Клиническая медицина

Yuldasheva D. S., d.m.s. Averyanov S. V.

Bashkir State Medical University, Ufa, Russian Federation

SOME ASPECTS OF TREATMENT OF INFLAMMATORY COMPLICATIONS OF DENTAL IMPLANTATION

Abstract. The article presents modern data on diagnostics and treatment of inflammatory complications in the area of implants.

Key words: dental implant, peri-implantitis, mucositis periimplantitis,

Dental implantology in recent years actively developing the technology of dental implantology today, it is widely used in the treatment of patients with complete or partial tooth loss worldwide. In many cases, the use of dental implants is the only ability of high-quality prosthetics [5,7]. Mucositis in the area of the implant is the inflammation of the surrounding soft tissues without disruption of osseointegration. Periimplantitis is an inflammatory reaction of the tissues surrounding the osseointegrated implant, accompanied by loss of supporting bone. Current data indicate that mucositis may occur in 80% of individuals with dental implants, and the development of peri-implantitis are described in 28-56% of examined individuals [1,2,3,7,8]. At the same time, experience shows that these measures are not always effective, which keeps the frequency of complications following dental implantation at a high enough level .

In recent years, for the prevention of surgical complications in dentistry is increasingly applied to various methods of modern physical therapy, which has a sufficiently pronounced anti-inflammatory, analgesic and regenerative effect, but not in all cases, these effects are sufficiently effective [4,8]. Key risk factors in the development of peri-implantitis are poor oral hygiene, history of periodontitis and Smoking habits. In accordance with the agreed opinion of the experts, there is also evidence on the potential role of such factors as genetic predisposition, diabetes mellitus, alcohol consumption, as well as characteristics of the implant surface and especially superconstructor, however, the probative value of these factors is relatively weak [6].

Diagnosis of lesions surrounding the implant tissues is based on probing depth of the gingival sulcus, bleeding upon probing and clinical attachment level and x-ray data concerning the characteristics and extent of loss of bone. Prognosis depends on the possibility of restoring lost tissues and of the required characteristics [8]. Currently, the most significant risk factors of periimplantitis of the natural hygiene of the mouth, the change in the biocenosis of the peri-implant tissues, the immune deficiency of local immunity, imbalance in the system of cytokines and others. The risk of developing the disease increases dramatically with the combined effects on the peri-implant zone of two or more factors [5,7,9]. Detection of clinical mobility of the implant is an absolute indication for its removal, because in this case it is impossible to achieve osseointegration. During each follow-up the patient carefully carried out professional care and coaching in self-oral hygiene. Upon detection of mucositis, which, by definition, limited to inflammation of the soft tissues and manifest bleeding while probing, normal or increased probing depth, but without radiological signs of atrophy of the bone, shows conservative therapy. Typically, this condition is reversible by using properly chosen non-surgical treatment and additional use of antimicrobial rinsing means of the mouth [7, 9]. When periimplantation mucosae in addition to the local anti-inflammatory therapy (preparations containing chlorhexidine), with special importance is a thorough professional oral hygiene, including instrumental removing soft and hard deposits with the use of tools with plastic-coated ultrasonic scaler and processing of "Air Flow" powder glycine Perio-Flow [1,2,3,4,10, 13]. Thus, the problem of finding the optimal technology of implantation and methods of prevention and treatment of periimplantitis is relevant to the present and includes not only the development of new techniques of surgical interventions, the use of additional events during the prosthetics, but also the creation of new implant systems, which fully meets the requirements of prevention of inflammatory diseases in periimplantitis area. New advances in this direction will help to reduce the number of complications after dental implantation in patients, improving their quality of life.

Bibliography

1. Bulyakov R. T., Gulyaeva O. A., Tukhvatullina D. N., Sabitova R. I. Postimplantation management of patients with dental implants in the presence of concomitant pathology of the periodontium // Dental Magazine. – 2012. - No. 9.- P. 52 – 55.

2. Bulyakov R. T., Gulyaeva O. A., Tukhvatullina D. N., Salyakhova G. A. Role of modern methods of destruction of biofilms in complex supportive periodontal therapy // Dental Magazine. – 2012. - № 5.- P. 64 – 67.

3. Bulyakov R. T., Chemikosova T. S., Gulyaeva O. A., Sabitova R. I., Tukhvatullina D. N., Gumerova, M. I. the Use of air-abrasive technology for the conservative treatment of inflammatory periodontal diseases // Dental Magazine. – 2012. - No. 7. – Pp. 20-22.

4. Bulyakov R. T., Gulyaeva O. A., T. S. Chemikosova, Tukhvatullina D. N., Salyakhova G. A. Gumerova, M. I., Sabitova R. I. Experience of application of aquakinetic method for the treatment of peri-implantitis // Problems of dentistry. 2012. No. 4. Pp. 24-28.

5. Guderian A. A. Systematic approach to the prevention and treatment of dental peri-implantitis in identifying risk factors for its occurrence. - Journal of dentistry No. 3, 2014; 51-52p.

6. Mikhalchenko D. V., Yakovlev A. T., Badrak, E. Y., Mihalchenko A.V. the Problem of inflammation in periimplantary tissues and factors affecting it (literature review). - The Volgograd scientific medical journal 4/2015; 17p.

7. Serak, S. V., Avanesyan R. A., Kopylova I. A., Kazieva I. E., the Organization of prophylactic medical examination of patients after dental implantation and prevention of peri-implantitis at an early defunctionalized period. - Medical science. Fundamental research №9, 2013.; 481 p.

8. Utyuzh A. S., Admakin O. I., R. M. Lushkov Guidelines for the diagnosis and treatment of periimplantitis. - Successes of modern science and education, 2016; 22.

9. Bulyakov R., Gulyaeva O., Sabitova R. Role of removal of a biofilm in prevention and treatment peri-implantitis // Nauka i studia. 2015. Т. 10. С. 30-33.