This thesis is focused on improvement of prosthodontic treatment effectiveness and prevention of patients at the expense of pathogenetic choosing of materials for dental prosthesis manufacture.
Clinical trials in 236 patients. All of them were fit fixed prosthesis. The first (control) group of 59 patients included patients without any sign symptoms of intolerance to dental prosthesis materials recorded both after appointment and in medical history.
The second and the third groups included patients with sign symptoms of negative effect of dental prosthesis on oral cavity tissues and, in general, intolerance to prosthesis materials by the body.
Patients of the second group (84 persons) were fit fixed porcelain prosthesis or overlay removable non-acrylic overlay denture without any additional diagnostics and treatment.
Patients of the third group (93 persons) passed diagnostic trial according to our self-developed methods (section 6), as well as our self-developed individual dental prosthesis and complex of preventive measures, including fetor oris prevention.
To choose optimal materials for dental prosthetics statistical trials on dental prosthesis prevalence rate using different prosthodontic treatment methods, different materials for dental prosthesis manufacture, prosthetic denture life time were carried out with the aim of prosthodontic treatment quality assessment with dental prosthesis and fetor oris prevalence rate, caused by dental prosthesis materials incompatibility.
To determine the response of oral cavity and body tissues to construction materials, assessment of fetor oris factors, significant clinical laboratory tests (analysis of cellular and humoral immunity parameters, inhibition of leukocyte migration, study of general oral cavity dental prosthesis surface seeding.
With the aim of development of individual complex test on sensitivity to dental prosthesis and individual choosing of construction materials, laboratory tests on the condition of blood and oral cavіty of patients were carried out.
For comparative assessment of clinical effectiveness of proposed methods for prevention of intolerance to dental prosthesis materials and fetor oris, caused by intolerance to construction materials, clinical tests (medical history, examination, palpation, fetor oris, clinical laboratory assessment of patient’s oral cavity, in terms of use of different dental prosthesis, assessment of oral hygiene) were carried out (Oral Hygiene Index, Fedorov-Volodkina index, Green- Vermillion index, Stallard index, Silness—Loe index).
One of the prosthetic dentistry fundamental problems is the development of individual choosing of dental materials in prosthesis manufacture; development of quality prognostic index for individual tolerability to the materials for dental prosthetics.
For the first time development of fetor oris pathogenesis, related to individual adverse response of the body to dental materials was established. Methods for fetor oris elimination and its prevention developed.
For the first time on the basis of objective data complex (data of objective clinical trial and functional tests) the new methods for pre-prosthetic preparation of patient, excluding negative effect of prosthetic denture materials on the body in general. For the first time, clinical assessment of long-term response after dental prosthetics with materials, used as construction materials for dental prosthesis carried out. Assessment of oral fluid and tissues composition in patients with dental prosthesis gave an opportunity to assess oral homeostasis of individuals in this category of patients.
On the basis of provocation test with the study of neutrophils migration, it was found, that the less responsive biological properties observed in the group of glass-ionomer cements, the most provocative response was shown by zinc-phosphate cements.
Developed instructions and recommended indications for the use of different materials in case of individual sensitivity.
Algorithm for fetor oris prevention, caused by incompatibility of dental prosthesis materials and individual oral cavity medium in patient with dental prosthesis.
Given clinical assessment gave an opportunity to develop a concept for practical application of the test-schemes in high-quality dental prosthesis manufacture.
