The dissertation on competition of a scientific degree of the doctor of medical sciences on a specialty 14.01.22 - dentistry. - Shupyk National Medical Academy of Postgraduate Education, Ministry of Health of Ukraine, Kyiv, 2020.
The dissertation presents a new conceptual solution to the current problem of modern dentistry - clinical and experimental justification of orthopedic treatment of periodontal diseases in patients with diabetes by determining the nature of patho- and morphogenetic changes in periodontal tissues and clinical experimental justification of therapeutic and prophylactic treatment and prevention.
The annual increase in the number of patients with diabetes determines the medical, social and clinical significance of this problem, including in dentistry. Diabetes mellitus is one of the most severe systemic diseases that affects the condition of the oral cavity, with changes in the maxillofacial area are multiple and depend on the level of glycemic control and the duration of diabetes mellitus.
The results showed a decrease in the number of intact dentitions in periodontal disease on the background of diabetes, which indicates a deepening of structural changes in the dental system. The largest number of defects was Class I Kennedy. Studies have shown the clinical features of partial tooth loss in patients with chronic generalized periodontitis on the background of diabetes mellitus, and without concomitant pathology.
Also in diseases of periodontal tissues on the background of diabetes revealed changes in the parameters of microcirculation, which leads to a deterioration of metabolic processes. In patients with generalized periodontitis on the background of diabetes, there are more significant changes in the parameters of occlusion with the same severity of the disease.
During the experimental study, changes in bone tissue and vessels of the mucous membrane under the conditions of simulated diabetes were studied. Characteristic changes and conducted biochemical parameters of blood of experimental animals are isolated and described.
However, based on the obtained data, a set of treatment-and-prophylactic measures with the use of methods of metabolism correction, biologically indifferent orthopedic constructions and hygienic support in patients with diabetes mellitus has been developed. Proposed self-developed splint-type prosthesis. The estimation of the offered treatment-and-prophylactic complex of actions and efficiency of use of the orthopedic design of a splinting type developed for replacement of defects of dentitions is given.
As a result of the conducted researches the diagnostic criteria and pathogenetic mechanisms of dystrophic-destructive processes of the dental apparatus of patients with diabetes mellitus of different age and sex are improved.
Establishment of morphofunctional features and condition of reparative periodontal systems of laboratory animals in the experiment. Scientific data on the dynamics of structural rearrangement of the vessels of the microcirculatory tract of periodontal tissues in diabetes have been supplemented
The influence of orthopedic structures on the condition of periodontal tissues in patients with diabetes mellitus of different ages and sexes has been studied. Functional changes were revealed during electromyographic examination, analysis of parameters after treatment was performed depending on the type of orthopedic structure selected for rehabilitation. The analysis of occlusion parameters at the stages of rehabilitation of dental patients is given.
Indications for the use of an individual set of treatment and prevention measures with the use of methods of metabolism correction, biologically indifferent orthopedic structures and hygienic support in patients with diabetes have been developed. The orthopedic design of the splinting type is developed for replacement of defects of dentitions.
The evaluation of the efficiency of the use of etiopathogenetically substantiated, treatment-and-prophylactic complexes of metabolism correction in patients with diabetes mellitus and the efficiency of the use of the splint-type orthopedic structure developed for the replacement of dentition defects is carried out.
Introduction into practice of the developed individual complex of treatment-and-prophylactic measures with application of methods of correction of a metabolism, biologically indifferent orthopedic designs and hygienic support at patients with a diabetes mellitus.
The developed splint-type prosthesis will increase the degree of rehabilitation of patients with periodontal diseases on the background of diabetes, reduce the number of complications in prosthetic dentition defects and increase the level of dental health of the population of Ukraine.
Key words: diabetes mellitus, periodontal tissue diseases, dentition defects, orthopedic treatment, treatment and prevention complex.
