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Review on prediction of results of dental implantation at patients with the accompanying pathology
the CG relative to the MG where the proportion of good results is 93,3±4,7%, figures are statistically significant, because Student's t-test=3,41, (p<0,05), which is the result of using a more effective method of surgical treatment PC. Satisfactory and unsatisfactory outcomes in the MG and the same number was on 3,33±3,14%. Satisfactory results referred a patient who after 8 months of the postoperative period developed local bone deformation due to the 7th costal cartilage, which required repeated surgery. Resection of cartilage 6-7 ribs on the right and the left rib cartilage 7, led to the complete elimination of the deformation. Unsatisfactory results in the exhaust gas carried with the patient's connective tissue dysplasia
syndrome. The patient had in addition PC morphologic appearance, scoliosis of the spine, joint hypermobility. We believe that the presence of this disease in the patient contributed to the development of relapse keeled deformation in a year.
Finally, summarizing all the results of our study, it is clear that we have developed a method thoracoplasty at PC are minimally invasive and very effective methods of treatment allows us to reduce the trauma of surgery, reduce the operation and, thus, anesthetic time, accelerate the activation time ofpatients and reduce the duration of pain, minimize operating and postoperative complications, improve cosmetic results.
References:
1. Ашкрафт К. У, Холдер T. M. Детская хирургия. - Ст-Петербург. - 1996. - Т. 1 - P. 168-175.
2. Виноградов А. В. Деформации грудной клетки у детей (Хирургическое лечение и медико-социальная реабилитация): Автореф. дис. ... докт. мед. наук. - М, - 2004. - 22 с.
3. Жила Н. Г. Хирургическая моделирующая коррекция врожденных и приобретенных деформаций грудной клетки у детей и подростков: Автореф. дис. ... д-ра мед. наук. - Иркутск - 2000. - 16 с.
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DOI: http://dx.doi.org/10.20534/ESR-16-9.10-155-156
Yarmukhamedov Bekhzod, Tashkent state dental institute, Uzbekistan Department of oral surgery and dental implantology Associated professor, PhD, E-mail: [email protected]
Review on prediction of results of dental implantation at patients with the accompanying pathology
Abstract: Dental implantation is actively introduced into everyday practice of maxillofacial surgeons and dental surgeons. Despite its high results achieved during the last decades, there is a number of unsolved issues associated with implants rejection. The number of such complications according to different authors varies from 3 to of 10%.
Keywords: dental implantation, prognostication, clinical and laboratory results, oral fluid.
At the present stage the method of dental implantation took the worthy place among other dental interventions and plays one of the leading roles in system of complex rehabilitation of patients with defects of dentitions [1; 2; 3]. Revived in the middle of the 20th century, he thanks to the scientific capacity and integrative potential endures rapid development. Perfecting of implants and techniques of their statement is carried out in various directions for the purpose of increase in their quality and elimination of the shortcomings revealed during clinical operation [1; 4; 5]. The modern achievements of scientific and technical progress in metallurgy, chemistry, physics, materials science, biology and toxicology are involved in this process [2; 3; 6; 7].
The listed above facts convince that dental implantation continues to take root actively into daily practice of maxillofacial surgeons and stomatologists — surgeons that emphasizes relevance of the submitted publication.
The work purpose — based on the analysis and synthesis of data of domestic and foreign express literature to provide theoretical justification of carrying out researches on development of the system of prediction of result of dental implantation.
Now particular progress in introduction of the composite and productive techniques for optimization of provision of implants and achievement not only the adequate functional, but also cosmetic results is observed [3; 4; 8; 9; 10]. Overwhelming number of ex-
press sources of information are devoted to surgical technology of statement of implants [1; 5; 9], the characteristic of a bone tissue and to requirements imposed to an alveolar shoot, a jaw bone when carrying out the specified AND operations contain, generally given beam research techniques, results of pathomorphologic, is more rare — biochemical characteristics of processes of osteointegration [4; 6; 7; 10].
Long-term success of implantation depends as from medical (the exact selection of patients, ensuring stable primary fixing of an implant), and on efficiency factors (optimum material, the production technology, reactivity of a surface of an implant, its macrostructure) [9]. It is known that at optimum osteointegration the dental implant has to: to have clinical stability, to function not less than 5 years, not to damage fabrics, adjacent to it; not to cause at the patient of negative symptoms and feelings, to satisfy the patient both in the functional, and in esthetic aspects.
The detailed analysis of express literature specifies that failures when using a method, unfortunately, are very widespread and meet more often than it is accepted to speak about them and furthermore to consider them at assessment of results of treatment [2; 7].
In most of the basic managements and monographs [1; 5; 6] in sections of absolute contraindications to performing dental implantation such states as are specified: pathology of immune system and dysfunction ofleukocytes; the diseases demanding periodic applica-
Sectiom 6. Medical science
tion of steroids; diseases of bone system; violations in coagulating system ofblood; the new growths needing a chemotherapy; uncontrollable endocrine diseases and diabetes mellitus; frustration of the central and peripheral nervous system; specific infectious diseases.
At the same time the list of the relative contraindications includes unsatisfactory hygiene of an oral cavity; centers of a chronic dontogenous infection; local inflammatory processes; malocclusion; diseases of a temporal and mandibular joint; bruxism; oral cavity mucosa diseases, especially facultative and obligate precancers.
In the social plan implantation is contraindicated to patients, carelessly falling into health, and also persons who abuse coffee that breaks a ratio of calcium and phosphorus in blood and their assimilation by a bone tissue [30].
According to M. D. Perova (2001), in 3 years the positive take of intra bone dental implantation makes not less than 92%, the increase of loss of bone structures for 3 years does not exceed 0,3 mm [8]. However it is necessary to emphasize that neither in domestic, nor in foreign sources and the annals of express literature there are no data on the uniform standard of assessment and prediction of results of dental implantation.
In spite of the fact that the world practice of dental implantation for the last 60 years of development proved the solvency, a part of maxillofacial surgeons falls into to this method of rehabilitation of dental patients with great doubt.
It is known that the changes developing owing to primary and secondary osteoporosis caused by endocrine pathology happen in all parts of a skeleton including in a bone tissue ofjaws [8, 9]. Violation of bone remodeling affects on intensity of defeat of fabrics of a periodontium at generalized periodontitis [4, 5, 6, 9], promotes emergence and progressing of carious process [10].
According to certain authors, the adequate contact between a surface of an implant and an environmental bone tissue can be reached even at osteoporosis [9, 10]. However the fact of ensuring osteointegrative contact at the specified state is not a guarantee of efficient functioning of an implant [8] as even physiological load of a bone with such type of very tectonics often causes "failure" of processes of its activity and functioning, there comes pathological reorganization and a resorption [9; 10].
Regionarny osteoporosis of jaws is observed at women at the age of40-50 years, that is at the age corresponding to the beginning
of a menopause when the third type of a bone which is characterized by the fact that preparation of the last during operation is performed with smaller effort is more often stated. This type ofvery tectonics is defined at nearly 60% of women of the specified age [1; 4; 7].
At age "switching off" of function of ovaries 60-80% ofwomen can have various clinical manifestations estrogen — a scarce state, so-called functional frustration, one of which is menopausal osteoporosis. In structure of osteoporosis it makes 85% [7]. The numerous epidemiological researches conducted abroad show various abundance of osteoporosis not only in the different countries, but also in regions separately of the taken state [6; 7; 9]. According to the expert opinion of WHO, incidence of osteoporosis takes the third place in the world after cardiovascular pathology and Diab-etum [8; 10]. This disease falls into to group heterogeneous, characterized by the progressing loss of the bone tissue beginning after a natural or surgical menopause. These phenomena in an organism involve features of approach to all medical manipulations including to dental implantation [4; 6; 9].
Urgent problem in achievement of long-term and stable result of rehabilitation of dental patients with use of implants is the lack of knowledge and experience in scheduling of treatment and monitoring of the patients who passed it. Sources of complications of any operative measure can be as features of an organism of the patient, his behavior, and specifics and technologies of realization of medical manipulations. At the same time it is almost always not so much about natural communications between the phenomena how many about degree of risk of development of this or that type of complications. However so far in sources of express literature there is no information on existence or system development for prediction of results of the dental implantation considering all factors in total.
Conclusion
The presented material, including the analysis of results of the pilot and clinical laboratory studies by preparation, performing dental implantation, in the course of overseeing by patients during the postoperative period and when functioning implants, represents a theoretical basis for development of uniform system of prediction of result of dental implantation that will promote decrease of number of complications and upgrading of rendering the dental help to patients.
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