American Journal Of Social Sciences And Humanity Research
146
https://theusajournals.com/index.php/ajsshr
VOLUME
Vol.05 Issue05 2025
PAGE NO.
146-150
10.37547/ajsshr/Volume05Issue05-36
Changes in The Top of The Mouth When Using Non-
Removed Metal-Free Ceramics Prosthesis
Yakubova Sarvinoz Rakhmonkul Kizi
Samarkand State Medical University, Samarkand, Uzbekistan
Received:
28 March 2025;
Accepted:
24 April 2025;
Published:
26 May 2025
Abstract:
Measures to develop the medical profile system have become widespread in our country, in particular,
to reduce the number of dental patients and their complications, as well as to provide qualified medical care to
persons with this pathology and its changes. "...the purpose of expanding the mystery and guidelines for the
effectiveness of medical care is to study the pool of a healthy lifestyle and the study of methods of technology in
prevention, as well as the selection and support of patients, the use of standardization methods in medicine, the
introduction of ways to improve the effectiveness of models of patronage and medical examination.
Keywords:
Orthopedic, prosthetic structures, ceramic, fixed dentures, oral cavity.
Introduction:
It is noted that there is a certain
connection between metal dentures and various
pathological conditions of the mucous membrane.
Along with complications in the oral cavity, changes are
noted in other organs and systems. The relevance of
the pathogenesis of denture wear and the lack of
scientific research, the large number of patients
suffering from this phenomenon, the theoretical and
practical importance of further research on this
problem determined the choice of the topic of this
dissertation work.Purpose: to determine the changes
that occur in periodontal tissues, denture base and oral
mucosa before and after orthopedic treatment when
using metal-free ceramic dentures.
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 bonded dentures
with and without ZDP TT have a number of
technological shortcomings that manifest themselves
during wearing.
In addition, the development of electrochemical-
mechanical corrosion of metal prostheses leads to a
change in the color and gloss of the above-mentioned
places, which turns into extensive flatness defects that
penetrate deep into the prosthesis. The insufficient
service life of a stamped and, especially, stamped
welded prosthesis, due to the variety of materials in its
composition, leads to its perforation. Most often,
perforation is localized on the occlusal surface of a
pressed artificial coating - this is under the strong
influence of all possible destructive factors - the
mechanical action of chewed food, the aggressive
chemical action 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 pressed and pressed
welded structures, which leads to the weakening of the
above-mentioned alloy structure due to the
temperature or thermal processing of the alloy. The
technologically necessary temperature for the
application of ZDP TT is the material 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 by fusing the prosthesis parts. The fusing of the
American Journal Of Social Sciences And Humanity Research
147
https://theusajournals.com/index.php/ajsshr
American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
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 the cast and cast-welded prostheses
was detected starting from 6 months after the
prosthesis was inserted. For patients with CLPD, a
marginal change in the color and gloss of the surface of
the prostheses was observed in 11.4 and 22.9% of cases
after 6 and 12 months after the prosthesis was
inserted.
For the first time, in 8.8% of cases, we observed an
insulating change in the color and gloss of the surface
of the prostheses in patients with SC, which, in our
opinion, was caused by the incompatibility of the alloy
composition with which the electrochemical corrosion
process began. The presented data showed that the
composition of the cast and cast-welded prostheses
showed a destabilizing-degrading effect on the
structural materials, which is primarily due to the
chemical heterogeneity of the structures of the ZDP TT,
and secondly, due to the fact that the parts of the
prosthesis are brought into a single state. At the same
time, we found a wide range of color changes and the
absence of darkening of the surface of the ZDP; the
change in the marginal color and gloss was 28.6%. It
should be noted that in patients with fully cast
prostheses, the gloss and color changes of the metal
coating surface were not observed even after 36
months.
At the end of the study (36 months after the prosthesis
was placed), in the group of patients with CK, changes
in the color and gloss of the prosthesis surface were
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 also did not change,
but at the end of the study, changes in the color and
gloss of the coating surface occurred in 34.3% of cases.
The study results showed that 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, and in
the cast and cast-fused prostheses group, the
destruction process of the metal prosthetic material
began. The fact that the color and gloss of the TQ
prostheses did not change in the highly aggressive
environment of the oral cavity indicates their high
chemical and physical stability. On the other hand, the
high rate of prosthesis destruction in ZDP TT prostheses
indicates that they are not durable. In patients with TK
and CLDP prostheses, no gaps, holes, or erosions were
observed on the prosthesis surface throughout the
study.
The marginal adaptation of the veneers was
manifested in the appearance of a gap between the
edges of the artificial veneer and the tooth tissue,
through which the probe could penetrate. 6 months
after the prosthesis was placed, these changes were
typical for patients with CLDP and MC prosthetic
designs; 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 reason
for this movement is the escape of the edges of the
abutment teeth and 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
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 TKA does not differ from the
control group and is directly positively correlated with
the length of the defect in patients with KTY. Thus, at a
constant concentration of phosphates in the oral fluid
of patients with TKA, a slight increase in the
American Journal Of Social Sciences And Humanity Research
148
https://theusajournals.com/index.php/ajsshr
American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
concentration of Na, K, Ca, Mg, SG and Fe is observed,
and in patients with KTY, on the contrary, 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 occurring on the gingival
margin of the teeth. In our case, teeth covered with
artificial veneers, including those that are 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 margin of
the teeth. Thus, the prefabricated and prefabricated
bonded prosthetic designs with and without ZDP TT
have a significantly negative effect on the tissues of the
gingival margin of the teeth of the prosthetic bed.
The RMA indices for patients with CLDP and MC
dentures 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
dentures is explained by the effect of chemical
elements in the form of ions released from these
structures on the gingival tissues of the teeth. It should
be noted that the differences in the RMA index values
for CLDP dentures (26.95 ± 0.35%) confirm our previous
conclusion about the negative effect of the PDP TT
denture base on the gingival tissues of the teeth. .
The Russell index values for CLDP and MC prostheses
12 months after prosthesis placement 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 a
negligible effect of CLDP and MC coatings on
periodontal tissues. When examining the group of
patients with CKD, it was found that there were
moderate statistically significant changes in the
concentration of Na+ in the oral fluid. After 0.5 months
after prosthesis placement, the concentration of Na+
increased by 18.1 ± 0.3 mmol/l compared to the control
group (17.53 ± 0.32 mmol/l); After 1 month, it reached
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-up visits - 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 prosthetic
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 the SK, an average increase in K+ concentration was
observed, starting from 0.5 months after the 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 the 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. This fact, in our
opinion, may be associated with the damaging effect of
the SK prosthesis design on the marginal periodontium,
which leads to a progressive course of periodontitis.
After 0.5 months after the prosthesis was inserted, an
increase in the concentration of Mg2+ in the oral fluid
of patients with SC was observed from 0.32± 0.01
mmol/l (control group) to 0.37±0.01 mmol/l; after 1
month - an increase to 0.4±0.02 mmol/l; this
concentration does not change until 12 months after
the prosthesis was inserted, by 24 months the Mg
concentration increases to 0.43 ± 0.01 mmol/l and
remains at this level until the end of the study.
It was found that after 0.5 months of prosthesis
placement, patients had a slight increase in Fe3+
concentration in oral fluid - up to 24.55 ± 0.05 mmol/l
and remained at this level up to 36 months (control
19.5 ± 0.32 mmol/l). The tendency for a gradual
increase in Fe3+ concentration in oral fluid is probably
associated with the processes of mechanical and
electrochemical corrosion of the material of prosthetic
structures.
Протез қўйилгандан 0,5 ой ўтгач, хлоридларнинг
консентрацияси 31,85 ± 0,27 ммоль/л increased to
1.0, while the values of the control group were 25.43 ±
0.74 mmol/l and remained unchanged until the end of
the study. Such a significant increase in the
concentration of chlorides may be due to a parallel
increase in the concentration of sodium ions and the
presence of a direct positive correlation with the
concentration of these ions in the oral fluid [10].
In the study group, the concentration of phosphates
was 3.89 ± 0.04 mmol/l 1 month after the prosthesis
was inserted, while in the control group, similar
indicators were 3.48 ± 0.21 mmol/l and remained
unchanged until 24 months after the prosthesis was
inserted, when this value increased to 3.98 ± 0.02
mmol/l (control group 3.45 ± 0.02 mmol/l) and
remained unchanged until the end of the observation.
The TK prosthesis designs led to an increase in Na+
concentration to 18.23 ± 0.35 mmol/l (control - 16.22 ±
0.03) after 3 months, and then it remained unchanged
American Journal Of Social Sciences And Humanity Research
149
https://theusajournals.com/index.php/ajsshr
American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
at 16.52 ± 0.25 mmol/l from 12 to 36 months after
prosthesis placement. When comparing the results
obtained with the results of patients with CLPD, it is
possible to clearly note a smaller change in the
concentration of sodium ions in the oral fluid (from
16.82±0.21 mmol/l to 17.83±0.24 mmol/l after 36
months of prosthesis placement and from 16.85±0.23
mmol/l to 17.77±0.32 mmol/l after 1 month), which
allows us to speak about the protective and protective
effect of the ZDP TT. During the 36-month follow-up
period, we did not obtain statistically significant data
on the change in the concentration of Ca2+ and Mg ions
in patients with a TK denture design. In addition, during
the experiment, statistically significant data on changes
in the concentration of chlorides and phosphates in the
oral fluid of these patients during the entire
observation period were not obtained.
Coating of complete cast prosthetic structures with
titanium trinitride dust leads to a greater effect of such
prosthetic structures on the parameters of oral fluid
homeostasis compared to prostheses without ZDP TT -
an average increase in the concentration of Mg2+ and
phosphates in the oral fluid is observed (0.38 ± 0.02 and
3.8 ± 0.07).
CLDPs are characterized by the following changes:
- an increase in Na+ concentration from 0.5 months to
16.55 ± 0.22 mmol/l (control - 16.06 ± 0.16 mmol/l),
after 1 month - to 16.82 ± 0.21 mmol/l, after 3 months
- to 16.95 ± 0.24 mmol/l, after 6 months - to 17.12 ±
0.22 mmol/l, then the indicator begins to decrease and
after 36 months after the prosthesis is inserted, it is
equal to 16.85 ± 0.23 mmol/l, (Fig. 24);
- 0.5 months after the prosthesis was inserted, the K+
concentration increased to 18.42 ± 0.15 mmol/l
(control - 16.37 ± 0.23 mmol/l) and remained at this
level until 24 months after the prosthesis was inserted,
by 36 months an increase in the concentration to 18.57
± 0.41 mmol/l was observed.;
- From the 6th month of observation, a statistically
significant increase in the Ca2+ concentration was
observed to 1.87 ± 0.03 mmol/l (control - 1.77 ± 0.03
mmol/l), and 12 months after the prosthesis was
inserted, the concentration increased to 1.89 ± 0.02
mmol/l. Starting from the 24th month of observation,
the Ca2+ concentration began to decrease and at 36
months it reached 1.85 ± 0.03 mmol/l;
0.5 months after the prosthesis was inserted, the Mg~
concentration increased to 0.3 ± 0.01 mmol/l (control -
0.32 ± 0.07 mmol/l). These indicators remained
unchanged until the end of the observation period;
- during the experiment, we were unable to obtain
statistically reliable data on the change in the
concentration of chlorides in the oral fluid for this type
of prosthetic constructions during the 36-month
observation period.
- the concentration of phosphates begins to increase
from 0.5 months and reaches 3.78 ± 0.14 mmol/l
(control - 3.55 ± 0.07 mmol/l), at 3 months - 3.81 ± 0.15
mmol/l and a maximum of -3.85 ± 0.41 mmol/l after 12
months of prosthesis insertion, decreasing to 3.8 ± 0.21
mmol/l by 36 months after prosthesis insertion.
Analyzing the results obtained, it can be assumed that
the concentration of potassium ions in the oral fluid of
the examined group of patients is due only to the
presence of various prosthetic structures in the mouth
and is not related to the chemical elements of the
structural materials they secrete.
MK prostheses are characterized by the following
changes:
- the Na+ concentration in the oral fluid increases from
0.5 months to an average of 17.38 ± 0.27 mmol/l
(control - 16.06 ± 0.14 mmol/l); 1 month after the
prosthesis is inserted, it increases to 17.82 ± 0.52
mmol/l, and by 3 months the Na+ concentration
increases to 18.04 ± 0.25 mmol/l.
- the K+ concentration in this group changes after 0.5
months of observation and amounts to 17.98 ± 0.05
mmol/l (control - 16.37 ± 0.55 mmol/l) and remains at
this level for 36 months;
- Ca concentration 0.5 months after prosthesis
insertion is 2.24 ± 0.05 mmol/l (control - 1.76 ± 0.04
mmol/l); by 3 months it increases to 2.41 ± 0.03 mmol/l
and remains so until the end of the study. We believe
that the increase in Ca2+ concentration in the oral fluid
of patients with MC prosthesis indicates the release of
dental components of the enamel into the oral fluid, in
which the mass fraction of calcium exceeds 37% [3]; -
during the entire observation period, the Mg
concentration changed insignificantly and by 36
months was 0.36 ± 0.02 mmol/l (control - 0.32 ± 0.03
mmol/l); - 0.5 months after placing the prosthesis,
chloride concentration increased to 27.35 ± 0.15
mmol/l (control - 25.43 ± 0.57 mmol/l), after 1 month
it increased to 27.95 ± 0.23 mmol/l, after 3 months -
28.14 ± 0.59 mmol/l and remained at this level until the
end of the study;
- an increase in the concentration of phosphates in the
initial stages after prosthetics, after 0.5 months to 3.95
± 0.09 mmol/l (control 3.55 ± 0.04 mmol/l); After 1
month of prosthesis placement, the phosphate
concentration increased to 4.23 ± 0.05 mmol/l, after 3
months - to 4.51 ± 0.07 mmol/l, and after 6 months - to
4.59 ± 0.01 mmol/l, which remained at this level until
the end of the study. We attribute the dynamics of the
American Journal Of Social Sciences And Humanity Research
150
https://theusajournals.com/index.php/ajsshr
American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
increase in phosphate concentration to the release of
chlorides from the ceramic coating of MC prostheses
into the oral fluid;
The MC prosthesis designs led to an average increase
in the Fe3+ concentration in the oral fluid from 0.5
months after prosthesis implantation to 21.35 ± 0.31
mmol/l (control - 19.58 ± 0.14 mmol/l), after 1 month
the Fe3+ concentration was 22.34 ± 0.4 mmol/l and
remained at this level until the end of the study.
According to laboratory studies, the pH of the oral fluid
in patients with CKD decreases 3 months after
prosthesis implantation to 6.9 ± 0.08 (control - 7.22 ±
0.03), which is maintained throughout the study. A
similar decrease in the pH of the oral fluid was
observed in patients with CKD. At the same time, the
decrease in the pH value of the oral fluid occurred later
- 12 months after the prosthesis, and in patients with
CK, the pH began to decrease 0.5 months after the
prosthesis (7.05±0.02; control - 7.22±0.03) and after 12
months was 6.9 ± 0.02 and remained at this level until
the end of the study. In our opinion, this difference in
the dynamics of pH changes is due to the protective
effect of the ZDP TT, which prevents the release of
structural elements of the prosthesis into the oral fluid
within 6 months after the prosthesis is inserted.
Thus, CKs are characterized by moderate erosion, poor
marginal adaptation and a significant negative effect on
the periodontal tissues of the abutment teeth and a
moderate decrease in the pH of the oral fluid. This type
of prosthetic construction leads to a moderate increase
in the concentration of Na, Ca, Mg, SG and Fe and a
slight increase in the concentration of Fe and
phosphates.
Even in patients with CLDP prostheses, insignificant
wear, good marginal adaptation are observed, they
practically do not affect the periodontal tissues of the
abutment teeth, they slightly reduce the pH of the oral
fluid, without affecting the concentration of chlorides,
and slightly increase the concentration of Na, K, Ca, Mg,
phosphates and Fe.
In patients with MC dentures, which are practically not
worn much, have a good limiting device and do not
affect the periodontium of the abutment teeth, metal-
ceramic denture constructions moderately increase the
concentration of Ca and phosphates in the oral fluid,
and slightly increase the concentration of Na+, K+,
Mg2+, chlorides and Fe3+ ions. MC dentures increase
the pH value of the oral fluid, which is the only
prosthesis we have studied that has an alkalinization
effect on the oral fluid.
CONCLUSION
1. Dentures lead to a change in the acid-base balance
of the oral fluid, complete cast dentures without a
protective-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).
4. 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.
REFERENCES
Абдувакилов Ж.У., ЯкубоваС.Р., Балтабаев У.А. Тиш
протезларига
мослашиш
жараёнларида
биокимёвий курсаткичларнинг ахамияти //Доктор
ахборотномаси. –
2021. -
№4.
-
С.139
-144.
Gavkhar
Nuriddinovna
Indiaminova,
Tulkin
Elnazarovich Zoirov. (2021). Improvement of Methods
of Providing Dental Care for Children with Mental
Delayed Development. The American Journalof
Medical Sciences and Pharmaceutical Research, 3(01),
111-116.
G. N. Indiaminova, “Duration of orthodontic treatment
in patients with dental jaw anomalies with removal and
withoutremoval
of
separate
teeth”
журнал
биомедицины и практики №si
-2 (2020).
«Клиническая
оценка
состояния
протезных
конструкций у больных с
частичной адентией»
Якубова С.Р., Абдувакилов Ж.У. «Актуальные
проблемы детской стоматологии» 2021 Стр
-285-
290.
Шаныгина
Д.В.
Неинвазивные
методы
исследования
в
клинике
ортопедической
стоматологии / Д.В. Шаныгина, Г.В. Большаков, А.А.
Подколзин // Институт стоматологии.
- 2002. -
№ 3.
-
С. 46
-47.
Craig R.G. Dental materials / R.G. Craig, J.M. Powers,
J.C. Wataha.- London: Mosby, 2000. - 327p.
DrapalS. Биологическая совместимость дентальных
металлов / S. DrapalIIНовое в стоматологии.
- 2001. -
№2.
-
С.39
-48.
