Stomatologiya最新文献

Objective: Evaluation of the accuracy of measurements of the size of intraosseous defects using imaging tools of cone-beam computed tomography and visualization tools of radiography of the vertebral intraoral.

Material and methods: In the study, cone-beam computed tomography and intraoral radiography were used as digital dental techniques. Prepared bone fragments from animals were used as materials.

Results: CBCT allows for obtaining a three-dimensional image with a smaller error, the magnitude of which is not clinically significant. Meanwhile, a two-dimensional image conveys information about sizes that differ significantly from the true defect. The accuracy of CBCT results is undeniable with the presence of skills in working with the software of the computed tomograph and adherence to visualization rules. Thus, CBCT is the preferred diagnostic method in dentistry.

Conclusion: Due to the specific nature of scanning and information processing, cone-beam computed tomography (CBCT) systems are designed to operate only within the range of bone tissue visualization. When intraosseous defects of the jaws occur, decalcification of bone tissue or its mechanical destruction takes place, resulting in a hypodense area of a certain configuration with soft tissue density visualized on CBCT. With experience in working with CBCT software and adherence to visualization rules, the researcher can obtain reliable information about the size, configuration, and location of bone defects in the jaws. Three-dimensional imaging in dentistry should be considered more reliable and informative than traditional two-dimensional imaging.

Objective: The aim of the study was to evaluate the function of sound reproduction in patients with postoperative defects the upper jaw with and without a prosthesis replacing the defect.

Material and methods: The study included 25 patients with an upper jaw defect acquired as a result of resection, aged 33 to 74 years. Among them are patients with various types of defects: a defect of only the alveolar process (3 patients, 12%), a defect of the alveolar process and half of the palatine process on the resection side (7 patients, 28%), a defect reaching the midline of the hard palate or a defect involving the tissues of the hard palate on both sides of the midline (12 patients, 48%), any defect involving soft palate tissues (3 patients, 12%). To replace the defect of the upper jaw, prostheses of various configurations were made for patients: a partial removable plate prosthesis with an obturator (13 (52%)), a complete removable upper jaw prosthesis with an obturator, including one collapsible complete removable prosthesis with an obturator (7(28%)), a clasp prosthesis with an obturator (5 (20%)).

Results: It was revealed that the use of an upper jaw prosthesis with an obturator significantly improves speech recognition and reduces the number of speech defects in patients with acquired upper jaw defects. It was found that the presence of a patient with an upper jaw defect in the anamnesis of radiation therapy for an upper jaw tumor negatively affects the quality of sound reproduction. It was also revealed that the configuration of the postoperative defect is a predictor of the success of the patient's speech rehabilitation using an upper jaw prosthesis with an obturator.

The aim the study: to make a comparative clinical analysis of the effectiveness of restoring the proximal surfaces of teeth using the active method as modified by the authors and the passive method without pressing the matrix.

Material and methods: The study consisted of 2 stages: preclinical and clinical. At the preclinical stage, a computer-mathematical simulation of matrix deformation was carried out depending on the pressing point in the AutoDesk SolidWorks 2019 software package. The clinical stage of the study involved 140 patients who were divided by block randomization with a block volume of 5 into 2 groups: control group (treatment passive method of restoring the contact point without pressing using a ring matrix system) and the study group (treatment with an active method with pressing along the anatomical landmarks of the teeth in combination with the use of a ring matrix system). Monitoring of the condition of the restoration, periodontium and tooth contact point was carried out after 6 months and after 18 months to assess long-term results.

Results: The results of the study demonstrated statistically significant differences (method used: Pearson Chi-square) between the control and study groups: for all studied parameters, the incidence of complications in the study group was lower than in the control group.

Conclusion: The results obtained during the study confirmed the need for anatomically correct compression of the matrix, even when using modern ring matrix systems, as well as the importance of periodic preventive examinations every 6 months to prevent the development of complications after treatment.

In the practice of a dentist, there are often contentious situations where it is necessary to choose a treatment strategy that provides the greatest benefit while minimizing costs for the patient. In extreme cases, when a patient presents with a nearly complete loss of the crown, even an experienced clinician may question the feasibility of preserving the tooth. This article presents a clinical case of comprehensive treatment of a patient using the concept of tooth extrusion-turbo-extrusion-in an aesthetically important area, employing orthodontic materials, followed by endodontic retreatment, preparation, and fixation of a ceramic prosthesis. After conducting a literature review, it was concluded that careful diagnostics and rational treatment planning can yield stable clinical outcomes, including tooth preservation, achieving the desired architecture of the marginal gingiva, and restoring aesthetic parameters.

Objective: To present a retrospective analysis, clinical picture, diagnostic and surgical tactics in the clinical observation of capillary blood vessel malformation.

The article presents an analysis of a clinical case of capillary malformation in a 17-year-old boy who was admitted to the children's clinic of the Central Research Institute of Dentistry and Maxillofacial Surgery after inadequate, long-term treatment with various treatment methods for capillary-type blood vessel malformations in the lower lip area. Incorrectly chosen treatment tactics led to hypertrophy and scarring of soft tissue in the affected area. The resulting cosmetic defect could only be eliminated surgically. The resulting cosmetic defect could only be eliminated surgically. At the stage of preparation for surgical treatment, additional research methods were carried out: ultrasound with Dopplerography of the soft tissues of the lower lip, chin, cheek areas, MRI of the soft tissues of the face and neck. The patient underwent surgical treatment. A comprehensive operation was performed - removal of pathological tissues with correction of the shape of the lower lip. Pathomorphological examination of the material was carried out after surgical treatment. As a result of the operation, a satisfactory cosmetic result was achieved.

Objective: To study the frequency of visits to dental surgeons in different subjects of the Russian Federation.

Material and methods: The work used the data of sectoral statistical observation for 2017-2023 presented in the 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. Statistical and analytical methods of research were used in the work.

Results: It was found that the highest attendance rate of dental surgeons nationwide was recorded in 2018 and 2019. During the COVID-19 pandemic period from 2019 to 2021, specialist attendance decreased by 10.5%. However, despite the imposed restrictive measures during the COVID-19 pandemic the number of visits to dental surgeons for the disease increased in 17.6% of the subjects of the Russian Federation. After the COVID-19 pandemic (from 2022 to 2023) the rate in general increased by 0.5%. In the period under study, the dynamics of attendance of dental surgeons in the country as a whole remains negative with a decrease of 9.9%.

Conclusion: The increase in the frequency of visits to dental surgeons among the population of the Russian Federation both during the COVID-19 pandemic and after it indicates an increase in the medical activity of the population in maintaining dental health.

Objective: To conduct a comparative analysis of the aesthetic results of treatment of patients with gingival recession of RD class I and II according to Miller using collagen matrices and connective tissue transplant (CTT).

Material and methods: The study included 25 patients with grade I and II RD in the area of 107 teeth on the upper and lower jaws. The patients were divided into 4 groups: Mucoderm (n=28), Fibro-Gide (n=22), FibroMATRIX (n=23) and CTT as controls (n=34). The operation was performed using a modified coronary displaced flap technique. In the postoperative period the pain syndrome was studied using a numerical scale. After 12 months, an aesthetic assessment of GR plastics was performed using the Root Coverage Esthetic Score (RCES), and the percentage of GR closure was determined.

Results: After two weeks, a significant decrease in pain intensity was recorded in all the study groups. At the same time, the pain level in the comparison groups was significantly lower compared to the control group. Complete closure of the exposed surface of the dental roots was achieved in 85% of cases in the Mucoderm group, in 90% in the Fibro-Gide group, in 80% in FibroMATRIX and in 95% in the control group (p<0.05).

Conclusion: Collagen matrices can serve as an alternative to CTT, but despite the positive results they provide a smaller increase in keratinized gums and do not always completely eliminate GR limiting their use in periodontal surgery.

Objective: To evaluate morphological changes in the mandibular condyle (MC) during its remodeling following bimaxillary orthognathic surgery in patients with skeletal class III malocclusion.

Material and methods: İn this study 32 three-dimensional virtual models of the condylar process of the mandible from 16 patients with skeletal class III malocclusion have been analyzed. The models were generated from computed tomography scans performed one week before (T₁) and 12 months after (T₂) bimaxillary orthognathic surgery. The analysis included a comparison of MC volumes between T₁ and T₂, as well as T₁-T₂ distance measurements on the apexes of five surfaces (superior, anterior, posterior, medial, and lateral). The relationship between changes in MC volumes and the surgical intervention characteristics (maxillomandibular advancement (MMA) and the degree of mandibular occlusal plane rotation (CCWR)) was also assessed.

Results: The mean MC volume before surgery was 2142.13±427.88 mm³ (95% CI 1987.86 mm³ to 2296.39 mm³), and after surgery, it was 2141.53±540.51 mm³ (95% CI 1946.66 mm³ to 2336.41 mm³). No significant differences were found between MC volumes before and after surgery (T-test=0.0103; p=0.9918; Wilcoxon test=251.0; p=0.8177). T₁-T₂ changes demonstrated minimal remodeling across all MC surfaces, with no significant differences observed between surface pairs (M_T1-T2=0.02±0.38 mm, Kruskal-Wallis test=0.523, p=0.971; ANOVA =0.294, p=0.882). No correlations were identified between changes in MC volume and the characteristics of surgical intervention (r=-0.026 (p=0.888) for MMA, r=-0.07 (p=0.704) for CCWR). Clinically significant symptoms in the temporomandibular joint (TMJ) or instability in mandibular position at T₂ were not observed.

Conclusion: Morphological changes in the MC following bimaxillary orthognathic surgery in patients with skeletal Class III malocclusion fall within the parameters of functional remodeling. These changes are accompanied by mandibular stability and do not lead to TMJ dysfunction in the late postoperative period.

Objective: To improve the level of individual oral hygiene based on personalized selection of interdental brushes in patients with moderate and severe chronic periodontitis.

Material and methods: The study included 42 patients with moderate and severe chronic periodontitis aged 35 to 65 years who underwent surgical treatment. Three groups were formed depending on the individual hygiene method: Group 1 - application of individually selected interdental brushes, Group 2 - self-selected brushes, and Group 3 - without the use of brushes. A web service was developed for selecting individual brushes, optimizing the documentation process and personalization of recommendations. Microbiological examination of periodontal pocket contents was performed using cultural analysis methods and real-time polymerase chain reaction (PCR) before treatment, 2 weeks and 3 months after treatment.

Results: Before treatment, the main isolated microorganisms were periodontopathogenic bacteria Prevotella intermedia (52.6%) and Porphyromonas gingivalis (33.8%), as well as representatives of oral microflora Streptococcus spp. (33.8%) and Lactobacillus spp. (21%). Three months after treatment, in patients using individually selected interdental brushes, the recovery rate of periodontopathogenic microflora Prevotella intermedia decreased to 14.3%, which was significantly lower compared to the group using uniform-sized brushes (42.9%) and the group without brush use (71.4%) (p<0.001). A similar trend was observed for Streptococcus spp., with recovery rates of 28.6%, 57.1%, and 85.7%, respectively. The OHI-S hygiene index after 3 months was significantly lower in the individually selected brush group (0.5±0.2) compared to the self-selected brush group (1.1±0.3) and the group without brush use (1.8±0.4).

Conclusion: The use of individually selected interdental brushes provides improvement in oral hygiene status by reducing the recovery of periodontopathogenic oral microorganisms. The developed web service for individual interdental brush selection increases physician work efficiency and allows for the formation of personalized recommendations for patients.

Mandibular distraction osteogenesis (DO) is a widely used surgical technique for bone lengthening based on the gradual separation of osteotomized bone segments with subsequent formation of a regenerate. The standard distraction rate is 1 mm per day; however, clinical observations reveal individual variations in regenerate mineralization rates, challenging the necessity of a uniform protocol. In recent years, increasing attention has been given to the personalized adjustment of distraction rates to optimize treatment duration and enhance bone quality. For this review, we analyzed 127 publications indexed in PubMed, as well as data from Scopus, Web of Science, and Google Scholar over the past 10 years. The review focuses on studies evaluating the effects of mechanical factors-such as distraction rate and regimen-on regenerate formation, as well as the efficacy of physiotherapeutic methods for stimulating osteogenesis, including low-intensity pulsed ultrasound (LIPUS), low-level laser therapy (LLLT), pulsed electromagnetic field therapy (PEMF), electrical stimulation, and hyperbaric oxygen therapy (HBOT). The development of automated distractors with feedback systems may represent the next step in the evolution of this technique, providing dynamic control of distraction based on objective data.