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International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5658996 

58 

  



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5658996 

59 

 

Art of Medicine International Medical Scientific journal 

 

Founder and Publisher Pascual Izquierdo-Egea 

Published science may 2021 year. Issued Quarterly. 

Internet address: http://artofmedicineimsj.us 

E-mail: info@artofmedicineimsj.us 

11931 Barlow Pl Philadelphia, PA 19116, USA +1 (929) 266-0862 

 

 
   

  



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5658996 

60 

PERIODONTAL STATE AND OPTIMIZATION OF PROSTHODONTIC 

DENTAL CARE IN HIV-INFECTED PATIENTS 

 

Anvar Alimov Center for the Development of Professional Qualifications of Medical 

Workers, Assistant at the Department of Dentistry 

Sunatullo Gaffarov Center for the Development of Professional Qualifications of 

Medical Workers, Professor, Head of the Department of Dentistry, Pediatric Dentistry 

and Orthodontics 

Alisher Alimov Center for the Development of Professional Qualifications of Medical 

Workers, Professor, Head of the Department of Dentistry The Republic of Uzbekistan 

 

Abstract Due to the fact that the provision of dental care to HIV-infected patients 

should be carried out with minimal invasive interventions, due to the high risk of 

transmission of the pathogen during manipulations, it seems very relevant to consider 

the issues of providing prosthetic dental therapy using modern materials that do not 

provide irritating, toxic and allergic effects  on the mucous membrane of the oral cavity, 

and also do not require additional preparation during the manufacture of prostheses, as 

well as overloading the abutment teeth. 

In this regard, based on the results of our research, preference was given to the 

manufacture of removable structures.  To replace dentition defects, «Ftorax» base plastic 

and «Vertex Thermo Sens» thermoplastic base material were used.  

When choosing the design of dentures in HIV-infected patients, the endurance of 

the periodontal teeth to loads was taken into accounts, which were determined using 

gnatodynamometric studies.  

When carrying out complex therapy, coupled with dental orthopedic therapy, 

there was a significant clinical improvement accompanied by normalization of both the 

general condition of patients and positive shifts in the dynamics of periodontal 

endurance to pressure.  

Keywords: HIV infection, periodontal condition, gnatodynamometry, orthopedic 

dental therapy. 

Introduction. Diseases of the oral cavity against the background of HIV infection 

have vivid manifestations, sometimes with an atypical nature of the course [2,3]. In 

patients with a reduced immune status, which include HIV-infected, there is a high 

probability of the simultaneous existence of several infections, including in the 

maxillofacial region, which significantly complicates the diagnosis of diseases.  

At the same time, periodontal diseases are one of the typical manifestations in 

patients infected with HIV, and one of the main reasons for premature tooth loss and 

destruction of the dentition [4]. 

Dental therapy of oral diseases in HIV-infected patients is complicated by the state 

of progressive immunodeficiency caused by HIV carriage against the background of 



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5658996 

61 

pressure from concomitant infections, massive use of antibiotics and other 

chemotherapeutic agents and has its own characteristics.  

HIV-associated patients are prescribed large doses of drugs, increase the duration 

of their use, and carry out targeted prophylactic administration [6, 7]. 

The success of dental treatment and prevention of secondary adentia, which is a 

consequence of caries and periodontal diseases, by replacing dentition defects with 

removable and fixed structures of dentures, depends on the correct preparation of the 

orthopedic treatment plan, on the choice of an adequate design of dentures and 

materials, on their hygienic state [1]   

However, analysis of the literature shows that the issues of providing prosthetic 

dental care to people living with HIV continue to remain little or almost unexplored. 

Meanwhile, scientific research in this area would make it possible to develop a 

tactic of approach to assessing the state of the oral cavity in HIV-infected patients and 

the peculiarities of the provision of dental, including orthopedic, care, starting with the 

solution of the issues of indications and contraindications to dental prosthetics, the 

timing of treatment, the choice  methods, designs, materials for the manufacture of 

dentures, as well as the features of oral care, dentures and tissues of the prosthetic bed 

[5].  

Objective of the study: optimization of orthopedic dental care in HIV-infected patients. 

The object of the study was HIV-infected patients.  The study included 67 patients 

aged 20 to 50 years and 14 volunteers aged 30 to 50 years, not infected with HIV.  We 

examined HIV-infected patients with III and IV stages of HIV who were registered and 

inpatient treatment at the Republican Center for the Fight against AIDS and at the 

Research Institute of Virology of the ANRUz. 

The examined 81 patients were divided into 3 groups:  

1-group of 14 patients not infected with HIV; 

2-group of 31 patients, HIV-infected with III stage of the disease; 

3-group of 36 patients, HIV-infected with stage IV disease. 

Results.  In HIV-infected patients in group 2, the following inflammatory 

periodontal diseases were revealed: gingivitis, including catarrhal – in 56.8% of patients.  

Periodontitis was observed in 18% of patients.  Mild periodontal inflammation in 

patients with HIV in group 2 was detected in 30.4% of patients, PI being 0.93 ± 0.25.  

Periodontitis of moderate severity (PI 1.89 ± 0.21) with pronounced destruction, 

confirmed by X-ray, was observed in 52.2% of patients.  Severe periodontitis was noted 

in 17.4% of the total number of patients with periodontitis.  PI in these cases was 2.41 ± 

0.26.  The average value of the periodontal index in this group of patients was 1.74 ± 

0.29.  The depth of clinical pockets averaged 5.8 mm, which corresponds to 3 points on 

the CPITN scale. 

Inflammatory periodontal diseases in patients with HIV in group 3 were presented 

as follows: gingivitis, including catarrhal, was observed in 61.4% of patients, 

necrotizing ulcers – in 6.3% of those examined.  A mild form of periodontal 



Art of Medicine           Volume-1 

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62 

inflammation was observed in 27.5% of patients, with a PI of 0.98 ± 0.27.  Moderate 

periodontitis (PI 2.1 ± 0.24) was observed in 52.3% of the examined patients.  Severe 

periodontitis was noted by us in 20.2% of cases, when the PI value was 2.8 ± 0.24.  The 

average value of the periodontal index was recorded at the level of 1.96 ± 0.23. 

The intensity of inflammatory periodontal diseases in the groups of HIV-infected 

patients was high compared to group I, which is primarily due to severe 

immunodeficiency.  Against the background of immunosuppression, destructive changes 

in the hard tissues of the teeth were also noted, which led to the formation of a large 

number of missing and destroyed teeth as a result of complicated caries, and this, in turn, 

contributed to the overload and disruption of periodontal trophism. 

The results of determining the endurance of the periodontium to loads (by the 

method of gnatodynamometry) showed that in patients with HIV infection in group 2, 

the difference in vertical stability between incisors and molars was 1.04 kg;  between 

incisors and canines and incisors and premolars – 1.99 and 1.49 kg, respectively (p≤0.05 

compared with intact periodontium). 

Against the background of severe immunodeficiency in patients with HIV in group 

3, significant disturbances in periodontal endurance were observed: the difference in 

vertical stability between incisors and molars was 0.82 kg;  between incisors and canines 

and incisors and premolars - 1.73 and 1.13 kg, respectively (p≤0.05 compared with 

intact periodontium). 

When studying the resistance of teeth to horizontal loads, a similar trend was 

found. In patients of group 1 in intact periodontium, the resistance of molars to 

horizontal loads exceeded that of incisors by 2.25 kg;  the corresponding excess in 

patients with HIV infection in group 2 was 0.3 kg, in patients in group 3 – 0.27 kg.  The 

difference in horizontal stability between incisors and canines and incisors and 

premolars is 1.0 and 0.95 kg in the intact periodontium, respectively;  a similar 

difference in patients in group 2 was 0.08 and 0.18 kg, in patients with HIV in group 3 – 

0.06 and 0.16 kg (p≤0.05 compared with intact periodontium). 

It is obvious that HIV infection leads to severe changes in the functional state of the 

periodontal complex, which is manifested by a sharp drop in the periodontal endurance 

to stress and loss of stress differentiation in different groups of teeth.  The leveling of 

gnathodynamometry indices in different groups of teeth indicates a decrease in the 

functional state of the periodontium. 

Due to the significant number of teeth destroyed as a result of the carious process 

and extracted teeth in HIV patients; there was an increase in the proportion of people 

with secondary edentulousness and needing prosthetics.  Moreover, in both groups of 

HIV-infected patients, the provision with prostheses was extremely low. 

The quality of the prostheses was at the same level.  On the day of examination, 

21.2% of HIV-infected patients needed fixed dental prosthetics (bridging).  In 

accordance with the size and localization of the dentition defect, 26 (78.8%) patients 

with HIV needed partial removable and removable dentures. 



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

10.5281/zenodo.5658996 

63 

So, after treatment, which included both pathogenetic and symptomatic therapy, 

including orthopedic treatment, the periodontal PI index was 0.87 ± 0.18 in the control 

group; in HIV-infected patients whose dentition defects were replaced with prostheses 

based on thermoplastic material «Ftorax» and «Vertex termo sens», PI was equal to 0.54 

± 0.15 (p≤0.01 compared with the data before treatment; p  ≤0.05 between groups). 

The obtained clinical and laboratory data on the state of the tissues of the prosthetic 

bed make it possible to recommend, for replacing defects in the dentition in people 

living with HIV, prostheses made of thermoplastic material «Vertex termo sens», as a 

method of choice, according to the results of our research, their use significantly 

increases the efficiency of performed activities. 

Thus, the planning of treatment for HIV-infected patients should be based on the 

joint work of all medical services, i.e.  Improvement of dental care should be carried out 

along the way of improving the quality of treatment of major dental diseases against the 

background of path genetically and symptomatically justified therapy. 

It should be noted that due to the fact that the provision of dental care to HIV-

infected patients should be carried out with minimal invasive interventions, due to the 

high risk of transmission of the pathogen during manipulations, it seems very relevant to 

consider the issue of providing orthopedic treatment using modern materials that do not 

provide irritation.  Toxic and allergic effects on the oral mucosa, as well as additional 

preparation and overloading of supporting teeth that do not require additional 

preparation during the manufacture of prostheses. 

  



Art of Medicine           Volume-1 

International Medical Scientific Journal        Issue-3 

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