STUDY OF ORAL HEALTH AND SUPPORTIVE STRUCTURES FOR PROSTHETIC RESTORATIONS IN METHADONE MAINTENANCE THERAPY...

Methadone Maintenance Therapy (MMT) is commonly used to treat opioid addiction but can cause significant oral health issues, including poor oral hygiene, dental caries, periodontal disease, and bone resorption. These issues can negatively impact on overall quality of life, leading to both aesthetic and functional concerns.

This research compares the oral health of individuals in methadone maintenance treatment (MMT) with those starting MMT. It examines the correlation between methadone use, illicit drug use, and oral health, focusing on the condition of supportive structures for future prosthetic restorations. The study also explores how prosthodontic interventions can improve oral health.

This study was conducted at the Center for Mental Health and Prevention of Addiction in Tbilisi, Georgia, involving 276 patients (138 initiating Methadone Maintenance Therapy (MMT) for the first time and 138 MMT beneficiaries with at least six months of treatment). Stratified random sampling was used based on the duration of opioid addiction and length of MMT enrollment. A questionnaire was used to assess participants' dental health perceptions, oral hygiene habits, and experiences with prosthetic treatments. A dental chart was employed, including the Kennedy Classification, Prosthetic Diagnostic Index (PDI), Eichner Index, and Robert H. Griffiths' guidelines for temporomandibular disorder assessment. Additionally, the Oral Hygiene Index Simplified (OHI-S), DMFT index, Dental Health Index (DHI), and Periodontal Index were used to evaluate overall oral health and supportive structures for future prosthetic treatment. Data were analyzed using SPSS version 23, with statistical significance set at p<0.05. Participants provided informed consent in accordance with ethical guidelines.

Group I (first-time MMT) showed higher caries experience (DMFT >13.9) compared to Group II (MMT beneficiaries), with 89.1% vs. 71.7%, respectively (p=0.001). Poor oral hygiene was observed more in Group I (24.6%) than Group II (17%) (p=0.000). The PDI revealed severely compromised edentulous areas in 32.6% of Group I and 39.1% of Group II (p=0.0492). Tooth mobility was more common in Group I (71.7%) vs. Group II (40.6%) (p=0.000). The remaining roots were found in 50% of Group I and 30.4% of Group II (p=0.001). Dry mouth complaints were higher in Group I (67.4%) vs. Group II (50.5%) (p=0.003). Significant edentulism and dissatisfaction with dentures were reported, especially in Group I. However, 54.3% of Group I felt their oral health stabilized with MMT (p=0.000).

As a result, we can conclude that both groups have a high need for prosthetic rehabilitation. However, the condition of abutment teeth and periodontal tissues is not suitable, requiring adjunctive therapy. Methadone maintenance therapy (MMT) beneficiaries show slightly better conditions of these structures, but they also have a lower number of abutment teeth and significant bone resorption.