Comparative evaluation of the effectiveness of prosthodontic treatment using the original immediate denture design and traditional methods

BACKGROUND: Patients with chronic non-correctable periodontal disease, leading to loss of teeth, can be rehabilitated using immediate dentures. However, removable dentures often produce excessive mechanical pressure on the underlying prosthetic bed tissues.

AIM: To evaluate the effectiveness of various options for immediate dentures and their effects on the rate of wound healing in patients with a complete absence of teeth due to surgical removal for chronic periodontitis.

MATERIALS AND METHODS: Early prosthodontics treatment was conducted on 30 patients after extracting multiple teeth at the Department of Orthopedic Dentistry and Orthodontics of the Ryazan State Medical University. The patients were divided into 3 groups depending on the options for immediate dentures: 1) combined construction of acrylic, non-monomer and elastic polymer, 2) hot curing acrylic polymer, and 3) thermoplastic plastic. Treatment effectiveness was measured by the objective state of the wound area with a planimetric assessment of wound healing. Pain sensitivity when using the prosthesis was rated according to a numeric rating scale for pain. The stability of prostheses was assessed according to the Mirgazizov method, an assessment of the safety of the drug based on the prosthesis. Diagnostic observations were carried out for 21 days.

RESULTS: Postoperative rehabilitation was faster in groups 1 and 3, than in group 2. By day 21, inflammation persisted only in group 2, which was confirmed by the largest wound size (8.3±1.1 mm) compared with that of groups 1 (5.1±1.9 mm) and 3 (6.3±2.4 mm). Complaints of pain during the use of prostheses were noted in half of the patients in groups 2 and 3, whereas only slight discomfort persisted in 3 patients in group 1. The stability of the prostheses deteriorated in group 3 by day 21 (5.9±1.4 points), indicating lower adaptability of thermoplastic prostheses to changes in the relief of the prosthetic bed than with the combined construction (6.7±1.4 points). The acrylic prostheses demonstrated the lowest adaptability (3.2±1 points). The indicator of daily preservation of drugs under the bases of dentures in group 1 patients was 36.8±2 mm², that in patients of group 3 was 30.3±1.8 mm², and that in patients of group 2 was the lowest at 24.4±1.4 mm².

CONCLUSION: The principle of combining polymeric materials to create immediate dentures was the method of choice for prosthodontics treatment of patients with a complete absence of teeth due to surgical removal, as this category of patients is most sensitive to inflammatory complications during the postoperative period.