Stomatologiya最新文献

Primary chronic osteomyelitis (PCO) is a rare non-bacterial autoinflammatory severe disease that most often affects children aged 7 to 12 years and is much less common in adults. The most common areas of lesion are long tubular bones, however, any bones of the skeleton, including the lower jaw, can be affected. The clinical picture of this disease is complex and similar to many tumor and tumor-like bone lesions, which often leads to a significant delay in making a correct diagnosis. The diagnosis of primary chronic osteomyelitis is primarily based on the exclusion of other diseases by comparing the data of radiation diagnosis, clinical course and histological examination of biopsy material. In this article, which is part 1 of a two-part series, the authors review the clinical presentation of PCO, its suggested causes found in the literature, and current diagnostic methods.

The main principles of management of children with root fractures of permanent teeth in the coronal third are presented using two clinical cases as an example. In the treatment of root fractures in the coronal third, an important condition for success is timely flexible or semi-flexible splinting of the tooth for a sufficiently long period (up to 4 months). In the absence of splinting or significant mobility of the coronal fragment after removal of the splint the probability of pulp necrosis is very high, and the method of choice is treatment with calcium silicate cements with their introduction by orthograde or surgical access. Significant mobility of the coronal fragment excluding stable healing with the formation of a hard-tissue connection is an indication for decoronation, while orthodontic extrusion in combination with surgical lengthening makes it possible to use the preserved root as a support for the orthopedic structure.

The aim of the study: Was to assess an impact of positioning occlusal splints made by various methods on the position of the articular disc of the temporomandibular joint according to MRI data.

Materials and methods: 40 patients (8 men and 32 women) aged from 18 to 60 years with temporomandibular joint pain dysfunction syndrome were examined (ICD-10 code K07.60). Patients were treated with splint therapy using traditional splints made with combined method (20 patients) and subtractive occlusal splints made by CAD/CAM technology (20 patients). All patients had MRI of the temporomandibular joints before splint therapy and at the final stage of treatment to determine the position of the articular disc in the habitual occlusion and at maximum mouth opening.

Results: After splint therapy, patients in both groups showed an improvement in the position of the articular disc in the usual occlusion: the rate of patients with bilateral dislocation of the articular disc decreased from 85% to 67.5%, and with unilateral articular disc dislocation decreased from 15% to 10%. With maximum mouth opening, complete reposition of the articular disc in both joints were recorded in 22.5%; the rate of patients with bilateral disorder of articular disc repositioning decreased from 85% to 67.5%, and with unilateral disorder of articular disc repositioning decreased from 15% to 10%.

Conclusions: Splint therapy had a pronounced positive clinical effect in patients with pain dysfunction syndrome in the temporomandibular joints. Splint therapy is more effective in correcting sagittal dislocation of the articular disc than transversal dislocation. The study showed comparable treatment results when using traditional and digital occlusal splints.

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.

Background: Augmented reality (AR - augmented reality) is the addition of digital information to one or more senses, which allows the user to perform tasks more efficiently. This can be achieved by overlaying images, videos, or computer models.

Objective: The aim the study is to study the use of AR for preoperative planning of perforant flaps and compare the results of visualization accuracy of various research methods.

Materials and methods: 3 patients with oncological diseases were examined, who were planned to lift and transplant a SCIP flap (in two cases) and a propeller flap on the perforant branch of the peroneal artery (in one case). All patients underwent a high-frequency ultrasound of 75 GHz examination of the donor zone and marking along it in the area of the planned flap lift. A CT scan of the donor area was also performed, followed by the superimposition of a segmentation image using HoloLens 2 virtual reality glasses. 7 measurements were obtained.

Results: AR for microsurgical planning was performed in two inguinal regions and was 100% correlated with the results of high-frequency ultrasound, in the case of perforant vessels of the peroneal artery, a discrepancy of 5 mm was noted for the X and Y axes in three perforant vessels.

Conclusion: Augmented reality allows the reconstructive surgeon to see the anatomy of the area of interest in a particular patient before the incision. This area of medicine is certainly in demand, promising and requires further research with larger patient samples and randomization.

One of the most prominent Russian odontologists of the early twentieth century, privat-docent of the Imperial Moscow University Gilyariy Ivanovich Vilga was engaged in the problem of dental education reforming all his life. Considering dentistry, a branch of medical science, equal to its other branches, he considered the optimal model of higher dental education in institutes with a four-year course of study. As the chairman of the Moscow Dentistry Society and the chairman of the board of the Russian Union of Dentists, he presented this initiative to the commission of the State Duma in 1914, but the project was rejected; as a member of the Scientific Dentistry Commission, he attempted again to present his model of dental education in 1918, but the project was rejected by the board of the Dentistry subsection of the People's Commissariat of Health. After his emigration to Poland, Vilga G.I. was a member of the board of professors and one of the directors of the State Institute of Dentistry, established in Warsaw in 1920 (since 1933, the Academy of Dentistry). In Russia, independent stomatological institutes also appeared, but much later.

The article presents information on the biography of a well-known scientist, clinician and teacher, a brilliant dentist, Honored Doctor of the Russian Federation, Doctor of Medical Sciences, Professor Sergei Ulitovsky. His contribution to the development of the preventive direction of domestic dentistry, the engineering of basic methods for assessing and dynamically monitoring the dental health of the population depending on the dental and hygienic status of a person, as well as the development of many classifications of means and objects of individual oral hygiene and individual hygienic prevention programs for patients of various ages.

Objective: To develop a universal system for assessing the speech function in patients with congenital palatal cleft in the postoperative period.

Materials and methods: A universal system for assessing the speech function for patients with a palatal cleft can be applied both after the primary operation of uranoplasty and for patients diagnosed with velopharyngeal insufficiency (VPI). The patient's speech is assessed according to the following criteria: defects in the pronunciation of consonants by place of articulation: labial, labiodental, lingual-dental, lingual-palatal, lingual-alveolar; speech breathing; tongue position; directed air stream; voicing disorders; The patient's is also evaluated for the following findings: hypernasality (reflected speech); hypernasality (spontaneous speech); hyponasality; pharyngeal reflex; audible nasal emission/turbulence; facial grimaces; speech intelligibility. The speech therapy and dental assessments are added to obtain a value characterizing the patient's condition: from 0 to 10 scoring indicates than only speech therapy correction is needed; from 11 to 18 - the decision on the necessity of surgical treatment is made by the surgeon together with the speech therapist, from 18 to 25 - surgical treatment is necessary with subsequent sessions with a speech therapist.

Results: With the help of this questionnaire, the operating surgeon can more accurately and objectively assess in dynamics the result of the surgical treatment, regardless of the results of speech therapy treatment in the postoperative period. The creation of this scoring system for speech assessment is aimed at objectivizing the results of uranoplasty and speech-improving operations. It allows the surgeon to compare the effectiveness of different surgical methods.

Conclusion: The universal scoring system for assessing the state of speech function can be applied in the diagnosis of a patient with a palatal cleft both after the primary operation on the palate and after corrective surgical interventions. It allows monitoring progress and identifying dynamics in surgical and speech therapy treatment.