DEVELOPMENT OF AN ORIGINAL REMOVABLE ORTHOPEDIC DISENGAGING CENTERING PROSTHESIS, IMPLEMENTED USING ADDITIVE TECHNOLOGIES

Objective. TImproving the effectiveness of the results of personalized complex rehabilitation of adult patients with a distal relationship of asymmetric integral dental arches using precision additive technologies for data transfer, design and manufacture of an original removable orthopedic disengaging centering prosthesis (RODCP). Methodology. A polymethyl methacrylate (PMMA) block was used to fabricate the internal part of the RODCP. Additive technologies were used, such as 3D scanning, 3D design and 3D milling, which made it possible to create a high-precision sandwich-like structure with uniformly thin walls of the parts and an individually designed occlusal relief. To reinforce the RODCP, a multi-strand orthodontic wire was applied to the internal part, which was then finally fixed by pulling in a vacuum former to fabricate the external part from a standard polyvinyl chloride plate. The production of the RODCP was completed by individual modeling of the occlusal relief by applying fast-hardening transparent plastic to the external part in an analog articulator. Results. The study showed that the use of additive technologies is appropriate for the creation of a removable orthopedic disengaging centering prosthesis (RODCP). The design includes an individually manufactured internal frame obtained by 3D milling and additional reinforcement with multi-strand wire. Conclusion. The use of 3D design and 3D milling for the manufacture of the inner part ensured the convenience of fitting, application, reliable fixation and stabilization of the prosthesis, and reinforcement with multi-core wire increased the mechanical strength of the structure. The use of the proposed prosthesis design, implemented using additive technologies, ensured smooth movements of the lower jaw during protrusion and laterotrusion with the tightest interdental contacts, made it possible to eliminate existing disocclusions in the lateral and anterior sections, restore the aesthetic center, successfully carry out subsequent orthodontic treatment of distal occlusion with abnormal shapes of dental arches during the period of permanent occlusion with devices of various manufacturing and fixation methods and ensured a stable and long-term positive result of complex rehabilitation in the retention period.