Клінічна оцінка реставрацій бічних зубів у хворих на генералізований пародонтит

Abstract

У статті наведені результати клінічної оцінки 349 реставрацій на контактних поверхнях бічних зубів у 122 хворих на генералізований пародонтит початкового та І ступеня відповідно до критеріїв «анатомічна форма» та «стан контактного пункту». Лише 46 з оглянутих реставрацій (13,2%) не мали порушень, 188 відновлень (54,4%) мали незадовільний стан контактного пункту, 57 відновлень (16,3%) вимагали негайної заміни; В статье приведены результаты клинической оценки 349 реставраций на контактных поверхностях боковых зубов у 122 больных генерализованным пародонтитом начальной и І степени в соответствии с критериями «анатомическая форма» и «состояние контактного пункта». Лишь 46 из осмотренных реставраций (13,2%) не имели нарушений, 188 восстановлений (54,4%) имели неудовлетворительное состояние контактного пункта, 57 восстановлений (16,3%) требовали немедленной замены; The complete tissue regeneration of interdental triangle in case of contact surfaces restoration of grinder teeth in patients with generalized parodontitis is considerably controvertible issue. The recent studies indicate insufficient level of restoration quality. After six months almost 30% of restorations can be considered as improper, in a year more than 50% and after 2 years 70% of restorations do not meet the specified requirements. The aim of the study. Clinical assessment of restoration condition on the contact surfaces of grinder teeth in patients with generalized parodontitis. Object and methods of research. The clinical evaluation of 349 restorations on the contact surfaces of grinder teeth according to FDI criteria «anatomical form» and «condition of contact point» was carried out in 122 patients of both genders aged from 18 to 45 years with generalized parodontitis of primary and I stage. The results and discussions. The excellent restoration condition of the anatomical form was determined in 55 cases (15.8%) according to data of photocomposite restorations research on the contact surfaces of grinder teeth considering «anatomic form» criterion. The study determined 212 restorations (60.7%) with minimal or approximate specificity of anatomical structures, incorrect restoration of the occlusal position with necessity of their correction and 82 (23.5%) restorations were subject to full replacement. The most common defect was the absence of marginal crests or incorrect modeling of anatomical shape. The study of restorations considering criterion «condition of contact point» revealed the very low recovery efficiency of grinder teeth with II class cavities according to Black. Only 46 restorations (13.2%) have received Romeo rating (code R) for the excellently performed restoration of contact points, which were on the border of the occlusal and middle third of the contact surfaces of restored and adjacent teeth and at a distance of 1.5-2 mm from the occlusal surface of the grinder teeth crowns were slightly displaced in the vestibular direction. In such cases the point or plane contact between the restoration and adjacent tooth was determined. Satisfactory contact points were identified in 113 restorations (32.4%) which have received the genaral Sierra assessment. The contact point was partially opened in 34 (9.7%) restorations, floss was easily pushed while starting the movement, and then tore (SCO code). The flattened contact points (SFA code) in the vestibular direction were diagnosed in 41 cases (11.8%) of the restorations. The contact points flattened in the oral direction (SLG code) were diagnosed in 38 cases (10.9%) of restorations. Non-functional contact point was identified in 133 (38.1%) restorations and got low Tango grade. The contact point disorders were revealed in 89 restorations that amounted to 25.5% (TCO code). This assessment was also given to 44 restorations (12.6%) with reduced interproximal cervical area and the adjacent tissues damage (TPX code). The critical low quality level was determined in 57 (16.3%) of restorations out of the total number, they have been partially destroyed, moving or even were absent. The restorations got the low grade according to Viktor criterion (VPN code). Conclusions. The assessment based on the clinical criteria «anatomic form» and «condition of contact points» identified the main disadvantages of restorations on contact surfaces of grinder teeth: the presence of anatomical and functional deficiency of the contact points; neglection of important anatomical structures modeling such as marginal crests, interdental embrasures; reactive soft tissues inflammation adjacent to the restoration and changes in the volume of the interdental papillae, architectonic disorders of the whole interdental space. Prospects for further research. The investigation and improvement of restoration approaches to the contact surfaces of grinder teeth in patients with generalized parodontitis with the development of the appropriate clinical algorithm will be carried out further.