THE PROSTHODONTIC TREATMENT OF THE MANDIBLE EDENTULOUSNESS. CLINICAL CASE
Authors: Pelekhan B. L. , Rozhko M. M. , Pelekhan L. I. 
Published: December 2021

The article presents a clinical case of the prosthodontic treatment of the mandible edentulousness.

Edentulousness is a widespread pathology that depends on the social and economic situation in the country, the demographic situation, the level of dental care and prevention organization. The current worldwide trend of population aging leads to an increase in the number of the elderly, and this number is expected to increase in the future. According to the WHO, today about 600 million people are people over 60, and this number will have doubled by 2030 and will constitute 2 billion in 2050 mostly in developed countries. The situation in Ukraine is not better.

Functional and aesthetic rehabilitation of patients with edentulousness requires a comprehensive approach to the prosthodontic treatment planning. Complete removable laminar dentures on the mandible have a number of disadvantages. Insufficient fixation, stabilization, diction problems, aesthetic problems, decreased self-esteem of the patient are among the key ones. Modern protocols of the prosthodontic treatment require the manufacture of dental prostheses based on intraosseous dental implants.

Complete dentures based on intraosseous dental implants have a number of advantages over the fixed dentures. Compensation for deficient bone support of the facial soft tissues occurs by means of the basis. Patients’ possibility to remove a secondary restoration by themselves lead to proper hygiene of the oral cavity and peri-implant area in particular.

The clinical research conducted by S. Wolfart (2016) showed the possibility of fixed/removable dental prosthesis fixation in 14-31 days (early loading) after the surgical stage of implantation provided that 4-6 intraosseous dental implants were installed. The maximum mobilization of the patient to comply with the recommendations and prescriptions is the main task considering the limited postoperative period before the dental prosthesis fixation.

Our publication describes the treatment of a patient born in 1967, who was diagnosed with a mandible complete absence of teeth. Diagnosis, examination and treatment were performed on the basis of the Department of Dentistry Postgraduate Education of Ivano-Frankivsk National Medical University.

The described prosthodontic treatment plan involves the manufacture of a complete denture with bar system based on four intraosseous dental implants according to the early loading protocol in a patient with primary treatment of mandible edentulousness.

The choice of treatment plan was based on the results of past medical history, the patient’s disease, basic and additional methods of examination, analysis of individual indications and contraindications and readiness for the selected treatment plan.

This treatment protocol has its advantages over the protocol of manufacturing a fixed prosthesis based on intraosseous dental implants such as a higher level of proprioceptive sensations, increased level of hygiene, lower complexity of clinical and laboratory stages, affordability.

The term of clinical and laboratory stages of manufacturing (from the surgical stage of implant treatment to the fixation of the dental prosthesis) constituted 16 days.

Additional opportunities for success in clinical and laboratory stages of treatment, the accuracy of manufacture and minimization of complications in the future were created as a result of the combination of digital and analog treatment methods in dental prosthesis manufacturing.