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118_MEDICAL SCIENCES / «©©LLOauHUM-JOUPMaiL» #8(201), 2024
Mammadova Sevda Gasan, Doctor of Philosophy in Medicine Department of Orthopedic Dentistry Assistant Ashrafov Davud Sergey, Department of Orthopedic Dentistry Assistant Aliyev Tarlan Yagubaga Doctor of Philosophy in Medicine,assistant Department of Pediatric Dentistry Azerbaijan Medical University, BaKu,Azerbaijan DOI: 10.24412/2520-6990-2024-8201-18-19 HYGIENIC CONDITION OF THE ORAL CAVITY WITH TEMPORARY FIXED DENTURES
SUPPORTED BY IMPLANTS.
Abstract.
Increasingly, in modern dental practice, the use of temporary non-removable orthopedic structures is a necessary step, especially in multi-stage dental implantation. With their help, chewing function is restored, aesthetic defects are filled, and the gum profile is formed. Temporary structures prevent the occurrence of deformations of the dentition.
Keywords: implant-supported temporary dentures, hygienic condition of surrounding tissues and implant.
After successful osseointegration and properly planned functional load, one of the main factors of implant survival is the good hygienic condition of the oral cavity, and in particular of orthopedic structures supported by the implant [1-6, 10, 11].
The purpose of the study is to evaluate the hygienic state of temporary fixed milled dentures supported by isoelastic implants and the surrounding soft tissues.
Material and methods. For the manufacture of temporary fixed dentures, we chose milled materials, since these factory-pressed materials have practically no pores, and their service life is longer than that of non-milled analogues. The study involved 32 patients who were randomized into four groups of 8 people each according to the material from which temporary fixed dentures were made, supported by isoelastic implants and natural teeth. For patients of the 1st group, temporary dentures were made from the material Dentokeep PEEK (nt-trading), for patients of the 2nd group - from the material Temp Basic (Zirkonzahn), for patients of the 3rd group - from the Russian photopolymerizable milled material Nolatek, with subsequent polishing of the finished structure, and for patients of the 4th group - from the same Nolatek material, but the finished structure was first polished and then coated with a special varnish included in the material kit. To objectively assess the hygienic condition of implants and orthopedic structures, as well as the soft tissues surrounding the implant, we determined 5 hygienic indicators [7-9]: 1) Modified Plaque Index (MPI) - assessment of the hygienic condition of temporary fixed orthopedic structures; 2) Gingivalndex (GI) - assessment of the condition of the soft tissues surrounding the neck of the implant; 3) Calculating score (CS) - tartar index; 4) Probing Depth (PD) - depth of gingival attachment; 5) Clinical Attachment Level (CAL) - assessment of the depth of gum recession. The study was carried out in the following periods: 7 days after fixation of temporary fixed structures supported by isoelastic implants,
1, 3, 6 and 9 months. Immediately after fixation of temporary fixed structures, patients were trained in hygienic care of the oral cavity and structures on implants. At each visit, after the assessment of the hygienic condition, if necessary, repeated professional oral hygiene and training in oral care were carried out. To statistically process the obtained data, we calculated the Kol-mogorov-Smirnov, Wilcoxon and Student tests in the IBM SPSS Statistic Subscription program Results. The highest level of hygiene, according to the MPI index, was detected in group 3 (with Nolatek polished material) at the initial examination 1.23 ± 1.07, at the end of the study period 0.87 ± 1.15. The lowest level of hygiene was in group 4 (Nolatek material polished and varnished) (1.77±0.75). The values of the MPI index in the 1st and 2nd groups occupied an intermediate position, and in the 2nd group (Temp Basic material) the indicators were slightly better (1.31±0.67). By the end of the study, the lowest level of hygiene was in the 2nd (1.27±0.59) and 4th (1.25±0.65) groups of patients. A statistically significant improvement in the hygienic condition of temporary fixed dentures over the entire study period was revealed in group 4 (Nolatek material polished and varnished) (p(0.36±0.60). Statistically significant improvement in the hygienic condition of soft tissues according to the GI index over the entire study period was detected in group 4 (p0.05).Analysis of the depth of gingival attachment in the area of supporting isoelastic implants (crestal and basal) and abutment teeth was determined using the PD index In the area of all supporting elements (teeth, crestal and basal implants), no statistically significant differences were found between the PD index values obtained during a one-week period of use of fixed temporary structures and after 9 months of their operation for assessing the clinical condition of the studied structures, and no statistically significant differences were identified. differences in index values between groups (p>0.05). The depth of gum recession in the area of supporting elements (isoelastic implants of crestal and basal and abut-
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ment teeth) was assessed using the CAL index The observed changes in the CAL index during the 9-month survey are not statistically significant. The distances from the edge of the artificial crown to the most api-cally probed point in the area of the supporting elements in all examination groups can be considered stable. There were no statistically significant differences in the values of the CAL index in the area of all supporting elements (teeth, crestal and basal implants) obtained within 7 days from the start of using fixsd temporary structures and after 9 months of their operation (p>0.05); Statistically significant differences in the values of the CAL index were revealed between the studied groups of patients.
Conclusion.
Assessment of the hygienic condition of temporary milled dentures supported by isoelastic implants and the surrounding soft tissues using the MPI, GI, CS, PD, CAL indices indicates a satisfactory state of oral hygiene in the case of professional hygiene for periods of 6 days, 1, 3, 6 , 9 months and careful monitoring of the implementation of recommendations for individual hygiene. Patients with structures made from materials Temp Basic of the 2nd group and Nolatek polished and coated with lag of the 4th group require more thorough hygienic care with the mandatory inclusion of regular professional hygienic measures. It is recommended that the manufacturer of the Nolatek material improve the physical and chemical properties of the topcoat varnish.
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