ASSESSMENT OF ORTHOPEDIC TREATMENT LATE RESULTS OF PATIENTS WITH FIXED PARTIAL DENTURES DUE TO THE FUNCTIONAL STATE OF ABUTMENT TEETH
Authors: Klymyuk Yu.V. , Ozhogan Z.R. , Kyrylyuk M.I. 
Published: April 2023

The scientific work highlights the results of an index assessment of the periodontal condition of patients abutment teeth with dentition defects which were replaced with metal-ceramic fixed partial dentures due to partial teeth loss. Since during the preparation of abutment teeth there is sometimes a need for endodontic treatment of them due to medical indications, we investigated the state of the periodontium before, during and after treatment and compared index indicators of pulpless teeth with teeth in which the vascular-nerve bundle was preserved. It was established that the periodontium of the vital tooth recovers and functions much better in comparison with the surrounding dental tissues of a nonvital tooth. Where there are inflammatory changes, which are objectively caused by pronounced swelling and bleeding of the gingival papilla. It is caused due to rubber dam pressure, which in turn is confirmed by reliable data of index indicators determined in various the terms of the treatment.

After conducting a detailed examination of patients with vital abutment teeth with defects in the hard tissues of the teeth, we found that in the age group of 30-39 years, the most common defect in the hard tissues of the teeth was caries damage, which was observed in 8 patients (72.7%), damage due to injuries was found in 2 patients (18.2%), enamel hypoplasia was found in 2 patients (18.2%).

Treatment of partial adentia involves the preparation of abutment teeth followed by the manufacture of fixed bridge prostheses. However, the vitality of the abutment tooth should be taken into account and the reserve forces of the periodontium should be taken into account in order to prevent functional overload. It is also necessary to monitor the hygienic condition of the oral cavity during the treatment and at various times after its completion.

The peculiarity of the proposed method of preparation of vital upper and lower abutment teeth consists in the creation of a champfer on the vestibular surface with the transition to an imitation of a champfer on the oral surface, under constant control of the thickness of the peripulpal dentin using a dentometer with the use of full water cooling and subsequent fixation of provisional crowns. The use of a complex of diagnostic techniques for full control of the effectiveness of treatment during and after prosthetics at different times is substantiated and proposed.

The gnathodynamometric study was carried out using an advanced device, the VIZIR E1000 gnathodynamometer: the plates placed between the opposing teeth were bitten, as a result of which the load was digitized using a flexible connection through an analog-digital converter and displayed on the display of a computer program, displayed graphically in newtons (N), the time of the masticatory load was also recorded in seconds.

Using data from clinical indices, it was determined that the preservation of vital teeth is a reliable criterion of the effectiveness of the use of partial fixed prostheses than the use of pulpless teeth. The absence of periapical trauma in vital teeth, which occurs in pulpless teeth due to extirpation of the neurovascular bundle, is demonstrated by the Russel index, and other indices also demonstrate mucosal irritation caused by the use of rubber dams due to the need for quality endodontic treatment.