Relevance. The studies which assess the quality of the implant-supported prostheses in elderly patients as well as the impact of the immediate loading on the peri-implant bone are scarce and inconclusive. Various automatic assessment software is known and applied in the clinic. A compact, informative and flexible software is obviously necessary for daily use and continuous control of the quality of the prosthetic treatment. The aim of studies was to improve the automatic quality assessment of implant prostheses in older adults and elderly patients.Materials and methods. 408 responders (151 male and 257 female subjects) aged from 54 to 85 (mean age 73.9 ± 4.9) participated in the clinical testing of the ROZA questionnaire. The conceptual (construct) validity included convergent, divergent and discriminant subtypes. In convergent validity, comparison with a battery of equivalent tests with similar requirements was used: Geriatric Oral Health Assessment Index (GOHAI), Oral Health Impact Profile-14 (OHIP-14) questionnaire, visual analogue scale (VAS) set and two related expert prosthesis quality assessment programs TREVOL and TRESIM. Results. Cronbach’s alpha, that confirms reliability and internal stability of the studied instrument, was 0.82 which is a good level. The correlation of the authors’ technique was low and insignificant (r = 0.242; p = 0.257) compared to the discriminant tests, which demonstrated the target focus of the studied technique.Conclusion. The studied questionnaire ROZA was highly sensitive, reliable for the examination of elderly patients with different implant-supported prostheses. It can be used to assess the quality of the prostheses in elderly, among others to evaluate the quality of the prosthetic treatment.
The article resents the results of developing a system of assessing the quality of orthodontic treatment of patients with various forms of dento-alveolar and facial anomalies, consisting of 3 parts: main and supplementary parts, and auxiliary section, allowing for conduct of comprehensive automated quality assessment of orthodontic dental care.
Currently, there are two dental approaches to the oral rehabilitation of elderly patients before implant prosthetics. One of them is conservative, based on a purely sparing approach, inspired by the classical dental prosthetics canons with commonplace replacement structures, the other is radical, empirically confirmed by unfavourable long–term prosthetic results, taking into account chronic diffuse periodontitis being a relative contraindication for implantation due to the abundance of periodontogenic and anaerobic flora in the oral cavity and in the periapical foci, as well as – polymorbidity of the elderly. This increases the risk of mucositis, peri-implantitis, leading to failure of implants, replacement of prostheses within warranty periods, and repeated prosthetics. The purpose of this work was to create a measuring instrument for a target preliminary choice of an alternative from two available approaches to oral health improvement in elderly patients before implant prosthetics. The object of the study was 10 expert software programs for assessing the quality of various dental and jaw prosthesis designs, including extended implant restorations with a few artificial supports. The methods and criteria used in these systems were studied. A portable computer program has been created that allows making a target choice between conservative, radical and moderately radical approaches to preparing the oral cavity of elderly patients for immediate implant prosthetics.The program is used to assess the morphofunctional state of those teeth whose prognosis is doubtful, and the indications for extraction are not absolute. The program implements a scoring system for evaluating the answers received according to a questionnaire of 20 criteria with the possibility of automatic summation and the issuance of a final conclusion.
Impression taking procedure from prosthetic area in case of constructing implant supported prostheses is one of the most important steps in the process of patient rehabilitation especially in producing long span structures. Quality of the impression could affect the precision and passive fit of the prosthesis to the implants therefore the overall quality of the work. Obtaining digital impressions of edentulous jaws with a different number of implants using intraoral devices is still an unresolved problem in full. The ergonomics of the process of obtaining an impression is not easy due to the need to place both scan abutments in the oral cavity and manipulate the working part of the intraoral scanner around them. The accuracy of digital impressions obtained from edentulous jaws for obtaining full-arch implant supported prostheses does not exceed that when obtaining a classic impression, and according to a number of researchers, it is even lower. The aim of this study was to construct implant impression convertible trays with increased to the optimum levels of rigidity, with simple disassemble process and having an easy access to the adapters, and also to digitally compare the rigidity of the author’s impression trays. The method of assessment was digital technology of analysing structural resistance and inherent stresses and deformations using SolidWorks software. We performed analysis of the resistance of the structure to external loads. We have developed and created the customised copyrighted versions of the upper and lower impression trays made of rigid titanium alloy by 3D printing using DMLM technology on a Concept Laser device made of titanium Ti6-Al4-V. Modeling was carried out in the Mimics Medical 21 program (Materialize, Germany) along the contours on the data of cone-beam computed tomography. Performed digital tests reveal the underlying advantages of the designed by authors impression trays.
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