Justification of the use of improved methods of manufacturing structures with support on implants based on the indicators of the occlusion state

Abstract

Summary. One of the main methods of controlling the treatment of dental defects is the computerized method of recording occlusion with a T-scan device.

The aim of the study – to study the indicators of occlusal contacts using the T-scan system in patients with unilateral end defects of small extent, who were treated with orthopaedic structures with support on implants according to the standard and improved technique.

Materials and Methods. We treated 63 patients aged 40-60 years with dentition defects, Kennedy Class 2 terminal unilateral defects on the lower jaw, in which 63 implant-supported metal-ceramic bridge prostheses were fabricated and fixed, which were divided into two groups. Patients of the main and control groups (n=30) were examined for the state of occlusion and load distribution between the right and left sides.

Results and Discussion. A study of the state and distribution of interocclusal contacts during maximum jaw compression was conducted. It was established that adaptation of occlusion to fixation of orthopaedic structures on implants takes place in stages. It was affected by the partial unwinding of the screw during the first week of the structure operation. It was also established that the structure made according to the improved technique (reinforcing transfers using A-silicone impression mass to fix the occlusal ratios and fixing the orthopaedic structure using an oxygen-containing gel for filling the shafts of implants after dental manipulations and sterile Teflon tape) provides somewhat better and faster adaptation to orthopaedic construction. The results of this study confirmed the hypothesis that the loosening of the screw at a significant distance from the location of the implant shaft to the marginal edge of the gums can affect the condition of the orthopaedic structure after its fixation. Considering the fact that 6 cases of this type of distance were recorded in group 1, and 4 cases – in group 2, another hypothesis is confirmed that the process of occlusion formation is gradual, usually at least one week is required for adaptation and formation of occlusal contacts.

Conclusions. On the basis of the conducted computerized study of the state of occlusion with the help of the T-scan device, it was established that the manufacture of bridge-like prostheses with support on implants significantly affects the operation of the maxillofacial system. It was established that the process of adaptation to the orthopaedic structure is gradual and is formed during the first weeks of using the prosthesis. According to this study, it is possible to form a conclusion that during orthopaedic treatment on implants, the appropriate time for correction of screws and occlusal ratios is one week after orthopaedic structures fixation in the oral cavity.