Currently, one of the most common types of prosthetics are restorative crowns or bridges, which cannot provide high-quality retention and long-term fixation with a low crown of supporting teeth. For an orthopedic dentist, the question arises of choosing a method of preparation before prosthetics. In this work, a comprehensive examination and treatment of 95 patients with a low crown of supporting teeth was carried out, who were randomized into 3 groups according to the methods of preparation for orthopedic treatment gingivoretraction, gingivectomy and gingiviplasty. The change in the state of the dentoalveolar complex was carried out clinically and functionally. The hygienic index API, papillary bleeding index PBI, the index of need for periodontal treatment CPITN, gum recession and depth of probing were determined. Laser Doppler flowmetry was used to assess the state of local blood flow and vasomotor activity of vessels. The studied parameters were evaluated before the start of preparation for orthopedic treatment and after 14 days. During the study, complications and side effects were not revealed, however, clinical and functional indicators indicate that preference should be given to gingivoplasty as one of the qualitative methods of preparing the dentoalveolar complex in patients with a low crown of supporting teeth.
A feature of mathematical modeling and study of a complex three-dimensional biomechanical object is the ability to achieve unity of geometric, physical, mechanical and biological indicators with the individual characteristics of the patient. A rather urgent problem of clinical dentistry is the development of recommendations on the distribution of masticatory pressure in patients with balanced occlusal-articulation relationships of the dentition. This paper considers one of the aspects of this problem associated with modeling the stress-strain state of the functional masticatory center, which is localized in the region of the first molars and the premolar groups of the upper and lower jaws during physiological occlusion. To determine the biomechanical parameters of the functional masticatory center, an analysis of the stress-strain state of mathematical models of this fragment of the dentition was carried out using the finite element method. When developing a model of a biomechanical system, the surrounding biological tissues were considered discretely in terms of structure and physical and mechanical properties: dentin, enamel, periodontium, bone, cement. A technique for analyzing models of the functional masticatory center is proposed, which makes it possible to establish the relationship between the magnitudes and directions of functional loads, as well as internal stresses and deformations. As a result of the analysis of the stress-strain state of geometric and finite element models, the distributions of maximum strains and stresses in a given section under the action of specified loads were obtained. It has been established that under the conditions of this mathematical model, the areas of the apical periodontium of the teeth have the maximum shock-absorbing properties, and the functional masticatory center is equated to a static system. The capabilities of modern computer software make it possible to expand the understanding of areas of stress concentration with varying load parameters in the functional masticatory center in order to determine the most “critical” zones in order to predict and prevent the development of long-term complications.
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