Method for assessing hygienic state of removable dentures in partial adentia

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to preventive and orthopaedic dentistry, and can be used in assessing the hygienic state of the oral cavity in the patient with removable dentures suffering partial adentia. An inner surface of the denture is coloured. A graphic mesh is applied. It is photographed, and a denture hygienic state index is determined. The graphic mesh is applied with using templates enabling dividing the inner surface of the denture into two segments. The inner surface of the denture is photographed with using a camera with a focusing centre lying along a median palatine suture at a mid-distance between a maxillary frenulum and a distal edge of the for maxillary dentures and along the line drawn between central incisors in the middle between a mandibular frenulum and a posterior edge of the denture, for the mandibular dentures. The dental deposit is assessed in each segment as 0 to 4 by the 4-point system, while the hygiene index is calculated by formula.

EFFECT: by using set of templates, method enables assessing the hygienic state of any removable dentures with partial adentia.

1 tbl, 3 dwg, 1 ex

 

The invention relates to medicine, namely to prevention and prosthetic dentistry, and can be used when assessing the hygienic condition of the mouth in patients with the presence of removable dentures partial absence of teeth.

Now to restore the integrity of the dentition with partial absence of teeth is widely used in manufacturing dental prostheses, while standard is the requirement to further hygienic care, which should be carried out, both within individual dental hygiene activities, and with the help of professional tools a dentist, a hygienist. Design features dentures partial absence of teeth, such as the possibility of their removal from the oral cavity, the presence of clasps or lock fastenings, the presence of additional retention points on the surface, contributes more to the formation of plaque on the inner surface of such prostheses and complicates the maintenance of optimal hygienic conditions dentures and mouth in General. However, to date there is a lack of ways to assess the hygienic status of dentures partial absence of teeth. All presented methods of hygienic assessment with the situation of removable dentures are for patients with complete absence of teeth, whereas for patients with partial absence of teeth, such techniques are not available.

There is a method of assessing hygiene dentures in the absence of teeth (S.SJeganathan, K.T.Thong, V.Chan, M.M.Singh A climicaly viable index for quantifying denture plaque // Quintessence International (Berline), 1996, Vol.27, No. 8, P.569-573), which consists in staining solution of erythrosine the inner surface of the denture in for 1 minute. Then the dye is washed off the surface of the dental prosthesis is dried and visual assessment of the surface of the dental prosthesis. Assessment of the level of hygienic condition of the dental prosthesis is determined depending on the ratio of the painted parts of the surface of the dental prosthesis to the total size of the inner surface of the dental prosthesis.

The disadvantage of this method is the large inaccuracy in the assessment of the level of hygienic condition of removable dentures because of the visual estimate of the amount of the colored part of the inner surface of the dental prosthesis and, as a consequence, little information value of this method.

The closest, according to the authors, analogue (prototype) is a method of determining the hygienic index used for assessing the hygienic state of the removable dental prosthetic in the absence of teeth PHI ((Schubert R, Schubert U. The prosthesis hygine index - a method for documentation and health education // Stomatol DDR. 1979 Jan;29(1):29-31). This method is staining within 5 minutes the inner surface of the denture in the absence of teeth. Then the dye is washed off the surface of the dental prosthesis is dried and is photographing the inner surface of the denture. The obtained photograph is applied graphic grid that divides the surface of the dental prosthesis on the segments, followed by the index estimation hygienic condition of the dental prosthesis based on the ratio of the colored segments to the total number of segments.

However, this diagnostic method is intended only for assessing the hygienic state of the removable dental prosthesis in the absence of teeth. In the method there is no description of the exact method of separating the inner surface of the dental prosthesis on the segments, thus, this procedure can be done about that can substantially reduce the accuracy of this method of assessing hygiene dentures.

The actual challenge remains the development of a method for identifying and assessing the hygienic state of the removable dentures partial absence of teeth.

The way to determine the hygienic status of dentures when part of the complete absence of teeth includes staining the inner surface of the dental prosthesis, the graphical mesh, photography and the index definition hygienic condition of the dental prosthesis, to obtain a graphical grid templates used for dividing the inner surface of the dental prosthesis on an equal segments, photographing the inner surface of the denture hold the camera with the center focus on the middle nebnom the seam at mid-distance between the maxillary frenum and the distal edge of the dental prosthesis to the maxillary dental prosthesis and a line drawn between the Central incisors at the middle point between the mandibular frenulum and the rear edge of the prosthesis, mandibular dentures, evaluation of staining of plaque in each segment are conducted on a 4-point scheme from 0 to 4, and the value of hygiene index calculated by the formula

AndndeKwith agandgandens(x)=with aymmandbandlaboutininwith aexaboutKpandWennsxwith aegmentaboutinabout byeeKaboutlandhewith atinaboutwith aegmentaboutin

The proposed method of determining the health state of dentures partial absence of teeth first by painting the inner surface of the dental prosthesis 5% solution of erythrosine for 5 minutes in order to detect the presence of plaque, then rinsed with water for 5 seconds to remove excess dye and dried with compressed air for 10 seconds. On the inner surface of the denture impose a template of the required size with a graphical grid.

Then photograph the inner surface of the denture with a graphic grid with a camera mounted on a tripod with the center focus on the middle nebnom the seam at mid-distance between the maxillary frenum and the distal edge of the dental prosthesis to the maxillary dental prosthesis and a line drawn between the Central incisors at the middle point between the mandibular frenulum and the rear edge of the prosthesis, mandibular dentures. The camera is placed at an angle of 90.

Evaluation of staining of plaque in each segment are conducted on a 4-point the scheme from 0 to 4 and calculate the index value of hygiene, using the ratio between the total score of all segments and the total number of segments

AndndeKwith agandgandens(x)=with aymmandbandlaboutininwith aexaboutKpandWennsxwith aegmentaboutinaboutbyeeKaboutlandhewith atinaboutwith aegmentaboutin

To obtain a graphical grid in the proposed method uses templates that enable you to divide the image into equal segments. The templates are made of transparent flexible plastic and put them in a graphical grid that divides the inner surface of the prosthetic bed on equal area segments. There are 6 different sizes of templates for maxillary dentures partial absence of teeth and 6 sizes of templates for mandibular dentures (table 1).

Table 1
The total area and the area of the segments on the templates with graphic grid.
No. templateThe total area, cm2. The upper jaw.The area of the segment, cm2.The upper jaw.Total 2 size, cm2. The lower jaw.Area 2 segment, cm2. Bottom
the jaw.
118,390,5914.4V0,6
220,30,5315,740,66
322,290,717,140,71
424,380,7618,60,78
556,570,8320,110,84
6 31,210,9821,690,9

This allows you to use the proposed method for patients with any size of the jaws. The separation of the inner surface of the dentures into equal segments allows to accurately calculate the area of staining of the plaque.

Evaluation of staining of plaque in each segment are conducted on a 4-point scheme from 0 to 4:

0 - no staining;

1 - slight staining;

2 - colouring is less than half the surface area of the segment;

3 - staining more than half of the surface area of the segment;

4 - painting the entire surface of the segment.

The index value hygiene denture partial absence of teeth calculated using the ratio between the total score of all segments and the total number of segments

AndndeKwith agandgandens(x)=with aymmandbandlaboutininwith aexaboutKpandWennsxwith aegmentabout inaboutbyeeKaboutlandhewith atinaboutwith aegmentaboutin

The results were evaluated as follows:

from 0 to 1.5 - excellent level of hygiene;

from 1.5 to 2.5 satisfactory level of hygiene;

from 2.5 to 4.0 - poor hygiene.

This allows you to get the most accurate and complete picture of the inside surface of the dental prosthesis.

Figure 1 presents a General view of the template of all sizes with printed graphics meshes. On figa depicted templates for maxillary dentures partial absence of teeth. Each template has a number from 1 to 6 with the letter "B". On figb depicted templates for mandibular dentures partial absence of teeth. Each template has a number from 1 to 6 with the letter "H". In addition, the templates specify the area (Stotalthe inner surface of the dental prosthesis and the area of one segment (Ssegm). Values of the total area (Stotaland square segments(Ssegmfor all of the templates listed in table 1 (p.5). Figure 2 shows the separation of the inner surface of the maxillary removable tooth crack is and segments to determine the hygiene index. Figure 3 shows the separation of the inner surface of the mandibular fixed prosthesis into segments to determine the hygiene index.

The proposed method of determining the health state of dentures partial absence of teeth allows the assessment of the hygienic condition of removable dentures with great precision, using a set of templates makes it possible to apply this method to all types of removable partial dentures with tooth loss. This allows you to get the most accurate and complete picture of the inside surface of the dental prosthesis.

Example: In the Department of Periodontology at the dental clinic has treated a patient for the purpose of conducting professional hygiene of the oral cavity.

After clinical and radiological examination she was diagnosed with "generalized periodontitis of moderate severity, cause secondary partial edentulous". A plan of the complex treatment of periodontitis, which contained the source for professional hygiene of the oral cavity and prosthetic dental structures.

To assess the state hygienic condition of the teeth and non-removable prosthetic dental structures were used: index of oral hygiene IG is-[OHI-S, Green, J.C.,Vermillion J.R., 1964], the index of the thickness of dental plaque PI [Sillness J. Loe N., 1964], the index of approximal tooth surfaces API [Lange D.E., 1977], and the index of the prevalence and intensity of destruction of periodontal tissues PI (Russel A.L., 1956)

To assess the hygienic status of existing patient A. removable dentures was applied the proposed method. The inner surface of the partial removable dental prostheses were stained with a 5% solution of erythrosine was rinsed with water for 5 seconds to remove excess dye and dried with compressed air for 10 seconds. Then for the upper jaw was selected and applied template with a graphic grid 4 size. To the inner surface of the denture lower jaw was selected and applied template with a graphic grid 3. The painted surface with superimposed graphics grid photographed by the camera (Nicon D90, Nicon Inc., Tokyo, Japan) at an angle of 90 degrees. The camera was mounted on a tripod (Slik Pro 340 DX, Testrite Inc., Newark, USA) with a Central focus on the middle nebnom the seam at mid-distance between the maxillary frenum and the distal edge of the denture (maxillary dental prosthesis), and a line drawn between the Central incisors at the middle point between the mandibular frenulum and the rear edge of the denture (mandibular dental about Azov).

Upon completion of photographing painted plaque was removed with a toothbrush and liquid soap under running water. Then dentures were returned to the patient.

Then evaluated the staining of the internal surfaces of dentures in each segment. The obtained data were included in the calculation formula, and were calculated the following values: 3.6 points for the maxillary denture and 3.2 points for the mandibular denture. Thus, the obtained value was interpreted as poor hygienic condition of the maxillary and mandibular dental prosthesis.

On the basis of the obtained data was determined amount for professional hygienic measures the patient A., installed the recommended algorithm for the individual patient dental hygiene activities, and conducted session with the patient in order to enhance motivation to maintain good hygienic condition of the mouth and prosthetic dental structures in the future.

The way to determine the hygienic status of dentures partial absence of teeth, including painting the inner surface of the dental prosthesis, the graphical mesh, photography and the definition of the Indus the KSA hygienic condition of the dental prosthesis, characterized in that for obtaining a graphical grid templates used for dividing the inner surface of the dental prosthesis on an equal segments, photographing the inner surface of the denture hold the camera with the center focus on the middle nebnom the seam at mid-distance between the maxillary frenum and the distal edge of the dental prosthesis to the maxillary dental prosthesis and a line drawn between the Central incisors at the middle point between the mandibular frenulum and the rear edge of the prosthesis, mandibular dentures, evaluation of staining of plaque in each segment are conducted on a 4-point scheme from 0 to 4, where 0 points assigned if no staining, 1 score for minor staining, 2 points - staining less than half the surface area of segment 3 points - staining more than half of the surface area of the segment and 4 points - painting the entire surface of the segment, the value of hygiene index calculated by the formula

and when hygiene index equal to from 0 to 1.5, level of oral hygiene status was evaluated as excellent, from 1.6 to 2.5 - satisfactory, from 2.6 to 4.0 as unsatisfactory level.



 

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4 ex, 1 tbl

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