STUDY OF THE EFFECTIVENESS OF ORTHOPEDIC TREATMENT OF PATIENTS WITH COMPLETE REMOVABLE PLATE PROTHESES ON THE LOWER JAW
Authors: Pelekhan В. L. , Rozhko М. М. , Pelekhan L. І. 
Published: January 2021

The manufacture of compete removable plate dentures remains a common method of treating patients with complete absence of teeth. According to Labunets, the need for full removable prosthetics in age groups over 50 years is from 23.8% to 80%. Depending on the chosen method of manufacturing a complete removable plate prosthesis, 30-60% of patients are dissatisfied with the functioning of orthopedic structures.

According to the results of the research conducted by O.Ya. Zablotska, the psycho-emotional level of satisfaction with a complete removable laminar denture decreased from the first week after the fixation. Incorrect occlusal scheme leads to the release of the restoration, and the abrasion of plastic teeth leads to the difficulty in chewing and loss of occlusal vertical dimension as a result of irrational occlusion starting from 2-5 months of use.

The objective of the research was to analyze the quality of prosthetic health of the patients with complete removable laminar dentures (CRLD) on the lower jaw 6 months after the fixation based on the subjective and objective examination. 

Materials and methods. We conducted a routine examination of 35 patients in the Dentistry Center of the University Clinic at IFNMU 6 months after the restoration fixation in order to study the quality of complete removable laminar dentures functioning on the lower jaw. The survey of the patients concerning their subjective assessment of the restoration functioning was conducted. The existing prosthetic restoration and denture-supporting tissues were examined for the objective assessment. Short Hamburg test was performed to determine TMJ dysfunction. Occlusiography was conducted in order to assess supra contacts in static and dynamic occlusion.

Results of the research. In the course of the subjective examination, the most important criterion for the assessment of functioning quality was the level of the patients’ satisfaction with the restorations. Only 39.4% of patients (13 individuals) who regularly used the dentures were completely or partially satisfied with the prosthetic restoration. Analysis of the survey results of 20 patients (61.6%) who were dissatisfied with the restoration indicated that 15 patients (75%) complained of insufficient fixation of a complete removable denture to the lower jaw. However, 8 patients (40%) were concerned about the pain during the restoration functioning. Difficulty in food chewing was observed in 13 people (65%). Assessment of CRLD and prosthetic bed conditions indicted the need for the restoration rebase or remanufacturing in 15 patients (45.5%). Analysis of static central occlusion showed supra contacts in 25 patients (75.8%), mainly in the area of the buccal (holding) cusps of the first molars (88%).

Conclusions:

The quality of a complete removable laminar denture functioning should be assessed only with the consideration of subjective and objective criteria.

6% of patients are not satisfied with the manufactured orthopedic design of a complete removable plate prosthesis 6 months after fixation. Psychological discomfort and unsatisfactory fixation are the dominant complaints.

The main task when manufacturing the restorations should be the individualization of each clinical and laboratory stages.

Supracontacts were observed in 75.8% of the examined patients, mainly in the area of the supporting humps of the first molars (88%).

Follow-up control of the patients with complete removable laminar dentures is important in order to timely correct and minimize complications in the course of time.

Due to the inconsistency of the orthopedic design with the prosthetic bed, 45.5% of patients 6 months ago required relocation.