PHONETIC REHABILITATION FOR REMOVABLE DENTAL PROSTHETICS
Authors: Nidzelsky M. , Chikor V. , Tsvetkova N. 
Published: July 2019

Removable prosthesis is considered as a device with therapeutic, rehab and prophylactic functions, which allows to improve the quality of life of the dentist. Its use is always aimed at solving three problems: restoration of chewing; restoration of pronunciation of sounds; restoration of aesthetic norms of a person.

Fixation of the complete removable denture depends on the anatomical retention, which is determined by the area and form of the prosthetic bed; from adhesion (capillary forces, viscosity of saliva) and from the functional suction of the prosthesis. For the stabilization of prostheses, the contour of the alveolar appendix and the production of artificial teeth are of special importance.

Therefore, a complete removable denture is a complex design, which always has a single plan of construction (basis and artificial teeth), but in each case is made taking into account the individual characteristics of the patient's body.

Adaptation to a complete removable denture is a multi-layered process. Its inalienable component is neuro-reflex mechanisms. From these positions, the habit of prosthetics is explained by the development of cortical inhibition, which leads to the disappearance of the feeling of a foreign subject in the oral cavity. These changes occur on the basis of the general law, according to which repeatedly the stimulus becomes a brake agent. Based on masticatography, it has been established that addiction to prosthetics is associated with the appearance, perfection and consolidation of new conditioned motor reflexes. An important component of the adaptation process in patients with prosthetics is psychological adaptation. It is believed that it represents the sum of complex conditioned-reflex responses of the patient, which belong to the sphere of human emotions and determine the degree of satisfaction with dentures. The significance of psychological factors in the development of adaptation to prosthetics stimulates the creation of new and improved existing methods for assessing the psycho-emotional state of orthopedic dental patients. According to the results of these methods, high personal anxiety is the main factor that causes the development of psycho-emotional stress during orthopedic treatment.

There is also a speech adaptation, which is the result of the interaction of the active organs of the articulation apparatus with dentures. The appearance of improper pronunciation of sounds is considered as a result of motor and sensory disorders of the central or peripheral nature: changes in the structure of the articulation apparatus and violations of muscle inertia involved in articulation; reduction of peripheral hearing and violations of the auditory perception of the central character. Wrong pronunciation is most often observed in groups of whistling, silent sounds, [p], [l], which are characterized by complexity of sounding and, accordingly, the complexity of articulation work. A certain range of works is devoted to methods of studying pronunciation of sounds from different points of view: physical (acoustic), anatomical-physiological and linguistic.

Detection of defects of articulation was done by listening. In a number of studies the study of violations of articulation of sounds was carried out using anatomical-physiological and acoustic characteristics with the help of apparatus. Modern methods of speech research are based on listening, audiometry and spectral analysis of sound.

Consequently, the features of rehabilitation of toothless patients with the help of a complete removable denture are widely covered in the literature. The concept of pathogenesis of violations with full or partial adentia and about mechanisms of their overcoming with the help of dentures is deepened. However, until now, the literature remains almost uninvolved into the consideration of phonetic aspects as in the analysis of anatomical and physiological features of the toothless mouth during preparation for prosthetics, and at different stages of the use of dentures.