Medicine, Associate Professor Arkhmammadova Gulshan Mubariz
Assistеnt
Department of Orthopedic Dentistry.Assistent Azerbaijan Medical University, Baku, Azerbaijan DOI: 10.24412/2520-6990-2022-27150-8-10 EVALUATION OF THE RESULTS OF THE TREATMENT OF MISSING TEETH WITH CLASP AND
LAMELLAR PROSTHESES
Архмамедов Асиф Мойла ог
Доктор философии по медицине,доцент Архмамедова Гюльшан Мубариз кызы
Ассистент
Кафедра Ортопедической Стоматологии Азербайджанский Медицинский Университет. г.Баку .Азербайджан
ОЦЕНКА РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ ОТСУТСТВИЯ ЗУБОВ БЮГЕЛЬНЫМИ И ПЛАСТИНЧАТЫМИ ПРОТЕЗАМИ
Abstract.
The conducted comparative analysis regarding the type of removable prostheses used in the case of partial absence of teeth indicates the greater reliability of clasp prostheses compared to laminar prostheses. However, the final conclusions regarding the reliability of each type of removable prosthesis can only be made taking into account the data on emerging defects and developing complications at different times of using these prostheses.
Аннотация.
Проведенный сравнительный анализ относительно вида используемых съемных протезов при частичном отсутствии зубов свидетельствует о большей надежности бюгельных протезов, по сравнению с пластиночными протезами. Однако окончательные выводы относительно надежности каждого вида съемного протеза могут быть сделаны лишь с учетом данных о возникающих дефектах и развивающихся осложнениях в различные сроки пользования данными протезами.
Key words: dentition defect, lamellar prosthesis, clasp prosthesis, prosthesis fixation, prosthesis breakage
Ключевые слова: дефект зубного ряда, пластиночный протез, бюгельный протез, фиксация протеза, поломка протеза
Among the problems of orthopedic dentistry, an important place is occupied by the features and terms of repeated prosthetics ofpatients with dentures [1]. After the completion of orthopedic treatment, patients who are satisfied with the immediate results do not visit the doctor for a long time. If there are no obvious signs of changes in the organs and tissues of the maxillofacial region or the dentures themselves, then this is quite satisfactory for patients [3]. Even in the case of wear of dentures, patients often continue to use imperfect dental structures[2], which leads to significant disturbances in the dentoalveolar system and makes further dental prosthetics more difficult [4,5]. When re-prosthetics in patients with adentia, dentists are faced with the need to choose the most appropriate method and means of treatment.
In order to study the results of orthopedic treatment of occlusal defects with removable dentures, the state of the orthopedic status of the oral cavity was assessed in 150 patients aged 20 to 60 years and older. In the examined patients, removable dentures were most used for combined defects of the dentition, with a single tooth on the jaw, as well as with end defects. Removable dentures were used least often with included occlu-sal defects. The largest number of lamellar prostheses
had a service life of 3 to 5 years. There was a significant prevalence of lamellar prostheses that need to be re-manufactured over clasp prostheses, with a service life of up to h years. At periods of more than 5 years, the number of clasp prostheses exceeds the number of plate ones. Comparing the reasons for the replacement of removable dentures with partial absence of teeth, it can be noted that complications associated with fractures of the supporting teeth occupy a leading position in clasp dentures, while in laminar dentures, prosthesis breakage and aesthetic disorders.
Purpose of the study
To study orthopedic indicators of the results of the treatment of missing teeth with removable dentures.
Material and research methods
For a structural assessment of the state of the orthopedic status of the oral cavity, a comprehensive examination of occlusal defects was carried out in 150 patients. All examined patients are divided into age groups (20-29, 30-39, 40-49, 50-59, 60 years and older).
The algorithm of dental examination consisted of taking an anamnesis, examining the constituent elements of the intensity of dental caries, examining the integrity of the dentition, conducting clinical, hygienic
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and radiological methods for examining the organs of the oral cavity. An in-depth assessment of the need for patients in various types of orthopedic dental care was carried out. The need of the surveyed persons for orthopedic dental care was assessed on the basis of the prevalence of the main dental diseases, expressed as a percentage.
Results and its discussion
The obtained materials allow us to note that in the examined patients, removable dentures were most used for combined defects of the dentition, with a single tooth on the jaw, as well as with end defects. Removable dentures were used least often with included defects in the dentition.
In the course of the examination of the orthopedic status, it turned out that among the examined there were 260 removable dentures that needed to be re-manufactured. Among these prostheses, the majority were laminar - 141 laminar prostheses with partial absence of teeth and 81 with complete absence of teeth. The number of clasp prostheses was 38. Among removable pros-theses that need to be replaced, plate prostheses predominate. There are almost many times more of them than clasp prostheses. Along with these types of removable dentures, patients needed to replace 189 plate dentures. Among the examined persons, various periods of use are noted for removable orthopedic structures. It should be noted that the proportion of prostheses with a service life of up to 3 years is 15.2%. The average period of using removable dentures was 5 years.
The terms of using removable lamellar dentures in the absence of teeth were as follows: up to a year -3.6%, from 1 to 3 years - 22.9%, from 3 to 5 years -40.5%, from 5 to 7 years - 13.4%, from 7 to 10 years -9.5%, over 10 years - 10.1%.
Comparing the terms of use of removable lamellar dentures and clasp dentures with partial absence of teeth, it can be noted that the largest number of clasp dentures had a service life of 3 to 5 years (37.4%), clasp dentures - from 5 to 7 years (34 ,four%). It can also be noted that there is a significant prevalence of lamellar prostheses that need to be re-manufactured over clasp prostheses, with a service life of up to 5 years. With terms of more than 5 years, the number of clasp pros-theses exceeds the number of plate ones. The average period of use of clasp prostheses is 6.5 years, lamellar prostheses with partial absence of teeth - 5 years, laminar prostheses with complete absence of teeth - 4 years.
Studying the results of treatment of partial absence of teeth with removable dentures in patients, we came to the conclusion that the reasons for the replacement of the mentioned prostheses were various complications and defects. In the course of the study, the possible reasons for replacing removable dentures were divided into the following groups: breakage of the prosthesis, fracture of the abutment teeth (this group includes all complications associated with the abutment teeth), aesthetic disorders (assessed according to patient complaints), the need to make additional prostheses, the occurrence of pain in the area of the prosthesis (this group includes all complications when the reason for replacing the prosthesis was pain, regardless of its
etiology), the subjective desire of the patient, poor fixation of the prosthesis (assessed according to patients' complaints and objectively). The most common of these reasons were prosthesis breakage (33.1%) and poor fixation of the prosthesis (27.9%). The third place is occupied by aesthetic disorders (12.9%).
Comparing the reasons for the replacement of clasp dentures and removable laminar dentures with partial absence of teeth, it can be noted that the leading position in clasp dentures is occupied by complications associated with abutment teeth - fracture of abutment teeth (60.6%), in lamellar dentures - breakage of the prosthesis (38.7%) and aesthetic disorders (13.6%). The proportion of cases of poor fixation of the prosthesis in plate prostheses is higher than in clasp prostheses (19.9% and 13.6%, respectively). Also, the patients themselves wanted to replace plate dentures more often than clasp ones (8.6% and 6.1%, respectively). These data show the advantage of clasp prostheses over lamellar ones in terms of the main types of complications and defects. However, final conclusions about the reliability of these prostheses can only be reached by considering the outcomes of their treatment, taking into account time aspects.
In the complete absence of teeth, the main reasons for the alteration of prostheses were poor fixation of the prosthesis (45.4%) and breakage of the prosthesis (29.4%). Aesthetic disorders accounted for 13.4%. In 8.8% of cases, the subjective desire of the patient was the reason for repeated prosthetics, and in 2.9% of cases - other reasons.
Studying the patterns of development of the outcomes of earlier treatment with removable prostheses, we found that, depending on the period of use of the prosthesis, the reasons for its replacement may be different. So, in clasp prostheses with a period of use of up to 3 years, the most common cause of re-manufacturing is the occurrence of pain in the area of the prosthesis. In subsequent years, among the reasons for re-manufacturing, the leading position is occupied by a fracture of the supporting teeth. The frequency of cases of poor fixation of clasp prostheses is distributed fairly evenly over the years. The most rare complication is the breakage of the prosthesis.
The analysis of the development of complications and defects during prosthetics with removable lamellar dentures in the case of partial absence of teeth shows that with a period of use from 7 to 10 years, the main reason for replacement is the breakage of the prosthesis (40.2%). With a period of use of 5 to 7 years, prosthesis breakdowns account for half of all cases of complications and defects (50.0%). For a period of use of more than 10 years, lamellar prostheses are most often redone due to poor fixation of the prosthesis (31.9%). Cases of fracture of supporting teeth, aesthetic disorders, the need to make additional prostheses with the expansion of prosthetics are quite rare (2.9%, 9.6% and 8.7%, respectively) and are evenly distributed over the years. The occurrence of pain in the area of the prosthesis, as a reason for repeated prosthetics, decreases in proportion to the time the prosthesis is used and most often occurs in the first three years (18.8%). According to the subjective desire, patients most often need to replace
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removable lamellar dentures with a service life of up to 3 years (16.7%) and more than 10 years (15.9%).
Regardless of the period of use of plate prostheses, the most common reasons for their re-manufacturing are prosthesis breakage (29.4%) and poor fixation (45.4). The shares of aesthetic disorders and the subjective desire of the patient (respectively 13.4% and 8.8%), as well as other reasons, are less significant and occur in all periods of use.
Conclusions.
Thus, the main reason for replacing lamellar dentures with partial absence of teeth is the breakdown of the prosthesis, and for clasp prostheses, a fracture of the supporting teeth. Lamellar dentures in the complete absence of teeth most often required replacement due to their poor fixation.
References
1. Alimskij A.V. Obespechenie ortope-dicheskoj stomatologicheskoj pomoshh'ju lic preklonnogo voz-rasta s polnym otsutstviem zubov // Stomatologija dlja vseh. M. 2001. № 1. S. 45-46.
2. Zholudev S.E., Oleshko V.P., Ban'kov V.I. Sposoby lechenija neperenosimosti s#emnyh zubnyh protezov // Panorama ortopedicheskoj stomatologii. M. 2003. № 3. S. 28.
3. Semenjuk V.M., Vagner V.D., Ongoev P.A. Stomatologija ortopedicheskaja v voprosah i otvetah. M., 2000. 180 s.
4. Shtorina A.A. Faktory, vlijajushhie na sroki funkcionirovanija polnyh s#emnyh protezov // Institut stomatologii. SPb. 2009. № 1. S. 52-53.
5. Norton M. R., Ferber G. The nonresilient hybrid removable prosthesis: treatment of choice for the atrophic maxilla // Int. j. periodontics restorative dent. - 2009. - Vol. 19. № 2. - P. 189-197.
Мадрахимова Дилафруз Мамматовна, Ахмедова Дилором Илхамовна
Ташкентский Педиатрический Медицинский Институт г. Ташкент.
К ВОПРОСУ ФИЗИЧЕСКОГО И НЕРВНО-ПСИХИЧЕСКОГО РАЗВИТИЯ ДЕТЕЙ С ВРОЖДЕННЫМИ ПОРОКАМИ СЕРДЦА ДО И ПОСЛЕ ХИРУРГИЧЕСКОЙ КОРРЕКЦИИ
Madrakhimova Dilafruz, Akhmedova Dilorom
Tashkent Pediatric Medical Institute, Tashkent.
TO THE QUESTION OF PHYSICAL AND NEURO-MENTAL DEVELOPMENT OF CHILDREN
WITH CONGENITAL HEART DEFECTS BEFORE AND AFTER SURGICAL CORRECTION
Аннотация:
В статье включены данные литературного анализа по аспектам физического и нервно-психического развития детей с врожденными пороками сердца до и после хирургической коррекции, которые имеют важное значение у медиков особенно у педиатров.
Abstract:
The article includes data from the literature analysis on aspects of the physical and neuropsychic development of children with congenital heart defects before and after surgical correction, which are important for physicians, especially pediatricians.
Ключевые слова: дети, популяция, сердце ,аспекты.
Key words: children, population, heart, aspects.
За последние десятилетие сердечно-сосудистая патология является одной из лидирующих в структуре заболеваемости, детей, а именно врождённые пороки сердца имеют свою значимость в этой структуре.
Врожденные пороки сердца (ВПС) представляют собой наиболее обширную- по численности и значимости нозологическую группу в связи с высокими цифрами выявляемое и смертности среди детской популяции.
Статистические данные показывают, что в настоящее время: на 1000 новорожденных рождается 5 детей с ВПС , которые требуют высококвалифицированного наблюдения педиатров и кардиологов, своевременной кардиохирургической коррекции и профессиональной реабилитации.
Врожденные пороки сердца (ВПС) являются важной проблемой педиатрии вследствие их высокой распространенности и необходимости ранней хирургической коррекции в связи с значительными нарушениями здоровья и ограничением жизнедеятельности у детей.
Как отмечают авторы литературных источников ,что значительный прогресс и возможности современной детской кардиохирургии позволяют радикально корригировать врожденные пороки сердца у детей в раннем возрасте, устраняя анатомический дефект и нормализуя гемодинамику, снижая вероятность неблагоприятных исходов и обосновывая необходимость совершенствования методов дальнейшей реабилитации.
Специалистами этой области отмечен тот факт, что сочетание врожденного порока сердца с
