Clinical, technological and economic justification of reinforcement with skeletal bases of complete removable dentures

The scientific article develops an algorithm for the interaction of manufacturers and consumers of frames reinforcing the bases of complete removable dentures in the large-scale healthcare system of the Russian Federation and dental practice, provides a clinical, technological and economic justification for strengthening such prosthetic structures with mesh frames of various production technologies according to the following criteria: clinical and economic, this refers to a decrease in the number of visits to the dental clinic by patients with complete loss of teeth during prosthetics with complete removable dentures (CRD) with a mesh-frame reinforced base of various production technologies; economic and technological — an increase in the profitability of the sale of CRD with a reinforced base, and a quotient of dividing its service life by a multiplier of the increase in the cost of such a prosthetic structure; socio-economic, estimated by a reduction in public health losses due to breakdowns of prosthetic bases and a reduction in forced downtime associated with patient visits to dentists, when reinforced with frames of various technologies for the production of CRD bases, and thereby the clinic’s profits for unpaid patient work on the reconstruction of CRD damage (warranty case). The results obtained showed that the use of factory-made metal mesh frames for reinforcing the bases of artificial teeth makes it possible to reduce public health losses annually due to breakdowns of prosthetic bases and reduce downtime associated with dental visits by patients by 2.2 billion rubles, factory-made quartz mesh frames reduce public health losses by 1.1 bn rubles per year, and personalized polymer reinforcing perforated frames, individually manufactured using digital 3D printing technology, annually reduce public health losses by 4.4 bn rubles. Printed polymer frames have an advantage over factory-made reinforcing metal mesh frames according to the criteria: clinical and economic — 2 times; economic and technological — 1.5 times; socio-economic — by 2 times, they also have an advantage over quartz mesh frames according to the criteria: clinico-economic — by 3.88 times; economic and technological — by 12.92 times; socio-economic — by 4 times. The multiplicative coefficient of synergy for metal mesh frames is 4.7 bn rubles, for quartz mesh frames it is 0.14 bn rubles, and for polymer printed frames it is 28.1 bn rubles. In other words, the multiplicative coefficient of synergy for a printed polymer frame has an advantage of 6.04 times over a similar indicator for a metal mesh frame, and 200.63 times for a quartz mesh frame, which proves the advantage of printed polymer reinforcing frames.