The dissertation provides a theoretical generalization and a new solution to the urgent problem of modern dentistry – increasing the efficiency of restoration of contact surfaces of lateral teeth in patients with generalized periodontitis of primary – I Degree by improving approaches to such restoration depending on the state of the elements of the interdental triangle.
To achieve the set goal and solve the problems, the following research methods were carried out: clinical, radiological, microbiological, algorithmization and programming, statistical, etc.
A clinical study revealed that a high risk of caries and periodontal diseases is associated with composite restorations which had defects in anatomical shape and contact points. It was found that the prevalence of caries of the contact surfaces of the lateral teeth is 82.6 % and the index of the intensity of carious lesions of the contact surfaces of the lateral teeth is 14.6±0.2, which corresponds to a high level according to the WHO criteria. Only 15.5 % of restorations (of the total number of the examined restorations) with the highest score according to the criterion of “anatomical shape” and 13.0 % of restorations with excellent contact points were identified.
It was found that in the interdental spaces with missing gingival papillae, the restoration of contact surfaces required immediate replacement; in the proximal spaces with insufficient volume of the interdental gingival papillae, the contact points and the anatomical shape of the restorations of the contact surfaces of the lateral teeth needed correction; in the proximal spaces, where the volume of the dental papilla was completely preserved, the contact surfaces of the lateral teeth were perfectly restored with full contact points. An in-depth clinical study of the elements of interdental triangles revealed the effect of parameters of contact alveolar height and cervical and proximal index on the volume of interdental gingival papillae, namely, in 23,5 % of the examined interdental spaces interdental gingival papillae were completely absent (PIS index – 0 Degree). The index of the contact alveolar height was equal to 7.6±0.1 mm and the cervical-proximal index was 3.0±0.1 mm.
Based on clinical studies, the advantages of using improved approaches to direct composite restoration of contact surfaces of lateral teeth in patients with generalized periodontitis of primary – I Degree, taking into account the index the of contact-alveolar height and the cervical-proximal index as well as their high efficiency were proved. It was revealed that after 24 months, 160 direct photos of composite restorations (91.4 %) of contact surfaces of lateral teeth made by the improved approaches were excellent. They had all the anatomical features of the lateral teeth and contact points were preserved. It was found that in the area of the above restorations, 93.7 % of the interdental gingival papillae fully restored their volume.
The proposed “Papillary Expert” software package demonstrated high efficiency of predicting the state of the interdental gingival papilla after restoration of contact surfaces of lateral teeth in such patients. Individual prognoses of the software product corresponded to clinical status in 93.7 % of cases.
Key words: generalized periodontitis, lateral teeth, contact surfaces, carious lesions, restoration, interdental gingival papillae.
