Orthopedic treatment with fixed dentures taking into account the distribution and causes of defects in dental hard tissues

Abstract

The aim of this work was to analyze the causes of complications of orthopedic treatment of dentition defects with metal-ceramic crowns and non-removable metal-ceramic bridges. Materials and methods. A total of 140 patients aged 34 to 49 years were examined during the work, who underwent the production of both single metal-ceramic crowns and non-removable metal-ceramic bridges. All patients were divided into 2 groups (70 patients each): the first one included patients with vital abutment teeth, the second one – with depulped. The abutment teeth had a different functional state – they were filled, had wedge-shaped defects or increased abrasion. Results. Orthopedic treatment showed that the manufacture of solid metal-ceramic crowns on dental teeth, which were filled more than 1 year ago, led to complications in 18 of 35 (51.4 %) patients in this group, which is insignificantly (P ˃ 0.05) by 17.2 % less than with similar prosthetics on depulped teeth. Regarding the manufacture of bridges, the trend of more complications in prosthetics on devital teeth persists, because in group I we had 20 (57.7 %) patients with complications, and in group II – 29 (82.9 %) cases, which is significantly different at the level of P < 0.05. In prosthetics of vital teeth, defects of hard tissues of which are replaced by filling material immediately before prosthetics, single crowns of complications occurred in 3 patients, i.e. in 8.6 %, which is insignificantly (P ˃ 0.05) less by 5.6 % than in group II where complications were found in 5 (14.2 %) people. Analysis of orthopedic treatment of patients with included defects of dentitions with metal-ceramic bridge prostheses revealed that when using filled teeth (filled for 1 year before prosthetics) in the case, when they were depulped, as abutment, complications were observed in 9 people, i.e. in 25.7 % of this group. This indicator insignificantly (P ˃ 0.05) exceeds the identical one from the first group (14.3 %) by 11.4 %, therefore, there is a tendency to reduce tooth resistance to negative external and internal factors, which has not acquired statistical significance. Conclusions. The study found that the frequency of complications that occur after prosthetics with fixed dentures depends on the condition of the tooth pulp, because the viable pulp provides metabolism, renewal of tooth cells and response to any damage. The need to replace fillings that were made more than 1 year ago to reduce the risk of secondary caries has been proven. Defects of hard tissues in the form of a wedge-shaped defect and the increased attrition do not increase frequency of complications in prosthetics by fixed dentures.