Assessment of the temporomandibular joint condition using two-dimensional ultrasound scanning and doppler ultrasonography methods in patients with chronic inflammatory periodontal diseases

Introduction. Currently, dentists are increasingly detecting changes in the temporomandibular joint in patients with chronic inflammatory periodontal disease.Aim of the study. To carry out a comprehensive dynamic assessment of the temporomandibular joint (TMJ) condition and the registration of regional blood flow using two-dimensional ultrasound scanning to improve the efficiency of diagnostics of inflammatory periodontal diseases.Materials and methods. The study included 2 groups of patients: group 1 (control) consisted of 20 volunteers aged 20–25; Group 2 consisted of 52 people aged 25–45 years with moderate chronic periodontitis. For TMJ ultrasound and Doppler ultrasound, a portable ultrasound scanner LogicScan 128 with an HL-10 linear ultrasound transducer with an operating frequency of 5 to 12 MHz was used.Results and discussion. During ultrasound examination of the temporomandibular joint and measuring the size of the joint space in patients with moderate chronic periodontitis in a state of relative physiological rest, the following values were obtained: in the anterior region – 2.3 ± 0.5 mm; in the upper section – 1.6 ± 0.6 mm; in the posterior section – 1.8 ± 0.3 mm. We also measured the area of the temporomandibular joint disc in various positions. According to ultrasound data, an increase in the size of the joint space from 12.2 to 16.1% and an increase in the area of the articular disc by 17.1 to 36.7% were found in patients with chronic periodontitis. When assessing the trajectory of the articular track, motion delay and joint wedging are determined. In addition, in the color Doppler mapping (CDM) mode, the speed and index indicators of Doppler ultrasonography of the external carotid and temporal arteries were calculated.Conclusions. Modern diagnostic methods of ultrasound and Doppler mapping, assessing the hemodynamics and functional state of the TMJ, allow early diagnosis of changes in order to prevent the development of TMJ disorders in patients with chronic inflammatory periodontal diseases.

The Macromicroscopic Anatomy and Microtopography of the Lower Jaw in Fetuses of 14–18 Weeks

In the article the features of anatomical structure and microtopography of the lower jaw of fetus at the age of 14–18 weeks were discussed. The relevance of the research is due to the prevalence of congenital pathology of the maxillofacial region, the possibilities of its early prenatal diagnosis and correction in connection with the development of fetal surgery.The aim of the research is to get new data of the macromicroscopic anatomy and microtopography of the lower jaw in fetuses of 14–18 weeks.Material and methods. The object of the research was the lower jaw of 40 male and female fetuses at the age of 14–18 weeks. The research was carried out using morphological methods and the method of ultrasound scanning. The qualitative and quantitative characteristics of the lower jaw were studied.Results. The lower jaw of the fetus at the age of 14–18 weeks is already formed and has basic anatomical structures. The body, angle, ramus, condylar and coronoid processes, teeth anlages, which can be described on morphological preparations and studied using the method of ultrasound scanning, are defined in the lower jaw. In front of the lower jaw, soft tissues are located, their thickness varies from 2.1 to 3.9 mm. Behind the lower jaw, there is a slit space with a width of 0.3 to 1.5 mm, behind it the tongue and the oral part of the pharynx are situated. The latter has an irregular shape. In a fetus of 14-18 weeks, major salivary glands (parotid, sublingual and submandibular) are already formed and determined on different cuts. The length of the alveolar arch is 29.1±6.2 mm, the width of the lower jaw is 19.5±4.2 mm. At this time, the lower jaw can be presented by two anlages and a symphysis located along the median line. The symphysis on horizontal cut has a fusiform shape, it narrows to the outer and inner surfaces of the lower jaw. In the narrow part, its size varies from 0.1 to 0.4 mm, the extension in the central part is from 0.5 to 0.9 mm. In the lower jaw, the anlages of decidual teeth of an irregular shape are determined. The size of anlages varies from 1.3 to 2.3 mm, depending on the type of tooth. On some cuts under the anlage of primary tooth, it is possible to determine the anlage of permanent one. The significant bilateral and sex differences of human fetuses at the age of 14–18 weeks of intrauterine development were not revealed.Conclusion. The lower jaw of fetuses at the age of 14–18 weeks has all elements of the anatomical structure, with certain fetal features (incomplete accretion of the mandibular processes, anlages of decidual and permanent teeth, microtopographic relationships with adjacent anatomical structures). At this stage of development, there are no significant bilateral and sex differences. The use of various methodological approaches to the research of the qualitative and quantitative anatomy of the lower jaw makes it possible to detail and supplement the substantiation of approaches for fetal surgery.

Study of the effectiveness of post-burn scars correction using Er:YAG laser

The purpose of this study was to investigate the effectiveness of post-burn scars laser correction using an Er:YAG laser (2936 nm) with an SMA module (6mm). 112 women aged 16–50 years were monitored on an outpatient basis. All patients were diagnosed with post-burn scars of the face and body. The main inclusion criteria were post-burn scars; non-inclusion criteria were other types of scars, previously performed procedures for the correction of scars by physiotherapy, general contraindications to laser therapy. During the study, high efficacy and safety of this method was demonstrated in 112 patients. The dynamics of changes were evaluated according to the Dermatology Life Quality Index (DLQI), Dermatological Symptom Scale Index and special research methods (ultrasound scanning, photographing). The follow-up period ranged from 3 to 7 months. Patients underwent from 2 to 6 laser procedures on the face and body with an interval of 1 month. The study is prospective and is planned to be continued. At the moment, a cross-section of the results is presented. During the course of laser procedures, 13 patients dropped out, 99 continue treatment.

DDH Diagnosis: What do we Know so Far?

Background: Developmental Dysplasia of the Hip (DDH) is a common disease worldwide. The success of treatment depends on making an early and accurate diagnosis using clinical examination and imaging. Diagnosis of DDH patients is challenging and controversial, and many cases still present late. There is still a lack of consensus among health care providers regarding the diagnostic methods in terms of interpretation, accuracy and appropriate timing. The clinical practice seems to widely vary between healthcare providers in different parts of the world. Aims: We aim to provide a clear pathway to help healthcare professionals from different disciplines in diagnosing DDH at the earliest age possible in order to start an effective treatment and avoid complex procedures and unnecessary complications. We also aim to provide an extensive review that will provide a standardized reference detailing the whole diagnostic process in order to improve the clinical outcome and save resources. Methods: We reviewed the relevant literature using Pubmed, Google Scholar, and the Cochrane library and looked into the references lists of all of these papers to gather all the available evidence. All papers were carefully critiqued to use the most rigorous in the conclusions of this review. We included articles discussing clinical examination and radiological diagnosis. Papers discussing the most used clinical examination tests and the timing of clinical evaluation were reviewed. Also, we looked into papers discussing radiological diagnosis using ultrasound scanning and standard radiographs in terms of sensitivity, specificity and reliability and their relation to patient’s age and other variables. Results: DDH diagnosis must start at a very young age by repeated examination using specific clinical tests looking mainly for signs of major instability. Ultrasound scanning is the investigation of choice in screening and early diagnosis, and the Graf method seems to be the most reliable method. X-rays are not reliable in early diagnosis, especially in the first four months of life, and can lead to over-diagnosis, particularly when using the Acetabular Index as the sole measurement tool. Conclusion: DDH diagnosis has many controversies, and the practice is still widely variable. This review provides an evidence-based, updated pathway for early DDH diagnosis in order to improve the clinical outcome, avoid complications, reduce the need for surgical treatment and save public resources. It highlights some malpractices that are still used in the diagnostic process. The review provides a standardized reference to doctors from different specialties and with different experience levels who are tasked with assessing children for DDH.

Heterogeneous effects of eccentric training and nordic hamstring exercise on the biceps femoris fascicle length based on ultrasound assessment and extrapolation methods: A systematic review of randomised controlled trials with meta-analyses

Objective To systematically review the effects of eccentric training based on biceps femoris fascicle length using ultrasound assessment and extrapolation methods. Design Systematic review and meta-analysis of randomised controlled trials. Data sources CENTRAL, CINAHL Plus with full text, PubMed and OpenGrey databases were searched on 6 July 2021. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) lasting at least four weeks and presenting data about biceps femoris (BF) fascicle length (FL) as an outcome. Method Searching databases, screening studies, performing risk of bias assessments and determining the level of evidence (LoE) for each meta-analysis were applied during the study. PRISMA 2020 statement and Cochrane Handbook for Systematic Reviews of Interventions were used as the guidelines of this systematic review. Results Eight randomised controlled trials included in meta-analyses. Based on the very low and low LoE, eccentric training has small (g = 0.29, 95% CI [-0.26, 0.85]), moderate (g = 0.72, 95% CI [0.17, 1.28]) and large (g = 2.20, 95% CI [0.99, 3.41]) effect sizes (ES) based on manual linear extrapolation (MLE), panoramic ultrasound scanning and trigonometric equation methods, respectively. Similarly, Nordic hamstring exercise (NHE) has small (g = 0.23 [-1.02, 1.47]), small (g = 0.38, 95% CI [-0.50, 1.27]) and large (g = 1.98, 95% CI [0.52, 3.44]) ES based on the MLE, panoramic ultrasound scanning and trigonometric equation methods, respectively. Conclusion ES of eccentric training, including NHE, vary between the MLE, panoramic ultrasound scanning, and equation methods. The relevant scientific community should have a consensus on measurement standards of the BF FL measurements. Further studies can be conducted to compare the effects of eccentric training based on the ultrasound assessment and extrapolation methods.

Capabilities of ultrasound scanning of head and neck vessels

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Features of venous blood circulation and valve function in the lower extremities according to duplex scanning data and morphofunctional studies

Aim. To study the mechanisms of venous return and the functioning features of lower extremity venous valves in horizontal and vertical positions. Methods. The study, conducted from April 2019 to December 2020, included 100 people. The study participants were divided into 2 groups. The first group was represented by 44 patients (88 limbs) with varicose veins, whose venous system was examined by duplex ultrasound scanning during inpatient rehabilitation. The second (control) group consisted of 56 healthy individuals (92 limbs) without visible signs of venous pathology who underwent an outpatient examination of the venous system. The average age of the patients in the two groups was 49.22.4 and 51.11 years, respectively; women predominated in both groups. The qualitative and quantitative parameters of venous blood flow were studied in the study. Venous valvular insufficiency was assessed by using reflux duration and the Psatakis index. A morphometric study was conducted on 140 limbs of 48 human corpses, from which venous fragments were taken for biomechanical studies of the valves. The clinical characteristics of patients are presented by descriptive statistics, quantitative parameters are reported as the mean value (M) and standard deviation (SD). The differences were tested for significance by using the Student's t-test. Results. In the study, we introduced the concept of the valve index, the aspect ratio of the ellipse, the shape of which has a venous valve in cross-section. Duplex ultrasound scanning, as well as a morphofunctional examination of the valves, made it possible to establish that the valve index is significantly higher in the presence of signs of varicose veins, which indicates dilation and incipient varicose vein, which leads to valvular insufficiency. The elasticity index defined by us, as the indicator of change in the venous lumen size, measured by the ratio of its diameters, also significantly (p=0.034) differed in the studied groups: the elasticity index in the group of healthy people was 1.370.11, in the group of patients with varicose veins 1.560.17. The studied factors allowed us to develop a test that has an important prognostic value for the early diagnosis of varicose veins as well as the implementation of preventive health measures. Conclusion. The features of venous blood circulation and valve function studied in the study not only have prognostic value for the early diagnosis of varicose veins but are also of practical interest for developing methods of surgical correction of venous valvular insufficiency.