Clinical effectiveness of fixed polymer prototype prostheses: a randomized controlled trial

Relevance. An analogous recording of occlusal relationships (articulating paper, foil, etc.) is not sufficiently informative for precise determination of occlusal forces and sequence, which is related to the large inaccuracy, labour intensity and lower predictability of prosthetic treatment results. Aim. The study aimed to evaluate the effectiveness of fixed polymer prototype dental bridges in patients with tooth-bounded edentulous spaces and occlusal defects.

Material and Methods. The randomized controlled study comprised two study groups: control (n = 21) and main (n = 21), which included the patients with tooth-bounded posterior missing teeth (second premolar and first molar). Prosthetic treatment corresponded to the conventional protocol in the control group. The main group had the missing teeth replaced with prototype prostheses and analogous-digital analysis of occlusal relationships. Intergroup effectiveness comparison rested on the integral occlusal score (IOS) data that considered scores received with T-scan 3 system (TekScan, USA). We also performed an intragroup comparative analysis of the periodontium condition around the abutment teeth using the Doppler ultrasound integral score (DUIS) at the stages before and after the treatment.

Results. The study did not reveal statistically significant differences between the values of IOS in the control and main study groups before the treatment (p > 0.05). At the followed treatment stages, control group IOS values significantly differed from those of the main group, namely, by 65.35 % (p < 0.05) just before the replacement of the provisional bridge by the final prosthesis; by 76.19 % (p < 0.05) immediately after the final prosthesis delivery; and by 65.94 % (p < 0.05) one week after the delivery of the final prosthesis. The Doppler ultrasound integral score values reflected the statistically significant positive changes in the study groups (p < 0.05).

Conclusion. Fixed polymer prototype prosthesis placement in patients with posterior tooth-bounded edentulous spaces and occlusal defects allowed us to increase prosthetic treatment effectiveness, improve microcirculation around abutment teeth, and harmonize the occlusion, decreasing the risk of possible damage to a ceramic bridge.

1. Arutyunov SD, Volkov EA, Kuzmichevskaya MV, Kholodov SV, Kuzina OV, Konoplya EE, editors. Prevention of caries. Moscow: MGMSU; 2003. 80 p. (In Russ.).

2. Dye BA. The global burden of oral disease: research and public health significance. Journal of dental research. 2017;96(4):361–363. doi: 10.1177/0022034517693567

3. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. Journal of dental research. 2014;93(11):1045–1053. doi: 10.1177/0022034514552491

4. Arutunov SD, Mayev IV, Romanenko NV, Surmayev EV. Features of a condition of periodontal tissues at the patients with a peptic ulcer of a duodenal intestine, associated with Helicobacter Pylori. Parodontologiya. 2005;36(3):30–33 (In Russ.). Available from: https://elibrary.ru/download/elibrary_9483519_58483712.pdf

5. Muslov SA, Lotkov AI, Arutyunov SD. Extrema of Elastic Properties of Cubic Crystals. Russian physics journal. 2019;62(8):1417–1427. doi: 10.1007/s11182-019-01859-w

6. Preetha A, Sujatha D, Patil BA, Hegde S. Oral manifestations in gastroesophageal reflux disease. General dentistry. 2015;63(3):e27–31.

7. Sato S, Slavicek R. The masticatory organ and stress management. International journal of stomatology & occlusion medicine. 2008;1(1):51–57. doi: 10.1007/S12548-008-0010-8

8. Slavicek R. Relationship between occlusion and temporomandibular disorders: implications for the gnathologist. American journal of orthodontics and dentofacial orthopedics. 2011;139(1):10-16. doi: 10.1016/j.ajodo.2010.11.011

9. Jaber AA, Alshame AM, Abdalla KO, Natarajan PM. The Association between Teeth Loss and Oral Health Problems. Indian journal of forensic medicine & toxicology.2021;15(1):1892–1902. Available from: file:///C:/Users/irakn/Downloads/TheAssociationbetweenTeethLossandOralHealthproblems9588.pdf

10. Javed MU, Asim MA, Fahimullah, Afreen Z, Afreen A, Khalil A. Association of tooth loss with temporomandibular disorders. Khyber medical university journal. 2020;12(1):29–33. doi: 10.35845/kmuj.2020.19658

11. Chiramana S, Dev RRJ, Banka M, Pssv S, Rao K, Chvn SK. Provisional Restoration in Prosthodontics: A Review. Journal of advanced medical and dental sciences research. 2019;7(5):46–51. Available from: http://jamdsr.com/uploadfiles/13ProvisionalRestorationinProsthodonticsvol7issue5pp46-51.20190613074319.pdf

12. Garg P, Ravi R, Ghalaut P. Outcome of Provisional Restorations on Basis of Materials and Techniques of Choice: A Systematic Review. EAS Journal of Dentistry and Oral Medicine. 2021;3(1):6–15. Available from: file:///C:/Users/irakn/Downloads/EASJDOM_31_6-15c.pdf

13. Maglad AS, Wassell RW, Barclay SC, Walls AW. Risk management in clinical practice. Part 3. Crowns and bridges. British dental journal. 2010;209(3):115–122. doi: 10.1038/sj.bdj.2010.675

14. Arutyunov SD, Chumachenko EN, Yanushevich OO, Lebedenko IY, Ignatieva DN, Losev FF, et al. The use of information technologies to choose rational dental prosthesis constructions. Russian journal of dentistry. 2010;14(3):19–22 (In Russ.).

15. Gaivoronskiy IV, Tscymbalystov AV, Gaivoronskaya MG, Voytyatskaya IV, Kopytov AA. Characteristics of form and size changes of the articular surfaces of temporomandibular joint in case of loss of teeth in an adult. Drug Invention Today. 2018;10(9):1602–1605. Available from: https://elibrary.ru/item.asp?id=35748071

16. Markov BP, Lebedenko IY, Erichev VV. Guide to practical classes in orthopedic dentistry. Part I. Moscow: VUNMC; 2001. 662 p. (In Russ.).

17. Dolgalev AA. Complex diagnostics of dentition occlusion disorders in patients with temporomandibular joint pathology. Journal of new medical technologies. 2008;15(2):226–227 (In Russ.). Available from: https://cyberleninka.ru/article/n/kompleksnaya-diagnostika-okklyuzionnyh-narusheniy-zubnyh-ryadov-unizhnechelyustnogo-sustava/viewer

18. Basson E, Kerstein R, Radke J. Ability to correctly select high force occlusal contacts from articulating paper markings. Advanced dental technologies & techniques. 2020;2(1):101–110. Available from: file:///C:/Users/irakn/Downloads/Abilitytocorrectly-selecthighforceocclusalcontactsfromarticulatingpapermarkings-Bassonetal-ADTTFeb2020.pdf

19. Kerstein RB, Radke J. Clinician accuracy when subjectively interpreting articulating paper markings. Cranio. 2014;32(1):13–23. doi: 10.1179/0886963413Z.0000000001

20. Koos B, Godt A, Schille C, Göz G. Precision of an instrumentation-based method of analyzing occlusion and its resulting distribution of forces in the dental arch. Journal of orofacial orthopedics/fortschritte der kieferorthopädie. 2010;71(6):403–410. doi: 10.1007/s00056-010-1023-7

21. Bozhkova T, Musurlieva N, Slavchev D. Comparative Study Qualitative and Quantitative Techniques in the Study of Occlusion. BioMed research international. 2021:1-9. doi: 10.1155/2021/1163874

22. Levchenko IM, Stepanov AG, Kirakosyan LG. Study of physical and mechanical properties of polymer materials used in additive manufacturing technology of dentures by 3D printing. Russian stomatology. 2020;(2):66–68 (In Russ.).

23. Arutyunov S, Krasheninnikov S, Levchenko I, Orjonikidze R, Sadovskaya N, Kirakosyan L, et al. Monitoring of changes in physicochemical and clinical characteristics of the dental polymer materials used in additive manufacturing of dental prostheses. Georgian Medical News. 2018;12(285):37–41. Available from: file:///C:/Users/irakn/Downloads/GMN2018N-12p.37-41.pdf

24. Arutyunov S, Kirakosyan L, Dubova L, Kharakh Y, Malginov N, Akhmedov G, et al. Microbial adhesion to dental polymers for conventional, computer-aided subtractive and additive manufacture: A comparative in vitro study. Journal of functional biomaterials. 2022;13(2):42. doi: 10.3390/jfb13020042

25. Cohen J. A power primer. Psychological bulletin. 1992;112(1):155–159. doi: 10.1037//0033-2909.112.1.155

26. Kharakh YN, Lezhnev DA, Malginov NN, Arutyunov SD. Analysis of geometry distortions on digital orthopantomograms. Radiology – practice. 2019;2(74):69– 77 (In Russ.). Available from: https://elibrary.ru/download/elibrary_41110239_50649087.pdf

27. Ryu JE, Kim YL, Kong HJ, Chang HS, Jung JH. Marginal and internal fit of 3D printed provisional crowns according to build directions. The journal of advanced prosthodontics. 2020;12(4):225–232. doi: 10.4047/jap.2020.12.4.225

28. Kerstein RB, Grundset K. Obtaining measurable bilateral simultaneous occlusal contacts with computeranalyzed and guided occlusal adjustments. Quintessence international. 2001;32(1):7–18.

29. Bondarchuk AV, Kharakh YN, Kirakosyan LG, Karpova VM, Arutyunov SD. Integral characteristics of Doppler ultrasound parameters in periodontal status assessment. Parodontologiya. 2022;27(2):126-133 (In Russ.). doi: 10.33925/1683-3759-2022-27-2-126-133

30. Levene H, editor. Robust Test for Equality of Variances. In: Contributions to probability and statistics: essays in honor of harold hotelling. California: Stanford University Press; 1960. 278–292 p.

31. Arutyunov SD, Beytan AV, Gevorkyan AA, Tsukor SV, Komov EV. Assessment of the quality of the edge fit of the fixed denture structure. The dental institute. 2006; 4(33):42–45 (In Russ.). Available from: https://elibrary.ru/download/elibrary_14343419_20026070.pdf

32. Krupnin AE, Kharakh YN, Kirakosyan LG, Zolotnitsky IV, Arutyunov SD. Numerical investigation of influence of defects of the dentition small extent on the stress-strain state of bridge prosthesis and periodontium. Russian journal of biomechanics. 2019;23(1):58-68. doi: 10.15593/RZhBiomeh/2019.1.06

33. Arutyunov SD, Zhulev EN, Volkov EA, Lebedenko AI, Glebova TE, Lebedenko IY, editors. Odontopreparation in the restoration of defects in the hard tissues of the teeth with tabs. Moscow: Molodaya gvardiya; 2017. 136 p. (In Russ.).

34. Kolesnikov LL, Arutyunov SD, Lebedenko IY, Bragin EA, Arutyunov AS, Antonik MM, editors. Anatomy and biomechanics of the dental system. Moscow: Prakticheskaya meditsina; 2007. 224 s. (In Russ.).

35. Derbabian K, Marzola R, Donovan TE, Cho GC, Arcidiacono A. The science of communicating the art of esthetic dentistry. Part II: Diagnostic provisional restorations. Journal of esthetic dentistry. 2000:12(5):238–247. doi: 10.1111/j.1708-8240.2000.tb00230.x

36. Gratton DG, Aquilino SA. Interim restorations. Dental clinics of North America. 2004;48(2):487–497. doi: 10.1016/j.cden.2003.12.007

37. Keys WF, Keirby N, Ricketts DNJ. Provisional Restorations – A permanent problem? Dental update. 2016;43(10):908–914. doi: 10.12968/denu.2016.43.10.908

38. Luo Q, Ding Q, Zhang L, Xie Q. Analyzing the occlusion variation of single posterior implant-supported fixed prostheses by using the T-scan system: A prospective 3-year follow-up study. The journal of prosthetic dentistry. 2020;123(1):79-84. doi: 10.1016/j.prosdent.2018.12.012

39. Kerdvongbundit V, Vongsavan N, Soo-Ampon S, Hasegawa A. Microcirculation and micromorphology of healthy and inflamed gingivae. Odontology. 2003;91(1):19–25. doi: 10.1007/s10266-003-0024-z

40. Arutiunov SD, Tsarev VN, Ippolitov EV, Apresian SV, Trefilov AG. Biofilm formation on temporary dentures: correlation of primary adhesion, coaggregation and colonization. Stomatology. 2012;91(5-1):5–10 (In Russ.). Available from: https://www.mediasphera.ru/issues/stomatologiya/2012/5/downloads/ru/030039-1735201252