COMPARATIVE EVALUATION OF THE QUALITY OF THE RECOVERY OF CHEWING EFFECTIVENESS IN THE TREATMENT OF PATIENTS WITH REMOVABLE ORTHOPEDIC STRUCTURES, MADE ACCORDING TO VARIOUS LABORATORY TECHNOLOGIES, BASED ON DATA ELECTRO-MYOGRAPHIC RESEARCH

Abstract

In Ukraine, the manufacture of removable laminar dentures with a rigid base reaches 80%. According to the literature, from 20 to 26% of patients do not use removable prostheses, and 37% are dissatisfied with the quality of orthopedic treatment with them. In addition, in 52% of cases, removable structures have insufficient fixation and stabilization on prosthetic beds. In 64% of patients, diseases of the mucous membrane of a traumatic etiology develop in the bases of prostheses (Labunets VA, 2010; Leus PA, 2013). Therefore, research into the process of adaptation to a new prosthesis is important for understanding the means of controlling the chewing muscles and can provide valuable information for determining the further way to solve problems that prevent patients from achieving full adaptation to prostheses. Analysis of electromyographic activity and kinetics of chewing movements is necessary for understanding the system of motor activity and chewing efficiency. The aim of the study is a comparative characteristic of the term / quality of adaptation of patients to removable laminar orthopedic structures made according to different laboratory technology, using an electromyographic study of the masticatory muscles. To achieve this goal, 80 patients with partial tooth loss between the ages of 45–65 years were examined and who were shown to replace dentition defects with partial removable orthopedic structures. The patients participating in the study were divided into three groups: patients of the first group of prostheses were made of acrylic plastic using the thermo-injection method. Patients of the second group of prostheses were made of acrylic plastic of hot polymerization by compression method. The third group consisted of patients whose prostheses were made from new domestic acrylic plastic using the free casting method, followed by polymerization under pressure. The main indicator of patient adaptation in our study is the normalization of the chewing function, which is assessed using electromyographic analysis of the masticatory muscles. Based on the average ratio of the indicators of electromyographic research, we can argue that the adaptation of patients in the group where prostheses were made using casting technology followed by polymerization under pressure was more consistent and high-quality than in groups of patients using other laboratory technologies for making removable prostheses. When comparing the treatment of patients with removable plate dentures manufactured using different laboratory techniques, we can note that the greatest chewing efficacy in patients using prosthetics is made by the injection molding method 290.04±0.23 μV. Not significantly less masticatory efficacy in patients with prosthetics that was made by the thermo-injection method is 181.24±1.05 μV, and the smallest index, where the prostheses were made using the compression technique 159.21±1.03 μV Thus, EMG studies have shown that the method of casting followed by polymerization under pressure in the manufacture of removable laminar prostheses restores the chewing function more qualitatively, and encourages the normalization and adaptation of the muscular system to chewing.