CHARACTERISTICS OF REACTIVE CHANGES IN THE GINGIVAL MUCOSA IN CONDITIONS OF VARIOUS TYPES OF ODONTOPREPARATION FOR CERMET STRUCTURES
DOI:
https://doi.org/10.11603/2415-8798.2018.2.9115Keywords:
cermet prosthesis, basal membrane, epithelial barrier, tooth-gingival sulcus, mechanical micro trauma of gums, gum recession, ledge, periodontal pocket, connective epithelium.Abstract
The issue of rehabilitation of patients with defects in hard tissues of teeth and dentition is one of the urgent problems of practical dentistry, since 65 % of the population of our country aged 35–45 years needs dental prosthetics. The traditional methods used to replace dentition defects do not always fully correspond to the aesthetic and functional requirements of patients. The aim of the study – to analyze the literature sources with the characteristic of reactive changes in the mucous membrane of the gum under conditions of various types of odontopreparation for cermet structures. In connection with the introduction of a large number of new materials into practice and the widespread prevalence of a burdensome anamnesis among the population, the issues of their biological tolerance and prevention of possible complications are especially important. The full preservation of periodontal functions after orthopedic treatment is one of the defining signs of the quality of the provided dental care. In addition to the tooth tissues, a significant influence with direct odontopreparation and prosthetics with non-removable orthopedic structures undergoes a tooth-gingival sulcus, is considered as a complex system where factors of the external and internal environment interact. Morphological integrity and functional properties of the dento-epithelial compound undergo constant tests during chewing food. Unlike multilayer flat gingival epithelium, the connective epithelium does not undergo keratinization, but due to its high mitotic activity it quickly regenerates after various injuries. With the introduction into practice of orthopedic dentistry of cast-in-one ceramic coated crowns and bridges, problems arose, the key moments of which are inflammation in the gingival margin of the supporting teeth, gum retraction, thermal injury of the pulp, periodontal overload and morpho-functional changes in the periapical tissues. Any manipulations with marginal gums during prosthetics should be carried out with the utmost care and consideration of the characteristics of the marginal gingival to avoid unpredictable periodontal reactions. The probability of a trauma of the tooth-gingival attachment increases with an irrational choice of the retraction method for various biotypes of the gums. Therefore, before the prosthetics, it is necessary to obtain data on the biotype of the gum, and additionally measure the depth of the gingival groove in order to determine its individual size, which determines the choice of the retraction method aimed at preventing gum injuries in orthopedic treatment.
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