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Scientific justification of development of domestic attachments and their clinic-biomechanical assessment.
The periodontal crack of the next tooth in norm testifying to lack of inflammatory process in a bone tissue.
Later 1 month after operation blurring of contours on border an implant — a bone is noted. Again formed fabric, is visually uniform, and only in separate sites the trabecularity of a structure of a neoformed bone tissue is defined.
The top of an alveolar bone hasn't restored yet, has not accurate contours. The horizontal decrease of a bone tissue is in the field observed. In communication with what height of an alveolar bone is reduced.
At this case for the 3rd month after operation, filling of a gleam with a neoformed bone tissue with trabecular drawing on border implant — bone is observed. The top of an alveolar bone isn't restored yet, but already gets more equal contour. The neoformed bone tissue has mainly close-meshed trabecular structure.
For the 6th month of research, on a place of surgery it is noted neoformed bone by fabric with trabecular drawing.
The top of an alveolar bone isn't restored yet, but already gets more equal contour. The neoformed bone tissue on all length of an implant found trabecular structure, completely identical with a surrounding bone tissue. The horizontal decrease of an alveolar bone visually hasn't observed.
On other 11 dogs similar research during which direct dependence of increase in density of a bone round a dental implant from the terms which passed from the moment of operation was observed was conducted. Strengthening of osteoreparative processes is reflected in
an operational field on average a gain of x-ray density of a bone and smaller degree of a decrease of a bone tissue of an alveolar shoot.
Positive dynamics of processes of an osteointegration is reached by 6th month, the regeneration which is noted density on border an implant — the confidant's bone to an initial indicator. It is coordinated with the data of Robustova T. G. (2005) who reports about existence of a small trabecular bone in 2-3 months after the performed operation. Though density of a neoformed bone during this period is less than control value, according to Kulakov A. A. (2004) in 6 months it comes nearer to that own bone.
Thus, by results of radiological research and densitometry it is possible to claim about positive dynamics of processes of osteointegration with use of a domestic dental implant.
The radiological data obtained by us testify to existence of a bone tissue in the field of surgery for the third month of research.
Conclusions
The conducted research showed a positive tendency of dynamic increase in density of a neoformed bone on border implant — bone during various periods of research. For definition of dynamics of process of regeneration of a bone tissue we recommend to conduct radiovisiography research with the computer analysis of x-ray images.
For an objective assessment of degree of a increase of a bone tissue and density of a neogenic bone in a hole we recommend to use the ImageJ program (Wayne Rasband. National Institute of Health, USA. http://rsb.info.nih.gov/ij).
References:
1. Bezrukov V. M., Matveeva A. I., Kulakov A. A. Results and prospects of research of problems of dental implantology in Russia//Sto-matology. - 2002. - No. 1. - P. 52-55.
2. Bittar-Cortez J. A., Passeri L. A., Boscolo F. N., Haiter-Neto F. Comparison of hard tissue density changes around implants assessed in digitized conventional radiographs and subtraction images//Clin Oral Implants Res. - 2006. - 17(5): 560-564.
3. Kavadella A., Karayiannis A., Nicopoulou-Karayianni K. Detectability of experimental peri-implant cancellous bone lesions using conventional and direct digital radiography//Aust Dent J. - 2006. - 51(2): 180-186.
4. Esposito M., Hirsch J. M., Lekholm U., Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (I). Success criteria and epidemiology//Eur J Oral Sci. - 1998. - 106(1): 527-551.
5. Khabilov N. L., Mun T. O., Usmonov F. K.//Rasmiy akhborotnoma. - 2013. - № 6. - P. 66-67.
6. Paraskevich V. A. Development of the system of dental implants for rehabilitation of patients with total absence of teeth//Dissertation work for doctor of medical sciences. - Moscow, 2008 - 219 p.
7. Kulakov A. A., Losev F. F., Gvetadze R. Sh. Tooth implantation. - M.: MIA, 2006. - 152 p.
8. Dedov I. I. and others. Bone densitometry in clinical practice//News of science and technics. Clin. endocr./VINITI. - 2000. - № 2: 1-7.
Salimov Odilkhon, Associate professor, PhD, Tashkent state dental institute, Uzbekistan, Department of faculty orthopedic stomatology E-mail: [email protected]
Scientific justification of development of domestic attachments and their clinic-biomechanical assessment of effectiveness at a denture with use of implants
Abstract: Motivation to use of implantation artificial limbs are high esthetic and adaptation opportunities of such designs. However, treatment with use of implants has the increased risk of complications. Fixing of an orthopedic design to implants is the reason of one of widespread complications. Along with it, high cost of import production limits possibility of their broad application. Localization of development and production of latch fastenings from domestic materials will allow improving rendering the dentistry help to the population.
Keywords: attachment, dental implant, prostheses, clinical complications.
Section 5. Medical science
The beginning of the XXI century is characterized by the increasing aging of the population, this process will proceed, and it is difficult to predict its result. Dentistry have to take into consideration that the intensive efforts enclosed in prophylaxis and the reduction odontology as a result will lead to that elderly patients will have an increased number of the remained teeth. It will end with huge increase of volume of the dental treatment necessary for elderly patients. The recent researches conducted in Switzerland showed that the increased number of elderly patients would be compensated by release of labor ability of the dental due to successful preventive treatment of teenagers and adults.
Over the last 10 years in Uzbekistan use the dental of implants received a wide distribution as provides a full-fledged restoration of all functions of dental — alveolar system. Designs of artificial limbs on implants on a principle of the fixing divide on: fixed (cement fixing), conditional and removable (screw fastening) and removable artificial limbs. Today the question of a best way of fixing of orthopedic designs with a support on implants remains open. Many foreign authors are another of a conditional and removable prosthetic repair.
In our country rapid development of need for a prosthetic repair with use of latch fastenings, however, in connection with poor amount of information is felt now, still application of attachments and selection of concrete latch connection depending on a concrete clinical situation puts the practicing doctor in a difficult situation.
The most widespread case of a prosthetic repair on the attachment is application of the combined artificial limbs. As connection in the combined artificial limbs except latch fastenings telescopic crowns can be used. The main indication for application of latch fastenings and telescopic crowns in the combined artificial limbs is increase of esthetic results of a prosthetic repair. Use of attachment possibly and in cases of lack of a parallelism of axes of basic teeth.
Various authors and researchers upon transition to new materials and technologies of bases of dentures made rather successful attempts of increase of extent of fixing and stabilization of plate artificial limbs. Esthetic qualities of the fixing elements of dentures, in most cases did not satisfy both patients, and orthopedic surgeons. Only in the seventies last century, in connection with development of the modern technologies and including technologies of molding, dentists of orthopedists had a possibility of creation of highly esthetic dentures with fixing on latch fastenings — attachments.
Prosthetic repair esthetics a far important factor, but it, undoubtedly, has to be combined with the functionality including and the biomechanical aspects combining a set of the factors promoting adaptation and the long-lived period of use of an artificial limb.
The attachments used by domestic dentistry are production of the foreign companies. Import production because of currency high cost is almost not accessible to medical institutions and patients. The conducted researches among domestic producers of medical production revealed possibilities of localization of production of
attachments in our republic. Predesigns showed reduction in cost of product cost by 5-6 times in comparison with foreign analogs.
Thus, relevance of a subject of the planned dissertation work is caused by need of health system and an operating control of all levels for researches on creation, rational functioning and development of system of ensuring quality of dental implantation in somatic patients.
The purpose of the planned research: Increase of clinical effectiveness of domestic attachments and a clinical — biomechanical assessment of their effectiveness at a denture with use of implants.
For realization of a purpose, we defined the following research problems:
1. To develop rational designs of domestic attachments and to carry out their preclinical tests.
2. To give a complex assessment of the dental status of patients with the acquired defects of jaws and to define needs in different types of the orthopedic dentistry help with use of tooth implants.
3. To estimate a microbiological, cytologic and functional condition of a mucosa of a prosthetic bed. Use of the device Vista Cam (Germany) for studying of a microbiological study of a prosthetic bed in situ of contact with an attachment and an artificial limb is planned.
4. To estimate adaptable mechanisms ofpatients to removable artificial limbs with fixing on implants according to an electromyography of masseters. Use of the device Biopac (USA) for objective research neuro-muscle system by filing of electric potentials of mas-seters is planned.
5. To estimate extent of osteointegration of ventplants for optimization of terms of a prosthetic repair. Use of the device Os-stell ISQ(Sweden) for filing of resonance electromagnetic oscillations of an implant and an environmental bone at impact on them of an electromagnetic field is planned.
6. On the basis of the pilot and clinical trials to develop and estimate effectiveness of the program of orthopedic rehabilitation of patients with use of implants.
7. To allocate groups of a dispensary observation and to prove treatment-and-prophylactic actions.
The expected results of the planned research
The rational designs of new domestic attachments executed with use of biologically inert materials and nanotechnologies will be for the first time developed, preclinical tests are carried out them. It will be developed, theoretically and a series of new and advanced designs and manufacturing techniques of attachments, tooth and dental — alveolar artificial limbs for orthopedic treatment of patients with use of implants is clinically proved.
The program of orthopedic rehabilitation of patients with use of implants will be developed and introduced. Clinical effectiveness of the offered designs and methods of orthopedic treatment of patients with use of implants will be estimated.
References:
1. Gvetadze R. Sh. Clinico-functional and biomechanical substantiation of orthopedic methods of treatment of patients in dental im-plantology. Avtoref. Diss. ... doct. med. sciences. - M., 2001. - 335 p.
2. Kamalyan A. V., Pashinian G. A., Bazikyan E. A. Increase of effi ciency of dental implantation on the basis of complex analysis of medical errors//The Institute of dentistry. - 2006. - № 4. - P. 20-23.
3. Olesova V. N., Rozhkovsky B. M., Olesov A. E., Aksametov A. D. The basics of dental implantation//Methodical recom. - M., 1999. - 16 p.
4. Paraskevich V. L. Dental implantology. Fundamentals of theory and practice. 2nd ed. - M.: "Medical info Agency" LTD. - 2006. - 400 p.
5. Petrukhin P. V. Clinico-functional justifi cation for the selection ofprosthetic design with support on subperiostal implants. Avtoref. kand. diss. - M., 2006. - 26 p.
6. Taylor T., Agar J., Vogiatzi Th. Implant Prosthodontics: Current Perspective and Future Directions//Int.J. Oral Maxillofac. Implants. -2000. - Vol. 15. - P. 66-75.
The problem of creating a bioactive layer of the intraosseous dental implants in Uzbekistan
7. Khabilov N. L., Mun T. O., Usmonov F. K.//Rasmiy akhborotnoma. - 2013. - № 6. - P. 66-67.
8. Paraskevich V. A. Development of the system of dental implants for rehabilitation of patients with total absence of teeth//Dissertation work for doctor of medical sciences. - Moscow, 2008-219 p.
9. Bezrukov V. M., Matveeva A. I., Kulakov A. A. Results and prospects of research of problems of dental implantology in Russia//Sto-matology. - 2002. - No. 1. - P. 52-55.
Habilov Nigman Lukmanovich, Usmonov Farkhod Komilzhonovich, Mun Tatyana Olegovna, Tashkent State Dental Institute Milusheva Rakiya Yunusovna, Holmuminov Abdufatto Axatovich, Research Center for Polymer Chemistry and Physics at National University of Uzbekistan E-mail: [email protected]
The problem of creating a bioactive layer of the intraosseous dental implants in Uzbekistan
Abstract: Calcium phosphate coatings on dental implants accelerate bone growth and enhance bone fixation. To increase the biocompatibility of the electrolytic coating is supposed to use bioactive natural polymer — Chitosan Bombyx mori, extracted from waste silk production in Uzbekistan. It is assumed that the inclusion of chitosan in electrodeposition coating tricalcium phosphate (CFP) will improve the biocompatibility of the coating, while retaining its original mechanical properties.
Keyword: dentistry, dental implants, bio-active layer, three-calcium phosphate coating, chitosan, bombyx mori, biocom-patibility, porosity, surface roughness of a bioactive layer.
Calcium phosphate coatings on dental or orthopedic implants accelerate the growth ofbone tissue and improve bone fixation [1]. Typically, these coatings promote bone ingrowth during the healing period of the first, leading to permanent fixation technique. Two types of calcium phosphate: hydroxyapatite and tricalcium phosphate are used as a coating material. Hydroxyapatite and tricalcium phosphate are the backbone of naturally occurring inorganic component ofbone. Tricalcium phosphate — a porous form of calcium phosphate. Tricalcium phosphate is used as a biological filler which is partly resorbed and replaced by bone. The transformation of tricalcium phosphate is a pivotal point of periodontal regeneration. This "scaffolding" for the formation of new bone, which is then replaced by newly formed bone. Since hydroxyapatite — is imported drug, however local product tricalcium phosphate was used in this study. The plasma spraying method mainly uses calcium phosphate coatings on metal sputtering [2]. However, this method is carried out at high temperatures, which may alter the structure of the coating of calcium phosphate (CFP).
An alternative method for the development of CFR at low temperatures is a method of electrodeposition. In addition, this method allows you to control the porosity and thickness of the coating [3]. To increase the biocompatibility of the electrolytic coating use of our bioactive natural polymer — Chitosan Bombyx mori, extracted from waste silk production in Uzbekistan is supposed. We believe that the inclusion of chitosan in electrodeposition CFP improves the biocompatibility of the coating, meantime it maintains its original mechanical properties.
Conventional methods of obtaining polysaccharide chitosan is characterized by chemical and structural heterogeneity since even after the harsh chemical processing conditions contains small amounts of protein and mineral impurities, and by a broad
molecular weight distribution. The latter causes the formation of insoluble gel particles by dissolving chitosan. These factors significantly limit its application field. For our studies highly purified chitosan was required, because its further use is associated with a medical application. For this purpose, cleaning chitosan Bombyx mori from the guild of chitosan, obtained on the basis of the Research Center for Polymer Chemistry and Physics at the National University of Uzbekistan (NUU.) was carried out. Chitosan is a guild grayish pulp particles of irregular shape, strongly contaminated extraneous mechanical impurities. Physico-chemical properties of the starting chitosan examined by elemental analysis, infrared spectroscopy (IR), X-ray analysis, the degree of deacety-lation (SDA), molecular weight (MW).
Plant chitosan was characterized by nitrogen content — 7.42 %, ash — 3.37 %, solubilityt — 86.05 %, humidityt — 13.68 %, crystall conditiont — degree of 41 % (Table 1). MM is defined viscomet-ric — 170 kDa; SDA determined Conductivity — 71.5 % (Fig. 1).
On the basis of this sample chitosan purification technique that was developed, which was pre-dissolved in 2 % chitosan in acetic acid, the precipitation and coagulation of the solution at a certain pH, alcohol washing, centrifugation and freeze-dried sample was conducted. Experimentally optimal concentrations of the chitosan solution were chosen, the ratio precipitant — chitosan solution, the coagulation time, pH. The obtained chitosan samples characterized by a high degree of purity: at the IR spectra no peak acetamido group related to chitin, amide II peak at 1590 cm-1 peak of greater intensity manifested. The nitrogen content and the solubility of the obtained samples is considerably increased and reaches 98, 8.52 and 8 %, respectively. Reduction of ash samples (1.43 %) is almost 2 times as evidenced by an increase in the purity of the sample (Table 1).
