THE EFFICIENCY OF THE USE OF INDIVIDUAL REMOVABLE DENTAL BITE SPLINTS FOR CORRECTION OF DENTAL DEFORMATIONS DEGREE IN PATIENTS WITH DENTURE DEFECTS

Objective: introduction of prevention methods and increase of the treatment efficacy of teeth deformations using individual dental bite splints. Materials and methods: The results of clinical examination of 67 patients of different age (20 to 59 years) with the existing dentition defects before and after use of individual removable dental bite splints are given in this article. The results of the work: the objective study showed a difference in data of the distances between certain points of the teeth surrounding the defect without dentition deformations and in their presence (distances АВ in the control and experimental groups was respectively 7.16 ± 0.19 mm and 4.32 ± 0.19 mm, АD -7.62 ± 0.19 mm and 4.16 ± 0.20 mm, ВС - 7.49 ± 0.19 mm and 4.07 ± 0.19 mm, СD – 6.96±0.19 mm and 3.67±0.19 mm). After the performance of the preparation of the patients with the dentition defects and deformations of the teeth with the use of individual dental bite splints to the prosthetic repair in several stages, it became possible to reduce significantly indexes of the distances in the presence of pathology and bring them closer to physiological data (АВ - 5.85 ± 0.21 mm, AD - 6.09 ± 0.18 mm, BC - 6.22 ± 0.19 mm, and СD- 5.73±0.19mm). Conclusions: The use of individual removable dental bite splints gave the possibility to improve significantly the prosthetic efficacy by normalizing the occlusal relations and chewing load onto the displaced teeth in the area of dentition defect

Clinical Aspects of Combination of Ceramic and Acrylic Occlusal Surfaces

The objective of the research was to develop and substantiate the methods of constructing the occlusal surfaces when manufacturing aesthetic fixed restorations through the combination of different materials.Materials and methods. The study included 65 patients with ceramic and acrylic occlusal surfaces of aesthetic fixed dental prostheses. Group I included 21 patients with a combination of ceramic and acrylic occlusal surfaces. Group II included 22 patients with a combination of ceramic occlusal surfaces. Group III included 22 patients with a combination of acrylic occlusal surfaces. The patients were observed 3, 6 and 12 months after prosthetic repair.Results. The greatest increase in the occlusal contact surface area of fixed restorations was observed in Group I, that is, when combining dental prostheses with ceramic and acrylic occlusal surfaces. Considering uneven abrasion of the occlusal surfaces, we do not recommend to combine different materials when veneering the occlusal surface of the antagonistic teeth.Conclusions. This study demonstrated the important role of the correct combination of materials when veneering the occlusal surfaces. Physical and chemical properties of materials, namely the abrasion resistance play a significant role in the long-term denture functioning.The smallest increase in the occlusal contact surface area was observed in Group II when combining ceramic occlusal surfaces. It was due to a good abrasion resistance of ceramics as compared to acrylic resin as well as the presence of the glazed layer which prevents the premature abrasion of the occlusal surfaces of the antagonistic teeth due to lower surface roughness.The combination of acrylic resin and ceramics when constructing the occlusal surfaces of fixed restorations in Group I demonstrated the highest rate of the increase in the occlusal contact surface area – 9.93%. It was due to a low hardness of acrylic resin and its high surface roughness. In addition, there was observed an uneven abrasion of the occlusal surfaces resulting in periodontal tissue overload, thereby negatively affecting denture functioning

Kappa-splints application for the treatment of pathological dental hard tissues abrasion in combination with dentition defects and dentition deformations

Research objective: to develop and implement a new clinical method of producing a set of kappa-splints for splint therapy: treatment and prevention of various forms of pathological teeth abrasion in combination with dentition defects and dentition deformations, which will enable to prevent significant disorders in the dentition.Materials and Methods: 36 patients aged 30-59 have been selected for the targeted research with a generalized form of pathological tooth wear in combination with dentition defects and dentition deformations.Results: After studying the movements of conventional hinge axis in articulate heads of TMJ with the help of condylograph «Cadiax Compact», some asynchronous, asymmetrical bias of articulate heads during the movements of the mandible were revealed in patients with pathological tooth wear in combination with dentitiondefects and dentition deformations. While examining, the patients complained about the aesthetic defects due to the abrasion of teeth and the change of their colour, the discomfort while closing, chewing and phonetic disorders. In the clinical picture of these patients, the typical symptoms of TMJ dysfunction can be singled out, such as pain and crunch in joints, fatigue of chewing muscles and pain in the muscles, the displacement of the mandible to the side during vertical movements, a feeling of fullness in the ears, headaches and bruxism. Dentition deformations were presented as a violation of the occlusal curve. The results indicate on the presence of functional TMJ disorders and masticatory muscles dysfunction in pathological teeth abrasion in combination with dentition defects.So, in most cases, temporary prosthesis structures and occlusal splints can be applied to normalize occlusive correlations at the dysfunction of TMJ and masticatory muscles. Gradual lifting of occlusion has been done due to a set of kappa-splints in terms of 14 days, 1 month and 3 months from 1.0 to 5.0 mm to the full restoration of occlusal height, depending on the severity of pathological teeth abrasion. It is the gradual application of a kappa-splints’ set which allows prevention of further tooth wear; it doesn’t influence the periodontium of teeth; it’s aesthetic and does not violate the pronunciation of sounds. The material, which a kappa-splints set is made of, provides better fixation and bite separation with optimal thickness throughout the dentition, which allows the lower jaw to take a position that helps to restore the functional balance of the entire dentition.Conclusions:1. According to the results of the research it has been established that the orthopedic treatment with the help of occlusive splints at the preparatory stage for the patients with occlusive disorders at pathological dental hard tissues abrasion in combination with dentition defects, periodontium tissue disease and dentition deformations are urgent for the normalization of occlusive correlations of the jaws.2. After studying the movements of conventional hinge axis in articulate heads of TMJ with the help of condylograph «Cadiax Compact» and eliminating the symptoms of stress in masticatory muscles of the patients with occlusive disorders at pathological dental hard tissues abrasion, it is the gradual application of a kappa-splints set, made of hard transparent plates of Ercodent Ercodur material (Germany) with a thickness of 1.0 to 5.0 mm, which allows prevention of further tooth wear, normalization of occlusive correlations of the jaws, separating a bite with optimum thickness throughout the dentition, thus the lower jaw takes a position at which the state of functional equilibrium of the entire dentition is restored

MODERN METHODS OF DIAGNOSIS AND TREATMENT IN PATIENTS WITH DENTITION DEFECTS COMPLICATED OF DISORDERS OF THE TEMPOROMANDIBULAR JOINT

The aim of research is to increase the efficiency of diagnosis in patients with dentition defects, complicated with disorders of the temporomandibular joint. Materials and Methods. 60 patients with dentition defects, teeth deformations and disorders of the temporomandibular joint were examined; condition and location of dentition defects, degree of the teeth mobility, degree of the alveolar bone atrophy, state of hard tissue of teeth were studied. The diagnostic analysis of models was by radiographic techniques and condilography and 3D scanner 3SHAPE. "Survey map" was developed, which is divided into such topics: history of the periodontal treatment, the endodontic treatment, the orthodontic treatment, the orthopedic treatment and the analysis of vertical, sagittal and transversal movements of the mandible. Results. During the examination lateral dental defects were found in 46 patients and defects in the frontal area were found in14 patients there were also combined defects. Due to our "Survey map" we revealed that endodontic history knew only 55% of patients, but details about the treatment knew only 36.7%. About periodontal treatment in general included 70%, but about more detailed inspection was only 28.3%. About preorthodontic treatment was 33.3% and young patients in details was only 21.7%.The largest percentage amounted the information about the orthopedic treatment was 83.3%, and in details aware the features about the previous orthopedic treatment was 61.7% of patients. We should note that the smallest part of patients knew about the state and previous diseases of the temporomandibular joint, this percentage was 16.7%. However, the exact data could indicate only 13.3% of patients. Studying the state of the TMJ and the masticatory muscles we take into account vertical movements of the mandible: maximum opening and S - like shift, pain; in the sagittal mandible movements are they limited or unlimited; in the transversal are they symmetry and blocked or not blocked. We have found the following clinical features during the examination of the temporomandibular joint according to the proposed map: in 53.3% of patients occurs occasionally stiffness and limitation of the mandible movements in the night; in 8.3% of patients presents crunch; 36.7% of patients S-like lowers jaw; 35.0% of patients has sagittal movements limitations of the mandible, 31.7% suffer from transversal movement restrictions and 26.7% of patients feel pain during the palpation of the TMJ. Our results indicate for a lack of attention during the examination of patients with dentition defects that are combined with teeth deformations and disorders of the temporomandibular joint and therefore occlusal relationship. One can suggest the algorithm for our patients with such disorders, including the examination of models in 3D scanner 3SHAPE, usage the equalizer and production of the temporary structures to fill dentition defects, stabilize the joint heads of the mandible on the base of the condylography for a period from 2 to 6 months. After stabilization of the TMJ the permanent modern design of aesthetic metal-based or zirconium dioxide constructions were made. Conclusions: So, it was found that detailed examination and diagnosis of patients, particularly the pre-history of the treatment will objectively assess the state of dentition and plan complex treatment. However, only from 13.3% to 61.7% of patients know in details about the preliminary stages and methods of dental treatment. Our results indicate for a lack of attention during the examination of patients with dentition defects that are combined with teeth deformations and disorders of the temporomandibular joint and therefore occlusal relationship. Beside, in 53.3% of patients occurs occasionally stiffness and limitation of the mandible movements in the night; in 8.3% of patients presents crunch; 36.7% of patients S-like lowers jaw; 35.0% of patients has sagittal movements limitations of the mandible, 31.7% suffer from transversal movement restrictions. Based on the results one suggest the algorithm of treatment, which includes the study of models in 3D scanner 3SHAPE, the use of temporary structures, kappa and modern aesthetic prosthetics

Clinical Aspects of Combination of Aesthetic Fixed Orthopedic Appliances

The article presents the results of examination of 80 patients with aesthetic fixed orthopedic appliances. The state of the occlusal surface of fixed orthopedic appliances as well as the occlusal contact surface area was studied. The occlusal surfaces were made of ceramics and zirconium dioxide. The surface area of occlusal contacts was studied using 3Shape Dental System since computer occlusiography provides the most accurate results. Physical examination indicated a higher level of ceramic occlusal surface abrasion compared to zirconia occlusal surfaces

Features of Determination of Parameters of Masticatory Function in Patients with Dentition Defects and Dentoalveolar Deformities

The objective of the research was to improve the efficiency of diagnosis of dentoalveolar deformities based on the study of clinical peculiarities and parameters of chewing efficiency in different groups of people.            Materials and methods. The results of clinical examination of 98 patients of different ages (20 to 59 years) with dentition defects are presented in this article.            Results. The objective study using statistical methods showed a difference in parameters of chewing efficiency between patients with dentition defects of various localization with co-existent dentoalveolar deformities. There were established some factors which develop in parallel with the change in the parameter of chewing efficiency, namely the degree of displacement (chewing ability of the teeth-antagonists reduces in case of reduction in their contact area), the state of the periodontal tissues of displaced teeth (the ability to cut, nibble or crush food reduces if pathologic tooth mobility occurs), trophic level of the teeth that are deformable or surround the area of displacement (chewing efficiency reduces if innervation and blood supply are absent).            Conclusions. The results indicate unreliable indicators obtained when using standard statistical method for determining the efficacy of chewing in patients with dentoalveolar deformities, the severity of the clinical picture of periodontal status and high rates of pathologic occlusion in these people

The Study of Developmental Mechanisms and Clinical Features of Secondary Deformations in Patients with Denture Defects

The objective of the research was to increase the prevention efficiency of the secondary dentoalveolar deformations based on the characteristics of their pathogenesis and clinical course. Materials and methods. The results of clinical examination of 120 patients of different age groups (from 30 to 59 years) concerning the characteristics of the types of the secondary dentition deformities are presented in the article. Results. Objective study showed a high degree of deformation development, which arose in half of the cases in patients with existing denture defects. Some factors that influence the type of the secondary deformities and the direction of their development were established. They were the effect of the lost tooth on effective transmission of chewing pressure through the maxillary counterforts (the direction of tooth displacement in case of the secondary deformity was directly opposite to direction of counterforts) and trophic level of the teeth that were deformable or surrounded the area of displacement (displacement of devitalized teeth occurred 30% more often than displacement of teeth that were innervated and supplied with blood). Radiological diagnosis made it possible to evaluate periodontal changes in case of the secondary deformities, which were characterized by changes in fibers tension of the tooth attachment apparatus. Conclusions. The obtained results made it possible to prevent any deformity using the early prosthetic repair.Keywords: orthopedic treatment, dentition deformation, periodontiu

Analysis of Biometric Studies the Small Defects of Dentition with Secondary Dentoalveolar Deformations

In this work the results of biometrics research of small defects of dentition with secondary deformations of dentition are presented. The objective is to analyse and compare the results of biometrics research of small defect of dentition and justification orthopedic treatments using the proposed adhesive prosthetic appliances. Materials and methods. After the examination of the patients, biometric analysis of diagnostic models and characteristics of defects of dentition  secondary dentoalveolar deformation was found, caused by small defects of dentition and determinated the form, nature, characteristics, signs, complexity of deformation. Results and discussion. When comparing biometric parameters in patients without deformations and with deformations it was found that the distance AB (distance from the center of medial aproxymal surface to the center of aproxymal distal surface in the area of clinical necks of the teeth surrounding the defect of dentition) is reduced to the deformation in comparison with that without deformation. There is quite a significant decreasing in the distance AD (distance from the medial aproxymal surface in the area of clinical neck of the tooth to the center of the distal aproxymal chewing surface). Also the decrease in the width of the alveolar bone was marked. Conclusions. Detailed diagnostics values the defects of dentition, condition of teeth, which limits the defect of dentition and its impact on the development of temporomandibular disorders and the need to prevent the development of secondary deformations, determine the optimal choice of options and methods for recovery of small defects of dentition by using conventional fixed prosthetic dentures, adhesive appliances, methods of implantation or proposed adhesive prosthetic appliances

Temporal Aspects of the Quality of the Permanent Dentures: a Combination of Structural Materials

Data on the quality and duration of using permanent dentures made from different structural materials under condition of combination on the teeth antagonists were analyzed. Tribological characteristics of all metal dentures are high, but they do not meet aesthetic and functional requirements and permanent dentures with ceramic coating cause significant abrasion of the antagonist teeth. Several studies indicated that zirconium dioxide dentures do not cause any abrasion of the antagonist teeth, they are aesthetic and bioinert.

FREQUENCY AND TYPES OF DENTOFACIAL ABNORMALITIES AMONG CHILDREN WITH NASAL SEPTUM DEFORMATIONS

Abnormalities of dentofacial system in children and adolescents take one of the first places among the diseases of the dentofacial area. Dentofacial system disorders occur from 60% to 90 % of cases in comorbidities of other body systems, especially ENT pathologies. Respiratory dysfunction and mouth breathing as a result belong to the most important etiological factors of dental arch narrowing.Difficulty in nasal breathing or “nasal obstruction” is a leading syndrome in rhinology. Being a manifestation of different diseases, chronic nasal breathing difficulties can give rise to similar changes in the body regardless of their causes. Frequent chronic obstructive abnormalities of the nose and throat include nasal septum deformation, chronic sinusitis, chronic rhinitis, adenoids, hypertrophia of palatine tonsils and others. Pathologies that influence the development of nasofrontal appendices of upper jaw, front part of maxillary arch and upper nasal passages often cause dentofacial deformations. Such pathologies include allergic reaction of nasopharynx and adenoids, hypertrophia of palatine tonsils, choanal atresia, hypertrophic rhinitis, etc. There is a correlation between mouth breathing and jaw abnormalities.“Pure nasal septum deformation”, i.e. without other “obstructive” pathologies of nose and pharynx, was observed in 8 children (11.4 % of cases) out of 70 patients. Combined pathology leading to the nose and pharynx obstruction was found in other 62 cases (88.6 %). Thus, nasal septum deformation often combined with chronic purulent rhinosinusitis in 53 children (76 %), hypertrophia of palatine tonsils in 5 patients (7.1 %), adenoid vegetation in 8 cases (11.3 %) and hypertrophic rhinitis in 4 children (5.7 %). Chronic purulent maxilloethmoidal sinusitis prevailed among chronic rhinosinusitis. Appropriate surgeries were simultaneously performed in other obstructive pathologies.Therefore, the impact of nose septum deformation on the development of the child’s body as a whole and the dentofacial system in particular is still underexplored. There is still no consensus on the influence of the nasal septum deformation on the growth and development of the dentofacial system and the appearance of dentofacial abnormalities. Frequency, types and pathogenesis of dentofacial abnormalities in children with nasal septum deformation require proper investigation.