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THE CHOICE OF THE OPTIMUM BASIC MATERIAL FOR THE MANUFACTURE OF TOOTH PROSTHESIS IN HIV-INFECTED PATIENTS
Alimov Alisher Sadykovych, professor, Tashkent Institute for Advanced Studies, of Medical Personnels (Doctors) (Uzbekistan)
Alimov A. A., researcher, E-mail: [email protected]
THE CHOICE OF THE OPTIMUM BASIC MATERIAL FOR THE MANUFACTURE OF TOOTH PROSTHESIS IN HIV-INFECTED PATIENTS
Abstract: When carrying out complex therapy (pathogenetic and symptomatic), together with dental orthopedic treatment, there was a significant clinical improvement accompanied by normalizations, both the general condition of patients, and the positive shifts in the dynamics of endurance periodontal loadings.
On the background of antiretroviral therapy, 27 HIV-infected patients were provided with orthopedic dental care. To replace the defects in the dental rows, the base plastic "Ftorax" and the thermoplastic basic material "Vertex Thermo Sens".
Keywords: HIV infection, periodontal endurance, dental prosthetics.
Dental treatment of oral diseases in HIV-infected patients materials that do not have irritating, toxic and allergic effects
is complicated by the state of progressive immunodeficiency caused by HIV infection against the background of compression of concomitant infections, massive use of antibiotics and other chemotherapeutic agents [1, 6, 7, 9]. Dental therapy for HIV-infected patients is often performed against the backdrop of the administration of large doses of drugs, with an increase in the duration of their use, which is a feature and complexity of treatment of this category of patients [2, 8, 10].
The success of the treatment and prevention of secondary adentia, which is the consequence of caries and periodontal diseases, by replacing the defects in the dentition with removable and non-removable dental prosthesis designs depends on the proper design of the orthopedic treatment plan, on the choice of the adequate design of dentures and materials, and their hygienic condition [3, 4, 5].
However, analysis of the literature shows that the issues of providing orthopedic dental care to people living with HIV continue to be little or hardly studied. Meanwhile, scientific research in this area would allow us to work out the tactics of the approach to assessing the condition of the oral cavity in HIV-infected patients and the specifics of dental, including orthopedic care, starting with the decision of questions of indications and contraindications to dental prosthetics, the timing of treatment, choice methods, design, materials for the manufacture of dentures, as well as features of oral care, prosthetics and tissues of the prosthetic bed.
Due to the fact that the provision of dental care to HIV-infected patients should be performed with minimal invasive interventions due to the high risk of transmission of the pathogen during manipulation, it seemed to us very relevant to consider the issue of orthopedic treatment using modern
on the mucous membrane of the oral cavity, as well as not requiring additional dental preparation in the manufacture of prostheses. According to some researchers [2, 6, 10], orthopedic dental treatment for patients with HIV, regardless of the design of the prosthesis and the material used for prosthet-ics, should be carried out in combination with antiretroviral therapy (ARVT).
This approach to therapy is designed not only to improve the overall condition of the patient, but also to achieve long-term positive results in the treatment of oral pathology.
In addition, due to the high risk of transmission and infection of HIV to other patients and attendants, it is desirable to use prosthetic methods with minimally invasive intervention.
The purpose of the study was to perform a comparative analysis of the basic materials in dental prosthetics in HIV-infected patients.
Materials and methods. Against the background ofARVT, 27 patients with HIV were given orthopedic dental care. Patients were divided into 2 groups: 13 patients in the 1 group were made removable dentures using acrylic plastic "Ftorax", and 14 patients 2 - groups made prostheses using thermoplastic new material "Vertex Thermo Sens".
Thermoplastic material of new generation "Vertex Thermo Sens" has a number of advantages in comparison with other basic materials. This material, unlike Plutox, is monomeric, moisture resistant, easy to polish, does not shrink, flexible enough, does not cause an allergic reaction, and is an ultra-strong material, which makes it possible to manufacture micro, clasp, and partially and fully removable dentures.
Gnathodynamometric studies provide reliable information about the functional state of periodontal tissues and can
Section 11. Medicine
serve as objective criteria for both establishing an accurate diagnosis and for evaluating the ongoing therapeutic and prophylactic measures.
The investigations were carried out with a gnathodyna-mometer of the device (Bekmetov M. V., Khodzhimetov T. A., Sokolov A. A.) - A. C. No. 1637782.
Endurance periodontal loadings are carried out in the dynamics of the disease before and after treatment in 2 directions: horizontal and vertical.
Results of the study. In HIV-infected patients, after complex therapy (pathogenetic and symptomatic), together with dental orthopedic treatment, we observed a significant clinical improvement accompanied by normalizations, both the general condition of patients and positive changes in the dynamics of endurance periodontal loadings (in group 1 after prosthetic stability the periodontium incisors to horizontal loads increased by 21.50%, in the 2nd group - by 54.44% (< 0.01), the corresponding increase in the canines was + 25.45% (p < 0.01) and 35.43% (p < 0.01), in premolars - + 16.80% (p <
0.01) and +33.18% (p < 0.001), on molars - + 17.26% (p < 0.01) and + 52.18% (p < 0.001), as well as the parameters of the immunological status of the oral fluid (the titer of S Ig A in group 1 increased compared to that before treatment (1.42 ± 0.2 g / l) and amounted to 1.68 ± 0.4 g/l, while a similar factor of local immunity in patients with HIV in group 2 before treatment was 1.24 ± 0.08 g/l, and after the prosthetics practically Approximately to the norm of 2.05 ± 0.6 g/l).
Our studies showed that the elimination of defects in the dentition by prosthetics using basic materials: "Ftorax" and thermoplastic material "Vertex Thermo Sens" resulted in an equal distribution of functional chewing load on the periodontium, a significant reduction in inflammation in the periodontium and an improvement in regional circulation.
The higher clinical effect was registered in patients with HIV in group 2, who underwent prosthetics with removable dental prostheses based on thermoplastic material "Vertex Thermo Sens".
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