Hotsko Y. Analysis of the condition of the marginal gingiva near the support crowns of fixed dental prosthesis and ways to prevent complications

The thesis presents a theoretical generalization and new solution to the scientific and practical problem of improving the prevention and treatment of side effects of porcelain fused to metal prostheses on the condition of the marginal gingiva of abutment teeth and oral homeostasis by a clinical justification for a complex of the preventive measures. There have been scientifically confirmed negative changes in the parameters of local immunity and oral homeostasis after treatment with porcelain fused to metal prostheses. Morphological studies at the ultrastructural level have shown that under long-term using of fixed porcelain fused to metal prostheses or single crowns, separate areas of disorganized connective tissue and the presence of plasma cells, neutrophilic granulocytes, leukocytes, and small lymphocytes were detected. It was determined that according to all parameters of the oral cavity index assessment, studied in persons with existing porcelain fused to metal prostheses, the Schiller-Pisarev test, PMA, periodontal index, Simplified Oral Hygiene Index (OHI-S by Greene and Vermilion), bleeding index by Millerman, Community Periodontal Index of Treatment Needs (CPITN) were statistically significant worse parameters compared to the control group. In the study of humoral immunity in the oral fluid of patients with fixed porcelain fused to metal prostheses, the significant changes in the concentration of immunoglobulins have been revealed. It has been found that after prosthetics with porcelain fused to metal prostheses, the immune status disorders deepen, which requires control and correction of treatment. According to the results of the study on the electrophoretic activity of buccal epithelial cell nuclei, there has been found the characteristic feature inherent for all variants of the performed study, such as a gradual decrease in the activity of buccal epithelial cells from the beginning of treatment to 12-14 days and its gradual increase to 3 months after treatment. We consider that exactly during the completion of the manufacture and fixation of the prosthesis, it is advisable to take preventive treatment to avoid inflammation in the marginal gums near artificial crowns. The complex of local preventive treatment was carried out within two weeks and began two days after completion of treatment and fixation of fixed prostheses in the oral cavity. We also prescribed general therapy, which included the use of the drug «Quercetin», which has anti-inflammatory and antioxidant effects. Preventive measures for the year included the professional oral hygiene once a year, and patients with signs of periodontal inflammation – 2-3 times per year; irrigation of the oral cavity with 0.2% solution of chlorhexidine before and after removal of dental plaque; use of toothpaste with anti-inflammatory and antibacterial action.