American Journal Of Social Sciences And Humanity Research
154
https://theusajournals.com/index.php/ajsshr
VOLUME
Vol.05 Issue05 2025
PAGE NO.
154-157
10.37547/ajsshr/Volume05Issue05-38
Orthopedic Treatment When Using Non-Metal Ceramic
Prosthesis
YAKUBOVA Sarvinoz Rakhmonkulovna
Doctor of Philosophy medical sciences (PhD), Samarkand State Medical University, Uzbekistan
Received:
28 March 2025;
Accepted:
24 April 2025;
Published:
26 May 2025
Abstract:
Objective: To determine the changes that occur in periodontal tissues, prosthetic bed and oral mucosa
before and after orthopedic treatment when using metal-free ceramic prostheses.
Methods: During the study, general clinical, laboratory, biochemical, functional, instrumental and statistical
methods were used. The object of the study was 185 patients with partial edentia aged 25-60 years were selected,
95 of whom were men and 90 were women, and the control group consisted of 20 healthy people.
Results: The wear of non-removable prostheses during wearing is manifested in the following pathological
changes in the condition of the prostheses and the tissues of the prosthetic bed. Stamped and stamped welded
prostheses with and without ZDP TT have a number of technological shortcomings, which are manifested during
wearing.
Conclusions: Dentures lead to a change in the acid-base balance of oral fluid, complete cast dentures without a
protective and decorative coating have the least effect on it ((pH 7.2±0.03, from 12 months after denture insertion
to the end of the study), metal-ceramic dentures have a small effect (pH 7.39±0.02 from 12 months after denture
insertion to the end of the study).
Keywords:
Orthopedic, prosthetic construction, ceramics, non-removable dentures, oral cavity.
Introduction:
Wide-scale measures are being
implemented in our country to develop the system of
the medical field, in particular, to reduce dental
diseases and their complications, as well as to provide
qualified medical care to patients suffering from this
pathology, and the following tasks have been defined.
"...in order to increase the quality and convenience of
the effectiveness of medical care, it is necessary to
introduce high-tech methods for the implementation
of a healthy lifestyle and prevention of diseases, as well
as diagnosis and treatment, standardization methods
in medicine, and the implementation of the
effectiveness of patronage and dispensary models..."
The purpose of the study: to determine the changes
that occur in periodontal tissues, prosthetic bed and
oral mucosa before and after orthopedic treatment
when using metal-free ceramic prostheses.
The object of the study was selected 185 patients with
partial edentia aged 25-60 years, 95 of whom were
men and 90 were women, the control group consisted
of 20 healthy people.
The results of the study: wear of non-removable
dentures during wearing is manifested in the
deterioration of the condition of the dentures and the
following pathological changes in the tissues of the
denture base. Stamped and stamped welded dentures
with and without ZDP TT have a number of
technological shortcomings that manifest themselves
during wearing.
In addition, the development of the electrochemical-
mechanical corrosion process of the metal prosthesis
leads to a change in the color and gloss of the above-
mentioned areas, which turns into extensive flatness
defects that penetrate deep into the prosthesis. The
sufficient service life of stamped and, especially,
stamped welded dentures is limited by the variety of
materials in their composition, which leads to its
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
perforation. Often, perforation is localized on the
occlusal surface of a crushed artificial coating - it is
under the strong influence of all possible destructive
factors - the mechanical effect of chewed food, the
aggressive chemical effect of oral fluid, and
electrochemical processes. corrosion, which increases
the effect of the first two factors on the alloy.
ZDT TT contributes significantly to the deterioration of
the operational characteristics of cast and cast welded
structures, which leads to the weakening of the above-
mentioned alloy structure due to the thermal process
of the alloy or the alloy. The technologically necessary
temperature for the application of ZDP TT is the
material, which is heated to 600-800 degrees, followed
by slow cooling of the prosthesis.
Prolonged cooling by local exposure to high
temperatures on the prosthesis gives an analytical
effect on the welding of the prosthesis parts. Welding,
which unites the prosthesis parts, increases the
chemical diversity of the prosthesis, thereby facilitating
and enhancing the occurrence of galvanic corrosion.
In our study, a marginal change in the color and gloss
of the surface of cast and cast welded prostheses was
detected starting from 6 months after the prosthesis
was inserted. In patients with CKD, changes in the color
and gloss of the surface of the prosthesis were
observed in 11.4 and 22.9% of cases after 6 and 12
months of prosthesis placement, respectively.
For the first time, in 8.8% of cases, we observed an
insulating change in the color and gloss of the surface
of the prosthesis in patients with CKD, which, in our
opinion, was caused by the incompatibility of the alloy
composition with the onset of electrochemical
corrosion. The presented data showed that the
composition of the cast and cast-welded prostheses,
the destabilizing-decomposing effect of the structural
materials was determined, which is primarily due to the
chemical heterogeneity of the structures of the cast
and cast-welded prostheses, and secondly, due to the
chemical heterogeneity of their structures as a result of
the fusion of the prosthesis parts into a single whole. At
the same time, we found a wide range of color changes
and the absence of darkening of the CKD surface; The
change in the marginal color and gloss was 28.6%. It
should be noted that in patients with complete cast
prostheses, the gloss and color change of the metal
coating surface was not observed even after 36
months.
At the end of the study (36 months after the prosthesis
was inserted), in the group of patients with SC, the
change in the marginal color and gloss of the prosthesis
surface was detected in 11.8% of cases, and no large-
scale changes were observed. During the study, the
color and gloss of the coating surface of the TQDP did
not change, but at the end of the study, the change in
the marginal color and gloss occurred in 34.3% of cases.
The study found that in patients in the TQDP group, the
color and gloss of the coating surface changed due to
friction of the prosthesis surface with the ZDP TT
surface and mechanical abrasion of the coating, while
in the cast and cast-fused prosthesis group, the
destruction process of the metal prosthetic material
began. The non-change in the color and gloss of the TQ
prostheses in the highly aggressive environment of the
oral cavity indicates their high chemical and mechanical
stability. On the other hand, the high percentage of
prosthesis destruction of the ZDP TT prostheses
indicates their lack of durability. In patients with TQ and
CLDP prostheses, the appearance of gaps, holes or
erosions on the prosthesis surface was not observed
throughout the study. The marginal adaptation of the
coatings was manifested in the appearance of a gap
between the edges of the artificial coating and the
tooth tissues, through which the probe could
penetrate. After 6 months of prosthesis placement,
these changes were typical for patients with CLDP and
MC prosthetic designs, and no marginal adaptation of
the veneers was observed during the entire study. We
attribute such marginal adaptation of the veneers to
the imperfection of the manufacturing technology and
the installation of pressed veneers. In this situation, the
insufficient bending strength of the pressed veneers
under the influence of chewing pressure and the
change in the dimensional characteristics of the bridge-
like dentures associated with this parameter play an
important role, the cause of which is the displacement
of the abutment teeth and the edges of the abutment
veneers from the hard tissues of the teeth.
Occlusal contact erosion was observed in 8.6% and
2.6% of patients with CLDP and MC prostheses,
respectively, 6 months after prosthesis insertion. By
the end of the study, occlusal contact erosion was
observed in 8.6% and 2.6% of patients with CLDP and
MC prostheses, respectively. Also, 36 months after
prosthesis insertion, perforation of the occlusal
surfaces of the pressed-in veneers and complete
obliteration of the occlusal relief of the hard elements
of the prosthetic structures were observed in 8.7% of
patients with SC, respectively. The number of defects
on the occlusal surface in the group of patients using
prostheses with ZDP TT was higher than in patients
using prostheses without ZDP TT, which confirms our
conclusion about the negative effect of ZDP TT on the
mechanical strength of prostheses.
Comparing the concentrations of Na, K, Ca, Mg, SG,
phosphates, Fe in the oral fluid of patients with a
diagnosis of TKTN 1-2, TKTN 3-5, KTY 1-2 and KTY 3-4
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
Fr, it is possible to draw conclusions about the influence
of localization in a certain area of the teeth and the
volume of TKTN and KTY on the above-mentioned
qualitative indicators of oral fluid. In the case of TKTN,
a slight increase in the concentration of Na+, K+, Ca2+,
Mg2+, SG and Fe3+ is observed, which has a direct
positive correlation with the number of affected teeth.
In the case of KTY, the concentration of Na+, K+, Ca2+,
Mg2+, SG and Fe3+ decreases slightly; in this case, the
correlation with the length of the defect is also directly
negative. The concentration of phosphates in the oral
fluid of patients with CKD does not differ from the
control group and is directly positively correlated with
the length of the defect in patients with CKD. Thus, in
patients with CKD, a slight increase in the
concentration of phosphates in the oral fluid is
observed, while in patients with CKD, a slight decrease
in the concentration of Na, K, Ca, Mg, Sg and Fe, as well
as an increase in the concentration of phosphates, is
observed. Our experimental data are consistent with
the literature [41, 42].
The change in the RMA index characterizes the
inflammatory processes present at the gingival margin
of the teeth. In our case, teeth covered with artificial
veneers, including those that were part of a bridge
prosthesis, were examined. When comparing the
values of the RMA index for identical prosthetic designs
that differ only in the presence of ZDP TT, we can note
a larger value of the RMA index for ZDP TT prostheses,
which allows us to draw a conclusion about the harmful
effect of ZDP TT on the gingival margins of teeth. Thus,
both cast and cast composite prosthetic designs with
and without ZDP TT have a significant negative effect
on the gingival margins of the denture base.
The RMA indices for patients with CLDP and MC
prostheses reached 26.95 ± 0.35 and 28.63 ± 0.31% 1
month after the prosthesis was inserted and remained
at this level until the end of the study. A slight increase
in the RMA index for patients with CLDP and MC
prostheses is explained by the effect of chemical
elements in the form of ions released from these
structures on the periodontal tissues of the teeth. It
should be noted that the differences in the RMA index
values for CLDP of prostheses (26.95 ± 0.35%) confirm
our previous conclusion about the negative effect of
the PDP TT prosthetic base on the periodontal tissues
of the teeth. .
12 months after the prosthesis was placed, the values
of the Russell index for CLDP and MC prostheses were
0.67 ± 0.04 and 0.64 ± 0.04, respectively, and remained
at this level until the end of the study. These indicators
indicate an insignificant effect of CLDP and MC coatings
on periodontal tissues.
When examining the group of patients with SC, it was
found that there were statistically significant changes
in the concentration of Na+ in the oral fluid. 0.5 months
after the prosthesis was inserted, the Na+
concentration increased by 18.1 ± 0.3 mmol/l
compared to the control group (17.53 ± 0.32 mmol/l);
after 1 month, it decreased to 18.35 ± 0.56 mmol/l,
after which the indicators stabilized at a low level of
17.91 ± 0.41 mmol/l and remained at all subsequent
follow-ups - 3, 6, 12 and 24 months after the prosthesis
was inserted. By 36 months, this indicator decreased to
17.27 ± 0.35 mmol/l. In our opinion, such dynamics of
Na+ concentration is characteristic of the process of
adaptation of the maxillofacial system to the prosthesis
design and is associated with an increase in the
secretion of sodium ions into the oral fluid due to
increased excitability of the central nervous system
during adaptation. (Fig. 19).
For SC, an average increase in K+ concentration is
observed, starting from 0.5 months after prosthesis
insertion to 18.1 ± 0.21 mmol/l compared to 16.37 ±
0.27 mmol/l in the control group, which remained at
this level until the end of the study.
1 month after prosthesis insertion, the Ca2+
concentration increased from 1.85 ± 0.03 to 2.31 ± 0.03
mmol/l compared to the control group and remained
at this level until the end of the study.
CONCLUSIONS
1. Dentures lead to a change in the acid-base balance
of the oral fluid, complete cast dentures without a
protective and decorative coating have the least effect
on it ((pH 7.2±0.03, from 12 months after the
prosthesis is placed until the end of the study), metal-
ceramic dentures have a small effect (from 12 months
after the prosthesis is placed until the end of the study
Н 7.39±0.02).
2. Complete cast dentures have a minimal effect on the
periodontal tissues of the abutment teeth (Russell
index 36 months after the prosthesis is placed
0.66±0.03 in the control - 0.5±0.02), metal-ceramic and
dentures have a smaller effect on the periodontal
tissues. (Russell index 36 months after the prosthesis is
placed 0.64±0.04 and 0.67±0.04, respectively).
3. Titanium Patients with metal-ceramic and full-cast
dentures without a protective and decorative coating
with trinitride showed minimal changes during wear 36
months after prosthesis placement. Complete cast
dentures protected with titanium trinitride and with a
decorative coating did not show significant changes,
but marginal changes in surface color were detected in
34.3% of cases.
American Journal Of Social Sciences And Humanity Research
157
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
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