Comparative evaluation of the efficiency of conducting individual and professional hygiene in prosthetics for dental implants

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Олимов A., & Хайдаров A. (2020). Comparative evaluation of the efficiency of conducting individual and professional hygiene in prosthetics for dental implants. in Library, 20(3), 862–868. извлечено от https://inlibrary.uz/index.php/archive/article/view/14289
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Аннотация

Under our supervision, there were 92 patients  with included and terminal defects of the dentition, who underwent prosthetics based on dental implants of the “DIO” system at the Department of Orthopedic Direction FPK TGSI Control  group  (13)  of  the  patient,  “manual  toothbrush”  -  during  the  entire  study period, patients used only a manual toothbrush to clean the crowns on implants; The  second  group  (30)  of  patients  who  were  prescribed  a  “manual  toothbrush  + interdental  brush”,  corresponding  to  the  size  of  the  proximal  space  of  the  orthopedic construction; The  third  group  (49)  of  patients  who  were  prescribed  a  “manual  toothbrush  + interdental  brush  +  irrigator”,  in  addition  to  a  manual  toothbrush,  were  prescribed  an interdental  brush  and  an  oral  irrigator,  an  irrigator  Waterpik  WP-660  (Aquarius)  was prescribed for the oral cavity after brushing teeth twice per day for 3-5 minutes, the power of the water jet of the irrigator corresponded to mode 2. An  index  assessment  of  the  amount  of  plaque  in  the  area  of  a  fixed  structure  on implants  was  carried  out  using  a  simplified  index  of  oral  hygiene  (IGR-U)  (J.  R. Vermillion, 1964) The condition of the gums in the area of dental implants was assessed based on the Gingival Index (GI) - Loe & Silness, 1963. Thus,  at  the  beginning  of  the  study  in  all  three  groups,  the  HI  was  low  and corresponded to good implant hygiene. After 3 and 6 months, the values of those indices were significantly worse, and corresponded to the unsatisfactory hygiene of the implants. In groups 2 and 3, throughout the entire study, HI indices were optimal and corresponded to good and satisfactory implant hygiene. The indicators of the 3rd group, in which the whole complex of individual and professional methods was applied, were the most positive throughout the study, in comparison with other groups. Analysis  of  the  results  of  the  Gingival  Index  study  showed  that  the  indicator increased in all observation groups. In  group  2  patients  using manual  dental  and  interdental  brushes  for  cleaning  the structure, by the end of the study period the index value increased to 0.95 ± 0.05 points, which corresponded to mild gingivitis of the gums in the area of implants, i.e. there was slight  hyperemia  and  individual  punctate  bleeding  of  the  gums  at  the  probing  sites. Patients of the 3rd group, using an irrigator, had minimal index values at all periods of the study,  and  the  index  values  were  interpreted  as  “normal  gums”,  that  is,  no  signs  of gingivitis were recorded.

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European Journal of Molecular & Clinical Medicine

ISSN 2515-8260 Volume 07, Issue 02, 2020

6273

Comparative Evaluation Of The Efficiency Of

Conducting Individual And Professional

Hygiene In Prosthetics For Dental Implants

Olimov V. Azim, Khaydarov M. Artur

Tashkent State Dental Institute Republic of Uzbekistan

Olimov A.B., Khaydarov A.M.

Tashkent State Dental Institute Republic of Uzbekistan


Under our supervision, there were 92 patients with included and terminal defects of the
dentition, who underwent prosthetics based on dental implants of the “DIO” system at the
Department of Orthopedic Direction FPK TGSI

Control group (13) of the patient, “manual toothbrush” - during the entire study

period, patients used only a manual toothbrush to clean the crowns on implants;

The second group (30) of patients who were prescribed a “manual toothbrush +

interdental brush”, corresponding to the size of the proximal space of the orthopedic
construction;

The third group (49) of patients who were prescribed a “manual toothbrush +

interdental brush + irrigator”, in addition to a manual toothbrush, were prescribed an
interdental brush and an oral irrigator, an irrigator Waterpik WP-660 (Aquarius) was
prescribed for the oral cavity after brushing teeth twice per day for 3-5 minutes, the power
of the water jet of the irrigator corresponded to mode 2.

An index assessment of the amount of plaque in the area of a fixed structure on

implants was carried out using a simplified index of oral hygiene (IGR-U) (J. R.
Vermillion, 1964)

The condition of the gums in the area of dental implants was assessed based on the

Gingival Index (GI) - Loe & Silness, 1963.

Thus, at the beginning of the study in all three groups, the HI was low and

corresponded to good implant hygiene. After 3 and 6 months, the values of those indices
were significantly worse, and corresponded to the unsatisfactory hygiene of the implants.
In groups 2 and 3, throughout the entire study, HI indices were optimal and corresponded
to good and satisfactory implant hygiene. The indicators of the 3rd group, in which the
whole complex of individual and professional methods was applied, were the most positive
throughout the study, in comparison with other groups.

Analysis of the results of the Gingival Index study showed that the indicator

increased in all observation groups.

In group 2 patients using manual dental and interdental brushes for cleaning the

structure, by the end of the study period the index value increased to 0.95 ± 0.05 points,
which corresponded to mild gingivitis of the gums in the area of implants, i.e. there was
slight hyperemia and individual punctate bleeding of the gums at the probing sites.
Patients of the 3rd group, using an irrigator, had minimal index values at all periods of the
study, and the index values were interpreted as “normal gums”, that is, no signs of
gingivitis were recorded.

Key words: implants, HI, ISP (the index of suprastructure plaque), ISC (the index of
supraconstruction calculus), irrigator, brush, gums, hyperemia.


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European Journal of Molecular & Clinical Medicine

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1.

Introduction

Dental implantation continues to be one of the most important areas among the priority
problems of dentistry in the modern world. The use of dental implants solves a significant
part of the problems in the case of partial and complete absence of teeth, plays a decisive role
in restoring the chewing function, helps in correcting and improving the aesthetics of the
dentition, smile and face as a whole [1,3,4,5,15].

Implants are in constant contact with various fluids in the oral cavity (oral, gingival),

food. In addition, the orthopedic construction on implants is a substance of accumulation of
microbial plaque, which, in turn, can be the source of the development of an inflammatory
reaction in the tissue surrounding the implant [6,9,14,16,17].

However, the lack of high-quality individual and professional oral hygiene leads to

inflammatory changes in the peri-implant tissues, such as peri-implantitis and mucositis, and
sometimes to the disintegration of the implant itself [1,2,7,11,12].

Therefore, high-quality, professional hygiene and the use of modern personal hygiene

products for the care of the oral cavity in general and for the orthopedic structure on implants
in particular is an important component of the success and longevity of this type of dental
treatment.

The objective of the study: assessment of the hygienic status of the oral cavity

depending on the methods used.

Material and research methods.
Under our supervision, there were 92 patients with included and terminal defects of the

dentition, who underwent prosthetics based on dental implants of the “DIO” system at the
department of orthopedic direction of the FPC TGSI. This system has an implant-abutment
connection in the form of a hex connection using a fixing screw.

The patients were divided into two groups by the method of fixed simple randomization

using a table of random numbers, depending on the prescribed treatment and prophylactic
complex. All groups were matched for gender and age.

The study was carried out 1, 3, 6 months after fixation of the orthopedic structure. Oral

consent was obtained from patients for the study.

Control group (13) of the patient, “manual toothbrush” - during the entire study period,

patients used only a manual toothbrush to clean the crowns on implants;

The second group (30) of patients who were prescribed a “manual toothbrush +

interdental brush”, corresponding to the size of the proximal space of the orthopedic
construction;

The third group (49) of patients who were prescribed a “manual toothbrush +

interdental brush + irrigator”, in addition to a manual toothbrush, were prescribed an
interdental brush and an oral irrigator, an irrigator Waterpik WP-660 (Aquarius) was
prescribed for the oral cavity after brushing teeth twice per day for 3-5 minutes, the power of
the water jet of the irrigator corresponded to mode 2.

All patients were trained in the method of teeth cleaning according to G.N. Pakhomova.

In order to achieve comparable results, patients used the same Colgate Total toothpaste
(Colgate-Palmolive) and a medium hardness prophylactic toothbrush Colgate 360 soft
massager. All patients underwent regular professional hygiene every 3 months, after fixation
of the structure according to the protocol for managing patients with dental implants.

The index assessment of the amount of plaque in the area of the fixed structure on the

implants was carried out using the simplified index of oral hygiene (IGR-U) (J. R.
Vermillion, 1964).


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Simplified Oral Hygiene Index (OHI-S) proposed by GreenJ.C., VermillionJ.R. (1964)

is a double index. The hygiene index of the supraconstruction supported on dental implants
was calculated by the formula: HI = ISP + ISC, where IPS is the index of suprastructure
plaque; ISC – the index of supraconstruction calculus.

The interpretation of the values of the hygiene index is given in table 1.

Table 1

Interpretation of hygiene index values

Hygiene index values

Hygiene Index Assessment

Oral hygiene assessment

0-0,6

Low

Good

0,7-1,6

Middle

Satisfactory

1,7-2,5

High

Unsatisfactory

>2,6

Very high

Bad

The index assessment of deposits was carried out visually on a 4-point scale in

accordance with the criteria: 0 points - no soft plaque; 1 point - intermittent approximal
deposits of soft plaque on the neck of the artificial crown of the prosthesis; 2 points - soft
plaque deposits covering the neck of the artificial crown of the prosthesis circularly; 3 points
- deposits of soft plaque covering the artificial neck on 1/3 of the surface of the crown of the
prosthesis. Plaque index was assessed on all artificial crowns supported by dental implants
and calculated by the formula:


Σ points
ISP (ISC) = -------------,
n

where Σ points is the sum of points according to the evaluation criteria; n is the number

of implant-supported crowns examined. The values of the soft dental plaque index of the
implants and the hard plaque index obtained separately were summed up, and the implant
hygiene index was calculated. The interpretation of the index was carried out according to the
following criteria: the IGS value from 0 to 0.6 corresponds to a low score; the HI value from
0.7 to 1.6 corresponds to the average HI score; HI value from 1.7 to 2.5 corresponds to a high
score; HI value> 2.5 corresponds to a very high estimate.

The condition of the gums in the area of dental implants was assessed on the basis of

the Gingival Index (GI) - Loe & Silness, 1963. To determine the index, the gums were
palpated with a blunt instrument and the implant-gingival sulcus was carefully probed with a
plastic probe. The assessment of the condition of the gums was carried out on a 4-point scale
at 4 points of the implant in accordance with the criteria: 0 points - normal gums, no
inflammation, no hyperemia; 1 point - slight inflammation of the gums - slight hyperemia,
slight edema, no bleeding; 2 points - average inflammation - hyperemia, edema, bleeding on
probing or palpation; 3 points - severe inflammation - severe hyperemia, edema, a tendency
to spontaneous bleeding.

The gingiva was examined in the area of all implant-supported crowns. The sum of the

scores near each implant was added up, divided into four (according to the number of
evaluated sites), and the index value of this implant was derived. After summing up all the GI
values and dividing by the number of implants, the average gingival GI value for this patient
was obtained according to the formula:


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European Journal of Molecular & Clinical Medicine

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GI teeth =

∑ points

Интерпретация:

4

0,1–1,0 — mild gingivitis;

1,1–2,0 — moderate gingivitis;

2,1–3,0 — severe gingivitis.




The

obtained results of the index

assessment were

processed in accordance with the

principles of medical statistics using the software package “Excel-7”, “Statistica 5.0” using
nonparametric methods for analyzing quantitative characteristics.

2.

Research results and their discussion

The data from the studies showed that in all three groups, regardless of the set of personal
hygiene products, 1 month after fixation of the orthopedic structure, the hygiene index score
was low, which showed good hygiene in the area of implants (Table 2).

At 3 and 6 months of the study, different amounts of plaque were observed in all three

observation groups. In the control group, 3 and 6 months after the fixation of the orthopedic
structure, IGSCs 1.2 and 1.7 were fixed, which corresponded to the average hygiene index
and satisfactory hygiene of the implants. At the same time, in patients of groups 2 and 3, the
indicator after 3 and 6 months was 0.8 and 1.6, and in the group where the entire set of
personal hygiene products was used, the values of the hygiene index were 0.6 and 1.0, which
corresponded to low assessments of hygiene and good hygiene of implants (table 2).

As can be seen from the data provided in Table 2, the hygiene in the area of implants

was also different depending on the personal hygiene products used.

Table 2

Hygiene index indicators in patients, depending on the hygiene methods used

Hygiene Index Values, Hygiene Index Assessment, HI

Group

Timing
1 month

3 months

6 months

Control

0.7 / low / good

1.2 / average / fair

1.7 / high / unsatisfactory

2 group

0.6 / low / good

0.8 / average / fair

1.6 / average / fair

3group

0.6 / low / good

0.6 / low / good

1.0 / average / fair


Thus, at the beginning of the study in all three groups, the HI was low and

corresponded to good implant hygiene. After 3 and 6 months, the values of those indices
were significantly worse, and corresponded to the unsatisfactory hygiene of the implants. In
groups 2 and 3, throughout the entire study, HI indices were optimal and corresponded to
good and satisfactory implant hygiene. The indicators of the 3rd group, in which the whole
complex of individual and professional methods was applied, were the most positive
throughout the study, in comparison with other groups.

Analysis of the results of the Gingival Index study showed that the indicator increased

in all observation groups.

GI individual =

GI teeth

n

teeth


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In patients of the 2nd group who use a manual dental and interdental brush to clean the

structure, by the end

During the study period, the index value increased to 0.95 ± 0.05 points, which

corresponded to mild gingivitis of the gums in the area of implants, i.e., there was slight
hyperemia and individual punctate bleeding of the gums at the probing sites. Patients of the
3rd group, using an irrigator, had minimal index values at all periods of the study, and the
index values were interpreted as “normal gums”, that is, no signs of gingivitis were recorded.
In patients of the 3rd group, after 6 months of functioning of the implants, the GI value did
not exceed 0.08 points, which was 92% lower than in the patients of the control group. In the
control group, the GI values in patients at the beginning of the study were insignificant, but
by the end of the study they reached 1.7 ± 0.05 points, which corresponded to moderate
gingivitis and was accompanied by mild hyperemia and pinpoint bleeding of the gums in the
area of implants. At the beginning of the study, patients of the 2nd group also did not show
any signs of gingival inflammation in the area of implants, however, after 3 and 6 months, the
values of the gingival index in the area of implants were 0.57 ± 0.05 and 1.2 ± 0.05 points
respectively. In general, in patients of the control and 2 st groups, despite regular professional
hygiene in the area of implants, there was a slight deterioration in the condition of the gums,
corresponding to gingivitis of moderate severity. Patients of the 3rd group showed a better
condition of the gums in the area of implants. In group 3, after 6 months, the state of the
gums, according to the interpretation of the gingival index, was defined as “no inflammation”
and significantly differed from the control group - by 92%.

3.

Conclusion

The performed index assessment allowed us to establish the relationship between the level of
dental hygiene and the hygienic state of the structure on the implants. The index score for the
implant area shows the absence of severe gingival inflammation and significant plaque
accumulation in the area of the implants in the first months of their operation. This is due to
the fact that it is, firstly, regularly conducted professional hygiene in the field of implants and
teeth, and secondly, individual hygiene measures carried out by the patient himself. The
inclusion of an oral irrigator in the home implant care kit has been particularly effective. The
use of an interdental brush has proven less effective in patients with an implant-supported
design. As shown by the data of the conducted index assessment, cleaning the structure with
a manual toothbrush alone does not provide sufficient implant hygiene. The use of an
irrigator in addition to the complex “manual dental + interdental brush” significantly
improves the quality of personal hygiene and ensures healthy gums and positive HI indicators
in the area of implants.

4.

References

1.

Akhmedov A.A., Rizaev Zh.A., Khaidarov A.M. Features of the composition of oral fluid
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p.

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Ilyasova S. R., Khaidarov A. M. Modern approaches to the use of composites of a fluid
consistency for aesthetic dental restoration // Problems of Biology and Medicine. - 2020.
No. 1 (116). - P.277-282.


background image

European Journal of Molecular & Clinical Medicine

ISSN 2515-8260 Volume 07, Issue 02, 2020

6278

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Muratova S.K., Khozhimetov A.A., Khaidarov A.M. Analysis of the peculiarities of the
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Khaidarov A.M., Rizaev E.A. The prevalence of periodontal diseases among children
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Аzim Olimov, Аrtur Khaydarov, Nusrat Akhmadaliev.

Quantitative Analysis of

Microbiota in Patients with Quantitative Analysis of Microbiota in Patients with
Orthopedic Structures on Dental Implants Using the Real-Time PCR Method
//International journal of pharmaceutical research 2020 р. 736-738

14.

Аrtur Khaydarov, Guzal Zamonova, Farangiz Bahramova. Тreatment of chronic
generalized gingivitis by the preparation «Stomatitis»// International conference science,
research, development philology, sociology and culturology. -Berlin 30-31.05.2018. -
р.195-197.

15.

Saodat Muratova , Artur Khaydarov, Nodira Shukurova The peculiarities of endothelial
dysfunction indicators in patients with chronic brain ischemia// International journal of
pharmaceutical research. -2020. -р.1725-1728

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Herbertus Spiekermann, Implantology. Color Atlas of Dental Medicine Implantology,
Thieme Medical Publishers, New York. 1995. 388 p.

17.

Khadjimetov A.A., Rizaev J.A., Khaydarov A.M., Nazarov Sh., Akramova A. The role
of vascular endothelium in the development of peri-implantitis in patients with
periodontitis with combined pathology of the cardiovascular system //Journal of research
in health science Volume 5-6 issue2020, р.53-65.

Библиографические ссылки

Akhmedov A.A., Rizaev Zh.A., Khaidarov A.M. Features of the composition of oral fluid glycoproteins in athletes of cyclic sports // Problems of Biology and Medicine. - 2020. -№2(118).-P.24-26.

Dudko AS Some aspects of hygienic care of dental implants // New in dentistry. - 1998. No. 3. -Vol. 63. -P.72-78.

Ivanov S. Yu., Kuzmina E. M., Bazikyan E. A., Gazhva S. O., Chuvilkin V. I., Bolshakov S. V. Oral hygiene during dental implantation // NGMA, Nizhny Novgorod. - 2003 38 P.

Ilyasova S. R., Khaidarov A. M. Modern approaches to the use of composites of a fluid consistency for aesthetic dental restoration // Problems of Biology and Medicine. - 2020. No. 1 (116).-P.277-282.

Muratova S.K., Khozhimetov A.A., Khaidarov A.M. Analysis of the peculiarities of the dental status and hemostasis indicators in patients with chronic cerebral ischemia // Problems of Biology and Medicine. - 2020. -№2 (118). - S.88-92.

Musin M.N. Oral hygiene during prosthetics using implants // Periodontology. - 2010. -No. 1.-Vol. 15.-P. 26-32.

Olimov A.B., Khaidarov A.M. Assessment of risk factors for the development of complications in dental implantation // Dentistry. - 2019. -№4 (77). - P. 88-90.

Olimov A.B., Khaidarov A.M., Olimzhonov K.Zh. Investigation of opportunistic microorganisms by PCR method in patients with orthopedic constructions on dental implants // Problems of Biology and Medicine. - 2020. -№1 (116). - P. 109-112.

Paraskevich V.L. Dental implantology. Foundations of theory and practice. Minsk: Unipress LLC. -2002. -364 p.

Khaidarov A.M., Zamonova G.Sh., Bakhromova F.N., Shorustamova G.T. et al. Treatment of chronic generalized periodontitis // Dentistry. - 2018. -№2 (71). - P.51-55.

Khaidarov A.M., Kamilov Kh.P. The need for periodontal treatment according to the CPITN index in patients with hypothyroidism // Med. magazine of Uzbekistan. -2010. No. 5.-P.49-51.

Khaidarov A.M., Rizaev E.A. The prevalence of periodontal diseases among children and adults living in cities with different environmental conditions // Medical Journal of Uzbekistan. - 2016. -№6. -FROM. 77-80.

Azim Olimov, Artur Khaydarov, Nusrat Akhmadaliev. Quantitative Analysis of Microbiota in Patients with Quantitative Analysis of Microbiota in Patients with Orthopedic Structures on Dental Implants Using the Real-Time PCR Method //International journal of pharmaceutical research 2020 p. 736-738

Artur Khaydarov, Guzal Zamonova, Farangiz Bahramova. Treatment of chronic generalized gingivitis by the preparation «Stomatitis»// International conference science, research, development philology, sociology and culturology. -Berlin 30-31.05.2018. -p.195-197.

Saodat Muratova , Artur Khaydarov, Nodira Shukurova The peculiarities of endothelial dysfunction indicators in patients with chronic brain ischemia// International journal of pharmaceutical research. -2020. -p. 1725-1728

Herbertus Spiekermann, Implantology. Color Atlas of Dental Medicine Implantology, Thieme Medical Publishers, New York. 1995. 388 p.

Khadjimetov A.A., Rizaev J.A., Khaydarov A.M., Nazarov Sh., Akramova A. The role of vascular endothelium in the development of peri-implantitis in patients with periodontitis with combined pathology of the cardiovascular system //Journal of research in health science Volume 5-6 issue2020, p.53-65.

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