Клінічна оцінка результатів протезування пацієнтів з дефектами зубних рядів різними конструкціями мостоподібних протезів

Abstract

The article presents the study results of clinical effectiveness of orthopedic rehabilitation for patients with dentition defects with different designs of implant-supported dental bridges. The work describes and analyzes complications that occurred during the operation of dental bridges and identifies the optimal design with the most predictable prognosis. The purpose of the study was to evaluate the results of prosthetics in patients with dentition defects with various implant-supported dental bridge designs in different observation terms. Materials and methods. For the clinical investigation we selected 90 patients with dentition free-end defects, who were divided into three groups, 30 patients in each group. Group I patients had dental bridges with cobalt-chromium alloy, faced with feldspar ceramic made, patients of II group – prosthetic constructions on the basis of zirconium dioxide with feldspar ceramic coating, patients of III group – zirconium dioxide framework with following press-ceramic coating. Oral hygiene index OHI-S and Leus comprehensive periodontal index, compliance of the fabricated dental bridges with clinical requirements, and the most common complications that occurred during the use of these fixed prostheses were evaluated for all patients. Results. After 36 months, we found that the highest mean value of OHI-S index was in patients of group I, specifically 1.24±0.19 points. Significantly (p<0.05) lower this index was in patients of group II – 0.64±0.09 points. Minimal OHI-S index was found in group III patients, being at 0.43±0.04 points, it was significantly (p<0.05) different from indicators of group I and group II patients. The mean values of comprehensive periodontal index also differed significantly (p<0.05) in all groups, their indices ranged between 1.24±0.21 points, 0.35±0.03 points and 0.24±0.02 points, respectively. Group II patients' orthopedic constructions turned out to be the most effective, with 96.7% of the prostheses having no malfunctions after 3 years of use. The only violation that occurred in this group was full fracture of intermediate part of one dental bridge. The number of dental bridges that functioned without complications in groups I and III during the same term was 70.0% and 90.0%, respectively. Among the complications, the most frequently observed were chipping of the aesthetic coating of the prosthesis, integrity and retention violations of the dental bridges in different terms. The worst hygienic and comprehensive periodontal indexes were recorded in patients with metal-ceramic dental bridges. Conclusion. The use of zirconium dioxide frameworks and veneered feldspar ceramics provides the most reliable functioning of fixed implant-supported dental bridges and the minimum number of complications in the observation period of 36 months