Objective The aim of this study is to improve the safety and efficiency of prosthodontic treatment of patients with dental defects. It is necessary to perform a comprehensive assessment of the dentofacial system disorders, including the analysis of the features of pain manifestations. This study also supports to improve the efficiency of prosthodontic rehabilitation of patients with complete dental reconstruction on the basis of an assessment of the severity of orofacial pain manifestations. Materials and Methods The study was a single-site prospective open nonrandomized study with the examination and treatment of 452 patients (age = 44.3 ± 15.2 years, including 282 men and 170 women) with partial or total edentulism. The patients were divided into two groups: group 1 (control) of 218 patients treated with a standard prosthodontic approach and group 2 (study) of 234 patients treated which the proposed interdisciplinary approach to prosthodontic rehabilitation. Results  The study establishes higher safety and clinical efficiency of the proposed interdisciplinary approach. The patients undergoing full-mouth reconstruction with the use of the interdisciplinary approach demonstrated statistically significant decrease in the rate of pain in muscles of the maxillofacial area on palpation, pain, and spasms in the neck area, statistically significantly less frequent pains in the temporomandibular joint (TMJ) during chewing, pain during opening and closing the mouth. Conclusion The application of the developed comprehensive approach to prosthodontic rehabilitation planning makes it possible to improve essentially the results of treatment at the expense of reduction of pain manifestations in the area of maxillofacial muscles and pain sensations associated with functioning of the TMJ.

This case report involved the development of a rehabilitation system for patient with edentulism and an algorithm for diagnostic and therapeutic measures to be planned based on the patient’s individual anatomical and physiological features. The results of treatment and rehabilitation made it possible to achieve the optimal distribution of loads on the dentition. It was shown that it is necessary to analyze casts in an articulator to reproduce a three-dimensional model of mandibular movements taking into account the individual features of the patient to obtain a satisfactory assessment and treatment planning of patients with edentulism requiring full mouth reconstruction. This case confirms that the developed algorithm is anatomically and pathogenetically justified, as it considers all changes and interrelationships of structures of the dentition.

Aim: based on occlusion and temporomandibular health indicators, to improve clinical effectiveness of dental orthopedic treatment of patients with a need for a full mouth reconstruction. Materials and methods. A total of 647 patients with adentia and a need for a full mouth reconstruction received comprehensive examination and treatment. Patients were divided into 3 groups. Group 1 (n=218) was exposed to standard treatment procedures. Group 2 (n=195) received certain elements of the interdisciplinary approach to dental orthopedic rehabilitation. Group 3 (n=234) was exposed to interdisciplinary approach towards dental orthopedic rehabilitation. The follow-up period was 7 years. A key step in the treatment of group 3 patients was to conduct full patient examinations sequentially. The corresponding procedures were supplemented with tests for temporomandibular disorder and occlusal relationships. In treatment planning, the cause-and-effect relationships between this disorder and malocclusion were identified. Results. It was found that the use of the present proposal contributes to the normalization of occlusion. For instance, the occlusal index dropped 2.1-fold (relative to that in the comparison groups). The frequency of ICP manifestations decreased by 2.1 to 4.3 times, the protrusion frequency decreased by 12.2 to 22.3 times, and the bruxism frequency became 4.8 to 5.2 times lower. Furthermore, the frequency of left and right mediotrusion detection dropped by 3.2—4.3 and 3.8—4.4 times, respectively. The revealed changes were persistent, and a positive effect maintained throughout the follow-up. Conclusion. The interdisciplinary approach to the restoration of the anatomical shape of teeth should involve the assessment and correction of occlusal disturbances.

The subject ― is the total restoration of the dentition. The goal ― the study was aimed at evaluating clinical effectiveness of orthopedic dental treatment for patients requiring full-mouth rehabilitation on the basis of the functional state of the muscles in the maxillofacial area. Methodology. Within the research, a thorough examination and treatment of 647 patients with adentia requiring full-mouth rehabilitation were performed. Patients were distributed to three groups. The treatment of the first group (218 people) included standard orthopedic dentistry techniques. During the provision of medical care to the second group (195 people), several elements of an interdisciplinary approach to orthopedic dental rehabilitation were applied. In the third group (234 patients), only the multidisciplinary approach to orthopedic dental rehabilitation was proposed. The patient monitoring process was carried out for seven years. Results. It was discovered that the application of the integrated multidisciplinary approach contributes to the reduction of pain during palpation of the postural muscles and muscles of the maxillofacial area already in a year after the start of treatment. It was also remarked that the improvement of the temporomandibular joint (TMJ) condition during the implementation of the interdisciplinary approach manifested in significant improvement of several indicators. In particular, among patients lessening of pain in the joint area, better results of radiological diagnostics, condylography, electromyography, and retrusive stability were noted. Conclusions. As part of a set of measures to orthopedic dental rehabilitation of patients with adentia, it is necessary to assess the condition of the muscles in the maxillofacial area and the severity of TMJ dysfunction. The most important stage in the implementation of the proposed approach is a complete and consistent screening of patients requiring a full-mouth rehabilitation, with the addition of a clinical examination through radiation diagnostics, condylography, and electromyography.

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