The dissertation presents the solution of an urgent problem in modern medicine, which cause the increasing the effectiveness of preventive measures in orthopedic dental treatment of patients with galvanosis through using of modified fixed orthopedic structures.
As a result of generalization of researches concerning a difference of biopotentials in an oral cavity of the examined patients we established that this indicator at representatives of 1 group of supervision made (68,7±11,3)mV. The average value of the biopotential difference for persons of group 2 was (178,3±46)mV, which was significantly higher than this indicator in the comparative aspect with patients without galvanosis in 2,6 times (p<0,05). Along with this, it is proved that the indicators of potential difference in patients of the 2nd observation group differed significantly depending on the type of orthopedic structures located in the oral cavity of the examined patients. It should be noted that the smallest potential difference was characteristic of patients with metal-ceramic prostheses (83,4±19,2)mV.
According to the results of our research to determine the resistance of the three groups of cements for fixing fixed orthopedic structures, it was found that the lowest resistance we observed in the samples of glass ionomer cement company «CX–Plus».
When studying the processes of free radical oxidation of lipids in oral fluid, we found a significant activation of these reactions in the second group of subjects, compared with these indicators of patients in group 1.
The microbiota of the cervical regions of patients with galvanosis, who use fixed orthopedic structures, included representatives of the normal microflora of the oral cavity - both lactobacilli and streptococci. In addition, fungi of the genus Candida and anaerobes were much more common. On the basis of the considered quantitative indicators of microbiota of cervical sites of patients of 1 group of research, we established in them the II level of a dysbiosis of an oral cavity according to Khazanova V.V. (1996). At the same time, patients of the 2nd observation group were characterized by the IV level of oral dysbiosis.
Patients with galvanosis had an inverse high correlation between the number of Lactobacillus spp. and a direct very high relationship between Candida spp. with a potential difference in the oral cavity.
After orthopedic treatment of patients of the 2nd observation group with the using of metal-ceramic crowns made according to the generally accepted technology, we observed a decrease in the complaints of patients associated with the occurrence of galvanic phenomena, compared with the data before treatment. However, in general, 20% of patients after complete replacement of metal prostheses with metal-ceramic structures had vague symptoms characteristic of galvanosis. In the analysis of subjective symptoms in patients of group 2b, who underwent galvanosis with the help of our proposed modified design, we found almost complete reduction of subjective symptoms.
It was found that after the treatment of patients of group 2 with galvanosis and the manufacture of new orthopedic structures, the potential difference in the oral cavity was significantly reduced. After the installation of the modified fixed orthopedic structure proposed by us, the potential difference in patients in group 2b was 48,4 mV, which was within normal limits and was significantly lower by 3,7 times compared to pre-treatment data (p<0,05).
The positive result of the complex treatment of galvanosis affected the improvement of biochemical, coagulation properties of oral fluid and the severity of dysbiosis (contamination by microorganisms of the cervical teeth).
Taking into account the data, we recommend for use for fixing metal-ceramic structures made with support crowns according to our proposed method, "Cemion" and polycarboxylate cement, because they have a high electrical resistance and a correspondingly lower electrical conductivity.
