Естетична складова як важливий фактор процесу адаптації до знімних протезів

Abstract

У статті представлений клінічний випадок реабілітації пацієнтки з дефектами зубних рядів, що передбачає відновлення не лише фізичного, а й психологічного здоров’я, а також повернення її до активного соціального життя. Естетична складова адаптації до знімних протезів не менш важлива, ніж відновлення жувальної ефективності на високому рівні.

В статье представлен клинический случай реабилитации пациентки с дефектами зубных рядов, предусматривающий восстановление не только физического, но и психологического здоровья, а также возвращения её к активной социальной жизни. Эстетическая составляющая адаптации к съемным протезам играет не менее важную роль чем восстановление жевательной эффективности на высоком уровне.

The topic of this work is to show on a clinical example the rehabilitation of the patient by eliminating the negative emotional influence from the previous orthopedic treatment. Job task: 1) carry out repositioning of artificial teeth and redistribution between the alveolar area in accordance with the height of the lower third of the face and facial features; 2) at the stage of checking the design of the prosthesis and the setting of artificial teeth, it is imperative to reconcile with the patient the appearance of the face and the nature of the smile. Patients three months ago made non removable denture, namely, metal-ceramic crowns on the lower front teeth and 14, 15, 16 teeth of the upper jaw; defects of the dentition on both jaws are replaced by bellowing dentures with support-retaining clameras. During the last three months, the patient has been in a state of constant dissatisfaction with her appearance, was suppressed. On the basis of this, the patient developed a complex of inferiority, she was ashamed of public communication, became a closed, negligent, felt loneliness and unnecessaryness to people around her and close. Research results and their discussion. When external examination of dentures is determined by the very high accuracy of cast structures, their good fixation and stabilization, as well as the restoration of the function of chewing at a sufficiently high level. The patient does not notice discomfort during chewing. On the face rofl: protruding lower lip relative to the upper. Expressions of small longitudinal wrinkles over the upper lip. Profile view: enlarged nasopharyngeal angle. The bite height is slightly lowered. In conversation and in a smile, only the lower teeth are visible. Upper artificial teeth from under the upper lip do not look. It’s not appeca because it’s covered by upperlip, as well as without equalization of the occlusal surface of the dentition: on the lower tooth row, on the right side, there is a dentine antagonists. Taking into account the precision of casting of frames of bellows prosthesis and the absence of pain sensations and other phenomena of discomfort during use the prostheses, it was decided to leave the frames of bellows prostheses unchanged. In order to compare the pre-measured height of bite with dentures to remove artificial teeth. Then artificial teeth were removed from the dentures and partly a plastic basis. Installed biting wax rollers, by means of which they determined the central occlusion with the optimal bite height, and a rational redistribution of interalveolar space. The selection of artificial teeth was carried out in form, size, color, as well as in accordance with available metal ceramic structures and oval face of the patient. By increasing the bite height and redistributing the interalveolar space, it was possible to align the occlusion curve. In accordance with the alveolar arc of the upper jaw of the patient, an enlarged tooth arch on the upper prosthesis. The formation of the lower side teeth is carried out within the limits of the Pound triangle, somewhat with a tongue tilt. Also, to approximate the profile of the face to the aesthetic norm, simulation of the vestibular surface of the basis of the upper prosthesis in the frontal area was performed. The final version of the design of the prostheses before the wax replacement on the plastic is agreed with the patient. With renewed prosthetics, the external appeal of the face and the compliance of artificial teeth with aesthetic criteria are noted. The face has a natural and harmonious look, like once before the loss of teeth. In the oral cavity there are dense multiple and simultaneous interdental contacts. Increased bite occurred within the compensatory capacity of chewing muscles and therefore there was no need for a special reorganization of myostatic reflex. Thus, good chewing can’t replace a bad aesthetic look. Indeed, the high chewing efficacy of manufactured prosthesis is known only to the patient, while aesthetic defects are noticed by everyone around them. Under such conditions, instead of rapid adaptation to the patient’s prosthetics, an uncertainty arises, negative emotions accumulate, an irritation appears. Rehabilitation of patients with defects in dentition involves the restoration of not only physical but also psychological health and the return to active social life.