Krasnokutskii O. Clinical and experimental substantiation of complex patient-consistent dental treatment of patients with deficiency of periodontal soft tissues

The dissertation work is devoted to the clinical and experimental substantiation of increasing the clinical effectiveness of complex dental treatment of patients with the need to correct periodontal soft tissue deficiency based on patient-agreed planning and objectification of changes in clinical and subjectively associated parameters. The dissertation presents a comprehensive approach to the dental treatment of patients with periodontal soft tissue deficiency based on patient-coordinated planning by optimizing the algorithm of iatrogenic interventions when choosing a xenogenic dermal graft and objectifying changes in clinical and subjectively associated parameters using digital diagnostic methods. For the first time, based on the results of a dental examination of patients in the city of Cherkasy, an arithmetic mean of the prevalence of gum recessions, implant-associated dehiscences, a thin mucosal phenotype in areas of adentia was established, which represents the total proportion of dental patients with the need to correct tooth deficiency and dental restorations. The innovative approaches are presented that can be used at the stages of initial assessment, planning and further prediction of soft tissue changes as a result of the treatment of recessions and degistescences, namely: an adapted method of digital profilometry of recession and degistescence areas as a tool for objectifying changes in soft tissue tissues and patient-agreed modeling of prognostic changes in the level of soft tissue coverage, taking into account the influence of associated factors of subjective perception. Using the proposed approach to the treatment of gingival recession with preliminary digital modeling of potential soft tissue changes, involving patients to determine agreed critical levels of subjective satisfaction, and using a xenogenic dermal graft, the best treatment results were achieved in terms of patient-oriented evaluation criteria (level of satisfaction with the treatment performed , the level of satisfaction with the result obtained, the level of satisfaction with the aesthetic result of the treatment). A device for fixing an autograft has been developed and proposed (Patent of Ukraine for a useful model No. 149673) and a method for using a device for fixing an autograft (Patent of Ukraine for a useful model No. 150538).