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7THE NEED TO USE MODERN METHODS OF ORAL HYGIENE IN PATIENTS WITH FIXED
DENTURES
Panahov N.,
Doktor of Medical Sciences. Professor Azerbaycan Tibb Univtrsiteti, Ortopedik stomatologiya kafedrasi
Baki Azerbaycan Huseynova Tibb uzra falsaf3 doktoru, assistent Azerbaycan Tibb Univtrsiteti, Ortopedik stomatologiya kafedrasi
Baki Azerbaycan Mehmani V.
Azerbaycan Tibb Univtrsiteti, Ortopedik stomatologiya kafedrasi assistent
Baki, Azerbaycan https://doi.org/10.5281/zenodo.6594664
Abstract
The problem of replacing the partial absence of teeth remains relevant and today due to the high prevalence of defects in the dentition.One of these methods is the use of fixed metal-ceramic bridges, fixed both on abutment teeth as well as on implants. It is known that for the duration the se of these structures is particularly affected by hygiene oral cavity, which can be carried out both with a toothbrush and and with the help of irrigators.
The aim of the study was a clinical study of the effect of the use irrigators on periodontal condition and oral hygiene in patients with based on natural teeth and implants. 25 patients who underwent orthopedic treatment with the use of aesthetic metal-ceramic fixed prostheses. The first group consisted of 13 patients with prosthetic ceramic-metal bridges, which after fixation fixed structures used an irrigator. Of these, five patients fixation of fixed prostheses on implants was carried out. second group consisted of 12 patients prosthetized with metal-ceramic bridges, which, after fixing fixed structures used a toothbrush. Four of them have dentures fixed was carried out on implants. Study of the state of oral hygiene was performed using the PBI gum bleeding index, hygiene index Sillnes-Loe and Schiller-Pisarev samples, which were determined before fixation of orthopedic structures, after one month and three months after prosthetics. When performing the study, we used JETPIK irrigators, the peculiarity of which is the use smart floss technology that combines the power of a water jet and penetrating power of pulsating dental floss. Irrigator provides deep cleansing in places inaccessible to a toothbrush, strengthens the gums. With the help of clinical examination methods, in in particular indexes of bleeding gums, oral hygiene, samples Schiller-Pisarev, it was proved that in patients who used the JETPIK irrigator, one and three months after the fixation of fixed dentures these indicators were significantly better than in patients who only a toothbrush was used for oral hygiene.
Keywords: fixed dentures, irrigators, oral hygiene, Abutment teeth, fixed constructions, irrigators.
The rapid development of modern society is characterized not only by rapid development of modern technologies, but also high requirements for the physical characteristics of the human body. One of of them is an aesthetic component, due, in particular, condition of the oral cavity. A number of factors are known to influence high aesthetic characteristics: balanced nutrition, compliance with oral hygiene, hereditary factors, as well as, environmental influence [1]. However, the problem of substitution of partial lack of teeth remains relevant today due to the high the prevalence of defects in the dentition [2, 3] One of these methods is the use of non-removable metal-ceramic bridge-like prostheses fixed both on natural abutment teeth and on implants. It is known that for the duration of data use structures are particularly affected by oral hygiene, which can be carried out both with the help of a toothbrush and irrigators [4, 5, 6]. than a conventional toothbrush, because it completely washes even smallest food items. This is what prevents reproduction of microorganisms and prevents the development of inflammatory processes in oral cavity. Among the advantages of the irrigator is the simplicity in use; helping to stop bleeding from the gums, bad breath and plaque; improving local exchange
substances, blood flow, and also it provides therapeutic and prophylactic action. According to the literature, only 1.0% of patients know prorigators, which should be recommended by dentists [7]. What cleaning of proximal surfaces of teeth with interdental brushes is the most effective method of removing dental plaque. Flossing has been shown to be generally ineffective in removal of dental plaque [8]. use of 0.06% chlorhexi-dine at irrigation with an irrigator can be a valuable addition to oral hygiene mouth in patients with implants. Oral irrigator combined with 0.2% chlorhexidine solution is highly effective in reducing the area biofilms . Daily use of an irrigator in combination with a manual brushing your teeth is much more effective in reducing gingival bleeding than flossing, as defined under 4-week study . It was found that the total amount of plaque removed by the oral irrigator reached approximately 40.7±16.7% compared to 71.6±11.5% with electric toothbrush. But an electric toothbrush causes much more gingival injuries than an irrigator . Currently up to date is the question of the effectiveness of the use of irrigators in patients for prevention of exacerbations of periodontal diseases and after orthopedic treatment. Therefore, the aim of the study was a clinical
study of the effect the use of irrigators on the condition of the periodontium and oral hygiene in patients based on natural teeth and implants.
Materials and Methods. We examined 25 patients who underwent orthopedic treatment using aesthetic ceramic-metal fixed prostheses. Of these, five patients underwent fixation of fixed prostheses on implants. The second group consisted of 12 patients who were pros-thetized with ceramic-metal bridges, who, after fixing fixed structures, used a toothbrush. In four of them, the fixation of prostheses was carried out on implants. months after prosthetics. The ARVI papilla gingival bleeding index was determined using a bellied probe, which was used to probe the gingiva of the papillae of the oral and vestibular surfaces of the teeth of the opposite halves of the jaws, exposed and removed. JETPIK, the peculiarity of which is the use of smart-flos technology, which combines the power of a water jet and the penetrating ability of a pulsating dental floss. The irrigator provides deep cleaning in places inaccessible to a toothbrush, strengthens the gums. Due to the mechanical friction of the floss, food microparticles and bacterial plaque are easily removed from open surfaces and hard-to-reach places (Fig. 1). The results of the study did not differ and amounted to 2.53±0.34 in the first group, and 2.65±0.21 points in the second. Such values of these indicators are due to the state of the gums after the preparation of the abutment teeth and the absence of artificial crowns. However, already a month after fixation of fixed bridge-like prostheses, the RVI index was significantly lower in patients who used an irrigator and amounted to 1.5 ± 0.27 points, while in patients who used a toothbrush, they were 2.03 ± 0 ,23 points. Further analysis of the clinical situation indicates that already three months after the fixation of ceramic-metal bridges in patients of group I, the RVI index significantly decreased and amounted to 0.41±0.08 points and was accompanied by the absence of bleeding gums, and in patients of group II it was 0.82 ± 0.15 points and was characterized by the appearance of separate pinpoint foci of bleeding (Fig. 2). To determine the hygienic index in the area of the abutment teeth, the Sillness-Loe hygienic index was used, which was used to determine the presence of plaque on the distal, medial, scoring system, points were determined and the resulting amount was divided by 4. Analysis of the results obtained showed that patients who used only a toothbrush for oral hygiene care, the hygiene index one month after fixing the prostheses was higher than in patients who used an irrigator and amounted to 1.27 ± 0.21 points compared with the first group -0, 91±0.19. Three months later, this indicator improved significantly, but was significantly worse - 0.68±0.04 points than in patients of group I - 0.51±0.05 points. Characteristics of the index of hygiene in patients of group I is characterized by a significant significant improvement in oral hygiene already a month after using the irrigator - 0.91 ± 0.19 points, as well as a significant improvement in these indicators after three months - 0.51 ± 0.05 points (Fig. 3). To determine the intensity of the inflammatory process of the gums, the Schiller-Pisarev test was performed, which consists in the lifetime coloring of gum glycogen, the amount of which increases with
inflammation. This test was used to determine the presence and extent of inflammation. .18 and 2.91±0.19 points, which indicates a moderately pronounced inflammatory process. However, one month after the fixation of prostheses and the application of appropriate methods of maintaining oral hygiene, the indicators of the Schiller-Pisarev test significantly improved and amounted to 2.33 ± 0.07 points in patients of group I and 2.53 ± 0.21 points in patients of group II, which are a sign of a mild inflammatory process in group I and its absence in these patients three months after fixing metal-ceramic bridges and using an irrigator (in particular, after three months, the Schiller-Pisarev test was 0.91 ± 0.27 points in group I patients and was significantly better than in the previous period, and better than the indicator in the II group of patients, which was 1.17 ± 0.16 points after three months. It has been proven that the use of irrigators contributes to the achievement of positive long-term clinical results after orthopedic treatment.
Conclusions. A feature of modern JETPIK irrigators is the use of smart-flos technology, which combines a powerful jet and the penetrating power of pulsating dental floss and provides deep cleaning in places inaccessible to a toothbrush, strengthens the mass. Due to the mechanical friction of the floss, micro-particles of food and bacterial plaque are easily removed from open surfaces and hard-to-reach places, and good oral hygiene is achieved. Pisarev, it was proved that in patients using JETPIK irrigators, these indicators are significantly better one and three months after fixation of fixed dentures than in the group of patients who used only a toothbrush for oral hygiene.
REFERENCES:
1. Ortopedicheskaya stomatologiya / N.G. Abolmasov, N.N. Abolmasov, V.A. Bychkov, A. Al'-Khakim. - M.: Medpress-inform, 2002. - 576 s.
2. Beda V.I. Gigiena polosti rta pri nes"emnom zubnom protezirovanii /V.I. Beda, M.A. Yarifa // Sovremennaya stomatologiya. - 2009. - № 4. - S. 124129.
3. Barkan I.Yu., Gorbunova I.L. Prognoz techeniya khronicheskogo generalizovannogo parodontita v otdalennye sroki posle protezirovaniya nes"emnymi mostovidnymi metallokeramicheskimi konstruktsiyami // Sovremennye problemy nauki i obrazovaniya, 2016, №5. Setevoe izdanie. URL: https://science-education.ru/ru/article/view?id=25428
4. Gulyaeva O.A., Bulyakov R.T., Gerasimova L.P., Chemi-kosova T.S. Sovremennye metody vkompleksnom lechenii vospalitel'nykh zabolevanii parodonta. - T. 190. - Ufa: UralPoligrafSnab, 2016. -S. 5-9.
5. Kosenko K.N., Gromov O.V. Otdalennye rezul'taty kompleksnogo lecheniya patsientov razlichnykh vozrastnykh grupp s patologiei parodonta kombinirovannymi konstruktsiyami zubnykh protezov // Vestnik stomatologii, 2011, №3, str63-66
6. Ozhogan Z.R. Kliniko-eksperimental'ne obrruntuvannya ortopedichnogo metodu liku-vannya znimnimi mostopodibnimi protezami z diskretnim chasom fiksatsii': Avtoref. dis. ...d-ra med. nauk: spets.
14.01.22 «Stomatologiya» / Z.R. Ozhogan. - Ivano-Frankivs'k, 2002. - 36 s.
7. Lebedenko I.Yu., Arutyunova S.D., Ryakhovskogo A.N. Ortopedicheskaya stomatologiya: natsional'noe rukovodstvo. Moskva: GEOTAR-Media, 2016. 824 str.
8. Reissmann D, Hacker T, Farhan D, Heydecke G. The Burdens in Prosthetic Dentistry Questionnaire (BiPD-Q): development and validation of a patient-based measure for process-related quality of care in prosthetic dentistry // Int. J. Prosthodont. 2013; 26(3): 250. DOI: 10.11607/ijp.3266.
