Methods of the individual selection of dental structural metal alloys for the treatment of patients with teeth and dentition defects

Abstract

Pathological reactions of the body assoc iated with the development of a patient’s symptom complex of untolerance to metal alloys are some of the complications in prosthodontics. This work is aimed at optimizing the results of the individual selection of dental metal alloys for preventing the dev elopment of intolerance to orthopedic fixed structures. A survey was conducted with the participation of 73 patients (30 male s and 43 females) aged 22 to 70 years. They were divided into two groups. The first group included patients (n=31), who did not hav e orthopedic metal structures (control group). The second group consisted of patients (n=42) with stamped brazed metal orthopedic structures with a nitride titanium coating, as well as ceramic metal and metal plastic dentures. Various manifestations of int olerance to metal alloys were observed in all patients of this roup. A study was made of the electrical conductivity of biologically active points of the “lymphatic meridian state” and “head allergy” in patients with i ntolerance to metal orthopedic dental structures, based on the methods by V.Nakatani and R. Voll. Such denture construction materials as stainless steel 20Kh18N9T , cobalt chromium alloy “Vitalium” and nickel chromium alloy “Viron 88” were tested. It was revealed that when using the Vitalium alloy, the risk of individual hypersensitivity to dental structural metal alloys is the least. The survey results indicate the dominant role of concomitant pathology (92.85 %) in the development of “intolerance to structural metals” and demonstrate the form ation of an endless circle (concomitant pathology leads to the emergence of “intolerance”, which in turn worsens the course of somatic diseases). The development of “intolerance” when using combined constructions (me tal + ceramics) makes it difficult to co nduct differential diagnosis and, accordingly, treatment tactics. The analysis of the results shows the sufficient sensitivit y of electropuncture diagnostic methods in identifying intolerance to metal orthopedic structures. These methods make it possible to determine a patient’s predisposition to individual hypersensitivity to dental alloys, to identify the incompatibility of certain metals with a pati ent’s body, and to select the most compatible materials with regard to the role of concomitant pathology. T he conducted study allowed us to develop a two step algorithm of diagnostic measures for patients at risk of hypersensitivity to dental metal alloys.