Clinical Evaluation of Periodontal Tissue Status in Prosthodontic Treatment of Patients with Partial Tooth Loss and Generalized Periodontitis

Abstract

The problem of selection and application of dental prostheses in periodontal disease is especially relevant in case of severe generalized periodontitis, which is accompanied by mobile tooth removal resulting in overloading the periodontium of the remaining teeth as well as the increase in tooth mobility. Therefore, in generalized periodontitis, it is important to apply the method of direct dental prosthetic rehabilitation since, in case of partial tooth loss, it will prevent the development of generalized periodontitis complications.

The objective of the research was to improve the effectiveness of combination therapy for patients with generalized periodontitis and partial tooth loss applying the developed method of direct fixed dental prosthetic rehabilitation based on the study of the periodontal status.

Materials and methods. The study included 129 patients with general periodontitis, II-III degree and partial tooth loss over the age of 45 years. According to prosthodontic treatment, all the patients were divided into three groups: Group I consisted of 42 (20 women and 22 men) patients who immediately after tooth extraction were rehabilitated with the application of direct plastic laminar immediate prosthesis and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 weeks after tooth extraction; Group II included 43 (21 women and 22 men) patients who underwent traditional permanent dental prosthetic rehabilitation using fixed dental bridges 6 weeks after mobile tooth removal and wound healing; Group III comprised 44 (21 women and 23 men) patients who immediately after mobile tooth removal were rehabilitated with the application of direct fixed sectional dental bridge (Ukrainian patent UA 20995. 2007 Feb 15) and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 months after tooth extraction. The control group consisted of 26 people with intact dentitions over the age of 45 years.

Results and discussion. The application of direct dental prosthetic rehabilitation method after mobile tooth removal in combination treatment of generalized periodontitis allows stabilizing degenerative and inflammatory processes in the periodontium in the initial stages, as well as increasing the resistance of the capillaries and bone mineral density of the interdental septa. The obtained data indicated that the application of the proposed direct fixed sectional dental bridge was more effective as compared to conventional prosthetics methods.

Conclusions. 1. Direct fixed prosthodontics using direct fixed sectional dental bridge is essential in combination treatment of generalized periodontitis, especially if mobile tooth extraction is needed. It allows increasing the effectiveness of treatment in comparison with direct removable prosthodontics using direct plastic laminar immediate prosthesis (Group I) and traditional treatment methods (Group II). 2. We have proved the advantages of direct fixed prosthodontics in treatment of patients with generalized periodontitis, II-III degree based on the improvement of oral hygiene indices, the gingival bleeding index, the papillary-marginal-alveolar index, the periodontal index and the depth of periodontal pockets 6-12 months after treatment.