Analysis of the results of digital examination of occlusal ratios in patients with generalized periodontitis on the background of atherosclerosis

Abstract

Summary. Periodontal tissue diseases affect all areas of dentistry, requiring a comprehensive approach to solving this problem. The approach to the diagnosis and treatment of periodontal tissue diseases should certainly be comprehensive, including the assessment of not only the degree of inflammation but also the functional state of the dentition. Thanks to the analysis of the results of occlusal relations, which can be caused by tooth extraction, restoration of hard tissues, deformities, the presence of supracontacts, we will be able to differentiate these contacts, trace the trajectory of the lower jaw during the transition from one occlusal position to another, determine the strength and sequence of occlusal contacts in static and dynamic occlusion. The results of occlusal relations using the T-Scan device will allow you to clearly separate normal contacts from excessive interference contacts and analyze the existing contacts.

The aim of the study – to determine the frequency and clinical significance of occlusal disorders in patients with generalized periodontitis on the background of atherosclerosis.

Materials and Methods. The analysis of occlusal relations and assessment of occlusion status was performed in 76 patients with generalized periodontitis (GP) on the background of atherosclerosis (AS) – the main group and in 27 patients with GP without generalized somatic diseases – the comparison group. Clinical diagnostics and analysis of occlusal contacts were performed using the T-SCAN apparatus developed by Tekscan Boston, MA, 1987. The principle of operation of the device: during the study, the patient bites an individual plate – a sensor that transforms the chewing pressure in the form of electromagnetic impulses. The obtained data is transferred to the software, which measures the qualitative indicators of the force exerted on the sensor when the teeth come into contact. Interpretation of the data on occlusal contacts on the computer monitor is displayed in the form of colored columns, the height of which corresponds to the strength of the occlusal contact in planar, three-dimensional and graphical form. The results of the study are evaluated according to graphs, for an adequate assessment of which all 14 colors of the measuring scale must be present. By increasing and decreasing the sensitivity of the sensor, the strongest and weakest contacts are determined. Occlusal analysis consists of recording several films (to clarify the data and eliminate errors). Based on the digital indicators of the occlusal relations of the teeth and the developed criteria for their evaluation, the digital occlusion index (DIO) was calculated using the formula: DIO = (∑points)/n x 100 %, where ∑ is the sum of points according to the diagnostic criteria of OS; n is the number of pairs of antagonist teeth (no more than 14). Index evaluation criteria: ≤42.9 % (total score ≤6) – no occlusion disorders; from 43 % to 57.1 % (from 6.1 points to ≤8 points) – mild occlusion disorders; from 57.2 % to 85.7 % (from 6.1 points to ≤12 points) – moderate occlusion disorders; 85.7 % and more (13 points above) – severe occlusion disorders. Statistical calculation of the obtained results was carried out using application programs “Statistica 8.0” (StatSoft, USA) and a package of statistical functions of the Microsoft Excel 2021 program.

Results and Discussion. The analysis of the results of occlusal relations using T-Scan revealed that in patients with generalized periodontitis on the background of atherosclerosis, 1.3 times more often there were super strong occlusal contacts in the central occlusion and 1.2 times more often there were contacts-interference when the mandible was displaced from the position of central occlusion to anterior occlusion than in patients with generalized periodontitis without concomitant somatic diseases. At the same time, the time of occlusion and disocclusion in the main group was significantly higher compared to the same data in the comparison group, especially in generalized periodontitis of the third degree. According to the digital occlusion index, in patients with generalized periodontitis on the background of atherosclerosis, moderate occlusion was determined, while in patients with generalized periodontitis without somatic diseases, mild occlusion was determined.

Conclusions. Thus, the analysis of the obtained data convincingly proved that in generalized periodontitis there is a significant violation of occlusal relations, which is aggravated not only with an increase in the intensity of dystrophic and inflammatory changes in periodontal tissues, but also with the presence of somatic pathology.