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Current clinical-functional aspects of occlusal rehabilitation in treatment with bridges


Author: Oineagra Vasile
Degree:doctor of medicine
Speciality: 14.00.21 - Stomatology
Year:2009
Scientific adviser: Ilarion Postolachi
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 12 November, 2008
Approved by NCAA on the 22 January, 2009

Abstract

Adobe PDF document – 0.39 Mb / in romanian

Thesis

CZU [616.314.26 + 616.314. – 76] – 08

Adobe PDF document 11.36 Mb / in romanian
120 pages

Keywords

reduced intercalated partial edentation, mandibulo-cranial correlation, occlusal position, type of occlusion (bite), occlusal correlation, occlusal disharmony, restoring of occlusal equilibration, dental bridge

Summary

The work is based on the findings of the complex examinations of 110 patients (25 men, 85 women), aged between 21 and 67 years and having reduced intercalated partial edentations in the lateral areas of dental arches, and on reports about cases of physiological occlusion showing no clinical signs of parodontium lesion.

A review of clinical and paraclinical results made it possible to determine the peculiarities of the clinical picture affected by occlusal disharmonies, these being caused by changes of occlusal surfaces in the teeth adjacent to edentations, decrease in the number of occlusal contacts and by the presence of defects in dental arches, migration of teeth adjacent to edentations and/or their antagonists, iatrogenic effects of fillings and dental prostheses. These peculiarities, by overloading some of the teeth and by blocking mandibular movement negatively affect other components of the stomatognat system.

The performed researches allowed to establish that the impairtments in dental arches leading to the deviation and/or blocking displacements of mandible serve as a basis for morphological and functional changes in the neuro-motor complex and temporal-mandibular joint (TMJ). The changes have been confirmed by the findings of the clinico-instrumental, radiological examinations, electromyography of masseteric and temporal muscles. The analysis of teleradiography results in the control-group patients helped to establish a correlation between the maxila position in the facial skeleton and the occlusal plane direction objectively necessary in the realization of prosthetic restorations, taking into consideration the occlusal reequilibration.

The results of complex examinations served as a basis for reasoning the prosthetic preparation of the oral cavity carrying on the principles and methods of treatment corresponding to the desired aim. Conceiving and accomplishing the treatment of reduced intercalated partial edentations in the lateral regions of dental arches have been possible taking into consideration the concept of occlusal reequilibration, this being the main objective in the optimal functional restoration on the stomatognat system. Occlusal reequilibration, in its turn, having an individual occlusal plane of dental bridges and corresponing to the requirements of functional occlusion, individual restoration of occlusal plane direction, as well as of the sagittal and transversal occlusal curves – all lead to the restoration of the function in the neuro-muscular and articular complex.

The analysis of follow-up (6 months – 3 years) results confirmed the efficacy of the proposed reequilibration algorithm for the treatment with dental bridges in case of reduced intercalated partial edentations in lateral dental arches.