Development of a forecast of the effectiveness of minimally invasive methods of treatment of carious lesions

Abstract

The representation of the system for assessing the level of invasiveness of dental treatment should be a polymodal structure with a defined vector direction of the sequences of stages of diagnosis, treatment and prognosis, the scalar significance of which should be justified by the data of previously conducted mathematical modeling and the significance of the identified statistical relationships. In essence, this system should be an algorithm of the treatment-diagnostic process, the relative prognostic efficiency of the implementation of the stages of which can be calculated using the appropriate statistical methods of analysis, and the relationship between the criteria is expressed by the regression function [1; 4]. Considering all of the above, it was advisable to develop a prognostic model of the effectiveness of the implementation of minimally invasive interventions during the treatment of carious pathology and its complications. The aim of the study is to develop a prognostic model of the effectiveness of minimally invasive interventions during the treatment of carious pathology and its complications. Materials and methods. When developing a forecast of the effectiveness of minimally invasive methods of treating carious lesions and their complications, an analysis of the component of the biological feasibility of the prognostic model of the effectiveness of the carious process treatment was carried out, a system of criteria for assessing the invasiveness of the treatment of the most common dental pathologies was implemented, the changes in the biomechanical parameters of teeth during classical operative and minimally invasive procedures were evaluated and compared treatment, a comparison of indicators of the clinical need for reduction of hard tissues according to the destruction index of the occlusal surface of the tooth and index of the depth of destruction of the crown part of the tooth indices was performed at the beginning of the preparation and after its completion. Results and discussion. The article describes the development of a prognostic model of the effectiveness of minimally invasive interventions during the treatment of caries pathology and its complications, as well as the results of a comparison of the effectiveness of the use of minimally invasive methods of treatment of initial caries in comparison with operative methods of intervention according to this model. According to the prognostic model of comparative effectiveness, it can be concluded that the use of minimally invasive methods of treatment of initial caries in comparison with operative methods of intervention was more appropriate according to the indicator of the relative risk of developing biological complications in the form of secondary caries, which was reduced by 1,75 times (р=0,5071); the level of excessive reduction of tissues according to the indicator of the ratio of differences between the actual amount of preparation and the size of the lesion according to the destruction index of the occlusal surface of the tooth index, which is reduced by 2,32 times (р=0,1); the level of excessive reduction of tissues according to the indicator of the ratio of the differences of the actual volume of the preparation to the size of the lesion according to the index of the depth of destruction of the crown part of the tooth, which is 1,99 times smaller (р=0,1). Conclusions. According to the prognostic model of comparative efficiency, it can be concluded that the use of minimally invasive methods of treatment of initial caries in comparison with operative methods of intervention was the same in terms of expediency, taking into account the indicator of the relative risk of developing biological complications in the form of damage to pulp tissues, which is similar to both the implementation of minimally invasive and classic protocols for the treatment of initial caries; as well as the level of time and material costs in terms of the calculated volumes of UOP is similar both in the implementation of minimally invasive and classical protocols for the treatment of initial caries.