Опыт применения бюгельного протеза для восстановления жевательной эффективности при двухсторонних экзостозах нижней челюсти (клинический случай)

Abstract

Авторы статьи предлагают усовершенствованную конструкцию бюгельного протеза для вос- становления жевательной эффективности при протезировании двухсторонних дефектов нижней челюсти, при наличии экзостозов с оральной стороны альвеолярных отростков, у пациента пожилого возраста. Авторами установлено, что данная усовершенствованная конструкция бюгельного протеза легко уста- навливается на протезное поле, надёжно фиксируется на опорных зубах, восстанавливает жевательную эффективность и эстетические потребности пациента.; Автори статті пропонують вдосконалену конструкцію бюгельного протеза для відновлення жу- вальної ефективності при протезуванні двосторонніх дефектів нижньої щелепи, при наявності екзостозів з оральної сторони альвеолярних відростків, у пацієнта похилого віку. Авторами встановлено, що дана удосконалена конструкція бюгельного протеза легко встановлюється на протезне поле, надійно фіксується на опорних зубах, відновлює жувальну ефективність та естетичні потреби пацієнта.; The authors point to the need to preserve the health of any group of people, and especially the elderly, it is the preservation or restoration of the masticatory apparatus, providing good chewing of food and, therefore, the proper functioning of the entire digestive system. The authors offer an improved structure partial denture to restore chewing efficiency in prosthetics bilateral mandibular defects, the presence of exostosis with the oral side of the alveolar processes, in elderly patients. The authors noted when recovering terminal defects dentures occur “the problem of the end of the saddle”, which over time can cause atrophy of the distal portions of the alveolar processes, and the irrational use of clasps covering abutment teeth, moves them in the direction of the defect. Furthermore, the presence of large defects terminal exists a high risk of sagging end seats in the vertical direction. Given these complications, the authors believe that the occlusal pad should be placed not in the distal but in medial fissure in the abutment tooth. Teeth, standing in front, taking part of the load of chewing on themselves, thereby relieving him and abutment retains his position. This situation explains well the scheme Osborne. It is known that the clasp on the mandible must be positioned so that the surface of the prosthesis was divided into equal parts. Therefore, in this case the selected transversal clasps line. To improve the fixation was added many lings clasp Kennedy, whose main function is the role antisbrasyvatelya. Also, the stabilization of the prosthesis, according to the observations of the authors, was achieved at the expense of the small the engagement tabs that are placed on the abutment teeth. They are located in the base area of the teeth, so the retention of the prosthesis is not involved and their small size does not disrupt the overall aesthetics. The presence of exostosis prevented normal oral placement of the arc on the mandible. Its use would lead to a systematic injury of the mucous membrane under the influence of the prosthesis, which could result in serious complications. The authors have considered the issue by modeling the vestibular arc that follows the shape of the vestibular surface of the alveolar bone. The article shows that the arc prosthesis for a given clinical situation has design features, but not the process of its manufacture. Paralellometriya (logical method), preparation of the model to duplicate, molding frame, its subsequent processing, including sawing runners, sand blasting, and the fit is on the model implemented by the usual method. The authors note that the improved design of partial denture can be easily installed on the prosthetic field, securely fixed on the abutment teeth, restore chewing efficiency and aesthetic needs of the patient.