Protetska rehabilitacija pacijenata s parodontitisom

master's thesis

• Title (english): Prosthetic rehabilitation of a patient with periodontal disease
• Author: Karlo Kežman
• Mentor: Davor Illeš (mentor)
• Committee member: Davor Illeš (predsjednik povjerenstva)
• Committee member: Ana Badovinac (član povjerenstva)
• Committee member: Ivan Puhar (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Removable Prosthodontics); Zagreb
• Defense date and country: 2019-09-27, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Parodontitis je široko rasprostranjena bolest koja zahvaća potporne strukture zuba, uzrokujući gubitak alveolarne potporne kosti, mobilnost zuba te njihov gubitak. Kako bi se prevenirali neuspjesi terapije, radi se pretprotetska priprema pacijenta koja između ostalog uključuje i parodontološku obradu. Ako je potrebno, provodi se inicijalna terapija te ponovni pregledi na kojima se utvrđuje smiruje li se bolest ili progredira. Tijekom oralne rehabilitacije, kliničar se susreće s dilemom treba li ostaviti zube koje je zahvatio uznapredovali parodontitis ili ih ekstrahirati. Kao terapija izbora, nudi se mogućnost stabilizacije takvih zuba koja se postiže fiksno-protetskim nadomjestcima. Stabilizacija zuba omogućuje lakše cijeljenje potpornim strukturama zuba, međutim, pri takvim se radovima uklanjaju i velike količine zdravih zubnih tkiva. Splintiranje mobilnih zuba omogućuje njihovu stabilizaciju djelujući poštednije od mostova na tvrda zubna tkiva. Uz besprijekornu oralnu higijenu i uz primjenu regenerativnih postupaka, moguće je potaknuti pozitivan odgovor tkiva na stvaranje izgubljenih potpornih struktura. U slučaju gubitka svih zuba, terapija izbora su implantati koji nadomještaju strukture izgubljene ekstrakcijom zuba. Pri njihovom postavljanju, posebna se pozornost daje parodontološkim aspektima zbog mogućnosti javljanja parodontne bolesti na njima, u vidu periimplantitisa. Implantati služe kao nosači pokrovnih proteza i pojačavaju njihovu retenciju. Za nadoknadu izgubljenih struktura, a s učinkom smanjenih troškova i povećanja ugode pacijenta, razvijeni su All-on-4® i Trefoil™ sustavi koji omogućuju imedijatno opterećenje implantata. Hibridna kombinacija povezivanja zuba i implantata djeluje stabilizacijski na mobilne zube, međutim, indikacija je za takve radove uska. U sklopu rada prikazan je slučaj oralne rehabilitacije pacijentice s uznapredovalom parodontitisom.

Abstract (english)

Periodontitis is a widespread disease which affects the supporting structures of the teeth, causing loss of alveolar bone, teeth mobility and teeth. In order to prevent therapy failure, pre-prosthetic preparation of the patient is performed, which, among others, includes, periodontal treatment. If it is required, the initial therapy and re-examinations are performed to determine whether the disease is stagnating or progressing. In oral rehabilitation, the clinician is faced with the dilemma to leave the teeth affected by advanced periodontitis or to extract them. The stabilization of such teeth is available as a therapy of choice, being achieved with fixed prosthetic restorations. The tooth stabilization makes it easier to heal the supporting structures of the tooth. Splinting mobile teeth enables their stabilization by acting more sparingly than bridges on hard dental tissues. With the impeccable oral hygiene and application of regenerative procedures, it is possible to stimulate a positive tissue response to the formation of lost supporting structures. In case of the loss of all teeth, therapy of choice is implants which replace structures lost due to tooth extraction. During the placement, special attention is given to periodontal aspects because of the possibility of periodontal disease in the form of peri-implantitis. Implants serve as support for implant-supported dentures and to enhance its retention. All-on-4® and Trefoil™ systems, which provide immediate implant loading, have been developed to compensate for lost structures and with the effect of reduced costs and increased patient comfort. The hybrid combination of tooth and implant bonding has a stabilizing effect on mobile teeth. This paper presents a case of oral rehabilitation of a patient with advanced periodontal disease.

• Keywords: parodontitis; implanto-protetika; fiksno-protetski nadomjestci; mostovi; oralna rehabilitacija; stabilizacija zuba
• Keywords (english): periodontitis; implant prosthodontics; fixed prosthetic restorations; bridges; oral rehabilitation; tooth stabilization
• Language: croatian
• URN:NBN: urn:nbn:hr:127:926937
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-01-16 11:34:28