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7the central occlusion determined in the clinic is fixed. The lost height of the crowns is modeled on the model with wax. They are brought into contact with the antagonist teeth, and the model is duplicated. A silicone combined impression is taken from the duplicated model. Further, in the clinic, a metal-plastic structure to be restored in the oral cavity is treated with honey, dried, treated with a monomer, freeing from self-hardening plastic, after which the color of the plastic is determined. Synma-M plastic powder of a given color is mixed with a monomer, freeing it from self-hardening plastic, and filling it with areas that require restoration in the print. After that, the impression is set in place in the oral cavity. After waiting 7-10 minutes, the spoon is removed from the impression and deforming the impression, the metal-plastic crowns restored with plastic are released, after which they are processed, ground and polished in the oral cavity. The patient is given recommendations on the care of metal-plastic crowns. Four patients with this pathology were observed in the clinic over a 2-year period. A delayed examination of each of them was carried out. At a repeated visual examination after six months, the boundary between the new and old plastic was not determined, there were no color changes and breaks, no chips. Based on this, we recommend using this technique in typical cases when using splint
structures in orthopedic treatment of periodontal diseases. In this case, when restoring the structure, a sparing attitude towards the periodontium and the financial situation of the patient is determined.
References
1. Borisenko A.V. Zabolevanija parodonta: ucheb. posobie (Sekrety terapevti-cheskoj stomatologii) / A.V. Borisenko. - K: VSI «Medicina», 2013. - 456 s.
2. Borisenko A.V., Antonenko M.Ju., Linovic'ka L.V. ta in. Stomatologichnizahvorjuvannja: Tera-pevtichna stomatologija: pidruchnik / Pid red. A.V. Borisenka. - K.: VSV «Medicina», 2017. - 664 s.
3. Deklaracijnij patent na korisnu model' U201202612 No 72812 A61S8/02, zajavleno 5.3.2012, opublikovano 27.8.2012. Bjul. No 16. Ishhenko P.V., Kl'omin V.A., Hondoshko M.V.
4. Deklaracijnij patent na korisnu model' U201211329 No 79037 A61S8/02, zajavleno 1.10.2012, opublikovano 10.4.2013. Bjul. No 7. Ishhenko P.V., Kl'omin V.A., Kashans'kij I.V., Laricheva T.S.
5. Rozhko M.M., Nesprjad'ko V.P. Ortopedichna stomatologija. - K: Kniga pljus, 2003. - 552 s.
PHONETIC PARTICIPATION OF THE PATIENT IN THE MANUFACTURE OF COMPLETE
REMOVABLE LAMELLAR DENTURES
Arkhmammadova G.
Azerbaijan Medical University, Department of Orthopedic Dentistry, Assistent
Baku, Azerbaijan JafarovaA.
Doctor of Philosophy in Medicine, Associate Professor Azerbaijan Medical University, Department of Therapeutik Dentistry
Baku, Azerbaijan Mamadova Sh. Doctor of Philosophy in Medicine, Assistent Azerbaijan Medical University, Department of Therapeutik Dentistry
Baku, Azerbaijan DOI: 10.5281/zenodo.7298679
ABSTRACT
Active phonetic participation of the patient in the manufacture of prostheses at the stage of checking the setting of artificial teeth on a solid basis and the use of an entropy assessment of the pronunciation of a consonant sound contributes to faster speech adaptation to prostheses in the process of their manufacture. Keywords: complete removable denture, use of phonetics.
To restore high-quality speech function during orthopedic treatment with complete removable laminar prostheses, special importance must be attached to the design of artificial dentitions of a particularly frontal group. Many authors recommend designing artificial dentition in such a way as to reproduce the signs of the chewing apparatus as much as possible. According to a number of researchers [1, 2], ideal occlusal relationships are a theoretical model that is not a biological reality or necessity. When designing artificial dentitions, it is necessary to take into account the peculiarities of the status and individual characteristics of the masticatory apparatus of a patient with a complete absence of
teeth at the time of treatment, anatomical, topographical and functional landmarks. To create sagittal and transversal curves in complete removable lamellar dentures, M.E. Vasiliev, based on the anatomical rules for placing artificial teeth, proposed to design artificial dentitions relative to the glass plane [3]. A number of authors [4] point out that this technique does not always provide good aesthetic and phonetic results, since the frontal groups of artificial teeth of the upper and lower jaws are designed with average anatomical principles and do not always correspond to individual pronunciation features in hard bases. of the oral cavity at the clinical stage of manufacturing a full-removable lamellar prosthesis, during which individual occlusal surfaces
are formed and each patient is individually corrected for speech function by recording and analyzing using the developed computer program WavAnalyzer v1.2 [5].
By checking the pronunciation of sounds, each patient was individually checked whether the design of artificial dentition corresponded to his individual characteristics. In the case of distorted pronunciation of sounds, a correction was made and again controlled until the desired result was achieved. The aim of the work is to increase the effectiveness of orthopedic treatment of patients with complete removable lamellar dentures by improving the method of constructing the frontal group of teeth, taking into account the patterns of speech articulation. 38 (44) people with complete absence of teeth were examined. Of these, 10 (12) people were re-prosthetized and for 28 (32) people full removable laminar dentures were made for the first time. Patients were offered a language task. It consisted in the pronunciation of the syllables "IS" and "ISh" of the Russian language, since the peculiarity of the pronunciation of these syllables is the contact of the lateral surface of the tongue with the palatine tubercles of the lateral teeth and the formation of a gap between the back (sound "S"), tip (sound "Sh") of the tongue and the anterior part of the hard palate with the adjoining part of the cellular process, while forming a narrow gap in the middle through which the air jet breaks out with force between the front teeth, a sharp noise resembling a whistle (non-rhythmic oscillations) occurs. Therefore, the clarity and purity of the pronunciation of the consonant sounds "s" and "Sh" depend on the position of the frontal teeth on the upper and lower basis.
For the analysis, the developed specialized software WavAnalyzer v1.2 was used, which makes it possible to implement the calculation of entropy estimates and comparison operations in automatic mode, followed by the presentation of the results in the form of digital sets that are convenient for graphical representation and processing. The use of entropy characteristics makes it possible to consider the studied sound signal as a probabilistic-temporal sequence, which in turn leads to the formation of representations of various shapes, more suitable for correlation analysis by relatively amplitude-frequency characteristics. To check and correct the pronunciation of sounds at the clinical stages of manufacturing complete removable lamellar dentures, a solid prosthesis base was used, made of a hard elastic plate that meets certain requirements: it had a minimum thickness, is uniform in thickness over the entire surface of the hard palate, durable, not deforma-ble from temperature in the oral cavity, is well fixed in the oral cavity, reproduces the anatomical relief of the hard palate.
The results of the study and their discussion of the 38 people for whom complete removable dentures were made using the improved method, 10 (26.32%) people were re-prosthetized and for 28 (73.68%) people full removable lamellar dentures were made for the first time. At the verification stage designing artificial dentitions, the orthopedic treatment of which was repeated, was 0.07±0.006 and 0.06±0.004, respectively. They did not need to be corrected, since the entropy value slightly deviated from the direct and subjective value; when assessed by ear, the pronunciation of the test syl-
lables was not very clear with the addition of insignificant noise. Among the 28 patients for whom orthopedic constructions were made for the first time, in 24 people (85.71%) the entropy value "S" and "SH" did not exceed 0.1. In 4 cases (14.29%), the entropy values of the pronunciation of the consonant sounds "S" and "Sh" ranged from 0.12 to 0.33 and from 0.12 to 0.41, respectively. In these individuals, the correction of the design of the frontal group of teeth was carried out, since the deviation from the straight line was quite significant and subjectively the pronunciation of the sounds "C" and "Sh" was complicated and distorted. In particular, the pronunciation of the sound "S" with admixtures of whistling and replacement with the letter "C", and the pronunciation of the sound "Sh" lisping. With the help of a heated spatula, the wax was softened on the upper and lower solid bases and we slightly tilt the frontal upper and lower artificial teeth to the labial or lingual sides, while it is necessary to maintain the gap between the frontal teeth during pronunciation, it characterizes the quality of pronunciation. In addition, depending on the inclination of the artificial teeth, the height of the lower frontal teeth was raised or lowered. When tilted to the labial side, the height of the lower frontal teeth was increased, and when tilted to the lingual side, it was reduced. <0.05). Subjectively, when listening to the sounds "S" and "Sh", there was a slight noise
Active phonetic participation of the patient in the manufacture of prostheses at the stage of checking the installation of artificial teeth on a solid basis and using the entropy assessment of the pronunciation of the consonant sound contributes to faster language adaptation to prostheses in the process of their manufacture. The patient gradually gets used to the pronunciation in the new environment. It is important that the design correction takes place in the presence of a doctor. Such a phonetically controlled defect-free pronunciation during the construction of the prosthesis prevents patients from developing incorrect speech skills and reduces the period of adaptation to removable structures.
References
1. Cymbalistov A.V. Sovremennye metody okkljuzionnoj reabilitacii bol'nyh v klinike ortopedicheskoj stomatologii / A.V. Cymbalistov, Je.Je. Statovskaja // Kofe servis. - 2005. - № 2. - S. 24.
2. Vojtjackaja I.V. Novye tehnologii v konstruirovanii zubnyh protezov pri lechenii bol'nyh s polnym otsutstviem zubov / I.V. Vojtjackaja, G.P. Fisenko, T.K. Jastrebov // Materialy 5-go nauch. foruma "Stomatologija". - M., 2004. -S. 13-15.
3. Voronov A.P. Ortopedicheskoe lechenie bol'nyh s polnym otsutstviem zubov: ucheb. posobie/A.P. Voronov, I.Ju. Lebedenko I., A. Voronov.
- M., 2006. -320 s.
4. Nesterov A.M. Optimizacija ortopedicheskogo lechenija bol'nyh s odinochnostojashhimi zubami v cheljustjah: Avtoref. dis. ... kand. med. nauk: spec. 14.01.22 "Stomatologija" / A.M. Nesterov. - S. 2010. -S. 24.
5. Mel'nichuk N.V. Razrabotka novogo sposoba korrekcii golosovoj funkcii pri ortopedicheskom lech-enii polnymi s#emnymi plastinochnymi protezami // Medicinskie novosti (Belarus', Minsk). - 2013. - № 11.
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