COMPLICATIONS AND CLINICAL SIGNS AFTER THE USE OF REMOVABLE DENTAL PROSTHESES, AND MODERN TREATMENT METHODS

Abstract

Relevance of the topic. Removable dentures are a functional and aesthetic solution for fully or partially edentulous patients and occupy an important place in orthopaedic dentistry. However, their long-term use may lead to various complications such as damage to the oral mucosa, resorption of the alveolar ridge, stomatitis, fungal infections and disorders of taste and speech. Scientific sources describe these problems and present methods of preventing and treating them. Effectiveness is being increased through alternative methods: implant-supported dentures, antifungal treatment and digital denture fabrication technologies. An individual approach to hygiene, to the patient's general health and to risk factors is also of considerable importance. Research materials and methods: The study was conducted in the orthopaedic dentistry department of the university dental clinic. Eighty patients aged 45-75 (52 women, 28 men) who had been wearing removable dentures for at least two years took part. Clinical examination assessed inflammation, ulcers and hyperplasia of the mucosa; the fit and stability of the dentures were determined. Bone resorption and root pathologies were assessed by panoramic radiography. Microbiological samples were taken on Sabouraud medium to detect Candida infection. Taste and speech functions were studied using standard tests. Data were collected using the DOHIP-19 questionnaire and on hygiene habits. Patients in whom complications were detected were offered relining, antifungal therapy, soft lining materials or implant-based dentures. Research results: Among the 80 patients, denture-related complications were frequent: mucosal ulcers were found in 45%, hyperplasia in 32.5% and stomatitis in 50% of cases. Candida albicans was found on the dentures of 65% of patients, and in cases of stomatitis the CFU value was significantly higher (p<0.01). Impaired taste perception was recorded in 30% of patients and speech disorders in 28.8%. Relining/rebasing improved the fit of the dentures and reduced the number of pains and ulcers. Antifungal treatment gave a positive effect in 85% of cases. Soft lining reduced pain, while implant dentures improved chewing ability. Insufficient hygiene and long-term denture wear were found to be associated with stomatitis and bone resorption. Conclusion: This study shows that complications associated with the long-term use of removable dentures are widespread and depend on many factors. Fungal ulcers, hyperplasia, bone destruction, stomatitis and functional disorders are the main problems. These conditions are often aggravated by improper hygiene, long-term wear and faulty denture design. Modern treatment methods, namely soft liners, relining, antifungal therapy and implant-based dentures, considerably improve the condition of the patient. Statistical analyses identified a strong association between complications and hygiene and the age of the denture. Patient education, periodic examinations and the timely replacement of dentures are likewise of great importance. A comprehensive approach and the application of new technologies are necessary for long-term results.