RESUMO
OBJECTIVE: The main purpose of this article is to study the effect of a change in the dominant side of chewing after prosthetics with fixed structures on implants on the main indicators of osseointegration, adaptation to dentures, and the clinical dental status of patients. MATERIALS AND METHODS: In a clinical trial, an analysis was made of the adaptation of 64 patients to intraosseous implant-supported fixed dentures and 56 apparently healthy volunteers. The examination complex included determination of the functionally dominant side of chewing, gnathodynamometry and electromyography indicators of masticatory muscles, and radiological osseointegration criteria. The overall treatment outcomes were evaluated using a visual analogue scale and an objective medical questionnaire, "Prognosis of Adaptation to Orthopedic Structures." RESULTS: Patients were divided into two subgroups: with a change in the dominant side of chewing after completion of orthopaedic treatment (40 cases) and without a change in the dominant side of chewing (24 cases). In the second subgroup of patients, in contrast to the first subgroup, relatively better indicators of gnathodynamometer and electromyography were observed. So, in the first group, gnathodynamometry indicators on the dominant side were 255.7 N and in the second group 225 N after 9 to 12 months. Electromyography indices amounted to (198.5 µV s) to (166.3 µV s) after 9 to 12 months. Bone density remained at the required level, and overall treatment outcomes were higher. Namely, the compact plate of the alveolar ridge was preserved, and the condition of the bone tissue around the implants testified to stable osseointegration. The participation of surface masticatory muscles in adaptation of patients to intraosseous implant-supported fixed orthopaedic structures and the necessity and importance of changing the dominant chewing side for the general outcomes of orthopaedic treatment have been discussed. CONCLUSIONS: It has been established that a change in the functionally dominant chewing side is accompanied by relatively unstable indicators of chewing function, which is combined with increased loads on the installed prostheses during 3 to 6 months of adaptation. This must be taken into account when planning an individual patient adaptation complex for dental orthopaedic structures.
RESUMO
BACKGROUND: Clinical measures and implant design innovation to improve primary osseointegration and reduce the bacterial contamination of the peri-implant area are intended to reduce the incidence of late inflammatory complications in dental implantation. PURPOSE: To study the effect of nanostructured coating and antiseptic sealant on the outcomes of dental implantation. MATERIALS AND METHODS: Ninety-six individuals were clinically supervised. In the first group (Screw Ti + sealant), a special antiseptic sealant matrix was used; the same sealant was used with nanocoated implants in the second group (Nanocoat + sealant), and the conventional treatment protocol was used in the control group (Screw Ti). Patients were evaluated longitudinally during treatment and rehabilitation phases with clinical examinations, radiography, periodontal pathogen detection, and patient experience surveys. RESULTS: For patients who received a nanocoated implant and an antiseptic sealant (Nanocoat + sealant), relatively better hygienic indices were observed; there was less contamination with periodontal pathogens, bone density remained at the required level, and the overall results of treatment were better. CONCLUSIONS: Using a matrix for sealing the dental implant-abutment interface with a nanostructured surface provides reliable results regarding stable osseointegration and clinical and patient-reported outcomes of treatment success.