Complete Removable Prostheses Research Articles

ОЦЕНКА ФОНЕТИЧЕСКОЙ АДАПТАЦИИ СТОМАТОЛОГИЧЕСКИХ ПАЦИЕНТОВ ПОСЛЕ ЛЕЧЕНИЯ ПОЛНЫМИ СЪЕМНЫМИ ПРОТЕЗАМИ

Background. As a result of teeth loss, a complex of factors arises that leads to changes in the dental system and impaired speech of the patient. Speech is an important communicative function, and assessing its intelligibility allows us to evaluate the result of prosthetic treatment. It is necessary to ensure unimpeded movement of the tongue, lips, cheeks and to fill in the missing components of the sound-producing system to restore phonetics. The optimal method of restoring complete absence of teeth is treatment with complete removable plate dentures made of acrylic plastics. Adaptation to this design over time restores the functions of sound pronunciation and the digestive system. The adaptation process depends not only on the patient’s abilities, but also on the quality of the manufactured structure. The discrepancy between the prosthetic bed and the base of the orthopedic structure is manifested by a violation of fixation and stabilization, which leads to pain. Aim. To evaluate the dynamics of the phonetic adaptation process of patients after the application of a complete removable prosthesis. Materials and methods. Application of phonetic control according to W. Wright and logopedic exercise “Drawing”. Results. During the study, the results were obtained that patients of groups II, III and IV improved their initial indicators, while group III increased their indicators by 25%. On average, the groups that followed the recommendations improved their results by 19.4%. Conclusions. According to the results obtained, the exercises used help patients with removable plate prostheses to adapt to them faster and accelerate the restoration of sound reproduction.

The dynamics of the state of done tissue of the alveolar process of the upper jaw when using a complete removable plate prosthesis

Objective. Improving the assessment of the state of the bone tissue of the alveolar process of the toothless upper jaw, by calculating the level of its atrophy according to the diagnostic model of the jaw. Material and methods. The study of patients was carried out: anamnesis of the disease, examination of the oral cavity, analysis of diagnostic plaster models of the upper jaw according to the method we proposed. In accordance with the classification of the Shreder, groups were formed: the first is the 1st type of Shreder (n=24); the second is the 2nd type of Shreder (n=23); the third is the 3rd type of Shreder (n=19). Results. In some areas of the alveolar process of the toothless upper jaw, atrophy reaches vertical values at points A1-D: 0.71±0.20 mm (group 1), 0.57±0.19 mm (group 2), 0.19±0.26 mm (group 3), sagitally A1-A2: 4.72±0.28 mm (group 1), 4.48± 0.30 mm (group 2), 3.85±0.32 mm (group 3); transversal – K1-K2: 3.22±0.29 mm (group 1), 3.67±0.32 mm (group 2), 3.37±0.47 mm (group 3) and more intensive in the first year of operation the prosthesis. Conclusion. Thus, the proposed diagnostic method makes it possible to determine the uneven level of bone loss in various areas of the alveolar process of the upper jaw. The data obtained are taken into account to minimize the negative consequences of the transfer of masticatory pressure from the basis of the prosthesis when planning orthopedic treatment of patients with this pathology.

Clinical and epidemiological characteristics of the frequency and structure of edentulism in elderly and senile people of the Republic of Sakha (Yakutia)

Aim. Based on the results of the study of the frequency and structure of complete loss of teeth in the upper and lower jaws, to determine the need of elderly and senile people in prosthetics with complete removable orthopedic structures. Materials and methods. A dental examination was carried out in 5,791 people aged 60 to 93 years. At the same time, on the recommendation of WHO, a key age group of 65-74 years was formed. The study took into account the topography of the absence of teeth, gender, age, the presence and evaluation of previously manufactured complete removable dentures and the need for prosthetics. Results. A high prevalence of complete loss of teeth on the upper and lower jaws was found in the examined age groups of elderly and senile age. The largest proportion of complete loss of teeth of the upper and lower jaws was revealed in the age group of 75-84 years. At the same time, in elderly people, complete adentia is detected mainly in women, since men occupy a quarter of the gender ratio. Meanwhile, taking into account the indications for reprosthetics and the absence of prostheses with complete loss of teeth, the need for the manufacture of orthopedic structures in the form of complete removable prostheses in the surveyed population is determined. Conclusions. The obtained results dictate the need to improve orthopedic rehabilitation of patients with complete loss of teeth in the upper and lower jaws, taking into account the data obtained on the structure and frequency of complete loss of teeth in elderly and senile people.

Forming the maxillary palatal relief on the outer palatal surface of the complete removable dentures

Prosthodontic treatment of secondary complete adentia in the upper jaw with completely removable plate prothesis consists in reflecting the palatal relief on the outer surface of the upper jaw prosthesis basis. Preparation of CRPP for SCA is an arrangement of known clinical and laboratory stages.
 During the prosthodontic treatment of SCA with maxillary CRPP, the following sequence was performed at the clinical and laboratory stages for the purpose of reflection of the palatal relief on the outer side of the maxillary prosthetic bases, the 2nd and 4th laboratory stages have been improved. So that:
 Replacing the wax with plastic in the composition of complete removable dentures. 4,5,6,7,8 figures of our work refer to this stage. At this stage: Figure 8-reflection of the relief of a part of the hard palate in the base plate wax added to the trial denture of a maxillary complete removable platen prosthesis. Figure 9-reflection of the relief of a part of the hard palate in the denture wax added to the trial denture of a maxillary complete removable platen prosthesis.
 The present study shows that the complete removable upper plate prosthesis (CRPP) is more functional in the prosthetic treatment of secondary complete adentia (SCA). By using CRPP on the upper jaw, unnatural disturbances in the relief of the palatine region are eliminated. It will be useful for improving other clinical and laboratory stages of preparation of maxillary CRPP.

Complete Removable Prosthesis Stabilized on Implants: Interest and Use of the Locator® Attachment

The complete removable denture retained by implants is a widely used therapeutic option, recognized for its functional and psychological esthetic rendering. Currently, the practitioner has an arsenal of retention systems at his disposal (axial attachments, anchor bars...) and since 2000, the Locator® attachment has been added to the large number of axial attachments. Thus, this article proposes to describe it and to expose, through two clinical cases, the process of its placement.

АДГЕЗИВНЫЕ СРЕДСТВА ДЛЯ ФИКСАЦИИ ЗУБНЫХ ПРОТЕЗОВ

The loss of natural teeth and, especially, the complete loss of teeth, is an urgent problem of domestic and foreign dentistry, in the solution of which a significant place is given to prosthetics with full removable plate dentures. To improve the fixation and stabilization of complete removable plate dentures, dentists often consider it appropriate to use adhesive agents, the use of which also gives the patient psychological confidence, ensuring the success of orthopedic dental treatment. The purpose of the literature analysis is to summarize and analyze the literature data for the period 2012-2023 on modern adhesive means for fixing complete removable plate prostheses, their composition, main characteristics and properties. The analysis of scientific articles allows us to come to the conclusion that it is advisable for dentists-orthopedists to recommend adhesive agents to their patients and assist them in selecting a fixing agent taking into account individual characteristics, which will improve the quality and effectiveness of dental treatment.

Mini Dental Implants in the Stabilization of the Complete Mandibular Removable Prosthesis

Mini-implants represent a therapeutic alternative to conventional implants as they were proposed following the Mc Gill consensus. Their installation is faster, relatively simpler, reducing the postoperative course. Clinically, their use improves chewing and comfort. In the long term, the complications are fairly comparable to those encountered with prostheses using additional retention using conventional implants. In conclusion, this therapeutic solution represents an alternative to conventional implants, which can be proposed in response to the difficulties experienced by patients with unstable removable prostheses. The rehabilitation of a totally edentulous, resorbed mandible, with conventional removable prostheses, constitutes a very difficult challenge for the practitioner and often gives poor results in terms of satisfaction, comfort, stability and masticatory efficiency. Following the publication of the Mc Gill consensus of 2002, implant therapies appeared and became indisputable and uncontested. However, in some patients, the placement of so-called standard implants proves to be impossible due to the complexity of the protocols, the surgical consequences, sometimes an insufficient quantity of bone or even for economic reasons. In this context, the existence of mini-implants offers an interesting therapeutic alternative in totally bi-maxillary edentulous patients, wearers of complete maxillary removable prostheses and only in these cases.

Assessment of orthopedic treatment quality in patients with complete absence of teeth

Objective. To evaluate the effectiveness of dental orthopedic treatment in patients with complete absence of teeth using removable plate prostheses applying integral qualitative and evaluative indicators. The relevance of the study is dictated by the need to improve the quality of orthopedic treatment in patients with complete absence of teeth, through the introduction of new composite materials, the use of which provides high strength of prosthetic structures. For an objective assessment of the effectiveness of dental orthopedic treatment of patients using removable plate prostheses, integral approaches based on the calculation of qualitative and evaluative indicators have been modified.
 Materials and methods. In order to improve the quality of orthopedic treatment of patients with complete absence of teeth, a design of a complete removable plate prosthesis with a combined basis and a method of its manufacture based on the use of digital technologies was developed. In the course of the work, the evaluation of the effectiveness of treatment in patients with complete absence of teeth in the long-term follow-up using integral qualitative and evaluative indicators was carried out.
 Results. Clinical and laboratory stages of manufacturing a new design combining analog and digital metols were developed and tested. As a result of clinical studies, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the indicator of the integral assessment of the quality of orthopedic treatment, with the exception of the criterion of the prosthesis integrity.
 Conclusions. To conclude, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the integral assessment of the quality of orthopedic treatment, except for the criterion of the integrity of the prosthesis; the introduction of a composite material based on fiberglass into the design of a combined prosthesis allows to improve the strength properties of the prosthesis basis and increase the performance characteristics of the structure. The use of CAD / CAM technologies provides the possibility of using high-strength composite materials, gives sufficient accuracy in the manufacture of the frame of a combined full removable plate prosthesis. Due to satisfactory physical and mechanical properties, the application of the developed design contributes to the predicted increase in the durability of prostheses.

Стан мімічних та жувальних м’язів у людей похилого віку з повною втратою зубів, які користуються повними знімними протезами (ПЗП)

Resume. Masticatory and facial muscles are an integral part of the gnathological system. Their coordinated work ensures synchronous operation of the chewing apparatus, swallowing functions, and speech. The functional state of the muscles of the maxillofacial area is interconnected and interdependent with the work of the TMJ. But over time, a person loses teeth, of course, all this affects the coordination, condition and work of the chewing muscles. Of particular interest is the work of the masticatory and mimic muscles in the age group after 75 years in people who have been using complete removable prostheses(CRPs) for a considerable time, against the background of pronounced processes of atrophy of the maxillofacial area. During this time, the structural elements of the CRPs change, prostheses wear out, and the height of the bite changes significantly. Clinical studies prove that masticatory and facial muscles take part in the maintenance of the CRPs during the functions of the oral cavity. In such conditions, these muscles are constantly in a state of adaptation to those changes that occur with the chewing apparatus. One of the indicators of the condition of the masticatory muscles is their bioelectric activity. Keywords: electromyography, coefficient k, bioelectric activity, bioelectric rest, temporal muscle, masseter muscle, orb muscle, mandible, bioelectric activity of muscles, complete removable prostheses(CRPs).

Prosthetic rehabilitation with removable dentures positively influences quality of life in older patients: a systematic review

Objective: This systematic review assessed the effects of prosthetic rehabilitation with removable dentures on oral health-related quality of life (OHRQoL) in older adults. Methods: A comprehensive electronic search was conducted in the PubMed/MEDLINE, Web of Science, and Cochrane databases to identify randomized clinical trials and prospective clinical studies. The included studies evaluated the effects of prosthetic rehabilitation on OHRQoL in patients whose mean age was > 60 years. The interventions included complete dentures, implant-retained overdentures, and removable partial prostheses, with a minimum follow-up period of 1 month after prosthetic rehabilitation. Patient-reported outcome measures, specifically OHRQoL, were the primary outcome. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized clinical trials and the ROBINS-I tool for prospective clinical studies. Results: Eleven articles were considered eligible for the systematic review. The findings indicated that removable dentures improved various OHRQoL domains, mainly functional limitations and physical and psychological disabilities. Retention, stability, comfort, speech, and masticatory efficiency were significantly better with implant overdentures than complete dentures, leading to higher patient satisfaction and OHRQoL. Conclusions: This systematic review suggests that prosthetic rehabilitation with removable dentures has a positive influence on OHRQoL in older patients. The findings highlight the beneficial impact of implant overdentures and fixed adhesive prostheses for enhancing functional outcomes and patient satisfaction. PROSPERO Registration: CRD42020209175.

Clinical substantiation of the method of treatment of patients with complete dentition and prevention of concomitant prosthetic stomatitis

Annotation. A solution to the problem of prevention and treatment of prosthetic stomatitis, which occurs when using complete removable acrylic prostheses, is presented. The author proposes a modification of the base of the prosthesis in order to create a depot of the medicinal substance — amaranth oil. For clinical approval, 114 people who were divided into three groups were given prostheses. Patients of the first group (n=22) were prescribed rinsing with “Rotokan” solution for the first 7 days and enhanced hygiene of the prosthesis; patients of the second group (n=36) used amaranth oil internally and rinsed the oral cavity with it; patients of the third group (n=46) used the prosthesis modified by us and the developed method of treatment and prevention of stomatitis. The condition of the mucous membrane of the prosthetic field was evaluated. We determined the stability of the capillaries of the mucous membrane, the dynamics of leukocyte migration, and the degree of desquamation of the epithelium of the prosthetic bed in these patients. The results were evaluated before prosthetics, after the first day of using the prosthesis, after 7 and 10 days, 1, 3 and 6 months. Statistical data processing was carried out according to the method of O. V. Montsevichute-Eringene using Student’s t-test. Data were considered reliable at a significance level of 0.95. When using this method of prevention, a 24.46% decrease in inflammation of the mucous membrane of the oral cavity was found. Thus, the application of the developed technology of modification of a complete removable prosthesis with the simultaneous appointment of a course of amaranth oil deposited in the prosthesis helped to restore the stability of the capillaries of the prosthetic bed, made it possible to soften the epithelial layer of the space on which the prosthesis is placed, in order to reduce the release of epithelial cells and reduce the level traumatization of the mucous membrane of the oral cavity.

The effect of neuropeptide ACTH4-10 on the adaptation of patients to dental prostheses according to the data of monitoring the emotional state using a polygraph

BACKGROUND: Monitoring and pharmacological correction of adaptation of patients to full removable dental prostheses is actual and practically important problem in stomatology.
 AIM: To study the effect of neuropeptide ACTH4-10 on the process of adaptation of patients to complete removable prostheses by monitoring the emotional state using a polygraph.
 MATERIALS AND METHODS: Examination and primary prosthetics with full removable dentures of patients (6075 years old) were performed of both sexes with total adentia. All patients were divided into three groups: the main group (correction of the adaptation process with ACTH4-10 neuropeptide Semax 0.1% nasal drops), the comparison group (0.9% NaCl solution was administered intranasally) and the control group (without pharmacological correction). Monitoring of the process of adaptation to prostheses was carried out by registering the emotional reaction of patients to the movements of the lower jaw with the help of a polygraph Barrier-14 of the company Antey (Russia).
 RESULTS: The emotional state of patients in the main observation group who received pharmacological correction with ACTH4-10 neuropeptide reaches the values of adapted patients for most of the studied indicators within 714 days after the application of prostheses, and a month after the application of prostheses - for all studied indicators of the curves of the trajectories of the lower jaw (p 0.05), which cannot be noted in patients of the comparison group (NaCl) and the control group. The results obtained indicate a positive effect of the neuropeptide ACTH4-10 on the process of getting used to patients with complete removable prostheses.
 CONCLUSIONS: Neuropeptide ACTH4-10 accelerates the process of adaptation of primary prosthetic patients to complete removable dental prostheses according to the monitoring of the emotional background of patients. The method of registering the emotional state of patients using a polygraph allows us to make an objective conclusion about the effect of occlusion and articulation on the psycho-emotional background and judge the patient's adaptation to a dental prosthesis.

DYNAMICS OF INDICATORS OF MICROBIOCENOSIS OF THE ORAL CAVITY IN TREATMENT OF PATIENTS WITH COMPLETE REMOVABLE PLATE PROSTHESIS WITH THE USE OF OZONE THERAPY

Removable plate prostheses (RPP) belong to the stimuli of combined action and have a direct effect on the oral mucosa, lead to disruption of homeostasis, microbiocenosis of the oral cavity (OC) and various complications; their negative effect is exacerbated by violation of the polymerization regime and increased level of residual monomer (RM).
 Our experimental researches have shown that the use of ozone therapy with Ozone DTA provides antimicrobial effect at the level of 98.8-100%, it has a pronounced bactericidal effect against aerobic and facultative anaerobic microflora of the OP, which may be potential etiological factors of prosthetic stomatitis. Therefore, the aim of our work was to evaluate the impact of ozone therapy on the dynamics of the microbiocenosis of the oral cavity in the treatment of patients with complete removable plate prostheses in clinical settings.
 118 patients were examined and underwent orthopedic treatment with complete RPP.
 There is a significant positive effect of the use of complete RPPs (made of plastic “Ftorax”) with control of the content of RM in their manufacture on the state of microbiocenosis of the mucous membrane of the prosthetic impression area of patients. Combination of these measures with ozone therapy is even more effective, from the standpoint of normalization of the microbiocenosis of the prosthetic impression area. The proposed therapeutic tactics have a preservative effect on the quantitative characteristics of the main resident participants of oral microbiocenoses – α-hemolytic streptococci, while reducing the proportion of stomatococci, epidermal staphylococci, veilonella and diphtheroids in the microbiocenoses of the prosthetic impression area. On the other hand, the combination of RM content control with ozone therapy provides effective elimination from the mucous membrane of the prosthetic impression area of microorganisms with high pathogenic potential.
 Observations of the composition of microbiocenoses of the mucous membrane of the prosthetic impression area of patients showed in the dynamics that the maximum changes are observed 1 month after orthopedic treatment, and they were slightly less severe after 6 months.
 Serious dysbiotic disorders were observed within 1-12 months in patients who used PPPs made of plastic “Ftorax” without control of the content of RM, which is apparently due to the effect of residual monomer on the mucous membrane of the prosthetic impression area. Patients of this group after the treatment with RPP undergo an adaptation period, when on the mucous membrane of the prosthetic impression area the population level of representatives of resident microflora is increased and at the same time the risk of colonization by microflora with high pathogenic potential increases.
 The use of the procedure of control over the content of RM in the process of making RPP from Ftorax plastic shortens the adaptation period, and 6 months after orthopedic treatment there is a steady trend to normalize the qualitative and quantitative composition of microbiocenoses of the mucous membrane of the prosthetic impression area.
 Additional application of the course of ozone therapy helps to eliminate the adverse effects of RPP (made of Ftorax plastic) on the microbiocenosis of the mucous membrane of the prosthetic impression area. This contributes to a significant reduction in the mass colonization of the mucous membrane of the prosthetic impression area by resident and transient representatives of the normal microflora, provides effective elimination of pathogens – β-hemolytic streptococci, Staphylococcus aureus, enterobacteria, and especially yeasts of the genus Candida.

Rehabilitation Of Anterior Maxillary Hypoplasia With Cleft Palate Using A Selectively Hollowed Complete Removable Prosthesis – A Case Report

Cleft palate is a congenital facial deformity that presents clinically with anterior maxillary hypoplasia, congenitally missing teeth, nasopalatal communication, anterior openbite and a constricted maxillary arch. Aesthetic and functional rehabilitation of cleft palate patient requires the use of a prosthesis that provides adequate support to the lip and reduces the problem of nasal regurgitation. This article describes the fabrication of a removable prosthesis that has been modified anteriorly by providing added thickness to the labial flange so as to increase the lip support. This flange has been hollowed out to reduce the weight of the prosthesis and also provides comfort and ease of use. The palatal plate evades nasal regurgitation and improves speech.

Vestibuloplasty using an apically-shifted flap in patients with edentulous mandibles

BACKGROUND: One of the most common problems of the dental system in the residential and senile age is the complete absence of teeth. This pathology affects up to 35% of patients aged 5570 years, and at the age of 75 years and older, more than 50% of patients have toothless jaws. A small vestibule of the oral cavity due to atrophy of the alveolar process on the lower jaw is an important reason for unsatisfactory fixation of a complete removable prosthesis, and therefore prosthetics of this group of patients is a complex clinical problem.
 AIM: Study: to optimize the surgical stage of treatment during the operation of deepening the vestibule of the mouth by the method of apically displaced flap in the complete absence of teeth on the lower jaw by using the gel preparation Emalan (Zelenaya dubrava, Russia) based on collagen.
 MATERIAL AND METHODS: The results of the study of 28 patients aged 67 to 76 years with complete absence of teeth in the lower jaw, whose treatment was carried out on the basis of the dental clinic Prime Dentistry of Ryazan, were analyzed. The study included elderly and senile patients, according to the WHO age classification. Patients were not assigned by gender. All patients were equally divided into 2 groups.
 Clinical evaluation of the early postoperative period was carried out for 10 days after surgery on the 2nd, 5th and 10th days. A verbal descriptive pain scale was used to assess the intensity of pain.
 In order to control the presence of an inflammatory reaction in the postoperative period, local thermometry was performed locally using an infrared scanner.
 RESULTS: Examination on the 2nd day showed that patients of both the main and comparison groups had slightly pronounced edema of the surrounding soft tissues. No increase in body temperature was recorded in both groups. Assessing the postoperative wound, on the 2nd day, all patients of the comparison group had marked hyperemia and swelling of the mucous membrane in the area of the surgical wound, and in patients of the main group such changes were detected less frequently. On the 5th day, no mucosal edema was observed in patients of the main group, and hyperemia was noted twice. In the comparison group, swelling and hyperemia of the mucous membrane in the wound area were recorded in almost half of the group. Examination of the wound defect on the 10th day showed that in the main group in all patients the wound was epithelized, whereas in the comparison group the signs of epithelization were weakly expressed. When studying the dynamics of local thermal symmetry using an IR scanner, carried out three times: on the eve of the operation, on the 2nd and 5th days after the intervention, a difference in indicators was noted between the main group and the comparison group. Patients assessment of the intensity of pain in the postoperative period using a verbal descriptive pain scale showed the following results. After complete cessation of anesthesia, most patients of the main group had slight discomfort in the wound area. Patients of the comparison group mainly complained of severe pain. On the 2nd day and on the 5th day after surgical intervention, some patients of the comparison group had complaints of mild pain in the wound, all other patients, including patients of the main group, had no pain.
 CONCLUSION: The use of collagen-based gel preparation Emalan to close wound postoperative defects with open methods of deepening the vestibule of the mouth gives positive results in the healing process of the wound defect in the form of absence or significant reduction of pain syndrome, reduction of inflammatory reaction in the wound and acceleration of epithelization.

Interarch space assessment in edentulous patients rehabilitated with complete removable dentures using open-access software.

BackgroundThe interarch space is defined as the vertical space between the edentulous ridge and the occlusal or incisal aspect of the opposing arch. Measuring the interarch space in a patient requiring an implant-supported fixed prosthesis is crucial for determining the prostheses to be used in each clinical situation. Depending on the measurements and other factors, such as the need for lip support or pink esthetics issues, decisions about the most convenient type of implant-supported prosthesis can be taken. Analogic workflow to measure the interarch space can represent a time-consuming and expensive procedure that may lead to inaccuracies. ObjectiveTo describe a step-by-step protocol to measure the upper and lower interarch space with open-access software, starting from the digital scan of the patient's complete dentures obtained with an intraoral scanner. MethodsAn extraoral scan (using an intraoral scanner) of the existing complete removable prosthesis is required to assess the interarch space for making an implant-supported prosthesis treatment planning. If the existing complete denture does not fulfill the required functional and esthetic parameters, a complete interim denture, a wax trial denture, or a printed denture prototype should be previously fabricated. The antagonist arch and the intermaxillary record scan also need to be obtained. Finally, all STL files are imported into an open-access software for measuring the interarch space. ResultsOpen-source software can be used to measure the upper and lower interarch space from existing complete dentures following the step-by-step protocol outlined in this paper. ConclusionInterarch space of edentulous patients rehabilitated with complete dentures can be measured with a 360 degrees scanning of the existing complete denture and open-access software by applying the protocol outlined in this paper. Clinical relevanceThe clinician can assess and digitally measure the interarch space of edentulous patients requiring an implant-supported fixed prosthesis using an open access software.

CLINICAL EVALUATION OF ATROPHIC CHANGES IN TISSUES OF PROSTHETIC IMPRESSION AREA IN TREATMENT OF PATIENTS WITH COMPLETE REMOVABLE PLATE PROSTHESIS WITH THE USE OF OZONE THERAPY

One of the main methods of treatment of patients with complete absence of teeth is the use of complete removable plate prosthesis (CRPP) made of acrylic plastics. Violation of the polymerization regime and increased amount of residual monomer in acrylic prostheses lead to a number of complications in the tissues of the prosthetic impression area. According to our previous experimental researches, the use of ozone therapy is a promising area for the prevention and treatment of inflammatory processes and microbial lesions of the oral mucosa. Therefore, the aim of our research was to evaluate the effect of monitoring the level of residual monomer in the bases of prostheses and the influence of ozone therapy on atrophic changes in the tissues of prosthetic impression area in the treatment of patients with CRPP.
 118 patients with CRPP were examined and underwent of orthopedic treatment. Patients were divided into the following groups:
 Group 1 consisted of 33 patients who underwent of orthopedic treatment with complete removable plate prostheses made of plastic "Ftorax" by conventional methods.
 Group 2 included 39 patients with complete removable plate prostheses made of plastic "Ftorax" with controlled level of residual monomer by the proposed method of spectrophotometry.
 Group 3 consisted of 46 patients with complete removable plate prostheses made of plastic "Ftorax" with controlled level of residual monomer by the proposed method of spectrophotometry using the course of ozone therapy.
 Each group was further divided into subgroups; the patients underwent of orthopedic treatment on the upper "a" and lower "b" jaw.
 The intensity of atrophic changes in alveolar processes of the jaws was assessed in the dynamics of orthopedic treatment in certain regions (A, B, C, D, E) of the prosthetic impression area and determining of the total atrophy of the alveolar process of the jaws after 1 week, 1, 3, 6, 12 months of a removable prosthesis using. Ozone generation was performed using the Ozone DTA (APOZA Enterprise Co., Ltd., Taiwan), which is recommended for clinical use in dental practice.
 There is a direct dependence of CRPP fixation on the intensity of atrophic changes in alveolar processes of the upper and lower jaws, which were less pronounced in patients with residual monomer control in prosthetic bases and in combination with ozone therapy of mucosa in the prosthetic impression area. Atrophic changes in mandibular alveolar processes have a more significant effect on the fixation of complete removable plate prostheses in comparison with atrophic changes of the upper jaw. A probable regularity was revealed during the period of 1-12 months of orthopedic treatment of patients with CRPP, which indicates more uniform atrophies in different areas A, B, C, D, E on the upper jaw but the atrophic changes are not uniform on the lower jaw. A course of ozone therapy of mucosa in the prosthetic impression area during orthopedic treatment of patients with CRPP in combination with control of the level of residual monomer in the bases of removable prostheses significantly slows down the process of atrophic changes.
 The obtained clinical results substantiate the possibility and expediency of using CRPP from acrylic plastic made with control of the level of residual monomer by the proposed method of spectrophotometry and the use of ozone therapy to prevent atrophic changes of alveolar processes of the jaws and prosthetic stomatitis.

Oral rehabilitation and quality of life in psychiatric patients undergoing deinstitutionalization

Introduction Oral Health-Related Quality of Life (OHRQoL) measures can be used in mentally impaired groups to evaluate the consequences of oral health treatments. The objective of this study was to describe the impact of a prosthetic rehabilitation treatment on oral health-related quality of life in psychiatric adults in the process of deinstitutionalization. Methodology We designed a quasi-experimental study to assess the OHRQoL of patients with mental disorders before and after prosthetic treatment on a sample of 165 institutionalized neuropsychiatric patients between 18 and 65 years of age (x=50.24 y.o.; SD= 7.85). Before treatment, the validated Spanish version of OHIP-14 was filled out by each participant. Caries experience was assessed using the DMFT index. Sex, age, type of mental disorder, length of hospitalization, and permanence in a deinstitutionalization program were registered. The diagnoses of the psychiatric pathologies were transcribed from the medical records, following the DSM-IV criteria. The therapeutic intervention consisted in manufacturing and installing partial and complete removable acrylic prostheses, according to each patient’s needs. Results The sample had a DMFT index mean of 19.71 (SD=5.54). Missing teeth represented 86.86% of the total of the DMFT index. The OHIP-14 score before the intervention had a mean value of 26.06 (SD=8.74). After the prosthetic treatment, the OHIP-14 score had a mean value of 7.70 (SD=3.96). The statistical analysis revealed a significant difference between pre and post treatment intervention (p= 0.018). Conclusion This study showed that oral rehabilitation affected the oral health-related quality of life of patients with psychiatric disorders included in a social integration program.

Functional Removable Prosthetic Rehabilitation Using the Electronic Condylograph: A Case Report

This article describes the design of complete removable prostheses following the Slavicek philosophy, which involves the integration between condylographic data and an individual cephalometric study of the patient. The electronic condylograph is a device that records the mandibular movements made by the patient. This case report shows how condylography data are useful not only in the individual articulator setting, but also for diagnostic completion and for planning a functional prosthetic rehabilitation.

Rehabilitation of an Extremely Atrophied Mandibule with Cortical Plates

A 74-year-old woman presented in our dental practice with severe loss of alveolar bone and soft tissue without any apparent systemic pathology contributing to her dental conditions. She had a complete removable prosthesis supported with a four locaters system. Unfortunately, two of the four supporting implants were failed. The patient wanted a fixed prosthesis. The treatment plan was to use the remaining implant with an additional axial implant and two cortical plates (Victory ®) followed by implant placement. The implants and plates were immediately loaded with a screw-retained prosthesis made with Znatex frame (Victory Implants ®) and resine.