Bobkova S.A, Lavrovskaya O.M

Chair of Dentistry (Postgraduate Education Division)

SI “Crimea State Medical University named after S. I. Georgievsky”

Impact of fixed implant-supported prostheses’ materials on biomedical measurements of mixed saliva.

The usage of dental implants expanded indications to restoration of teeth alignment defects with fixed implants, which gives us possibility to perform balanced prosthetic repair without teeth dissection. The material compatibility condition becomes the most primary problem for implants and tooth prosthesis made from different alloys. This article is related to optimization of the fixed implant-supported prostheses’ constructional materials’ choice.

53 persons were selected for carrying out of investigation. Besides 15 almost healthy persons (norm) were examined. The first group of 38 persons was composed of those whom were made the prosthetic appliance with PFM prosthesis based on cobalt-chrome alloy (Duceram). The second group of 15 persons was composed of those patients whom were made the prosthetic appliance with the usage of nonmetal ceramic dental prostheses. Prosthetic alignment was carried out by two stage implant procedure using “U-Impl” endosteal titanium screw implants with the further restoration using different permanent constructions.

Inside the investigated groups were segregated 2 subdivisions (19 persons in the first group and 8 persons in the second group), which were everyday intramuscular injected in gluteus with 1 ml single-dose of the “Erbisolum” immunomodifier and antioxidant. The duration of therapeutic course comprises of 10 days.

Antioxidant potency of mixed saliva was measured by the property of biomaterial to inhibit oxidation-reduction rate of Fe(2+)-2,6 - dichlorophenol-indophenol (DCPIP) system.

Table 1	1	2	3	4	5	6
Group of investigation	Term of investigation (months)
First group (PFM prosthesis based on CCA), n=38. A – without usage of Erbisolum, n=19 B – with using of Erbisolum, n=19	0,037± 0,001 p>0,005 0,036± 0,002 p>0,05	0,045± 0,003 +36,4 p<0,001 0,044± 0,004 +33,3 p<0,01	0,051± 0,002 +54,5 p<0,001 0,042± 0,001 +27,2 p<0,05	0,047± 0,003 +42.4 p<0,001 0,040± 0,003 +21,2 p<0,05	0,036± 0,001 +9,0 p>0,05 0,035± 0,002 +6,0 p>0,05	0,034± 0,002 +3,0 p>0,05 0,033± 0,004 0 p>0,05
Second group (nonmetal ceramic prosthesis), n = 15. A – without usage of Erbisolum, n=7 B – with using of Erbisolum, n=8	0,034± 0,004 p>0,05 0,036± 0,003 p>0,05	0,043± 0,002 +30,3 p<0,01 0,042± 0,002 +22,2 p<0,05	0,040± 0,002 +21,2 p<0,05 0,035± 0,004 +6,0 p>0,005	0,036± 0,003 +9,0 p>0,05 0,034± 0,002 +3,0 p>0,05	0,034± 0,002 +3,0 p>0,05 0,033± 0,003 0 p>0,05	0,034± 0,003 +3,0 p>0,01 0,033± 0,002 0 p>0,05
Control group n = 15	0,033± 0,002

Toward the first month of investigations after the prosthetic repair changes were imperceptible and had imperceptible slight static attribute (p>0,05) in relation to control group. Towards the second month of investigations the cascade growth of mixed saliva enzymatic activity was marked in all the investigated groups, but the most expressed growth was in the first group, Table 1.

Toward the third month of investigations in the subdivision A of group 1 progressive growth of mixed saliva enzymatic activity was observable, which activity in comparison with control group was increased on 54,5% (p<0,001), at same time in the subdivision B, where “Erbisolum” immunomodifier was used, was registered the tendency to decrease of mixed saliva enzymatic activity. In the second group of patients, where were used nonmetal ceramic dental prostheses, in the subdivision A enzymatic activity of the mixed saliva was higher than benchmark on 21,2% (p<0,05), and in the subdivision B where “Erbisolum” was included in the structure of multimodality therapy the growth of AOA equaled 6% thus acquiring uncertain character in relation to control. Toward the fourth month of investigations antioxidant activity in the first group, especially in the A subdivision was on the high level. The same time in the second group, both in A and B subdivisions mixed saliva enzymatic activity had the slight static attribute (p>0,05).

Henceforth (5-6 month) levels of AOA both in the first and in the second investigation groups converged to the benchmark level.

In such a manner as the result of handled investigation it’s possible to come to the conclusion that nonmetal ceramic dental prostheses are the most comparable with titanium implants. Usage of “Erbisolum” immunomodifier and antioxidant essentially improves adaptation of organism during the postsurgical period and decreases the risk of complications’ development.