Scientific and practical evidence of the efficacy of various dentures in orthopedic dentistry in HIV-positive patients

Background: Dental care in HIV-positive patients is a significant problem. The clinical course of the disease, particularly the high risk of infection, along with social and psychological stress, makes the diagnosis and treatment difficult. This necessitates specialized dental care, including the use of modern dentures that improve the functional status of periodontal tissues, increase the stability of masticating pressure, and consider etiopathogenetic mechanisms. Aim: To provide scientific and practical evidence of the efficacy of alternative denture designs in HIV-positive patients with specific clinical and morphological features of periodontal tissue and oral mucosa lesions. Methods: The study included 384 HIV-positive patients (treatment group, TG) and 258 control subjects (control group, CG) who were followed up at the Republican AIDS Center and its Bukhara branch. Of these, 134 TG patients (TG-1), including 68 TG patients (TG-2) and 66 reference group (RG) patients, as well as 38 CG patients, received orthopedic treatment using various types of dentures. TG-2a (n=33) received thermoplastic monomer-free Vertex ThermoSens dentures, whereas TG-2b (n= 5) received Vertex ThermoSens dentures with the Gluma Comfort Bond adhesive for surface treatment; RG-1 (n=32) received Ftorax acrylic plastic dentures, whereas RG-2 (n=34) received Ftorax acrylic plastic dentures with the Gluma Comfort Bond adhesive for surface treatment. CG patients received Vertex ThermoSens dentures. The study subjects were followed up for 12 months; clinical, dental, laboratory, functional, and histomorphological examinations were performed. Results: Taking into account the clinical features of oral lesions in HIV-positive patients, thermoplastic monomer-free Vertex ThermoSens dentures with the Gluma Comfort Bond adhesive were superior to Ftorax acrylic plastic dentures. However, considering the social and economic acceptability of Ftorax dentures, the use of the Gluma Comfort Bond adhesive is justified, eliminating the major shortcomings of currently used acrylic plastics. Conclusion: A treatment and prevention algorithm for dental restoration has been developed for HIV-positive patients. The algorithm involves treating Vertex ThermoSens and Ftorax dentures with the Gluma Comfort Bond adhesive, which reduces periodontal tissue inflammation and improves masticatory efficiency.