Big amount of patients over the age of 45 (35-65%) have partial tooth loss associated with edentulous area of big length and free-end saddles, which are replaced by removable partial dentures. Such clinical situations are difficult for treatment especially if patients have only few preserved teeth on both jaws and have not had prosthodontic dental care for a long time. This category of patients has a loss of teeth-antagonists, abnormalities of occlusal relationships caused by toothjaw deformations, decrease of vertical dimension of occlusion, displacement of the lower jaw position, the hypertonicity, discoordination and asynchrony of the chewing muscles. There are often changes in the temporomandibular joint. Such clinical conditions lead to frequent mistakes and difficulties at the stage of production of new dentures, and during subsequent use of them. We observe the insufficient use of methods of modern occlusal diagnostics in the manufacture of various types of removable and non-removable prosthetics. In addition, an important issue in the prosthodontic treatment is the consideration of anatomical and physiological features of the tooth-jaw system in patients with functional impairments. Therefore, the objective of this research was to study the peculiarities of the tooth-jaw system condition in patients who simultaneously use different designs of fixed and removable dental prosthetics.Object and methods of research. There was an examination of 109 patients with partial teeth loss, who simultaneously use fixed and removable dentures made by the classical method. The examination included collection of medical history and complaints, clinical investigation of condition of periodontal tissues, edentulous area of alveolar ridges, chewing muscles and temporomandibular joints. Occlusiography was performed using 200 μm Bausch articulation paper Bausch Articulating Papers Inc. (USA) and T – Scan Novus computer diagnostic complex TekScan (USA) to evaluate the condition of occlusal relationships. Results and discussion. Among 109 patients, who simultaneously used different designs of fixed and removable dental prosthetics, were predominant individuals with removable partial dentures on both jaws, 63,3% (69). Most of their complaints concerned the periodontitis – 68,1% (47), pain during palpation of chewing muscles (18,3% (20)), deviation of the mandible (39,1% (27)) and abrasion of artificial teeth of the lateral area in 44,9% (31) of persons. The biggest amount of patients (61.4% (67)) had the third group of dental arch defects according to Betelman classification. The same defect group was dominant among patients with removable partial dentures on both jaws (33.9%). We observed different types of occlusal disorders. The most common ones were unilateral premature contacts in 28.4% (31) of individuals and no contact between several pairs of antagonist teeth – in 45.0% (49) of patients. The same complications were in 30.4% (21) and 58% (40) of the patients with removable partial dentures on both jaws. Conclusions. The obtained results allowed us to establish that patients who use both fixed and removable dentures at the same time on both jaws have the most problems associated with the restoration of occlusal relationships, periodontal tissue diseases and the development of muscular dysfunction. This should be considered during the planning of treatment, manufacturing of dental prosthetics and further rehabilitation of such patients.
occlusal disorders, removable dentures, edentulous area, chewing muscles dysfunction
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 377-382 pages, index UDK 616-071, 611.314, 616.314-77
