Stomatologiya最新文献

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.

Objective: To determine the prevalence of dentition defects and the need for orthopedic treatment among the population of the regions of Mongolia.

Materials and methods: The study involved 444 residents over the age of 18 living in the Khangai region of Mongolia. After a written agreement to participate in the study, an oral examination was performed and the examination data were marked on the map. When determining the topography of dentition defects, the classifications of E. Kennedy and E.I. Gavrilov were used, the presence and type of dentures were noted. Statistical processing of the results was carried out using the SPSS Statistics 25.0 program.

Results: Dentition defects were found in 91.3% of the subjects, complete absence of teeth in 0.4%, and 7.7% of the subjects had complete dentition. With an increase in the age of the subjects, there was a tendency to a predominance of terminal defects (80.8% aged 45 to 74 years). Regardless of age, defects in the anterior parts of the dentition were less common. Of the study participants, 209 (51.0%) had dentures, 97.1% wore removable structures. Acrylic and nylon prostheses prevailed among removable structures (97.0%), only 6 participants had clasp structures. Of the 410 examined with dentition defects, 201 (49.0%) did not have dentures and needed prosthetics after rehabilitation and special preparation of the oral cavity for prosthetics.

Conclusion: The reasons leading to early tooth loss and the most commonly used prosthetics methods are related to the economic level of the country's development, the lifestyle of the population, the state of sanitary and educational work and the low level of prevention of oral diseases. Comprehensive budgetary preventive measures in a particular region of the country are important for reducing oral diseases, aimed not only at reducing the incidence rate, but also at raising public awareness about oral health.

The aim of the study: Was a comparative analysis of the structural features of the endodontic system and the thickness of hard dental tissues over the past ten centuries.

Materials and methods: 180 teeth of people who lived from the X to XX centuries AD were studied using cone-beam computed tomography in endodontic mode: the volume of the endodontic system and the thickness of hard dental tissues were calculated using the algorithm developed by us. The Pearson correlation coefficient and Student's t-test were calculated in Excel program, and the data was analyzed with GraphPad Prism 8 Statistics Guide statistical program.

Results: The most significant Pearson correlation coefficient was found between the volume of the endodontic system and the thickness of the enamel in the area of the support cusp (r=0.723) and had a linear relationship for ten centuries. The dynamics of changes in other parameters has a non-linear dependence. Changes in parameters occur in a wave-like way.

Conclusion: The article assesses variability of structure of endodontic system and variation of features of internal structure of teeth.

Objective: Systematic review of literature on the pre-clinical studies of dental implantation in different models by finding out data about primary stability.

Materials and methods: PubMed, NCBI, Wiley Online Library, MBPI, Elibrary systems were used for search.

Results: Based on the literature review of the described animal species dogs have the most similar bone structure to humans but their usage is complicated by ethics and law reasons. They are next followed by rabbits with a frequency of use of 35%. Small ruminants', pigs' and mini-pigs' bones are close to human bones and their use is not ethically complicated. The mini-pig model allows assessing bone and soft tissue status of the previously surgical treated area for a sufficient time. Polyurethane blocks have been proposed as an artificial substitute for in vitro simulation in dental implant placement. The advantage of this material is its homogeneous structure.

Conclusion: Small ruminants, pigs and mini-pigs are the most optimal for preclinical studies on dental implantation.

Hypoplasia of the upper jaw to one degree or another inevitably occurs in patients with cleft lip and palate. The most difficult task is to fix skeletal deformity of the upper jaw, especially the discrepancy between its transversal dimensions due to the high risks of recurrence after treatment. One of the key stages of rehabilitation of this group of patients is orthodontics and surgical treatment aimed at eliminating functional and aesthetic problems of the dental system. The variety of treatment protocols illustrates the special approach in the treatment of patients with clefts, however, the development of recommendations to eliminate the imbalance of the upper jaw in these patients should include an interdisciplinary approach when choosing treatment tactics. The search for an effective rehabilitation algorithm continues, and the development of a digital protocol is especially useful in planning and interpreting patient treatment results. The purpose of this literature review was to analyze existing methods of conservative and surgical correction of transversal maxillary discrepancy in adult patients with cleft lip and palate.

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.