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International Medical Scientific Journal       Issue-2 

10.5281/zenodo.5533441 

125 

    



Art of Medicine           Volume-1 

International Medical Scientific Journal       Issue-2 

10.5281/zenodo.5533441 

126 

 

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 

 

 
  



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International Medical Scientific Journal       Issue-2 

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127 

Clinical and radiological assessment of the dental implantation technique in 

patients with complete absence of teeth using the DICOM program. 

Dustmatov J.E.
1
, Makhkamova F.T.

2
, Gulyamov S.S.

2 

1- Tashkent State Dental Institute 

2- Tashkent Pediatric Medical Institute 

Corresponding author: pulatabilov1985@mail.ru 

Abstract. According to data from various regions of Uzbekistan, patients with 

a complete absence of teeth (POD) are encountered for the first time in the 45-49 age 

group. By 2020, the number of patients with POI in Uzbekistan will exceed 15 

million people, and then among our adult fellow citizens every five years, this 
number is expected to increase by 3-5%.During follow-up (6-18 months) after 

prosthetics, signs of peri-implant mucositis in the form of hyperemia, edema were 

observed in the area of 4 out of 100 (4.00%). Such patients were prescribed Traumeel 
S. During the study of suppuration, the presence of ulcerations, fistulas, pain was not 

noticed, and complaints of these manifestations were absent, the phenomena of 

mucositis could be quickly stopped. No cases of peri-implantitis were diagnosed. 

Radiographically vertical bone atrophy, i.e. the appearance of peri-implant pockets 
was not detected. Insignificant horizontal atrophy was observed in 2 implants by the 

end of 18 months (2.00%) and averaged 0.62 ± 0.13 mm. In the control group (39 

patients), 39 complete removable prostheses were made, supported by 98 implants. 
During follow-up (6-18 months after prosthetics), signs of peri-implant mucositis in 

the form of hyperemia and edema were observed in the area of 8 implants (8.10%). 

At the same time, loosening was determined in 4 of them (4.08%). During the study, 

no suppuration, the presence of fistulas, or pain was detected. There were no 
complaints about these manifestations. The phenomena of mucositis could be quickly 

stopped. But it should be added that 1 case of peri-implantitis was diagnosed in this 

group. 
Conclusions. The loss of bone tissue in the main group was at the level of 0.54 

± 0.21 mm, while in the control group it was 0.74 ± 0.32 mm. Moreover, foreign 

studies have shown that in the presence of 3 implants, bone loss ranged from 0.5 ± 

0.46 mm to 0.7 ± 0.76 mm. 
Keywords: DICOM program; complete absence of teeth; peri-implantitis; 

mucositis; implants; dental computed tomography 
 

Introduction. According to data from various regions of Uzbekistan, patients 

with a complete absence of teeth (CAT) are encountered for the first time in the 45-

49 age group. At the age of 55-59 years, every fourth surveyed has the named 
pathology, and for the age of 65-69 years this figure is already 42.8%. The overall 

prevalence of complete absence of teeth for different regions of our country ranges 

from 8.2 ± 0.46 to 9.3 ± 0.67. By 2020, the number of patients with CAT in 
Uzbekistan will exceed 15 million people, and then among our adult fellow citizens 

every five years, this number is expected to increase by 3-5%. 

Abroad, the number of patients with CAT in the United States is 27 million, 

and although the reduction in the prevalence of CAT is declared a major medical goal 

mailto:pulatabilov1985@mail.ru


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in the United States, according to forecasts for the first 3-5 decades of the 21st 

century, this prevalence will grow steadily [5, 12, 23, 27, 30 , 38]. According to some 
foreign authors, CAT occurs already in patients aged 34 years [1, 2, 4, 8, 14, 25, 31]. 

In modern conditions, patients with CAT have every opportunity to abandon 

conventional removable prostheses in favor of non-removable prosthetic structures 

supported by implants. 
The manufacture of implant-supported dentures can significantly improve the 

chewing function and improve the quality of life of patients with POP. The use of 

complete removable dentures with implant fixation in comparison with conventional 

removable prosthetics increases patient satisfaction with the results of treatment by 
more than 2 times. Satisfaction of patients with CAT also significantly increases after 

conditionally removable and fixed prosthetics [6, 11, 13, 17, 20-22, 28, 33, 34, 

36,35]. 
Thus, dental implantation can be considered not only one of the most 

promising options for orthopedic treatment of patients with POP, but also considered 

as the basis for effective orthopedic treatment and improving the quality of life of this 

category of patients [3, 7, 15, 19, 24, 29, 32, 39]. 
As you know, the installation of any implants requires increased attention and 

absolute accuracy from the implantologist. The lack of a clear planning of the 

placement of implants in the bone tissue, their installation depending only on the 
clinical situation, which is assessed only visually on the basis of our own clinical 

experience and X-ray data, can lead to incorrect implant placement. However, in 

dental implantation, CT examination itself without specialized software and 3-D 

modeling is not informative enough [9,10,16,18,26,37,40]. There are various 
computer programs that allow the planning and placement of implants with a 

predetermined result with the presence of parallel suprastructures. One of these 

programs is DICOM (Implant-assistant). 
The low quality of life of patients, especially those with complete loss of teeth, 

against the background of a relatively high frequency of complications that occur 

after the installation of dental implants, confirms the postulate that there is still a 

shortage of methods with a high efficiency of choice of tactics and sequence of 
orthopedic treatment of this pathology, indicating on the relevance of this study. 

Purpose of the study. To evaluate the effectiveness of using the DICOM 

program in patients with complete absence of teeth according to the data of dental 
computed tomography at the stage of the dental implantation technique. 

Materials and research methods. In total, we examined 80 patients with 

complete loss of teeth, of which 29 were men, 51 were women. The age of the 

patients was 51-66 years (mean age 58.5 ± 4.5 years). 
Implant prosthetics was carried out at the Department of Advanced Training of 

Prosthetic Dentistry TGSI. Implants from Osstem Implant (South Korea) were used. 

All patients were divided into 2 groups: group 1 (main) - 41 patients, of whom 
14 were men, 27 women (mean age 56.7 ± 4.2 years), group 2 (control) - 39 patients 

were included 15 men, 24 women (mean age 59.5 ± 4.7 years). 

Patients were separated by simple randomization. 



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All patients signed written consent to participate in the study. 

Research methods. 

1. Clinical - included a standard technique, which consisted of examination, 

examination of the oral cavity. Clinical evaluation included determination of the 

severity of gingival recession, the severity of the implant, bleeding of the peri-

implant cuff, inflammation, the level of oral hygiene and prostheses. 
2. X-ray - performed using a dental computed tomograph PLANMECA 

PROMAX 3D. Her data were used using the DICOM program to assess anatomical 

and topographic landmarks, the risks of surgical intervention and planning for 

implant insertion.  
X-ray examination was performed before implantation, 6 months after the 

prosthetics 

1. Statistical - carried out using the methods of variation statistics of the 
Student-Fisher test. 

Research results. In the main group (41 patients), 41 complete fixed 

prostheses were made, supported by 100 implants. Before the operation, plaster 

models of the jaws were obtained and fixed in an Asa dental articulator using a facial 
arch. In the dental laboratory, a wax composition with artificial polymer teeth (before 

the surgical template) was prepared, an individual template-spoon made of 

transparent plastic for the subsequent impression of the prosthetic bed during the 
operation with simultaneous registration of the central ratio.  

Fig. 1. Planning dental implantation using the DICOM program.  

 



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130 

 
According to the obtained X-ray template, a surgical template was made using the 

DICOM program (Fig. 2). 

Fig. 2. Carrying out an operation using a surgical template 

 
Fig. 3. Template fixed with a screw to the implants 

 



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Fig. 3. Template fixed with a screw k During observation (6-18 months) after 

prosthetics, signs of peri-implant mucositis in the form of hyperemia, edema were 
observed in the area of 4 out of 100 (4.00%). Such patients were prescribed Traumeel 

S. During the study of suppuration, the presence of ulcerations, fistulas, pain was not 

noticed, and complaints of these manifestations were absent, the phenomena of 

mucositis could be quickly stopped. No cases of peri-implantitis were diagnosed. 
Radiographically vertical bone atrophy, i.e. the appearance of peri-implant pockets 

was not detected. Insignificant horizontal atrophy was observed in 2 implants by the 

end of 18 months (2.00%) and averaged 0.62 ± 0.13 mm. 

In the control group (39 patients), 39 complete removable prostheses were made, 
supported by 98 implants. 

The preliminary prosthesis was fixed on the day of taking the impression using 

transitional elements - temporary support heads made of titanium alloy, having been 
carefully previously carefully finished, ground and polished 

implants.  

Fig. 4. Temporary support heads fixed to implants. 

 
Since these patients did not undergo dental computed tomography using the 

DICOM program, and the results were assessed only using an orthopantomogram, the 

patients were prescribed antibiotic therapy for 5-7 days (Ampiox 250 mg, 1 table 3 

times a day), NSAIDs (Ketorol Pro ) to reduce soft tissue edema. The sutures were 

removed on day 14 by removing the prosthesis and washing the implant shafts with 
antiseptic solutions. 

During follow-up (6-18 months after prosthetics), signs of peri-implant 

mucositis in the form of hyperemia and edema were observed in the area of 8 
implants (8.10%). At the same time, loosening was determined in 4 of them (4.08%). 

During the study, no suppuration, the presence of fistulas, or pain was detected. There 

were no complaints about these manifestations. The phenomena of mucositis could 



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132 

be quickly stopped. But it should be added that 1 case of peri-implantitis was 

diagnosed in this group. 
Conclusions. The loss of bone tissue in the main group was at the level of 0.54 ± 

0.21 mm, while in the control group it was 0.74 ± 0.32 mm. Moreover, foreign 

studies have shown that in the presence of 3 implants, bone loss ranged from 0.5 ± 

0.46 mm to 0.7 ± 0.76 mm. These values are comparable to those obtained by us in 
the main group. 

  



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