Stomatologiya最新文献

The aim of the study: To study the effectiveness of percutaneous electroneurostimulation (TENS) for normalization of masticatory muscle tone and improvement of the effectiveness of permanent dental prosthetics in patients with increased tooth wear.

Materials and methods: Electromyographic examination (EMG) was performed in 20 patients of both sexes aged 35 to 54 years, in patients with a clinically pronounced generalized form of increased tooth wear and temporomandibular joint (TMJ) dysfunction. Patients complained of soreness and tension in the area of the masticatory muscles during mouth opening and chewing. The examination was performed using an electromyograph "Synapsis" (Neurotech), adapted for dental purposes. All patients were prescribed a TENS course of up to 5 sessions, lasting 45 minutes, and additionally a muscle relaxation mouthguard was manufactured.

Results: The results of the electromyographic examination at the first stage (up to TENS) showed a pronounced asymmetry of the masticatory muscles: the predominant muscles are the left temporal (Ts) - 449+27 (MV) and the left masticatory proper (Ms) - 387+27 MV, the lowest values were noted in the right temporal muscle (Td) - 326+15 Mv and the right masticatory muscle (Md) - 352+21 mcV. The difference between the average amplitude of Md and Ms muscles was 35 Mv, and the difference between Td and Ts muscles was 123 Mv, statistically significant. At the second stage, a TENS course of up to 5 sessions was prescribed. The highest values were observed in the left temporal muscle (Ts) - 437+27 Mv, the lowest in the right (Td) - 346+28 Mv. The indices of the right masticatory muscle proper (Md) were 398+37 Mv, the left (Ms) - 377+32 mv. The difference between the average amplitude of Md and Ms muscles was 9 Mv, and between Td and Ts muscles - 21 Mv.

Conclusion: After a course of TENS in patients with increased tooth wear, positive dynamics of changes in the bioelectric conductivity of the chewing muscles are determined. Electrical impulses contributed to the improvement of the functional characteristics of the stimulated muscles, which proves the importance of using percutaneous electrical stimulation to increase the effectiveness of treatment in this group of patients.

Objective: To summarize and present the experience of general anesthesia with nasotracheal intubation for children suffering from dystrophic epidermolysis bullosa (DBE) during dental interventions on an outpatient basis.

Materials and methods: In 2023, 18 children with DBE received dental treatment under general anesthesia, two patients underwent general anesthesia twice a month with a break due to the large volume of intervention.

Results: The paper highlights the main features of preoperative examination of this category of patients, preparation for monitoring, induction of anesthesia, and ensuring patency of the upper respiratory tract. The practical recommendations and techniques mentioned in the article allow the anesthesiologist to minimize the risks of damage to the skin and mucous membrane of the mouth and pharynx. The duration of anesthesia ranged from 50 to 225 minutes, the average duration of anesthesia was 135 minutes. The observation time in the wake-up ward ranged from 105 to 360 minutes, the average time of postoperative observation was 177 minutes. There were no perioperative hemodynamic and respiratory disorders.

Conclusion: With proper preparation of the anesthesiological team, strict observance of the rules for working with children suffering from DBE, general combined anesthesia with nasotracheal intubation ensure a high safety profile for these patients and create comfortable conditions for high-quality dental work.

The aim of the study: Was to improve the quality of symptomatic diagnostics of mesial occlusion.

Materials and methods: The object of our epidemiological study was 2842 schoolchildren aged 6 to 18 years, and 458 conclusions of Professor Yu. M. Malygin to patients who sought consultative assistance. The analysis of the archive of diagnostic models of jaws of the Department of Orthopedic Dentistry of the Central Institute of Orthopedic Medicine and the Department of Orthodontics of the Russian Medical Academy of Postgraduate Education in the volume of 20.000 pairs and a sample of 2490 models of jaws of patients with mesial occlusion were conducted, and then an in-depth biometric study of 205 pairs of models of jaws of patients with permanent mesial occlusion was carried out.

Results: Clinical and epidemiological characteristics of mesial occlusion showed the percentage of occurrence among bite anomalies 5.6+2.03; it occurs more often in boys than in girls and more often in mixed dentition than in permanent dentition. The efficiency of determining individual types of mesial bite varied from 100% to 14%, and on average the visual diagnosis was established correctly in 44.7%. A comparative analysis of 205 pairs of jaw models with mesial bite relative to the norm showed that differences in 39 parameters out of 43 were not statistically guaranteed, so the inclinations of the anterior teeth were also studied, and then 9 typical types of mesial bite were determined using the "diagnostic key" of Yu. M. Malygin and the algorithm we developed.

Conclusion: An algorithm for symptomatic diagnostics has been developed, which made it possible to identify and systematize typical types of mesial bite.

The aim the study: Improving the effectiveness of treatment of patients with recurrent oroantral fistula in conditions of local tissue deficiency and chronic odontogenic maxillary sinusitis using a free autograft from the wide fascia of the hip (fascia lata).

Materials and methods: Surgical treatment was performed in 6 patients with scarring of soft tissues, absence of an oral vestibule, chronic odontogenic maxillary sinusitis after repeated unsuccessful attempts at surgical treatment of oroantral fistulas (OAS). To eliminate OAS and maxillary sinusitis, a free autograft from the wide fascia of the thigh was used.

Results: In all patients, 3 months after surgical treatment, closure of the oroantral anastomosis of the maxillary sinus and oral cavity with complete epithelialization in the postoperative area was observed, as well as the elimination of symptoms of chronic odontogenic sinusitis.

Conclusion: The experience of clinical use of an autograft from the wide fascia of the hip can serve as a basis for its further study in the reconstruction of other defects of the oral cavity and maxillofacial region.

Ectodermal dysplasia (ED) is a group of rare hereditary disorders characterized by impaired development of ectodermal derivatives. The anhidrotic (hypohidrotic) form of ED is accompanied by pronounced hypoplasia of the jaws, partial or complete adontia, leading to functional impairments (difficulty chewing, swallowing, and speaking) and pronounced aesthetic changes. These factors have a significant impact on the quality of life of patients, causing psychological discomfort and social maladjustment. The article presents in detail a clinical case of a 20-year-old patient with anhidrotic (hypohidrotic) ED, who underwent comprehensive surgical rehabilitation.

The most common cause of the arteriovenous junction between the carotid artery and the jugular vein is iatrogenic damage to the vessel walls during vein catheterization, however, this article describes a rare clinical case of traumatic carotid jugular junction of the neck. In addition to the well-known local symptoms of this pathology such as swelling, pulsation, redness of soft tissues, the formation of purulent crusts in the right eye was observed in the patient, which was not characteristic of arteriovenous anastomosis. The article presents the outcomes of multispiral computed tomography (MSCT) of the neck and brachiocephalic vessels with intravenous contrast enhancement confirming the diagnosis, as well as angiography of the common carotid artery basin. During the operation, the ligation of the vessels involved in arteriovenous discharge, the facial vein and artery, was performed. The results of surgical treatment are: reduction of swelling and redness of the soft tissues of the right buccal and suborbital areas, cessation of pulsation and formation of purulent crusts in the right eye after sleep. The article presents the main results of studying foreign literature on this topic: statistical data on the frequency and etiology of arteriovenous junction, characteristic clinical manifestations of this pathology and methods of differential diagnosis. Additionally, it lists treatment tactics used in world practice. Given the rarity of the pathology, the complexity of its diagnosis, and the lack of a standard surgical treatment technique, the presented clinical case is of the signficant practical interest.

Based on eight clinical cases the article analyzes the main clinical and radiographic features of eight children aged 6-14 years with rare cystic lesions: juvenile inflammatory collateral cyst (ICC). ICCs were associated with incompletely erupted first (6 children) or second (2 children) permanent molars. Only in 5 cases did they manifest as pain in the area of the affected teeth, in the remaining cases they were radiographic findings during examination before orthodontic treatment. At the same time, the teeth in the projection of the cyst retained their vitality in all cases, which was confirmed by the cold test and continued root growth after cystectomy. On OPG, ICCs were manifested by a wide variety of localizations (in the bifurcation projection, below, distal or medial to the roots of the teeth), but CBCT made it possible to detect a common symptom - predominantly the vestibular location of the lesion. Cystectomy without endodontic treatment of teeth in the projection of the cyst turned out to be a successful treatment tactic, which is confirmed by observation for 6 -84 months without recurrence of ICCs and dental complications.

Objective: The aim of the study. To assess the effect of rapid palatal expansion on the nasal septum and midface in children aged 6 to 12 years.

Material and methods: The results of treatment of 60 patients with narrowing and deformation of the upper jaw during the early and late mixed dentition are presented. The patients were divided into groups according to the stage of formation of the midpalatine suture: Group 1 included 38 patients with stage «A» (average age 6-9 years); Group 2 - 22 patients with stage «B» (average age 8-12 years). The study also included a control group of patients who were not prescribed orthodontic treatment. The treatment was carried out using devices for rapid palatal expansion with dental, intraosseous and hybrid types of fixation. After clinical and radiological examination of patients and analysis of the obtained data, we identified and assessed the effect of rapid palatal expansion on changes in the midface and nasal septum.

Results: Expansion of the upper jaw in the area of the apex of the palatine roots of the first molars at the skeletal level was achieved by 3.02±1.71 mm (p<0.05) and its effects on the structures of the midface and nasal septum were analyzed. As a result of the conducted studies, an increase in the length of the septum was revealed by 5.1±1.39 mm (p<0.05) after the use of rapid palatal expansion in patients aged 6 to 12 years, undergoing orthodontic treatment compared with patients in the control group.

Conclusion: The use of the rapid palatal expansion technique allows achieving skeletal effects not only at the level of the upper jaw, but also contributes to an increase in the volume of the nasal cavity, exerting a positive effect on the growth of the maxillary complex.

Objective: The aim of the study is to assess the role of the dentoalveolar pathology in the face soft tissues lymphostasis development in patients after facial contour injection plastic.

Material and methods: Clinical, ultrasound and dental X-ray examination was performed in 37 patients (36 women and 1 man) aged 21 to 70 years with facial lymphedema and close history of facial CIP. The patients were divided into two groups: early development of complications - up to 4 weeks (17 patients - 45.9%) and delayed development - from 4 weeks or more (20 patients - 54.1%). Unilateral facial lymphedema was diagnosed in 17 patients, and bilateral lymphedema with greater severity on one side was diagnosed in 20 patients.

Results: Among the examined patients with facial lymphedema, patients after multiple CIP predominated (62.2%). Early complications prevailed in patients with single CIP (64.3%), delayed complications prevailed in patients with multiple CIP (65.2%). In patients with multiple CIP the lymphedema grade 2 and 3 predominated, in patients with a single CIP grade 0 and 1. X-ray dental examination detected inflammatory dental diseases in 86.5% of patients: in all cases changes on the side of lymphostasis predominated.

Conclusion: Facial CIP is not a harmless procedure and may have undesirable consequences in the form of regional lymphostasis (lymphedema). Inflammatory dental diseases are an important pathogenetic link in the occurrence of facial lymphedema after CIP. A clinical examination of the patient's oral cavity should be supplemented by an X-ray dental examination. The detection of inflammatory dental diseases requires mandatory oral sanation to reduce the risk of post-injection complications and prevent complications afner subsequent injection procedures.

The aim of the study: Was to improve methods for diagnosing the morphofunctional state of the TMJ in individuals with normal occlusion with various types of facial skull growth.

Materials and methods: The study comprised 35 volunteers aged 18-45 years (average age 25.6±4.8 years) with normal occlusion and intact dentition. Telerentgenography (TRG), cone beam computed tomography (CBCT), magnetic resonance imaging, and ultrasound examination of the TMJ were performed.

Results: Horizontal type of growth of the facial part of the skull was established in 13 people; 12 had neutral type and 10 had vertical type. According to CBCT data, in patients with horizontal growth type, the highest values of the parameters of the width of the articular head, the smallest parameters of the length of the condyle process and the size of the articular gap in the upper-anterior and upper-posterior sections were determined. In patients with the vertical type, an inverse correlation of values was established, which may be due to the anatomical features of the TMJ structure: the articular head is narrower and longer, and the articular gap is wider. According to MRI data, in all patients, regardless of the type of growth of the facial part of the skull, the posterior thickening of the articular disc was located at «11-12 hours» mark in the sagittal plane, and the poles of the articular disc did not extend beyond the poles of the articular head of the same name in the coronal plane. According to ultrasound data, the indicators of the size of the articular gaps were fully consistent with the conclusions obtained from CT and MRI. The smallest length of the articular pathway was found in patients with vertical growth type, the largest in patients with horizontal growth type.

Conclusion: Statistically significant differences in morphometric (the size of the articular gap) and functional (the length of the trajectory of the articular heads) parameters of the TMJ were established for various types of growth of the facial part of the skull, which confirms the need to study the state of the TMJ, considering the identified differences.