Decompensated (compromised) dentition (philosophical essay)

Abstract

Relevance. In our clinical practice we’ve noticed a substantial amount of patients seeking prosthodontic treatment with the situation where all the teeth in dental arches (maxilla or mandible) have to be extracted due to distrophic, degenerative periodontal conditions. We started to define this condition as “decompensated dental arch” (compromised dentition). However, there is no information on treatment tactics in such patients.Purpose. To develop medical tactics in the dental treatment of patients with decompensated dental arches.Materials and methods. We examined 211 patients (74 males, 134 females) aged from 54 to 83 years old (mean age: 72.4 ± 6.3) with 275 decompensated (compromised) upper (73) and lower (202) dental arches. We used clinical and paraclinical (additional) diagnostic methods such as ultrasound, Doppler, electromyography, CT scan, OPG evaluation.Results. Comprehensive description of “decompensated dentition” (compromised)lead us to implementation of radical treatment approach during preparation for prosthodontic rehabilitation. First of all that approach facilitates quick transition from handicapped condition to the high quality of life in case of applying principals of immediate (including implant supported) prosthetics. Clinical experience proves that “Merciful” (tooth saving) tactics with the attempt to relative saving of some teeth with conservative approach will prolong the agony of decompensated dentition (compromised) especially in case of treating elderly patients with compromised medical condition. Radical approach helps to get long term survival of implants and prostheses.Conclusion. That’s the reason that in cases of clinical situation of decompensated dentition (compromised) we have to focus on more radical preparation to prosthodontic -especially implant supported – rehabilitation.