The dissertation is devoted to the study of the state of the components of the tooth - jaw system of patients with disorders of adaptation to fixed dentures, to determine the causes of violations of occlusion relationships of dentitions during the period of adaptation to fixed dentures, on the basis of which was developed, clinical engrainded and evaluated the effectiveness of the algorithm for the restoration of functional occlusion in the period of adaptation of patients to fixed dentures.
We conducted a study of 98 patients. 79 patients - with a violation of adaptation to fixed dentures and 19 persons without signs of violation of adaptation to fixed dentures. For all patients replacement of defects in dentition was carried out by fixed dentures with ceramic lining. The period of using of fixed dentures ranged from 2 weeks to 6 months.
The results of the data obtained from 19 people in the control group indicate a favorable course of adaptation of patients to fixed dentures in this group. According to the analysis, in all 79 patients with signs of violation of adaptation to fixed dentures, we observed morpho-functional changes in the tooth-maxillofacial apparatus.
The basis of the developed algorithm for correction of occlusal ratios of dentition in patients with a violation of adaptation to fixed dentures is the normalization of the sequence of closing teeth in the position of centric occlusion, reducing the time of closing and unlocking dental rows, as well as the removal of occlusive obstacles in eccentric occlusions.
In 90,9% of the subjects there was a normalization of the state of occlusion and chewing muscles, disappearance of complaints and pain symptoms.
Scientific novelty of the results. In the dissertation research realized the solution of the actual scientific and practical task, which consists in improving the quality of orthopedic treatment of patients with fixed dentures, is determined by determining the state of the components of the tooth-jaw apparatus during the period of adaptation to the fixed dentures and the occlusal relationships analysis with subsequent normalization.
The complaints of patients with signs of violation of the adaptation to the fixed dentures were systematized based on the results of anamnesis and the initial examination of patients during the period of adaptation to the fixed dentures.
The clinical features of the state of the constituents of the tooth-jaw apparatus in patients with favorable adaptation to the fixed dentures, as well as in patients with signs of violation of adaptation to the fixed dentures were diagnosed.
The etiology of occlusal relationships violations during the period of adaptation to the fixed dentures was established due to a detailed collection of anamnesis and a set of performed diagnostic measures at the stage of the primary examination of patients.
The scheme of initial examination of patients during the period of adaptation to the fixed dentures has been improved and supplemented with the help of which it is possible to determine the etiology, to systematize the scrubs and to determine the plan for the further treatment of patients with signs of violation of the adaptation to the fixed dentures.
According to the results of clinical and functional studies, an algorithm for restoring functional occlusion in patients during the period of adaptation to fixed dentures was developed and its effectiveness was evaluated in the early and late terms.
The practical value of the obtained results. The proposed comprehensive examination of patients provides the opportunity to choose and plan the further treatment, eliminates the occlusive interferences available at the time of treatment and thoroughly plan the volume of further problems in the occlusion of the dentition, prevent possible mistakes in the stages of prosthetics and further adaptation to fixed dentures.
For the initial examination of patients with disorders of adaptation to fixed dentures was developed algorithm for examination, which allows, based on anamnesis, general clinical, additional research methods, to establish the main etiological factor of the violation of adaptation to fixed dentures and to draw up a rational plan for further treatment.
To improve the effectiveness of prosthetic dentures with ceramic lining, it is proposed to make temporary crowns for all patients, which should be the prototype of permanent fixed dentures, taking into account the interalveolar height, available natural teeth in the oral cavity and morpho-functional characteristics of the masticatory surface, cutting edges, shape and size of the patient's teeth.
Key words: tooth-maxillary apparatus, fixed dentures, adaptation, centric occlusion, eccentric occlusion, electromyography, chewing muscles, occlusal relationships of dentitions, computer analysis of occlusion "T-Scan III", functional occlusion, interferences.
