Introduction. Reducing the time of implant integration and the period of prosthetics is an important task of dentistry since this leads to improved quality of life and successful rehabilitation of the patient. Therefore, currently, there is an intensely increased interest in immediate or early loading of the implant, when certain parameters of primary implant stability in the bone tissue are achieved. Materials and Methods. The materials used to perform the procedure for placement of a customized provisional composite abutment were a provisional prefabricated abutment with a retention grip for the composite; aluminum oxide powder with a particle size of 27 μm for better adhesion of the composite, with which the retention grip of the provisional abutment is coated; 3M Single Bond Universal light-curing adhesive applied to the provisional abutment; and Filtek Bulk Fill 3M composite including a low-viscosity radiopaque nanocomponent and ytterbium trifluoride filler with a particle size of 0.01–3.5 nm. Methods used in this study were as follows: fabrication technique using the Cervico system for a customized provisional composite abutment; sandblasting of the provisional abutment using the apparatus RONDOFLEX (KERR); light polymerization of low-viscosity composite using Demi Ultra Kerr lamp (luminous flux power not less than 1100 mW/cm2); and radiographic control of the abutment fit in the implant. Results. The surgical and orthopedic treatment of 20 patients was performed using this technique. The control group consisted of 11 patients with similar pathology, in whose surgery the fabrication of a provisional prosthesis was used. As a result, it was possible to form a gingival profile, in comparison with the control group, to accelerate mucogingival and bone integration, as well as to quickly carry out orthopedic rehabilitation of the patient. The average value of the time required for the final formation of soft tissues for prosthetics in patients in the experimental group was significantly lower than those in the comparison group ( p = 0.007 and p = 0.028 , respectively). In most clinical cases, there is no need for surgery on soft tissues, which eliminates the possibility of additional traumas. Conclusions. The use of a promising technology for the fabrication of a crown on the implant and a customized provisional composite abutment significantly reduced the period of orthopedic rehabilitation of the patient. Immediate implantation with a customized provisional composite abutment completely forms the gingival profile, reduces the risk of microbial contamination in the area of bone formation, minimizes soft tissue ischemia, and accelerates the processes of mucogingival and bone integration around the implant.
Аннотация: для анализа стоматологического здоровья, связанного с качеством жизни пациентов, применяют специальные тесты, каждый из которых предназначен для оценки степени влияния стоматологических проблем на функциональное и со-циально-психологическое состояние пациентов. Особенно удобны такие короткие версии измерений статуса здоровья, как Оral Health Imрact Рrоfile (OHIP-14), имеющие преимущество использования в различных клинических ситуациях. Короткая версия данного теста, реализованная в виде компьютерной программы, имеет преимущество использования в повседневной клинической практике врачей-стоматологов. Авторами разработан алгоритм и внедрена в практику компьютерная программа оценки стоматологического здоровья и показателей качества жизни на основе теста ОНIР-14 в процессе стоматологического лечения, которая может быть использована для всех пациентов стоматологического профиля. Работоспособность программы была проверена авторами в процессе лечения пациентов с полной утратой зубов и пациентов с диагнозом «красный плоский лишай». У таких пациентов нарушен процесс приема пищи, отмечаются боли в полости рта и кровоточивость десен, возни-кают психологический дискомфорт, чувство неполноценности, нарушение коммуникативных функций. Компьютерная оценка качества жизни дала возможность проводить мониторинг состояния пациентов на различных этапах лечения, позволяя получать данные о физическом, психологическом и социальном состоянии, как конкретного пациента, так и группы больных для определения эффективности проведенного лечения в динамике. Ключевые слова: стоматологическое здоровье, качество жизни, компьютерная программа.
Purpose: histological and radiographic study and comparison of osseointegration and stability of implants without orthopedic load, installed in different ways (simultaneously in a fresh socket immediately after tooth extraction and in mature bone).Materials and methods: the criterion for inclusion in the study was the possibility of placing a test (immediately after tooth extraction) and a control implant (in mature bone) on opposite sites without the use of osteoplastic materials or membranes. The procedures were followed by periapical radiography, which was repeated three months later. According to the comparative data of the images, the marginal loss of bone tissue was calculated. Both implants were removed to obtain histological specimens. Sections were prepared by standard staining with hematoxylin and eosin. Using an X-ray digitizer, the percentage of implant-to-bone connection was calculated.Results: the data of histological and radiographic studies showed no significant difference in the osseointegration of the implant in the post-extraction lenok and in the mature bone. There was no statistically significant difference in the percentage of bone connection between test and control implants placed in different jaws. Connective tissue in implants is absent, as well as fibrous. Bone destruction was not observed in histological sections.Conclusions: jsseointegration and survival of dental implants without orthopedic load, installed without the use of osteoplastic materials in a fresh post-extraction hole and in a mature bone is almost the same, regardless of the place of installation (upper or lower jaw).
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