Use of Elastic Substrates during Partial Removable Platform Prostheses in Patients with Asymmetrical Distal Unlimited Defects of the Dentures on the Background of Metabolic Syndrome Complicated with Sensory Peripheral Neuropathy

Abstract

Metabolic syndrome is recognized as a major public health issue worldwide, as it is a group of modifiable risk factors that increase the likelihood of developing cardiovascular diseases, type 2 diabetes, cognitive disorders, and sensory peripheral neuropathy. Metabolic syndrome causes notable changes in the organs of the oral cavity due to metabolic disturbances, chronic low-grade inflammation, hemodynamic issues, and microbiocenosis imbalance, leading to disruptions in the dentofacial system, significant morphofunctional changes in the craniomandibular region, and serious effects on the peripheral nervous system within the oral cavity. Therefore, it is crucial to explore methods to improve diagnosis and orthopedic rehabilitation of patients with metabolic syndrome to enhance prognosis and prosthetic outcomes.
Aim: To justify the use of elastic substrates during early prosthetics with partial removable plate dentures in patients with asymmetric distally unlimited dentition defects complicated by metabolic syndrome and sensory peripheral neuropathy.
Materials and methods. Electromyographic examinations were conducted on 16 patients with metabolic syndrome complicated by sensory peripheral neuropathy, presenting with distally unlimited asymmetric dentition defects (Kennedy class I–II), who received early orthopedic treatment with partial removable dentures. Electromyographic assessments were performed immediately before prosthetics and one month after fabricating the orthopedic structures, using the BioEMG III electromyograph (BioRESEARCH Associates, Inc., USA). The bioelectric activity of the temporal and masticatory muscles was measured during maximum voluntary contraction and chewing. Quantitative data on biopotential amplitudes and qualitative analysis of chewing cycles were obtained.
Results. Patients with metabolic syndrome and asymmetrical distally unlimited dentition defects exhibited a significant reduction in the biopotential amplitudes of masticatory muscles and notable asymmetry in bioelectric activity compared to the control group, both during maximum voluntary contraction and chewing. During chewing, there were significant differences in the size and duration of chewing cycles, with a reduced duration of rest periods. One month post-prosthetics, the bioelectric activity of the masticatory muscles showed improvement in both patient groups.
Conclusions. The high effectiveness of local clinical repositioning using an elastic substrate for successful rehabilitation in patients with asymmetric distally unlimited ­defects, particularly in the context of metabolic syndrome complicated by sensory ­peripheral neuropathy, has been demonstrated. This approach significantly shortens the adaptation period to new conditions during early orthopedic intervention.