Stomatologiya最新文献

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.

The aim: The of study was to assess the prevalence and features of acute dental trauma in children living in educational institutions.

Materials and methods: 131 medical records of children from orphanages who suffered dental injuries in the period from 2017 to 2021 were studied. The analysis of the relationship of the type of acute dental injury (ADI) with the gender, age of patients, history, and the timing of medical care access was carried out. A dental examination was also performed on 52 healthy pupils of the Center for the Promotion of Family Education in Moscow (study group) with ADI. The control group consisted of healthy children living in families (n=52). The dental aesthetic index DAI was determined in patients of both groups.

Results: Based on a retrospective analysis of the medical histories of children in educational institutions, 38.2% had a tooth luxation, 61.8% had a tooth fracture. The timing for medical care provision was characterized by a large range of values, an asymmetry of distribution (Me=4.5 days). The prevalence of ADI was higher in children from orphanages compared with children of the control group. In the case of a history of tooth injury, the DAI index was on average 5.2 points higher (p=0.016).

Conclusion: Dental examination of children in orphanages revealed a higher prevalence of OTD compared to children living in families. The DAI b index in patients of both groups is on average 5.2 points higher (p=0.016) in the case of a history of ADI. The study highlights the need to improve dental care and prevent dental injuries among children in educational institutions.

The aim of the study: Was to determine the risk factors for pulp necrosis and external inflammatory resorption in children with permanent teeth trauma.

Materials and methods: The study involved 68 pediatric patients aged 6 to 16 years (mean age 10.9±2.9 years) with a history of trauma to 152 permanent teeth. Of the 152 teeth, 55 had unformed roots, and 97 teeth had formed roots. Multiple trauma was observed in 43 teeth, and isolated trauma was observed in 109 teeth. All patients were assessed for the risks of pulp necrosis and external inflammatory root resorption in traumatized permanent teeth depending on a number of factors. The patients were observed clinically and radiographically from 6 months to 9 years.

Results: The probability of external inflammatory resorption in case of pulp necrosis in permanent teeth with unformed roots is 2.3 times higher than in formed ones. Multiple trauma (30.9%) is more common in patients with unformed roots of permanent teeth, while combined trauma (87.6%) is more common in patients with formed roots. The probability of pulp necrosis in case of multiple trauma of a permanent tooth is higher (67.4%) than in case of isolated trauma (36.7%). Of all types of trauma, avulsion and impaction of a permanent tooth most often lead to pulp necrosis and development of external inflammatory root resorption.

Conclusion: Multiple trauma, which is more typical for permanent teeth with unformed roots, is a risk factor for pulp necrosis and, consequently, external inflammatory root resorption of a tooth. A risk-based approach can be an effective tool for a dentist in choosing the tactics of managing children with permanent tooth trauma. Evaluation of risk factors for pulp necrosis and external inflammatory resorption in a specific permanent tooth in a child will allow the dentist to provide a personalized way to prevent these complications, and therefore increase the likelihood of tooth survival after trauma.

The aim of the study: To study the expression of NOD receptors of immunotropic periodontal tissue cells in patients with aggressive periodontitis before and after complex treatment.

Materials and methods: 15 patients aged 22 to 36 years with aggressive periodontitis were examined before and 21 days after the start of complex treatment. 15 patients with fibroids of the oral mucosa without signs of inflammation served as controls. Samples of the gingival mucosa after surgical treatment were sent to a routine histological and immunohistochemical (IHC) method with polyclonal rabbit antibodies. The expression of pro- and anti-inflammatory receptors was studied: NOD receptors - NLRP3 and NLRP12 as the most significant. The criterion for evaluating the expression of NLRP12 and NLRP3 receptors was the staining of nuclei and cytoplasm of cells of the multilayer squamous epithelium and cytoplasm of inflammatory infiltrate cells in the own plate of the mucous membrane. The intensity of staining was assessed as: no staining (0), weak staining (1+), medium (2+) and intense (3+).

Results: In the control group of patients diagnosed with fibroma without signs of inflammation in the oral mucosa, expression of NOD receptors was not observed. The maximum expression of NOD receptors was detected during exacerbation of the aggressive form of periodontitis in the nuclei and cytoplasm of stratified squamous epithelial cells and in the lamina propria of the gingival mucosa in the cells of the inflammatory infiltrate. After complex treatment of patients with an aggressive form of periodontitis, there is a significant (p<0.05) decrease in the expression of NLRP12 receptors in the cells of the inflammatory infiltrate, which inhibit the inflammatory response in periodontal tissues.

Conclusion: The expression of NMDA receptors in the multilayer squamous epithelium characterizes the activity of the inflammatory process in the oral mucosa and can be recommended for use in evaluating the effectiveness of the treatment of an aggressive form of periodontitis.

Objective: Study on the impact of medical wound dressing compositions on reference strains of microorganisms in vitro conditions.

Materials and methods: The study compared the antimicrobial activity of three types of dressing materials (DM): iodoform gauze bandage, DM with furagin and sodium alginate, DM from hydrogel with dimexide and silver nitrates. Gauze bandage with chlorhexidine was used as a control. Their impact on various strains of bacteria and fungi was investigated by measuring zones of growth inhibition of microorganisms over several days at different temperatures.

Results: Iodoform showed short-term action: the inhibition of microorganism growth ranged from 6 to 9 mm during the first few days, and then disappeared. The sample with furagin and sodium alginate demonstrated stable activity throughout the entire period; the largest inhibition of growth was observed for S. aureus (up to 13.5 mm) and P. aeruginosa (up to 12 mm), and the smallest for C. albicans (5.5 mm). The hydrogel with dimexide and silver nitrate was the most effective, showing antimicrobial activity against all strains, especially against C. albicans (up to 12 mm). The control bandage with chlorhexidine was twice as effective as the furagin sample in antimicrobial activity against E. cloacae and S. pyogenes and on average 2.6 mm against P. aeruginosa.

Conclusion: The hydrogel from sodium alginate with dimexide and silver nitrates is effective against all the studied microorganisms, including yeast fungi of the genus Candida. The antimicrobial activity remains for 7 days, which can reduce the frequency of dressing changes and minimize wound surface trauma, improving the quality and safety of medical care.

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.

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.