Stomatologiya最新文献

Objective: Aim of the work is to increase the effectiveness of complex treatment in patients with mesial occlusion during active skeletal growth. mproving the effectiveness of complex treatment of patients with mesial occlusion during active skeletal growth.

Material and methods: Clinical and radiological examination and comprehensive treatment of 30 patients with skeletal anomalies according to sagittale were carried out (average age 15 years). Orthodontic treatment of patients was performed using the Damon self-ligating bracket system («Ormco», USA), H4 («OC Orthodontics» USA) with a sequential change of arches. According to the indications, orthodontic mini screws, removable, non-removable dilators, a facial mask, occlusal pads for disconnecting the bite, in the retention period, non-removable retainers in the anterior part of the dentition, a removable retention device at night «Corrector», or removable plate devices were used.

Results: Rapid palatal expansion was performed according to the traditional method, based on the stages of formation of the median palatine suture (the first algorithm is the stage of formation of the palatine suture A-B). In patients with narrowing of the HF with the stage of formation of the median palatine suture C, the beginning of stage D, the use of the proposed expansion scheme with the use of piezocorticotomy to eliminate the buttresses of the upper jaw, the use of laser corticotomy and the protocol of activation and deactivation of the screw to relax the bone and achieve skeletal expansion of the upper jaw was effective. The change in the dental alveolar height, normalization of the incisor overlap height improved harmony in the gnatic part of the facial skull of patients. In the process of orthodontic treatment, the inclination of the occlusal plane was normalized, the profile of the face improved. Changes in the soft tissues of the profile consisted in an increase in the thickness of the upper lip by 2.27±0.48 mm (p<0.05) and its length by 1.45±0.39 mm (p<0.05), the total length of the lower lip and chin by 3.16±0.45 mm (p<0.05). The position of the lips relative to the aesthetic plane has changed most significantly. An algorithm was developed for the treatment of patients with dental anomalies in the sagittal plane, with a narrowing of the upper jaw during the bite of permanent teeth 12-17 years.

Conclusion: The method of complex treatment is designed to increase the effectiveness of orthodontic treatment of patients with skeletal abnormalities during active skeletal growth and is aimed at changing skeletal growth, as well as to prevent the development of skeletal malocclusion during permanent bite, which is necessary to prevent the development of more pronounced skeletal deformity at the stage of complete skeletal maturation.

The aim the study. Increasing the effectiveness of treatment of chronic generalized periodontitis of moderate severity according to microhemodynamics and oxygenation in periodontal tissues.

Materials and methods: A clinical and functional study and treatment of chronic generalized periodontitis of moderate degree were conducted in 56 people (22 men and 34 women) aged 37 to 55 years. The patients were divided into 2 groups depending on the type of treatment: group 1 (main) - 28 people (11 men and 17 women, the average age of the group was 43.5±2.8 years, photodynamic therapy (PDT) with 1% dimegin gel using an AFS Spectrum LED emitter with a wavelength of 660 nm and an energy density of 95 J/cm²), in group 2 (control) - 28 people. (9 men and 19 women, the average age of the group was 45.0±3.1 years) standard treatment was performed without PDT. The level of tissue blood flow, its activity and vasomotor activity of microvessels, as well as the blood flow bypass index were determined by laser Doppler flowmetry. The study of oxygenation was carried out by optical tissue oximetry with determination of the index of oxygenation, specific oxygen consumption and perfusion oxygen saturation.

Results: After PDT, the periodontal tissues showed an increase in blood flow by 65.5% after 3 months, the level of oxygen metabolism increased by 51%, which increased after 6 months. The use of PDT in the complex treatment of chronic generalized periodontitis of moderate severity has an activating effect on the microcirculation system and the level of oxygen metabolism in periodontal tissues both in the near and long-term follow-up periods.

Conclusions: The use of PDT with 1% dimegin gel has an effective effect on the state of microhemodynamics and oxygenation in periodontal tissues.

The study objective: Was to assess the qualitative and quantitative characteristics of the bone regenerate in the distant period following compression-distraction osteosynthesis.

Material and methods: Results from the treatment of 30 patients with mandibular micrognathia, were analyzed. Compression-distraction osteosynthesis (CDO) was performed in the area of the mandibular angle. The patients were divided into two groups: group 1 consisted of 16 patients with congenital micrognathia, and group 2 comprised 14 patients with acquired (post-traumatic) micrognathia. For the assessment of qualitative and quantitative characteristics of the bone regenerate, three-dimensional modeling, morphometric measurements of the regenerate, and evaluation of bone density using the Hounsfield scale through multislice computed tomography were used.

Results and discussion: The study of the bone regenerate parameters in group 1 yielded the following results: the length of the bone regenerate decreased by 2.14%; the thickness of the bone regenerate increased by 8.75%; the height of the bone regenerate increased by 1.75%. In group 2, the values were 3.14; 3 and 3.76%, correspondingly. In patients of group 1, the length of the mandibular branch increased by 4%; the length of the mandibular body increased by 5.35%. In group 2, the length of the mandibular branch increased by 1.94%; the length of the mandibular body increased by 2.2%. The density of the cortical bone of the regenerate corresponds to the density of the intact bone, while the density of the cancellous bone is slightly reduced.

Conclusion: Qualitative and quantitative characteristics of bone regenerate in the long-term period after CDO correspond to the parameters of intact bone. CDO can be considered not only as a preparatory stage for reconstructive operations after the growth of the skull bones has completed, but also as an independent stage of treatment.

Purpose: Evaluation of the effectiveness of a new method of plasty of an extensive defect in the mucous membrane of the Schneiderian membrane, which occurs during the sinus lift operation, using an artificial collagen membrane and a developed method for fixing it.

Material and methods: A total of 188 patients took part in the study, all of these patients underwent an open sinus lift operation with simultaneous or delayed implantation. Operations were performed under balanced anesthesia. Six months after the operation, according to computed tomography, the height of the formed bone regenerate was estimated. In the area of each missing tooth, the initial bone height and the resulting bone grafting were assessed. Then we compared the average values before and after the operation, the average height difference before and after the operation.

Results: In 19 patients during the sinus lift there was an accidental extensive rupture of the mucous membrane of the maxillary sinus. Elimination of the mucosal defect was carried out according to our patented method. All 188 patients were diagnosed with partial loss of teeth with bone tissue deficiency in the distal maxillary sinus. The height of the alveolar process in the projection of missing teeth ranged from 0.5 mm to 5 mm. Delayed dental implantation was performed when the height of the alveolar bone was less than 3 mm, direct when the presence of 3-5 mm. After 6 months, dental implants were installed in the reconstruction zone, after another 6 months - rational prosthetics.

Conclusions: The proposed method of plastic surgery has the following advantages. Firstly, it allows to eliminate the defect of the mucous membrane together with an increase in the height of the alveolar ridge. Secondly, after this method, the integrity of the mucous membrane will be restored. Thirdly, with an alveolar bone height of 3 mm or more, dental implants should also be installed.

Objective: The physical and mechanical properties of samples printed from different materials subjected to post-processing in a clinic were evaluated.

Material and methods: Studied hardness and modulus of elasticity before and after sterilization by autoclaving. Based on the analysis of the literature and monitoring of the dental materials market, our choice fell on the most popular materials for 3D printing of surgical templates for dental implantation, such as: material 1 (FormLabs Dental SG Resin (Formlabs, USA)) and material 2 (NextDent SG (NextDent, Netherlands)). In connection with the events of recent years, we also took into the study a domestically produced polymer - material 3 (HARZLabs Yellow Clear PRO (HARZLabs, Russia)).

Results: As a result of the study, it was found that in each of the groups of materials studied, the values of the elastic modulus of sterilized samples are higher than the elastic modulus of samples that have not undergone sterilization. According to GOST 31572-2012 (ISO 1567:1999 Polymeric materials for denture bases, non-sterilized samples of group 2 are considered not to have passed the test, since all three samples of the studied group have a crack resistance index of less than 1 MN/m1.5. Crack resistance index of sterilized samples of the group of materials 2 is also close to 1. Samples of group 1 (both sterilized and non-sterilized) have the highest crack resistance. This group also has the highest flexural strength. On non-sterilized samples of material 1, there was no crack initiation along the cut and groove. The samples of other groups were mainly destroyed along the axis of the groove.

Conclusion: Analyzing the obtained data and considering that all studies carried out were in accordance with dental standards, the researchers concluded that the increase in flexural strength after sterilization by autoclaving and the feasibility of using material 1 for the production of surgical templates in accordance with all manufacturer's recommendations.

Objective: The aim of the study is comparative analysis of the condition of oral organs and tissues in people with metabolic syndrome (MS) of varying severity before orthopedic dental rehabilitation based on dental implants.

Material and methods: 255 patients (151 women and 104 men) aged from 35 to 65 years were examined. 3 groups were formed: 2 study groups and a comparison group. Groups 1 and 2 included individuals with excess body weight and MS. The control group consisted of 88 people without MS. An index assessment of the condition of the periodontium and tissue structures of the alveolar bone (according to cone-beam computed tomography), microcirculation in the gingival mucosa was carried out using laser Doppler flowmetry.

Results: The analysis of the periodontal condition indicators showed that in all groups of patients with MS, periodontal pathology occurred, the value of which was significantly higher than in patients of the control group (p <0.05). The analysis of bone tissue according to CBCT data showed that the most favorable conditions (type 1 and type 2 of bone according to Misch) for dental implantation are found in people without MS, respectively 3.5% and 35.1% of cases. The intensity of blood flow (σ) was 21.2% lower in group 1 and 48% in group 2, compared with the control group. Vasomotor activity (Kv) was 13.2% lower in the first group and 35% lower in the second group. A decrease in amplitudes in the area of all rhythms in the LDF gram was found: low-frequency - by 15.6%, high-frequency - by 16.9%, pulse - by 3.6%.

Conclusion: Changes occurring in the organs and tissues of the mouth against the background of MS of varying severity lead to a decrease in tissue perfusion with blood and blood flow activity, a local decrease in bone density, and as a result, pathological changes in periodontal tissues. Before performing dental rehabilitation, it is necessary to take into account all the risks of possible complications caused by the general condition of organs and systems of people with MS.

The aim of the study: Was to determine the presence of an amoxicillin-based antibiotic in bone implant biopsies by Raman spectroscopy in an experiment.

Materials and methods: Experimental animals (n=10, a miniature pig of the Svetlogorsk breed) were divided into 2 groups of 5 animals. Groups 1 and 2 were injected with amoxicillin 2 ml per 20 kg of body weight 30 minutes before dental implantation surgery, then group 2 was additionally injected with 1 ml per 20 kg of body weight for 5 days. Each animal has 6 implants installed. On the 1st, 3rd, 7th, 14th day, an implant-bone biopsy was removed from each animal, micro-preparations were made and Raman spectroscopy was performed to assess the peak matching of the Raman spectrum.

Results: In animals of the 1st and 2nd groups, the main peak of the Raman spectrum, which is closest to the values of the antibiotic spectrum of interest to us, is located closer to 1448 cm^-1 and 1446 cm^-1, respectively. At the same time, in both observations, the peaks relate to the spectrum of bone tissue, which cannot indicate the content of an antibiotic in the drug.

Conclusion: No scattering spectra corresponding to the antibiotic molecule were found in any animal from both groups, regardless of the mode of administration and dosage of amoxicillin. The detected peaks corresponded to bone tissue without an antibiotic.

Based on archival data, the authors describe the Moscow School of Dentistry with dental courses for doctors, dentists, and dentists of the Moscow University, Privat-docent Dr. Gilyari Ivanovich Vilga, examine the background to its formation, provide unique archival data on the location of the school, as well as its internal organization and equipment. The authors review in detail the program of courses, as well as their duration, cost, and form of student accountability. During its existence (1909-1918), more than two thousand dentists were educated at G.I. Vilg's school, among them Alexander Ivanovich Evdokimov, a future corresponding member of the USSR Academy of Medical Sciences, director of the State Institute of Dentistry (GIZ) and the State Institute of Dentistry and Odontology (GIZO). The authors of the article also focus on analyzing the differences in the approaches to the organization of several dental schools, viz: The First Moscow I.M. Kovarsky School of Dentistry and the Second G.I. Vilga School of Dentistry. In his efforts, I.M. Kovarskij's aspirations to establish the best dental school in Russia were crowned with success: a specially constructed and equipped building meeting the state-of-the-art requirements (the building even boasted an X-ray machine), and the best professors and instructors of the University of Moscow of that time were hired. In contrast, G.I. Vilga rented premises for his school, the equipment was in short supply, and he himself was the only eminent professor. Nevertheless, his fierce desire to unite the entire dental community and organize the best dental care for the entire population of Russia allowed his brainchild to enter the top five schools of the time.

Objective: The aim of the sthudy. To study the influence of general and local factors on the regenerative potential of bone tissue to optimize augmentation mechanisms in the treatment of jaw atrophy.

Materials and methods: The influence of general and local factors on the regenerative potential of the bone during the augmentation operation of the alveolar process (part) of the jaw in 68 patients was studied. The survival rate of dental implants and the incidence of complications after completion of dental rehabilitation in the long-term follow-up period (more than 5 years) were evaluated. 18 indicators were studied, which were evaluated by qualitative and quantitative methods. The study of the effect of indicators on regeneration was carried out using an accurate Fischer test for conjugacy tables. The assessment of the strength of the influence was calculated as the ratio of the chances of developing an unfavorable outcome of bone grafting and dental implantation.

Results: He highest chances of developing adverse outcomes were found in smoking patients with diabetes mellitus, high body mass index, low survival of bone walls, severe bone atrophy (5.6 and higher class according to Cawood & Howell), three-dimensional bone defect, in the absence of 3 or more bone walls, the presence of subcompensated and decompensated psychological state the patient. In the course of histological examination, the influence of these factors on the mechanisms of reparative osteogenesis morphologically manifested a lower degree of progress of regenerative processes and a lower degree of maturity of bone tissue.

Conclusion: To reduce the chances of developing an unfavorable outcome, in the presence of negative general and local factors, it is not advisable to use dental implantation simultaneously with bone augmentation procedures. In order to reduce the pathophysiological impact of negative factors during sinus lifting, increase the proportion of autosteal material for potentiating the metabolic activity of bone tissue, as well as prescribe antioxidant, antihypoxant and membrane stabilizing therapy before surgery and in the early postoperative period.

Objective: To establish the criteria for selecting surgical treatments for velopharyngeal disfunction and to evaluate their effectiveness.

Materials and Methods. 34 patients with velopharyngeal insufficiency underwent surgery at the National Medical Research Center for Surgery and Maxillofacial Surgery. Five common surgical methods for treating velopharyngeal disfunction were employed.

Results: The choice of surgery was primarily based on the anatomical and functional state of the muscle lifting the soft palate, specifically its position, which was determined visually or by MRI. Repositioning of the muscle helped to improve or restore speech in patients with velopharyngeal disfunction through surgeries such as secondary cleft revision, Furlow's palatoplasty, and triangular miomucosal flaps. In cases of soft palate palsy or correct positioning of the m. levator veli palatini, the focus of surgical treatment shifted to the pharynx, where surgeries like pharyngoplasty with a posterior pharyngeal flap and Hynes pharyngoplasties were performed. These also improved or restored speech in patients, though more towards improvement than complete restoration. If the muscle's position was optimal, the choice of treatment method subsequently depended on the results of additional nasopharyngoscopy: determining the size of the opening and the type of velopharyngeal closure. Besides the common methods used for speech management, various surgical procedures were combined based on the clinical situation.

Conclusion: The position of the levator muscle is very important for its function. The optimal treatment for velopharyngeal disfunction, especially in patients with large openings, involved using a buccal flap alone or in combination with triangular mucosal-muscle flaps, where the highest percentage of normal speech rate was achieved.