Implant-prosthetic rehabilitation of a patient with an extensive maxillofacial defect

Put, V.; Solodkiy, V.G.; Решетов, И. В.; Il’ichev, E.A.; Podstavnev, V.G.

doi:10.17116/stomat20209905187

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…A progressive trend in maxillofacial and bone surgery is the possibility of personalizing implantprosthetic structures [ [13][14][15][16] ]. Application of additive technologies for manufacturing individual maxillofacial implants makes it possible to design and prototype complex solutions on models, optimize prosthesis fixation systems taking into account elasticity modulus and bone density.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the most important criterion is the possibility of protecting the augmentation area in the clinic of dentistry and maxillofacial surgery with temporary prosthetic constructions. This will improve healing and is a prevention of suture divergence [ 9,14 ]. Important criteria are treatment time and its reduction and the quality of life of the patient, especially for interventions in the frontal zone of the jaws [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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A Personal Approach to Implant-Prosthetic Dental Rehabilitation After Autopolitrauma

Put

Usatov

Svyatoslavov

et al. 2023

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With extensive damage of the facial skeleton, multiple bony and soft tissue cicatricial defects and deformations are formed. Traditional methods of reconstructive are reliably not able to restore the defects fully. Often the bony structures of the facial skeleton can't be restored in one stage. Additional reconstructive surgeries are needed. A problematic situation is the condition after multiple surgeries in the defect area. Failure of bone grafting is associated with cicatricial deformities and lack of soft tissue, lack of gingiva, defects in the vestibule and damaged periosteum. The main problem is constriction and subsequent atrophy and deformation of the soft tissue in the area of the defect. This complicates further treatment and often it isn't possible to restore the bone volume required for a successful dental implantation.Implant prosthetic rehabilitation in the area of extensive bone defects after a facial injury requires preparation that is more careful, design and prototyping of the outcome with the use of computer programs and diagnostic models. Biocompatible materials for dentistry and maxillofacial surgery are clinically proven and recommended for usage in patients at the treatment stages. Clinical experience with individual temporary endoprosthesis, so called "tissue expander", produced by layer-by-layer synthesis (3D-printing) from biologically inert plastic based on CT data of the patient is presented in this article. The expander is made in the form of a 3D element to form the required soft tissue volume in the patient for 4-6 months and is fixed in place subcutaneously, in the area of mandibular frontal defect, using intraosseous screws. Dental implants were placed laterally on both sides. The following was carried out intraoperative direct replacement, fabrication and placement in the mouth of a temporary screw-retained prosthesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Personal Approach to Implant-Prosthetic Dental Rehabilitation After Autopolitrauma

Put

Usatov

Svyatoslavov

et al. 2023

View full text Add to dashboard Cite

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The use of adaptation training in the immediate postoperative period in patients with acquired defects of the maxillofacial region

Кочурова

Кудасова

Nikolenko

et al. 2022

Opuholi golovy i šei

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Introduction. Surgical treatment of tumors in the maxillofacial region is always accompanied by the involvement of a significant amount of bone structures of the jaws. At the same time, the main method of dental orthopedic treatment of patients is prosthetics with a removable prosthesis. The larger the defect in the maxillofacial region, the more pronounced the subjective feeling of the patient’s rejection of the removable structure.There is a close relationship between the adaptive ability of a person and oral stereognosy as the anatomical and physiological mobility of the tongue and the synthetic activity of the cerebral cortex.One of the options for improving adaptability and increasing the activity of the synthetic activity of the cerebral cortex is a special adaptation training, which includes articulatory movements of the tongue. Stimulation of the muscles of the cheeks and lips with the tongue contributes not only to normal pronunciation / improvement of the intelligibility of the speech stream, but also adapts the tongue to the changed conditions after the imposition of removable prostheses.In connection with the above data, the study objective is to analyze the effectiveness of adaptive training to improve adaptability to removable dentures in patients with acquired defects of the maxillofacial region.Materials and methods. Dental orthopedic treatment of 39 patients was carried out after surgical treatment, including resection of the upper jaw and simultaneous replacement with a removable dental resection shaping prosthesis of the upper jaw directly on the operating table.A clinical control group (n = 40) was introduced to identify parameters in determining the synthetic activity of the cerebral cortex. Depending on the assigned adaptive support, the patients were divided into 2 subgroups: Subgroup 1 – the modernized adaptation training complex was prescribed (n = 18), Subgroup 2 – the standard observation of the patient (n = 21).Stereognostic testing and determination of adaptive capacity before treatment, after 7 / 14 days and 1 / 3 month after the placement of a resection prosthesis.Results. Adaptive support for patients of Subgroup 1 is represented by adaptation training 1 complex (33.3 %). Repeated stereognostic testing 7 days after surgery showed a decrease in adaptive values in all patients. After 14 days, in Subgroup 2, stereognostic testing of patients remained unchanged. Another 14 days (1 month after the placement of a resection prosthesis) in the Subgroup 1 of patients, the reference test values were found in 2.5 % of cases. The number of patients with high and moderate values increased by 1.3 times, and the number of patients with low test values also decreased by 3 times. 3 months after the placement of the resection prosthesis, the test values in Subgroup 1 approached the values before the surgical treatment. None of the patients of Subgroup I had a low level of adaptability.Discussion. The training exercises contributed not only to the muscular development of the tongue, but also stimulated the synthetic activity of the cerebral cortex. In 3 months after the placement of a resection prosthesis in the 1st subgroup of patients, the values of stereognostic testing approached the preoperative level.Conclusion. Normalization of the tone of the muscles of the oral cavity through functional training changes the stereognostic abilities of the patient. All this together increases the patient»s adaptability to removable dentures. Adaptation support reduced the time of adaptation to new removable dentures, which was confirmed by objective research – stereognostic testing. The influence on the synthetic activity of the cerebral cortex through the exercises of training for the tongue increased the adaptability to the resection prosthesis, changed the quality of life for the better.

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Methodological recommendations for improving the adaptability of patients with accessed defects of the maxillofacial region

Кудасова

Uklonskaya

Уклонская³

et al. 2020

Russian Journal of Dentistry

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Introduction. After the application of a removable prosthesis, adaptation is one of the most difficult periods for the patient. This period is especially pronounced in the absence of experience in using a removable prosthesis or in the presence of general somatic pathology in parallel. Acquired defects of the maxillofacial area require restoration of anatomical areas of significant volume, and the problem of adaptation to replacement constructions has become significant. The adaptive ability of the patient and oral stereognosy are closely related. Tongue muscles stimulate brain activity to improve the adaptability to removable structures. In this study, a set of special adaptive exercises was developed to increase the synthetic activity of the cerebral cortex and improve adaptability to removable prostheses. Materials and methods. The study involved patients aged 4475 years. All patients were divided into three groups: clinical control (30 people), group with acquired defects of the dentition of the maxilla (25 people), and group with acquired defects of the upper jaw after surgery (25 people). Patients in the clinical comparison group were scheduled for surgical treatment of the teeth and the imposition of immediate prostheses immediately after surgery. Immediate prostheses were made prior to surgery using a standard technique. Results. Patients of the main group with neoplasms of the maxillofacial region were planned to resect the maxilla and apply a resection prosthesis directly on the operating table. Manufacturing of resection shaping prostheses was carried out following the standard procedure. All patients underwent stereognostic testing, and the degree of the patients adaptive ability was determined. Depending on the assigned adaptive support, each group was divided into subgroups. Patients in the first subgroup were prescribed modernized functional training, and patients in the second subgroup received the main treatment without prescribing exercises. Conclusion. On the basis of the results of examination, treatment, and dynamic observation of groups of patients with acquired defects in the dentition, the adaptation support reduced the time of adaptation to new removable dentures. The results were confirmed by objective research through the stereognostic testing and subjective feelings of patients.

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Implant-prosthetic rehabilitation of a patient with an extensive maxillofacial defect

Cited by 4 publications

References 15 publications

A Personal Approach to Implant-Prosthetic Dental Rehabilitation After Autopolitrauma

A Personal Approach to Implant-Prosthetic Dental Rehabilitation After Autopolitrauma

The use of adaptation training in the immediate postoperative period in patients with acquired defects of the maxillofacial region

Methodological recommendations for improving the adaptability of patients with accessed defects of the maxillofacial region

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