Визначення жувальної ефективності у пацієнтів з відновленою коронковою частиною зуба

Abstract

Відновлення жувальної ефективності є одним з головних завдань ортопедичного лікування при виготовленні незнімних ортопедичних конструкцій, а одже, авторами визначалася жувальна ефективність у пацієнтів з відновленою коронковою частиною зуба (54 особи віком від 20 до 60 років) у 2 дослідних групах. До першої дослідної групи увійшли 29 осіб що становить 53,7% від загальної кількості пацієнтів, яким проводили ретракцію ясен опорних зубів за допомогою діатермокоагуляції, а пацієнтам другої дослідної групи, яка налічувала 25 осіб (46,3%), ретракцію ясеневого жолобка проводили бавовняними нитками «Ultrapak», фірма-виробник «Ultradent» (США), які мають декілька розмірів. Було встановлено, що протезування незнімними металокерамічними коронками сприятливо впливає на рівень жувальної ефективності, про що свідчить зменшення числових значень індексу жувальної проби на 7 добу після фіксації коронки і в групі 1, і в групі 2. Привертає увагу той факт, що статистично значущої різниці між показниками в пацієнтів 1 і 2 груп виявлено не було. На 30 добу після фіксації конструкції показники жувальної ефективності залишаються майже на попередньому рівні.

Supporting teeth preservation at the restoration of dentition defects with the help of fixed porcelain fused metal dentures is considered one of the most important issues of prosthodontics. Margin line preparation strategies are still disputable nowadays. In most cases preparation is confined to the ledge creation. Its function is to provide a smooth transition of orthopedic restoration to a tooth root and prevent the traumatization of marginal paradontium. These issues are gaining a momentum when the possibility of manufacturing fixed prosthesis with the use of partially or completely ruined teeth with the preserved root as a support appears. Since the opportunities of thermal method for gingiva retraction and marginal line formation around the supporting teeth are not studied enough in modern scientific sources, our research aims to define the mastication efficiency state in patients of sample groups after the fixation of dentures on the supporting teeth prepared for prosthesis with the help of diathermocoagulation and mechanical retraction. The authors of the article have determined the mastication efficiency in the patients with the restored tooth crown. Altogether 54 patients of two sample groups aged from 20 to 60 years and above with completely ruined tooth crowns were examined. Their soft tissues around the supporting teeth were prepared for the fixed prosthesis manufacturing. The first sample group involved 29 patients that made up 53.7% of general studied population. Their supporting teeth gingiva margins were retracted with the help of diathermocoagulation while preparing them for the fixed dentures. While the gingiva margins of the patients of the second sample group, consisting of 25 people (46.3% of general studied population), were retracted with the help of cotton Ultrapak cord, produced by Ultradent (the USA). It is offered in several size options. Mastication efficiency state after prosthesis was determined with the help of mastication test (Ukrainian Utility Patent # 94841). In this case, mastication index was the main diagnostic tool. It was received with the help of computer analysis of digital samples in software “Adobe Photoshop Extended”. The analysis of the dynamics of mastication test indices of the patients of sample group 1 delivered typical results. In a week after the fixation of fixed porcelain fused metal dentures, the reduction of the mean value of mastication test index by 0.2 was fixed. The verification of these changes according to the statistical significance showed positive result (at p = 0.0004). At the same time, the verification of the changes, occurred during the period from the 7th to the 30th day after the fixation of dentures in patients of sample group 1, with the help of Wilcoxon test showed that at p = 0.9 the reduction of the mean value to 5.148 had no statistical significance. While the dynamics of mastication test changes in sample group 2 looked as follows. The reduction of the mean values of mastication test index from 5.184 to 5.112 was observed. So, the spread between the values received before the retraction and in seven days after crown fixation made up 0.072. The conducted statistSupporting teeth preservation at the restoration of dentition defects with the help of fixed porcelain fused metal dentures is considered one of the most important issues of prosthodontics. Margin line preparation strategies are still disputable nowadays. In most cases preparation is confined to the ledge creation. Its function is to provide a smooth transition of orthopedic restoration to a tooth root and prevent the traumatization of marginal paradontium. These issues are gaining a momentum when the possibility of manufacturing fixed prosthesis with the use of partially or completely ruined teeth with the preserved root as a support appears. Since the opportunities of thermal method for gingiva retraction and marginal line formation around the supporting teeth are not studied enough in modern scientific sources, our research aims to define the mastication efficiency state in patients of sample groups after the fixation of dentures on the supporting teeth prepared for prosthesis with the help of diathermocoagulation and mechanical retraction. The authors of the article have determined the mastication efficiency in the patients with the restored tooth crown. Altogether 54 patients of two sample groups aged from 20 to 60 years and above with completely ruined tooth crowns were examined. Their soft tissues around the supporting teeth were prepared for the fixed prosthesis manufacturing. The first sample group involved 29 patients that made up 53.7% of general studied population. Their supporting teeth gingiva margins were retracted with the help of diathermocoagulation while preparing them for the fixed dentures. While the gingiva margins of the patients of the second sample group, consisting of 25 people (46.3% of general studied population), were retracted with the help of cotton Ultrapak cord, produced by Ultradent (the USA). It is offered in several size options. Mastication efficiency state after prosthesis was determined with the help of mastication test (Ukrainian Utility Patent # 94841). In this case, mastication index was the main diagnostic tool. It was received with the help of computer analysis of digital samples in software “Adobe Photoshop Extended”. The analysis of the dynamics of mastication test indices of the patients of sample group 1 delivered typical results. In a week after the fixation of fixed porcelain fused metal dentures, the reduction of the mean value of mastication test index by 0.2 was fixed. The verification of these changes according to the statistical significance showed positive result (at p = 0.0004). At the same time, the verification of the changes, occurred during the period from the 7th to the 30th day after the fixation of dentures in patients of sample group 1, with the help of Wilcoxon test showed that at p = 0.9 the reduction of the mean value to 5.148 had no statistical significance. While the dynamics of mastication test changes in sample group 2 looked as follows. The reduction of the mean values of mastication test index from 5.184 to 5.112 was observed. So, the spread between the values received before the retraction and in seven days after crown fixation made up 0.072. The conducted statist