Complex treatment of prosthetic candidous stomatits

Background. The available information on the incidence of dental pathology began to show high values of indicators of the absence of teeth in different segments of the population of Ukraine and the population of other countries. Types of removable prostheses made of acrylic plastics are quite often used to restore partial and complete defects of the dentition. Now a lot of clinical experience has been accumulated from observing patients who use such prostheses. Removable lamellar acrylic prostheses are directly affected by oral fluid and microbiota of the oral cavity. The use of lamellar prostheses placed on a prosthetic bed can cause prosthetic stomatitis in 40–70% of patients. Acquired resistance of fungal flora is observed in chronic forms of candidal stomatitis. Purpose – of the work is to find clinical measures for the prevention and treatment of candidal stomatitis due to the impact on the surface of the base of a removable lamellar prosthesis to improve its biocompatibility with the oral cavity and effective therapy of such stomatitis. Materials and methods. Publications related to the management of the surface properties of acrylic removable plate prostheses and modern data on the treatment of candidal prosthetic stomatitis were studied and analyzed using the methods of comparative research. The properties of the surface of basic acrylic plastics that affect biocompatibility were studied: wetting angle, water absorption, changes in surface texture, on samples with uncompacted and compacted surfaces. Treatment of chronic candidal prosthetic stomatitis was carried out according to the recommendations of the Information sheet on innovations in the field of health care No. 42-2020 «Method of treatment of chronic candidal stomatitis» (Litovchenko I.Yu., Ilenko N.M., Petrushanko T.O., Nikolishina E.V., Marchenko A.V., UMSA, department of therapeutic dentistry, 2019). The results of the application of the «Method of treatment of chronic candidiasis stomatitis» were evaluated based on the dynamics of changes in patients’ complaints and the results of clinical observations: the degree of inflammation of the mucous membrane of the oral cavity was determined on a three-point scale by intravital glycogen staining of its epithelium according to Schiller-Pisarev. Results and their discussion. The analysis of the results of our research shows that vitrification of base plastics samples led to an improvement in the marginal wetting angle values. The differences in the values of the marginal wetting angle when examining samples with compacted and non-compacted surfaces are significant (p < 0.05). In non-vitrified samples from Ftorax, the values were 67.9 ± 5.7, in vitrified ones – 97.9 ± 7.1. In non-vitrified samples from Protokrilu-M, the values were 68.1 ± 4.5, in vitrified ones – 86.5 ± 6.4. We conducted studies of water absorption by samples of basic plastics throughout the year. The research results did not reveal a significant difference in the obtained data (p > 0.05), but showed that vitrification reduced the sorption capacity of compacted samples. In samples from Ftorax, water absorption was 1.95 ± 0.007% in uncompacted samples, and 1.83 ± 0.005% in compacted ones. In samples from Protacryl-M, water absorption was 2.68 ± 0.003% in uncompacted samples, and 2.23 ± 0.006% in compacted ones. Visual examination also revealed a significant improvement in the surface texture of compacted samples from Ftorax and Protacryl-M, but the obtained results cannot exclude the sorption capacity of base plastics using vitrification. A steady decrease in complaints was observed in the majority of patients, but the existing complaints did not change in three patients (7.9%), a significant improvement in the condition was noted by 10 patients (26.3%), the disappearance of complaints was observed in 25 examined (65.8%). In addition to the normalization of subjective data, an improvement of objective data was observed: hyperemia, swelling of the tissues of the prosthetic bed decreased. The degree of swelling and redness did not change in two people (5.3%), a significant improvement occurred in twelve (31.6%), normalization was observed in twenty-four (63.2%) of the examined. The dynamics of the results of the Schiller-Pysarev test had a similar character. At the end of the course of treatment, the value of the test results was: 3 points in 5.3% of people undergoing treatment, 2 points in 13.2%, 1 point in 18.3%, the test was negative in 63.2%. Conclusions. The results of the analysis of the clinical data obtained by us in the treatment of candidal prosthetic stomatitis by the method of treatment of chronic candidal stomatitis (Litovchenko I.Yu., Ilenko N.M., Petrushanko T.O., Nikolishina E.V., Marchenko A.V., UMSA, 2019 ) in patients who underwent sealing of the surface of prostheses by vitrification showed high efficiency of the complex application of the mentioned methods.