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4ORTHOPEDIC TREATMENT WITH COMPLETE REMOVABLE DENTURES IN PATIENTS WITH ALLERGIC REACTIONS AND SOMATIC DISEASES
Panahov N.
Doctor of Medical Sciences. Professor Azerbaijan Medical University, Department of Orthopedic Dentistry
Baku, Azerbaijan Arkhmammadova G. Azerbaijan Medical University, Department of Orthopedic Dentistry, Assistant
Baku, Azerbaijan Mehmani V. Azerbaijan Medical University, Department of Orthopedic Dentistry Baku, Azerbaijan DOI: 10.5281/zenodo.7340801
Abstract
This article notes the need to improve the technology for obtaining impressions for the manufacture of complete dentures, establishing a scheme for interaction between an orthopedic dentist and doctors of other specialties, extending the time of operation of complete dentures due to the individual selection of material for prosthetics for patients.
Keywords: complete removable prosthesis, allergic reactions, features of obtaining impressions.
The problems that arise during the prosthetics of patients with removable dentures with complete loss of teeth have not yet been resolved. According to the WHO, up to 26% of patients who have received complete removable dentures cannot use them due to poor fixation and stabilization. Another 4-7% of patients avoid the use of removable dentures due to allergic reactions in the oral cavity in case of incorrect selection of materials for prosthetics [1]. One of the main reasons for poor fixation and stabilization is severe atrophy of the edentulous alveolar processes of the jaws. In our opinion, a certain role in this situation is played by the general clinical condition of the patient and, as a result, the manifestation of pathological conditions in the oral cavity. The manifestation of somatic diseases, as well as the allergological status, must be taken into account by the orthopedic dentist while working with such patients [2,7]. An analysis of many years of consultative work at the department indicates that the fixation and stabilization of complete removable dentures are affected by somatic diseases, in the symptoms of which there is swelling of the oral mucosa, in particular the prosthetic bed. Such manifestations are observed in cardiovascular, endocrine, nephrological diseases, as well as allergic reactions [3]. Also, unfortunately, today there is a problem of under-examination of patients who applied to an orthopedic dentist for the purpose of prosthetics, due to insufficient communication between dentists and doctors of other specialties (family doctors, cardiologists, allergists, endocrinologists, etc.) [ 4.6]. Rational prosthetics and the full functional value of removable dentures is an urgent task in orthopedic dentistry.
The purpose of the study is to improve the technology for obtaining prints for the manufacture of complete removable dentures; establish a scheme of interaction between an orthopedic dentist and doctors of other specialties, in particular with allergists; to extend the time of operation of complete removable dentures
due to the individual selection of material for prosthet-ics of patients, taking into account the manifestation of somatic diseases in the oral cavity.
Materials and research methods.
We consulted 41 patients with complaints of poor fixation and stabilization of complete removable dentures. In 15 patients (36.58%) there were only cardiovascular, endocrine and nephrological diseases, in others 24 (58.54%) were combined (with a predominance of one of them), in 2 people from the group (4.88%) the course of somatic diseases is hampered by the presence of allergic reactions in history. The studies were carried out in a state of remission of a concomitant disease after consultation with an appropriate specialist and a detailed study by a dentist of the medical history of each patient.
Scientific novelty.
We have optimized the technology for obtaining imprints of the prosthetic bed in patients with concomitant somatic diseases. For 10 days, hourly, subjective sensations were noted in terms of the degree of fixation and stabilization of the prosthesis, the presence of its pressure on soft tissues, and sometimes unsatisfactory fixation or stabilization. After processing the obtained results and evaluating changes in the condition of the soft tissues of the prosthetic bed, we determined the time interval when there were no symptoms of compression under the prosthesis, and how it was held hourly. At the same time, the time from which the prosthesis began to fall off or the fixation or stabilization worsened was determined. We calculated the time with better fixation and stabilization of the prosthesis in the prosthetic bed. In the manufacture of new prostheses for taking anatomical and functional imprints, patients were prescribed for a time equidistant from the symptom of compression under the prosthesis to the absence of fixation. Patients with aggravated allergic status were additionally offered an examination by an allergist. Two out of three patients were offered provocative
in vivo tests after taking anamnesis. In all cases, provocative tests were performed exclusively by an allergist, patients were informed about possible complications and gave written consent to testing. One patient was offered in vitro diagnostics due to the high risk of an immediate allergic reaction. At the same time, all three patients were found to be allergic to acrylic plastics and alternative materials for prosthetics were proposed [5,8,9]. Results and discussion. After the examination, a detailed study of the anamnesis and general somatic status of each patient, questioning and prosthetics, taking into account the optimal time for taking anatomical and functional imprints and selecting material for prosthetics, we obtained the following results. Out of 41 patients, we achieved optimal fixation and stabilization in 34 people (82.92%). Other patients had to use fixative creams or implants to improve fixation. We conducted control appointments 3, 6 and 12 months after the last correction for each patient in order to study the long-term results of prosthetics. Of the 34 people in whom we managed to achieve optimal fixation and stabilization of prostheses, after 3 and 6 months, there were no complaints about deterioration in fixation.
After 12 months, complaints about poor fixation and stabilization of prostheses in the oral cavity appeared in 2 people. At the same time, repeated exacerbations of concomitant diseases and a significant deterioration in the general somatic condition of patients were noted in the anamnesis during the year. After a detailed study of the case histories of these individuals, it was decided to improve the fixation of prostheses in the oral cavity with the help of creams, as well as follow-up with a prosthodontist during the year.
It can also be noted that in the group of patients in whom we managed to achieve optimal fixation of prostheses, only 1 person refused to continue wearing pros-theses. The attention of orthopedic dentists should be drawn to the fact that the use of the described technique is justified with a moderate degree of atrophy. In the case of severe atrophy, there was no improvement in the fixation of complete removable dentures.
The results obtained allow us to draw the following conclusions.
Conclusions:
The manufacture of complete removable dentures in patients with cardiovascular, endocrine, nephrologi-cal diseases and aggravated allergic status should be carried out in a state of remission of a concomitant disease. Removal of anatomical and functional prints must be carried out at the optimal time of day. To determine the optimal time of day, it is necessary to take into account the results of the survey. An individual approach to the selection of material for prosthetics allows you to avoid allergic reactions in the oral cavity and, as a result, improves fixation, reduces the percentage of refusals to wear removable dentures. Communication of orthopedic dentists with doctors of other specialties and
detailed studying the medical history of each patient increases the percentage of successful prosthetics. Monitoring the fixation and stabilization of prostheses in patients for 12 months allows the orthopedic dentist to respond in time to changes in the prosthetic bed and adjust further tactics for treating patients with concomitant diseases. Therefore, the conducted studies suggest that an integrated approach to prosthetics in patients with complete loss of teeth can significantly increase the percentage of successful results.
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