Comparative assessment of the processes of adaptation of supporting tissues in prosthetics with the use of implants

Abstract

The study of the adaptation processes of supporting tissues during removable prosthetics with the use of implants according to the data of microhemodynamics and oxygenation in the supporting tissues. A clinical and functional study of the state of supporting tissues was carried out in 60 people aged 50 to 65 years with a diagnosis of complete loss of teeth in the lower jaw during orthopedic treatment based on dental implants, which were divided into 2 groups: group 1 (29 people) - with the use of removable structures with locking with a lock attachment (type locator). Group 2 (31 people) - in which orthopedic treatment was carried out with the production of removable prostheses with fixation on telescopic crowns. Implantation was performed using intraosseous implants from Astra-Tech (Sweden). Orthopedic treatment was carried out according to the generally accepted method. To study the state of microcirculation in the mucous membrane of the alveolar ridge, the method of laser Doppler flowmetry (LDF) was used using a LAKK-M device (NPP Lazma, Russia). The state of microcirculation was assessed by the index of microcirculation (M), which characterizes the level of tissue blood flow; parameter «σ», which determines the fluctuations in the flow of erythrocytes. According to the Wavelet analysis of LDF-grams, the shunting index (PS) of blood flow was determined. Using the multifunctional diagnostic laser complex «LAKK-M» in the «LDF + spectrometry» mode, we studied oxygenation in periodontal tissues by optical tissue oximetry (OTO), the results of which were used to determine the oxygenation index in the mucous membrane of the alveolar ridge (SpO2) and the specific consumption index oxygen (U,%). According to LDF data, it was established that the level of microcirculation in the mucous membrane of the alveolar ridge in response to the functional load after fixation of the removable prosthesis with fixation on locators (group 1) and on telescopic crowns (group 2), it is accompanied by an increase in the level of M and σ by 37% and 66%, and by 2.2-2.4, respectively, which indicated the development of hyperemia in the microcirculatory bed, which is associated with functional load and persists up to 3 and 6 months, respectively. Restoration of microcirculation occurs after 6 and 12 months, respectively, after prosthetics, depending on the supporting elements. After fixation of the removable prosthesis, SpO2 and U decreased, which characterized the development of hypoxia in the tissues due to functional load, which stopped after 3 and 6 months, respectively. The study showed that in orthopedic treatment based on implants, adaptation processes according to microhemodynamics and oxygen metabolism in supporting tissues occur 3-6 months after prosthetics, depending on the design of the supporting elements.