Stomatologiya最新文献

Objective: To evaluate the effectiveness of the dynamic electroneurostimulation method in the rehabilitation of patients with skeletal mesial occlusion after orthognathic surgery using surface electromyography.

Material and methods: The study included 32 patients with skeletal class III, who were divided into two equal groups: A (study) - patients underwent dynamic electrical neurostimulation (DENS) in the postoperative period, B (control) - standard postoperative care. Group C was also used for comparison - 30 student volunteers without bite pathology. For an objective assessment of the effectiveness of DENS, surface electromyography was used, the values were determined during relaxation and maximum voluntary contraction at the following times: before surgery, 3 months, 6 months after surgery.

Results: After the orthognathic surgery, the electromyographic activity of the masticatory muscles during maximum contraction decreased, showing incomplete recovery by the 6th month after surgery in the control group B (501±56 μV and 583±50 μV) and higher values in the study group A than before surgery (624±72 μV and 576±52 μV). In the postoperative period, an increase in the bioelectrical activity of the temporal muscles during maximum voluntary contraction was observed, while 3 months after surgery (T1), the indicators in the study group (879±95 μV) exceeded the values of the control group (847±92 μV). Resting temporal muscle activity levels after 6 months were comparable to those in healthy volunteers (group A: 35±4.7 μV, group B: 36±5.9 μV, group C: 36±8.9 μV, p>0.05).

Conclusions: DANCE can be effectively used in the rehabilitation of patients after orthognathic surgery.

The article presents the results of more than 60 years of scientific and practical work, corresponding member. RAS, professor B.N. Davydov - the founder of the largest scientific school for the study of one of the most pressing problems in pediatric dentistry - the treatment of congenital facial defects. The humanistic value and practical contribution of the scientist and clinician to Russian medicine runs through as a common thread. The results of his fruitful work are reflected, which continues to contribute to the training of highly qualified medical personnel for pediatric dentistry, maxillofacial surgery, the improvement of pediatric dentistry services, the introduction of advanced technologies for the prevention and treatment of diseases of the orofacial zone with innovative components that increase the efficiency of the process of formation and preservation of the dental health of children and adolescents and youth of Russia.

Objective: To develop a technique for 3D analysis of the upper part of the cervical spine, to study possible correlations with temporomandibular joint (TMJ) parameters in patients with signs of its dysfunction.

Material and methods: The data from cone beam computed tomography (CBCT) of the heads of 92 patients who sought treatment for TMJ dysfunction (49 people), comprehensive dental treatment (28 people), and orthognathic surgical treatment (15 people) were analyzed. Patients with signs of TMJ dysfunction were divided into 2 subgroups: 1 - patients with asymmetric narrowing of the articular gap (24 people); 2 - patients with symmetrical narrowing (25 people). The width of the articular gap in the posterior and upper thirds was chosen as the main parameters of the TMJ. To analyze the cervical spine, a technique was developed that determines the rotation of the cervical vertebrae; lateral tilt of the cervical vertebrae; anteroposterior tilt of the cervical vertebrae; distance from the tooth (2nd vertebra) to the atlas (1st vertebra); postural compensation.

Results: Contrary to expectations, we found no signs of even a weak relationship between the studied parameters of the TMJ and the cervical spine within the entire group of subjects (the correlation coefficients were 0.17-0.22). However, it was noted that there was a pronounced mutual dependence between violations of the ratios of the elements of the TMJ and the parameters of displacement of the cervical vertebrae in patients of the 1st subgroup.

Conclusion: Any methods of fixing the patient's head can distort its natural position during a CBCT scan, especially its postural balance. Therefore, such an analysis and analysis of the anteroposterior tilt of the vertebrae were intentionally excluded for the study. Nevertheless, the study showed that even with standard methods of conducting CBCT examinations with stops for the patient's head, it is possible to reliably record and quantify disorders not only of the TMJ, but also of the cervical spine.

Objective: Analysis of a clinical case of successful removal of odontogenic keratocyst of the mandible using methods of differential diagnostic, clinical and X-ray analyses and by forming several bone windows.

Material and methods: The clinical case of a patient who applied to the clinic of the Russian University of Medicine for consultation and treatment is presented. For diagnostic purposes, computed tomography and histological examination were performed to determine the condition of bone tissue and teeth.

Results: Based on clinical and laboratory studies, the diagnosis of "Odontogenic keratocyst occupying the body, angle and branch of the mandible" was confirmed. Through the formed three windows, the cyst shell was removed without fragmentation. Bone tissue restoration was monitored for 4 years. For complete restoration of bone tissue, an audit was carried out, followed by the use of hydroxyapatite and a resorbable membrane, for complete restoration of bone tissue.

Conclusion: The creation of bone windows to isolate the cyst shell without fragmentation is the optimal approach to the treatment of large-sized odontogenic keratocysts. We guided the patient using the principle of both cystectomy and cystotomy, despite the removal of the keratocyst shell in full. The management of the patient by cystotomy, using iodophoric turunda, allowed to avoid complications associated with the formation of a large clot, and residual phenomena in case of recurrence after removal of the cyst shell. To enhance the formation of healthy bone tissue, we performed depulpation and resection of the roots of the teeth, which were at the defect level bone tissue, to improve the appositional bone growth.

The aims of the study: To perform systematic search, qualitative and quantitative synthesis of the scientific evidence on the associations between melatonin levels in saliva in patients with periodontitis and healthy individuals.

Material and methods: In accordance with the PRISMA-2020 guidelines, we conducted a systematic search of scientific publications in Russian and English using PubMed and eLibrary.Ru sources. A total of 252 papers were identified. Finally, 20 studies were included in qualitative synthesis. Meta-analysis was performed using the random effects model with Cohen's d as the effect size measure.

Results: Twenty selected articles were published between 2003 and 2023. In 10% of the papers, patients with periodontitis had higher concentrations of melatonin in saliva compared to healthy individuals. However, most of the studies reported the opposite. According to the results of the meta-analysis, the melatonin level in individuals with periodontitis was lower than in healthy subjects: the overall effect was -1.90 (95% CI: -3.47; -0.34). High level of heterogeneity was noted (I²=96.5%).

Conclusions: The results suggest that lower concentrations of salivary melatonin were associated with periodontitis. However, high variability of concentrations of melatonin in saliva and heterogeneity of the effects across individual studies warrant further research using larger samples.

Objective: To study the dental status of patients depending on the presence of precancerous diseases of the oral mucosa.

Material and methods: For the first time in the Ryazan region 1857 people aged 18 to 89 years were examined. To assess the dental status of patients the CFE (DMFT) index and the OHI-S hygienic index (Green, Vermillion, 1964) were used, the presence of orthopedic structures was noted.

Results: During the examination 1700 (92.34%) patients did not have diseases of the oral mucosa, while 141 (7.66%) had precancerous diseases: leukoplakia, lichen planus, papilloma and papillomatosis of the palate. The highest value of the CFE index was found in women aged 60-74 years, as well as in men and women aged 75-89 years, both among patients with and without precancerous diseases of oral mucosa. When analyzing the data of individual components of the CFE index of patients with precancerous diseases of the oral mucosa, the predominant C index (caries) was identified in the group of men aged 45-59 years, a high value of the F index (filling) was obtained among women aged 18-44 years. There were equally many extracted teeth (an indicator E of the CFE index) in men and women aged 75-89 years, both in the group of patients with precancerous diseases of the oral mucosa and in the group of patients without them. A significantly higher number of orthopedic structures were found in patients diagnosed with leukoplakia (44 people - 61.11%). A satisfactory level of hygiene was diagnosed in all age groups of patients with both precancerous diseases of the oral mucosa and healthy patients.

Conclusion: Based on the results of the study of the dental status, the absence of differences in the CFE index and its individual components, the OHI-S index, and the number of orthopedic structures between groups of patients with and without precancerous diseases of the oral mucosa was obtained and statistically proven. A statistically significant higher number of orthopedic structures was shown in patients diagnosed with leukoplakia in comparison with the group of patients without pathological changes of the oral mucosa.

The aim of the study: Was to determine the impact of the timing of radiographic detection of external inflammatory root resorption of an injured permanent tooth on the disease outcome.

Material and methods: The study comprised 16 children aged 6 to 13 years (mean age 9.2±3.5 years) having the history of dental injury in 23 permanent teeth. Five patients (31%) were followed-up with clinical and radiological assessment according to protocol of International Association of Dental Traumatology (IADT). Remaining 11 patients (69%) were reffered with complains one year and later after dental injury.

Results: From five patients followed-up according to IADT protocol 4 had non-invasive external inflammatory root resorption. After treatment, stabilization of external inflammatory resorption or its transition to external replacement resorption was noted in all teeth. One patient was diagnosed with complete root resorption after tooth replantation and therefore the tooth was removed. In the remaining 11 patients referred a year or more after injury from the 17 injured teeth, only 3 (18%) showed stabilization of the external inflammatory root resorption after treatment. In 4 (23%) teeth, complete external inflammatory root resorption was detected and the teeth were removed. Penetrating external inflammatory root resorption was diagnosed in 3 (18%) teeth, but the patient did not apply again for endodontic treatment. In 7 (41%) teeth, the transition of external inflammatory resorption to external replacement was noted with significant loss of the root hard tissues.

Conclusion: External inflammatory resorption of the root of a permanent tooth requires an early and accurate X-ray diagnosis. Late detection of external inflammatory root resorption of an injured tooth limits the choice of treatment methods and often leads to tooth loss.

The purpose of this study: Was to evaluate alveolar bone grafting success using the autograft from the mandibular body, own bone fragments and xenogeneic material.

Material and methods: This study was conducted by Central Research Institute of Dentistry and Maxillofacial Surgery (Moscow, Russia) from 2013 through 2023. Consecutive 128 patients with cleft lip/palate who underwent alveolar bone grafting by one surgeon were included. The median age at alveolar bone graft was 12.7 years (range 7-23 years). Inclusion criteria were unilateral and bilateral cleft lip and alveolus and a computed tomography (CT) scan obtained >8 months (128 patients) and 2-10 years (range 3.2 years, 52 patients) after alveolar bone grafting.

Results: The success rate of surgical intervention was 92.6%. Alveolar bone graft undergoes remodeling but not lysis long-term.

Conclusion: Alveolar bone grafting with mandibular bone proved to be effective and has demonstrated good long-term results. The bone level in the grafted area was satisfactory with no signs of resorption.

The aim of the study: To study in vivo the biological properties of simvastatin and pentoxifylline and their ability to potentiate the action of bone morphogenetic protein-2 (BMP-2) for bone tissue regeneration in conditions of simulated postmenopausal osteoporosis.

Materials and methods: The study was performed on 60 female Wistar rats. To create conditions that provoke the development of osteoporosis, 30 rats underwent ovariectomy; 30 animals underwent false ovariectomy without removing the ovaries. After 8 weeks, changes in the levels of osteoporosis markers, osteocalcin (OCN) and type I collagen C-telopeptide (CTX-1), in blood serum were assessed in all animals by enzyme immunoassay. To assess the osteoinductive properties, all animals underwent subcutaneous implantation of drugs and their combinations with BMP-2. In each group, both with ovariectomy and in falsely operated animals, 5 subgroups of 6 animals each were formed: simvastatin (0.13 mg/ml) was implanted in group 1, pentoxifylline (0.14 mg/ml) in group 2, BMP-2 (100 mcg/ml) in group 3, simvastatin and BMP-2 (0.13 mg/ml and 100 mg/ml) in group 4, pentoxifylline and BMP-2 (0.14 mg/ml and 100 mcg/ml) in group 5.

Results: Simvastatin and pentoxifylline did not have osteoinductive properties. During BMP-2 implantation, the volume of newly formed bone tissue was 0.5±0.2% in the group of rats with ovariectomy and 2.8± 1.5% in falsely operated animals. In turn, implantation of simvastatin with BMP-2 caused the formation of bone tissue in the volume of 7.4±4.2% and 5.4±1.5%, and pentoxifylline - 0.01±0.001% and 2.1±1.5% in the groups of rats with ovariectomy and falsely operated animals, respectively.

Conclusion: The results obtained demonstrate the possibilities of using well-known pharmacological substances to enhance the osteoinductive effect of BMP-2 and can be used to create new effective bone graft materials in dentistry and maxillofacial surgery.

Study objective: : to assess the morphological changes in the mandibular condylar processes during functional remodeling after bimaxillary orthognathic surgery in patients with Class II skeletal malocclusion.

Material and methods: The study analyzed 30 3D models of mandibular condyle (MC) obtained from computed tomography scans of patients (n=15), conducted 1 week before and 12 months after bimaxillary orthognathic surgery (T1 and T2, respectively). The analysis included a comparison of the volumes of the 3D MC models at T1 and T2, as well as measuring the T1-T2 distances of the 3D MC models at the poles of five surfaces (superior, anterior, posterior, medial, and lateral). A correlation was determined between the extent of maxillomandibular advancement (MMA), counterclockwise rotation of the occlusal plane (CCWROP), and morphological changes in the MC.

Results: A decrease in MC volume was observed postoperatively, averaging 14.5% (p<0.001). T1-T2 distance changes showed more pronounced remodeling with a reduction in the distance between the poles on the superior and posterior surfaces of the MC compared to the other surfaces. However, the lack of differences in all paired comparisons of changes in intersurface distances of the 3D MC models at the poles of the five surfaces at T1 and T2 (p>0.05) indicates uniform volume reduction in the MC. No correlation was found between morphological changes in the MC and the degree of MMA or CCWROP. Morphological changes in the MC at T2 were not accompanied by clinical manifestations in the temporomandibular joint (TMJ).

Conclusion: Morphological changes in the MC after bimaxillary orthognathic surgery with MMA in patients with Class II skeletal malocclusion are within the range of functional remodeling, do not lead to TMJ dysfunction or occlusal disturbances. However, the reduction in MC volume approaches the threshold values for condylar resorption.