ENHANCING MANAGEMENT OF ORAL PATHOLOGIES INDUCED BY DIVERSE DENTAL PROSTHETIC DESIGNS

Аннотация

Dental prostheses—whether fixed, removable, or implant-supported—frequently precipitate complications in the oral cavity, particularly when improperly fitted or maintained. This article synthesizes current evidence on common prosthesis-related pathologies, including inflammatory papillary hyperplasia, epulis fissuratum, and peri-implant mucositis, and proposes a structured, evidence-based treatment paradigm. Emphasis is placed on interdisciplinary strategies involving precision prosthesis fabrication, optimized hygiene, biomaterial selection, andpatient education to improveoutcomes and prevent recurrence. Key words: Dental prostheses ,Oral pathologies, Inflammatory papillary hyperplasia , Epulis fissuratum,Peri-implant mucositis , Prosthesis-induced lesions , Oral rehabilitation , Prosthodonticcomplications Introduction. Dental prosthetic rehabilitation, while fundamentally aimed at restoring oral function, aesthetics, and masticatory efficiency, is not without its biological and biomechanical complications. Despite advances in prosthodontic materials and techniques, prosthesis-induced pathologies remain a significant clinical concern. Lesions such as inflammatory papillary hyperplasia, epulis fissuratum, and peri-implant mucositis represent common adverse outcomes that can compromise the integrity of the oral mucosa, diminish prosthesis longevity, and substantially impair patient quality of life. These conditions typically arise from a complex interplay of chronic mechanical irritation, microbial biofilm accumulation, and individual host response factors, including systemic comorbidities and immune function. As such, their incidence highlights the critical need for refined diagnostic algorithms, preventive prosthodontic protocols, and multimodal treatment strategies that address not only the symptomatic manifestations but also the underlying etiological mechanisms. A paradigm shift toward personalized, evidence-based prosthetic care is essential to mitigate these risks and enhance long-term clinical outcomes. Purpose of the study. The purpose of this study is to explore and enhance the clinical strategies used in the diagnosis, prevention, and treatment of oral pathologies resulting from various types of dental prostheses, including fixed, removable, and implant-supported restorations. Despite significant advancements in prosthodontic materials and design, prosthesis-induced conditions— such as inflammatory papillary hyperplasia, epulis fissuratum, and peri-implant mucositis— remain prevalent and can negatively affect oral health, prosthesis longevity, and patient quality oflife. http://www.internationaljournal.co.in/index.php/jasass 862 Volume 15Issue 06, June 2025 Impact factor: 2019: 4.679 2020: 5.015 2021: 5.436, 2022: 5.242, 2023: 6.995, 2024 7.75 Materials and methods. This investigation was designed as a prospective, longitudinal clinical study, incorporating both quantitative and qualitative methodologies to evaluate the prevalence, etiopathogenesis, and clinical outcomes of prosthesis-induced oral mucosal pathologies. The study was supplemented by a narrative synthesis of contemporary literature to contextualize clinical findings within current prosthodontic paradigms. Ethical clearance was obtained from the Institutional Review Board (IRB) and all procedures conformed to the ethical standards of the 2013 revision of the Declaration of Helsinki. A total of 60 participants (n = 60; age range: 35–75 years; mean age: 54.2 ± 9.6 years; 63.3% female, 36.7% male) were recruited from the Department of Prosthodontics and Oral Medicine, meeting strict inclusion criteria based on clinical and prosthodontic parameters. Clinically diagnosed soft tissue alterations associated with theuseoffixed, removable, orimplant-supported dental prostheses Minimumof6monthsof prosthesis usage Absence ofsystemic mucocutaneous disease (e.g., lupuserythematosus, oral lichen planus) Patientwillingness to comply withfollow-up and hygieneprotocol History ofrecent maxillofacial surgery or radiotherapy to thecraniofacial region Use of systemic immunosuppressants, corticosteroids, or chemotherapy within the past 12 months Presence of uncontrolled systemic conditions (e.g., uncontrolled diabetes mellitus, Sjögren's syndrome) Each patient underwent a standardized comprehensive intraoral and extraoral examination, performed by two calibrated examiners to ensure inter-rater reliability (κ > 0.85). Clinical parameters recorded included: Lesion location, dimension, morphology, and surfacecharacteristics Degreeoferythema, induration, pain (measured via10-point VisualAnalogueScale) Type, age, material, and fit oftheprosthesis Prosthesis adaptation was verified using pressure indicator paste and intraoral scanners (Trios 3Shape), and occlusal contacts were examined usingshimstock and articulating foil. Panoramic radiography was utilized for all subjects; CBCT imaging was reserved for implant- associated complications (n = 21) to assess crest