THE CONCEPT OF A COMPREHENSIVE PROGNOSTIC MODEL OF THE EFFECTIVENESS OF IMPLEMENTATION OF MINIMALLY INVASIVE INTERVENTIONS IN THE TREATMENT OF CARIOUS PATHOLOGY

  • S.B. Kostenko Uzhgorod National University, Uzhgorod, Ukraine
  • O.Ya. Bilynskyi Uzhgorod National University, Uzhgorod, Ukraine
  • G.N. Nakashydze Uzhgorod National University, Uzhgorod, Ukraine
  • M.O. Stetsyk Uzhgorod National University, Uzhgorod, Ukraine
  • M.Yu. Goncharuk-Khomyn Uzhgorod National University, Uzhgorod, Ukraine
  • I.V. Penzelyk Uzhgorod National University, Uzhgorod, Ukraine
Keywords: caries, iatrogenic interventions, minimally invasive concept, biological expediency, biomechanical expediency

Abstract

The research presents a prognostic model of the effectiveness of minimally invasive interventions in the dental patients’ treatment of carious pathology, which was developed to reduce the impact of iatrogenic interventions, increase the results of biological, biomechanical and financial feasibility of treatment.

The aim of research is to develop a mathematical representation of a comprehensive prognostic model of the minimally invasive treatment effectiveness of carious pathology.

Materials and methods of research. Comprehensive prognostic model of comparative efficiency of minimally invasive implementation of treatment protocols of carious pathology included consideration of relative risk indicators of biological complications (secondary caries and affected tissue pulp), decreased biomechanical forecast of the tooth (based on the performance index IROPZ and IHRKCHZ) and the financial feasibility of these methods, taking into account the ratio of material costs and unit labor intensity of the biological level and biomechanical forecast of the functioning of the dentition unit.

Results of the research. The factors were identified during the scientific research; it was provided that the volume of iatrogenic interventions in the dental patients’ treatment of caries can be minimized. The structure of a complex prognostic model of the effectiveness of realization minimally invasive methods of treating caries of hard tooth tissues was developed. A comparative assessment of the biological, biomechanical and financial feasibility of treatment of carious pathology depending on the depth of damage to the hard tissues of the tooth using classical (invasive) and mini-invasive methods of treatment was held. The study showed that the implementation of minimally invasive approaches to the treatment of carious pathology in terms of risk and complications in secondary destructive changes of dental hard tissues and pulp tissue damage contributes to the effectiveness of limited nuclear interventions with controlled enamel reduction and determination of connection of restoration with the bottom of the formed cavity. The highest biomechanical feasibility of minimally invasive dissection protocols has been established in the defects treatment within the enamel in order to minimize unreasonable enamel reduction and dentin tissues, carious cavities treatment at the border of medium-deep types of lesions to limit the caries spreading in the cavities deep localization in order to prevent the development of associated lesions of the pulp complex, which in terms of biological prognosis can provoke the development of irreversible changes.

Conclusion. As a result of scientific research and comparative analysis of the effectiveness of caries treatment by mini-invasive methods of intervention, the fact of improving the biological and biomechanical prognosis of the affected units of the dentition compared to the results of treatment of pathological lesions by surgery in accordance with classical protocols, confirming the developed complex prognostic model of efficiency of use of minimally invasive methods of treatment of carious pathology of dental patients. However, the creation of a unified comprehensive forecasting model, which would include the most complete reflection of all these criteria and was at the same time reliable, is impossible. Biological stacking relative risk indicators in the process of secondary development and pulpitis indicate the excess of minimally invasive treatment in all analyzed clinical cases, cases of initial treatment in relation to the risk of pulp production and cases in the center of caries relative to the risk of the previous year.

Downloads

Download data is not yet available.

References

1. Abrams SH, Sivagurunathan KS, Silvertown JD, Wong B, Hellen A, Mandelis A, & Amaechi BT. (2017). Correlation with Caries Lesion Depth of The Canary System, DIAGNOdent and ICDAS II. The Open Dentistry Journal, 11(1).

2. Banerjee A. (2013). Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and techniques. British dental journal, 214(3), 107.

3. Banerjee A, Frencken JE, Schwendicke F, & Innes NPT. (2017). Contemporary operative caries management: consensus recommendations on minimally invasive caries removal. British dental journal, 223(3), 215.

4. Da Mata C, Cronin M, O’Mahony D, McKenna G, Woods N, & Allen PF. (2015). Subjective impact of minimally invasive dentistry in the oral health of older patients. Clinical oral investigations, 19(3), 681-7.

5. Kostenko YY, Kostenko SB, & Havryleshko KI. (2015). Teoretychne obgruntuvannia vykorystannia ultrazvukovoi identyfikatsii osnovnykh stomatolohichnykh materialiv [Theoretical substantiation of the use of ultrasonic identification of basic dental materials]. Naukovyi visnyk Uzhhorodskoho universytetu. Seriia: Medytsyna - Scientific Bulletin of Uzhhorod University. Series: Medicine. 1, 198-205. (Ukrainian).

6. Iarhyn SV. (2013). Mynymalno-ynvazyvnaia stomatolohyia: voprosy orhanyzatsyy [Minimal-invasive dentistry: questions of organization] Hlavvrach - Chief Physician, 8, 3-7. (Russian).

7. Dorri M, Dunne SM, Walsh T, & Schwendicke F. (2015). Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth. The Cochrane Library.

8. Udod AA. & Remezov DV. (2013). Klynycheskye rezultatы mynymalno ynvazyvnoho lechenyia karyoznыkh porazhenyi zubov [Clinical results of minimally invasive treatment of carious lesions of the teeth]. Ukrainskyi stomatolohichnyi almanakh - Ukrainian Dental Almanac, 6. (Russian).

9. Green D, Mackenzie L, & Banerjee A. (2015). Minimally invasive long-term management of direct restorations: the ‘5 Rs’. Dental update, 42(5), 413-26.

10. Hamama HH, Yiu CK, & Burrow MF. (2015). Caries management: a journey between Black’s principals and minimally invasive concepts. Int J Dentistry Oral Sci, 2(8), 120-5.

11. Mackenzie L, & Banerjee A. (2014). The Minimally Invasive Management of Early Occlusal Caries: Ao Practical Guide. Primary dental journal, 3(2), 34-41.

12. Mackenzie L, & Banerjee A. (2017). Minimally invasive direct restorations: a practical guide. British dental journal, 223(3), 163.

13. Martin J, Fernandez E, Estay J, Gordan VV, Mjor IA, & Moncada G. (2013). Minimal invasive treatment for defective restorations: five-year results using sealants. Operative dentistry, 38(2), 125-33.

14. Holmgren CJ, Roux D, & Doméjean S. (2013). Minimal intervention dentistry: part 5. Atraumatic restorative treatment (ART)–a minimum intervention and minimally invasive approach for the management of dental caries. British dental journal, 214(1), 11.
Published
2021-06-29
How to Cite
Kostenko, S., Bilynskyi, O., Nakashydze, G., Stetsyk, M., Goncharuk-Khomyn, M., & Penzelyk, I. (2021). THE CONCEPT OF A COMPREHENSIVE PROGNOSTIC MODEL OF THE EFFECTIVENESS OF IMPLEMENTATION OF MINIMALLY INVASIVE INTERVENTIONS IN THE TREATMENT OF CARIOUS PATHOLOGY. Ukrainian Dental Almanac, (2), 27-33. https://doi.org/10.31718/2409-0255.2.2021.05
Section
THERAPEUTIC DENTISTRY