Dentition Defects Research Articles

The effect of attachment systems and denture cleaning methods on microbial biomass and composition in implant-supported overdentures: an experimental study

ObjectiveThis research endeavors to scrutinize the influence of attachment systems and denture cleaning methodologies on microbial biomass and composition within the realm of implant-supported overdentures, a crucial consideration for patients with dentition defects necessitating such prosthetic solutions.Subjects and methodsEmploying five polymethyl methacrylate specimens designed to emulate the fitting surfaces of traditional dentures and implant-supported overdentures. Following the polishing of each specimen and the quantification of its roughness, co-cultivation with three distinct microbial strains ensued, culminating in ultrasonic cleaning in water. The bar-clip group, differentiated by the depth of attachment, underwent cleaning employing four diverse methods. Biomass quantities were meticulously recorded both pre and post cleaning interventions, with subsequent data analysis via t-testing and one-way ANOVA, maintaining a significance level of α = 0.05.ResultsThe bar-clip groups demonstrated an elevated degree of microbial adhesion, with the deeper locator group exhibiting heightened biomass residue post-cleaning, indicative of increased cleaning complexity. Ultrasonic cleaning predominantly targeted biofilm and deceased bacteria, whereas chemical cleaners primarily reduced the quantity of viable bacteria. The synergistic application of ultrasonics and chemical cleaning treatments yielded the minimal biomass residue.ConclusionIn contemplating the utilization of dentures milled by dental computer-aided design/manufacturing systems, meticulous pre-use surface polishing is imperative. The extent of biofilm adhesion correlates with the chosen attachment system. This study advocates for the incorporation of ultrasonic cleaning in conjunction with chemical cleaning solutions to optimize the removal of biofilm and live cellular entities in the context of implant-supported overdentures.

Modern views on the etiology and role of microbial persistence in the development of inflammatory processes in the periodontal complex (review)

Alveolar tissue diseases cause the appearance of dentition defects, thereby reducing the patients' work capacity and quality of life. The purpose of this research was to investigate, modern views on the etiology of periodontitis and the role of microbial persistence in the development of inflammatory processes of periodontal complex basing on a review of literary sources. Literature review was conducted using PubMed, Web of Science, Scopus, Google Scholar from 2018 to March 2024. There were no restrictions on the date of publication or the language of scientific sources. Searches were conducted according to MeSH (Medical Subject Headings) with using the following search terms: "periodontitis", "oral mucosa", "gums", "dental plaque", "periodontium", "traumatic occlusion", "microorganisms". In total, during the initial analysis 82 literary sources were selected and processed, after further systematization of the selected information using general scientific methods, 70 of them remained. Used methods: bibliographic and analytical. Generalized perio­dontitis is a chronic inflammatory-dystrophic process that occurs as a result of various factors. In the pathogenesis of this disease, the key role is played by the inflammatory process, which is a complex interaction of microcirculatory, he­matological and connective tissue reactions to the lesion. Local (exogenic) and general (endogenic) causative factors are distinguished. The main factors that cause pathological changes in periodontium are bacterial biofilm, traumatic occlusion and various anatomical anomalies. Dental plaque occupies a special and main place among the causes of periodontitis. At present, leading pathogenetic links in the development of the inflammation in the periodontium, in par­ticular, the disruption of free radical oxidation, the processes of peroxide oxidation of lipids and proteins, the disorder of the functional state of the antioxidant system, the formation of oxidative stress, as well as the humoral link of adaptive immune protection and cytokinesis, have not been sufficiently studied. There is no doubt about the role of the microbial factor in the etiology of periodontal diseases, but the penetration of microbes into the periodontium does not always lead to the development of the disease, because the organism has a number of protective mechanisms that counteract the development of inflammation.

Preparation of zirconium hydrogen phosphate coatings on alkali thermal titanium via a one-step sol–gel method to improve the friction resistance, bioactivity, and osteogenic potential

Titanium implants are widely used in dental restorations for patients suffering from dentition defects. However, the biologically inert of Ti, poor osteoinduction properties and the release of Ti particles due to friction between the bone and the implants can inhibit osseointegration and adversely affect the success rate of implantation. In this study, a zirconium phosphate (ZrP) coating was constructed on the surface of alkali thermal titanium (AT-Ti) via a one-step sol–gel approach. Subsequently, the friction resistance, bioactivity, and osteogenesis properties of the prepared coating were studied. The surface characterization results confirmed that AT-Ti was successfully coated with amorphous ZrP, and ZrP modification was found to effectively reduce the friction rate. In addition, the surface morphology after friction test was smoother. In terms of the bioactivity, the presence of a phosphate group in the ZrP coating led to the effective enrichment of Ca2+ to promote the formation of hydroxyapatite (HAp). It was also discovered that ZrP exhibited an excellent performance in cell viability and mineralization experiments, in addition to up-regulating the expression of osteogenesis related genes. Overall, ZrP modification of AT-Ti leads to an excellent friction resistance, bioactivity, and osteoinductive properties, thereby indicating its broad application prospects in implant therapy.

Clinical efficacy of a two-piece abutment conforming to the concept of one abutment one time in the posterior region: A clinical pilot study.

To assess the impact of a two-piece abutment workflow on enhancing the stability of the alveolar bone and gingiva surrounding the dental implant, and to determine the level of patient satisfaction. A total of 48 patients with dentition defect in the posterior region were included and divided into two groups: the two-piece abutment workflow (TAW) and the sealing screw with submerged healing workflow (SHW). Marginal bone level (MBL), soft tissue indicators, oral hygiene indicators, and patient satisfaction were assessed and recorded partially at 0, 3, 6, and 12 months after surgery. The primary outcome was the change of MBL in different time periods. A generalized linear mixed model (GLMM) was used to take into account the correlated nature of the data, and adjust for potential confounding factors within inter-group differences. The survival rate of implants and prosthesis reached 100% at 12-month follow-up, with an average decrease of 0.25 mm (SD 0.23 mm) of MBL in the TAW group and 0.48 mm (SD 0.45 mm) in the SHW group. The change of MBL in the TAW group (0.15 ± 0.31 mm) was significantly lower than the SHW group (0.41 ± 0.41 mm) through the analysis of GLMM within 6 months, while no significance was found in 12 months. Moreover, less gingival pain and oppression during prosthesis loading, and less time consumption overall duration were showed in the TAW group through Visual Analogue Scale (VAS, p < 0.05). Within a 6-month period, the two-piece abutment workflow showed superior efficacy in preserving the integrity of the marginal bone level. Furthermore, it streamlined treatment procedures and mitigated discomfort, hence increasing patient satisfaction.

Knowledge, attitudes, and practices among patients with combined dentition defect and non-functional impacted teeth toward tooth autotransplantation

BackgroundTooth autotransplantation (TAT) is a surgical procedure involving the extraction of a tooth from one location and its subsequent transplantation into another alveolar socket within the same individual. This innovative treatment approach holds significant promise. Nonetheless, the potential recipients exhibit a limited level of awareness and understanding of this procedure. This study investigated the knowledge, attitudes, and practices (KAP) among patients with combined dentition defects and non-functional impacted teeth toward TAT.MethodsThis web-based cross-sectional study was conducted between December 2022 and February 2023 at one hospital. A self-designed questionnaire was developed to collect demographic information of the patients and assess their knowledge, attitudes, and practices toward TAT.ResultsA total of 533 valid questionnaires were collected. The mean knowledge, attitude, and practice scores were 5.55 ± 2.38 (possible range: 0–10), 26.82 ± 2.46 (possible range, 8–40), and 27.45 ± 7.40 (possible range, 9–45), respectively.ConclusionThe participants had insufficient knowledge, negative attitudes, and passive practices toward TAT. Targeted interventions should be implemented to improve the understanding and practice of TAT among patients with dentition defects.

Observation of the curative effect of orthodontic combined repair on malformation with dentition defect.

Observation of the curative effect of orthodontic combined repair on malformation with dentition defect.

Dental rehabilitation of a patient with a decrease in bite height due to pathological abrasion of hard tooth tissues (clinical case)

At the present stage of diagnostics and treatment of dental diseases, morphofunctional disorders of the dento-maxillary system associated with a decrease in the height of occlusion are becoming more common. In the scientific literature, this pathological condition is described under the name "occlusion" that decreases. The reasons that cause it include partial or complete loss of teeth, irrational prosthetics and untimely restoration of dentition defects, doctors' mistakes in the restructuring of the masticatory apparatus, and a generalized form of pathological abrasion of hard tooth tissues. The purpose of the study – demonstration of a clinical case of pathological abrasion of hard tissues of teeth with a decrease in bite height, complicated by defects in the dentition. Patient S., 47 years old, applied for orthopedic help with complaints of anatomical deformity, significant abration of teeth on the upper and lower jaws, increased sensitivity to various types of irritants, partial absence of teeth, impaired masticatory function, periodic clicking in the temporomandibular joint, aesthetic and phonetic defects. Based on the data obtained, we established the following diagnosis: generalized form of pathological abrasion of hard teeth tissues, subcompensated form of reduced bite height, complicated by defects in the dentition of the upper jaw – class I according to the Kenedy classification, lower jaw – class III according to the Kenedy classification. The loss of chewing efficiency according to Agapov was 68%. Patient S. was recommended a two-stage orthopedic treatment, which involves preliminary separation of the bite with the help of individual vinyl mouth guards which have an increasing thickness of 2, 4 and 6 mm, made for the lower jaw.The planned treatment period with each of the muscle relaxant splints will be 2 months. Subsequently, 15, 14, 13, 12, 11, 21, 22, 23, 24 will be restored with one-piece metal crowns with ceramic cladding, and the final defects in the lateral areas will be restored with a clasp prosthesis with a locking system of fixation. The included defect of the lateral part of the lower jaw is planned to be restored with a metal-ceramic bridge-like prosthesis with a support on 47, 45, 44, and the worn-out hard tooth tissues will be completely restored with photopolymer material. In patients with a reduction in bite height of more than 2 mm, it is advisable to carry out treatment in two stages. At the first stage, we normalize the occlusal height and rebuild the function of the masticatory muscles. At the second stage, we provide rational prosthetics. Orthopedic rehabilitation with myorelaxing splints of increasing thickness makes it possible to correctly rebuild myostatic reflexes and prevent functional disorders in the TMJ. Any case of complex treatment of patients with a decrease in bite height due to pathological abrasion of the hard tooth tissues deserves the attention of both scientists and dentists in practical health care.

PRIMARY AND POST-OSSEOINTEGRATION STABILITY OF SHORT (ULTRA-SHORT) IMPLANTS ON EDENTULOUS ATROPHIED DISTAL SEGMENTS OF THE MANDIBLE - AN INDICATOR OF IMMEDIATE OR DELAYED LOAD

Introduction. The issue of determining the possibility of immediate or long-term load on the selected type of implants, which will ensure the predictable result of their long-term functionality, remains an ongoing discussion. The results of the resonance frequency analysis, which perfectly characterize the stability of short and ultrashort implants at all stages of their osseointegration and post-osseointegration periods, can serve as such an indicator basis. Aim. To analyze the primary and post-osseointegration stability of short (ultra-short) implants placed by the methods at the level of the cortical bone layer and subcortically in case of bone atrophy caused by acquired final dentition defects. Materials and methods. The primary and post-osseointegration stability of thirty-nine dental short (h = 6.5 mm X b = 4.0 mm – 20 pieces) and ultra-short (h = 5.5 mm X b = 4.0 mm – 19 pieces) implants placed on the edentulous distal segments of the human mandible was studied. According to the clinical assessment that met the aim and objectives of this study, all patients were divided into four study groups: the first group consisted of patients with a preserved dentition who did not require dental implantation; the second group – 25-45 years old, the third group – 46-60 years old, and the fourth group – ≥ 61 years old. Using the resonance frequency analysis (RFA) method by Penguin Instruments, the results were interpreted in declarative units of measurement – the implant stability quotient (ISQ). Results. The installed short (ultrashort) implants, according to the methodology by the level of the cortical layer of bone tissue, are characterized by their high primary stability by anti-rotational force: in the second group of the study (25-45 years old) with a mean number (M) of 87.0 and an error of the mean (± m) of ± 2.3 ISQ; in the third group (46-60 years old) – 76.4 ± 3.0 ISQ; in the fourth group (persons ≥ 61 years old) – 69.8 ± 4.8 ISQ. Low values of primary stability were obtained in implants installed by the subcortical implantation technique in the second age group of the study and amounted to 59.6 ± 2.7 ISQ with a slight increase to 66.0 ± 4.1 ISQ in the third group and 71.7 ± 4.2 ISQ in the fourth group of the study, which do not guarantee the prognosis of functional redistribution of the supra occlusion immediate load on the biological basis, with further preservation of the course of normal physiological processes in the bone tissue around the implanted implants. Conclusions. Rehabilitation of patients with bone atrophy caused by the loss of the masticatory group of teeth is possible using short (h = 6.5-6.0 mm) and ultra-short (h = 5.5 mm) implants, with clinical justification for the choice of methods of immediate or post-osseointegration load, with a detailed resonance frequency analysis as a priority and reliable method – an effective indicator of their stability, at all stages of clinical rehabilitation of patients.

Case of precise full-mouth occlusal reconstruction guided by digital occlusal function analysis.

The clinical demand for occlusal reconstruction increases rapidly with increasing number of patients who have lost their normal occlusion because of tooth wear and dentition defects. Occlusal reconstruction is a special type of restoration defined as a comprehensive restoration of the function of the stomatognathic system by reestablishing a uniform and stable occlusal relationship between the upper and lower dentitions. Occlusal function analysis is an important part of occlusal reconstruction to achieve accurate restoration design and adjustment. Digital occlusal function analysis was conducted to monitor the movement of the mandible and obtain related data for the parameter design of occlusal reconstruction. Preoperative design, intraoperative adjustment, and postoperative verification were achieved, thereby improving the efficiency and accuracy of occlusal reconstruction.

ИСПОЛЬЗОВАНИЕ ЦИФРОВЫХ ТЕХНОЛОГИЙ ПРИ РЕАБИЛИТАЦИИ ПАЦИЕНТОВ С ПЕРВИЧНОЙ АДЕНТИЕЙ

Abstract. Introduction. Number of patients with hypodontia has increased at orthodontic appointments. According to different authors, the frequency of tooth rudiments absence ranges from 2 % to 16.5 %. The highest rank is held by maxillary lateral incisors hypodontia. Due the increased patients’ aesthetic requirements, it is a difficult task, especially with the alveolar ridge bone deficiency. Treatment of such patients requires a multidisciplinary approach and the use of digital technology. The aim of the study is to improve the treatment effectiveness for patients with hypodontia, using digital planning, surgical templates, intraoral scanning, and the CAD/CAM modelling of metal-free screw-retained crowns on dental implants. Materials and Methods. The clinical study was performed in the dental office PreziDent (Cheboksary) in 2018-2023. The total number of patients was 24 people (female), aged 16 to 34 years. There were two groups (n=12). The first group patients had their missing teeth replaced using dental implantation without using any digital technology. In the second group, those with the use of digital technologies. Gingival condition of the dentition defect area was assessed: Severity of stippling phenomenon degree, density gingival margin adherence to the structural materials, vacuum capillary resistance by Kulazhenko, and Mülleman-Cowell bleeding index. SPSS 13.0 software package was used for the statistical processing of the results obtained. Results and Discussion. The first stage of treatment included orthodontic treatment, bracket placement and canine distalization. Some patients were fitted with orthodontic miniscrews in the subclavicular region. After creating gaps for the future lateral incisors, a surgical template was fabricated and dental implants were placed. Four months after implantation, the bracket system was removed and the implant temporary crowns were placed; six months later, CAD/CAM digital metal-free prosthetics were placed. Not a single case of implant loss was detected. An algorithm framework was developed for managing patients with maxillary lateral incisor hypodontia. Conclusions. Using computer programs for planning dental implantation and in navigation surgery allows installing dental implants most accurately and making digital metal-free prosthetic constructions by computer-aided modelling and manufacturing. Thus, the risk of complications is reduced and an effective functional and aesthetic state of dentoalveolar system is achieved in patients with primary anodontia.

Assessment of dental mobility in elderly and senile patients with various types of dentition defects

Objective. To determine the differences in the degree of tooth mobility in elderly patients with various types of dentition defects. To establish and differentiate the degree of tooth mobility in relation to the type of dentition defect in elderly and senile patients. Materials and methods. 500 patients aged 60 to 75 divided into 4 groups were examined. In the first group of patients, terminal defects were revealed (on one or both sides). The second group consisted of patients with included defects (on one or both sides). The third group was presented by combined defects (included and not included). Patients with single standing teeth constituted the fourth group. Patients with complete absence of teeth were excluded from the study. The assessment of dental mobility was carried out using the Periodotest device. All studies on dental mobility were conducted as part of the initial examination of the patient. To obtain objective data, periotestometry was performed 2 times in each patient. Average periotestometry data were calculated for each patient. The average readings of periotestometry for different groups of patients were determined. Results. On the basis of the data obtained while comparing the results of periotestometry, in relation to the type of dentition defect, statistically significant differences were established (p 0.001) (method used: the Kraskel – Wallis criteria). The results of periotestometry obtained in patients of group 4 were significantly higher than in representatives of other examined groups. The least mobility according to the results of periotestometry was observed in groups 2 and 3. Conclusions. The study revealed significant differences in the degree of tooth mobility in relation to the type of dentition defect. In patients with single standing teeth, 2–3 degree of their mobility was determined, while patients with included defects had 1–2 degree of the mobility of existing teeth. The obtained data of periotestometry indicate the need to use unloading dentures in elderly patients, in order to preserve the remaining teeth in patients with single-standing teeth, as well as in patients with terminal defects of the dentition.

Suitability and Trueness of the Removable Partial Denture Framework Fabricating by Polyether Ether Ketone with CAD-CAM Technology.

The object of the study was to evaluate the suitability and trueness of the removable partial denture (RPD) framework fabricated by polyether ether ketone (PEEK) with the CAD-CAM technology in vitro. Four different types of dentition defects were selected. In each type, five PEEK RPD frameworks were fabricated by the CAD-CAM technology, while five Co-Cr RPD frameworks were made by traditional casting. The suitability of the framework was evaluated by silicone rubber film slice measurement and the three-dimensional image overlay method. The trueness of the PEEK framework was detected by the three-dimensional image overlay method. Data were statistically analyzed with the use of an independent samples t-test (α = 0.05). The suitability values by silicone rubber film slice measurement of the PEEK group were lower than those of the Co-Cr group in four types, with the differences indicating statistical significance (p < 0.05) in type one, type two, and type four. The suitability values using the three-dimensional image overlay method showed no statistical differences (p > 0.05) between the two groups in four types. The trueness values of the PEEK group were within the allowable range of clinical error. The suitability and trueness of the PEEK RPD framework fabricated by CAD-CAM technology met the requirements of the clinical prosthesis.

Fully digital workflow of occlusal reconstruction treatment in a patient with congenital dentition defects.

Occlusal reconstruction is a critical intervention for patients with dental hard tissue defects, temporomandibular joint (TMJ) disorders, and jaw position abnormalities. Clinical efficiency and outcomes of these procedures have improved with advances in digital technologies. This case report aims to illustrate a comprehensive digital workflow for occlusal reconstruction in a patient with congenital dentition defects, emphasizing the application of digital technologies to enhance treatment outcomes. A 28-year-old woman with previously installed porcelain-fused-to-metal bridge restorations presented with a fractured prosthesis and TMJ symptoms. A multidisciplinary approach was adopted involving the use of digital facebow, intraoral scanners, digital smile design, and CAD/CAM technologies. The process included the extraction of defective restorations, temporary restorations to refine jaw position, and final permanent restorations. The digital workflow facilitated precise diagnostics and treatment, culminating in the successful installation of permanent restorations. Regular follow-ups at one- and three-months post-treatment confirmed stable occlusal function and high patient satisfaction. This case report showcases the potential of multiple digital technologies to streamline complex dental treatments and achieve high-quality results. The integration of digital technologies in occlusal reconstruction treatments offers significant benefits in terms of precision, patient comfort, and esthetic outcomes.

КЛИНИЧЕСКАЯ ОЦЕНКА РЕЗУЛЬТАТОВ ПОДГОТОВКИ К НЕСЪЁМНОМУ ПРОТЕЗИРОВАНИЮ ПОСЛЕ ПРОВЕДЕНИЯ ДЕНТАЛЬНОЙ РЕПЛАНТАЦИИ

After dental replantation surgery, it is necessary to take measures to promote the healing of the replanted tooth. In almost 100% of cases, clear signs of an acute inflammatory reaction of periodontal tissues are diagnosed. The effectiveness of combined preparation and pharmacological therapy in the prevention of the inflammatory process of periodontal tissues after tooth replantation was assessed. The condition of the periodontal mucosa and periodontal ligamentous apparatus in the area of supporting teeth was studied in preparation for orthopedic treatment of dentition defects, after the operation of their dental replantation. To solve the set tasks, research methods were used in the work: visual, palpation, instrumental, and statistical analysis of the research results. The patients are divided into two groups. Drug therapy was carried out using traditional medications: antiseptics, antibacterial drugs, biogenic stimulants, etc. Drug therapy used to treat patients in group 1 and group 2 was identical in the list of medications used. Patients of the 2nd group underwent complex treatment of inflammatory phenomena of the desmodontal structures and periodontal mucosa that occur after replantation surgery. In addition to pharmacological drugs, exposure to modulated red light was used using a Stomasvet physiotherapeutic device with a wavelength of 328 nm, a pulse modulation frequency of 76 Hz, and a radiation power of up to 30 mW. On the first day of the study, patients of group 1 and group 2 were characterized by hyperemia of the periodontal mucosa in the area of the replantation, swelling, and pain. By the fourth day, in patients of group 2, the inflammatory phenomena completely disappeared. In patients of group 1, inflammatory phenomena completely disappeared only by the eighth day. An integrated approach to the diagnosis and treatment of periodontal pathologies that arise after dental replantation will reduce the preparatory period for subsequent orthopedic correction of dentition defects, reduce the duration of patient adaptation to the structures used, and also increase the overall level of orthopedic treatment in dentistry.

Features of Hygienic Care for Removable Prostheses Made of Thermoplasts

As a result of the study, 74 patients with a diagnosis of dentition defects were made partial removable lamellar dentures from various structural dental materials. To identify the awareness of patients about the peculiarities of hygienic care for the oral cavity when using removable dentures, a preliminary survey of all respondents was conducted. The results of this survey demonstrated a low level of patient awareness of the specifics of hygienic procedures for the care of dentures. More than half of the respondents (52.4 %) did not have sufficient information about the rules and features of hygienic oral care when using removable orthopedic structures. Only 31 % of respondents cleaned removable dentures twice a day, more than half, 60 % cleaned the denture once a day. According to the results of the survey, 76.5 % of respondents revealed violations of the rules of personal oral hygiene. Additional hygiene products for the care of removable dentures in the form of cleaning tablets are used by 5.6 % of patients, 83.1 % of patients did not use additional hygiene products.

Influence of the angle of dental implant placement on the stress-strain state of the jaw

prosthetics on dental implants is a complex and responsible stage of treatment of patients with dental defects. The success of dental implantation depends not only on careful planning and performed surgical intervention in compliance with the requirements of the protocol, but also on the type of load on the dental implant, the choice of orthopedic design and material. Thorough preparation for prosthetics, taking into account the initial clinical situation and individual characteristics of the patient, ensures a full restoration of the dentition defect with reproduction of the chewing function. The parameters of the stress-strain state in the bone tissue around dental implants are of the greatest importance for the effectiveness of prosthetics on implants, especially in the long term of their functioning. Significant power loads of variable amplitude in the jaw lead to resorption of bone tissue and failure of implants as artificial dental prostheses. In this regard, research on modeling the stress-strain state in bone tissue under different loading conditions of implants is relevant. This research presents the results of studying the stress-strain state of the bone-implant system under static loading. Numerical calculations were performed for four installation angles of the implant: 0°, 7°, 15°, and 22°. The solid model of the mandible and the implant model were made in Spaceclaim software, and the stresses were determined using ANSYS Workbench. The results obtained show the effect of the implant placement angle on the distribution of stress fields in the bone tissue and implant. The analysis of the calculation results will help to ensure optimal functioning and durability of dental implants.

APPLICATION OF ANTIMICROBIAL NANOPARTICLES OF METALS AND THEIR OXIDES IN IMPROVING DENTAL PROSTHESES

Many nanoparticles of metals and their oxides, including silver, titanium, zinc, copper, zirconium, have antimicrobial properties. These nanoparticles are a promising strategy for the treatment and prevention of oral cavity infections and can be used in various fields of dentistry. The purpose of the work is to present a literature review on the application of applying antimicrobial nanoparticle of metals and their oxides in orthopedic dentistry, in particular, in the improvement of materials for the prosthetics of dentition defects. Literature sources were searched in the PubMed database. Articles for the years 2013–2023 were selected for their involvement in orthodontic dentistry and for the availability of microbiological test data. Recent trends indicate a shift towards enhancing the composition of fundamental materials used in dental prostheses. To mitigate infectious complications, a modification of the base plastic by incorporating nanoparticles with antimicrobial properties is proposed. Silver nanoparticles are widely utilized to modify denture materials and, when combined with polymers or applied as a surface coating on biomaterials, exhibit antimicrobial properties against oral pathogens, along with an anti-biofilm effect. Zinc oxide nanoparticles, recognized for their biocompatibility and non-toxic nature, possess significant biocidal properties effective against a broad spectrum of bacteria and fungi. They demonstrate the ability to inhibit biofilm formation by oral cavity microorganisms, not only on acrylic prostheses but also on surfaces like glass, polystyrene, and silicone. Titanium oxide nanoparticles contribute to reducing microorganism adhesion on various prosthetic materials, including acrylic resins, ceramic glass, and stainless steel. Zirconium oxide nanoparticles, distinct from other metal oxide counterparts, do not compromise the aesthetics of dentures. Simultaneously, they enhance density and reduce polymethylmethacrylate porosity, thereby decreasing candida adhesion and proliferation in the samples. Copper oxide nanoparticles exhibit dose-dependent inhibition of C. albicans and Streptococcus spp. growth, along with biofilm formation, and show cytotoxic effects only at high concentrations. Thus, there are metal and metal oxide nanoparticles that can improve the antimicrobial properties of prosthetic materials for orthopedic dentistry and thus ensure the prevention of infectious complications when using dental prostheses, but for their clinical use, the gap between experiment and practice has yet to be bridged.

ELECTROMYOGRAPHY AS A METHOD FOR ASSESSING THE EFFECTIVENESS OF ORTHOPEDIC TREATMENT OF PATHOLOGICAL ABRASION OF HARD TISSUES OF TEETH

The combination of pathological wear of the teeth with defects of the dental rows causes significant changes in the maxillofacial complex, which leads to substantial morphofunctional disorders and creates difficulties in the orthopedic rehabilitation of such patients.&#x0D; The combination of pathological tooth wear and defects of the dental rows causes significant changes in the maxillofacial complex, which leads to substantial morphofunctional disorders and creates difficulties in the orthopedic rehabilitation of such patients.&#x0D; Thirty four persons aged from 35 to 60 years with a generalized form of pathological wear of grades I-II, in combination with defects of dentition of classes I, II and III according to Kennedy, were treated. The examination has included the data of the anamnesis, general clinical examination, measuring interalveolar height, study of diagnostic models, X-ray examination, and EMG of the masticatory muscles.&#x0D; The results. The EMG data of the research groups before treatment showed a different degree of the rhythm of chewing movements, a clear alternation of the phases of activity and rest, uneven inclusion of motor units in the contraction process compared to healthy patients, the habitual side of chewing was determined, as a result of which an extension of chewing time, a decrease in its rhythm and chewing efficiency.&#x0D; Thirty days after the appropriate treatment, the electromyographic study showed morphological and functional changes in the maxillofacial apparatus of the patients of the experimental groups, which were reflected in the quantitative indicators of the EMG of the masticatory muscles. In the I group, the EMG parameters significantly approached those in the control group, and in the II group, a tendency to approach the norm was determined.&#x0D; Appropriate orthopedic treatment of pathological attrition, complicated by existing dentition defects, various structures contributed to the emergence of new myotatic reflexes, the creation of a new chewing stereotype.&#x0D; A positive change in EMG indicators, especially the "K" coefficient, and their approach to the indicators of the control group indicates the appropriate choice of the prosthetic method, which will contribute to the process of adaptation to the orthopedic structure and improve the psycho-somatic condition of patients in general.&#x0D; Conclusions. Analyzing the variance in biopotentials of the masticatory muscles enables the evaluation of both the extent and the characteristics of existing disorders in patients with pathological attrition.&#x0D; The positive dynamics of electromyography indicators in the treatment of patients with a generalized form of pathological wear, complicated by defects of the dental rows, indicates the quality of the treatment, the feasibility of choosing an orthopedic structure, and the smoothness of the process of adaptation to it.&#x0D; The future research involves continued monitoring of long-term treatment outcomes, including the potential for determining the duration required for complete adaptation to the orthopedic prosthesis.

DIRECT IMPLANTATION IN THE REHABILITATION OF OF PATIENTS WITH PERIODONTAL DISEASE

The article highlights the optimization of the rehabilitation protocol for patients with periodontal disease using the direct dental implantation technique. To achieve the goals, 50 patients were selected who had indications for implant placement in the anterior region of the upper and lower jaws, 23 and 27 patients, respectively. The clinical study was conducted according to generally accepted methods. Resorptive and destructive processes in the periapical tissues were studied using cone-beam computed tomography. The state of oral hygiene was determined using the plaque index (PI) (Silness and Löe, 1964). The quality of implant integration and the condition of the alveolar bone were assessed using radiological methods, and the degree of implant stability was determined using an Osstell device. The operation was performed without detachment of the muco-periosteal flap, except when infected periapical tissues were detected. Bone augmentation was performed with the biologically active material "Bio-oss", which was mixed with the patient's autoplasm enriched with growth factors. In most cases, a one-stage implant treatment protocol was implemented. The finished temporary orthopedic structure was fixed the next day. After 6 months of use, the temporary denture was replaced with a permanent structure metal-ceramic bridges with screw fixation. The obtained results of the study indicate the feasibility and high efficiency of using direct implantation to replace dentition defects with fixed structures, including in patients with generalized periodontitis.

A retrospective study of occlusal reconstruction in patients with old jaw fractures and dentition defects

PurposeThis study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects. MethodsPatients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled. Clinical treatment was classified into 3 phases. In phase I, techniques such as orthognathic surgery, microsurgery, and distraction osteogenesis were employed to reconstruct the correct 3-dimensional (3D) jaw position relationship. In phase II, bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions. In phase III, implant-supported overdentures or fixed dentures were used for occlusal reconstruction. A summary of treatment methods, clinical efficacy evaluation, comparative analysis of imageological examinations, and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects. All data are summarized using the arithmetic mean ± standard deviation and compared using independent sample t-tests. ResultsIn 15 patients with old jaw fractures and dentition defects (an average age of 32 years, ranging from 18 to 53 years), there were 7 cases of malocclusion of single maxillary fracture, 6 of malocclusion of single mandible fracture, and 2 of malocclusion of both maxillary and mandible fractures. There were 5 patients with single maxillary dentition defects, 2 with single mandibular dentition defects, and 8 with both maxillary and mandibular dentition defects. To reconstruct the correct 3D jaw positional relationship, 5 patients underwent Le Fort I osteotomy of the maxilla, 3 underwent bilateral sagittal split ramus osteotomy of the mandible, 4 underwent open reduction and internal fixation for old jaw fractures, 3 underwent temporomandibular joint surgery, and 4 underwent distraction osteogenesis. All patients underwent jawbone augmentation, of whom 4 patients underwent a free composite vascularized bone flap (26.66%) and the remaining patients underwent local alveolar bone augmentation. Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation (73.33%).The 15 patients received 81 implants, of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures. The survival rate of all implants was 93.82%. The final imageological examination of 15 patients confirmed that the malocclusion was corrected, and the clinical treatment ultimately achieved occlusal function reconstruction. The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy, phonetics, aesthetics, and comfort after treatment. ConclusionOcclusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment, consisting of 3D spatial jaw correction, alveolar bone augmentation and soft tissue augmentation, and implant-supported occlusal reconstruction, achieving satisfactory clinical therapeutic efficacy.