[Mucoperiodontal lesions: improvement of prosthodontic treatment considering initial indicators of patients' oral health]

OBJECTIVE

To assess the need for prosthodontic treatment and to substantiate the features and perspectives for optimizing prosthodontic treatment in patients with mucoperiodontal manifestations of lichen planus (LP).

MATERIAL AND METHODS

For assessment of the need and identification of problematic aspects of prosthetic treatment 74 patients (48.3% of the primary sample of all patients with oral LP) with oral LP-associated mucoperiodontal lesions (MPL) participated in a multicenter open cohort prospective controlled clinical trial with elements of retrospective analysis. The prospective part of the study summarizes the results of prosthodontic treatment of 41 patients (8 men and 33 women aged 45-70 years) carried out using improved therapeutic and diagnostic algorithms applied to the specifics of the MPL forms and stages.

RESULTS

The use of standard protocols of prosthodontic treatment without taking into account the status of oral mucosa in patients with oral LP was associated with the development of nonspecific (prosthetic stomatitis - 25.8%; contact-allergic stomatitis - 22.6%; focal hyperplasia - 16.1%; decubital ulcers - 12.9%, etc.) and oral LP-associated specific reactions (Kebner's symptom - 35.5%; transformation of the typical form into complicated ones - 22.6%; desquamative gingivitis and gingival lichenization - 19.4% each; gum recession - 16.5%) with the involvement of skin and mucous membranes of other localizations (6.5%) and the appearance of symptoms of carcinophobia/dentophobia (25.8%). Prosthetic treatment according to improved protocols for the management of patients with oral LP indicated a decrease in the frequency of nonspecific oral mucosal reactions (by 70.7%, p<0.001), single (4.8%) specific reactions, improvement of masticatory efficiency by 32.8-55.3% (p<0.01), harmonization of speech function, maintenance of a high level of hygiene of prostheses, a significant reduction in the time of adaptation to removable dentures and increased satisfaction with the results of treatment on the GRS scale (1.06±0.3 points after treatment; 3.8±0.5 points before treatment; p<0.001).

CONCLUSION

The best dynamics of clinical and sociological indicators was noted in persons with prosthetic replacement structures based on implants.

[The effectiveness of the application of mineral water from the Klyuchi health resort in the programs of combined spa-based rehabilitation of the patients presenting with acquired jaw defects]

The results of the present study give evidence of the well-apparent sanation effect of balneotherapy with the use of therapeutic mineral water (MW) extracted at the Klyuchi health resort. Irrigation of the oral cavity with this mineral water was shown to reduce the number of the strains of opportunistic microorganisms and their virulence potential. It is concluded that the proposed method may be recommended for the treatment and prevention of dysbiosis in the oral cavity of the patients presenting with acquired jaw defects.

[Complex treatment approach in patients with lower jaw defects]

The aim of the study was to evaluate the clinical efficiency of modern materials in complex treatment of patients with lower jaw defects. The study demonstrates the advantages of biologically inert materials (carbon composite material "Uglekon-M" and titanium alloys) for lower jaw defect restoration.