Kryvchuk O. Clinical and laboratory justification of improved method of manufacturing laminar bases of removable dentures

According to the results of the survey of 114 edentulous patients, it was found that in 100% of cases, patients with the inability to use complete removable dentures have an objective reason. They are loose adherence of the denture bases to the tissues of the prosthetic bed (61.4%), reduction of the denture boundaries (9.6%), incorrect teeth placement (9.6%), disruption of plastic technology (3.5%), and a combination of several possible causes (27.2%). In 100 edentulous patients, after the start of the use of complete dentures, dysbiotic disorders in the oral cavity could be described as an increase in the number of opportunistic microorganisms while decrease the normal quality composition of the microflora. The use of removable dentures led to an increase in the content of the indicators of the activation of the enzymatic chain of oxidative homeostasis of the mucous membrane and the local immunity. The originality of proposed methods of manufacturing bases of complete removable dentures was, first, in the application for pressing the bugel of the proposed design and, second, in applying a bioinert coating of polyvinyl alcohol on the inner surface of the bases. After data of experimental researches, the thickness of plastic lattice was reduced to 0.15 ± 0.05 mm against the use of the traditional method using 0.85 ± 0.20 (р < 0.05). The application of 5-6% polyvinyl alcohol on the surface of acrylic plastic samples allowed to reduce free monomer in 1 month of the experiment to 0.14 ± 0.01 mmol / g vs 0.26 ± 0.03 mmol / g of the control sample (p < 0.001) and in 3 months up to 0.20 ± 0.02 mmol / g vs 0.11 ± 0.01 mmol / g of control (p < 0.001). According to the clinical trial in 30 edentulous patients, the use of removable dentures, the bases of which are made of acrylic plastic using advanced technology, can reduce the inflammatory response of the mucous membrane of the prosthetic bed according to clinical estimates, which was confirmed by the decrease in the level of dysbiosis. The immunometabolic status was characterized by normalization of secretory immunoglobulin A level, decrease in antioxidant protection indices, in particular decrease in the level of recovered glutathione and catalase. It should be noted the preservation of the functional value of the dentures made by the proposed method, in terms of stability, chewing efficiency, an integrated index of maximum force of compression of the jaws and the density of fit (p ˃ 0.05). Patients also experienced an improvement in the adaptation process, in particular the dynamics of quality of life. The amount of occlusion correction measures reduced from 100% to 40.0% of cases.