Bobkova S.A., Kazinin V.G., Kushnir K.G., Shuman M.D.

Crimea state medical university named after S. I. Georgievsky, Simferopol.

Clinical condition of periimplantational tissues during the use of dental implant-supported metal-ceramic and all-ceramic fixed restorations

Nowadays , the dental defects are common problem in dentistry because of using dental restorations, made of precious group of metals and their alloys. In despite of high technological, good physical and mechanical characteristics, the metal materials can't be considered as completely indifferent for human body.

The application in dentistry a lot of metal alloys, different in composition and properties, determines the necessity of development of clinical recommendations and protocols.

Consequently, it can be argued , the problem of study the material for implants and suprastructures interaction in oral cavity, it influence on human body still actual , and was the the reason for our research.We assessed the clinical condition of periimplantational tissues during the use of dental implant-supported metal-ceramic and all-ceramic fixed restorations.

For our investigation were examined 86 patients:the first group included 62 patients, which used metal-ceramic prothesis and second group included 24 patients with metal-free prosthesis. Also examined 15 almost people as a control group. Each group was subdivided into 2 subgroups :subgroup A(31 patients in first group and 12 in second ) - the patients didnt use preparation “Erbisol”, subgroup B(31 patients in first group and 12 in second) – patients used the preparation.“Erbisol“ - immunomodulator, reparant and adaptogen. For orthopedic patients of both group of examination we produced orthopedic structures with implant-supported cement fixation : for first group produces metal-ceramic prostheses based on cobalt-chromium alloy Duceralloy *C, which were fixated on titanium implants. For second group produced metal-free ceramic prostheses based on zirconium oxide and pressed ceramic IPS Empress.

The estimation of periimplantational tissues condition carried out during 1,2,3,4,5,6 months after implants fixation by visual examination, instrumental examination (determine the degree of mobility of the implants and estimate the values of the sulcus bleeding index by Muhlemann (BI)).

By first month of investigation in 1 and 2 group the sulcus bleeding index was low, not significantly different from the initial values and was 0,17-0,18 c. u.(p1>0,05), that evidence about prosperous condition of periimplantational soft tissues.

By 2 month after implants installation noticed changes of periimplantational tissues condition in patients of 1 group, in 1A subgroup were revealed 6(17,6%) implants with signs of inflammation, BI-1 , mobility was absent and 1(3%) implant with BI=2 ;in subgroup 1B – 4(8,7%) implants with low level of inflammation. The average BI in first group in this period was: in subgroup 1A – 0,20±0,04 c. u.(p1<0,01),that was 33% above the initial values, and in subgroup 1B 0,19±0,03 c. u. (p1<0,05), that was 26 % above the values at the time of prosthesis.

At the same period in 2 group of patients in 2A subgroup – the signs of low level of inflammation noticed in zone of 2 implants (14,2%), and in 2B subgroup in zone of 1 (7,7%) implant. The clinical picture refers to mild gingivitis.

Further observation of patients of 1 group determined the tendency of reduction estimates of bleeding index and visual signs of inflammation in time – 4 months from the prostheses, the most pronounced in 1B subgroup, where used “Erbisol”. Thus, by 4 month of investigation in subgroup 1A the amounts of implants with visual signs of inflammation were 9(26,5%)(BI – 1),in subgroup 1B – 1(2,2%)(BI-1). The positive dynamics preserved before the end of the study(6 month), the periimplantational soft tissues (BI-0) in both subgroup 1A and 1B.

During the clinical observation estimated, that the carrying out of orthopedic treatment by implant-supported fixed restorations has irritaion effect and leads to inflammation of periimplantational soft tissues , as evidenced the increase of bleeding index – up 29 %.

Considered, that during the using preparation “Erbisol” in complex treatment of the patients having implant-supported fixed restorations the intensity of inflammatory processes decreased by 23%