Vol 24, No 3 (2020)

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.

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%.

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.

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.

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.

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.

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.

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.