Stomatologiya最新文献

The relevance of the study is associated with the widespread use of osteomodifying agents in patients with bone metastases and osteoporosis. Bisphosphonates and other osteo-modifying agents are widely used in oncology and prevention of age-related changes in the human bone system. The use, therapeutic effects and complications of therapy with osteo modifying agents are being investigated all over the world. However, the etiology and pathogenesis of drug-induced osteonecrosis of the jaws (MONCH) have not been fully studied, in this regard, the study of risk factors and mechanisms of its development remains relevant. New data on the etiology and pathogenesis of drug-induced osteonecrosis are presented. The literature review is carried out on the electronic resource PubMed.

Objective: Improving the effectiveness of complex treatment in patients with distal occlusion of the dentition during the period of active skeletal growth.

Material and methods: 202 patients with skeletal distal occlusion were examined and treated. Patients are divided into three subgroups depending on the position/size of the jaw bones and the main link of pathogenesis. The parameters of TRG and CBCT sections were measured before and after treatment. Various parameters were used for the analysis: skeletal (SNA, SNB, ANB, etc.), dental (II/SN, II/ii, APog-I, APog-i, etc.), skeletal profile and soft tissue parameters.

Results: Various orthodontic techniques have been applied, including FNTA, the Damon bracket system, the Biederman apparatus and others. In the retention period, non-removable retainers in the frontal section and removable night retention devices of various structures were used. Patients were monitored for up to 15 years after the completion of the active orthodontic treatment stage. The analysis of the X-ray examination data indicates the normalization of the mutual position of the jaw bones in relation to the base of the skull, optimization of the ratios of the bone elements of the TMJ. An algorithm has been developed for the treatment of patients with dental anomalies in the sagittal plane, with narrowing of the upper jaw during the bite of permanent teeth.

Conclusion: Comprehensive treatment of patients with distal occlusion during the period of active skeletal growth makes it possible to achieve significant improvements in dentition, position and closure of teeth, as well as skeletal parameters of X-ray examinations. The results indicate the importance of early intervention using modern orthodontic techniques. Long-term follow-up in the retention period shows the stability of the results and the effectiveness of the treatment.

The aim the study: To analyze the density of the mandible in cancer patients during treatment with zoledronic acid.

Materials and methods: A retrospective cohort study included 45 patients with cancer aged 26-81 years (average age 55±12.88 years), of whom 14 patients had bone metastases (n=14) and took 4 mg of zolendronic acid once every 28 days. The patients underwent standard PET-CT examinations in the «whole body» mode, and the density of the mandible was examined on CT. Radiation therapy was performed by intracavitary administration of strontium 89 chloride; remote radiation therapy with cisplatin radiomodification. In the presence of bone metastases, patients received complex supportive therapy with zolendronic acid. The effect of zolendronic acid on the density of the mandible in the frontal and lateral sections was studied by multidimensional dispersion analysis.

Results: Statistically significant differences (p=0.002) were revealed for density indicators according to CT scans of the mandible in the frontal region against the background of zolendronic acid therapy. We attribute the absence of statistically significant differences for the density of the mandible in the lateral sections (p=0.101 and p=0.082) against the background of zolendronic acid therapy to a measurement bias. We attribute the absence of statistically significant differences in density indices against the background of hormonal, radiation, targeted and chemotherapy to the design of the study.

Conclusion: Density measurement based on CT examination data can be recommended for use as an additional tool in assessing the effect of zolendronic acid on the density of the mandible. However, the method of measuring the density of the mandible in the lateral sections requires improvement to prevent measurement bias.

The aim of the study: Was to explore the accumulation and distribution of the photosensitizer Photoditazine in the oral mucosa when applied to pathological lesions in patients with severe forms of lichen planus.

Material and methods: A clinical and laboratory examination was carried out in 50 patients with severe forms of lichen planus (bullous and erosive-ulcerative) aged 18 to 70 years, including 6 men and 44 women. For autofluorescent imaging a LED device with a wavelength in the violet region of the spectrum (400±10 nm) was used. Quantitative registration of the kinetics of accumulation and distribution of the photosensitizer was carried out using the method of local fluorescence spectroscopy by measuring the fluorescence spectra.

Results: The measurements were made before applying the photosensitizer, 10, 20 and 30 minutes after application. The study showed that in most patients with erosive-ulcerative and bullous forms of lichen planus, the accumulation of the photosensitizer in the lesions on the oral mucosa increased as the exposure time increased from 20 to 30 minutes. The fastest accumulation of the photosensitizer occurred in the areas of mucosal lesions with the most pronounced vascularization, namely, in the area of the tongue and the bottom of the oral cavity.

Conclusion: Using the method of local fluorescence spectroscopy, the kinetics of accumulation and destruction of photosensitizer in pathological areas of the oral mucosa was determined, and therefore the optimal time of laser exposure to the lesion was determined.

The aim of the study: To develop and implement a comprehensive algorithm for the rehabilitation of patients after partial resection of the mandible using a titanium «growing» endoprosthesis.

Material and methods: The study included 16 patients aged 2 to 7 years, with benign (6 cases) and malignant (10 cases) tumors of the mandible. The patients were divided into 2 groups depending on the time of fixation of the endoprosthesis. Group 1 included patients with simultaneous installation of a prosthesis (7 people). Group 2 included patients with delayed installation of an endoprosthesis (9 people). For the reconstruction of the mandible, «growing» titanium endoprostheses made of Ti6Al4V alloy of various designs were used. Removable orthodontic devices of mechanical and functional type of action, standard elastic mouthguards were used in the process of dental treatment.

Results: A comprehensive algorithm has been developed for the rehabilitation of children after partial resection of the mandible, depending on the time of fixation of the prosthesis and the volume of surgical intervention.

Conclusion: The developed algorithm of complex rehabilitation using a «growing» endoprosthesis and dental support at the pre and postoperative stages allows to reduce the volume of secondary deformation of facial structures and dentition.

Background: The era of using adhesives to fix brackets began in the 70s of the last century. There are eight generations of foreign-made adhesive systems for the restoration of teeth. However, until now, in orthodontics, the development of domestic adhesive systems with improved properties of adhesion of brackets to tooth enamel still important, especially in the posterior teeth.

Objective: The purpose of this work was to study the shear strength of fifth generation domestic adhesive between metal brackets and the enamel of molar teeth in laboratory conditions.

Material and methods: The study included 17 specimens of extracted maxillary molars embedded in acrylic resin blocks. Brackets from G&H Orthodontics (G&H Wire Company, USA) were fixed to the tooth enamel using the domestic Compofix (ortho) set. The enamel was treated with etching gel (37% phosphoric acid) for 30 seconds. Then the gel was washed off with water and the surface of the enamel was thoroughly dried. A primer was applied to the prepared surface with an applicator, inflated with a weak air flow for 5-10 seconds and photopolymerized for 20 seconds. The surface of the bracket was treated with degreaser, then a thin layer of adhesive was applied, and the sample was fixed to the enamel. Excess material was removed with an applicator. The samples were photopolymerized for 20 sec. Then, the shear bond strength of the adhesive was determined according to the method of GOST 31574-2012 on a (Zwick/Roell Z010 testing machine, Zwick, Germany).

Results: The shear strength of the adhesive joint obtained during the test is 13.54±1.01 MPa, the average value of the index of adhesive residues on the surface of the bracket was 23%±4%, which corresponds to the standard average values according to GOST.

Conclusion: The tested domestic adhesive system of the fifth generation can be recommended for the practical work of an orthodontist.

The article presents a case of a surgical treatment of removing a dermoid cyst of the floor of the oral cavity in a patient with severe hemophilia A. A detailed analysis was carried out of the surgical operation, postoperative management, coagulation factor replacement therapy and accompanying therapy, as well as the features of anesthesia, which allowed a surgical intervention without any hemorrhagic and infectious complications.

The aim of the study: Was to assess the efficacy and timing of emergency dental care in children with permanent teeth trauma according to analysis of medical records in an emergency unit of a municipal dental clinic.

Material and methods: The study involved 320 medical records of pediatric patients admitted to emergency dental care unit of a municipal dental clinic in 2021 because of maxillofacial trauma from which 221 records of children with acute dental trauma were extracted. The quality of documentation of the medical records, rationale for diagnosis and adequacy of emergency dental treatment were analyzed.

Results: No records included diagnosis code according to ICD-10. Trauma history was described in the majority of records by in 67% of them no trauma time was stated with proper precision. In 67.6% of permanent teeth trauma cases emergency aid was carried out inadequately. All patients with uncomplicated crown fractures were dismissed with no treatment. In complicated crown fractures needing pulp vitality preservation the pulp was devitalized or just anesthetized. Tooth replantation in avulsion cases was not performed. In 13.5% of records the treatment was not properly described. In 67.6% of records there were no recommendations for follow-ups.

Conclusion: There is a strong need for the improvement of knowledge of traumatic dental injuries management among Russian pediatric dentists by elaboration and implementation of protocols for dental traumas treatment.

Rehabilitation of patients with adentia and severe atrophy of the alveolar process of the upper jaw is one of the most difficult tasks of modern dentistry. The article demonstrates the experience of using a combination of traditional dental and zygomatic implants to create a fixed prosthesis support on the upper jaw. The combined installation of standard and zygomatic implants is a predictable rehabilitation technique in the case of severe atrophy of the alveolar process of the upper jaw, which reduces the number of surgical stages and reduces the duration of treatment.

An overview of various cell engineering techniques being developed for modern conservative and reconstructive periodontology is presented. The accelerated development of cellular engineering technologies poses to medicine and, in particular, periodontics, the task of early implementation of the results of such experiments into patient management protocols. The main groups of promising techniques that are closest to practical healthcare are: isolation and use of stem cells; synthesis of biologically active (inductive) signaling molecules; development of scaffolds that ensure three-dimensional tissue growth.