Perm', Perm, Russian Federation
Subject. The current level of development of dentistry requires the use of an algorithm for diagnosis, monitoring and quality control of orthopedic treatment of patients using functional research methods, planning and manufacturing of dental prosthesis designs based on digital technologies. The goal is to develop an algorithm for orthopedic treatment of patients with defects in the hard tissues of teeth and dentitions using digital functional examination methods. Methodology. Clinical data are based on the results of orthopedic treatment of two groups of patients with defects in the hard tissues of teeth and dentitions. The main group consisted of 129 people, whose diagnostic and treatment complex had an extended instrumental clinical and functional analysis of static and dynamic ratios of teeth and jaws, and orthopedic treatment was carried out according to an improved CAD/CAM protocol. Comparison group ― 147 people, comprehensive dental diagnostics and prosthetic treatment carried out using the standard CAD/CAM technique. Results. Using in-depth functional diagnostics of the dento-jaw system based on digital technologies, a comprehensive assessment of the status of the dental status of the examined patients is given, an algorithm for their comprehensive diagnosis and treatment is developed, indications for their prosthetics in the usual occlusion or in the central ratio of the jaws are specified. The production of fixed anatomical structures of dentures has been optimized by improving the methodology for modeling their masticatory surfaces using the Hint-Els CAD/CAM system. Conclusions. Analysis of the examination results and monitoring of the stages of orthopedic treatment of patients testifies to the effectiveness of the proposed algorithm and advanced CAD/CAM technology. The developed indications for the replacement of defects in the hard tissues of teeth and dentitions are determined as the result of many years of research that can achieve practical results ― increasing the effectiveness of their treatment using digital functional diagnostic methods and orthopedic treatment.
zirconia, CAD/CAM, diagnostics, defects in the dentition, defects hard tissues of teeth
1. Khvatova, V. A. (2005). Klinicheskaya gnatologiya [Clinical Gnatology]. Moscow : Medicine, 296. (In Russ.)
2. Lebedenko, I. Yu., Arutyunov, S. D., Antonik, M. M. (2010). Instrumental'naya funktsional'naya diagnostika zubochelyustnoy sistemy [Instrumental functional diagnostics of the dentofacial system]. Moscow : MEDpress-inform, 80. (In Russ.)
3. Lebedenko, I. Yu., Arutyunov, S. D., Antonik, M. M., Stupnikov, A. A. (2008). Klinicheskiye metody diagnostiki funktsional'nykh narusheniy zubochelyustnoy sistemy [Clinical methods for the diagnosis of functional disorders of the dentition]. Moscow : MEDpress-inform, 112. (In Russ.)
4. Slavichek, R. (2008). Zhevatel'nyy organ: Funktsii i disfunktsii [Chewing organ: Functions and dysfunctions]. Moscow : ABC of the dentist, 543. (In Russ.)
5. Rogozhnikov, A. G., Vildeman, V. E., Bikkulova, A. V., Zubova, E. M., Rogozhnikov, G. I., Shuliatnikova, O. A. (2018). Eksperimental'noye issledovaniye protsessov razrusheniya polunaturnykh keramicheskikh elementov zubnykh protezov metodom registratsii signalov akusticheskoy emissii [An experimental study of the destruction of semi-natural ceramic elements of dental prostheses by recording acoustic emission signals]. Russian Journal of Biomechanics [Rossiyskiy zhurnal biomekhaniki], 2 (22), 230-240. (In Russ.) DOI:https://doi.org/10.15593/RZhBiomeh/2018.2.07
6. Slavicek, R. (2002). The Mastricatory Organ: Funktions and Dysfunktions [The Mastricatory Organ: Funktions and Dysfunktions]. Klosterneuburg : GAMMA Medizinisch-wissenschaftliche Fortbildung-AG, 554. (In Austria)
7. Tokarevich, I. V., Naumovich, Yu. Ya., Bogush, A. L. (2011). Metodika opredeleniya zhevatel'noy effektivnosti s primeneniyem razrabotannoy zhevatel'noy proby [Methods for determining chewing effectiveness using the developed chewing test]. Voyennaya meditsina [Military Medicine], 2, 106-109. (In Russ.)
8. Ryakhovsky, A. N., Antonik, M. M. (2005). Sistema otsenki i kriterii kachestva protezirovaniya iskusstvennymi koronkami. Chast' I [Assessment system and quality criteria for prosthetics with artificial crowns. Part I]. Klinicheskaya stomatologiya [Clinical Dentistry], 2, 54. (In Russ.)
9. Abakarov, S. I. (2001). Disfunktsiya visochno-nizhnechelyustnogo sustava pri patologicheskoy stirayemosti tverdykh tkaney zubov [Dysfunction of the temporomandibular joint with abnormal abrasion of hard tooth tissues]. Trudy Vsesoyuznogo s"yezda stomatologov [Proceedings of the All-Union Congress of Dentists], 137-138. (In Russ.)
10. Abakarov, S. I. (2001). Ortopedicheskoye lecheniye bol'nykh s zabolevaniyami visochno-nizhnechelyustnogo sustava pri normal'noy vysote nizhnego otdela litsa [Orthopedic treatment of patients with diseases of the temporomandibular joint at normal height of the lower face]. Trudy Vsesoyuznogo s"yezda stomatologov [Proceedings of the All-Union Congress of Dentists], 138-139. (In Russ.)
11. Antonik, M. M., Kalinin, Yu. A. (2011). Primeneniye instrumental'noy diagnostiki registratsii smeshcheniya golovki nizhney chelyusti kak vazhnyy element kompleksnoy diagnostiki myshechno-sustavnoy disfunktsii u patsiyentov s patologiyey okklyuzii [The use of instrumental diagnostics for recording displacement of the head of the lower jaw as an important element in the comprehensive diagnosis of muscular-articular dysfunction in patients with pathology of occlusion]. Rossiyskiy stomatologicheskiy zhurnal [Russian Dental Journal], 3, 15-17. (In Russ.)
12. Antonik, M. M. (2011). Dinamicheskiy tsefalometricheskiy analiz dvukh grupp patsiyentov s disfunktsiyey zubochelyustnoy sistemy i patologiyey okklyuzii [Dynamic cephalometric analysis of two groups of patients with dentition of the dentition and pathology of occlusion]. Ortodontiya [Orthodontics], 3 (55), 4-13. (In Russ.)
13. Antonik, M. M., Kalinin, Yu. A., Basova, V. I. (2008). Rol' diagnostiki pri stomatologicheskoy okklyuzionnoy reabilitatsii u patsiyentov so snizhennymi adaptatsionnymi vozmozhnostyami organizma [The role of diagnosis in dental occlusal rehabilitation in patients with reduced adaptive capabilities of the body]. Materialy XIX i XX Vserossiyskiy nauchno-prakticheskikh konferentsiy [Materials of the XIX and XX All-Russian scientific and practical conferences], 174-176. (In Russ.)
14. Antonik, M. M., Kalinin, Yu. A., Vafin, S. M. (2010). Registratsii smeshcheniya golovki nizhney chelyusti, kak element kompleksnoy instrumental'noy diagnostiki u patsiyentov s generalizovannoy formoy povyshennogo stiraniya tverdykh tkaney zubov [Registration of displacement of the head of the lower jaw as an element of a comprehensive instrumental diagnosis in patients with a generalized form of increased abrasion of hard tooth tissues]. Sovremennaya ortopedicheskaya stomatologiya [Modern orthopedic dentistry], 14, 28-29. (In Russ.)
15. Beinarovich, S. V. (2014). Noveyshiye metody issledovaniya v ortopedicheskoy stomatologii [The latest research methods in orthopedic dentistry]. Meditsina Urala [Medicine of the Urals], 2, 9-10. (In Russ.)
16. Betelman, A. I. (1965). Ortopedicheskaya stomatologiya [Orthopedic dentistry]. Moscow : Medicine, 411. (In Russ.)
17. Boyko, F. B. (2003). Fizicheskiy diskomfort i psikhoemotsional'nyye reaktsii patsiyentov stomatologa [Physical discomfort and psycho-emotional reactions of dentist patients]. Stomatologiya dlya vsekh [Dentistry for everyone], 4, 42-45. (In Russ.)
18. Wagner, V. D., Gurevich, K. G., Peshkov, M. V., Arkharova, O. N. (2013). Znacheniye stomatologicheskogo zdorov'ya dlya kachestva zhizni patsiyentov [The importance of dental health for the quality of life of patients]. Problemy stomatologii [Actual problems in dentistry], 2, 21-25. (In Russ.) doi.org/10.18481/2077-7566-2013-0-2-21-25
19. Vorozhko, A. A., Klemin, V. A. (2015). Vozmozhnosti individual'nogo podkhoda k planirovaniyu ortopedicheskogo lecheniya s uchetom allergicheskogo anamneza patsiyenta [Possibilities of an individual approach to planning orthopedic treatment, taking into account the patient’s allergic history]. Problemy stomatologii [Actual problems in dentistry], 23, 27-29. (In Russ.)
20. Grinin, V. M., Predtechensky, H. H. (2003). Analiz prichin i tseley obrashcheniy naseleniya za terapevticheskoy i ortopedicheskoy stomatologicheskoy pomoshch'yu v usloviyakh stomatologicheskogo rynka [Analysis of the reasons and goals of the population seeking therapeutic and orthopedic dental care in the dental market]. Stomatologiya dlya vsekh [Dentistry for everyone], 1, 32-33. (In Russ.)
21. Iordanishvili, A. K. (2007). Klinicheskaya ortopedicheskaya stomatologiya [Clinical orthopedic dentistry]. Moscow : MEDpress-inform, 240. (In Russ.)
22. Lebedenko, I. Yu., Kalivrajiyana, E. S. (2011). Ortopedicheskaya stomatologiya [Orthopedic dentistry]. Moscow : GEOTAR-Media, 640. (In Russ.)
23. Loginova, N. K. (1994). Funktsional'naya diagnostika v stomatologii [Functional diagnostics in dentistry]. Moscow : Partner, 74. (In Russ.)
24. Trezubov, V. N., Mishnev, L. M., Zhulev, E. N. (2008). Ortopedicheskaya stomatologiya. Prikladnoye materialovedeniye [Orthopedic dentistry. Applied Materials Science]. Moscow : Academy, 447. (In Russ.)
25. Shatrov, I. M., Vedernikova, L. V., Zholudev, S. E. (2013). Izucheniye kachestva zhizni u patsiyentov s defektami zubov i zubnykh ryadov posle ortopedicheskogo lecheniya s ispol'zovaniyem keramicheskikh restavratsiy [The study of the quality of life in patients with defects in teeth and dentitions after orthopedic treatment using ceramic restorations]. Problemy stomatologii [Actual problems in dentistry], 4 (9), 53-57. (In Russ.) doi.org/10.18481/2077-7566-2013-0-4-53-57.
26. Shleiko, V. V., Zholudev, S. E. (2013). Komp'yuternaya tomografiya kak osnovnoy instrument pri planirovanii i prognozirovanii kompleksnogo stomatologicheskogo lecheniya [Computed tomography as the main tool in the planning and prediction of complex dental treatment]. Problemy stomatologii [Actual problems in dentistry], 2, 55-57. (In Russ.) doi.org/10.18481/2077-7566-2013-0-2-55-57