A NEW APPROACH TO THE CHOICE OF TREATMENT OF DEFECTS OF HARD TISSUES OF TEETH

Objectives: to study the clinical effectiveness of the proposed algorithm for the treatment of patients with defects in the hard tissues of the teeth. Methods. To achieve this goal and test the effectiveness of the proposed algorithm, treatment and observation of 50 patients with defects of hard tissues of the teeth of different localization, who received dental treatment according to our proposed algorithm. During the examination of the patients, they first paid attention on the complaints related to previously made restorations. Surveys were conducted on the type of treatment and duration of the restoration. The restoration itself was carried out according to the modified USPHS method, attention was paid to the material from which it is made, the method of manufacture. Anatomical shape, marginal adaptation, surface roughness, marginal color, color matching, and discomfort or sensitivity were assessed to determine the quality of the restoration. We evaluated and divided cracks and fractures of teeth according to the AAE classification. Results. As a result of our research, we proposed the systematization of dental hard tissue defects LOV/DD and the algorithm for choosing the method of treatment of dental hard tissue defects, based on the systematization LOV/DD and can serve as a selection criterion in the treatment of this pathology. To test the effectiveness of the proposed algorithm, treatment and observation of 50 patients with defects of the hard tissues of the teeth of different localization, who underwent dental treatment according to our proposed algorithm. When evaluating the effectiveness of the proposed algorithm, after our treatment of patients, the percentage of successful treatment for 18 months was generally (96.0 ± 2.8)% according to USPHS criteria. Only in 2 clinical cases (4.0 ± 2.8)% these restorations needed to be replaced (with a Charlie score (C)). After analyzing the results of the study of complications, we noted that these patients did not have cases of different types of fractures or tooth loss. Our researches allow us to state that with the right choice of treatment for dental defects, the number of clinical situations with an unfavorable prognosis for such teeth (up to their loss) decreases. Thus, we can conclude that the proposed systematization fills the obvious gap in academic ideas about hard tissue defects, opens the prospect of reaching a consensus on differentiated diagnostic and therapeutic approaches in dental treatment of patients with this pathology and lays a methodological «bridge of continuity» between therapeutic and orthopedic methods of treatment in the field of treatment of defects of hard tissues of teeth. Conclusions. It is recommended to use the developed algorithm for selecting the method of treatment of defects of hard tissues of teeth when planning the orthopedic treatment of patients with defects of hard tissues of teeth, based on our proposed systematization LOV/DD. At defects 3/3, 3/4, 4/1, 4/2 it is expedient to use indirect restoration, at defects 4/3, 4/4 - artificial crowns, and in all other cases to carry out treatment by a method of direct restoration. According to the indicators of clinical and statistical research, the efficiency and advantages of the proposed algorithm for choosing the method of treatment of defects of dental hard tissues, based on our proposed systematization of LOV / DD, are proved.