Methodological recommendations for improving the adaptability of patients with accessed defects of the maxillofacial region

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Introduction. After the application of a removable prosthesis, adaptation is one of the most difficult periods for the patient. This period is especially pronounced in the absence of experience in using a removable prosthesis or in the presence of general somatic pathology in parallel. Acquired defects of the maxillofacial area require restoration of anatomical areas of significant volume, and the problem of adaptation to replacement constructions has become significant. The adaptive ability of the patient and oral stereognosy are closely related. Tongue muscles stimulate brain activity to improve the adaptability to removable structures. In this study, a set of special adaptive exercises was developed to increase the synthetic activity of the cerebral cortex and improve adaptability to removable prostheses. Materials and methods. The study involved patients aged 44–75 years. All patients were divided into three groups: clinical control (30 people), group with acquired defects of the dentition of the maxilla (25 people), and group with acquired defects of the upper jaw after surgery (25 people). Patients in the clinical comparison group were scheduled for surgical treatment of the teeth and the imposition of immediate prostheses immediately after surgery. Immediate prostheses were made prior to surgery using a standard technique. Results. Patients of the main group with neoplasms of the maxillofacial region were planned to resect the maxilla and apply a resection prosthesis directly on the operating table. Manufacturing of resection shaping prostheses was carried out following the standard procedure. All patients underwent stereognostic testing, and the degree of the patient’s adaptive ability was determined. Depending on the assigned adaptive support, each group was divided into subgroups. Patients in the first subgroup were prescribed modernized functional training, and patients in the second subgroup received the main treatment without prescribing exercises. Conclusion. On the basis of the results of examination, treatment, and dynamic observation of groups of patients with acquired defects in the dentition, the adaptation support reduced the time of adaptation to new removable dentures. The results were confirmed by objective research through the stereognostic testing and subjective feelings of patients.

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About the authors

E. O. Kudasova

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Russian Federation, Moscow

D. V. Uklonskaya

Central Clinical Hospital “RZD-Medicine”

Russian Federation, Moscow

Ekaterina. V. Kochurova

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.

MD, Dr. Sci. (Med.), Assistant Professor, Professor of the Department of Prosthetic Dentistry, I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

V. N. Nikolenko

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Lomonosov Moscow State University

Russian Federation, Moscow; Moscow


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