Relevance of the topic. Removable dentures are a functional and aesthetic solution for fully or partially edentulous patients and occupy an important place in orthopaedic dentistry. However, their long-term use may lead to various complications such as damage to the oral mucosa, resorption of the alveolar ridge, stomatitis, fungal infections and disorders of taste and speech. Scientific sources describe these problems and present methods of preventing and treating them. Effectiveness is being increased through alternative methods: implant-supported dentures, antifungal treatment and digital denture fabrication technologies. An individual approach to hygiene, to the patient‘s general health and to risk factors is also of considerable importance. Research materials and methods: The study was conducted in the orthopaedic dentistry department of the university dental clinic. Eighty patients aged 45-75 (52 women, 28 men) who had been wearing removable dentures for at least two years took part. Clinical examination assessed inflammation, ulcers and hyperplasia of the mucosa; the fit and stability of the dentures were determined. Bone resorption and root pathologies were assessed by panoramic radiography. Microbiological samples were taken on Sabouraud medium to detect Candida infection. Taste and speech functions were studied using standard tests. Data were collected using the DOHIP-19 questionnaire and on hygiene habits. Patients in whom complications were detected were offered relining, antifungal therapy, soft lining materials or implant-based dentures. Research results: Among the 80 patients, denture-related complications were frequent: mucosal ulcers were found in 45%, hyperplasia in 32.5% and stomatitis in 50% of cases. Candida albicans was found on the dentures of 65% of patients, and in cases of stomatitis the CFU value was significantly higher (p<0.01). Impaired taste perception was recorded in 30% of patients and speech disorders in 28.8%. Relining/rebasing improved the fit of the dentures and reduced the number of pains and ulcers. Antifungal treatment gave a positive effect in 85% of cases. Soft lining reduced pain, while implant dentures improved chewing ability. Insufficient hygiene and long-term denture wear were found to be associated with stomatitis and bone resorption. Conclusion: This study shows that complications associated with the long-term use of removable dentures are widespread and depend on many factors. Fungal ulcers, hyperplasia, bone destruction, stomatitis and functional disorders are the main problems. These conditions are often aggravated by improper hygiene, long-term wear and faulty denture design. Modern treatment methods, namely soft liners, relining, antifungal therapy and implant-based dentures, considerably improve the condition of the patient. Statistical analyses identified a strong association between complications and hygiene and the age of the denture. Patient education, periodic examinations and the timely replacement of dentures are likewise of great importance. A comprehensive approach and the application of new technologies are necessary for long-term results.
Актуальность. Съёмные протезы являются функциональным и эстетическим решением для пациентов с полной или частичной адентией и занимают важное место в ортопедической стоматологии. Однако длительное использование таких протезов может привести к различным осложнениям, таким как травмы слизистой оболочки, резорбция альвеолярного отростка, стоматит, грибковые инфекции, нарушения вкусового восприятия и речи. Научная литература освещает эти проблемы и предлагает методы их профилактики и лечения. Альтернативные подходы — протезы на имплантах, противогрибковая терапия и цифровые технологии изготовления протезов — повышают эффективность лечения. Кроме того, важное значение имеют соблюдение гигиены полости рта, общее состояние здоровья пациента и индивидуальный подход к факторам риска. Материалы и методы иследования. Исследование проводилось на кафедре ортопедической стоматологии университетской стоматологической клиники. В нём приняли участие 80 пациентов в возрасте от 45 до 75 лет (52 женщины и 28 мужчин), которые носили съёмные протезы не менее двух лет. В ходе клинического осмотра оценивались воспаление, язвы и гиперплазия слизистой оболочки, а также прилегание и стабильность протезов. Панорамные рентгеновские снимки использовались для оценки резорбции кости и патологий корней. Для выявления инфекции Candida проводился микробиологический посев на агаре Сабуро. Функции вкуса и речи оценивались с помощью стандартных тестов. Были собраны данные с использованием опросника DOHIP-19 и / информации о гигиенических привычках. Пациентам с осложнениями были предложены релайнинг, противогрибковая терапия, использование мягких прокладок или протезы на имплантах. Результаты исследования. Среди 80 пациентов осложнения, связанные с протезами, встречались часто: язвы слизистой оболочки — у 45%, гиперплазия — у 32,5%, стоматит — в 50% случаев. Кандида албинанс была обнаружена на протезах у 65% пациентов, при этом уровень КОЕ (колониеобразующих единиц) был значительно выше у пациентов со стоматитом (p
Mavzuning dolzarbligi. Olib qo‘yiluvchi protezlar to‘liq yoki qisman tishsiz bemorlar uchun funksional va estetik yechim bo‘lib, ortopedik stomatologiyada muhim o‘rin egallaydi. Biroq, ularning uzoq muddatli qo‘llanilishi og‘iz shilliq qavatida shikastlanish, alveolyar o‘siq rezorbsiyasi, stomatit, zamburug‘li infeksiyalar, ta‘m bilish va nutq buzilishlari kabi turli asoratlarga olib kelishi mumkin. Ilmiy manbalar bu muammolarni yoritib, ularni oldini olish va davolash usullarini taqdim etadi. Muqobil usullar – implantga tayanadigan protezlar, antifungal davolash va raqamli protez tayyorlash texnologiyalari orqali samaradorlik oshirilmoqda. Shuningdek, gigiyena, bemorning umumiy sog‘lig‘i va xavf omillariga individual yondashuv muhim ahamiyat kasb etadi. Tadqiqot materiallari va usullari: Tadqiqot universitet stomatologiya klinikasining ortopedik stomatologiya bo‘limida o‘tkazildi. 45–75 yoshdagi, kamida ikki yildan beri olib qo‘yiluvchi protez taqib yurgan 80 nafar bemor (52 ayol, 28 erkak) ishtirok etdi. Klinik tekshiruvda shilliq qavatdagi yallig‘lanish, yara va giperplaziya baholandi; protezning mosligi va barqarorligi aniqlandi. Panoram rentgen orqali suyak rezorbsiyasi va ildiz patologiyalari baholandi. Candida infeksiyasini aniqlash uchun Saburo muhitida mikrobiologik namuna olindi. Ta‘m bilish va nutq funktsiyalari standart testlar yordamida o‘rganildi. DOHIP-19 so‘rovnomasi va gigiyena odatlari haqida ma‘lumotlar to‘plandi. Asorat aniqlangan bemorlarga relining, antifungal terapiya, yumshoq qavat materiallari yoki implant asosidagi protezlar taklif qilindi. Tadqiqot natijalari: 80 nafar bemor orasida protezga oid asoratlar yuqori uchradi: shilliq qavat yaralari 45%, giperplaziya 32,5%, stomatit 50% hollarda aniqlandi. Candida albicans 65% bemor protezlarida topilib, stomatit holatlarida CFU ko‘rsatkichi sezilarli yuqori bo‘ldi (p