DISPLAYS OF UNBEARABLENESS OF STOMATOLOGICAL MATERIALS ARE IN CAVITY OF MOUTH (CLINICAL CASE)
Authors: Sokolovska V.M. , Tsvetkova N.V. 
Published: December 2022

Intolerance of dental materials is a rather problematic issue in modern orthopedic dentistry. Therefore, one of the important points in the diagnosis of individual sensitivity is the collection of an allergic history and the use of specific and non-specific tests. The purpose of this work is to highlight a clinical case of intolerance to dental materials, predict and prevent negative reactions using tests to determine individual sensitivity.

Object and research methods. Patient P. who was born in 1968, complained of pain, redness and swelling in the area of the gums, itching, burning sensation in the oral cavity. From the anamnesis of patient P., it became known that she was treated in a private dental clinic in Kharkiv in February 2022, where all-cast bridge prostheses with ceramic lining were made and fixed. The patient began to present all the abovementioned complaints already on the fifth day after fixing the bridge-like structures in the oral cavity. But in connection with the beginning of hostilities, she was unable to consult a dentist due to the necessity of evacuation. An objective examination of the oral cavity revealed the following: diffuse hyperemia and swelling of the gums were observed in the area of attachment of the bridge-like structures. During palpation, the gums are sharply painful, when probing they bleed easily.

Taking into account the fact that patient P. associates the symptoms of this disease with the fixation of bridge-like prostheses and taking into account the clinical picture in the oral cavity, we made a diagnosis of intolerance to dental materials and decided to remove these structures. After that, patient P. consultated with periodontist and allergist. 14 days after final treatment at the periodontist, the patient referred to the orthopedic dental clinic. During objective examination of the oral cavity of the patient P., it was established: the mucous membrane is pale pink without visible pathological changes, there is no hyperemia and swelling of the gums. The patient has no complaints.

For the further treatment of patient P, it is recommended to make one-piece bridge-like prostheses with ceramic lining. For metal frames, we plan to use cobalt-chromium alloy Co-Cr alloy for ceramic, BeGo, produced in Germany . Therefore, we prepare a cobalt-chromium alloy chip in advance, which we mix with a drop of photopolymer restorative dental adhesive during the test. After that, this mixture is applied around the neck of one of the supporting teeth and polymerized. To evaluate the results of the tissue reaction, we appoint the patient to appear in 72 hours. During an objective examination of the oral cavity, we note that the mucous membrane around the neck of the abutment tooth is pale pink in color, without pathological change.

We conduct a similar test for individual sensitivity to Duceram Kiss, Degudent ceramic mass, manufactured in Germany, which we plan to use for lining frames. Prepare a mixture of ceramic mass powder and a drop of dental adhesive. After 72 hours, we observe the results of the reaction of tissues adjacent to the neck of the abutment tooth, and we conclude that the test is negative. We plan to fix bridge-like structures on Fuji-1 glass ionomer cement, manufactured in Japan. Therefore, to conduct a study on the compatibility of the fixation material in the oral cavity, we prepare a mixture containing mixed fixation cement and dental adhesive. We observe for three days and conduct an analysis. In this case, the test is also negative. The conducted studies on the compatibility of structural materials and fixation cement give us the reason to recommend them for further prosthetics of patient P. After fixation of metal-ceramic bridge prostheses in the oral cavity, the patient was recommended to be examined by a dentist after 14 days and after one month. Long-term results of the examination of the oral cavity of patient P. confirmed the correct choice of materials for prosthetics and fixation.

Conclusion. The clinical case of diagnosing the intolerance of dental materials indicates the need to conduct a study of a potential prosthesis carrier for compatibility with structural and fixation materials.