Stomatologiya最新文献

Objective: To study the effectiveness of implant-supported full-arch metal-ceramic prosthesis with gold-platinum alloy framework in elderly patients.

Materials and methods: The study included patients with complete and/or partial loss of teeth and terminal dentition. In 2007-2008, 354 implants were inserted in 27 patients. The age of the patients was 61.31±5.08 years. Mombelli index criteria (mBI [modified Sulcus Bleeding Index]) were used. The plaque index was determined using a modified Löe & Silness method. The state of the peri-implant bone (ΔMBL) was determined by a series of OPG. The Geriatric Oral Health Index (GOHAI) was used to assess oral health in the elderly.

Results: Metal-ceramic full-arch implant prostheses with a gold-platinum alloy framework, based on a sufficient and optimal number of implants (6-8), showed high survival rate (100%) after 15 years. Marginal bone loss (ΔMBL) after 15 years was -1.44±1.27 mm. The survival rate of implants was 99.4%. Scores on the GOHAI scale were higher in patients after orthopedic rehabilitation (from 52.7±7.1 to 54.1±8.4, p<0.001).

Conclusion: After 15 years, all prostheses had mechanical defects, which at the same time allowed them to be used without restrictions. Screw fixation of full-arch implant prostheses, although it was associated with mechanical complications, nevertheless made it possible to perform surgical interventions in a timely manner and stop the development of inflammatory complications. Thus, we do not see any grounds for removing metal-ceramic prostheses and replacing them with new implant prostheses even after a 15-year period of operation. At the same time, it is necessary to take into account the reduction in the possibility of individual oral hygiene in elderly patients, as well as possible restrictions on self-visiting a dentist or dental hygienist.

The article is a review of literature on various methods for measuring gingival thickness at implant site and tooth recession. The purpose of the study was to analyze existing methods for assessing volumetric changes in soft tissues based on literature data and give recommendations on the choice of methods. The authors analyzed available methods and identified limitations and recommendations for the use of different methods. The literature review is also helpful to identify promising methods for assessing changes in soft tissue volume, which may help authors of future studies with method selection.

Objective: Development and implementation in practice of a technique for applying a postoperative decongestant kinesiological bandage.

Materials and methods: A comparative analysis of the effectiveness of the developed methodology was carried out. Three groups of patients were formed, consisting of 20 people. The first group of patients received a kinesiological bandage after surgery. The second group used a pressure bandage, while the third group used a chilotherapeutic cooling mask.

Results: The average value of the volume of postoperative edema (in cm) on the 5th day after surgery was 10.9 in the first group; 11.4 in the second group; 11.1 in the third group. On the 10th day the corresponding values were 10.7, 11.2 and 11 cm in the third group.

Conclusions: The revealed indicators of average values in the three studied groups proved that the proposed method of applying the decongestant kinesiology dressing has the most pronounced effectiveness in the postoperative period.

The aim of the study: Was an improvement of dental health by optimizing dental medical examination in socially significant groups of the population.

Materials and methods: A continuous sample of 500 patients aged 65 to 95 years who applied to selected private dental organizations and public dental organizations in the period 2017-2020 was made. The clinical study was carried out by taking an anamnesis and a dental examination. The results of a retrospective analysis of the prevalence and intensity of the main dental diseases in elderly and senile people are presented, a scheme for dental medical examination of the study group is proposed.

Results: In a comprehensive dental examination of groups of elderly and senile people, the DMFT in the age group of 65-74 years is 18.8 [14.35-24.4], in the group of 75-84 years 20.5 [13.7-27.3], while in people from the group over 85 years 24.9 [19.05-28] teeth, in order to reduce high dental morbidity we have developed an original scheme for the procedure for conducting preventive medical examinations of older age groups of the adult population.

Conclusions: The results of the study indicate the insufficiency of preventive programs and therapeutic measures among the elderly and senile. The data obtained are aimed at substantiating the main directions for improving dental care for patients of the older age group in the current conditions of the healthcare system.

Objective: The aim of the study is to determine the X-ray morphometric parameters of the neck of the mandible for the rational choice of fixing elements during osteosynthesis.

Material and methods: Based on 145 computed tomography scans of the mandible, the parameters of the upper and lower borders, the area and thickness of the neck of the mandible were studied. The anatomical boundaries of the neck were determined using the classification of A. Neff (2014). The parameters of the neck of the mandible were studied depending on the shape of the mandible ramus, gender, age and preservation of dentition.

Results: The sizes of morphometric parameters of the neck of the mandible prevail in men. Statistically significant differences were found between the sizes of the neck of the mandible in men and women in the width of the lower border, area, and thickness of bone tissue. It was revealed that there are statically significant differences between hypsiramimandibular, orthoramimandibular and platyramimandibular forms in the following parameters: the width of the lower and upper borders, the middle of the neck, the area of bone tissue. When comparing the morphometric parameters of the neck of the articular process, there were no statistically significant differences between the age groups (p>0.05), and no differences were found between the groups identified by the degree of preservation of the dentition (p>0.05).

Conclusion: Morphometric parameters of the neck of the mandible have individual variability, statically significant differences depending on the sex and shape of the mandibular ramus. The obtained results on the width, thickness, and area of the bone tissue of the neck of the mandible will help in clinical practice to rationally choose the length of screws; the size, number, and shape of titanium mini-plates to achieve the requirements of stable functional osteosynthesis.

Objective: To improve the methodology for conducting preventive examinations of children by a dentist by identifying and preventing the risks of achieving their qualitative results.

Material and methods: A test version of the questionnaire was created, which was tested in a pilot study to assess validity and correction. A survey of 100 general dentists in Smolensk, Kaluga, Kaliningrad, Tula, who had previously participated in preventive dental examinations of children, was conducted. Questions were asked regarding the problems of organizing inspections, training, proposals for improving inspections. A comparative analysis of the risks of reducing the quality of examinations for each of the regions was carried out, proposals were made to improve the organization and conduct of medical examinations of children.

Results: As a result of the survey, a significant similarity of opinions of dentists in four cities of the Russian Federation on the problems and risks of annual preventive examinations of children was established. Among the weaknesses of the process, one should highlight the lack of time to examine the child; lack of specialized premises and a nurse; the absence of a unified form of a dental preventive examination card. This reduces the quality of diagnostics and continuity of medical care. Self-assessment by general practice dentists of their training in relation to diagnostics in children demonstrated a low level of knowledge of the issues of bite pathology, oral mucosa, and age periods of the dentoalveolar system. The lack of medical knowledge of more than 70% of doctors involved in preventive examinations of children is a key risk that requires immediate corrective action.

Conclusion: The results of this study are the basis for the recommendation of advanced training of dentists at least once every three years on the subject of preventive examinations of children. The process of dental medical examination of the child population needs to be corrected at the legislative and executive levels.

Objective: To improving the effectiveness of complex treatment of adult patients with the absence of individual teeth.

Material and methods: Clinical and radiological examination and comprehensive treatment of 37 patients with dental anomalies and the absence of individual teeth were carried out, 24 of them were women (average age 35 years), 13 men (average age 38 years). The patients were divided into two groups: the 1st group - 22 patients with distal occlusion; the 2nd group - 15 patients with mesial occlusion.

Results: The results of the developed algorithms for the complex treatment of patients with dental anomalies and the absence of individual teeth during the bite of permanent teeth are presented on a clinical example. The complex treatment included orthodontic treatment using a bracket system, functional fixed telescopic appliance, orthodontic mini screws for bone support and further rational prosthetics. After conducting a clinical and radiological examination and analyzing the data obtained, an individual patient treatment plan was developed, which included orthodontic and orthopedic stages. Orthodontic treatment made it possible to normalize the position of the teeth, the shape of the dental alveolar arches, occlusal planes, improve the bite, which made it possible to prepare the patient for rational prosthetics. The chosen treatment plan was optimal and correct for this patient: all the tasks were solved with changes not only at the dental alveolar level, a stable dental ratio was achieved and not only dental, but also facial parameters were improved.

Conclusion: Orthodontic preparation of adult patients before orthopedic treatment significantly improves the quality of orthopedic treatment and allows to achieve the most stable functional and aesthetic results.

Objective: To estimate the influence the dysplastic phenotype on the stomatological status in the persons living in the different climatic and geographical conditions (the south of Tyumen region, Khanty-Mansiysk and Yamalo-Nenets autonomous districts).

Material and methods: The cross-sectional and observational study of 578 male and female adolescents aged 13.65±1.7 was carried out. The level of oral hygiene, caries intensity and spreading and parodontium inflammatory diseases were estimated. All examined persons were divided into 2 groups depending on the presence of signs of connective tissue dysplasia (CTD).

Results: The significant spreading of undifferentiated forms of CTD was determined. It was 53.05% on the territory of the south of Tyumen region, 63.7% was in Khanty-Mansiysk district, 64.4% was in Yamalo-Nenets district (p=0.010). The involvement of the dento-maxillary system in the process was observed in 83.1% of adolescents with CTD. Caries spreading and intensity is significantly higher in the group of adolescents with CTD. The differences are statistically significant in all studied climatic and geographical zones. The higher spreading of signs of parodontium inflammatory diseases in the presence of CTD is registered. Spreading of parodontium inflammatory diseases among adolescents with CTD is statistically higher in Khanty-Mansiysk and Yamalo-Nenets autonomous districts than in the south of Tyumen region (p=0.004 and p<0.0001 respectively).

Conclusion: In the circumpolar region the share of persons with CTD and dysplastic depended changes of dento-maxillary system is statistically higher than on the territory of moderate latitudes. In the presence of CTD caries spreading and parodontium inflammatory diseases increases considerably but in the circumpolar zone the changes are significantly marked. The further study of the role of some factors including confounding in the dysplastic phenotype forming and stomatological pathology in the different climatic and geographical zone conditions is required.

The aim the study: This study aims to assess the postoperative condylar displacement after orthognathic surgery using three-dimensional analysis of computed tomography.

Material and methods: This retrospective study included 64 condyles from 32 patients with skeletal Class II (Group 1, n=16) and III (Group 2, n=16) deformities. All patients underwent a bimaxillary surgery. The three-dimensional CT images were evaluated to assess condylar displacement.

Results: The condyle exhibited mainly superior and lateral torque immediately after surgery. Posterior displaced condyles were found in two cases in group 1 (Class II malocclusion).

Conclusion: The present study found the condyle displacement that can be mistaken as posterior displacement of condyle in analysis of sagittal sections of CT scans.

Expert Council Resolution «Multidisciplinary approach to quality of life and health improvement in elderly patients with partial or total teeth loss».