Stomatologiya最新文献

Objective: The aim of the study was an analysis of changes in the legal institution of voluntary medical insurance program (and their possible consequences) in order to make proposals for the settlement of disputed issues.

Material and methods: Using the content analysis method 19 sources of regulatory legal documentation on the legal phenomena of voluntary medical insurance were studied, of which 6 are federal laws and the Code, 3 are Government resolutions of the Russian Federation, 7 are regulatory legal acts of federal executive authorities, 3 are other regulatory documents. In order to search for the primary material, computer databases of the legal reference systems ConsultantPlus, Guarantor and Pravo.RU were used. The depth of the study was 32 years.

Results: The considered legislative norms designed to establish legal, organizational, and economic principles in the field of voluntary health insurance, contain only general provisions without taking into account its specifics.

Conclusion: It is necessary to consolidate the accumulated experience and start regulating the sphere of voluntary medical insurance by the Government.

Objective: The aim of the study to study of physical, mechanical and biocompatible properties of the matrices manufactured by antisolvent 3D printing from the solutions of polylactide-co-glycolide in tetraglycol.

Material and methods: Three-dimensional scaffolds were made from a solution of polylactide-co-glycolide mixed with tetraglycol using antisolvent 3D printing. The elastic properties and the structure of the obtained matrices were studied. MTT-test and staining with PKH-26, Calcein-AM, DAPI with subsequent fluorescence microscopy were used to study biological properties.

Results: The three-dimensional scaffolds had good mechanical properties. Young's modulus value was 18±2 MPa, tensile strength was 0.43±0.05 MPa. The relative survival rate of cells after the first day was 99.58±2.28%, on the 14th day - 98.14±2.22%. The structure of the scaffold promoted cell adhesion and spreading on its surface.

Conclusion: The polylactide-co-glycolide matrices produced by antisolvent printing have high porosity, biocompatibility and good mechanical properties. It is allowed to use them in the future as a basis for personalized constructions for the replacement of extensive bone defects of the maxillofacial region.

Background: Dentinal fluid is very close in its physical and mechanical properties and composition to blood plasma, which makes it a potentially aggressive biological environment for modern adhesive systems. An in-depth study of the physiological processes of the functioning of tooth dentin remains relevant in order to solve problems associated with its artificial restoration.

Purpose of the study: Study using computer simulation speed of movement and pressure distribution of dentinal fluid in the dentinal tubule of the tooth to assess the possibilities of their regulation.

Material and methods: To model the distribution of flow velocity and pressure of dentinal fluid in the dentinal tubule, the finite element method (Fluent ANSYS computer program) was used.

Results: Immediately behind the spherical tip of the odontoblast, there is a rapid increase in the hydraulic diameter of the flow section of the dentinal tubule, and, accordingly, a decrease in capillary pressure, while the tip of the odontoblast creates a large local hydraulic resistance. The resulting distribution of pressure drop in the damaged dentinal tubule is consistent with the fact that fluid movement is due, to a greater extent, to the capillary effect rather than the inlet pressure into the dentinal tubule.

Conclusion: By changing the length of the odontoblast process, it is possible to influence the parameters of the hydrodynamics of dentinal fluid in the space of the dentinal tubule.

Objective: To assess the prevalence and quantitative characteristics of skeletal asymmetries of the body and lower jaw branches in three-dimensional space.

Materials and methods: Using depersonalized data archive, of 400 CBCT scans, forty studies were picked randomly. Patients aged 25 to 35 years participated in research, no history of maxillofacial reconstructive surgery; gender, race, and facial anomaly were ignored. Three experienced doctors, independently, identified 15 reference points on radiographic images of AUTOPLAN software. Expert consensus found in the orientation determination. Six planes and eight points were constructed, using Math algorithms and the Python OOP; body and branches of the lower jaw length measurements performed and processed automatically.

Results: The study identified symmetry, using a method for determining parameters of the lower jaw in 3D space (Priority Reference No.2023100466 at 10.01.2023), modern dentistry research method. Both sides of data obtained shown asymmetry of the body and branches of the lower jaw occurred in 45% (18 people) and 67.5% (27 people) of cases. Forty percent of cases were noted with Mild asymmetry of the lower jaw body (16 people), moderate asymmetry noted in 5% (2 people). These parameters were 57.5% for branches, (23 people) and 10% (4 people). Combined form of anomaly observed in 37.5% (15 people) of cases, among which 12 people (75%) showed adaptive compensation of anomalies, which requires further investigation on a larger number of patients.

Conclusion: Lower body jaw asymmetry is prevalent (80%). Patients with moderate and serious anomaly form appeared in 15% of cases.

Objective: Conducting a retrospective analysis of the indicators of orthodontic care provided in Ryazan and the Ryazan region from 1999 to 2017.

Material and methods: During the study, institutions providing orthodontic care were divided into three levels of dental organizations. Level 1 medical care centers provide assistance to residents of districts of the region, the results of the work of clinics located in 2 districts of the region were analyzed for the period since 2005 to 2017. Level 2 StMO includes state dental clinics and private dental clinics in the city of Ryazan, where you can get orthodontic care. The work of state structures was analyzed from 1999 to 2011 with a step of 3 years, from 2011 to 2017. - yearly. Level 3 SMEs include specialized departments of universities, where only consultative and diagnostic assistance is provided. An analysis was made of the orthodontic pathology with which the patients treated, as well as an analysis of the orthodontic equipment used for treatment during the study period.

Results: The prevalence of AFA among the child population of the region's districts is at the level of 80.10±0.68%, fixed equipment is used 3 times more often in level 1 SMO than in level 2 SMI, and removable equipment is used only 10-20% less often. in the SMC and levels 1 and 2, the main part of the contingent is the child population (97.7-99.1% and 67.82-0.63%, respectively), but in the region for this type of assistance, the appealability among patients over 18 years of age is 10% less than in the city.

Conclusion: The data obtained indicate the need for changes in the structure of orthodontic care. It is required to allocate at least 2 rates of an orthodontist in each district to provide assistance to the population living in the Ryazan region.

A method for diagnosing, planning and surgical treatment of patients with micrognathia of the mandible with physiological occlusion is proposed, which makes it possible to objectively assess the severity of the anomaly and concomitant functional disorders of external respiration in the nasopharynx and oropharynx, as well as to identify the pathophysiological mechanisms of obstructive sleep apnea syndrome (OSAS) and develop an optimal surgical treatment plan with high functional and aesthetic results.

Objective: To correlate the magnitude of the amount of translation of prosthesis and the native joint, and the postoperative change in the volume of the contralateral condylar process after unilateral total joint replacement.

Material and methods: The study examined 16 patients with post-traumatic jaw deformation treated with unilateral TMJ replacement using total endoprosthesis. The mandible kinematics was recorded using the Cadiax Diagnostic system and correlated with the remodeling of the native joint.

Result: On average, the group showed an 8.5% decrease in the volume of the native condylar process. In 13 patients, the amplitude of the native joint movement in the mouth opening and the mandible pro- and laterotrusion markedly deviated quantitatively that combined with the translational movement of the TMJ endoprosthesis in all types of mandibular abduction in all the patients. Correlation analysis showed a moderate negative relationship (r= -0.43) in opening the mouth between the amplitude of movement of the native joint and of the endoprosthesis, as well as a noticeable negative strength of relationship. Also, the correlation analysis showed a moderate positive relationship between the change in the native condylar process volume and movement amplitude when opening the mouth, and an inverse correlation of the high strength of relationship between the change in the native condylar process volume and movement amplitude of the TMJ endoprosthesis.

Conclusion: Electronic axiography found that patients in the postoperative period could restore some of the translational movements even with the attachment of the lateral pterygoid muscle cut off. The main factor influencing the magnitude of the endoprosthesis translational movement is the design of the fossa component: the ratio of the circumferential surface of the fossa to the diameter of the head of the endoprosthesis, as well as the presence of lateral stoppers. The study showed that unilateral TMJ reconstruction provides changes in the volume of the native joint directly related to the amplitude of the movement of the joint itself and inversely correlated with the amplitude of the movement of the endoprosthesis.

Objective: Improvement of methods for studying the processes of demineralization of hard tissues of temporary teeth.

Material and methods: The study included primaries second molars (n=11). Samples of primary teeth were placed in a test tube with a demineralizing solution for - 1, 4, 8, 21 and 31 days. The of primary teeth samples were examined using methods - laser induced fluorescence (LIF) and autofluorescence microscopy (AFM). Assessment of the degree of demineralization of samples of temporary teeth was carried out according to the score scale developed by us.

Results: The enamel of the samples is demineralized slowly and evenly for up to 8 days with minimal objective signs, starting from the 8th day of the experiment, there is a significant increase in demineralization indicators. By the 21st day, the peak of demineralization is reached with partial dissolution of the enamel, an increase in the fluorescence effect to 80 UE, and reaches a maximum of 4 points on the evaluation scale. Dentin's hard tissues are demineralized gradually without "sudden jumps" in the fluorescence effect and at the same rate throughout the experiment, reaching a maximum on 31 days (30 UE - LIF). Dentin demineralization is characterized by less dissolution, however, the phenomenon of delamination is determined by the type of exfoliation of the organic dentin matrix, starting from the 21st day of the experiment.

Conclusion: Enamel and dentin of deciduous teeth demineralize at different rates and have a characteristic specificity of morphological changes. Logistic regression analysis showed the consistency of the classifier for the predictive accuracy of each unit of the proposed scale for assessing the degree of demineralization of temporary teeth samples.

The aim of the study: Was to assess the impact of two toothpastes marked as «Whitening» and two electric toothbrushes on the dental health values of young adults aged 18-25 years.

Material and methods: The study comprised 139 young adults 18-25 years old participated to assess the improvement of dental index score in dynamic observation. The study groups were formed by random sampling.

Results: The effectiveness of two types of electric toothbrushes in combination with two different toothpastes has been studied. Significant improvement of oral health indices in 3 months of investigation was found in the study group with sonic electric brush and toothpaste specially designed for use with electric toothbrushes (p<0.01).

Conclusion: The study showed the benefit of combined use of sonic electric brush and low abrasive toothpaste containing bromelain, xylite, calcium glycerophosphate and magnesium chloride for dental health of young adults aged 18-25 years.

Purpose of the study: to study the features of microhaemodynamics and oxygenation in soft tissues in the area of the plastically reconstructed jaw after the vestibuloplasty.

Materials and methods: The study included 40 patients aged 20 to 65 (21 males and 19 females). The patients were divided into two groups: I group (14 patients) - patients after reconstructive surgery with the use a fibula autograft without the inclusion of a musculocutaneous «islet»; II group (26 patients) - patients after reconstructive surgery with the use a fibula autograft with the inclusion of a musculocutaneous «islet». To correct the prosthetic bed soft tissues, all patients underwent vestibuloplasty with the use of a free dermal autograft. To study microcirculation in tissues, the laser Doppler flowmetry (LDF) method was used. Microcirculation status was assessed by microcirculation index characterizing the level of tissue blood flow; parameter «σ,» which determines the oscillability of the flow of red blood cells and by coefficient of variation, characterizing vasomotor activity of microvessels. According to the Wavelet analysis of LDF-grams the blood flow bypass was determined. An oxygenation study was carried out in the tissues of the plastically restored jaw by optical tissue oximetry, the results of which determined the oxygenation index and the specific oxygen consumption index.

Results: According to LDF data after vestibuloplasty, it was found that in I group, the microcirculation in soft tissues of the plastically reconstructed jaw restored in 21 days, and in II group in 2 months, which persisted at 6 months. In I group, the level of oxygenation and specific oxygen consumption normalized in 21 days, and in II group in 2 months, which persisted at 6 months.

Conclusion: Based on the results of this functional study, it was found that before vestibuloplasty microcirculation and oxygenation indices in II group patients were lower than those in I group patients. After vestibuloplasty with the use of a free dermal autograft, microcirculation indices in II group patients restored in 2 months, while in I group patients those indices restored in 21 days.