Havaleshko V. P.

DENTISTRY

Scentific article

Prosthetics of teeth and dental rows defects is the final stage of complex orthopedic treatment of patients, which is due to the aging and activity of the course of rheumatoid arthritis, a clinical picture of the partial absence of teeth and changes from the jaws, muscles, temporomandibular joints (TMJ). The aim of the study was to evaluate clinically the results of prosthetics of dental row defects in patients with TMJ diseases on the background of rheumatoid arthritis, taking into account the features of denture structures, materials and manufacturing technologies. The prosthodontic treatment was performed on 126 patients with partial absence of teeth, 82 of them with the disease of the temporomandibular joint on the background of rheumatoid arthritis (RA). The patients with partial absence of teeth and diseases of TMJ were presented as follows: the defects of dental row were found in 68 persons (54.0%), of which 48 patients with rheumatoid arthritis (70.6%) and practically healthy persons – 20 people (29.4%). Distal unlimited defects were recorded in 58 cases (46.0%); from this number of people, RA had 34 patients (58.0%) and 24 practically healthy persons (42.0%). Defects of hard teeth tissues were restored only with solid and ceramic crowns. In patients with RA and TMJ disorders, the readings for the manufacture of artificial crowns were extended, this was due to the peculiarities of the manifestations of the underlying disease. Unilateral and bilateral inclusive dental row defects of small and medium length were restored with bridges. Distally unlimited and combined defects were restored with removable dentures (partial and /or bridge-like). In the manufacture of bridge-like dentures, preference was given to solid-fiber and metal-ceramic structures. In the absence of at least one tooth, we developed adhesive bridge-like dentures in order to create the maximum number of contact points and prevent the displacement of the mandible. Distal unlimited defects of the dental row were restored with acrylic and metal partial removable dental prothesis. Control of occlusal contacts was carried out with articulation paper (thickness 0.1-0.2 mm) before and after treatment. In the analysis of occlusion on the canine and on each cusp of the premolar should have been reflected one contact point and 3-4 points – on the cusps of the molar. In conclusion, orthopedic treatment of patients with partial absence of teeth and diseases of TMJ on the background of rheumatoid arthritis has a number of features in the choice of designs of prosthetics, materials and manufacturing technologies. By modeling orthopedic constructions, it is necessary to remove the usual (before treatment) movements of the mandible, to create new occlusion-articulation relationships, to evenly distribute the functional load and to restore the chewing efficacy in full volume

prosthodontics, dentures, defects, rheumatoid arthritis, temporomandibular joint.

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«Bulletin of problems biology and medicine» Issue 1 Part 2 (149), 2019 year, 337-340 pages, index UDK 616.314-77-036.8:616.72-002.77

10.29254/2077-4214-2019-1-2-149-337-340