Today, an interdisciplinary approach to solving the problems of implantology is key to the effective use of intraosseous dental implantations. The functional properties of restoration structures for the dentition depend significantly on the mechanical stresses that occur in the structural elements and bone tissues in response to mastication loads. An orthopedic design with a bar fixation system connected to implants may be considered to restore an edentulous mandible using an overdenture. In this study, the problem of the mechanics of a complete overdenture based on a bar and four implants was formulated. A mathematical model of the interaction between the orthopedic structure and jawbone was developed, and a methodology was established for the analytical study of the stress state of the implants and adjacent bone tissue under the action of a chewing load. The novelty of the proposed model is that it operates with the minimum possible set of input data and provides adequate estimates of the most significant output parameters that are necessary for practical application. The obtained analytical results are illustrated by two examples of calculating the equivalent stresses in implants and the peri-implant tissue for real overdenture designs. To carry out the final assessment of the strength of the implants and bone, the prosthesis was loaded with mastication loads of different localization. In particular, the possibilities of loading the prosthesis in the area of the sixth and seventh teeth were investigated. Recommendations on the configuration of the distal cantilever of the overdenture and the acceptable level and distribution of the mastication load are presented. It was determined that, from a mechanical point of view, the considered orthopedic systems are capable of providing long-term success if they are used in accordance with established restrictions and recommendations.

The article presents a clinical case of the prosthodontic treatment of the mandible edentulousness. Edentulousness is a widespread pathology that depends on the social and economic situation in the country, the demographic situation, the level of dental care and prevention organization. The current worldwide trend of population aging leads to an increase in the number of the elderly, and this number is expected to increase in the future. According to the WHO, today about 600 million people are people over 60, and this number will have doubled by 2030 and will constitute 2 billion in 2050 mostly in developed countries. The situation in Ukraine is not better. Functional and aesthetic rehabilitation of patients with edentulousness requires a comprehensive approach to the prosthodontic treatment planning. Complete removable laminar dentures on the mandible have a number of disadvantages. Insufficient fixation, stabilization, diction problems, aesthetic problems, decreased self-esteem of the patient are among the key ones. Modern protocols of the prosthodontic treatment require the manufacture of dental prostheses based on intraosseous dental implants. Complete dentures based on intraosseous dental implants have a number of advantages over the fixed dentures. Compensation for deficient bone support of the facial soft tissues occurs by means of the basis. Patients’ possibility to remove a secondary restoration by themselves lead to proper hygiene of the oral cavity and peri-implant area in particular. The clinical research conducted by S. Wolfart (2016) showed the possibility of fixed/removable dental prosthesis fixation in 14-31 days (early loading) after the surgical stage of implantation provided that 4-6 intraosseous dental implants were installed. The maximum mobilization of the patient to comply with the recommendations and prescriptions is the main task considering the limited postoperative period before the dental prosthesis fixation. Our publication describes the treatment of a patient born in 1967, who was diagnosed with a mandible complete absence of teeth. Diagnosis, examination and treatment were performed on the basis of the Department of Dentistry Postgraduate Education of Ivano-Frankivsk National Medical University. The described prosthodontic treatment plan involves the manufacture of a complete denture with bar system based on four intraosseous dental implants according to the early loading protocol in a patient with primary treatment of mandible edentulousness. The choice of treatment plan was based on the results of past medical history, the patient’s disease, basic and additional methods of examination, analysis of individual indications and contraindications and readiness for the selected treatment plan. This treatment protocol has its advantages over the protocol of manufacturing a fixed prosthesis based on intraosseous dental implants such as a higher level of proprioceptive sensations, increased level of hygiene, lower complexity of clinical and laboratory stages, affordability. The term of clinical and laboratory stages of manufacturing (from the surgical stage of implant treatment to the fixation of the dental prosthesis) constituted 16 days. Additional opportunities for success in clinical and laboratory stages of treatment, the accuracy of manufacture and minimization of complications in the future were created as a result of the combination of digital and analog treatment methods in dental prosthesis manufacturing.

Резюме. Згідно з даними В.А. Лабунця, потреба у повному знімному протезуванні у вікових групах понад 50 років складає від 23,8% до 80%. У залежності від вибраного методу виготовлення повного знімного пластинкового протезу, 30-60% пацієнтів є незадоволеними функціонуванням ортопедичних конструкцій. Мета. На основі суб’єктивного та об’єктивного обстеження провести аналіз якості ортопедичного здоров’я пацієнтів із виготовленими повними знімними пластинковими протезами на нижню щелепу через 6 місяців після фіксації. Проведено плановий огляд 35 пацієнтів через 6 місяців після фіксації ПЗПП на нижню щелепу. Для об’єктивної оцінки проводився огляд наявної ортопедичної конструкції, тканин протезного ложа. Проводився Гамбурзький тест та оклюзіографія. Результати. При суб’єктивному обстеженні критеріями оцінки якості функціонування був рівень задоволення пацієнтів конструкціями. Утруднення пережовування їжі спостергіається у 13 осіб (65%). Оцінка стану конструкції ПЗПП та стан протезного ложа показали потребу перебазування чи повторного виготовлення конструкції у 15 пацієнтів (45,5%). Аналіз стану статичної центральної оклюзії показав у 25 пацієнтів (75,8%) наявність супраконтактів, переважно у ділянці щічних горбиків перших молярів (88%). Висновки: Оцінку якості функціонування ПЗПП необхідно проводити лише із врахуванням суб’єктивних та об’єктивних критеріїв. 61,6% пацієнтів не задоволені виготовленою ортопедичною конструкцією через 6 місяців після фіксації. У 75,8% обстежених пацієнтів спостерігалися супраконтакти. У зв’язку із невідповідністю ортопедичної конструкції із протезним ложем, перебазування потребували 45,5% пацієнтів, яким зафіксовано ПЗПП на нижній щелепі 6 місяців тому.

About 30 – 60% of patients complain on malfunctioning removable laminar dentures whatever the manufacturing method was chosen. An alternative method to correct complete anodontia is the construction of fixed implant-retained prostheses. Plan of prosthetic treatment for individuals with complete anodontia is elaborated based on a number of factors including initial examination, analysis of clinical and additional laboratory findings, and choosing the optimal and accessible option for a patient. The objective of this study was to analyze the impact of the patient’s psychological type on selecting the treatment tactics to correct complete anodontia in the lower jaw and on the level of the patient’s motivation regarding the choice of the prosthetic restoration. Materials and methods. 45 patients with compete anodontia who required prosthodontic treatment were included into the study. The clinical examination was performed in 2 stages. The patient’s psychological type was determined according to the House classification (1950) during the primary clinical examination. The patients were distributed into the groups according to the data obtained. We evaluated the decisions on the proposed priority options of the treatment plan made by the patients of each groups. Results. Our study demonstrated 62.2% of the patients (28 people), who sought help at the prosthetic dentistry clinic, had clearly defined needs. An option of intraosseous dental implants placement and then fixed denture placement without extensive reconstructive interventions was chosen by 8 patients (66.7%) of the study group 1. The patients classified as exacting mind conduct themselves in conformity with the personality characteristics typical for this class in the process of elaborating the treatment plan. 88.9% of people classified as indifferent psychological type tended to choose the simplest and the least expensive treatment options. Conclusions: 1. A key character trait of the patients classified as philosophical minds is the credibility to dentists. Decision making on choosing the optimal option is only possible when patients are completely aware of possible risks and complications. 2. Adherence to a clear treatment plan according to the established requirements is a priority for the patients classified as exacting minds. 3. When making a decision on the treatment plan for the patients with an indifferent psychological type, it is necessary to ensure the patient’s ability to follow all recommendations and prescriptions. 4. When dealing with the patients with hysterical psychological type, the doctor-patient mutual understanding should be built up taking into account the emotional instability of the patients.

Abstract. According to conclusions of ITI World Congress (2018), the accuracy of the dental impression determines the quality of the working model and, consequently, the fixation of the prosthetic restorations at the final stage. Inaccurate dental impression will inevitably lead to technical and biological complications (Wolfart S., 2016). According to Lee and co-authors (2019), the accuracy of the dental impression is influenced by the chosen method, namely closed or open tray, the presence or absence of transfers splinting and the choice of impression material type. The most accurate impression has been proved to be an impression taken with the use of an open tray impression technique, by means of polyether impression material with preliminary transfers splinting using internally interfaced implant system. The objective of the research was to evaluate the quality of implants placement transferring to the model by comparative analysis of different methods of clinical transfers splinting in order to take impressions using an open tray impression technique. Twelve clinical situations were studied. Four groups were formed according to the method of transfer splinting. Each group included 3 clinical cases. Impressions were taken with the use of an open tray impression technique in all clinical cases with preliminary custom-made trays with holes in the implants projections. A grading scale was created when assessing the quality of transfer splinting as a key factor in the accuracy of implant placement transferring. Each of the groups received from 1 to 4 points where 1 point was the worst result according to this criterion and 4 points meant the best one. Among the criteria for splinting quality evaluation, 1-3 criteria were considered to be subjective, criterion 4 was considered to be objective. Therefore, criterion 4 received coefficient ×2 in order to increase the objectivity of the results evaluation. There were 4 criteria: The simplicity of the technique and the time spent splinting. The cost of the technique. Passivity when fixing the bridge prosthetic restoration after manufacturing. Radiologically measured distance between the centers of implant analogues on the model relative to each other after an impression taking by means of different splinting techniques and deviation of the value from the position of the centers of implants heads tops after osseointegration according to CT scan. Analyzing the results of the research, splinting techniques were ranked according to the obtained points. Research group 1 scored 6 points using dental floss and flowable compomer. A considerable amount of time was spent splinting with relatively inexpensive technology. The passivity of the fixation was the worst in comparison with other methods and the largest error was determined radiographically. Group 4 scoring 17 points was determined as the best of the chosen techniques. Despite the high cost of the chosen technique, prosthetic restorations made after transfers splinting by means of this technique had the highest fixation accuracy and the lowest deviation of the implants analogues on the model radiographically in comparison with the position of the implants in the upper alveolar ridge and lower alveolar ridge due to the cost of the material based on poly-vinyl siloxane.

Urgent problems of modernity necessitate the humanization and democratization of all spheres of public life. In these conditions, the social significance of the medical profession is growing. Particular attention is paid to the professional and ethical culture of the medical worker, because ignoring the universal values ​​and professional norms leads to the deterioration of the patient's health. The need to study the problem of developing professionally significant qualities of future doctors in the process of professional training is caused by the requirements for medical workers, as they have a great responsibility for human health and life. The profession of a doctor makes high demands on his personality, concerning not only the quality of professional training, but also a number of personal characteristics. That is why the priority direction of improving the professional training of medical students is the formation of their professionally significant qualities. Based on the analysis of scientific sources, various approaches to determining the essence of professionally significant qualities of medical students are analyzed, their content is detailed, and prospects for further research are determined. The positive intellectual qualities included flexibility of thinking, competence, observation, professionalism, erudition, curiosity, and the negative ignorance (lack or limitation of basic knowledge required to meet the standards of professional activity), mediocrity (intellectual limitations in the field of professional knowledge, satisfaction minimum level of knowledge and experience, lack of desire for self-education); inattention (difficulty in perceiving and fixing attention on professionally significant facts, which leads to confusion and errors in professional activitiesIt is investigated that for effective professional activity the set of professionally important qualities of a medical student in the most general form can be represented as follows: moral and ethical (honesty, decency, responsibility, intelligence, humanity, kindness, reliability, principledness, selflessness, ability to keep one's word) ; communicative (personal attractiveness, politeness, respect for others, willingness to help, authority, tact, attentiveness, observation, sociability, trust in others); strong-willed (self-confidence, endurance, restraint, balance, determination, initiative, independence, purposefulness; organizational (demanding of oneself and others, tendency to take responsibility, ability to make decisions, properly evaluate oneself and the patient, ability to plan one's professional activity) .

The objective of the research: to define the dynamics of changes in bioelectric activity of mm. masseter dexter et sinister in patients with mandible edentulousness treated by means of four implant-supported dental prostheses of various types. 105 patients were examined at the premises of the Center of Dentistry of the University Clinic of Ivano-Frankivsk National Medical University. 30 individuals out of 105 at the age of 23-28 with intact dentition, without somatic pathology were included in the control group. 75 patients with mandible edentulousness underwent clinical examination, prosthodontic treatment, and follow-up. 3 clinical groups (Group I; II; III) were formed from this cohort of patients depending on the structural features of the manufactured dental prostheses. We conducted electromyography of mm. masseter dexter et sinister to the patients of the examination groups (n = 75) and the control group (n = 30) in order to achieve the objective of the research. The examination was performed by means of two-channel electroneuromyographic complex “Neuro-EMG-Micro” (“Neurosoft”) in the functional diagnostics office at the premises of the Department of Dentistry of Postgraduate Study Faculty at IFNMU. Quantitative indicators of bioelectrical activity of the right and left masticatory muscles were analyzed. Namely, the average values of the maximum amplitudes (μV) when performing the test of maximum bite force were analyzed. Recording of electromyographic indicators was performed before the prosthodontic treatment, 14 days after the fixation of the dental prosthesis, in 6 months and 12 months after the dental prosthesis functioning in order to study the dynamics of changes in the indicators of the examination groups. Electromyography recording and analysis of the findings in the individuals of the control group was performed once. Analyzing quantitative indicators of electromyographic examination significant differences in the dynamics of an increase in the indicators in 12 months compared to the initial indicators depending on the type of fixed dental prosthesis (subgroup A рІ-ІІІ<0.001; subgroup B рІ-ІІІ<0.001) and the order of prosthodontic treatment (рА-Б <0.001 for all groups of patients) were observed. Despite the fact that bioelectric indicators of mm. masseter dexter et sinister activity in the patients of the examination groups approximated to the indices of the control group, the dynamics of change was not equivalent and depended on the type of the dental prosthesis. The dynamics of an increase in the indicators of the patients in the examination groups differed by growth, however, the greatest increase was recorded in the period of “14 days” – “6 months” after the fixation of the dental prosthesis. On performing the test of maximum bite, the indicators of the masticatory muscles bioelectrical activity increased during the period named “before the treatment” – “12 months of functioning” most of all in IIIA examination group – by 66.52% (рd<0.001) on the right and by 76.37% (рd<0.001) on the left; and IIIB examination group – by 61.63% (рd<0.001) on the right and 67.20% (рd<0.001) on the left. The lowest indicators have increased in patients of IA examination group – 39.98% (рd<0.001) on the right and 39.95% (рd<0.001) on the left and IB examination group – by 32.48% (рd<0.001) on the right and by 34.75% (рd<0.001) on the left.