Periodontal Diseases: Major Exacerbators of Pulmonary Diseases?

Periodontal diseases are a range of polymicrobial infectious disorders, such as gingivitis and periodontitis, which affect tooth-supporting tissues and are linked to playing a role in the exacerbation of several pulmonary diseases. Pulmonary diseases, such as pneumonia, chronic obstructive pulmonary disease (COPD), asthma, tuberculosis, COVID-19, and bronchiectasis, significantly contribute to poor quality of life and mortality. The association between periodontal disease and pulmonary outcomes is an important topic and requires further attention. Numerous resident microorganisms coexist in the oral cavity and lungs. However, changes in the normal microflora due to oral disease, old age, lifestyle habits, or dental intervention may contribute to altered aspiration of oral periodontopathic bacteria into the lungs and changing inflammatory responses. Equally, periodontal diseases are associated with the longitudinal decline in spirometry lung volume. Several studies suggest a possible beneficial effect of periodontal therapy in improving lung function with a decreased frequency of exacerbations and reduced risk of adverse respiratory events and morbidity. Here, we review the current literature outlining the link between the oral cavity and pulmonary outcomes and focus on the microflora of the oral cavity, environmental and genetic factors, and preexisting conditions that can impact oral and pulmonary outcomes.

Airway patency in children for dental therapeutic procedures in ambulatory practice

This article presents a literature review of basic concepts of artificial airway patency in children during anesthetic management for prolonged dental procedures in outpatient surgery (MedLine, PubMed). The following considers the necessity to protect airways from the moment of onset of deep sedation, when verbal contact with a child is not always adequate, the le-vel of reflex activity is reduced, and vital functions control is not complete yet without additional supporting mechanisms. Airway patency management and selection algorithms are given depen-ding on various factors, such as the duration and invasiveness of dental intervention, the characteristics of the child’s anatomy, and concomitant pathologies, as well as associated emergency conditions with a strategy for their prevention. Comparative cha-racteristics of the use of laryngeal devices and various intubation techniques in the aspect of pediatric dentistry have been carried out. A separate paragraph in the article highlights the methods of monitoring in the operating theatre and the strategy of the Difficult Airway Society, the support and implementation of which is mandatory in any private structures of pediatric outpatient anesthesia practice in Europe and America.

Senile mouth as a component of geriatric status

According to the literature, there is a high prevalence of the syndrome of senile asthenia (frailty) among the elderly. This condition is associated with a number of physical, functional and biochemical changes in the body. The interrelationships of the senile mouth with the malnutrition syndrome are known, the associations with other geriatric syndromes are insufficiently studied. At the same time, early diagnosis of conditions and diseases as the risk factors for the development of senile mouth is very important. The aim of the study: To study the role of the senile mouth in the formation of geriatric status. Materials and methods: In total, 570 elderly and senile people were included in the study (58 persons without adentia, 512 persons with adentia. The age of the patients ranged from 65 to 84 years. The groups of patients without adentia and with adentia were comparable in age and sex composition. Results: The study showed that the senile mouth is associated with the loss of 11 or more teeth in any variant of adentia, and with a smaller number of lost teeth – with the 1st and 4th classes of adentia according to E. Kennedy, while the ethiological causes of adentia do not have a significance in increasing the risk for developing of senile mouth. Cardiovascular pathology, type 2 diabetes mellitus and diseases of the musculoskeletal system increase the risk of developing the progression of the senile mouth. The senile mouth is associated with such geriatric syndromes as the syndrome of malnutrition and the risk of its development, dina/ sarcopenia, falls syndrome, depression, cognitive disorders and uncorrected sensory deficits. Conclusion: Senile mouth take place in the processes of formation of geriatric status in elderly patients. It is necessary to investigate the state of the dentition according to E. Kennedy. The patients with complete adentia, as well as with grades 1, 4 of adentia and its mixed forms are the groups of increased risk of frailty. It is also advisable to conduct a comprehensive geriatric assessment with targeted correction of the identified geriatric syndromes in people with senile mouth before and after dental intervention.

Experience of joint management of patient with Huntington's chorea by neurological and dental specialists with use of tetrabenazine

Huntington's chorea is a hereditary disease causing progressive degeneration of the central nervous system with the damage to extrapyramidal structures: basal nuclei, striatum, subthalamic nucleus with increased activity of the central dopaminergic pathways, with the development of neurological, psychiatric, and emotional/personality disorders [1, 17]. The inheritance pattern of the disorder is autosomal dominance. The prevalence of Huntington's disease ranges from 3 to 17 cases per 100,000 population, averaging 5–7 cases per 100,000 population in Russia [2]. The development of the disease is associated with the expansion of CAG (cytosine-adenine-guanine) trinucleotide repeats in the frst exon of the HTT gene encoding the huntingtin protein. This expansion of trinucleotides (long sections of glutamine residues) leads to the selective loss of neurons that connect the striatum and the globus pallidus. This leads to a loss of inhibitory activity and an increase in the excitation impulse, which leads to uncontrolled movements.Unfortunately, medical treatment does not slow down the progression of this disease (a lethal outcome occurs within 15–20 years). Improvement of the quality of life of people with Huntington's chorea, with the provision of medical services at an appropriate level, remains an urgent issue. This direction is especially relevant in providing dental care to patients with Huntington's chorea. Due to the pronounced hyperkinetic syndrome and compulsive movements in the muscles of the arms, trunk, neck and face, it is almost impossible to provide dental care for these patients. Currently, general anesthesia is used to enable dental intervention, but patients note that with frequent use of anesthesia, the patient's condition deteriorates, with an increase in hyperkinetic symptoms. Tetrabenazine is known to reduce the severity of hyperkinetic symptoms and is used in many countries [5].However, in our country many specialists are not familiar with it. During the follow-up of a patient with Huntington's chorea, with the selection of a therapeutic dose of tetrabenazine, it was possible to provide three stages of dental care for the patient without the use of general anesthesia. The material presented in the article can provide useful information on the use of tetrabenazine in patients with Huntington's chorea.

Clinical Application Of Dental Photography By A Dentist

"One picture is worth a thousand words" - Frederic Bernard Currently, many dentists use a camera in their daily practice, turning into photographers for a while. In aesthetic dentistry, the main tool for diagnosis and communication is the art and practice of obtaining a photo. The use of dental photography is the standard of modern dental treatment, since photographs of the results of treatment facilitate understanding of the features of dental intervention. And most importantly, visualization increases the motivation of the patient and promotes the establishment of friendly relations between him and the doctor.

Oral health status and dental care for hospitalized patients with facial fractures

Objective: to analyze the oral health profile of inpatients victims of oral and maxillofacial trauma at the Institute Dr. José Frota Hospital, Ceará, Brazil. Methodology: a study carried out in 2020 started with an examination of the oral cavity at the bedside, application of the DMFT and The Bedside Oral Exam indexes, together with the survey of dental needs and application of the Oral Health Impact Profile Scale (OHIP-14), relating the findings, applying average, standard deviation and calculating Cronbach's alpha coefficient and Spearman's correlation for the OHIP-14 finding. Results: We evaluated 78 patients, mostly male (88%), with a mean age of 32.72 ± 11.63 years old, with hypertension being the most prevalent comorbidity. Besides, 60% of the sample had a fracture in the lower third of the face. The average number of decayed teeth per patient was 5.69. About 62.82% had poor oral health, seen from generalized biofilm and swollen gums. Low-Level Laser therapy was indicated for 94.8% of the sample, periodontal treatment in 58.9%, restorative therapy in 69.2%, and surgical in 42.3%. Regarding the OHIP-14 questionnaire, facial trauma negatively impacted the participants' quality of life, especially in dimensions related to pain. Conclusion: there was a significant prevalence of oral diseases, such as gingivitis and dental caries, which justifies the need for dental intervention before the maxillofacial surgical approach.

Contribution to the study of improving the aesthetics of the smile by repairing and reshaping the incisors with composite materials.

Introduction. Dental aesthetics, although it seems something relative and difficult to evaluate, it is governed by a series of laws and rules that connect the dental disciplines, creating a unitary whole. It is structured by rules, perfected by artistic sense and by the inclination towards beauty of all specialists in dento-facial cosmetics. The aim of the study is to highlight an overview of aesthetic factors to consider when restoring anterior teeth with direct composite materials. Material and methods. A total of 25 patients were included in the study where the anterior teeth were restored using Gradia Direct Anterior (from GC) and Filtek Z550 (from3M-ESPE) composite kits, in perfect isolation using rubber damn, with a separate appointment after 24 hours for the polishing step, for which Rainbow Kit Technic and polishing Platina Hi-Gloss (from Prevest) paste were used. While the replacement of the tooth defect, we ensured that the composite increment, which we used should not be more than 2mm in thickness, and light cured for 20 seconds as the producer recommends. In none of all tooth shape modification (elongation in incisal zone) we did not modify the occlusion, by eliminating all premature contacts. All patients included in the study have signed the informed consent and agreed to participate in this research. Results. From a total of 25 patients, we repaired 20 central incisors with the mesial (18 cases) or distal (2 cases) angles fractured, in different accidents, 5 cases with diastema by small shape of the crown or malposition of one of the central incisors. Conclusions. Restoring the incisal angle or the incisal edge and refining a natural and improved smile of the patient is e very frequent dental intervention, especially nowadays when aesthetics plays an important role in the social society.

Effect of dental intervention on improvements in metabolic syndrome patients: a randomized controlled clinical trial

Background Metabolic syndrome (MetS), caused by the accumulation of visceral fat, is considered a major cause of cardiovascular disease. This randomized controlled trial aimed to clarify the effect of dental intervention, including prosthodontics and/or periodontal treatment, combined with dietary and exercise guidance on MetS. Methods In total, 112 patients who met the Japanese waist circumference criteria of MetS were recruited. The intervention group (ITG) received dental intervention along with dietary and exercise guidance, while the control group (CTG) received dietary and exercise guidance alone. Three outcome measurements were obtained before intervention (BL), 1 month after intervention (1M), and 3 months after intervention (3M). Results Body water rate (p = 0.043) was significantly higher in ITG than in CTG at 1M. Simultaneously, fasting blood sugar level (p = 0.098) tended to be lower in ITG than in CTG. Lean mass (p = 0.037) and muscle mass (p = 0.035) were significantly higher and body weight (p = 0.044) significantly lower in ITG than in CTG at 3M. Body mass index (p = 0.052) tended to be lower in ITG than in CTG. Conclusions Dental intervention combined with lifestyle guidance may improve anthropometric status and reduce the risk of MetS. Trial registration University Hospital Medical Information Network Center Unique UMIN000022753. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026176.

MATHEMATICAL MODELING OF TELEROENTGENOGRAPHIC PARAMETERS ACCORDING TO THE METHOD OF SCHWARZ A. M. DEPENDING ON THE BASIC CEPHALOMETRIC PARAMETERS IN UKRAINIAN YOUNG MEN AND YOUNG WOMEN WITH DIFFERENT FACE TYPES

The aim: Is development and analysis of regression models of teleroentgenographic indices according to Schwarz A. M., which can be adjusted during surgery depending on the parameters that usually do not change in Ukrainian young men and young women with with normal occlusion close to orthognathic occlusion and different facial types. Materials and methods: Teleroentgenographic indices were obtained using a dental cone-beam tomograph Veraviewepocs 3D Morita and studied in 49 young men and 76 young women with normal occlusion close to orthognathic. Persons were divided into groups with different face types according to the recommendations of Schwarz A. M. In the license package “Statistica 6.0”, regression models of teleroentgenographic indices were built according to Schwarz A. M. Results: For young men with orthognathic occlusion and with different types of faces according to Schwarz A. M. constructed 10 of 27 possible reliable regression models of the group of teleroentgenographic indicators, which can be corrected during surgical, orthopedic interventions in dentistry depending on the group of basic, invariable cephalometric indicators greater than 0.6 (R2 = from 0.609 to 0.996); and in young women with different face types, 8 of the 27 possible reliable regression models in which the coefficient of determination is greater than 0.6 (R2 = from 0.642 to 0.986). Conclusions: The developed regression models provide the most individualized approach in determining the method and scope of the required dental intervention.