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Clinical aspects and morphofunctional treatment of patients with occlusal disorders


Author: Alexandru Postolachi
Degree:doctor of medicine
Speciality: 14.00.21 - Stomatology
Year:2007
Scientific adviser: Gheorghe Nicolau
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 31 January, 2007
Approved by NCAA on the 1 March, 2007

Abstract

Adobe PDF document0.26 Mb / in romanian

Keywords

occlusal, occlusal disorders, occlusal contacts, lateral teeth, restoration

Summary

The work presents the complex examination results and the clinical picture peculiarities of 110 patients (47 men and 63 women) aged 20-61 years and having occlusal disorders, but having no es-sential clinical signs of parodontium lesion.

New principles and methods of direct and indirect restoration of the occlusal surface architecture of the damaged / absent lateral teeth have been elaborated on the basis of the clinical and paraclinical examination results and the assessment of the obtained data has been done.

The changes in the occlusal area structure of the lateral teeth have been studied and defined and the risk factors of occlusal disorders development have been sysematized. Research work al-lowed to determine the clinical picture peculiarities of occlusal disorders dependent on the de-creased number of occlusal contacts and the degree of occlusal surface lesion of lateral teeth and to decide upon the strategy and performing of a complex restorative treatment by using direct and in-direct techniques.

The data on the patients complex examination allowed to establish the clinical picture peculi-arities of the occlusal disorders to be influenced by the number of occlusal contacts, a poor occlusal plane leveling and peculiarities of interocclusal relationship in the affected dental arch area. All these result in morphofunctional changes in the involved tooth parodontium, TMA and the muscular system. The above – mentioned disturbances have been confirmed by the clinical investigation find-ings, imaging results (orthopantomography, TMA tomografy, X-ray examination with alveolar cor-tical densitometry of the lower lateral teeth), EMG of the maseteric muscles and the anterior bands of the temporal ones, etc. This interdependence supports the importance and necessity of occlusal equilibrium restoration, this being an absolutely essential condition of ensuring a proper functioning of the stomatognat system.

The results of our complex investigations served as a basis in the premier elaboration and adoption of improved principles and methods of direct and indirect restoration of the lateral teeth occlusal surface morphology by using the proposed devices and contemporary composites. The proposed methods of lateral teeth occlusal architecture modeling preserving the individual occlusal picture according to the “envelope” principle and lesions MOD “sectional” principle increases the exactness of interocclusal contacts topographic restoration, these being important for ensuring the occlusal equilibrium.