RESUMO
OBJECTIVE: The aim of the study is comparative analysis of the condition of oral organs and tissues in people with metabolic syndrome (MS) of varying severity before orthopedic dental rehabilitation based on dental implants. MATERIAL AND METHODS: 255 patients (151 women and 104 men) aged from 35 to 65 years were examined. 3 groups were formed: 2 study groups and a comparison group. Groups 1 and 2 included individuals with excess body weight and MS. The control group consisted of 88 people without MS. An index assessment of the condition of the periodontium and tissue structures of the alveolar bone (according to cone-beam computed tomography), microcirculation in the gingival mucosa was carried out using laser Doppler flowmetry. RESULTS: The analysis of the periodontal condition indicators showed that in all groups of patients with MS, periodontal pathology occurred, the value of which was significantly higher than in patients of the control group (p <0.05). The analysis of bone tissue according to CBCT data showed that the most favorable conditions (type 1 and type 2 of bone according to Misch) for dental implantation are found in people without MS, respectively 3.5% and 35.1% of cases. The intensity of blood flow (σ) was 21.2% lower in group 1 and 48% in group 2, compared with the control group. Vasomotor activity (Kv) was 13.2% lower in the first group and 35% lower in the second group. A decrease in amplitudes in the area of all rhythms in the LDF gram was found: low-frequency - by 15.6%, high-frequency - by 16.9%, pulse - by 3.6%. CONCLUSION: Changes occurring in the organs and tissues of the mouth against the background of MS of varying severity lead to a decrease in tissue perfusion with blood and blood flow activity, a local decrease in bone density, and as a result, pathological changes in periodontal tissues. Before performing dental rehabilitation, it is necessary to take into account all the risks of possible complications caused by the general condition of organs and systems of people with MS.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Síndrome Metabólica , Periodonto , Humanos , Pessoa de Meia-Idade , Síndrome Metabólica/fisiopatologia , Feminino , Masculino , Adulto , Idoso , Periodonto/diagnóstico por imagem , Periodonto/irrigação sanguínea , Periodonto/fisiopatologia , Fluxometria por Laser-Doppler , Microcirculação , Gengiva/irrigação sanguínea , Gengiva/diagnóstico por imagem , Boca/diagnóstico por imagem , Boca/fisiopatologiaRESUMO
AIM: To compare the precision of centric relation (CR) assessment by various methods using digital technologies. MATERIAL AND METHODS: Determination of the CR was carried out in the clinic of prosthetic dentistry on patients with intact dentition using methods of bilateral manipulation, anterior jig, leaf gauge and device for intraoral recording of the gothic arch angle. Optical jaw impressions were obtained using the intraoral 3D scanner Trios (3Shape) and the CR registers were scanned using the laboratory scanner Prime (DOF). To evaluate the reproducibility of the CR, the computer program of 3D modeling Avantis (Russia) was used, which integrated the obtained optical impressions and digital copies of the CR registers. RESULTS: None of the methods showed 100% accuracy in CR assessment. The most stable reproducibility of the position of the mandible in the CR relative to the first registration was determined by the method using an anterior jig (of our own design) and amounted to 0.119±0.012 mm, which is significantly less than using the methods of bilateral manipulation (0.225±0.028, p≤0.05) and a leaf gauge (0.207±0.02, p≤0.05). We observed a similar mean values of the reproduction accuracy when determining the CR by recording the Gothic arch angle (0,120±0,013, p≤0.05), which also has a significantly lower value (p≤0.05) compared to other methods for CR determining.
Assuntos
Técnica de Moldagem Odontológica , Modelos Dentários , Relação Central , Desenho Assistido por Computador , Arco Dental , Humanos , Imageamento Tridimensional , Reprodutibilidade dos Testes , Federação RussaRESUMO
The aim of the study was to investigate accuracy of the most frequently used methods of obtaining centric relation in clinical practice. Finding of CR was carried out in clinic of prosthodontic dentistry on a 5 patients with intact dentition using four methods that are most often used, including: bimanual manipulation, leaf gauge, using an anterior deprogrammind device, the technique of determining CR with intraoral devices recording the gothic angle. To assess the accuracy of each technique there were performed 10 registrations of the central relation by one operator (200 CR registrations), with 30 minutes' intervals between the CA determination. Analysis of the contacts in CR were carried out using a photometric method of investigation. The graphic images were downloaded in Adobe Photoshop for calculation, metric data translated into digital values. The studies above showed that the accuracy of finding CR in all methods were not ideal. It can be noted that the smallest deviation of the position of the first contact in the CR was observed with use of the anterior deprogrammind device and with the intoral gothic angle recording device. The deviation along the VO axis was 0.039±0.002 mm and 0.084±0.004 mm respectively, along the MD axis 0.043±0.002 mm and 0.054±0.001 mm, respectively. The greatest error of recording the CR was shown by bimanual manipulation Dawson technique, the deviation along the axis of the VO and MD was 0.634±0.04 mm and 0.388±0.04 mm, respectively.
Assuntos
Reparação de Restauração Dentária , Registro da Relação Maxilomandibular , Dente , Relação Central , HumanosRESUMO
The purpose of the study was to determine the correlation features in position of the TMJ and the atlantoaxial compound in presence of dentition defects. The study included 20 patients (10 males and 10 females) aged 37 to 59 years with mandible terminal dentition defects. The comparison group included 20 patients of men and women equally, aged from 18 to 29 years with intact dentition. All patients were diagnosed with CT scan of the maxillofacial area, including the craniovertebral zone. In the analysis of the TMJ, the ratio of bone structures were determined by studying the CT scan in sagittal plane. The position of the elements of the atlantoaxial compound were evaluated on CT scan in frontal and transversal plane along the distance from the lateral masses of the CI vertebrae to the dens CII process. In persons with one-sided terminal dentition defect any changes of the position of the TMJ elements were not determined except for the right L1 parameter (8.91±0.45 mm and 6.8±0.77 mm, respectively, p=0.020). At the same time, the L1 distance on the left significantly changed to 6.86±0.40 mm relative to the comparison group (8.21±0.77 mm, p=0.030). In contrast to the ratio of the bony structures of the TMJ on the analysis of the craniocervical zone we determined the differences in the relationships of all elements of the atlantoaxial compound. The asymmetry index of CI-CII in the study group was 1.12±0.15 mm, in the comparison group 0.1±0.02 mm, p=0.001. The correlation analysis of the investigated structures showed different variants of the relation (direct and inverse) between the L1, L5 parameters of the TMJ and the distance from the lateral masses CI to dens CII. The structures of the TMJ in the presence of dentition defects remain practically unchanged and are more stable, it can be assumed that the primary link which undergo the changes considering the relationship between bone structures is the atlantoaxial junction.