Restoration of normal occlusal relations in the complex treatment of patients with generalized periodontitis and bounded edentulous spaces

Abstract

The aim of the work is to restore occlusal relations during the orthopedic stages of complex treatment in patients with chronic course of generalized periodontitis (GP) of the І and ІІ degree and bounded edentulous spaces using the “T-Scan” system to achieve stable disease. Materials and methods. A total of 55 patients aged from 20 to 44 years old were examined, including 20 persons with oral health and occlusal equilibration and 35 patients with GP in its chronic phase of the I and II degree presenting with Kennedy classes III and IV partially edentulous situation (1–3). After evaluation of the dental occlusion relationships, all patients were performed a complex treatment of GP by selective grinding or occlusal surface adjustment with a composite material under the control of the apparatus “T-Scan III”, achieving the most correct distribution of occlusal contacts. At the same time, the local instrumental and medical treatment using antimicrobial and anti-inflammatory drugs and medicines with systemic effect orally to correct metabolic disorders. This was followed by the orthopedic treatment, restoring the dentition defects with fixed metal-ceramic structures under the control of the “T-Scan III” system. The results of therapy were evaluated immediately, after 6 and 12 months. Results. We have confirmed that the normal masticating pressure between the left and right parts of the dentofacial system is distributed evenly. However, we have found out, that there are not always ideal occlusion relationships, and the variation range is (48.7 to 51.3) ± 0.24 % in healthy persons. At the stages of orthopedic treatment, and especially fitting denture with the help of the “T-Scan III” system, we have reached the norm determined by us, striving for perfection. The state of periodontium and occlusion achieved after the complex treatment, remained for more than 12 months, that was confirmed by clinico-radiological data. Conclusions. Restoration of normal occlusal relations under the control of the “T-Scan III” system contributed to rapid GP remission during the orthopedic stages of complex treatment in patients with GP and bounded edentulous spaces after initial and medicamentous periodontal therapy and provided prevention of various complications and long-term stabilization of the pathological process in the periodontium.