Stomatologiya最新文献

Objective: The aim of the study is to study the prevalence of dental anomalies (DA) and assess the need for orthodontic treatment (NOT) among adults in the Arctic part of the Arkhangelsk region.

Materials and methods: In total, 1068 adult residents of Arkhangelsk and Primorski rural district aged 35-90 years took part in a cross-sectional study. The Dental Aesthetic Index (DAI) was used to assess the prevalence of DA and NOT in the study population. The prevalence is presented as percentage with 95% confidence intervals (CI) calculated using Wilson's method.

Results: The overall prevalence of DA was 55.2% (95% CI: 52.2-58.1). It was found that 58.2% (95% CI: 53.5-62.8) of men and 53.1% (95% CI: 49.2-56.9) of women required orthodontic treatment. The highest prevalence of malocclusion and the need for orthodontic treatment was identified in the age group of 60-74 years in both men and women. This high rate is due to removed teeth, periodontaland somatic diseases so that ortodontical treatment should be used to improve quality of life.

Conclusions: The prevalence of dental anomalies and the need for orthodontic treatment in the adult population of the Arctic zone of the Arkhangelsk region is at a high level. Improving dental literacy and developing strategies directed at early prevention of dental diseases starting from childhood, particularly in remote areas, is warranted.

Objective: The aim of this study. Comparison of the accuracy of segmentation of TMJ elements in different ways and assessment of the suitability of the data obtained for the diagnosis of TMJ dysfunction.

Materials and methods: To study the segmentation of the bone elements of the TMJ (articular fossa, head of the LF), 60 computed tomograms of the maxillofacial region of patients were randomly selected in various ways (archival material). In group 1, the results of CT processing by AI diagnostics algorithms (Russia) were collected; in group 2, the results of CT processing based on the semi-automatic segmentation method in the Avantis3D program. The results of CT processing by Avantis3D AI algorithms (Russia) with different probability modes - 0.4 and 0.9, respectively, were selected for the third and fourth groups. Visually, the coincidence of the contours of the LF heads and articular pits isolated using different methods with their contours on all possible sections of the original CT itself was evaluated. The time spent on TMJ segmentation according to CT data was determined and compared using the methods described above.

Results: Of the 240 objects, only 7.5% of the cases showed a slight discrepancy between the contours of the original CT in group b1, which was the lowest of all. A slight discrepancy in the TMJ contours to be corrected is characteristic of the semi-automatic method of segmentation by optical density was detected in 50.4% (group 2). The largest percentage of significant errors not subject to correction was noted in the first group, which made it impossible to perform a full 3D analysis of the TMJ, and the smallest in the second and fourth. The magnitude of the error in determining the width of the articular gap in different groups is comparable to the size of one voxel per CT. When segmentation is carried out using AI, the difference between segmented objects is close to zero values. The average time spent on TMJ segmentation in group 1 was 10.2±1.23 seconds, in group 2 - 12.6±1.87 seconds, in groups 3 and 4 - 0.46±0.12 seconds and 0.46±0.13 seconds, respectively.

Conclusion: The developed automated method for segmenting TMJ elements using AI is obviously more suitable for practical work, since it requires minimal time, and is almost as accurate as other methods under consideration.

The aim: Jf the study was to assess the efficacy of mineral trioxide aggregate for treatment of children with complicated permanent teeth trauma.

Material and methods: The study comprised 29 children aged 6-13 years (mean age 8.6±1.7 years) with 36 injured constant teeth, from which 30 had immature roots, 27 (75%) teeth had necrotic pulp at baseline examination, 12 (33.3%) teeth showed radiological signs of external imflammatory root resorbtion, 2 teeth were diagnosed with of the root fracture (5.6%). MTA was used for pulp regeneration procedure in 25 (69.5%) teeth, external closure of resorbtion site in 3 (8.3%) teeth, root canal filling in 4 (11.1%) teeth, apical plug creation in 4 teeth (11.1%). The patients were folowed up for 1 to 9 years.

Results: From 36 teeth only one was extracted 9 years after regenerative endodontic procedure because of cervical root fracture. In 2 teeth with external imflammatory resorbtion progession of replacement resorption took place, in 1 tooth necrosis of regenerated pulp tissue occurred 2 years after the procedure because of restoration marginal seal failure. In 25 teeth favorable outcome was registered with stabilisation of external root resorbtion, continous root growth in 24 teeth and radioluscent lesions healing in 6 teeht showing them at baseline examination. Change of external imflammator root resorbtion to replacement resorption was detected in 1 teeth from 3 with external closure of resorbtion site. Root calan filling with MTA was performed in 3 avulsed teeth with replantation delayed for more than 1 day and in 1 tooth with root fracture. All teeth were clinically asymptomatic during more than 5 years follow-up. Favorable outcome was received in all cases of apicl plug formation.

Conclusion: MTA is highly effective for preservation of constant teeth in children with clinically complicated situations. In many cases with hopeless long-term prognosis for a teeth MTA allows stabilization of dental tissue level with the teeth being an object for guided tissue regeneration.

Objective: The aim of the study is reducing the risks of surgical injury to the inferior alveolar nerve, by taking into account individual topographic and anatomical features, improving diagnostic methods, and techniques for removing retinated teeth with a close fit to the mandibular canal.

Material and methods: An examination was conducted in the Department of Surgical Dentistry (CBCT/OPG) and surgical treatment of 223 patients, with a close fit of the roots of the retinated lower third molar to the mandibular canal. Microslips of teeth with roots intact during removal (n=96) of the main group and the control group (n=52) were prepared with a Micromet Remet manual petrographic machine. The sections were carried out along the longitudinal axis of the tooth with the capture of the area of close fitting of the nerve, the teeth from the control group were sawed longitudinally along the axis of the root. The measurement of the macroanatomic features of the roots was carried out with a micrometer (MCC-MP-100 0.001 electronic «CHEESE», manufactured in the Russian Federation), measurements of the thickness of dentine and cement tissues on macroglyphs were carried out using a microscope calibration ruler with an accuracy of 0.01 mm.

Results: In the main group, three types of attachment of the mandibular canal to the root of the third molars were distinguished: 20 (96) cases of inter-root attachment of the mandibular canal, 42 (96) apical, 34 (96) lateral (buccal and lingual). A number of anomalies in the structure of the roots of the third molars have been revealed, which are a factor in injury to the neurovascular bundle of the mandibular canal during tooth extraction. The surface of the roots, as well as the microscopes of the tooth sections adjacent to the mandibular canal, were studied under a microscope.

Conclusion: A number of specific anomalies of the roots of retinated third molars formed by root dilaceration, thinning of cement tissues, hypercementosis, which are formed at the site of the mandibular canal.In the presence of a deep indentation on the root of the tooth, as well as in the presence of areas of apical hypercementosis in the form of a «spike», the probability of nerve injury during tooth extraction increases many times, which must be taken into account when removing retinated third molars.

Objective: The aim of the sthudy is to sthudy the level of soluble Immune Checkpoint Molecules (B7.2, CTLA-4, Tim-3, Lag-3, PD-1) in the oral fluid during dental caries with the background of a lack and/or deficiency of 25-hydroxy-vitamin D in body.

Materials and methods: During the research 3 groups of people were formed, each one of them included 17 people aged from 20 to 24 years. The first group included students with high-intensity caries (above 9 DMFt index) and 25-hydroxy-vitamin D levels in blood serum >30 ng/ml, the second included students with high caries intensity and 25-hydroxy-vitamin D levels <30 ng/ml. The control group consisted of students with an average DMFt index of 1.5 (from 0 to 3) and a level of 25(OH)D in the blood more than 30 ng/ml. To determine the content of B7.2 (CD86), CTLA-4, Tim-3, Lag-3, PD-1, the Human Vascular Inflammation Panel 1 multiplex analysis kit from Biolegend (USA) was used.

Results: The results of the research showed that during dental caries with a normal level of 25-hydroxy-vitamin D there are no significant changes in the content of Immune Checkpoint Molecules. With the background of deficiency and lack of 25-hydroxy-vitamin D there is a decrease in the amount of B7.2, LAG-3, Tim-3 and PD-1. These changes are being aggravated with an increase of the caries intensity.

Conclusion: Vitamin D deficiency leads to a decrease in mucosal immunity of the oral cavity, the multiplication of pathogenic microorganisms, which in turn, releasing various metabolites, including cytokine-like substances, aggravate the pathological process and intensify carious lesions.

Purpose of the study: To study the effectiveness of the drug Cholisal as part of the conservative treatment of chronic periodontitis.

Material and methods: We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute stage with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of periodontitis, patients were divided into two groups of 50 people. In the main group, Cholisal dental gel was used as part of complex conservative treatment, and in the control group, Metrogil-denta gel was used. To assess the effectiveness of treatment, a dental examination of patients was carried out with an index assessment of the condition of periodontal tissues and a biochemical analysis of the content of arachidonic acid and prostaglandin E2 in gingival blood, comparing the indicators before treatment and 14 days after the start of treatment.

Results: When the drug Cholisal was included in complex treatment, 14 days from the start of treatment, patients experienced a statistically significant decrease in the depth of periodontal pockets from 4.7±0.32 mm to 3.6±0.19, and the Green-Vermillion hygiene index by 60.7%, Silness-Loe plaque index by 73.1%, PMA index by 68.8%, Muhlemann-Cowell bleeding index by 68.0% (p<0.001 compared to baseline). When Metrogil-denta gel was used in complex therapy, the effectiveness of treatment was lower: the depth of periodontal pockets did not change significantly (from 4.5±0.22 mm to 4.2±0.17 mm, p>0.05), reduction in the hygiene index Green-Vermillion was 51.9%, Silness-Loe plaque index - 64.0%, PMA index - 43.7%, Muhlemann-Cowell bleeding index - 45.8% (p<0.001 compared to baseline, p<0.001 compared to the main group). A laboratory study showed that in patients of the main group, after completing a course of conservative treatment, the content of biomarkers of inflammation significantly decreased compared to the initial level (p<0.05), while in patients of the control group the content of arachidonic acid and prostaglandin E2 in the gingival blood during the study period did not change significantly (p>0.05 compared to the initial level).

Conclusions: The use of the drug Cholisal in the conservative treatment of chronic periodontitis has demonstrated more pronounced positive dynamics of clinical and biochemical parameters compared to traditional therapy, which suggests its high effectiveness.

Objective: The aim of the study is to identify the prospects and possibilities of using artificial intelligence (AI) and domestic software in the provision of organization dental care in the Russian Federation.

Materials and methods: An analysis of the actual situation on the use of domestic computer programs using AI for the provision of medical care in the Russian Federation was carried out based on information presented on the official websites of software developers, in scientific sources of information and analytical systems of the Higher Attestation Commission, eLibrary, PubMed, Scopus, Google Scholar. Content analysis and analytical method were used, followed by interpretation of the data and conclusions obtained.

Results: To date, information technologies and domestic software aimed at automation, improving safety and quality of medical care are being actively introduced. The requirements for AI-based programs are justified, namely: safety, accessibility for medical professionals and patients, as well as high competitiveness among developers. AI helps to process large amounts of medical data, contributes to the creation of a personalized approach to patient treatment, automates and optimizes administrative processes in healthcare, increases the accuracy of diagnosis, identification of early signs of the disease, predicts the outcome of treatment, neural networks accelerate the development of remote healthcare and telemedicine. However, it is the doctor who should be responsible for the decisions made based on the "tips" and recommendations of artificial intelligence.

Conclusion: The use of computer programs using artificial intelligence in dentistry opens up significant prospects for improving the quality of medical care, interaction with patients and improving the level of education of doctors. The most popular programs will be in therapeutic and pediatric dentistry, aimed, among other things, at the prevention of dental diseases.

The name of Alexander Ivanovich Evdokimov is widely known to dentists all over the world. An outstanding leader, teacher, scientist and doctor, a wonderful man and a wonderful family man - this is how the first and only Hero of Socialist Labor in dentistry remains in the memory of grateful descendants. In 2012, by the decision of the Minister of Health and Social Development of the Russian Federation T.A. Golikova, his name was given to the Moscow State University of Medicine and Dentistry, and the textbooks published under his pen are still relevant today, in the year when we celebrate the 140th anniversary of the coryphaeus' birth.

Objective: To reveal need for prosthodontics in permanent teeth in children aged 8-18 years.

Materials and methods: The study was performed in Khimki Dental Municipal Clinic. Dental examination and radiological studies were conducted in 97 primary patients aged 8-18 years. Indications for prosthodontics in permanent teeth were occlusal deterioration index more than 40% and crown decay of more than 50% in incisors and canines. Additional features were registered including DMFT index, the presence of extracted teeth and teeth after root canal treatment, as well and teeth with extensive restorations with resins and marginal seal quality.

Results: From 97 primary patients (27.8%) children needed prosthodontics in permanent teeth (in average 2.3±2.1 teeth): 1 tooth in 10 children, 2 teeth in 11 children, 3 teeth in 1 child, 4 teeth in 3 children and 4 teeth in 2 children. Mean DMFT was 8.1±4.5 teeth. Six children already had extracted permanent teeth (9 teeth in total). Half of the teeth (49.2%) which needed orthodontic treatment had history of root canal treatment while 46% needed primary or secondary endodontic treatment. Occlusal deterioration index was more than 40% in 41.3% of cases, more than 60% in 49.2% of teeth and more than 80% in 9.52% of teeth. From all the teeth restored with composite resins 41.7% had good marginal seal but 58.3% showed macroscopic signs of marginal leakage.

Conclusion: Our study shows high percentage of adolescents having need for prosthodontics in permanent teeth and unjustified widening of indications for direct resin restorations in this group of patients.

Objective: To evaluate the possibility of improving the effectiveness of early postoperative healing in patients after surgical interventions on periodontal tissues due to the topical application of alginate plates with a complex of antimicrobial peptides and cytokines.

Materials and methods: 40 patients who underwent periodontal surgery were examined: operations aimed at bone tissue regeneration; mucogingival operations (elimination of gum recession), corticotomy with osteoplasty, apical surgery. The patients were randomly divided into 2 groups of 20 people (main and control). At the end of the operation, alginate plates with a complex of antimicrobial peptides and cytokines were applied to the surgical intervention area to the main group. Further, 2-3 times a day, it was recommended to apply them independently for 10-14 days, after antiseptic treatment. In the control group, they were limited to double treatment with 0.05% chlorhexidine bigluconate solution daily for two weeks. Follow-up examinations and evaluation of the index of early wound healing, as well as indicators of postoperative pain, bleeding and edema were carried out on day 3, 7, 14.

Results: In all patients in the early postoperative period, positive dynamics of healing were observed, however, in the main group, pain indicators, as well as bleeding and swelling, according to a patient survey, were less pronounced. The early wound healing index was also more positive in the main group - on days 3, 7 and 14 there was a more intense decrease. (1.9 points.,1.5 points., 1.2 points., respectively, and in the control group 2.3 points., 2.1 points., 1.9 points.).

Conclusion: Local application of alginate plates with a complex of antimicrobial peptides and cytokines in the early postoperative period allows to improve early wound healing after surgical interventions on periodontal tissues, and can be recommended for use at a dental appointment, as well as for use at home.