Neuromuscular rehabilitation of patients with prosthetics using digital and analog algorithms.

Abstract

Summary: Innovations in the field of digital orthopedic dentistry contribute to the growth of the quality of dental care for patients with dentition defects of various lengths and improve the ergonomics of the doctor’s work. In turn, operating with the latest technologies requires a thorough scientific study of not only the occlusal and articulating components of the human dentition and jaw apparatus, but also the analysis of neuromuscular structures, since they provide the adaptive mechanism of physiological functioning and getting used to rehabilitation orthopedic structures.

The aim of this study is to study and compare the nature and degree of changes in the electromyographic activity of the main and auxiliary masticatory muscles in patients with restored dentition defects during prosthetics using analog and digital methods.

Research materials and methods. The representative contingent of patients included 165 people in the age range of 18–60 years, of which 78 (47.3%) patients were male, 87 (52.7%) were female. To analyze the adaptive changes of the dento-maxillofacial apparatus, 1031 electromyograms were analyzed before prosthetics of patients and 6 months after prosthetics. Electromyographic research of masticatory muscles was performed using the BioEMG III computer complex (BioRESEARCH Associates, Inc., USA).

The results of the analysis of 1,031 unfolded (oscilloscope) electromyograms recorded during potentiated controlled load during voluntary chewing of the patient determined that 6 months after prosthetics with full controlled occlusal load in CG I patients, the functional capacity of the neuromuscular component of the OA was restored by 79.4%, in CG II patients, the functional capacity of the neuromuscular component of the SCA was restored by 58.9%, in patients of CG III, the functional capacity of the neuromuscular component of the SCA was restored by 89.3%, in patients of CG IV, the functional capacity of the neuromuscular component of the SCA was restored by 64.3%. This fact confirms the presence of modulation of the  activity of the central masticatory generator and shows nociceptive influences from the periphery and is a valid criterion for the correct choice of prosthetic design for the patient.

Conclusions. Prosthetics of patients with full controlled occlusal load using veneers and artificial crowns according to a digital protocol (pre-ceramics, zirconium dioxide) restores the functional capacity of the neuro-muscular component of OA by 79.4%; bridge-like structures made according to a digital protocol - by 89.3%. In patients who underwent prosthetics according to the analog protocol, this percentage of restoration of functional capacity was 58.9% and 64.3%, respectively. This fact allows us to assert the priority of choosing the method of treatment of patients with defects of dental rows and teeth using the digital protocol method.