Vol 27, No 4 (2024): Опубликован 27.12.2024

Analysis of orthodontic treatment of patients in cooperation with doctors of related specialties, such as an otolaryngologist, pediatric orthopedist, neurologist, and the results of treatment of patients in the presence or absence of cooperation on the part of the patient. Despite the fact that the processes of development of anomalies of the dental system under the influence  of factors such as nasal breathing disorders, posture problems, bad habits have been studied for a long time, orthodontists do not always achieve the necessary clinical result. Using the example of two groups of patients who underwent orthodontic treatment, the article analyzes the achieved results of treatment, depending on how fully the recommendations of the doctors involved in rehabilitation were fulfilled. In addition, a study of patient satisfaction with treatment was conducted, which focused on the need for a personalized interdisciplinary approach.

Поражения полости рта являются одними из ранних признаков ВИЧ-инфекции, и у лиц с неизвестным ВИЧ-статусом они могут свидетельствовать о возможном диагнозе ВИЧ. Цель: сравнить распространенность кандидоза у ВИЧ позитивных пациентов в зависимости от уровня CD4 клеток. Материалы и методы: было проведено комплексное стоматологическое обследование 842 ВИЧ позитивных пациентов, с уровнем CD4-клеток от 0 до >500 кл/мл.  Все пациенты были распределены на 3 группы, в зависимости от уровня CD4 клеток: 1 группа - CD4 >500 кл/мл, 2 группа - CD4 200-500 кл/мл, 3 группа - CD4 0-199 кл/мл.  Результаты: из  обследованных 842 пациентов, у 511 был выявлен кандидоз различной локализации. В группе с наименьшим количеством CD4 клеток кандидоз встречался достоверно чаще. Также нами были выявлены случаи сочетания кандидоза с другими заболеваниями слизистой. При высоком уровне CD4 клеток кандидоз наиболее часто встречался, как изолированное заболевание полости рта, и, наоборот, при снижении уровня клеток у пациентов к кандидозу присоединялись другие оппортунистические заболевания полости рта. Вывод: Во всех группах пациентов кандидоз встречался достоверно часто. Локализация была различной: кандидоз полости рта, кандидозный глоссит, кандидозный хейлит. Высокий уровень распространенности кандидоза у ВИЧ позитивных пациентов, показывает необходимость включения лечения у врача-стоматолога для повышения качества уровня жизни данных пациентов.

The article considers the urgent problem of improving the methods of re-prosthetics for patients with failed orthopedic structures and periodontal diseases. The fundamental differences between repeated prosthetics and re-prosthetics are determined, and the need to search for optimal methods of tooth restoration taking into account the state of periodontal tissues is substantiated.

The key advantages of the vertical preparation technique are revealed, including minimal invasiveness, the possibility of creating an optimal ferrule effect and a more uniform distribution of the occlusal load. The main limitations of the method, such as the risk of overhanging edges and the need for a long period of tissue healing, are determined.

The study included a comprehensive assessment of the clinical effectiveness of the vertical preparation technique in re-prosthetics with fixed orthopedic structures. The study involved 32 patients (19 women and 13 men) aged 42 to 58 years, divided into the main (n = 17) and control (n = 15) groups. The observation period was 18 months.

The features of the clinical and radiographic examination of patients are considered, the criteria for assessing the effectiveness of treatment are determined. A detailed treatment protocol is presented, including the stages of preparation, temporary prosthetics and the manufacture of permanent structures. Particular attention is paid to the technique of performing vertical preparation and the formation of an optimal eruption profile

A comparative study of the efficiency of using the Russian-made light-curing composite material ReLight and the composite material Харизма Клиник in the treatment of caries of lateral teeth with cavities of class I and II according to Black was conducted. 217 teeth were treated: ReLight - 50 restorations of class I according to Black, 77 restorations of class II according to Black, Charisma Clinic - 41 restorations of class I according to Black, 49 restorations of class II according to Black. Observation periods: 7-14 days, 6 months, 12 months, 18 months and 24 months after the treatment. Evaluation criteria: compliance of the restoration shape with the anatomical shape of the tooth; marginal adhesion of the material; tightness of the border of the restorative material with tooth tissues; homogeneity of the material structure (presence of pores, signs of restoration delamination).

All studied groups of restorations of classes I and II according to Black, made of ReLight and Charisma Clinic materials, showed comparable clinical characteristics. When analyzing all criteria at all time points using Fisher's exact test, no statistically significant differences were found between the groups (p>0.05).

Russian-made light-curing composite material ReLight (SM DMT) is recommended for clinical use in the treatment of caries of lateral teeth in cavities of classes I and II according to Black as an alternative to imported analogues, not inferior to them in significant clinical characteristics.

According to the World Health Organization, the distal occlusion is the most common among other forms of dentition ratio abnormalities. In growing patients, active functional appliances have been used for many years at the first stage of treatment, the purpose of which is to change or redirect the growth of the lower jaw to correct an anomaly in the ratio of dentition. However, there is much debate today about the direct effect of these devices on skeletal growth.

The aim of this study was to increase the effectiveness of orthodontic treatment by introducing digital technologies for the diagnosis and planning of functional appliances for the treatment of distal occlusion in growing patients. Methods. 40 patients aged 9-11 years were divided into two groups. In group 1, patients were treated using Twin-block manufactured using the traditional method. In group 2, patients were treated with appliances manufactured using digital diagnostic methods and 3D-imaging. A control group of patients who did not receive orthodontic treatment was also monitored. Results. In groups 1 and 2, we observed an increase in the size of the mandible compared to the control group, while the results in group 2 were more significant. Go-Gn in group 2 increased by 7.4 mm, in group 1 by 4.25 mm, while in the group of patients without treatment the increase was insignificant – 2.2 mm. Conclusions. Thus, the use of digital technologies in the planning of orthodontic treatment and the manufacture of functional appliances in growing patients with distal occlusion gives a more predictable and significant result.

Progressive tissue atrophy under the base of removable plate dentures is a pressing issue in modern dentistry. The aim of this study is to investigate the dependence of its intensity on the design features of the manufactured denture. In the course of the study, 90 patients were selected and divided into 3 equal groups. Patients from group A were rehabilitated using a removable plate denture of the original design, while patients from groups B and C were rehabilitated using dentures made of thermoplastics and acrylic polymers. After prosthetics, at the time of 6, 12, 18 months of the study, patients underwent CBCT and X-ray densitometry. Based on the data obtained, after statistical processing, average indicators for the groups for each time point were calculated. According to them, it was found that in patients from group A at the time of examination on month 6, the volume of bone tissue was on average greater than 2.83 mm³ and 7.9 mm³ than in patients from groups B and C. Similarly, at the time of examination on month 12, this difference was 5.77 and 10.37 mm³, and at the time of examination on month 18, 6.9 and 12.3 mm³. In turn, the densitometry results in group "A" at the time of examination on month 6 were better than the indicators of groups "B" and "C" by 19 and 39 units. At the time of examination on month 12, the densitometry indicators in group "A" were better than in groups "B" and "C" - by 30 and 50 units, and at the time of examination on month 18 - by 10 and 31 units, respectively. Thus, the study found that the removable plate denture of the original design allows to reduce the severity of atrophic processes occurring in the area of the prosthetic bed.

Currently, an urgent issue of dentistry is the preservation of the health of the elderly and senile population. According to WHO, patients aged 60 to 74 years belong to the elderly age group, from 75 to 89 years – to the senile. Important components of health in this category of patients are the improvement of orthopedic dental treatment, preservation of the integrity of existing teeth and the manufacture of high-quality dentures. In modern dentistry, it is noted that a large number of specialized measures are carried out, which are aimed at reducing the time of adaptation to removable dentures, treatment and prevention of complications from the tissues of the prosthetic bed. At the same time, the steady increase in complications and their intensity among elderly and senile patients with missing teeth remains quite high. The studied literature data indicate that currently the number of clinical studies conducted to analyze the adaptation of elderly and senile patients with missing teeth to removable plate prostheses is insufficient.

The literature notes that patients suffering from psoriasis experience changes in the intestinal microbiocenosis, which leads to increased permeability of the intestinal barrier, endointoxication and a pathological cascade of inflammation. Therefore, in the treatment of psoriasis, the use of dietary fiber, fermented milk bifido- and lacto-containing products, as well as sorbents is indicated. The study involved 10 patients aged 40 to 60 years with a diagnosis of vulgar psoriasis and a disease history of 10 to 20 years. This group of patients was prescribed a pectin-containing enterosorbent (composition: 60% apple pomace powder, 23% starch, 11% kaolin and 6% pectin from zostera sea grass), which has both sorption and prebiotic activity. To assess the intestinal microflora of patients with psoriasis and the effectiveness of the sorbent, a bacteriological analysis of feces was performed, which included quantitative and qualitative determination of bifidobacteria (Bifidobacterium), lactobacilli (Lactobacterium), bacteroides (Bacteroides), klebsiella (Klebsiella), staphylococci (Staphylococcus) and Escherichia coli. Our studies have confirmed that patients suffering from vulgar psoriasis have a clear decrease in the number of normal microflora representatives and an increase in opportunistic microorganisms, which causes the manifestation of a dysbiotic shift. It has been established that when taking the enterosorbent under study, the intestinal microbiome is normalized, normal microflora is restored, and opportunistic microorganisms are removed before the absorption of colony decay products through the intestinal walls into the blood. It is proposed to use a pectin-containing enterosorbent to correct the intestinal microflora and, as a result, reduce the pathological processes characteristic of psoriasis.