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7PARODONTAL TISSUES DURING PROSTHETICS WITH ZIRCONIUM DIOXIDE BRIDGES Akhmedov H.K.
Akhmedov Hurshid Kamalovich - Assistant, DEPARTMENT OF ORTHOPEDIC DENTISTRY AND
ORTHODONTICS, BUKHARA STATE MEDICAL INSTITUTE, BUKHARA, REPUBLIC OF UZBEKISTAN
Abstract: for a dentist, it may be of practical interest to find out the role of psycho-emotional factors and features of the patient's psychotype in the formation of his motivation and compliance to orthopedic treatment. Periodontal disease does not extend to inflammatory diseases, but at the same time leads to a decrease in bone tissue and atrophy of the alveolar processes, and in the absence of surgical treatment - to tooth loss. The causes of periodontal diseases are not entirely clear today. Poor heredity, diabetes mellitus, glandular disorders, diseases of internal organs can be indirect factors affecting the occurrence of periodontal diseases.
Keywords: paradontitis, partial absence of teeth, pre-prosthetic preparation.
Relevance. Isolated CPL sopr is detected in 25.6-35.0% of patients with CPL, more often occurs in complicated, recurrent forms, accompanied by pronounced structural-functional and aesthetic (when localized on the red border of the lips) disorders, leads to a decrease in the dental components of the quality of life [10, 22, 24]. If CPL accounts for from 1.5 to 2.5% of cases of dermatological diseases, then its manifestations occupy the first place in the structure of the incidence of COPD (from 35.0 to 50.0% in different populations); combined CPL-Associated skin and mucosal lesions, including COPD, are detected in 45.0-75.0% of patients with CPD, which determines the extensive aspect of the problem's relevance [5, 18, 23].
Before describing the types of prosthetics for periodontal diseases, it is necessary to briefly describe the disease itself.
Periodontal diseases are quite rare (on average in 1-8% of patients), many confuse its symptoms with periodontitis [2.4.6.8]. These two diseases have common features, but periodontitis is characterized by inflammation of soft tissues, gum exposure and purulent discharge [7.9.10.11]. Periodontal disease does not extend to inflammatory diseases, but at the same time leads to a decrease in bone tissue and atrophy of the alveolar processes, and in the absence of surgical treatment - to tooth loss. The causes of periodontal diseases are not entirely clear today. Poor heredity, diabetes mellitus, glandular disorders, diseases of internal organs can be indirect factors affecting the occurrence of periodontal diseases [1.3.5].
The dental aspects of CPL are multi-faceted and fall within the area of scientific and practical interests of dentists of various profiles and internists. The most fully studied features of clinical manifestations and the effectiveness of various schemes of physiotherapy and pharmacotherapy of CPL SOPR [8, 18, 21]. However, attention is drawn to the fact that even with the use of modern drug therapy regimens, it is not always possible to achieve an optimal clinical result with a stable remission of CPL.
Purpose of research. To identify the features of orthopedic treatment of patients with diseases of the oral mucosa.
Material and methods. The peculiarities of the clinical picture of periodontal disease, complicated by tooth loss, should include the appearance of an additional functional load due to a decrease in the number of teeth. The number of lost teeth, the location of the defect, the type of bite, the degree of atrophy of the alveolar part are of great importance for the development of the disease in these conditions. If the lateral teeth are lost, the front teeth receive an additional load. In this regard, the mobility of the teeth increases, the upper incisors and canines fan out, moving forward, the gaps between them increase, the interalveolar height decreases, as a result of which the lower third of the face decreases. At the same time, the position of the lower head of the mandible in the articular fossa changes, there is a danger of functional overload of the joint. Patients with partial or complete loss of teeth and the presence of chronic diseases of the oral
mucosa often come to the clinic of orthopedic dentistry. Currently, it is proved that orthopedic treatment of patients with diseases such as lichen planus, leukoplakia, gum fibromatosis, papillomatosis, and angular cheilitis is not only possible, but also necessary. This is due to the undoubted role of dental prosthetics in the prevention of exacerbations of these nosological forms.
Patients with periodontal diseases and teething continuity can be divided into three groups. The first group includes patients with included, the second group includes terminal (unilateral and bilateral) defects of the dental arch; the third group consists of patients with multiple defects and small (2-3) groups of teeth. When the defect is located in the front of the dentition, prosthetics are performed using various types of bridges. The pillars are the remaining teeth. The bridge prosthesis is a tire. If the defect is large (loss of canines, premolars), the remaining root teeth are split by a fixed splint, and the defect is replaced by a removable prosthesis. In the presence of unilateral and bilateral included defects, which are formed when 1-2 molars and premolars are removed, splinting is carried out by bridges, the supporting elements of which are equatorial and full crowns. Reducing the height of the bridge body leads to a decrease in the area of its adhesion to the crown, which leads to the breakdown of dentures. In these cases, cast structures or large saddle prostheses with fasteners on teeth blocked by fixed tires are used. Bridges are contraindicated if the distal tooth is movable. To do this, splinting with an arc prosthesis is used by continuous processes of the fastener and claw with the mobility of the front teeth. Removable splinting prostheses are shown with major defects, significant periodontal damage or lack of sufficiently strong dental support. Apply an arc prosthesis that takes into account lateral stabilization. The front group of teeth is a tire with fixed tires. With high mobility of teeth, splinting can be improved by.
Results: Local mechanical and electrochemical stimuli play an important role in the pathogenesis of diseases of the oral mucosa. These are: first, anomalies in the position of the teeth, deformities of the dentition, sharp edges of the teeth, partial loss of teeth that contribute to injury to the oral mucosa; second, incorrectly
designed or defective dentures; third, orthopedic structures made of metals with different electrochemical potentials .
When preparing the oral cavity for prosthetics, you should plan a set of measures for the rehabilitation of the oral cavity, including professional hygiene, grinding of sharp edges of teeth, and removal of poorly made prostheses. In order to eliminate electrochemical trauma, normalize the microelement composition of saliva and mucosa, and reduce the activity of saliva enzymes, it is shown to remove prostheses made of dissimilar metals and amalgam fillings .
Diseases of the oral mucosa occupy a special place among dental diseases. Diagnosis and treatment of such diseases are extremely complex. In addition, many of these diseases are infectious in nature, which causes the risk of infection of medical personnel. In this regard, questions arise about when to conduct orthopedic treatment of patients with diseases of the oral mucosa and what are the features of prosthetics.
Conclusions: The disease still remains an urgent problem of modern dentistry and medicine due to the ambiguity of etiopathogenesis, a variety of trigger and trigger risk factors, the development of clinically manifest morphofunctional and aesthetically significant lesions of the skin, mucous membranes and internal organs. In the structure of dermatological morbidity, CPL accounts for 1.5% -2.5% of cases, the frequency of simultaneous damage to the mucous membranes and skin varies from 23.0 to 28.6%. Isolated lesions of the SOPR, according to various authors, were registered in 35.0% - 58.0% of cases. Manifestations of CPL on the SOPR are more severe, may long precede the appearance of skin symptoms and remain the only sign of the disease.
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