Поддерживающее лечение после дентальной имплантации

Abstract

Представлений аналіз сучасних підходів і схем підтримувального лікування після дентальної імплантації, мета якого - профілактика ускладнень у післяопераційний і протетичний періоди. Обґрунтована доцільність та представлені конкретні рекомендації практикуючим лікарям щодо диференційованого підходу до вибору гігієнічних і медикаментозних засобів та кратності їх застосування залежно від початкового рівня гігієни порожнини рота.

Представлен анализ современных подходов и схем поддерживающего лечения после дентальной имплантации, целью которого является профилактика осложнений в послеоперационный и протетический периоды. Обоснована целесообразность и представлены конкретные рекомендации практикующим врачам относительно дифференцированного подхода к выбору гигиенических и медикаментозных средств и кратности их применения в зависимости от начального уровня гигиены полости рта.

It is known, that despite of the implementation of all recommendations on rational hygienic care after the dental implant is not always possible to maintain a satisfactory level of oral hygiene, particularly in patients with pathology of the periodontal tissues. The purpose of the study to develop a differentiated approach of drug therapy in the early postoperative stage and study the multiplicity of occupational health in the phase of the implants with the original hygienic condition of the mouth. We found that in patients with a healthy periodontium and "satisfactory" level of hygiene parameters affecting the level of oral hygiene, are in the normal balanced state. Therefore there is no need to conduct their drug correction to maintain a "satisfactory" level of care after the dental implant. In the postoperative period it is sufficient to take the recommendations on rational hygienic care. In patients with chronic catarrhal gingivitis and "unsatisfactory" hygiene the microbiological parameters affecting the level of oral hygiene were significantly different from those in healthy periodontium and "satisfactory" level of hygiene. Therefore, in the postoperative period in order to maintain "satisfactory" level of oral hygiene, it is advisable to recommend probiotic preparations of local action to improve the reduced level of contamination of lactobacilli toothgum compound. In patients with generalized periodontitis I-II degree and "poor" level of hygiene and microbiological and immunological parameters that affect the level of oral hygiene, there were significant changes in comparison with those with healthy periodontium and "satisfactory" level of hygiene. Therefore, in the postoperative period in order to maintain "satisfactory" level of oral hygiene, it is appropriate to recommend anti-microbial and anti-fungal drugs to suppress the local action of parodonto-pathogens and yeasts that are prevalent in the contents of the periodontal pockets in these patients. In addition, the imbalance indicators of immune response in the oral fluid causes the usefulness of topical immune-modulators. Professional oral hygiene after implant prosthetics, we also recommend that differentially depending on the initial level of the hygienic condition of the mouth, which is correlated with the degree of destruction of periodontal tissues. Thus, in individuals with a healthy periodontium, whose level of oral hygiene by IG Green-Vermillion (OHI-S) corresponded to a satisfactory (1,38 ± 0,14 points) supporting hygiene activities carried out with the traditional multiplicity - in the first year of every three months. Patients with CCG, whose level of oral hygiene by IG Green-Vermillion (OHI-S) corresponded to the lower boundary of the poor state of (1,88 ± 0,19 points) supporting hygienic measures carried out with the following multiplicity - in the first year of every two months. Patients with GP ² severity whose level of oral hygiene by IG Green-Vermillion (OHI-S) corresponded to the upper boundary of the poor state of (2,34 ± 0,22 points), and in patients with GP II severity in where the level of oral hygiene by IG Green-Vermillion (OHI-S) corresponded to "poor» (2,81 ± 0,20 points), supporting activities carried out with the following multiplicity - in the first year of each month. Thus, the presented results of the study will allow clinicians to spend more informed choice of hygiene and medication for postoperative management of patients and the multiplicity of relevant hygiene measures after implant prosthetics.