Analysis of the Success of the Stages of Orthopedic Rehabilitation of Patients with Small Included Dentition Defects with Fixed Structures Supported by Dental Implants by Studying the Prevalence of Current Complications

Abstract

Abstract. The article is devoted to analyzing the success of dental implantation and the complications that arise during the orthopedic stage, specifically from obtaining an impression to fixing the finished orthopedic structure in the patient’s oral cavity. The impact of complications that occur at this stage on the quality of the final work and patient satisfaction is also investigated.
Objective: To assess the success of the stages of orthopedic rehabilitation of patients with minor dental defects with fixed structures supported by dental implants by studying the prevalence of ongoing complications.
Materials and methods. The success of the orthopedic restoration process with structures supported by one or two dental implants was assessed in 189 patients aged 18 to 45 years (108 women and 81 men) with Kennedy Class III dentition defects. Patients who received orthopedic structures supported by one or two dental implants with an 11-degree internal cone of the suprastructure were divided into two groups depending on the type of fixation: Group I—with screw fixation (108 patients) and Group II—with cement fixation (81 patients). The main manipulations during which complications could occur were analyzed: 1) at the stage of obtaining an impression (clinical), 2) at the stage of selecting the suprastructure (laboratory), and 3) at the stage of fixing the finished orthodontic structure in the patient’s oral cavity. After the fixation of the finished orthopedic structure, an analysis of patient satisfaction with the orthopedic structure was conducted using the Net Promoter System (NPS).
Results. When analyzing the study results, 109 (57.8%) patients did not experience any special problems or complications during the orthopedic stage; everything proceeded according to the protocol without any unusual occurrences. The remaining patients, namely 80 (42.2%), had problems at various orthopedic stages that could cause complications in the further functioning of the orthopedic structure. Analysis of complications that occurred during the stages of orthopedic restoration revealed that a problem was observed in 37.71% of patients in groups I and II (11.18% and 26.53%, respectively) during impression taking. At the stage of selecting the superstructure and manufacturing an artificial crown (in the laboratory), 34.7% of complications were observed in groups I and II, with rates of 6.13% and 28.57%, respectively. At the stage of fixing the finished orthopedic structure, complications occurred in 27 (27.61%). In the analysis of patient satisfaction, the NPS index in the screw fixation group was 75.6% among men and 70.49% among women. In the cement fixation group, the NPS index was 64.64% among men and 58.14% among women, indicating high satisfaction with this type of rehabilitation. The NPS index for patients with screw fixation was 12% better than for those with cement fixation. The difference in satisfaction with the service received between men and women was not significant and was within 5% in favor of men.
Conclusions. The results of the obtained studies indicate the relevance of this problem and determine the further direction of research, aiming to improve the quality of dental care with orthopedic structures supported by dental implants.
The analysis of the studies indicates a high prevalence of complications at the orthopedic stage of dental implantation in 42.2% of patients, which was more common with cement-type fixation in 28.5% of cases, compared to 13.7% with screw fixation. The highest frequency of complications was observed at the stage of obtaining an impression (37.71%) and when selecting a prosthetic component (34.7%). Despite this, the patient satisfaction index NPS was high in all patients and, with screw-type fixation, 12% higher compared to cement type.