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transmission and clinical therapies on coronavirus dis- PMCID: PMC7068984. ease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020 Mar 13;7(1):11. doi:
TREATMENT OF PERIODONTITIS BY SPLINTING AND SELECTIVE GRINDING
Aliyev M.,
Doctor of Philosophy in Medicine Department of Therapeutic Dentistry Assistant Azerbaijan Medical University Baku, Azerbaijan Yagubova F.,
Department of Pediatric Dentistry Assistant Azerbaijan Medical University Baku, Azerbaijan Kalbiyeva N.
Department of Pediatric Dentistry Assistant Azerbaijan Medical University Baku, Azerbaijan DOI: 10.5281/zenodo.7467564
Abstract
An important link in the complex treatment of periodontal diseases is the selective grinding of teeth, aimed at eliminating increased occlusal loads and creating a stimulating, functional tension in the supporting tissues of the teeth in order to rehabilitate and prevent traumatic occlusion. Traumatic occlusion develops against the background of an intact periodontium as a result of the action of an occlusal load that is excessive in magnitude or unusual in direction. The load begins to exceed the tolerance of the tissues surrounding the tooth and turns into a traumatic factor. Combined traumatic occlusion occurs when an increased load is combined with periodontal disease.
Keywords: periodontitis, selective grinding, splinting of teeth.
Compared with gingivitis, chronic generalized periodontitis at the organ level is characterized by the presence of persistent progressive morphological and functional changes, and at the level of the organism as a whole - by the formation of a locally chronic odonto-genic focus [1]. Accordingly, the dentist faces qualitatively different tasks in the treatment of this disease: the need to eliminate the chronic odontogenic focus of infection and reconstruct the affected periodontium. It is possible to achieve positive results only with the use of complex treatment of the disease [2]. Given the nature of inflammatory and destructive changes in the perio-dontium, the general treatment, planned depending on the degree of organ damage, is aimed at:
• treatment and stabilization of the affected organ or system;
• normalization of the organism's reactivity;
• restorative treatment;
• Correction of inflammatory, metabolic, micro-circulatory disorders in periodontal tissues and increase of local resistance of these tissues.
A necessary link in solving this problem during local treatment is the selective grinding of optimal chewing surfaces by eliminating premature tooth contacts and ensuring unhindered movements of the lower jaw. Supracontacts are determined using carbon paper or clasp wax plates in the position of central, anterior and lateral occlusion, as well as during movement of the lower jaw. Preliminary grinding of teeth can be carried out during the period of exacerbation of periodontitis. It consists in shortening the teeth that have protruded
from the hole and eliminating significant irregularities of the teeth [3.4]. The final grinding of the teeth is carried out in several visits only after conservative treatment of periodontal diseases and before the surgical stage. The intervals between visits should be at least 1014 days. If it is necessary to increase the interalveolar height or make a fixed splint, the final grinding of the teeth is carried out after these measures. We started grinding teeth by eliminating premature contacts in the position of central occlusion.
In the anterior section, the cutting edges of the lower incisors are often ground, in some cases both antagonists. Supracontacts on the lateral teeth are eliminated by grinding off the bumps or depressions (fissures) after analyzing the lateral movements of the lower jaw [5]. When studying anterior occlusion, su-pracontacts are eliminated depending on the nature of the closing of the incisors in the position of central occlusion. With point or linear contact, the cutting edges of the upper teeth are ground, with planar contact, both antagonists. With orthognathic bite, premature contacts in the position of lateral occlusion are eliminated by grinding the upper buccal and lower lingual tubercles [6]. The buccal slopes of the palatine tubercles of the upper teeth and the lingual slopes of the buccal tubercles of the lower teeth fix the interalveolar height. Therefore, during transversal movements, the jaws should not grind. Grinding the surface of the teeth during anterior and lateral movements of the jaw should ensure uniform contact of multiple interdental contacts
in the position of central occlusion and eliminate interference with smooth movements of the lower jaw [7.8]. The final stage of tooth grinding is polishing of their surfaces, application or electrophoresis of calcium or fluorine ions, and coating of teeth with a protective varnish. Splinting of mobile teeth is the most important moment in the process of eliminating or, more often, reducing the functional overload of teeth [9.10]. In case of inflammatory-destructive diseases of periodontal tissues, this stage favors the optimization of tissue functioning and increases the effectiveness of the complex treatment of periodontal diseases. In our work, we abandoned the generally accepted principle that it is always necessary to splint mobile teeth before performing surgical procedures. One of the main points justifying our decision was the fact that a non-removable splint in such a disease simply interferes with the implementation of surgical interventions in full. The second important fact is the possibility of an ambiguous decision about the tactics of treating any tooth, in terms of its safety. There are situations when even in the presence of orthopantomograms, dental radiographs and clinical studies, it is not always possible to unequivocally determine the tactics in relation to a particular tooth. Thirdly, splinting in patients with periodontal disease can be performed as soon as possible after surgery, which contributes to greater stabilization of the dentition. The basic model of a modern periodontal splint consists of reinforcement and a light-cured composite. A groove was formed with diamond burs on the oral surface of the anterior teeth and the chewing surface of the lateral teeth. The width of the groove must correspond to the width of the material + 1mm. A liquid-flowing light-curing composite was placed at the bottom of the furrow, into which a wire or tape was pressed. After polymerization, restoration was carried out. With each patient, the conditions for hygienic care of the oral cavity were also discussed, with mandatory periodic medical supervision. With a good hygienic condition of the oral cavity, control meetings were scheduled less often - 1 time in 3-4 months. When using the tires described above, it was also necessary to control that the interdental spaces remained open, which is necessary to comply with the rules of good oral hygiene using superfloss or brushes. If during the treatment of periodontal tissues there was a need to depulp the tooth, in this case, the formed cavity was used to introduce a splinting structure into it and fix it with a light-cured material. These structures were designed to stabilize the dentition, since they tied the teeth into a single block -the patient was able to use splints for a long time. With localized and generalized (mild and moderate) periodontitis, it is possible to apply a splint in sectors: molars and premolars enter into the 1st and 3rd, incisors and canines into the 2nd. In case of moderate and severe generalized process, it is necessary to splint the entire dentition along the arc in order to reduce the impact of negative horizontal loads. To solve this problem, 4 groups of patients were formed, who are registered in the dispensary. In the complex treatment of periodontal tissues, various types of splinting structures were used, taking into account the positive and negative qualities of each method. The results of splinting were evaluated
after a year, the evaluation of the effectiveness of treatment was carried out according to the following criteria:
1. Reliability of fixation of teeth.
2. Aesthetics.
3. Subjective feelings of patients.
4. Structural strength.
Tires made of Ribbond carcass tape had visible defects, composite chips in the area where the splinting tape transitioned to the tooth. In various clinical situations, it is advisable to use certain splinting methods, the choice of which depends on the indications for their use:
Splinting with Flex wire is possible:
— in the presence of intact teeth or a small number of fillings;
— with crowding of teeth, deformations of the dentition;
— in the presence of three, diastema no more than 1-2 mm.
If several teeth are missing, then Flex wire splinting is supplemented with other types of structures.
Splinting with Ribbond frame tape is possible in the following cases:
— absence of significant crowding of teeth and a defect in the dentition;
— the presence of diastema, three; -only depulped teeth;
— tooth immobilization in case of traumatic dislocation or subluxation;
— temporary prosthetics in the absence of 1 tooth.
Splinting with a block of crowns is possible in the
following cases:
— with a large number of fillings;
— the presence of three, diastema, deformities of the dentition;
— if the abutment teeth are affected by caries, depulpated;
— in case of defects in the dentition (1-3 teeth), splinting bridges with 3 or more supports are used.
Splinting with a removable one-piece splinting structure is shown:
— if the parallelism of the teeth is preserved, with intact teeth;
— in the presence of a small number of seals;
— Poor oral hygiene.
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САНАТОРНО-КУРОРТНОЕ ВОЗМОЖНОСТИ ЮГА КЫРГЫЗСТАНА ДЛЯ РЕАБИЛИТАЦИИ БОЛЬНЫХ ПЕРЕНЕСШИЙ ИНСУЛЬТ НА ПРИМЕРЕ КЛИНИЧЕСКИЙ САНАТОРИЙ
«САЛАМАТ»
Юсупов Ф.А.
Доктор медицинских наук, профессор, Медицинский факультет ОшГУ, г. Ош, Кыргызстан ORCID: 0000-0003-0632-6653 Юлдашев А.А.
Аспирант кафедры неврологии, нейрохирургии и психиатрии
медицинского факультета ОшГУ, г. Ош, Кыргызстан ORCID: 0000-0002-4179-9205 Максимов И.И. Директор клиники «Саламат», врач невролог,
г. Ош, Кыргызстан
SANATORIUM-RESORT FACILITIES OF THE SOUTH OF KYRGYZSTAN FOR THE REHABILITATION OF PATIENTS WHO HAVE SUFFERED A STROKE ON THE EXAMPLE OF
THE CLINICAL SANATORIUM "SALAMAT"
Yusupov F.,
Doctor of Medical Sciences, Professor, Faculty of Medicine, Osh State University, Osh, Kyrgyzstan ORCID: 0000-0003-0632-6653 Yuldashev A.,
Graduate student of the Department of Neurology, Neurosurgery and Psychiatry Medical Faculty of Osh State University,
Osh, Kyrgyzstan ORCID: 0000-0002-4179-9205 Maksimov I.
Director of the clinic "Salamat", neurologist,
Osh, Kyrgyzstan DOI: 10.5281/zenodo.7467568
Аннотация
Здоровье людей - проблема мирового масштаба, и одним из самых эффективных средств его укрепления является оздоровление в санаторно-курортных условиях. Значимость санаторно-курортного лечения обусловлена продолжающимся процессом преждевременного старения населения и высоким уровнем заболеваемости взрослого населения. На современном этапе жизни все больше внимание уделяется сохранения здоровье населения и восстановление нарушенных функций для улучшения качество жизни. Острые формы цереброваскулярных заболеваний являются актуальной медико-социальной проблемой ввиду высокой распространенности, смертности и первичной инвалидизации. Следовательно восстановление нарушенных функций у больных после острых цереброваскулярных событий проблема актуальная, для этого санаторно-курортные условия с новейшими реабилитационными оборудованиями залог успешной реабилитации больных, перенесших инсульт. Abstract
People's health is a global problem, and one of the most effective means of strengthening it is health improvement in sanatorium-resort conditions. The importance of sanatorium-resort treatment is due to the ongoing process of premature aging of the population and the high morbidity rate of the adult population. At the present stage of
