RATIONALE FOR THE USE OF DORZALLY TILTED DISTAL ARTIFICIAL SUPPORTS FOR EXTENDED IMPLANT PROSTHESES IN ELDERLY PATIENTS

The subject of the research is implant prosthetics. The goal is to increase the efficiency of implant prosthetics by optimizing the design of the prosthesis. Methodology. 131 patients (57 men and 74 women) aged from 60 to 82 years (mean age 68.3 ± 7.3 years) were examined. The patients were divided into 3 groups: group 1 – 36 patients (14 men and 22 women with an average age of 70.1 ± 5.4 years) with vertical distal implants without dorsal weight; group 2 – 44 people (19 men, 25 women with an average age of 69.4 ± 7.2 years) with inclined distal implants without dorsal weight; group 3 – 51 people (24 men and 27 women with an average age of 68.4 ± 6.8 years) with inclined distal implants, which also carried the dorsal body of the prosthesis with unilateral support on them. The condition of the peri-implant bone was assessed using 16 criteria obtained using clinical and instrumental research methods. The study of the distributions and magnitude of elastic stresses in the peri-implant bone was carried out using mathematical modeling using finite elements. Results. Identical results were obtained for the reaction of the peri-implant bone and mucous membrane of the peri-implant cuff, as well as the levels of preservation of implants and implant prostheses in the long term (2–3 years) in patients with different configurations of the distal parts of extended implant prostheses. Mathematical modeling by the finite element method also showed the non-criticality of the distribution of elastic stresses in the prosthesis, distal implant, compact and cancellous bone with different configurations of the distal parts of the prosthesis. Conclusion. Inclined implants, including those with additional load in the form of a dorsal body with unilateral support, can be quite widely used in elderly patients.