Stomatologiya最新文献

Objective: Increasing the effectiveness of treatment of chronic generalized periodontitis using PDT based on clinical and functional substantiation of the effects of a photosensitizer.

Materials and methods: A clinical and functional study and treatment of moderate chronic generalized periodontitis was carried out in 62 people (26 men and 36 women) aged from 35 to 55 years without a somatic model with an orthognathic occlusion diagnosed according to ICD-10 - K05.3. Of these, 2 groups were divided depending on the type of treatment: Group 1 (main) - patients with moderate chronic generalized periodontitis - 32 people. (17 men and 15 women, average age of the group - 43.2±2.2 years); Group 2 (control) - patients with moderate chronic generalized periodontitis - 30 people. (14 men and 16 women, average age of the group - 44.0±3.3 years). Complex treatment consisted of sanitation of the mouth, removal of dental plaque and curettage of periodontal pockets in group 1, followed by PDT with Revixan gel using a special wired aligner REVIXAN DENTAL LED (16 r). The clinical condition of the periodontium was assessed using the Greene Vermillion Hygienic Index (OHI-S), the Mühlleman Bleeding Index (SBI) modified by Cowell, and the periodontal index PI. To study the state of microcirculation in the gum tissue, the laser Doppler flowmetry (LDF) method was used using the LAKK-M device (NPP «Lazma», Russia). The state of microcirculation was assessed by the microcirculation index (M), which characterizes the level of tissue blood flow; parameter - «σ», which determines the fluctuation of the erythrocyte flow. According to Wavelet analysis of LDF-grams, the shunt index (SH) of blood flow was determined. In the «LDF + spectrometry» mode, oxygenation in periodontal tissues was studied using optical tissue oximetry (OTO), based on the results of which the perfusion saturation index (Sm) and the specific oxygen consumption index (U, %) were determined.

Results: According to LDF data, after PDT (group 1), normalization of clinical indices and the level of microcirculation in periodontal tissues was established, which was accompanied by an increase in the level of blood flow (M) and its activity (σ), which persisted after 3 and 6 months. after PDT. The perfusion saturation index (Sm) and specific oxygen consumption (U) increased more significantly after PDT, which persisted after 3 and 6 months. In the control group, the dynamics of indicators was less pronounced.

Conclusion: The use of PDT with Revixan gel normalizes the clinical condition of the periodontium, indicators of microhemodynamics and oxygen metabolism.

The aim of the study: Was to investigate the dynamics of mandibular density in cancer patients during therapy with zolendronic acid.

Materials and methods: The study comprised 14 patients who received zolendronic acid at a dosage of 4 mg once every 28 days for bone metastases. In all 14 patients, measurements of mandibular density values on CT scans were performed over time.

Results: Using multiple linear regression analysis, a model was developed to predict the effect of the number of zolendronic acid injections «X₁» on the dynamics of mandibular density «Y». The resulting formula for predicting mandibular density is Y = 5.9 X₁ + 49 HU.

Conclusion: The model has limitations due to the study design but still can be used by oncologists and dentists to assess mandibular density in patients taking zolendronic acid.

Objective: Comparative study of changes in the secondary structure of dental biofilm proteins in people with cariesogenic and cariesoprotective status using synchrotron IR microspectroscopy.

Materials and methods: Dental biofilm samples from 50 patients without caries (group 1) and with carious lesions of tooth enamel (group 2) were studied. The molecular composition of biofilms was studied using IR microspectroscopy. Changes in the secondary structure of dental biofilm proteins were evaluated based on deconvolution of Amide I or Amide II amide bands. using the analysis of variance. Patients of both groups took tablets containing a mineral complex with calcium glycerophosphate.

Results: Based on the deconvolution of the IR spectral profile of the Amide I and Amide II bands, the changes occurring in the secondary structure of dental biofilm proteins have been studied. Using a large set of spectra, it was shown that the prediction of the secondary structure of the biofilm protein network is influenced by both the cariesogenic situation in the oral cavity (with initial carious lesions of the enamel) and the fact that patients use a modulator - calcium glycerophosphate (a tableted mineral complex with calcium glycerophosphate). Significant intra-group and intergroup differences in the secondary structure of dental biofilm proteins were established for patients in normal and carisogenic situations in the mouth, including after the use of a tableted mineral complex with calcium glycerophosphate. This allowed us to give a mathematical assessment of shifts in the secondary structure of proteins depending on the activity of caries and external modulation.

Conclusion: The results obtained can form the basis of a technique for spectroscopic diagnosis of changes (shifts) in the oral microbiome leading to the development of the carious process, as well as become the basis for choosing the optimal therapeutic ways to treat enamel caries, including through preventive measures aimed at restoring the microflora of the patient's oral cavity.

The aim of the study: Was to evaluate the use of Ketorol Express as a preventive analgesia to increase the effectiveness of local anesthesia in providing emergency dental care to patients with arterial hypertension.

Materials and methods: The study was conducted on the basis of the state autonomous healthcare institution of the Moscow region «Royal Dental Clinic» with the participation of 83 people. The patients were divided into two groups. In group 1, Ketorol Express was prescribed as a preventive analgesia in a dosage of 20 mg before local anesthesia. Patients of group 2 underwent dental interventions without the use of preventive analgesia. A 3% solution of mepivacaine was used as a local analgesic solution. For a subjective assessment of the effectiveness of anesthesia, use a visual analog scale. All patients had their blood pressure and heart rate measured before and after the interventions and hemodynamic parameters were continuously monitored during emergency dental care.

Results: In group 1, the effectiveness of combined anesthesia with the infiltration method of local anesthetic administration was 93±1.17%, according to the patient, 94±1.47%, according to the doctor, with the conductive method of anesthesia at the mandibular orifice - according to the patient it was 91±1.01%, according to the doctor 92± 1.36%. In group 2, when providing emergency dental care with the infiltration method of administration of 3% mepivacaine the anesthesia was effective in 80±1.97% of cases according to the patient and in 80±1.17% of cases according to the doctor, with the conductive method of anesthesia at the mandibular orifice, the effectiveness of anesthesia according to the patient was 82±1.11%, according to the doctor 85±1.23%.

Conclusion: The results of the study demonstrated a statistically significant increase in the effectiveness of local anesthesia performed with a 3% solution of mepivacaine in patients with arterial hypertension due to the use of preventive analgesia with Ketorol Express at a dosage of 20 mg (2 tablets of 10 mg) in emergency dental care with registration and analysis of changes in hemodynamic parameters.

The aim of the study: To assess the effectiveness of pulp revascularization procedure in children with external inflammatory root resorption (EIRR) after constant teeth injury.

Materials and methos: The study comprised 17 children aged 6-10 years diagnosed with EIRR as a long-term complication of dental trauma in 19 teeth. EIRR was diagnosed with periapical radiographs and CBCT was performed to further assess the pathology extension. Pulp revascularization was carried out in all 19 teeth.

Results: There was no resorption progression in all cases. EIRR areas were substituted by bone. In 10 from 19 teeth with early stages of root development bone or cement-like tissue ingrowth into the root canal was observed radiologically. In cases of severe EIRR this ingrowth may partially compensate for lost tissues which is confirmed by a high percentage (94.7%) of functional teeth during mean follow up time of 38±10 months.

Conclusion: Pulp revascularization is an effective method for retaining teeth with EIRR for a relatively long period of time and allows maintaining alveolar bone volume both due to functional tooth preservation and healing of bone lesions in periapical and resorption areas.

Objective: Prevention of the development of pronounced skeletal abnormalities in patients with mesial occlusion.

Materials and methods: Biometric analysis of control and diagnostic models of dentition was performed in 60 patients with dental anomalies before and after treatment in 3 mutually perpendicular planes to identify violations in the formation of dental arches by sagittal and transversal dimensions, and alveolar processes - by vertical dimensions (methods of A. Pont, G. Korkhaus). Measurements of 23 parameters of TRG and sections of CBCT were carried out using the modified Nad-Ars technique with analysis of skeletal parameters before and after treatment. Treatment was carried out using dilators for the upper jaw in combination with a facial mask and further dynamic observation using active retention devices.

Results: The results of treatment showed an increase in the length of the anterior segment of the upper dental arch by 2.8±0.55 mm (p<0.05 mm); expansion in the area of temporary molars by 2.85±0.65 mm (p<0.05); in the area of permanent molars by 2.75±0.55 mm (p<0.05); in the area of the apical basis of HF by 3.82±0.45 mm (p<0.05). The length of the lower dental arch in the anterior segment has not changed. Analysis of TRG parameters showed a significant increase in the values of p<0.05); Wits - number by 2.85±0.45 mm (p<0.05); total anterior morphological height of the facial skeleton by 4.25±1.53 mm (p<0.05). As a result of the orthodontic treatment, the optimal position of the teeth, the shape of the dental alveolar arches, the inclination of the occlusal plane, and the improvement of the bite were achieved.

Conclusion: Early orthodontic treatment made it possible to create favorable conditions and prepare the patient's occlusion for a change of teeth, to form dental alveolar arches, to reduce the degree of complexity of therapeutic measures that may be needed after the completion of skeletal growth.

Objective: Topographic and blood vessel architecture study of the parietal area and distal regional pool of the superficial temporal artery (STA) to assess the possibility of revascularized cranium vault bone autograft formation.

Material and methods: For the topographic and anatomical study, 30 non-fixed corpses (17 male and 13 female) were selected, the average age of which was 59±5 years. In the anamnesis and catamnesis, there were no indications of trauma or other pathology of the head and neck, including vascular. STA was contrasted with a non-radiocontrast dye (brilliant green) with the introduction of the dye into the STA with preliminary ligation of the frontal branch of the STA. The area of blood supply to soft tissue and bone structures was studied. The angioarchitectonics of the parietal region was studied, the feeding vessel of the studied flap was identified.

Results: The obtained anatomical landmarks for the collection of CPFP flap make it possible to form a flap with high accuracy and minimize the morbidity of the donor area.

Purpose: To study the effect of magnetic therapy on the formation of distraction regenerate of the lower jaw in patients with lower micrognathia.

Materials and methods: The study comprised 159 patients with inferior micrognathia of congenital and acquired etiology. The patients were divided into 2 groups. The main group consisted of 112 patients who received magnetic therapy: 55 patients with congenital micrognathia and 57 patients with acquired micrognathia. The control group included 47 patients who did not undergo magnetic therapy: 20 patients with congenital micrognathia and 27 patients with acquired micrognathia. Magnetic therapy was performed daily starting from day 1 or 2 after surgery. Ultrasound monitoring began on the 7th day of distraction and was carried out every 3-4 days, which made it possible to assess the dynamics of the formation of the distraction regenerate.

Results: Ultrasound examination on the 7th day of distraction revealed that in the main group the number of distraction regenerates of the normotrophic type was 36.5%, hypotrophic type 18%, hypertrophic type 54.5%. In the control group, the corresponding rates were 53%, 31% and 22%.

Conclusion: Magnetic therapy induces osteogenesis and accelerates the maturation of the distraction regenerate. This makes it possible to accelerate the pace of distraction without reducing the quality of the regenerate.

Ceramic based on zirconium dioxide (ZD) is a modern, durable material for the manufacture of dentures. It is known that ZD is not etched as glass-ceramic, making it difficult to prepare this material before fixing.

Objective: To study the impact of various methods of surface treatment of ZD-based ceramic on adhesive strength.

Materials and methods: Sandblasting with Al₂O₃ particles sized 50 μm and application of primers with 10-MDP phosphate monomer were used. Adhesive strength values for following 4 groups of samples were obtained: 1st group - RelyX U200 + sandblasting + Compofix new primer (n=9); 2nd group - Compofix + sandblasting + Compofix new primer (n=9); 3rd group - Panavia F 2.0 + sandblasting (n=9); 4th group (control) - Variolink Esthetic DC + sandblasting + Monobond Plus primer (n=9).

Results: The highest strength of adhesion was in the 4th group - 48.71±5.71MPa, the smallest in the 3rd group - 9.49±35.24 MPa. Fully domestic components used in the 2nd group allowed to obtain values of 42.50±9.79 MPa. Adhesive strength in the 1st group was 34.11±4.78 MPa.

Conclusion: The absence of the 10-MDP-based primers application in the preparation of ZD ceramic reduces the adhesive strength between resin cement and its surface. The domestic set for fixation of dentures can be effectively used for ZD on the same basis as European analogue.

Objective: The aim of the study is to evaluate the syndrome of PSAF-autoadaptation in patients with tumors of maxillofacial localization based on the analysis of the results of a survey of the patient's Voluntary Confidential Information Sheet (DDIV Sheet).

Material and methods: The object of the study was 110 patients (39 men and 71 women (average age 58 years) with malignant neoplasms of the skin, tongue, bottom of the oral cavity, parotid salivary gland, upper jaw, submandibular salivary gland (stage II-IV of the disease). Rapid diagnostics of psycho-sensory-anatomical-functional-autoadaptation (PSAF) was performed by analyzing self-filled patient lists of DDIV with its self-assessment of the main complaints. After distributing complaints and manifestations of the disease into 4 clusters, the severity and structure of autoadaptation were calculated in points.

Results: It was found that in the majority of cancer patients in the preoperative period, complaints related to mental and functional clusters prevailed. At the same time, 80% of patients rated the degree of concern for their health as extremely alarming, and 20% as very anxious. In the postoperative period, the number of psychological complaints decreased and the number of complaints corresponding to anatomical, sensory and functional clusters increased.

Conclusion: The study of personal response to the disease according to PSAF-autoadaptation of cancer patients showed that the presence of a tumor lesion not only affects the internal picture of the disease, adversely affects the physical, mental and social well-being of patients, but also requires the involvement of psychologists, psychotherapists, clinical pharmacologists in the treatment of cognitive behavioral psychotherapy.