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Home / Issues / № 2, 2013

Materials of the conference "EDUCATION AND SCIENCE WITHOUT BORDERS"

THE MORPHOLOGICAL CHANGES DYNAMICS IN BONE TISSUE AFTER DENTAL IMPLANTS INSTALLING AT EARLY FUNCTIONAL LOADING
Ashuev Zh.A., Ildarov R.B.
               The people’s world outlook has already been changed so much, that the delayed rehabilitation, using the dental implants is quite not the best solution, and they ask to be shortened the medical treatment [1]. 

                The most implant systems have already been designed, so that the delayed implantation method is considered, as the most reliable one. However, the expectant management after the teeth extraction, as well as the long period of time from the surgical operation before the prosthetics commence are the main disadvantages of the delayed method of the treatment [e.g. Listgarden].        

               So, in recent years, the early functional loadings at the dental implantation are being violently discussed. According to the proponents of the early patients’ rehabilitation with the dental implants using, such loadings are practical reparative osteogenesis activator. For all this, the osteoblasts’ and the bone tissue calcification are being increased, as well as the energy and the cell metabolisms are being further improved.     

        Thus, the complications can be occurred, as at the early postoperative periods, well as at the later ones – after a few years. By their classification, the Japanese researchers Hobo S., Ishida E., Hanks (e.g. 1993) have already counted 26 species at the 1 – st and the 2 – nd stages of the implant surgery (e.g. the 12 ones – at the first stage, and the 14 ones – at the second one).      

               So, the clinical, the morphological, and the instrumental research methods are being applied to be examined the living tissues response for the fixed dental implant, as well as the treatment results forecasting, with the early functional loadings use. Thus, the contemporary works’ analysis have been shown, that the experimental studies had already been conducted insufficiently to be able to be traced the changes, that were occurred in the bone tissue during 1 year (e.g. (1, 3, 6 и 12 months), with the early functional loadings use on the dental implants. The clinical research methods are, largely, subjective. The promising methods for the bone tissue response studying in the dental implants with the early functional loadings use are the experimental, roentgenologic, and functional methods of the diagnostics. In this connection, we had already developed the comprehensive tactics, which was completely included all the above – listed research methods, having justified the early functional loadings usefulness of the dental implants in the patients’ treatment with the partial or the complete loss of their teeth.

               The bone tissue rebuilding of the alveolar process and the further capsule formation around the implant, basically, have been finished by the three months (e.g. 90 days). So, the obtained results of the experimental studies have already been extrapolated to the clinic for the further method development of the early functional loading at the patients’ dental implants with the partial or the complete loss of their teeth. The stone has its maximum limit of their functionality. When the permissible level exceeding of the physical load (e.g. more 3,000 cycles microtension of the structural units per day), the bone tissue elements are practically subjected to the stress transshipment, resulting in the resorption is taken its place. If the local stress value does not match the local load autonomy, and, moreover, the development degree of the bone’s structural units, the pathological alteration may be, really, started, which is the failure disease, the temporal insufficiency, and the bone decompensation.       

          So, the clinical part of the work has already been done during the 332 patients’ examination and their further treatment, and all these patients have been partitioned into the two main groups: the I –st main group (e.g. 234 people) – the patients, whom after the surgical implants installation, the early functional loads were conducted; the II – nd control group (e.g. 98 people) – the patients, whom after the implant installation, the orthopedic designs were made by the well – known scheme – deferred. It has been installed the 573 implants.      

               So, the great practical significance, at the dental implants, are presented the forces, having arisen in the chewing process. It is quite known, that the prosthetic design, as the biomechanical system, for its successful operation should be provided the masticatory forces redistribution on the supporting tissues of the mouth cavity, in order to be maintained and preserved their normal function at the load capacity. The excessive exercises and its loads, as a rule, are accompanied by the stress concentration in the certain areas of the alveolar ridge, and it is resulted in the inflammatory process further development. The prevention of the stress occurrence in the prosthetic bed tissues has the essential significance for the prosthetics functional results prediction, the bone tissue preservation, and the prosthetic design choice. Therefore, for all the patients, who we had already been performed the early functional loads (e.g. the main group) the temporary orthopedic prosthesis was produced from the plastics, that was allowed to be connected the implants to the single structure immediately after the intraosseous implantation. This is significant, from the standpoint of the implant’s functioning durability, and, moreover, to be provided the physiological loadings on the bone tissue of the jaw, which is made the patient to be felt and the quite usual his reactions. Therefore, the fuller picture of the forces real distribution, having acted on the implant, all the more, the more accurately it is quite possible to be calculated the implants’ number, and the form of the final prosthetic design.     

         It is quite well known, that the prosthetics, on the basis of the implantation method using, is depended on the individually expressed specific clinical situation, the periodontal tissues status, the type of the dentition defects, the occlusion specific features and its peculiarities, the somatic diseases presence, and their local manifestations in the oral cavity. The thorough clinical and laboratory, the radiological, and the functional studies have already been conducted by us, to be determined the indications and the contraindications for the surgery intraosseous implantation carrying out.        

    The special indications for the dental implants’ carrying out have been the following: the satisfactory oral cavity hygiene, any pathological changes absence in the oral cavity, the sufficient volume of the bone tissue for the dental implants’ installation, the patient’s willingness to be participated in the post-operational examination program. The contraindications for the dental implants’ carrying out have been the following: the insufficient volume of the bone tissue, the liver, kidneys and blood diseases, the pregnancy, the inflammatory and the autoimmune diseases presence of the oral cavity, the insufficient hygiene of the oral cavity, the heart failure presence, the carried out post-radiotherapy, chemotherapy status.        

              The blood supply state to the issues in the area of the suspected implantation, the vascular reserve capacity presence of the regional hemodynamics, as well as the vascular response nature to the early functional loads have been applied, as the functional determinants, having defied the prosthetic bed tissues status with the early functional loads using. The change dynamics in the status and the bone tissue density in the «implant – bone» system have also been taken into account. The significant premise at the dental implants with the early functional loads using is the blood supply condition to the area of the suspected implantation, and the vascular response nature to the surgical trauma, and the blood supply recovery dynamics in the post-operational period. For all this, there is no less significant assessment of the metabolism intensity, which is closely associated with the micro-circulation, and the necessary tissues’ oxygen supply.        

               Thus, all the patients, having wished to be conducted the prosthetics with the implantation method using, have their strong enough motivation, and they are striving to be achieved their final goal, i.e. getting rid of the removable dentures. So the danger is that the patients sometimes are deliberately concealed, that they have any diseases, which are the direct contraindication to the necessary surgery. That is why, it is quite necessary, that the patient is clearly understood and comprehended, the risk of the complications is rapidly increased, at a number of the somatic diseases presence; and also that the further complications’ development, in its turn, will be complicated the subsequent medical treatment and the prosthetics.



References:
1. Kalininskaya А.А., Sadykov M.K., Kunitsyna N.M., “Organization Forms of Preventative Work in Stomatology”./ «European Journal of Natural History». – № 6. – 2012. P.P. – 20 – 22.


Bibliographic reference

Ashuev Zh.A., Ildarov R.B. THE MORPHOLOGICAL CHANGES DYNAMICS IN BONE TISSUE AFTER DENTAL IMPLANTS INSTALLING AT EARLY FUNCTIONAL LOADING. International Journal Of Applied And Fundamental Research. – 2013. – № 2 –
URL: www.science-sd.com/455-24481 (20.04.2024).