Evaluation of quality of permanent teeth restorations in children of areas contaminated by heavy metal salts
AbstractThe influence of the environment on the child health is one of priority issues of the present time and it is of great social importance. Increased dental diseases associated with climatic and geographical characteristics of the area are widely discussed in the literature. The leading among them are environmentally determined dental diseases in children associated with geochemical and technogenic pollution of the area where they live. Increasing amounts of hard metal salts is the urgent hygienic problem, due to severity of their multi-element analysis in microsubjects, and negative influence on health of the children population, due to tropism, ability to cumulation, long biological life in the body and antagonism of heavy metal salts to the number of microelements. Influence of hard metal salts on dental diseases development is undeniable. Particular attention is paid to their influence on caries process and treatment peculiarities. Despite the fact that modern аdhesive dentistry in recent years has made a significant breakthrough in improving adhesive systems, correct choice of adhesive system depending on changes in the structure of hard tissue under geochemical contaminants (like heavy metal salts) is the most important step. It is the decisive factor for adaptation and connection of restoration with the restoration base. We should remember that on the way of adhesive system there is an altered structure preventing from deep penetration of such system and, consequently, leading to violation of restoration tightness. Therefore, early detection of complications by clinical evaluation of quality of the restorations is of great interest. Multi-vector approach to treatment of dental caries in children living in conditions of technogenic pollution by heavy metal salts is extremely urgent and important issue. Significant niche in this approach is given to adhesive preparation methods combined with local fluoridation, using fluoride medication of the new generation. One of them is Hluftored which promotes the formation of microcrystalline СаF2. Protocol of work with this new generation drug is based on the sequential precoating of enamel with magnesium-fluoride silicate, and then with suspension of high desperasible calcium hydroxide promoting formation of microcrystalline СаF2, magnesium and copper with the size of ~50Аº, leading to easy penetration of fluoride into pores of softening range. Moreover, microcrystals of CaF2 are protected by silicic acid gel from outwashing. Therefore, they release fluoride for a long period of time (over 1 year), which promotes remineralization and prevents complications of dental caries. This article includes the data regarding effectiveness of the Hluftored use in combination with various adhesive systems. Also, we show data of clinical quality assessment conducted for restoration procedures in children of different age groups and territories by using index of USPHS, after 6 and 18 months of carrying out such procedures. Clinical observations indicate the effectiveness of deep fluoridation and different adhesive systems in the complex of caries treatment in different age groups at present time and in future.
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