Український стоматологічний альманах (Mar 2015)
THE REASONS THAT LEAD TO THE REDUCTION OF THE USE OF NON-REMOVABLE PROSTHESIS DESIGNS
Abstract
Introduction. Treatment of patients in the clinic of orthopedic dentistry is designed not only to restore function and prevention of complications resulting from dental system damage, as well as the return of the patient to the appropriate aesthetic and cosmetic appearance. Share in the total amount of all non-removable denture designs, according to different authors, from 70 to 93%. Different figure needs of the population in nonremovable dentures is a relative through nevidtvorennya pictures re prosthetics and clinic visits. In the United States, according to Welton SN, Gardner PM, the average term to use fixed structures is 8.3 years, and the maximum - 14.3 years. The analysis in this country, according to the average data, gives the period of use of fixed structures 5.8 years, one crowns - 6.3 years. The aim of the study was to establish the causes leading to a decrease in frequency of use of orthopedic constructions. Materials and methods. For qualitative research prosthetics and the term of use removable dentures which are made in prosthetic dentistry clinic Poltava regional dental clinic we analyzed indicators restore chewing efficiency in 130 patients (38 men and 92 women), who addressed the orthopedic department for 2012-2014 and who for medical reasons have been removed fixed constructions. It fixed prosthesis 141 removed, 101 of them (79%) of the metal 23 (20.7%) and only a combined 7 (3%) plastics. With single-sided support (cantilever) prostheses 29 (20.7%), two - 101 (72%) with constituents - 9 (6.5%) and a quadrilateral - 2 (0.4%). In addition to bridges, was also removed 44 rare crowns. The main reasons that lead to a decrease in the frequency of use dentures, according to the literature are: dental caries and its complications, breaking bridges, periodontal inflammation, regional periodontal roztsementuvannya and others. The analysis shows that the largest number of patients (43 -30.49%) used prostheses 6-10 years. During inspection and assessment of quality indicators of fixed structures should be noted about their poor quality as the fault of dental laboratories (Table 3) and for non-compliance dentist - orthopedist (Table 4), which, in our opinion, and led to their withdrawal. By prosthetics with 310 teeth were treated with 54 (17.5%), after removing the prosthesis 70 (22.7%) teeth were destroyed, what prompted roztsementuvannya and retraction of the gingival margin. After removing the prosthesis, we studied the prepared teeth and note that 205 (66.4%) cases were properly prepared and the prepared, and 104 (33.6%) admitted physicians various errors. To determine the reduction of marginal periodontal abutments used sample Pisarev - Schiller, as a result of which found that 226 (78.8%) cases it was positive, and in 84 (27.2%) negative. These tests were performed only in patients without clinical signs of periodontitis and phenomena parodontopatii. Conclusions. These data indicate a phenomenon sources chronic infection caused by the prosthesis. Therefore, failure to comply with the rules and requirements to prostheses, as well as the negativity of the same design used in different people may have different manifestations, depending on the individual structure and condition of the oral cavity. The indications and contraindications as well as to prosthetic teeth are pathological conditions as in the first case (as reading), found dentures and in the second case, as contraindications.