Stomatologiya最新文献

Objective: Development and implementation into practice of a method for applying a postoperative anti-edematous kinesiological bandage used in extended genioplasty.

Material and methods: A comparative analysis of the effectiveness of the developed method was conducted. Three groups of patients were formed, consisting of 20 people. The first group of patients after surgery used a kinesiological bandage. The second group - a bandage pressure bandage. The third - a hylotherapeutic cold mask. The results were assessed immediately after applying the bandages, on the 5th day after their removal, and also on the 10th day using MSCT examination of the facial skeleton and 3D photographs of the face, analyzed using the «Planmeca ProFace» program.

Results: The average value of the volume of postoperative edema (in cm) on the 5th day after surgery was: 9.4 in the first group; 10.6 in the second group; 10.3 in the third group. On the 10th day: 9.1 in the first group; 10.4 in the second group; 10.1 in the third group.

Conclusion: The results obtained in the three study groups proved that the proposed method of using an anti-edematous kinesiological bandage in extended genioplasty has the most pronounced effectiveness in the postoperative period in extended genioplasty.

Objective: To perform a comparative morphometric analysis of mandibular body length and ramus height in adolescents with unilateral mandibular underdevelopment, and to develop a classification of severity grades and an algorithm for surgical treatment planning.

Materials and methods: The study included 50 patients (27 boys and 23 girls) aged 9 to 17 years (mean age 13.4 ± 2.1 years) with unilateral underdevelopment of the mandible of various etiologies. All patients underwent multisection CT of the maxillofacial region with morphometric analysis of key parameters (Go-Me, Co-Go). The obtained values were compared with the normative age indicators identified according to literature data and CT scans of 10 healthy children, and the shortening in millimeters and percentages was calculated.

Results: A quantitative classification of unilateral underdevelopment of the mandible has been developed. With grade I underdevelopment, shortening of the body and/ or branch is less than 10% of the age norm; with grade II, a decrease in size in the range of 10-30%, grade III corresponds to severe underdevelopment with a shortening of more than 30%. A clear relationship between the morphometric degree of shortening and clinical manifestations was established: at grade I, distal bite was observed without pronounced functional disorders.; Grade II revealed a pronounced malocclusion (Angle class II) with deep incisor overlap and crowding of teeth; grade III showed gross changes in the profile of the face with pronounced asymmetry, distal bite and severe functional disorders - impaired chewing, swallowing and speech.

Conclusion: The morphometric classification made it possible to quantify three degrees of underdevelopment of the mandible - mild, moderate and severe - based on shortening of body length and/or height of the branch relative to the age norm. Taking into account the prevailing type of shortening (horizontal, vertical, or combined) provides a more accurate reflection of the clinical picture. Based on the classification, a treatment algorithm has been developed. The proposed approaches standardize the planning and implementation of surgical correction of mandibular underdevelopment in adolescents.

Objective: To evaluate the osteogenic properties of porous polylactide granules (PLA) and hydroxyapatite granules (HA) impregnated with recombinant bone morphogenetic protein-2 (BMP-2) in vitro and in vivo.

Materials and methods: Osteogenic differentiation in the presence of polylactide granules was studied in a culture of mesenchymal stromal cells obtained from rat adipose tissue (MSC-AT). For this purpose, the expression of the Bmp2, Spp1, and Bglap genes and the production of osteocalcin and osteopontin proteins were analyzed, as well as the mineralization of the intracellular matrix. In vivo, the osteogenic properties of PLA granules and two types of hydroxyapatite with BMP-2 were studied using a model of orthotopic osteogenesis. After 28 days, histological analysis and morphometry were performed to assess the volume of newly formed bone tissue and connective tissue surrounding and sprouting into the material.

Results: Polylactide granules with BMP-2 stimulated the osteogenic differentiation of MSC-AT, caused an increase in the expression of genes for markers of osteogenic differentiation, Bmp2, Spp1 and Bglap, and the production of proteins osteopontin and osteocalcin, and contributed to the mineralization of the extracellular matrix. In vivo, the material based on polylactide granules with BMP-2 led to the formation of a larger volume of bone tissue, compared with hydroxyapatite HA-1 granules, and contributed to less fouling of connective tissue.

Conclusion: Highly porous polylactide granules impregnated with BMP-2 demonstrated osteogenic properties in in vitro studies, and were also characterized by better osteoinductive properties compared with impregnated BMP-2 hydroxyapatite granules in vivo. Thus, polylactide granules with recombinant BMP-2 can be used to produce highly effective bone graft materials for the restoration of bone defects in dentistry and maxillofacial surgery.

Objective: To implement an optimized surgical protocol and evaluate the effectiveness of treatment in patients with bilateral cleft lip and palate and severe premaxillary displacement during the preparation stage for alveolar bone grafting of the maxilla.

Materials and methods: A standardized protocol for correcting significant premaxillary displacement was applied in 15 patients aged 7 to 15 years who underwent surgery at the Central Research Institute of Stomatology and Maxillofacial Surgery. The protocol included model surgery, the fabrication of an individual occlusal splint for fixation, and an atraumatic surgical approach. Inclusion criteria were significant premaxillary protrusion, vertical displacement, or rotation, as well as the impossibility of achieving proper alignment through orthodontic compensation alone to prepare for alveolar bone grafting of the maxilla. Effectiveness was assessed based on the following criteria: achieving the planned position of the premaxilla, preservation of maxillary blood supply, creation of conditions for two-stage alveolar bone grafting without the need for additional orthodontic or surgical correction.

Results: The planned position of the premaxilla was achieved in 100% of cases. Vascularization of the premaxilla was preserved in all patients. One case of partial ischemia of the premaxilla was observed in the early postoperative period, likely due to multiple previous surgeries on the upper lip. Nevertheless, full rehabilitation was achieved. Anatomically correct positioning of the maxilla was ensured in all patients, enabling alveolar bone grafting without the need for additional correction.

Conclusion: The proposed protocol for surgical repositioning of the premaxilla in patients with bilateral cleft lip and palate demonstrates high clinical effectiveness due to increased accuracy and standardization. The use of preoperative modeling, an individual occlusal splint for fixation, and well-defined inclusion criteria minimizes intraoperative risks, ensures stability of the premaxilla, and creates optimal conditions for subsequent bone grafting.

Objective: To assess the sealing properties of the most commonly used materials for retrograde filling using a novel reproducible and standardized laboratory testing method.

Materials and methods: The study included 36 intact teeth divided into four experimental groups according to the type of filling material used (Dia-Root BioMTA, Biodentine, Trioxident, Ketac Cem) and two control groups consisting of intact teeth with cleaned and pulp-filled cavities. Sealing ability was evaluated through visual inspection and spectrophotometric analysis of dye penetration over a period of one month.

Results: No dye penetration through the retrograde filling was observed in any of the experimental groups, confirming the high sealing capacity of the materials. Changes in environmental pH from neutral to acidic did not significantly affect permeability.

Conclusion: All tested materials demonstrated reliable sealing of the retrograde cavity, indicating their suitability for use in apical surgery.

The review summarizes the disparate data on the prevalence of bone defects and the need for bone graft materials. Data from publicly available sources has been analyzed. Parallels have been drawn between the structure of the prevalence of bone lesions and the volume of the market for bone graft materials. An approximation of the demand for bone graft materials in Russia is given.

The purpose of this scientific article is to analyze the scientific literature aimed at identifying the relationship between vitamin D levels in the body and diseases of the oral organs, in order to determine the potential impact of vitamin D deficiency on their development. Special attention is paid to the development of recommendations for maintaining optimal vitamin D levels for various population groups in order to strengthen both general health and prevent diseases of the oral cavity.

The aim the study. The aim of the study was to conduct a comparative analysis of methods for determining the optimal individual position of the mandible using a hydrostatic mouth guard and transcutaneous electrical stimulation (TENS) techniques.

Material and methods: The study comprised 188 patients with musculoskeletal and articular dysfunction of the TMJ. The subject of the study is cone beam computed tomography and magnetic resonance imaging of the TMJ of these patients. Before starting treatment, all patients underwent magnetic resonance imaging of the TMJ with functional tests (in the open and closed mouth position) and seizure of the masticatory muscles.

Results: It was found that the results of the therapeutic and diagnostic procedure for finding the optimal position of the lower jaw using a hydrostatic mouth guard and the TENS method are comparable to each other.

Conclusion: CBCT and TMJ MRI are informative diagnostic tools that can be effectively used in the diagnosis and treatment of patients with musculoskeletal dysfunction. Methods for determining the optimal position of the mandible using a hydrostatic mouth guard and TENS have shown their effectiveness at the therapeutic and diagnostic stage of rehabilitation of patients with musculoskeletal dysfunction of the TMJ.

Objective: The aim of the study was to assess the dental status, including the condition of periodontal tissues, in patients with liver cirrhosis.

Material and methods: Based at the Federal State Autonomous Educational Institution of Higher Education of the First Moscow State Medical University named after I.M. Sechenov a dental examination of 52 patients with liver cirrhosis of various etiologies was conducted. The main diagnosis was established based on the results of biochemical blood parameters and ultrasound examination of the abdominal organs, according to which the patients had all 3 classes of liver cirrhosis according to Child-Pugh.

Results: Comparison of the periodontal index in groups depending on the severity of liver cirrhosis showed a significant difference between groups (p<0.05): the maximum was determined in patients with Child-Pugh C (59±0.14 percentage), the minimum - with Child-Pugh A (36.4±0.13 percentage). Comparison of periodontal pocket depth (PD index) in groups depending on the degree of severity showed a significant difference between groups (p<0.05): the maximum was determined in patients with Child-Pugh C (4.02 mm), the minimum - in Child-Pugh A (2.96 mm). Comparison of clinical loss of attachment (CAL index) in groups depending on the degree of severity showed a significant difference between groups (p<0.05): the maximum was determined in patients with Child-Pugh C (-4.1 mm), the minimum - at Child-Pugh A (-2.8 mm).

Conclusion: Based on the results of the study, the presence of a direct connection between periodontitis and the severity of liver cirrhosis could not be excluded.

Objective: The aim of the study was to investigate the dynamics of attendance of oral surgeons in the subjects of the Russian Federation per one inhabitant per year.

Material and methods: The data of statistical compilations of the Ministry of Health of Russia on resource provision in federal districts and subjects of the Russian Federation for 2018, 2020, 2022 and 2024 were used in the work.

Results: In the Russian Federation the attendance of oral surgeons per resident per year decreased by 9.7% from 2017 to 2023/ In most federal districts, the dynamics of the attendance rate of oral surgeons per one inhabitant for the period from 2017 to 2023 is comparable to the trend for the country as a whole, except for the North Caucasus, where there was an increase of the indicator by 12.6% for the same period. During the COVID-19 pandemic, the attendance rate decreased by 10.5% in 84.7% of the subjects, after the pandemic it increased in 56.5, decreased in 38.8, and stabilized in 4.7% of federal districts.

Conclusions: The results of the study show the ambiguity of the situation on the attendance of oral surgeons in the subjects of the Russian Federation, which is probably related to the age characteristics of patients and the accessibiility of specialized medical care to the population.