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PROSTHETICS OF TEETH WITH SMALL DEFECTS WITH BRIDGES
Kuzieva Madina Abdusalimovna
Asian International University.
https://doi.org/10.5281/zenodo.15498147
Аbstract. Theterm "orthopedics" was proposed in 1741 by N. Andri (1658-1742), who
first named the specialty that deals with the study, prevention and treatment of persistent
deformities of the human div. Prosthetics has been known to man since ancient times. Indeed,
even long before our era, dental prosthetics were known, as evidenced by the findings of
excavations of ancient monuments, tombs and mounds. The theoretical richness of orthopedic
dentistry is extensive. It has ten basic theoretical principles: an orthopedic dentist should have a
higher medical education; prosthetics, elimination of deformities and anomalies are most
effectively performed only in orthopedic institute clinics and large orthopedic departments of
dental clinics; unity of various div systems: the disease of the maxillary system should be
considered taking into account the state of the entire div; prosthetics is a therapeutic and
preventive measure, based on a solid foundation of knowledge of the structure and function of
normal organs, pathology of organs and systems of the maxillofacial region; any prosthesis or
orthopedic device is considered as a therapeutic tool that has, in addition to therapeutic,
undesirable (side) effects; staging; completeness of treatment; complex therapy of various
diseases; prevention; deontology.
Key words: prosthetics, bridges, minor defects, crowns.
Most often, bridge prostheses are used to replace small and medium – sized included
defects, and less often-end ones. End defects can be replaced with bridge prostheses only with
one-sided support. As a rule, this type of defect is corrected by means of bridge structures, only
if there are contraindications to prosthetics with removable dentures. They can not be used for
periodontal diseases, low clinical crowns of teeth, borderline defects, pathological mobility. If
there is a contraindication and the doctor decides to use this type of orthopedic structure, you
should follow some rules:
1. Align occlusal ratios well.
2. The artificial tooth should not be wider than the premolar.
3. At least two teeth must be used for support.
For the use of bridge prosthesesследую-, the following clinical conditions are
contraindicated:
1.Defects of large extent bounded by teeth with different функциfunctionalональной
significance.
2. Defects limited distally by a tooth with abnormal mobility.
An equally important part of prosthetics is the choice of supporting teeth. Incorrect
evaluation of teeth intended for supports is one of the most common mistakes. In practice, this
leads to functional overload of the supporting teeth, and then to their removal. The correct choice
requires a thorough clinical and paraclinical examination. Obviously, in addition to standard
clinical indicators, it is necessary to take into account the type of bite, occlusal relationships in
the area of the defect, and the periodontal condition of existing teeth, especially those supporting
ортопедиorthopedic construction. The periodontal condition can be judged by the stability or
mobility of the teeth, the ratio of the clinical crown and root, the presence of fillings, and the
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color of the tooth. X-ray examinations are the main method for assessing the periodontal
condition of teeth. All teeth that were previously covered with artificial crowns, sealed, changed
in color, as well as in the presence of pathological erasability and changes in their position in the
dentition are subjected to radiography. Diagnostic models are used to study occlusal
relationships, which is also an integral part of treatment.
As for the biomechanics of bridge prostheses, they are complex orthopedic structures that
experience heavy loads during chewing and transfer them to the periodontal support teeth. The
main types of biomechanical structures that need to be taken into account when creating
prostheses are:
1. Biomechanics of a bridge prosthesis with bilateral support on premolars and molars.
2. Biomechanics of a bridge prosthesis with one-sided support.
3. Biomechanics of bridge prostheses based on the front teeth.
Clinical evaluation of bridges:
Bridges are medical devices and can be evaluated with a clinical position. In orthopedic
dentistryмо-, dental prostheses, despitethemany contraindications, are the most common
prostheticнcon-struction. And there are several reasons for this: first, they are not removable, and
this is a plus for the psychological state and mood of the patient, since they often worry about the
possibility of using removable dentures. Secondly, the patient adapts most quickly to bridge
prostheses, which is due to their small size and minimal contact with the mucous membrane,
with the exception of the gum edge. Third, this type of construction is characterized by good
functional properties: with their help, the complete restoration of masticatory function occurs,
they hold the created occlusal relations well. And fourthly, the advantage is their rather high
aesthetics, created thanks to modern clinical techniques and developed technologies.
However, the clinical picture of bridge prostheses is characterized not only by positive
qualities. There are also undesirable effects. Possible toxic and allergic effects in the oral cavity,
when creating an orthopetid prosthesis, it is necessary to prepare the supporting teeth. Dental
preparation, as shown by clinical and experimental studies [Gavrilov E. I., Pogodin V. S.,
Dzhumadillaev D. N., Postolaki I. I., Bolshakov G. V.], causes vascular disorders and changes in
the nerve elements of the pulp. In addition to vascular hyperemia, leukocyte infiltration is
observed – a phenomenon that indicates the expansion of раз- the pulp, its aspetic inflammation.
Another side effect is functional overload of the periodontal abutment teeth, since it is
impossible to completely exclude it. In addition, when prosthetics with bridge prostheses are
performed, the natural mobility of the tooth is restricted due to its inclusion in the splinting
system.
Do not forget about microcurrents that occur in the oral cavity in the presence of
prostheses made of various metals. Metals with different electrical, potentials immersed in
salivary fluid form a simple element. Microcurrents manifest clinical symptoms: a ме-
таллическийmetallic taste, darkening of the gold crowns, a burning sensation, a perversion of
taste, and chronic inflammation of the oral mucosa. According to other studies [Manaev V. G.,
Kopeikin V. N.], corrosion products of metals, including gold-based alloys, are important, which
can play the role of haptens and cause allergic reactions in the wearer of metal prostheses.
Conclusions:
When creating a bridge prosthesis, it is very important to take into account the
topography of the defect, that is, the teeth that limit the defect must have the same function – -
biting (for incisors whose periodontal fibers are oriented to the perception of vertical load) -
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chewing (for a group of lateral teeth whose periodontal fibers absorb both horizontal and vertical
load). As for canines, they can perform mixed functions, since their periodontal dampens both
types of load.
The size of clinical dental crowns should be medium or large to provide sufficient
support after preparation. The periodontist must have sufficient reserve forces. Bridge prostheses
are contraindicated for large included defects (loss of more than 3 teeth); end defects; when the
defecate is limited to teeth with different functional orientation; with low clinical crowns; with
deep traumatic bite; in the presence of deep and extensive carious cavities on the supporting
teeth; as well as for defects distally limited by a tooth with different functional orientation.
pathological mobility. Based on the clinical assessment, it can be concluded that today, this type
of prosthetics is one of the most relevant and most frequently used.
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