Bobkova S.A., Roganov G.G.,Kushnir K.G.

State institution “Crimea state medical university named after S. I. Georgievsky” Simferopol, Ukraine

The objective evaluation criteria of periodontal tissue in orthopedic patients.

Summary

In the course of our study it was conducted the development and practical application of the index of peridontal destruction as a criterion for assessing the state of periimplantal tissue from orthopedic parients taken after dental implants and fixing the metal-ceramic and non-metal dentures.

Keywords:fingerprints of gums,implants,dentures.

The study of last years has showed , that intraosseous implantation carrying out sometimes does not give guaranteed results and the early diagnostics of complications occupies a special place in the solution of this problem.

Nowadays the new methods of diagnosis and treatment implemented in practice, the technical base is expanded , approaches to solving the problems of prophylaxis are rationalizated.The timely diagnostic of diseases issues are particulary important, because namely adequate and early diagnosis is the key to successful treatment. The conducted in Central Research Institute of Communication a new cytomorphometric method of assessing the state of peridont allows to solve the problem of early diagnosis of inflammotory complicantions.

The purpose of our investigation is scientific development and practical implementing of index of peridontal destruction in monitoring of orthopedic patients group with different types nonremovable prothesis after dental implantation.

Material and methods

The main groups of investigation formed during examination of 64 orthopedic patients , which were carried out dental implantation by 2-stage method with endoosseous implants “U-impl” .The patients divided into 2 groups depending on type of nonremovable dentures . For first group group used metal ceramic prosthesis, 2 group – mom-metal ceramic prosthesis. In each group the part of patients had therapy by immunomodulator and adaptogen Erbisol with a view to possible postoperative complications prophylaxis , and acceleration of adaptation processes after prosthetics. Also examinated 15 patients with no defects of teeth and no dentures in oral cavity , it was control group.

During our investigation for first group produced metal ceramic prosthesis based on cobalt chromium alloy Duceralloy C, which fixed on titanium implants. For second group used non metal dentures based on zirconium oxide and pressed ceramics.

The method of diagnostic of early inflammatory complications based on cytomorphometric investigation of prints from the gums.(method explored by A.S. Grigoryan in Central Research Institute of Communication).

The sampling was carried out on 1,2,3,4,5,6 month after prosthetics by gum prints.

Results and Discussion

By 1 month after nonremovable prostheses fixation the index of periodontal destruction almost exactly the same as the control. By 2 month after fixation in all invetgated groups observed the increase of index of periodontal destruction. In first group ,where used metal ceramic prostheses , in subgroup A the IPD was 19,05±0,14, that was 57,6% higher than control. In subgroup B it was 18,67±0,21, that 54,4% higher than control.

We carried out the correlation analysis of index of peridontal destruction in 2 groups of patients with different types of nonremovable prostheses. The results of correlation analysis on 2-3 and 4-5 month of investigation had showed, that there is strong positive link in the 1 and 2 group.

Conclusions:

1. The use in orthopedic dentistry the our conducted index of periodontal destruction(IPD), from the perspective of evidence-based medicine, can serve convincing early prognostic criteria of risk of inflammatory and destructive changes in peridontal and periimplantal tissues development.

2. The carried out monitoring of our conducted index of periodontal destruction(IPD) in orthopedic patients after dental implantation allowed to make a conclusion, that the most biocompatible with titanium implants are metal-free ceramic fixed restorations.

3. The using immunomodulator Erbisol reduces the period of adaptation to 2-3 months , decreases the risk of complications, caused by electrochemical processes during nonremovable prostheses based on metals using, fixed on titanium implants.This is testified by index of periodontal destruction.