Application of the complex algorithm for rehabilitation of patients needing a full reconstruction of dentition (clinical case)

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Abstract

Introduction. Aim of the study is testing the algorithm of complex clinical, functional and instrumental analysis in the treatment of patients with the need for total restoration of the dentition with manifestations of myofascial pain syndrome.

Material and methods. A system for the rehabilitation of patients with adentia is proposed, in which, when planning occlusion correction, objective examination data for patients obtained using a set of diagnostic methods should be taken into account. Particular attention is paid to assessing the function of the temporomandibular joint and the presence of pathological signs of disorders of maxillofacial muscles.

Results. A clinical case is described a patient who has been diagnosed with a set of indicators of clinical, functional and instrumental analysis obtained using methods of condylography and cephalometry. The results of treatment and rehabilitation measures allowed achieving the optimal distribution of loads on the dentition, while reducing the risk of ceramic chipping and improving oral hygiene. The approach used allowed timely correction of functional and aesthetic disorders.

Conclusions. The algorithm for working with patients who need total restoration of the dentition should include a thorough history taking, clinical functional analysis using condylography methods, model analysis to register and evaluate the static and dynamic ratios of the dentition. As well as performing cephalometric analysis and other manipulations, in accordance with standard criteria for clinical examination. The developed algorithm is anatomically and pathogenetically justified, since it takes into account the entirety of changes and interconnections of the structures of the dentofacial system and other body systems that underlie the clinical manifestations in this category of patients.

About the authors

Fatima K. Dzalaeva

First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: dzalayevaf1625@bk.ru

PhD, Professor of the Department of prosthodontics

Russian Federation, Moscow

S. O. Chikunov

First Moscow State Medical University (Sechenov University); People's friendship University (RUDN)

Email: dzalayevaf1625@bk.ru
Russian Federation, Moscow

A. S. Utyuzh

First Moscow State Medical University (Sechenov University)

Email: dzalayevaf1625@bk.ru
Russian Federation, Moscow

Z. K. Dzhagaeva

“North Ossetian State Medical Academy” of the Ministry of Health of the Russia

Email: dzalayevaf1625@bk.ru
Russian Federation, Republic of North Ossetia

A. V. Yumashev

First Moscow State Medical University (Sechenov University)

Email: dzalayevaf1625@bk.ru
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Condition of teeth and gums before treatment.

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3. Fig. 2. Condylogram of patient A.

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4. Fig. 3. Making models and performing splint therapy.

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5. Fig. 4. Re-plastering of the lower jaw model in the articulator. The following parameters were used for wax modeling: I dental class, ratio of teeth 1: 2, teeth 16–46, 17–47, II class of dentition closure.

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6. Fig. 5. Wax modeling. a - trying on a silicone key to transfer the occlusal surface of the teeth to a new wax-up; b - fixing the silicone key on the working model; c - wax modeling of the occlusal surface of the teeth.

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7. Fig. 6. Making a second set of temporary crowns. a - fitting a template with plastic temporary crowns in the oral cavity; b - models with pre-prepared teeth and pre-made temporary crowns; c - installation of temporary plastic crowns on the template. The canines and second molars of the upper jaw are left without preparation to control the fixation of the template; d - vise from the prepared teeth of the upper jaw.

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8. Fig. 7. Moving the shape of the occlusal surfaces from the wax-up.

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9. Fig. 8. Patient A. The final result of treatment.

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