PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Despite innovations in orthopedic dentistry, removable dentures belong to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. It was observed 100 patients with oral candidiasis of various age groups from 45 to 65 years. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis in 60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

THE RESULT OF THE STUDY OF THE DEGREE OF ATROPHIC PROCESSES OF PROSTHETIC BED TISSUES UNDER THE BASES OF PROSTHESES OF VARIOUS DESIGNS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AGAINST THE BACKGROUND OF THE USE OF A BIO-SOLUBLE ADHESIVE FILM AND A VITAMIN-MINERAL COMPLEX

Литературные данные за последнее десятилетие свидетельствуют о неуклонном росте количества больных, нуждающихся в съемных конструкциях зубных протезов. Адаптация пациентов к съемным пластиночным протезам, в особенности изготовленным из акриловой пластмассы, несомненно, является актуальной проблемой. Известно, что базис протеза изготовлен из материалов, не являющихся полностью биологически инертным веществом, а, следовательно, возможно их местное и общее воздействие на организм. В целях профилактики негативного действия съемных пластиночных протезов и улучшения качества протезирования многими исследователями были предложены различные способы, такие как уменьшение концентрации примесей, путем кипячения, применение СВЧ-полимеризации. Широкое применение получили эластичные материалы для изготовления базисов съемных протезов. Недостатком данных методов является то, что требуются наличие специального оборудования и материальных затрат как со стороны пациентов, так и стоматологических учреждений. В последние годы клиницистов привлекает возможность применения лекарственных препаратов для лечения и профилактики осложнений со стороны тканей протезного ложа. Идет постоянный поиск фармакологических средств, позволяющих оказывать противовоспалительное, противомикробное, антиаллергическое и иммуномодулирующeе действие. Перспективным направлением в профилактике осложнений является использование биорастворимых лекарственных пленок. Биорастворимая адгезивная плёнка имеет отличную особенность значительным противовоспалительным эффектом, подтверждаемым микробиологическими и клиническими показателями. Комплексное лечение заболеваний пародонта с применением рекомендуемой биорастворимой адгезивной плёнки позволит увеличить период ремиссии у пациентов с сахарным диабетом. Согласно последним данным доказано, что они нетоксичны, инертны для организма, пролонгируют действие биологически активных веществ, входящих в их состав. Таким образом, разработка биорастворимой адгезивной плёнки для профилактики и лечения местных осложнений со стороны слизистой оболочки протезного ложа у пациентов с сахарным диабетом 2-го типа, является на наш взгляд актуальным Iterature data over the past decade indicate a steady increase in the number of patients in need of removable denture structures. The adaptation of patients to removable plate prostheses, especially those made of acrylic plastic, is undoubtedly an urgent problem. It is known that the basis of the prosthesis is made of materials that are not completely biologically inert, and, therefore, their local and general effects on the body are possible. In order to prevent the negative effects of removable plate prostheses and improve the quality of prosthetics, many researchers have proposed various methods, such as reducing the concentration of impurities by boiling, the use of microwave polymerization. Elastic materials have been widely used for the manufacture of removable prosthesis bases. The disadvantage of these methods is that special equipment and material costs are required both from patients and dental institutions. In recent years, clinicians have been attracted by the possibility of using medications for the treatment and prevention of complications from the tissues of the prosthetic bed. There is a constant search for pharmacological agents that can provide anti-inflammatory, antimicrobial, antiallergic and immunomodulatory effects. A promising direction in the prevention of complications is the use of bio-soluble medicinal films. The bio-soluble adhesive film has an excellent feature of a significant anti-inflammatory effect, confirmed by microbiological and clinical indicators. Complex treatment of periodontal diseases with the use of the recommended bio-soluble adhesive film will increase the remission period in patients with diabetes mellitus. According to the latest data, it has been proven that they are non-toxic, inert to the body, prolong the action of biologically active substances that make up their composition. Thus, the development of a bio-soluble adhesive film for the prevention and treatment of local complications from the mucous membrane of the prosthetic bed in patients with type 2 diabetes mellitus is, in our opinion, relevant

PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Background: Despite innovations in orthopedic dentistry, the manufacture of removable dentures belongs to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. According to the WHO, one-fifth of the world s population suffers or has suffered various candidiasis forms at least once. The worldwide increase in the incidence of the disease is primarily related to the fact that this infection is opportunistic, more than half of the world s population is a carrier of fungi of this kind, i.e., in most cases, it is an endogenous infection, which makes candidiasis different from other opportunistic mycoses. Aims: The purpose of this study was to study the prevalence of candidiasis in patients using removable dentures and to evaluate the effectiveness and prevention of candidiasis treatment. Methods: 100 patients with oral candidiasis of various age groups from 45 to 65 years were observed. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Results and Discussion: Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis-60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. Conclusions: The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

Assessment of the bioelectric activity of the masticatory muscles in orthopedic treatment with partial removable plate prostheses

Relevance. According to a number of authors, it is known that full adaptation to complete removable dentures occurs within 3 months [3–5, 9]. The main criterion for patients getting used to removable dentures is the synchronization of the work of the masticatory muscles and, as a consequence, the normalization of the chewing function.The aim of the study was to evaluate the bioelectrical activity of the masticatory muscles in patients using the CSPP.Materials and methods. In patients of the control (n = 23) and main (n = 63) groups, electromyographic examination was performed using the electroneuromyographic system "Synapsis" (Neurotechnology, Russia). Registration of the bioelectric activity of the chewing muscles was carried out directly on the day of applying the prostheses, after 1 and 3 months, respectively.Results and discussion. The electromyographic indices of the masticatory muscles in the patients of the control group decreased within one month after the treatment and amounted to 231 ± 18.2 μV for the right and 229 ± 16.1 μV for the left proper chewing muscles. The values were also reduced for the right and left temporal muscles – 228 ± 15.2 μV and 225 ± 24.1 μV (p < 0.05). It should be noted that the electromyographic parameters in patients of the main group were comparable to the lower limit of the norm and amounted to 269 ± 16.5 μV and 256 ± 20.4 μV, respectively, after one month of treatment.Conclusions. In the treatment of dysfunction of the temporomandibular joint with the use of thermoplastic prostheses, an increase in the biopotentials of the masticatory muscles is observed. In the orthopedic treatment of patients with terminal dentition defects using thermoplastic prostheses, the electromyographic parameters of the masticatory muscles are most close to normal after 3 months of using these prostheses.

Evaluation of the Effect of Zataria Multiflora Essential Oil and Fluconazole Solution on the Accumulation of Candida Albicans and Streptococcus Mutans on Orthodontic Removable Plate

Introduction: Since orthodontic removable appliances might be infected with fungi and bacteria, they need to be cleaned using natural disinfectants and chemicals. This study aimed to compare the clinical impact of thyme essence and Fluconazole solution on the amount of Candida albicans colonies and Streptococcus mutans accumulated on the removable appliances in orthodontic patients. Materials & Methods: In this descriptive-analytical study, 21 patients were selected who used the wear Hawley’s retainer for 24-hours. Patients were divided into three groups of seven. One group first washed the plaque with soap and water and then spray thyme essence all over it at a 5-centimeter distance (4 times on each side). In the other group, as before, the plaque was washed and from the same distance as before, the fluconazole solution (10 mg/ml) was sprayed on all surfaces 4 times. In the control group, the retainer was washed every night only with soap and water. After one month, the retainers were delivered form patients. The two samples were then separated from the Kami platelets and sent to a laboratory for microbial culture. Data were analyzed by Mann-Whitney, T-test (α = 0.05). Results: The use of thyme essence increases the mean area of Candida albicans inhibition, which was significantly higher than that in the control group (p value = 0.03). The effect of Fluconazole solution on this mean area )Candida albicans inhibition zone( was not significant compared to that observed in the control group (p value = 0.5). In the group in which thyme essence was used, the mean area of Streptococcus mutans inhibition, which was significantly higher than that in the control group (p value = 0.05). When Fluconazole solution was used, the mean area of Streptococcus mutans inhibition, was not significant compared to that observed in the control group (p value = 0.071). Conclusion: Compared to Fluconazole solution, thyme essence functions more effectively in increasing Candida and Streptococcus mutans inhibition zones.

Adhesive photocomposite prosthese – option of restoration of dental row defect in the frontal area (clinical case report)

Summary. Having and maintaining a smile aesthetic is an essential component of modern popular culture. Adhesive bridges («Maryland bridge») have been developed to eliminate single included defects in the dentition in the frontal areas, without preparing the supporting teeth. In modern conditions this technology is the method of choice since single defects in the anterior part of the dentition can also be eliminated through orthodontic treatment, manufacturing of a partially removable plate prosthesis, a traditional dental bridges, the manufacturing of cantilever orthopedic structures and prosthetics based on a dental implant. Adhesive dentures are a relatively new dental technology (which is on the border of orthopedic and therapeutic dentistry) the first work in this direction was carried out in the early 80s of the twentieth century. Modern adhesive bridges are divided into two large groups – solid metal and photopolymer (composite) which prevail in practice. The optimal form of the release of the reinforcing element which combines a slight preparation of abutment teeth to a safe depth, high physical and mechanical properties, simple achievement of the anatomical shape of the teeth in the bridge structures of the anterior and posterior teeth is fiberglass in the form of ribbons 2 mm wide, up to 0.5 mm (this is the most effective width and thickness for clinical practice) and braided type. Using adhesive bridges, it is possible to optimally restore the aesthetics of the anterior part of the dentition in one visit without preliminary preparation of adjacent teeth. An example of the manufacture of a photocomposite adhesive prosthesis reinforced with glass fiber for the restoration of a single included defect in the dentition in the frontal area using domestically produced materials is given. Key words: teeth, defect, composite, adhesion, fiberglass.

ANALYSIS OF WORK ON NANOSTRUCTURED MATERIALS IN ORTHOPEDIC DENTISTRY UNDER THE DIRECTION OF PROFESSOR E.S. KALIVRADZHIYAN

Развитие технологий, основанных на использовании низкотоксичных материалов, позволит в скором будущем начать их применение в медицине. Применение наночастиц серебра, меди, кремния, цинка, титана, кобальта в качестве модифицирующей добавки позволит оказать активное влияние на структуру исходных материалов и изменение их свойств, а именно улучшение физико-механических, физико-химических и токсико-гигиенических свойств материалов. Наноразмерные частицы кремния, введенные в фиксирующие стоматологические материалы, приводят к улучшению физико-химических, физико-механических свойств кристаллизующихся материалов, а малая теплопроводность кремния может увеличить его рабочее время и снизить выделение тепла при реакции кристаллизации. Так как от этих характеристик зависит объем манипуляций, при фиксации ортопедических конструкций на опорных зубах целесообразно было бы привести рабочее время твердения к чистому времени твердения, что позволит увеличить объем манипуляций приготовленной массой без ухудшения ее свойств. Разработка высокопрочных, биосовместимых, высокотехнологичных нанопластмасс для базисов съемных пластиночных протезов является актуальной проблемой повышения качества жизни пациентов. Модификация наноразмерными частицами серебра, кремния акрилового полимера позволит улучшить такие физико-механические свойства, как ударную вязкость, прочность, температуростойкость, барьерные свойства, уменьшить усадку полимера на этапе полимеризации, в отличие от уже известных отечественных и дорогостоящих импортных полимеров. Наноразмерные частицы кремния, серебра являются сокатализаторами метилметакрилата, влияющими на уменьшение количества остаточного мономера после процесса полимеризации, тем самым повышая санитарно-химические и токсико-гигиенические характеристики полимера. Все вышеизложенное позволило сформулировать цель исследований по наноструктурированным материалам под руководством профессора …посвящается памяти профессора, д.м.н. Каливраджияна Э.С. The development of technologies based on the use of low-toxic materials will make it possible to begin their application in medicine in the near future. The use of nanoparticles of silver, copper, silicon, zinc, titanium, cobalt as a modifying additive will make it possible to actively influence the structure of the starting materials and change their properties, namely, improve the physicomechanical, physicochemical and toxicohygienic properties of materials. Nanosized silicon particles introduced into fixing dental materials lead to an improvement in the physicochemical, physicomechanical properties of crystallizing materials, and the low thermal conductivity of silicon can increase its working time and reduce heat generation during the crystallization reaction. Since the volume of manipulations depends on these characteristics, when fixing orthopedic structures on abutment teeth, it would be advisable to bring the working time of hardening to a pure hardening time, which will increase the volume of manipulations with the prepared mass without deteriorating its properties. The development of high-strength, biocompatible, high-tech nanoplastics for the bases of removable plate prostheses is an urgent problem to improve the quality of life of patients. Modification of acrylic polymer with nano-sized particles of silver and silicon will improve such physical and mechanical properties as impact strength, strength, temperature resistance, barrier properties, and reduce polymer shrinkage at the stage of polymerization, in contrast to the already known domestic and expensive imported polymers. Nanosized particles of silicon, silver are cocatalysts of methyl methacrylate, affecting the reduction of the amount of residual monomer after the polymerization process, thereby increasing the sanitary-chemical and toxic-hygienic characteristics of the polymer. All of the above made it possible to formulate the goal of research on nanostructured materials under the guidance of the professor …dedicated to the memory of the professor, d.m.s. Kalivrajiyan E.S.

EVALUATION OF THE EFFECTIVENESS OF THERAPEUTIC AND PREVENTIVE MEASURES OF DYSBIOSIS IN DENTAL PRACTICE

Увеличивающаяся тенденция нуждаемости пациентов использования несъемных, съемных зубных протезов, ортодонтических и челюстно-лицевых апппаратов, наблюдающаяся в последние годы, сопряжена с многими проблемами. Использующиеся в практике ортопедической стоматологии зубные протезы и аппараты оказывают побочное действие на слизистую оболочку полости рта (механическое, химико-токсическое, сенсибилизирующее), что приводит к нарушению биоценоза, чрезмерному росту патогенных микроорганизмов и увеличению числа дрожжевых колоний. Установлено также, что при использовании адгезивных препаратов для улучшения фиксации съемных протезов статистически достоверно увеличивается число дрожжевых колоний при количественном посеве по сравнению с контрольной группой пациентов. Еще более сложная ситуация наблюдается у пациентов, уже имеющих хроническое нарушение соотношения нормальной и условно - патогенной микробиоты и нуждающихся в протезировании съемными пластиночными протезами. Эти пациенты, как правило, имеют неудовлетворительную гигиену полости рта и тяжелую сопутствующую патологию, чаще всего сахарный диабет или дисбактериоз ЖКТ. В настоящее время получены убедительные данные о важной роли иммунных нарушений в патогенезе развития кандидоинфекции и антифунгальной резистентности. В частности, дисфункции клеточного звена иммунной системы, что способствует хроническому, рецидивирующему и зачастую торпидному к терапии течению заболевания. Это, в свою очередь, требует выполнения научных исследований в направлении коррекции состояния микрофлоры ротовой полости пользующихся ортопедическими конструкциями. Данная обзорная работа посвящена актуальным на сегодняшний день вопросам применения пре-, пробиотических культур и синбиотиков в комплексном лечении больных с дисбиотическим изменением полости рта, пользующихся ортодонтическими конструкциями, лечебно-диагностическими аппаратами. Целью работы стал всесторонний анализ проблемы целесообразности и эффективности использования вышеназванных средств с точки зрения этиопатогенеза дисбиоза в полости рта The increasing trend of patients ' need to use non-removable, removable dentures, orthodontic and maxillofacial devices, observed in recent years, is associated with many problems. Dental prostheses and devices used in the practice of orthopedic dentistry have a side effect on the oral mucosa (mechanical, chemical-toxic, sensitizing), which leads to a violation of the biocenosis, excessive growth of pathogenic microorganisms and an increase in the number of yeast colonies. It was also found that the use of adhesive preparations to improve the fixation of removable prostheses statistically significantly increases the number of yeast colonies during quantitative seeding compared to the control group of patients. An even more difficult situation is observed in patients who already have a chronic violation of the relationship between normal and opportunistic microbiota and need prosthetics with removable plate prostheses. These patients usually have poor oral hygiene and severe comorbidities, most often diabetes mellitus or gastrointestinal dysbiosis. Currently, there is strong evidence of the important role of immune disorders in the pathogenesis of Candida infection and antifungal resistance. In particular, dysfunction of the cellular link of the immune system, which contributes to the chronic, recurrent and often torpid to therapy course of the disease. This, in turn, requires scientific research in the direction of correlation of the state of the oral microflora using orthopedic structures. This review is devoted to current issues of the use of pre - probiotic cultures and synbiotics in the complex treatment of patients with dysbiotic changes in the oral cavity, using orthodontic structures, medical and diagnostic devices. The aim of the work was a comprehensive analysis of the problem of expediency and effectiveness of the use of the above-mentioned means, from the point of view of the eiopathogenesis of dysbiosis in the oral cavity

MODERN METHODS TO IMPROVE BIOCOMPATIBILITY OF REMOVABLE DENTURES BY APPLYING ULTRASOUND TECHNIQUES

This article is devoted to the problem of toxic impact of prostheses made of acrylic polymers on the tissues of the denture foundation areas and the search for ways to improve the physical and chemical parameters of polymeric base materials. For this purpose a new technique of polymerization of acrylates in the ultrasonic field is proposed. This technique will enable to increase the efficiency of prosthetic restoration for patients with partial and complete anodontia. According to the results of laboratory studies, the bases of removable plate prostheses, manufactured by using ultrasound technology, have 1.5 times higher strength, a 50% lower residual monomer level and a 40% lower water absorption rate. Investigation of the temperature of the mucous membrane can indicate changes in tissue trophism, the severity of pathological changes, and the process of adaptation to the denture. To study the effectiveness of the proposed technique for manufacturing bases of removable plate dentures, the parameters of the temperature of the mucous membrane of the denture foundation areas in the patients during the adaptation to the prostheses and at different periods of their wearing were studied. One month interval of wearing prosthesis, the temperature indices in the patients, whose were manufactured by applying ultrasound remained unchanged. The patients, who worn dentures manufactured by using conventional techniques, had temperature indices typical for inflammatory conditions and impaired thermoregulation. This was confirmed by microbiological research: the high temperature promoted the increase in the number of microorganisms both on the mucous membrane of denture foundation areas and on the denture base. The analysis of the results obtained has shown that wearing dentures with bases manufactured by applying ultrasound technique is characterized by slight inflammation, no impairment of thermoregulation, better process of mucosa self-cleaning. The results of thermometric studies have demonstrated that complete removable plate dentures made by applying polymerization techniques for treating base material have thinner denture base, do not impair the processes of trophic tissues, since they produce less pressure on the substrate tissues; do not deteriorate thermoregulation. All these factors promote better adaptation to denture, reduce negative effects of denture bases on the oral tissues. The analysis of clinical and laboratory findings has shown the best indicators of the functional quality of removable plate dentures manufactures by applying ultrasonic polymerization.

PREVENTION OF TOXIC-ALLERGIC REACTIONS WHEN USING DENTURES AND DEVICES

Subject. Today, nanoparticles of chemical elements that make up the body are of particular interest. Such nanomaterials usually do not cause allergic reactions, they can potentially be broken down and removed from it, and, for example, drugs can be placed in the pores of these materials. At the Department of Prosthetic Dentistry of V.G. N.N. Burdenko together with Voronezh State University developed a polymer modified with nanosized silver particles, which was successfully tested on patients in the manufacture of removable plate prostheses. However, there is no data on the effect of this polymer in patients with complex jaw pathology in combination with somatic pathology, in which visible changes occur in the oral cavity. Goal ― to consider the problem of prevention of toxic-allergic reactions when using complex-jaw prostheses and devices. To study the state of the oral microbiocenosis and the cytological characteristics of the mucous membrane in patients with apparatus bases made of a polymer modified with nanoscale silver. Materials and methods. 80 people were examined and 60 patients were treated for complete absence of teeth with various degrees of atrophy according to A.I.Doynikov (1967) I, II, III, IV, V, with a uniform quantitative distribution in groups. Methodology. 80 people were examined and 60 patients were treated for complete absence of teeth with various degrees of atrophy according to A.I.Doynikov (1967) I, II, III, IV, V, with a uniform quantitative distribution in groups. Results. The dynamics of the inflammatory processes of the mucous membrane of the prosthetic bed under the bases of removable jaw devices made by the known method and with bases from modified materials was studied. A complex of personalized prevention of complications associated with the action of basic polymers has been developed. Conclusion. Obtained by analyzing the results of the study, it was possible to create, on the basis of the use of modified acrylic polymer as the material of the bases of removable prostheses and devices, a program for individual prevention of the inflammatory complications induced by them from the mucosa of the prosthetic bed, the efficiency level of which is at least 60 %. This predisposes to recommendations for the further implementation of the modified nanosilver acrylic polymer in practical dentistry.