THE CONCEPT OF A COMPREHENSIVE PROGNOSTIC MODEL OF THE EFFECTIVENESS OF IMPLEMENTATION OF MINIMALLY INVASIVE INTERVENTIONS IN THE TREATMENT OF CARIOUS PATHOLOGY
Authors: Kostenko S.B. , Bilynskyi O.Ya. , Nakashydze G.N. , Stetsyk M.O. , Goncharuk-Khomyn M.Yu. , Penzelyk I.V. 
Published: June 2021

The research presents a prognostic model of the effectiveness of minimally invasive interventions in the dental patients’ treatment of carious pathology, which was developed to reduce the impact of iatrogenic interventions, increase the results of biological, biomechanical and financial feasibility of treatment.

The aim of research is to develop a mathematical representation of a comprehensive prognostic model of the minimally invasive treatment effectiveness of carious pathology.

Materials and methods of research. Comprehensive prognostic model of comparative efficiency of minimally invasive implementation of treatment protocols of carious pathology included consideration of relative risk indicators of biological complications (secondary caries and affected tissue pulp), decreased biomechanical forecast of the tooth (based on the performance index IROPZ and IHRKCHZ) and the financial feasibility of these methods, taking into account the ratio of material costs and unit labor intensity of the biological level and biomechanical forecast of the functioning of the dentition unit.

Results of the research. The factors were identified during the scientific research; it was provided that the volume of iatrogenic interventions in the dental patients’ treatment of caries can be minimized. The structure of a complex prognostic model of the effectiveness of realization minimally invasive methods of treating caries of hard tooth tissues was developed. A comparative assessment of the biological, biomechanical and financial feasibility of treatment of carious pathology depending on the depth of damage to the hard tissues of the tooth using classical (invasive) and mini-invasive methods of treatment was held. The study showed that the implementation of minimally invasive approaches to the treatment of carious pathology in terms of risk and complications in secondary destructive changes of dental hard tissues and pulp tissue damage contributes to the effectiveness of limited nuclear interventions with controlled enamel reduction and determination of connection of restoration with the bottom of the formed cavity. The highest biomechanical feasibility of minimally invasive dissection protocols has been established in the defects treatment within the enamel in order to minimize unreasonable enamel reduction and dentin tissues, carious cavities treatment at the border of medium-deep types of lesions to limit the caries spreading in the cavities deep localization in order to prevent the development of associated lesions of the pulp complex, which in terms of biological prognosis can provoke the development of irreversible changes.

Conclusion. As a result of scientific research and comparative analysis of the effectiveness of caries treatment by mini-invasive methods of intervention, the fact of improving the biological and biomechanical prognosis of the affected units of the dentition compared to the results of treatment of pathological lesions by surgery in accordance with classical protocols, confirming the developed complex prognostic model of efficiency of use of minimally invasive methods of treatment of carious pathology of dental patients. However, the creation of a unified comprehensive forecasting model, which would include the most complete reflection of all these criteria and was at the same time reliable, is impossible. Biological stacking relative risk indicators in the process of secondary development and pulpitis indicate the excess of minimally invasive treatment in all analyzed clinical cases, cases of initial treatment in relation to the risk of pulp production and cases in the center of caries relative to the risk of the previous year.