MODERN ASPECTS OF CHOICE OF MATERIAL FOR ORTHOPEDIC TREATMENT OF PATIENTS IN NEED OF DENTAL PROSTHETICS

Аннотация

The most common structural material in removable prosthetics is acrylic plastic. However, it has a number of disadvantages: 1) residual monomer, which increases to 8% when the polymerization mode is violated, which causes local and general allergic reactions; 2) microporosity of acrylic plastic bases; 3) low strength of acrylic plastics. As an alternative to removable dentures made of acrylic plastics, new technologies for the manufacture of removable orthopedic structures from thermoplastic materials have appeared on the dental market. Their chemical structure is devoid of the main negative properties inherent in acrylic plastics, and their strength indicators are many times better. Thermoplastic materials used in dentistry are of 5 types: 1. polyoxymethylene 2. nylon 3. ethylene-vinyl acetate 4. acrylic 5. monomer-free Thus, the range of thermoplastic base masses, as an alternative method of prosthetics for people with intolerance to acrylic plastics, is quite large, which allows choosing the type of base material depending on the specific clinical situation. Key words: allergic history, removable dentures, acrylic plastics, thermoplastic materials. СОВРЕМЕННЫЕ АСПЕКТЫ ВЫБОРА МАТЕРИАЛА ДЛЯ ОРТОПЕДИЧЕСКОГО ЛЕЧЕНИЯ ПАЦИЕНТОВ, НУЖДАЮЩИХСЯ В ЗУБНОМ ПРОТЕЗИРОВАНИИ Аннотация. Наиболее распространенным конструкционным материалом в съемном протезировании является акриловая пластмасса. Однако она имеет ряд недостатков: 1) остаточный мономер, который при нарушении режима полимеризации увеличивается до 8%, что вызывает местные и общие аллергические реакции; 2) микропористость базисов акриловых пластмасс; 311 ResearchBib IF - 11.01, ISSN: 3030-3753, Valume 2 Issue 1 3) низкая прочность акриловых пластмасс. В качестве альтернативы съемным зубным протезам из акриловых пластмасс на стоматологическом рынке появились новые технологии изготовления съемных ортопедических конструкций из термопластичных материалов. Их химическая структура лишена основных отрицательных свойств, присущих акриловым пластмассам, а прочностные показатели во много раз лучше. Термопластичные материалы, используемые в стоматологии, бывают 5 видов: 1. полиоксиметилен 2. нейлон 3. этиленвинилацетат 4. акриловые 5. безмономерные Таким образом, ассортимент термопластичных базисных масс, как альтернативного метода протезирования для людей с непереносимостью акриловых пластмасс, достаточно велик, что позволяет выбирать вид базисного материала в зависимости от конкретной клинической ситуации. Ключевые слова: аллергический анамнез, съемные зубные протезы, акриловые пластмассы, термопластичные материалы. Orthopedic treatment of patients with complete or partial absence of teeth using removable dentures occupies a leading place in the clinic of orthopedic dentistry. However, it is extremely difficult in the presence of diseases of the oral mucosa due to intolerance to the materials used to make the bases of removable dentures. One of the reasons for this phenomenon in recent years is the increase in the number of patients with intolerance to drugs or with a history of allergic diseases. Due to insufficient information, lack of clear recommendations and practical skills, dentists avoid patients with a burdened allergy history. This is due to the danger of the negative impact of structural materials on the mucous membrane of the prosthetic field and on the patient's body as a whole. Therefore, the choice of structural material is made based not only on its physical and chemical characteristics, but also on the biological impact on the surrounding tissues of the oral cavity. The most common construction material in orthopedic dentistry is acrylic plastic. However, it can cause allergic reactions, manifested in the form of inflammation of the oral mucosa. The main etiological factor in the development of allergy to acrylate is considered to be the residual monomer contained in the plastic in the amount of 0.2%, which increases to 8% when the polymerization mode is violated. Plastics used in dentistry for orthopedic treatment are high- polymer organic compounds. They do not have a protein nature and therefore cannot cause allergies by themselves. 312 ResearchBib IF - 11.01, ISSN: 3030-3753, Valume 2 Issue 1 The monomer, methacrylic acid ester, is a low-molecular compound, i.e. it is a potential hapten, and when combined with body tissue proteins, it turns into an antigen. Its direct toxic effect on the cells of the oral mucosa, including mast cells and basophils, leads to non-specific release of histamine, which is capable of modulating the allergic response to the effects of causative allergens, thereby causing allergic contact dermatitis. It has been established that the monomer reduces the titer of lysozyme in saliva. The residual monomer washed out of the dentures, even in small quantities, affects the functional state of neutrophils in the oral cavity and suppresses their activity. According to some authors, the monomer is a protoplasmic poison, extremely acti