CC BY
14«ШУШ(ШШиМ-Ши©Ма1> #2ЩШ)), 20222 / MEDICAL SCIENCES
7
MEDICAL SCIENCES
УДК 616.31
Huseynova £heshmz Bahadur
Doctor of Philosophy in Medicine, Assistent Azerbaijan Medical University,Department of Orthopedic Dentistry
Baku, Azerbaijan Abdulazimova Gulchin Nazim Azerbaijan Medical University, Department of Orthopedic Dentistry Assistent
Baku, Azerbaijan Ismayilova Hajer Irade Azerbaijan Medical University, Department of Orthopedic Dentistry Assistent
Baku, Azerbaijan DOI: 10.24412/2520-6990-2022-28151-7-9 OPTIMIZATION OF REPEATED REMOVABLE PROSTHETICS WITH CLASP AND PLATE
DENTURES.
Гусейнова Чешмя Вахадур кызы
Доктор философии по медицине,ассистент Кафедры ортопедической стоматологии Азербайджанский Медицинский Университет
Азербайджан Баку Абдулазимова Гюльчин Назим кызы ассистент Кафедры ортопедической стоматологии Азербайджанский Медицинский Университет
Азербайджан Баку Исмаилова Хаджар Ираде кызы ассистент Кафедры ортопедической стоматологии Азербайджанский Медицинский Университет
Азербайджан Баку
ОПТИМИЗАЦИЯ ПОВТОРНОГО СЪЕМНОГО ПРОТЕЗИРОВАНИЯ БЮГЕЛЬНЫМИ И
ПЛАСТИНОЧНЫМИ ПРОТЕЗАМИ.
Abstract
The article gives a description of the complications of repeated prosthetics of teeth with clasp and removable lamellar dentures. Most patients do not adhere to the recommended terms for using removable structures and apply for re-prosthetics only when the condition of the existing prostheses is critical, the aesthetics and chewing function are disturbed. With repeated prosthetics for three years of observation, the total number of complications, shortcomings and defects in repeated prosthetics was higher when using removable lamellar dentures compared with orthopedic treatment with clasp prostheses. Optimization of repeated removable prosthetics of teeth is associated with the use of clasp prostheses and the limitation of the widespread use ofplate prostheses.
Аннотация.
В статье дана характеристика осложнений повторного протезирования зубов бюгельными и съемными пластиночными протезами. Большая часть пациентов не придерживаются рекомендуемых сроков пользования съемными конструкциями и обращаются на повторное протезирование лишь тогда, когда состояние имеющихся протезов критично, нарушаются эстетика и функция жевания. При повторном протезировании за три года наблюдения общее число осложнений, недостатков и дефектов повторного протезирования было выше при использовании съемных пластиночных протезов по сравнению с ортопедическим лечением бюгельными протезами. Оптимизация повторного съемного протезирования зубов связана с применением бюгельных протезов и ограничением широкого применения пластиночных протезов.
Key words: repeated prosthetics of teeth, clasp dentures, removable plate dentures, efficiency.
Ключевые слова: повторное протезирование зубов, бюгельные протезы, съемные пластиночные протезы, эффективность.
Among the problems of orthopedic dentistry, an important place is occupied by the features and terms
of repeated prosthetics of patients with dentures [1]. After the completion of orthopedic treatment, patients who are satisfied with the immediate results do not visit
8
MEDICAL SCIENCES / <«g©yL©(MUM~J©U©MaL» #281111), 2022
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, 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. . Any structures in the oral cavity (fillings, crowns, inlays, prostheses, and others) experience a huge load during chewing, which is accompanied by significant temperature changes (for example, cold ice cream and hot tea). Over time, this leads to wear and tear and the need for re-treatment. Any removable design needs to be replaced after 3-5 years of wearing. This is due to atrophy of the jaw bone tissue on which the prosthesis rests: it begins to fall out of the mouth or rub the gums. The plastic teeth on these dentures are also subject to wear and loss of chewing effectiveness over time.[7.8]
Clasp prosthetics meets the increased aesthetic and functional requirements, and is increasingly included in the practice of orthopedic dentistry [2, 6]. Meanwhile, in the literature for repeated prosthetics, there is no comparative analysis of the use of clasp prostheses with removable lamellar dental structures.
Table 1
Distribution of patients by groups of defects in the dentition (classification of adentia according to Ken-
All of the above indicates the relevance of studying the effectiveness of repeated prosthetics with clasp and plate prostheses. The purpose of the work is to give defects of repeated prosthetics with clasp and removable lamellar dentures.
Materials and methods
A total of 95 patients with adentia were examined and received repeated orthopedic treatment. Depending on the organization of repeated removable prosthetics, two groups of patients were identified. In the 1st group of patients (n=31), clasp dentures with clasps were used, and in the 2nd group (n=64), removable plate dentures were used. The criteria for inclusion of patients in the study were: partial adentia, age less than 75 years, the period between primary and repeated pros-thetics of 3 years or more, indications for removable prosthetics, ... is the need to repair or replace the orthopedic dentoalveolar structure.
In the 1st group, 31 people were selected, of which 14 (45.16%) male patients, 17 (54.84%) female patients. In the 2nd group, 64 patients were under observation. Of these, women - 33 (51.56%), men - 31 (48.44%). With previous prosthetics in groups 1 and 2, the duration of using prostheses in most cases ranged from 5 to 7 years (60% and 61.2%, respectively). In patients of clinical groups, the encountered Kennedy classes of adentia are presented in Table 1.
Dentition defect Group 1(n = 31) Group 2(n = 64)
№ % № %
Distally not limited on both sides (end defect) 5 16,13 2 3,13
Distally not limited on one side (end defect) 2 6,45 13 20,31
Absence of anterior and posterior teeth (included defect) 4 12,9 2 3,13
Combination of defects of different classes 20 64,52 47 73,43
More often than other observations in two groups there was a combination of defects of different classes.
Research results
In the 1st group for three years of observation, the total number of complications was 8 (25.8%). In group 2, complications of repeated orthopedic treatment developed in 57 (89%) patients. The disadvantages of repeated prosthetics in the 1st group occurred in 7 (22.58%) cases, and in the 2nd group - in 44 (68.75%) cases. Defects in repeated prosthetics were noted in group 1 in 5 (16.1%) patients, and in group 2 - in 49 (76.56%) patients. The number of complications, shortcomings and defects of repeated prosthetics was higher when using removable laminar prostheses compared with orthopedic treatment with clasp prostheses.
In the 1st group, with repeated prosthetics with clasp prostheses, complications of orthopedic treatment in most cases occurred in the abutment teeth, and the reason for this was ineffective fixation of the prostheses with clasps. A fracture of the abutment teeth was noted in one patient, which was 3.22%, the mobility of the abutment teeth was also 3.22% in one patient. The incidence of decementation of abutment crowns and inlays was 6.45% (in two patients). Violations of clasp
fixation in four patients were 12.9% of cases. Complications with clasp prosthetics occurred more often with terminal and combined defects.
More often than others, the cause of defects in repeated prosthetics in the 2nd group when using removable lamellar dentures was inflammatory changes in the tissues of the prosthetic bed (pressure sores, marginal gingivitis, toxic stomatitis) due to poor preparation before prosthetics of the oral cavity. Errors in determining the central ratio of the jaws amounted to cases. Incorrect determination of the interalveolar height, accompanied by maceration of the corners of the mouth and angular cheilitis. Unsatisfactory installation of artificial teeth with their deviation from the center of the alveolar process, and this was the reason for complaints about diction, aesthetic problems, and difficulties in the act of chewing. A similar percentage was the overload of the supporting apparatus of the teeth. The analysis of defects indicated the following errors in the design: non-overlapping of blind holes by the distal edge of the denture, shortening of the boundaries of the bases of dentures, poor fixation of complete removable dentures, incorrect choice of denture design, poor quality of finishing and polishing of dentures, incorrect location of clasps.
«COyyOMUM-JMTMaL» #2®mâ, 2022 / MEDICAL SCIENCES
9
Comparative analysis of the frequency of clinical complications in the 1st and 2nd groups is summarized in Table 2.
In the 2nd group, compared with the 1st group, the pathology of the abutment teeth was significantly more common (46.3% vs. 0.04). Many complications occurred during prosthetics with lamellar prostheses and were not observed with clasp prostheses: breakage of prostheses, inflammatory changes in the periodontium, chewing and speech dysfunctions. Thus, with plate prostheses, breakage is a frequent problem, the second most important problem is insufficient fixation of the prosthesis. With clasp prostheses, the main problem is the pathology of the teeth under the clasp. With lamellar prostheses, timely relining is needed; long-term exposure of clasps to the teeth should not be allowed. In the course of the study, an assessment was made of how much the relative risk increased when using lamellar prostheses compared with clasp prostheses during repeated prosthetics.
Conclusions
Thus, a comparative study of the results of repeated orthopedic treatment of patients with adentia testified to the advantage of clasp prostheses over lamellar ones in terms of the number of complications, shortcomings and defects, and terms of use. With repeated prosthetics, clasp prostheses show a high degree of reliability and fewer complications compared to plate prostheses.
Optimization of repeated removable prosthetics of teeth is associated with the use of clasp prostheses and with the limitation of the widespread use of plate pros-theses.
Table 2
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. Gazhva S. I., Sobir R. K. Oshibki pri proteziro-vanii s ispol'zovaniem zamkovyh kreplenij bjugel'nyh i mikroprotezov // Nizhegorodskij medicinskij zhurnal. - N. Novgorod, 2008. - № 2 (vypusk 2). - S. 145-146.
3. Zherebcov A. Ju., Kirilina M. R., Butova V. G. Individual'nyj srok sluzhby na zubnye protezy // Mater. mezhinstitut. nauch. konf. s mezhdunar. uchastiem, posvjashh. 65-let. okonchanija Vtoroj mirovoj vojny, 3 sentjabrja 2010 g. - M., 2010. - S. 80-83.
4. 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.
5. Maksjukov S. Ju. Puti povyshenija jeffek-tivnosti povtornogo protezirovanija zubov // Mezhdu-narodnyj zhurnal prikladnyh i fundamental'nyh issledo-vanij. - 2010. - № 9. - S. 119.
6.Semenjuk V.M., Vagner V.D., Ongoev P.A. Stomatologija ortopedicheskaja v voprosah i otvetah. M., 2000. 180 s.
7. Owal V., Kaiser A. E., Carlsson G. B. Prostho-dontics: principles and management strategies. - London: Mosby-Wife, 2006. - 467 p.
8. Shetty M. S., Shenoy K. K. Techniques for evaluating the fit of removable and fixed prosthesis // ISRN dentistry. - 2011. - Vol. 11. - P. 348-372
Comparative analysis of the frequency of clinical complications in the 1st and 2nd groups
Group of clinical complications Group 1(n = 35) Group 2(n = 67) p
Abs % Abs %
Pathology of supporting teeth (fracture, mobility, removal, removal of crowns) 4 11.4 31 46.3 0.006
Adverse structural remodeling of jaw bone 2 5.7 10 14.9 0.08
Denture breakage 0 0 6 9
Breakdown of clasps 3 8.6 5 7.5 0.94
Violation of the fixation of prostheses, of which clamp fixation errors 3 3 vq vq 8. 8. 18 6 26.9 9 0.04 0.85
Defects in artificial teeth 0 0 7 10.4 0
Inflammatory changes in the periodontium 0 0 16 23.9 0
Allergy 0 0 8 11.9 0
Violation of the function of chewing, speech, swallowing 0 0 18 26.9 0
