Vol 24, No 3 (2020)

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Experimental and Theoretical Investigation
An experimental study using known variants of transport immobilization and comparing them with the original temporary splint for the treatment of jaw fractures
Mitin N.E., Zolotova M.I., Mitina E.N.

Academician I.P. Pavlov Ryazan state medical University of the Ministry of health of the Russian Federation, 390026, Ryazan, Russian Federation

Patients with injuries of the maxillofacial region make up about 30% of all patients treated in the in-patient departments of maxillofacial surgery. Meanwhile, fractures of the lower jaw account for about 70%—85% of all fractures of the bones of the face. The need for immobilization is due to the risk of pain and complications (bleeding, microbial contamination, asphyxiation, damage to nerves and blood vessels). The article provides a comparative analysis between temporary immobilization of the jaws using well-known designs and a new universal temporary bus with a channel. We conducted the experiment under simulated conditions using the following splinting structures: a smooth splint bar and a patented temporary splint with a channel for treating jaw fractures (Application No. 2020103350/14 (005106) (22) Application submission date 27.01.2020). From the experimental research complex, it was possible to verify that the methods of temporary splinting of the jaws have their own characteristics of superposition and displacement of structures. It is worth noting that the displacement of jaw fragments occurred in each splinting and this should definitely be taken into account at the stage of first aid. The study also revealed that that the splinting technique for the splint has a number of disadvantages, the most significant of which are the negative impact on periodontal disease, a significant decrease in oral hygiene, and the possibility of secondary infection. Among the obvious advantages of a universal temporary bus with a channel, include the simplicity of applying and fixing fragments, the ability to supply the patient, receive fluids and drugs through the probe, as well as ensuring full breathing in the absence of nasal breathing.

Russian Journal of Dentistry. 2020;24(3):122-126
Clinical Investigation
Features of chewing disorders in children with grade III vertebral disocclusion of dentition
Ali A.E., Vodolatsky V.M.

We aimed at studying the peculiarities of violations of function for the vertical disocclusion dentition III level in children. We performed this study in 27 patients aged 7—18 years before and after orthodontic treatment using the statistical method of N. I. Agapova, based on determining the percentage of each tooth in the chewing process. We analyzed chewing efficiency in patients with grade III vertical dentition dysocclusion in each age group from 7 to 18 years with same number of boys and girls. The mean chewing efficiency index of grade III vertical disocclusion of the dentition was 52.3%, indicating a high degree of its violation. We observed the highest percentage of chewing efficiency loss in children aged 18 years (63.4%). This loss occurred due to the absence of occlusal relationships in the area of incisors and canines, as well as premolars and first molars on one or two sides of the dentition. In addition, we recorded the lowest percentage of loss of chewing efficiency in children aged 7 years (40.8%). The decrease in chewing efficiency observed in this age group was due to the switching-off of incisors and canines from occlusal relationships on both sides of the dentition. After the end of the treatment stage, reanalysis of the average loss of chewing efficiency in patients with grade III vertical dentition was 7.7%.

Russian Journal of Dentistry. 2020;24(3):127-130
Evaluation of functional potential of CAD-programs in integrated digital planning of dental treatment
Apresyan S.V., Suonio V.K., Stepanov A.G., Kovalskaya T.V.

The article compares popular dental digital platforms as part of a comprehensive treatment planning. Digital smile planning was conducted into 3Shape and Avantis 3D on an identical protocol. The results of the study showed the viability of both programs, with some functional superiority with Avantis 3D, in the case of rehabilitation of dental patients with articulation disharmony. We also determined the possibility of applying Avantis 3D in mathematical calculations by finite element method.

Russian Journal of Dentistry. 2020;24(3):131-134
Development of complex of digital planning of dental treatment and assessment of its clinical effectiveness
Apresyan S.V., Stepanov A.G., Retinskaya M.V., Suonio V.K.

The article considers prerequisites and methods of developing a complex of treatment planning profile in a patient using modern dental computer technologies. We performed a retrospective analysis of data based on the results of a protocol using digital dental technologies for planning, layout, and prototyping of dental prostheses This developed complex allows for obtaining a predictable result of dental treatment. The use of innovative computer technologies makes it possible not only to control each stage of rehabilitation, but also to make the necessary changes in the early stages of planning. Coordination with patients’ shape and size of teeth at initial stages avoids conflict situations by completing manipulations in oral cavity.

Russian Journal of Dentistry. 2020;24(3):135-140
Features of spatial localization of dental plaque during orthodontic treatment on braces
Amkhadova M.A., Zorina O.A., Boriskina O.A., Petrukhina N.B., Nechaev A.A.

The aim of the study was to evaluate the features of spatial localization of dental plaque in patients with braces, depending on the type of toothbrush used. We enrolled 63 patients from 11 to 18 years old, needing orthodontic treatment on a bracket system due to the tight position of the teeth in unilateral cleft palate and lip (Q37.1 according to ICD-10) after reconstructive surgery, in combination with mesial occlusion (K07.2 according to ICD-10).

Material and methods: We evenly divided all participants into three groups depending on the type of brush used. Group 1 (n = 21) patients used an orthodontic manual toothbrush (“Professor persin,” Spazzolificio Piave S. p.A, Italy). Group 2 (n = 22) patients used an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n = 20) used an electric toothbrush (“Oral-B Pro-Expert,” Procter & Gamble, USA). To assess the level of hygiene and determine the spatial accumulation of plaque, we used the Silness & Loe index in the modification of Williams P. et al. (1991) at various stages. These included one week after professional hygiene after fixing both arcs. Then, six, and twelve months of wearing them.

Material and methods: Group I contained the most pronounced deterioration in the hygienic state of the oral cavity during orthodontic treatment using a manual brush. Predominantly, the plaque accumulated in pricesavvy region. Uneven distribution of dental plaque relative to orthodontic techniques in group 1 was found in all quadrants of the upper and lower jaw.
Conclusion: When assessing the spatial distribution of dental plaque relative to the bracket systems, it was possible to identify an additional advantage of using an ultrasonic brush. In comparison with an electric brush, we observed slight expressions in plaque accumulation on the four surfaces of the tooth., In the posterior area, plaque accumulated without pronounced deviations from the other areas of the tooth.

Russian Journal of Dentistry. 2020;24(3):141-145
Effectiveness of nicotinamide adenine nucleotide hydride in the complex treatment of patients with peri implantitis
Amkhadova M.A., Amkhadov I.S., Aleskerov E.S., Zelensky V.I., Remizova E.A., Atamanchuk A.A.

Background: In treating peri-implantitis, dentists pay attention to drugs that do not contain chemically aggressive agents. They rather use those having natural mechanisms for normalization of the functional activity of cells and tissues in addition to local antiseptic and antibacterial agents.

The aim of the study was to determine the clinical effectiveness of nicotinamide adenine nucleotide hydride dental gel in the treatment of peri-implantitis.

Materials and methods: Depending on the therapeutic tactics patients (n = 40), we divided patients into two groups. In Group 1 (n = 20), we used a standard treatment of peri-implantitis including professional hygiene measures, antiseptic treatment and the use of antibacterial agents. In Group 2 (n = 20), the complex treatment included photodynamic effects of 1% photosensitizer gel instead of the antibacterial therapy.

Results: Due to the use of the photodynamic therapy in addition to standard treatment of group 2 patients, the concentration of a tartrate-resistant acid phosphatase in the peri-implantation exudate reached the level of healthy people in the gingival fluid. In addition, the concentrations of cathepsin K and interleukin-6 were as close as possible to the control level.

Conclusion: The use of NADH for peri-implantitis helps to eliminate inflammatory phenomena and stimulates the regeneration of the oral mucosa.

Russian Journal of Dentistry. 2020;24(3):146-153
Evaluation of the effectiveness of treatment of patients with hypogonadism using complex dental therapy
Afanasiev V.V., Kalinchenko S.Y., Damadaev M.M.

The authors conducted a dental examination of 77 patients treated in an Endocrinology Clinic for Hypogonadism. All patients were diagnosed with sialadenosis, decreased salivation rate, increased saliva viscosity, and acidity level. We supplemented hormone replacement therapy for hypogonadism with comprehensive dental treatment, which significantly improved the treatment parameters.

Russian Journal of Dentistry. 2020;24(3):154-157
Application of the complex algorithm for rehabilitation of patients needing a full reconstruction of dentition (clinical case)
Dzalaeva F.K., Chikunov S.O., Utyuzh A.S., Dzhagaeva Z.K., Yumashev A.V.

Introduction. Aim of the study is testing the algorithm of complex clinical, functional and instrumental analysis in the treatment of patients with the need for total restoration of the dentition with manifestations of myofascial pain syndrome.

Material and methods. A system for the rehabilitation of patients with adentia is proposed, in which, when planning occlusion correction, objective examination data for patients obtained using a set of diagnostic methods should be taken into account. Particular attention is paid to assessing the function of the temporomandibular joint and the presence of pathological signs of disorders of maxillofacial muscles.

Results. A clinical case is described a patient who has been diagnosed with a set of indicators of clinical, functional and instrumental analysis obtained using methods of condylography and cephalometry. The results of treatment and rehabilitation measures allowed achieving the optimal distribution of loads on the dentition, while reducing the risk of ceramic chipping and improving oral hygiene. The approach used allowed timely correction of functional and aesthetic disorders.

Conclusions. The algorithm for working with patients who need total restoration of the dentition should include a thorough history taking, clinical functional analysis using condylography methods, model analysis to register and evaluate the static and dynamic ratios of the dentition. As well as performing cephalometric analysis and other manipulations, in accordance with standard criteria for clinical examination. The developed algorithm is anatomically and pathogenetically justified, since it takes into account the entirety of changes and interconnections of the structures of the dentofacial system and other body systems that underlie the clinical manifestations in this category of patients.

Russian Journal of Dentistry. 2020;24(3):158-163
Expression of CD44, CD29 and osteocalcin differentiation factors in the alveolar bone during past fixation of a free gingival graft
Edranov S.S., Matveeva N.Y., Kalinichenko S.G.

Aim: To study the localization of stem stromal cells on the surface of a free gingival graft.

Material and methods: We studied the immunolocalization of stem cell markers (CD29, CD44 and osteocalcin) the mucosa plate and bone tissue of the lower jaw of outbred miniature pigs with bone fixation of a free gingival graft.

Results: In the third month after the operation, a new bone tissue is formed in the contact area, characterized by formed bone plates, osteons, and a system of Havers and Volkman channels. When studying the immunolocalization of CD29, CD44, and osteocalcin, we detected a heterogeneous distribution. CD29and CD44-immunopositive cells prevail at the border of the newly formed bone and its own gingival plate, as well as in the cavity of the Havers canals. Osteocalcin-positive cells are localized mainly in the layer of common plates, on the surface of the bone plates of osteons surrounding the Havers channel and in its cavity, which are in close proximity to the graft.

Conclusion: Bone fixation of SDT remodels the alveolar bone, showing signs of a reparative process. The presence of expression of CD29 and CD44 in bone tissue indicates the activation of mesenchymal cambial cells, which differentiate into osteocalcin-containing osteoblasts. The inducing role of a free gingival graft in the formation of a new bone is determined by the ability of its cells to synthesize trophic factors stimulating the proliferation and differentiation of MSC and vascular growth. Thus, the model on miniature pigs is a useful tool for studying this process.

Russian Journal of Dentistry. 2020;24(3):164-170
Clinical case of surgical treatment of patient with toxic phosporus osteonecrosis of maxilla
Medvedev Y.A., Ispiryan D.K., Zakharova I.V., Petruk P.S.

During the last few years on the territory of the Russian Federation, the number of cases of toxic phosphoric osteonecrosis of the jaws illicit use of drugs of “artisanal” production (pervitin, desomorphin). The aim of our study was to increase the effectiveness of surgical treatment of a patient diagnosed of toxic phosphorus necrosis of the maxilla. We performed a comprehensive treatment of a patient with a history of drug addiction and the above diagnosis. We performed complete resection of pathologically altered tissues and reconstructive techniques using local tissues and a replaced flap. This achieves good esthetic and functional results in the early and late postoperative period. Thus, we can use our proposed method of surgical treatment in similar clinical situations.

Russian Journal of Dentistry. 2020;24(3):171-175
Correction of soft tissue defects in patients with oblique facial clefts
Mustafayeva S.M., Vissarionov V.A., Mustafaev M.S.

The article presents the most commonly used methods of eliminating deformations and defects associated with congenital oblique facial clefts. It revealed the expediency of complex interaction of maxillofacial, plastic surgeons with ophthalmologists and otorhinolaryngologists in the process of complex treatment.

Russian Journal of Dentistry. 2020;24(3):176-179
Organization of Healthcare Service
Analysis of readiness of medical university graduates for labor activity
Alekseeva M.V., Nikolaev A.I., Shashmurina V.R.

Purpose of work — orders to study the readiness of the Medical University graduates for work, a survey of 90 students of the dental and pediatric faculties of Smolensk State Medical University was conducted.
Material and methods. Characteristics common to graduates were revealed: lack of confidence in the beginning of work, difficulties in communicating with patients, colleagues, employers, desire to work in budget medical organizations. The specifics of the faculty did not play a significant role in the choice of answers. Students in the pediatric faculty are more knowledgeable in continuing professional development, medical standards and clinical guidelines than dentistry students. Dentists are more practical in professional path choosing. For faculty of pediatrics graduates the last year of study escalates the problem of further professional choice, literally introducing young professionals into a stressful state who declare complete disappointment in choosing a profession.
Results of the survey emphasize the need for vocational guidance, educational work with students of a medical university.
Conclusion. Adaptation to work improving should be reflected in the content of work programs, activities to promote the employment of graduates, the possibility of obtaining legal advice at the university, the creation of a portal for posting resumes, and the widespread use of internships at workplaces.

Russian Journal of Dentistry. 2020;24(3):180-185
Prevalence of damage to the jaw, cheekbones, nose and orbital zone according to the department of maxillofacial reconstructive and plastic surgery of the national hospital of the ministry of health of the kyrgyz republic in 2010–2018
Urgunaliev B.K., Yuldashev I.M., Shayahmetov D.B., Kuramaeva U.K.

The article presents a systematic literature review of data on fractures of the jaws, middle part of the face. The types, causes of injuries of maxillofacial area are considered. It highlighted the main methods of diagnosis and treatment of patients with lesions of the middle face. The retrospective analysis of the history of the diseases indicates the need for comprehensive studies aimed at studying the frequency, structure, and location of damage to the middle facial bones in modern conditions.

Russian Journal of Dentistry. 2020;24(3):186-188
Evaluation of pathological changes of the temporomandibular joint in patients with type 2 diabetes
Lapina N.V., Skorikova L.A., Shabalina I.M., Gerbova T.V., Kochurova E.V.

This article discusses a modern vision of the impact of type 2 diabetes in the morphology and function of the temporomandibular joint (TMJ). Based on a number of studies, a more severe course of TMJ dysfunction was revealed in patients with type 2 diabetes compared with individuals without diabetes. We established the interconnection between the age of patients, the duration of diabetes and the degree of manifestation of TMJ dysfunction. Peripheral diabetic neuropathy is determined by an independent risk factor for TMJ dysfunction. Pathological changes in the structures of the TMJ and periarticular tissues have been described in rats with diabetes. The study of the possible morphological damage to the components of the TMJ in patients with type 2 diabetes remains relevant.

Russian Journal of Dentistry. 2020;24(3):189-192
Features of dysfunctional states of the temporomandibular joint in patients with different types of facial skeletal growth (literature review)
Soyher M.G., Pisarenko I.K., Amkhadova M.A., Soyher M.I., Antonov N.M., Stroganova A.G., Abdurakhmanova M.S.

From previous research, diseases of the temporomandibular joint are a functional pathology and take a special place among diseases that affect both the joint and the structures surrounding it [1]. Disorders of the anatomical relationship between the components of the joint are the most common reason of temporomandibular joint dysfunction [2]. Patients with this disease need a thorough clinical and functional analysis, in order to identify the relationship between pathology and structural features of the facial skeleton.

Russian Journal of Dentistry. 2020;24(3):193-198

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