COMPREHENSIVE APPROACH TO DIAGNOSIS AND PROSTHETIC DENTAL TREATMENT OF PATIENTS WITH MENTAL DISORDERS

Abstract

Relevance. An assessment of psychiatric services in the Republic, including in the Bukhara region, was carried out. Problems were identified regarding the diagnosis and dental treatment of psychiatric patients, as this study population required specific approaches due to the presence of anxiety states. At the same time, a sociological, psychological, neurological, and dental evaluation of the cohort was conducted. It was established that unsatisfactory oral hygiene and poor periodontal tissue condition lead to the aggressive progression of carious lesions of the hard dental tissues and their complications. For the provision of qualified medical care to patients with mental disorders, individualized methods were developed for the diagnosis of musculoskeletal pathologies, as well as for the restoration of dental and dentoalveolar defects and deformities using high-quality materials manufactured with digital technology.

Aim of the Study. To improve diagnostic methods and dental treatment of patients with mental disorders through the use of effective materials, advanced techniques, and digital technologies for the fabrication of removable dentures in both outpatient and inpatient settings.

Materials and Methods. The study was based on retrospective and prospective data and included an assessment of the dental status of 850 patients with mental disorders (main group, MG) and 175 patients in the control group (CG) without psychiatric pathology, aged 18 to 70 years. In the entire study cohort, the neuropsychiatric status of patients was examined; the intensity of dental caries and its complications, the need for prosthetic treatment of the jaws, oral hygiene status, periodontal tissue condition, sensitivity of the oral mucosa, and the clinical condition of fabricated dental prostheses were evaluated.

Results. The retrospective analysis revealed high prevalence rates of psychiatric disorders, including schizophrenia – 4,455 cases; epilepsy – 1,790 cases; oligophrenia – 6,606 cases; and other forms of psychoses – 4,849 cases. Among these, 53% of patients were associated with psychiatric disorders due to disability, including 7,921 with group II disability, 609 with group I, and 125 with group III. Patients with mental disorders were characterized by a high intensity of dental caries (20.67 ± 0.82*), including the following subgroups: schizophrenia – 21.52 ± 0.98*; epilepsy – 22.86 ± 0.94*; oligophrenia – 19.64 ± 0.78*; and other psychiatric disorders – 18.66 ± 0.98*. In contrast, patients in the control group (CG) demonstrated significantly lower values – 11.44 ± 0.62, due to the greater number of carious and extracted teeth and high prosthetic needs ranging from 8.2 ± 0.48 to 9.4 ± 1.4. Periodontal disease prevalence reached 82%, while the risk of chronic oral sepsis was 13.3%. It was established that the application of the new clinical classification of TOR, its methods of identification, and the use of the Esthesiometer device improved diagnostic outcomes and enhanced the effectiveness, timing, and quality of prosthetic treatment, thereby determining the features of an individualized approach for this patient cohort.

Conclusion. Thus, patients with mental disorders are characterized by a high prevalence of dental caries, significant prosthetic treatment needs, and periodontal disease (82%), which is directly associated with an increased risk of chronic oral sepsis. The results of clinical, dental, neuropsychiatric, and sociological studies of oral fluid demonstrate the effectiveness of preventive measures for gingival papilla trauma, provide a highly informative classification of torus and oral mucosal pain sensitivity, and confirm the clinical utility of the Esthesiometer device for the diagnosis and treatment of both outpatient and inpatient conditions in patients with mental disorders.