RU2529403C2 - Method for assessing hygienic state of removable dentures in partial adentia - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to preventive and orthopaedic dentistry, and can be used in assessing the hygienic state of the oral cavity in the patient with removable dentures suffering partial adentia. An inner surface of the denture is coloured. A graphic mesh is applied. It is photographed, and a denture hygienic state index is determined. The graphic mesh is applied with using templates enabling dividing the inner surface of the denture into two segments. The inner surface of the denture is photographed with using a camera with a focusing centre lying along a median palatine suture at a mid-distance between a maxillary frenulum and a distal edge of the for maxillary dentures and along the line drawn between central incisors in the middle between a mandibular frenulum and a posterior edge of the denture, for the mandibular dentures. The dental deposit is assessed in each segment as 0 to 4 by the 4-point system, while the hygiene index is calculated by formula.

EFFECT: by using set of templates, method enables assessing the hygienic state of any removable dentures with partial adentia.

1 tbl, 3 dwg, 1 ex

Description

The invention relates to medicine, namely to preventive and orthopedic dentistry, and can be used in assessing the hygienic condition of the oral cavity in patients with removable dentures with partial absence of teeth.

Currently, to restore the integrity of the dentition with a partial absence of teeth, the manufacture of dentures is widely used, while the requirement for further hygienic care for them, which should be carried out both within the framework of individual hygiene dental measures and with the help of professional dentists, is generally accepted. hygienist. The design features of dentures with partial absence of teeth, such as the possibility of extraction from the oral cavity, the presence of clasps or locks, the presence of additional retention points on the surface, contribute to the formation of plaque on the inner surface of such dentures and significantly complicates the maintenance of the optimal hygienic condition of dentures and the oral cavity as a whole. However, today there is a lack of methods for assessing the hygienic condition of removable dentures with partial absence of teeth. All the presented methods for assessing the hygienic condition of removable dentures are intended for patients with complete absence of teeth, while for patients with partial absence of teeth there are no such methods.

There is a method for assessing the hygienic condition of removable prostheses in the complete absence of teeth (S.S. Jeganathan, KTThong, V.Chan, MMSingh A climicaly viable index for quantifying denture plaque // Quintessence International (Berline), 1996, Vol. 27, No. 8, P.569-573), which consists in staining with an erythrosine solution of the inner surface of a removable prosthesis for 1 minute. Then the dye is washed off, the surface of the denture is dried and a visual assessment of the surface of the denture is performed. Assessment of the level of hygiene of the denture is determined depending on the ratio of the size of the painted parts of the surface of the denture to the total size of the inner surface of the denture.

The disadvantage of this method is the large inaccuracy in assessing the level of hygiene of removable dentures due to the exclusively visual assessment of the number of painted parts of the inner surface of the denture and, as a result, the low information content of this method.

The closest, according to the authors, analogue (prototype) is a method for determining the hygienic index used to assess the hygienic condition of removable dental orthopedic structures in the complete absence of PHI teeth ((Schubert R, Schubert U. The prosthesis hygiene index - a method for documentation and health education // Stomatol DDR. 1979 Jan; 29 (1): 29-31). This method stains for 5 minutes the inner surface of a removable denture in the complete absence of teeth, then the stain is washed off, the surface of the denture is dried and produced photographing the inner surface of the denture A graphic grid is applied to the resulting photograph, dividing the surface of the denture into segments, after which an index assessment of the hygienic condition of the denture is performed depending on the ratio of the stained segments to the total number of segments.

However, this diagnostic method is intended only to assess the hygienic condition of removable dental prostheses in the complete absence of teeth. The methodology does not describe the exact method for dividing the inner surface of the denture into segments, so this procedure can be carried out approximately, which can significantly reduce the accuracy of this method of assessing the hygienic condition of dentures.

An urgent task, as before, is to develop a method for determining and assessing the hygienic condition of removable dentures with partial absence of teeth.

The method for determining the hygienic condition of removable dentures with partial absence of teeth involves staining the inner surface of the denture, applying a graphic grid, photographing and determining the index of the hygienic state of the denture, while templates are used to obtain a graphic grid to divide the inner surface of the denture into equal segments, photographing the inner surface of the denture is carried out with a camera with a focus center along the middle palatine at the seam at the middle of the distance between the maxillary frenulum and the distal edge of the denture for the maxillary dentures and along the line drawn between the central incisors at the middle of the distance between the mandibular frenulum and the posterior edge of the denture, for the mandibular dentures, plaque coloring in each segment is evaluated by 4 -scale scheme from 0 to 4, and the value of the hygiene index is calculated by the formula

$$\underset{\left(x\right)}{\mathrm{AND}nde\mathrm{to}\mathrm{from}g\mathrm{and}g\mathrm{and}ens}=\frac{\mathrm{from}\mathrm{at}mm\mathrm{but}b\mathrm{but}l\mathrm{about}\mathrm{at}\mathrm{at}\mathrm{from}ex\mathrm{about}\mathrm{to}R\mathrm{but}wennsx\mathrm{from}egment\mathrm{about}\mathrm{at}}{\mathrm{about}buee\mathrm{to}\mathrm{about}l\mathrm{and}he\mathrm{from}t\mathrm{at}\mathrm{about}\mathrm{from}egment\mathrm{about}\mathrm{at}}$$

According to the proposed method for determining the hygienic condition of removable dentures with a partial absence of teeth, the inner surface of the denture is first stained with 5% erythrosine solution for 5 minutes in order to detect the presence of plaque, then rinsed with water for 5 seconds to remove excess dye and air-dried in within 10 seconds. A template of the required size with a graphic grid is placed on the inner surface of the denture.

Then, the inner surface of the denture with a graphic grid is photographed with a camera mounted on a tripod with a focus center along the middle palatine suture in the middle of the distance between the maxillary frenulum and the distal edge of the denture for maxillary dentures and along the line drawn between the central incisors in the middle of the distance between the mandibular frenulum and the posterior edge of the prosthesis, for mandibular dentures. The camera is positioned at an angle of 90 °.

Assessment of plaque staining in each segment is carried out according to a 4-point scheme from 0 to 4 and the hygiene index value is calculated using the ratio between the sum of the scores of all segments and the total number of segments

$$\underset{\left(x\right)}{\mathrm{AND}nde\mathrm{to}\mathrm{from}g\mathrm{and}g\mathrm{and}ens}=\frac{\mathrm{from}\mathrm{at}mm\mathrm{but}b\mathrm{but}l\mathrm{about}\mathrm{at}\mathrm{at}\mathrm{from}ex\mathrm{about}\mathrm{to}R\mathrm{but}wennsx\mathrm{from}egment\mathrm{about}\mathrm{at}}{\mathrm{about}buee\mathrm{to}\mathrm{about}l\mathrm{and}he\mathrm{from}t\mathrm{at}\mathrm{about}\mathrm{from}egment\mathrm{about}\mathrm{at}}$$

To obtain a graphic grid in the proposed method, templates are used that allow you to divide the image into equal segments. The templates are made of transparent flexible plastic and a graphic grid is applied to them, dividing the inner surface of the prosthetic bed into equal-sized segments. There are 6 different sizes of templates for maxillary removable dentures with partial absence of teeth and 6 sizes of templates for mandibular dentures (Table 1).

Table 1 The total area and the area of segments on templates with a graphic grid. Pattern No. Total area, cm ² . Upper jaw. Segment area, cm². Upper jaw. Total 2 area, cm ² . Lower jaw. Area 2 segments, cm ² . Lower
jaw. one 18.39 0.59 14,4 0.6 2 20.3 0.53 15.74 0.66 3 22.29 0.7 17.14 0.71 four 24.38 0.76 18.6 0.78 5 56.57 0.83 20.11 0.84 6 31.21 0.98 21.69 0.9

This allows you to use the proposed method for patients with any size of the jaw. Dividing the inner surface of dentures into equal segments makes it possible to accurately calculate the area of staining of plaque.

Assessment of plaque staining in each segment is carried out according to a 4-point scheme from 0 to 4:

0 - lack of staining;

1 - slight staining;

2 - coloring less than half the surface area of the segment;

3 - coloring more than half of the surface area of the segment;

4 - staining the entire surface of the segment.

The hygiene index value of a removable denture with partial absence of teeth is calculated using the ratio between the total score of all segments and the total number of segments

$$\underset{\left(x\right)}{\mathrm{AND}nde\mathrm{to}\mathrm{from}g\mathrm{and}g\mathrm{and}ens}=\frac{\mathrm{from}\mathrm{at}mm\mathrm{but}b\mathrm{but}l\mathrm{about}\mathrm{at}\mathrm{at}\mathrm{from}ex\mathrm{about}\mathrm{to}R\mathrm{but}wennsx\mathrm{from}egment\mathrm{about}\mathrm{at}}{\mathrm{about}buee\mathrm{to}\mathrm{about}l\mathrm{and}he\mathrm{from}t\mathrm{at}\mathrm{about}\mathrm{from}egment\mathrm{about}\mathrm{at}}$$

The results are evaluated as follows:

from 0 to 1.5 - an excellent level of hygiene;

from 1.5 to 2.5 - a satisfactory level of hygiene;

from 2.5 to 4.0 - unsatisfactory level of hygiene.

This allows you to get the most accurate and complete image of the inner surface of the denture.

Figure 1 presents a General view of the templates of all sizes with applied graphic grids. On figa shows patterns for maxillary removable dentures in the partial absence of teeth. Each template has a number from 1 to 6 with the letter "B". On figb shows patterns for mandibular removable dentures with partial absence of teeth. Each such template has a number from 1 to 6 with the letter "H". In addition, the templates indicate the total area (S _total ) of the inner surface of the denture and the area of one segment (S _segment ). The values of the total area (S _total ) and the area of segments (S _seg ) for all templates are given in Table 1 (p. 5). Figure 2 shows the separation of the inner surface of the maxillary fixed denture into segments to determine the hygiene index. Figure 3 shows the separation of the inner surface of the mandibular fixed denture into segments to determine the hygiene index.

The proposed method for determining the hygienic condition of removable dentures with partial absence of teeth allows us to assess the hygienic condition of removable dentures with great accuracy, using a whole set of templates makes it possible to apply this method for any type of removable dentures with partial loss of teeth. This allows you to get the most accurate and complete image of the inner surface of the denture.

Example: Patient A. applied to the periodontology department of a dental clinic to conduct professional oral hygiene measures.

After a clinical and X-ray examination, she was diagnosed with “generalized moderate periodontitis, complicated by secondary partial adentia”. A comprehensive treatment plan for periodontitis was drawn up, which contained the initial conduct of professional hygiene measures in the oral cavity and orthopedic dental structures.

To assess the hygienic state of the teeth and fixed orthopedic dental structures were used: the oral hygiene index IGR-U [OHI-S, Green JC, Vermillion JR, 1964], the thickness index of the dental plaque PI [Sillness J. Loe N., 1964] , API Approximate Tooth Surfaces Index [Lange DE, 1977], as well as the prevalence and intensity index of PI periodontal tissue lesions (Russel AL, 1956)

To assess the hygienic condition of the patient A. removable dentures, the proposed method was applied. The internal surfaces of partial removable dental prostheses were stained with 5% erythrosine solution, rinsed with water for 5 seconds to remove excess stain and dried with an air stream for 10 seconds. Then, for the upper jaw, a template with a graphic grid of 4 sizes was selected and superimposed. For the inner surface of the denture of the lower jaw, a template with graphic grid 3 was selected and applied. Painted surfaces with superimposed graphic grid were photographed with a camera (Nicon D90, Nicon Inc., Tokyo, Japan) at a 90-degree angle. The camera was mounted on a tripod (Slik Pro 340 DX, Testrite Inc., Newark, USA) with a focus center along the middle palatine suture in the middle of the distance between the maxillary frenulum and the distal edge of the denture (for maxillary dental prostheses), and along the line drawn between central incisors in the middle of the distance between the mandibular frenulum and the posterior edge of the prosthesis (for mandibular dental prostheses).

At the end of the photographing procedure, the colored plaque was removed using a toothbrush and liquid soap under running water. Then the dentures were returned to the patient.

Then, staining of the internal surfaces of the dentures in each segment was evaluated. The data obtained were entered into the calculation formulas, and the following values were calculated: 3.6 points for a maxillary denture and 3.2 points for a mandibular denture. Thus, the obtained values were interpreted as an unsatisfactory hygienic condition of both the maxillary and mandibular dentures.

Based on the data obtained, the scope of professional hygiene measures for patient A. was determined, the recommended algorithm for the patient to carry out individual dental hygiene measures was established, and a lesson was conducted with the patient in order to enhance motivation to maintain optimal hygiene of the oral cavity and orthopedic dental structures in the future.

Claims (1)

A method for determining the hygienic condition of removable dentures with partial absence of teeth, including staining the inner surface of the denture, applying a graphic grid, photographing and determining the index of the hygienic state of the denture, characterized in that templates are used to obtain a graphic grid to divide the internal surface of the denture into equal segments, photographing the inner surface of the denture is carried out with a camera with a focus center on a single palatine suture in the middle of the distance between the maxillary frenulum and the distal edge of the denture for the maxillary dentures and along the line drawn between the central incisors in the middle of the distance between the mandibular frenulum and the posterior edge of the denture for the mandibular dentures, plaque staining in each segment is assessed by 4-point scheme from 0 to 4, where 0 points are assigned in the absence of staining, 1 point - with slight staining, 2 points - coloring less than half the surface area segment, 3 points - staining more than half the surface area of the segment and 4 points - staining the entire surface of the segment, the hygiene index value is calculated by the formula

and with a hygiene index of 0 to 1.5, the level of hygiene is assessed as excellent, from 1.6 to 2.5 as satisfactory, from 2.6 to 4.0 as unsatisfactory.

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