Stomatologiya最新文献

Aim: To compare the clinical results of treatment of patients with multiple gingival recessions class I and II according to Miller using the modified coronary advanced flap (MCAF) technique in combination with collagen matrix (CMX) and connective tissue graft (CTG).

Material and methods: The study included 20 patients with Class I and II Miller gum recessions in the area of 136 teeth. Recessions were divided into 2 groups, the first group was operated with a MCAF+CMX combination (test group), and the second one using MCAF+CTG (control group).

Results: Complete root closure was achieved in 87% of the teeth in the test group and 95% of the teeth in the control group (p<0.05). At 6 months the complete root coverage observed in 85% in the test group and 97% in the control group. The average width of the attached keratinized gum had an increase in values 3 mm in the test group and 3.3 mm in the control group. The recession depth decreased in both groups, but in the test group, the residual recession depth was 1.2 mm, and in the control group 0.7 mm. The thickness of the keratinized gum increased from 1.1 mm to 1.7 mm in the test group, and from 1.1 mm to 1.8 mm in controls. Surgery duration and postoperative pain in the test group were significantly lower compared to the control group.

Conclusion: The use of collagen matrix with cross-linked collagen can be an alternative to SST and can also be used in cases where it is not possible to use the donor resource of the palate. However, the use of collagen matrix leads to a lower growth of keratinized attached gingiva and does not always contribute to the complete elimination of gingival recessions.

Objective: Aim: To determine the current coefficients of transverse parameters for calculating the ideal width of the dental arch.

Material and methods: This study examined the ideal width of the dental arch, considering the anatomical dimensions of the jaws and teeth. Correlation between the mesiodistal dimensions of the upper incisors and the width of the dental arch in the premolar and molar regions was used to calculate index values. Patients with a history of orthodontic treatment were excluded from the study. The sample consisted of 500 young patients (18-44 years old) as categorized by WHO. Each participant underwent a dental examination and cone-beam computed tomography. Control-diagnostic models of dental arches were also obtained for further measurements. The width of the dental arches was measured with a caliper between selected points, allowing the determination of parameters in the premolar and molar regions of the upper and lower jaws. Statistical analysis was performed using StatTech v. 4.2.5 software, including the Kolmogorov-Smirnov test to assess normality of distribution. Correlation evaluation was conducted using Pearson's coefficient, and a predictive model was developed via linear regression.

Results: By using occlusal points to measure the width of the dental arch in the premolar and molar regions, values applicable to both the upper and lower jaws were calculated. These points represent the contacts between the teeth of the upper and lower jaws during occlusion, ensuring normal alignment. Regression analysis was used to determine the calculated coefficients for the ideal width of the dental arch in the premolar and molar regions. The results obtained were transformed into molar and premolar coefficients.

Conclusion: Diagnosis of dental arch narrowing based on anthropometric parameters directly impacts the stability of orthodontic treatment outcomes. A combination of traditional anthropometric methods and modern technologies provides more precise and individualized diagnostics. This not only improves the accuracy of detecting dental arch narrowing but also allows for the selection of optimal orthodontic treatment strategies, leading to predictable and stable results while minimizing the risk of complications.

A clinical case of successful application of platelet-rich fibrin (PRF) to eliminate a large residual cavity after enucleation of a radicular cyst is described. The method is based on the use of biological substances that produce growth factors that stimulate reparative osteogenesis. A similar source of growth factors is PRF. According to the literature, it is able to reduce inflammation of periodontal tissues, preserve the location of the alveoli and eliminate defects in the alveolar bone, thereby enhancing bone regeneration and ensuring its good stability. PRF is easy to manufacture, does not require the appointment of anticoagulants, is resistant to stretching and elastic, while it can be used independently and in combination with various bone plastic materials. In our study, the use of PRF allowed not only to eliminate a large residual cavity after enucleation of a radicular cyst, which was confirmed by the results of cone beam computed tomography, but also to preserve the functionality of the teeth in an aesthetically significant area.

The aim of the study: To study the effectiveness of percutaneous electroneurostimulation (TENS) for normalization of masticatory muscle tone and improvement of the effectiveness of permanent dental prosthetics in patients with increased tooth wear.

Materials and methods: Electromyographic examination (EMG) was performed in 20 patients of both sexes aged 35 to 54 years, in patients with a clinically pronounced generalized form of increased tooth wear and temporomandibular joint (TMJ) dysfunction. Patients complained of soreness and tension in the area of the masticatory muscles during mouth opening and chewing. The examination was performed using an electromyograph "Synapsis" (Neurotech), adapted for dental purposes. All patients were prescribed a TENS course of up to 5 sessions, lasting 45 minutes, and additionally a muscle relaxation mouthguard was manufactured.

Results: The results of the electromyographic examination at the first stage (up to TENS) showed a pronounced asymmetry of the masticatory muscles: the predominant muscles are the left temporal (Ts) - 449+27 (MV) and the left masticatory proper (Ms) - 387+27 MV, the lowest values were noted in the right temporal muscle (Td) - 326+15 Mv and the right masticatory muscle (Md) - 352+21 mcV. The difference between the average amplitude of Md and Ms muscles was 35 Mv, and the difference between Td and Ts muscles was 123 Mv, statistically significant. At the second stage, a TENS course of up to 5 sessions was prescribed. The highest values were observed in the left temporal muscle (Ts) - 437+27 Mv, the lowest in the right (Td) - 346+28 Mv. The indices of the right masticatory muscle proper (Md) were 398+37 Mv, the left (Ms) - 377+32 mv. The difference between the average amplitude of Md and Ms muscles was 9 Mv, and between Td and Ts muscles - 21 Mv.

Conclusion: After a course of TENS in patients with increased tooth wear, positive dynamics of changes in the bioelectric conductivity of the chewing muscles are determined. Electrical impulses contributed to the improvement of the functional characteristics of the stimulated muscles, which proves the importance of using percutaneous electrical stimulation to increase the effectiveness of treatment in this group of patients.

Ectodermal dysplasia (ED) is a group of rare hereditary disorders characterized by impaired development of ectodermal derivatives. The anhidrotic (hypohidrotic) form of ED is accompanied by pronounced hypoplasia of the jaws, partial or complete adontia, leading to functional impairments (difficulty chewing, swallowing, and speaking) and pronounced aesthetic changes. These factors have a significant impact on the quality of life of patients, causing psychological discomfort and social maladjustment. The article presents in detail a clinical case of a 20-year-old patient with anhidrotic (hypohidrotic) ED, who underwent comprehensive surgical rehabilitation.

The most common cause of the arteriovenous junction between the carotid artery and the jugular vein is iatrogenic damage to the vessel walls during vein catheterization, however, this article describes a rare clinical case of traumatic carotid jugular junction of the neck. In addition to the well-known local symptoms of this pathology such as swelling, pulsation, redness of soft tissues, the formation of purulent crusts in the right eye was observed in the patient, which was not characteristic of arteriovenous anastomosis. The article presents the outcomes of multispiral computed tomography (MSCT) of the neck and brachiocephalic vessels with intravenous contrast enhancement confirming the diagnosis, as well as angiography of the common carotid artery basin. During the operation, the ligation of the vessels involved in arteriovenous discharge, the facial vein and artery, was performed. The results of surgical treatment are: reduction of swelling and redness of the soft tissues of the right buccal and suborbital areas, cessation of pulsation and formation of purulent crusts in the right eye after sleep. The article presents the main results of studying foreign literature on this topic: statistical data on the frequency and etiology of arteriovenous junction, characteristic clinical manifestations of this pathology and methods of differential diagnosis. Additionally, it lists treatment tactics used in world practice. Given the rarity of the pathology, the complexity of its diagnosis, and the lack of a standard surgical treatment technique, the presented clinical case is of the signficant practical interest.

Based on eight clinical cases the article analyzes the main clinical and radiographic features of eight children aged 6-14 years with rare cystic lesions: juvenile inflammatory collateral cyst (ICC). ICCs were associated with incompletely erupted first (6 children) or second (2 children) permanent molars. Only in 5 cases did they manifest as pain in the area of the affected teeth, in the remaining cases they were radiographic findings during examination before orthodontic treatment. At the same time, the teeth in the projection of the cyst retained their vitality in all cases, which was confirmed by the cold test and continued root growth after cystectomy. On OPG, ICCs were manifested by a wide variety of localizations (in the bifurcation projection, below, distal or medial to the roots of the teeth), but CBCT made it possible to detect a common symptom - predominantly the vestibular location of the lesion. Cystectomy without endodontic treatment of teeth in the projection of the cyst turned out to be a successful treatment tactic, which is confirmed by observation for 6 -84 months without recurrence of ICCs and dental complications.

Objective: The aim of the study. To assess the effect of rapid palatal expansion on the nasal septum and midface in children aged 6 to 12 years.

Material and methods: The results of treatment of 60 patients with narrowing and deformation of the upper jaw during the early and late mixed dentition are presented. The patients were divided into groups according to the stage of formation of the midpalatine suture: Group 1 included 38 patients with stage «A» (average age 6-9 years); Group 2 - 22 patients with stage «B» (average age 8-12 years). The study also included a control group of patients who were not prescribed orthodontic treatment. The treatment was carried out using devices for rapid palatal expansion with dental, intraosseous and hybrid types of fixation. After clinical and radiological examination of patients and analysis of the obtained data, we identified and assessed the effect of rapid palatal expansion on changes in the midface and nasal septum.

Results: Expansion of the upper jaw in the area of the apex of the palatine roots of the first molars at the skeletal level was achieved by 3.02±1.71 mm (p<0.05) and its effects on the structures of the midface and nasal septum were analyzed. As a result of the conducted studies, an increase in the length of the septum was revealed by 5.1±1.39 mm (p<0.05) after the use of rapid palatal expansion in patients aged 6 to 12 years, undergoing orthodontic treatment compared with patients in the control group.

Conclusion: The use of the rapid palatal expansion technique allows achieving skeletal effects not only at the level of the upper jaw, but also contributes to an increase in the volume of the nasal cavity, exerting a positive effect on the growth of the maxillary complex.

Objective: The aim of the study is to assess the role of the dentoalveolar pathology in the face soft tissues lymphostasis development in patients after facial contour injection plastic.

Material and methods: Clinical, ultrasound and dental X-ray examination was performed in 37 patients (36 women and 1 man) aged 21 to 70 years with facial lymphedema and close history of facial CIP. The patients were divided into two groups: early development of complications - up to 4 weeks (17 patients - 45.9%) and delayed development - from 4 weeks or more (20 patients - 54.1%). Unilateral facial lymphedema was diagnosed in 17 patients, and bilateral lymphedema with greater severity on one side was diagnosed in 20 patients.

Results: Among the examined patients with facial lymphedema, patients after multiple CIP predominated (62.2%). Early complications prevailed in patients with single CIP (64.3%), delayed complications prevailed in patients with multiple CIP (65.2%). In patients with multiple CIP the lymphedema grade 2 and 3 predominated, in patients with a single CIP grade 0 and 1. X-ray dental examination detected inflammatory dental diseases in 86.5% of patients: in all cases changes on the side of lymphostasis predominated.

Conclusion: Facial CIP is not a harmless procedure and may have undesirable consequences in the form of regional lymphostasis (lymphedema). Inflammatory dental diseases are an important pathogenetic link in the occurrence of facial lymphedema after CIP. A clinical examination of the patient's oral cavity should be supplemented by an X-ray dental examination. The detection of inflammatory dental diseases requires mandatory oral sanation to reduce the risk of post-injection complications and prevent complications afner subsequent injection procedures.

Objective: To summarize and present the experience of general anesthesia with nasotracheal intubation for children suffering from dystrophic epidermolysis bullosa (DBE) during dental interventions on an outpatient basis.

Materials and methods: In 2023, 18 children with DBE received dental treatment under general anesthesia, two patients underwent general anesthesia twice a month with a break due to the large volume of intervention.

Results: The paper highlights the main features of preoperative examination of this category of patients, preparation for monitoring, induction of anesthesia, and ensuring patency of the upper respiratory tract. The practical recommendations and techniques mentioned in the article allow the anesthesiologist to minimize the risks of damage to the skin and mucous membrane of the mouth and pharynx. The duration of anesthesia ranged from 50 to 225 minutes, the average duration of anesthesia was 135 minutes. The observation time in the wake-up ward ranged from 105 to 360 minutes, the average time of postoperative observation was 177 minutes. There were no perioperative hemodynamic and respiratory disorders.

Conclusion: With proper preparation of the anesthesiological team, strict observance of the rules for working with children suffering from DBE, general combined anesthesia with nasotracheal intubation ensure a high safety profile for these patients and create comfortable conditions for high-quality dental work.