RESTORATION OF CORONAL PART IN CHEWING TEETH WITH SIGNIFICANT LOSS OF HARD TISSUES BY POST AND CORE CROWN

Abstract

The purpose of this study was to improve the quality of orthopedic treatment of hard dental tissues of chewing teeth destroyed below the level of the gums by a post and core crown using ashless modeling plastics. We examined 30 patients with severe destruction of the hard tissues of the crown portion of the teeth (IROPZ more than 80%) and concurrent periodontal diseases. A retrospective analysis revealed that teeth with deep subgingival defects restored by casts functioned as follows: for up to 1 year in 17 cases (14.2%), from 1 to 3 years in 36 cases (30.0%), from 3 to 5 years in 43 cases (35.8%), and for more than 5 years in 24 cases (20.0%). The results of a comparative evaluation of the effectiveness of tooth restoration with subgingival defects using ashless acrylic plastic "Modeplast" as a modeling material demonstrated the highest quality of such inserts, with most observed cases showing no signs of secondary caries. Complications, such as the dislodgement of metal inserts, were noted in 6.7% of cases, violation of marginal fit in 4.5%, and partial decementation of the structure in 8.3%. Incorrect positioning and suboptimal pin dimensions of the post and core crown occurred with approximately equal frequency: 3.5% and 3.2%, respectively. Destruction of the hard tissues of the tooth and caries relapse during restoration with metal inserts were noted in 13.3% and 29.1% of cases, respectively. Typical complications leading to tooth extraction included tooth root fractures (13.3%). The developed method of manufacturing post and core crowns using ashless acrylic plastic "Modeplast" at the modeling stage enables to gently remove tooth tissues and atraumatic fit of the post to the gums, prevents the accumulation of dental plaque and does not have a destructive effect on periodontal tissues.