Options to optimize the orthopedic treatment protocol to prevent inflammatory complications at the immediate prosthetic stage in patients after multiple teeth extraction

Abstract

BACKGROUND: Simultaneous multiple loss of teeth significantly increases the need for immediate orthopedic treatment in dental patients, often with the use of removable immediate dentures due to general somatic pathologies and local Dental Prostheses System features. AIM: The study aimed to optimize the orthopedic treatment protocol for patients after multiple teeth extractions. MATERIAL AND METHODS: As part of the study, the orthopedic preparation of 18 patients was conducted for further permanent prosthetics. Patients underwent tooth extraction in the upper or lower jaw amounting to the formation of included, combined, or terminal dentition defects. The following were used for patient treatment: a standard protocol for immediate prosthetics, a modified protocol, including an improved method of vital mucous membrane staining of the prosthetic bed in the surgical intervention area using standard and immediate original design prostheses. The treatment option effectiveness was evaluated based on the results of diagnostic monitoring of wound healing zones in the prosthetic bed area of immediate prostheses, including visual-palpation assessment, vital oral mucosa staining with an iodine-containing diagnostic solution to control inflammation, and a modified Doppler observation method. RESULTS: Study results revealed that all patients, who used standard immediate prostheses without considering the diagnostic control of inflammation areas, had objective signs of inflammation up to the 20th day of treatment with low microcirculation dynamics in the wound healing area. In 4 out of 6 patients using standard immediate prostheses, considering inflammation control, the vital staining indicators by day 20 indicated a possible trend toward chronic inflammation development in the prosthetic bed area, which was confirmed by an unstable microcirculation picture. The severity of inflammatory changes was insignificant in patients who received the original design of the immediate prosthesis, starting from the 7th day of observation and minimal by the 20th day. At this time the hemodynamics are physiologically normal. CONCLUSIONS: Based on the study results, the orthopedic rehabilitation protocols effectiveness, with the use of a modified design based on the immediate prosthesis and permanent diagnostic, mucous membrane staining of the prosthetic bed was established to detect inflammatory complications in the wound healing areas.