Histological and X-ray structural analysis of the conditionof the bone tissue of the jaws with direct and delayed implantation using implants with different surface microstructures

This article presents the results of histological and X-ray studies of bone condition, stability, and degree of osteointegration of implants with different microstructure of the surface during immediate and delayed implantation in the animal experiment. The results of the study did not reveal significant differences in the process of osteointegration during direct and delayed implantation. Data from histological and X-ray studies of direct implantation in fresh extraction holes are comparable to those obtained during delayed implantation and are not inferior to the traditional two-stage protocol. At the same time, a certain correlation between the type of surface of the implant and the time of its adaptation in different periods of the experiment was revealed. When using an implant with an innovative surface, HSTTM. The process of osteointegration is mor clear, and the bone wall of the hole is more compacted, which indicates an accelerated and successful process of osteointegration. Key words: X-ray diffraction, frequency resonance and histological analysis, fibrous capsule, collagen fibers, trabeculae, bone tissue, periotestometry osseointegration, stability.

Six-year analysis of traumatic injuries of the craniomaxillofacial area: relation between maxillofacial and traumatic brain injuries

Summary. Craniofacial trauma is one of the most difficult types of injuries. There is disagreement among various authors about the relationship between maxillofacial trauma (MFT) and traumatic brain injury (TBI). Purpose. Retrospectively evaluate the epidemiology of traumatic injuries of the craniomaxillofacial area and determine whether there is a relationship between different isolated or combined fractures of the facial bones and brain damage. Materials and methods. The case histories of three groups of patients with isolated fractures of the mandible (I group), isolated fractures of the midface zone (II group) and combined fractures of all areas of the face (III group), who were hospitalized in the period from 2012 to 2017, were analyzed. The main epidemiological indicators were determined. The analysis of indicators of severity of MFT and TBI is carried out. Correlation analysis of indicators, analysis using the Kruskal- Wallis test and Steel-Dwass test for pairwise comparisons was performed. Results. Were treated519 patients. 457 men (88 %) and 62 women (12 %). The main causes of injuries were assaults (40 %). Correlation analysis did not reveal the dependence of MFT and TBI. The difference in severity of isolated fractures of the mandible and midface bones was statistically significant, and there is a statistical significance between the severity of TBI in case of isolated fractures of midface bones and panfacial fractures (p < 0.05). Conclusions. The severity of maxillofacial trauma in the case of panfacial fractures is on average 3 times higher than in the case of isolated fractures of the lower jaw or midface bones. The severity of TBI is largely consistent with concussion in all groups, but in the group with panfacial fractures, the median rate is lower comparing to other groups. Key words: Glasgow coma scale, fracture, Le Fort, traumatic brain injury

Comparative characteristics of dynamic masticatory tests

Summary. Chewing is one of the important functions of a person that ensures vital functions. Many works have been devoted to the definition of chewing efficiency for almost a hundred years. However, most of them are not currently used, which is due to the complexity and complexity of the implementation. This review is devoted to the coverage and comparison of dynamic masticatory samples to select the optimal for use in patients in the postoperative period with defects of the oral cavity and oropharynx. Key words: chewing efficiency, dynamic test, oral cavity defects.

Restoration of oral health as one of the important factors improving the quality of life

Summary: The search for and development of methods for determining the quality of life is an urgent problem of foreign and domestic medicine, and the state of dental health plays a very important role. An important role in human communication plays the maxillofacial area. Therefore, the most important areas and defects associated with the communication process – defects in the frontal area, smile, change of pronunciation, spitting during the conversation – all these signs accompany a number of anomalous processes. Objective: to assess the impact of dental status on the quality of life of the adult population in the presence of the disease periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities. Materials and methods. To study this goal, a survey of 283 patients who applied was conducte with complaints of aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity. Results. A complete analysis of factors that significantly affected the quality of life of patients with a number of diseases was obtained oral cavity. Conclusions. Deficiencies related to oral health reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But for the best results positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment. Key words: quality of life, dental health correction.

Comparative analysis of the strength of restoration polymers of light polymerization for dental restoration using the acoustic emission method: part one

Purpose. Comparative analysis of the strength of hybrid restoration composites of light polymerization during their local loading using the phenomenon of acoustic emission. The following restoration composites were studied: Latelux, Tetric N-Ceram, Charisma Classic. Results. It was determined that the nature of the destruction of all composites is the same: elastic-plastic at the initial stage of the load with a transition to brittle as its further growth. Three types of composite failure are observed: correct, incorrect and mixed. The first predominated during fracture under the action of local loading of the Latelux composite, for Tetric N-Ceram and Charisma Classic materials a mixed type of fracture is characteristic. Conclusions. Analysis of the parameters of the AE signals showed that the signals had the highest amplitude and energy when the Tetric N-Ceram composite was destroyed, and the lowest – Latelux. All dental composites are dominated by high-energy ductile-brittle and brittle fracture, which indicates the spread of micro- and macrocracks of various sizes in materials. Key words: polymer composites, strength, acoustic emission method.

Regenerative therapy for the treatment of periimplantitis

The purpose of this study is to evaluate the outcome of regenerative therapy of peri-implantitis. The 32 patients involved in this study with inflammatorydestructive processes in the field of peri-implant tissues of osseointegrated implants. The diagnostic parameters used for assessing peri-implantitis include clinical indices, Probing Pocket Depth (PPD), Bleeding On Probing (BOP), periimplant radiography. 16 implants with peri-implant mucositis, 8 implants with early peri-implantitis and 5 implants with moderate peri-implantitis was treated only conservative treatments methods, 6 implants with early peri-implantitis, 7 implants with moderate peri-implantitis and 4 implants with severe periimplantitis was treated surgically. PPD and BOP data at the re-examination were retrospectively compared to baseline data. A statistical significant reduction in both PPD and BOP were seen at alltimepoints as compared with the baseline clinical measurements. Stable clinical measurements PPD and BOP were demonstrated after 1 year the initial treatment, remaining stable during the following three years. Surgical regenerative treatment combined with mechanical and chemical detoxification of the implants’ surface, magneto-laser therapy and regenerative therapy using an autologous bone, xenograft, hyaluronic acid and a restorablemembrane a reliable method for stopping and treatment peri-implantitis. Key words: Peri-Implantitis; Dental Implant; Regenerative Therapy; Magneto-Laser Therapy; Hyaluronic Acid.

Genetic and epigenetic factors of caries

Summary. The paper analyzes the literature on the causes of caries, including the most common epigenetic factors, such as poor oral hygiene, adequate or deficient nutrition, the nature of food, biogeochemical and territorial factors, the content of microelements of water and soil, the level of environmental pollution, etc., as well as considering the genetic component, type of blood group, the structure of the hard tissues of the tooth, including a set of genes responsible for the occurrence and development of carious pathology. It was found that in conditions of fluoride and iodine deficiency, environmental factors have a critical role in the formation of the population-characteristic pattern of changes in dental status associated with the prevalence and intensity of caries. However, variations in these indicators may be partly mediated by the influence of genetically associated factors. The results of the analysis allowed to identify opportunities for the formulation of several independent analytical approaches that would help establish the significance of the genetic component in the structure of caries prognosis in terms of interaction with environmental conditions, actually determining how certain environmental factors can influence changes in genetic predisposition to caries. It can be summarized, that all currently available studies of the role of heredity in the risk structure of caries pathology is divided into two broad categories: identification of specific localized changes in genotype and verification of combinations or sets of such changes that can determine caries risk. Key words: caries, caries intensity, caries prevalence, genetics, twins, epigenetics, environment, saliva pH.

The results of the application of an advanced algorithm of direct prosthetics based on dental implants with a personalized approach

Summary. Partial adentia is a topical issue in modern dentistry. Rational use of dental implants (DI) with direct prosthetics (DP) on installed implants at partial adentia is a modern and quick answer to this question. But still there is a number of unresolved issues in the method of direct prosthetics on DI. The most relevant of these is how to use modern CAD/CAE/CAM technologies to personalize the eruption profile of natural teeth while maintaining the height of periimplantative bone tissue (BT) and the volume of surrounding soft tissues. Purpouse: to improve the quality of stomatological treatment of patients at the stages of dental implantation by applying an improved algorithm of direct prosthetics on dental implants on the basis of scientific justification of rational use of personalized prosthetic constructions and prosthetic elements, as well as pharmacological support of such interventions. Materials and methods of research. The clinical study included 80 patients – 63 patients were included in the main cohort (had dentition defects and/or required tooth extraction) who were randomized into three groups (I–III), according to the applied treatment; 17 patients were included in the additional cohort (group IV – without dentition defects) who’s clinical and laboratory parameters were within the physiological norm. According to the above distribution of patients of the main cohort by study groups (groups I-III), each patient received the following treatment measures according to the study plan. Patients in group I (21 patients) used an improved direct prosthetics (DP) algorithm on DI with screw fixation of prosthetic structures from the level of the implant platform, and patients in group II (21 patients) – from the level of mesostructure of multi-unit abutment with the manufacture of individualized hybrid and/or crowns using CAD/CAE/CAMtechnologies. Prevention of inflammation and pain in patients of groups I–II was carried out by prescribing a complex of pharmacological support, which contained – the drug nimesulide, a complex drug bromelain, trypsin, in combination with drug rutoside threehydrate, and the drug trometamol dexketoprofen. Patients in group III (21 patients) used the conventional protocol of DP on DI with screw fixation of prosthetic structures from the level of the DI platform with the use of standard prosthetic elements and structures of artificial crowns made by traditional laboratory methods, while preventing inflammation and pain in patients of this group was carried out by prescribing a complex of pharmacological support, contained of the drug meloxicam, a complex drug of bromelain, trypsin, in combination with the drugrutoside threehydrate, as well as the drug ibuprofen. Clinical, functional and radiological studies, followed by statistical analysis of the results were provided for the patients of groups I–IV. Results. Prescription of the proposed pharmacological support complex at the stage of direct prosthetics in dental patients of groups I and II allowed to prevent pro-inflammatory resorption of BT due to surgical trauma of bone and soft tissues in the area of dental implantation, minimize loss of marginal BT around DI. Patients of groups I and II achieved a significant (p < 0.05, compared with group III) increase in the coefficient of stability of the implant (CSI) starting from the 20th day (group I – 65.37±1.12 units and group II – 64.93±0.75 units) in contrast to the delayed increase of this coefficient in group III (63.18±0.72 units), in which this indicator began to increase only from the 30th day. As a result, the loss of the height of the marginal BT after 12 months (1.11±0.03 mm) in group III was significantly (p < 0.05) higher than in groups I and II. Structural features of standard abutments, and the lack of ability to reproduce the anatomical features of the natural eruption profile of prosthetic structures made manually in traditional way contributed to a significant increase in the rate of loss of marginal BT (1.20±0.04 mm) in 24 months in patients of group III in contrast to patients of groups I and II. Instead, the minimal loss of marginal BT height throughout the study period was observed in group II which used an improved algorithm of DP on DI with screw fixation of prosthetic structures from the mesostructure of multi-unit abutment with the manufacture of individualized hybrid crowns with the help of CAD/CAE/CAM-technologies. The use of multi-unit abutments allowed to seal the access to the DI shaft and to carry out all subsequent stages of prosthetics at a level higher than the DI shaft. In particular, in group II of the study absence of infection with oral fluid in the DI shaft during the stages of prosthetics, minimization of trauma to the marginal bone, periosteum and soft tissues around the DI during impression obtaining, fixation of temporary and permanent structures of dental prostheses, as well as the author's algorithm of reproduction of a natural profile of eruption allowed to maintain a significantly higher (p < 0.05) volume of BT around the DI after 12 and 24 months in comparison with group I where titanium platforms and personalized constructions of abutments and profiles of eruption of dental prostheses were used and group III, where standard abutments from the level of DI shaft and traditional constructions of dental prostheses were used. The results of remote clinical trials have demonstrated the high efficiency of the proposed complex of treatment measures and the rationality of its components according to the algorithm in patients of groups I and II compared to traditional approaches in patients of group III. The loss of periimplantative soft tissue height after 12 and 24 months of DI was significantly lower (p < 0.05) in patients of groups I and II, compared with group III. In group II after 12 and 24 months the loss of soft tissues around DI was significantly lower (p < 0.05) compared with group I. Conclusions. Prescription of the proposed pharmacological support complex at the stage of dental implantation and direct prosthetics on DI, contained of the drug nimesulide, complex drug bromelain, trypsin in combination with the drug rutoside threehydrate and trometamol allowed to prevent inflammation-induced resorption of BT in areas of surgical trauma of bone and soft tissues, helped to minimize the loss of marginal BT height around the DI. In patients of groups I and II, that received the proposed complex of pharmacological support, the loss of BT in the first 6 months after the intervention was significantly smaller (p < 0,05) (group I – 0,15 ± 0,04 mm, group II 0,10 ± 0,02 mm), and KSI credibly (p < ) bigger in contrast to patients of group III (loss of BT 0.66 ± 0.03 mm, KSI 79.06 ± 0.54 units) in whom pharmacological support contained meloxicam and ibuprofen, the action of which was insufficient for full prevention of trauma and inflammation for induced local resorption of the marginal bones around the installed DI, and as a consequence of the predominance of BT resorption processes over its formation. According to the results of remote (after 12 and 24 months) clinical and radiological examinations in patients of groups I and II who used identical in composition to author's complex of pharmacological support and developed personalized protocol of direct prosthetics on DIfound significant differences in bone and soft tissue loss around DI between these groups. It is proved that the use of personalized protocol of direct prosthetics on dental implants from the level of mesostructures of multi-unit abutments in patients of group II prevented multiple injuries of the marginal bone, periosteum and mucous tunic around the DI during routine prosthetic manipulations. As a result, in group II were found significantly lower (p<0.05) rates of bone and soft tissue loss around DI after 12 and 24 months after dental implantation and direct prosthetics in comparison with group I. The proposed author's protocol of direct prosthetics on dental implants using modern CAD/CAE/CAM technologies allowed reproducing natural eruption profile in personalized way. When used in patients of group II from the level of multi-unit abutments after 24 months significantly better (p<0.05) results were obtained in maintaining the height of periimplantative bone tissue and the volume of surrounding soft tissues compared to traditional prosthetic methods used in patients of group III. Key words: direct prosthetics, dental implantation, personalized approach, CAD/CAE/CAM-technologies, multi-unit abutment.

Assessment of the dynamics of x-ray morphometric indices of the jaws in children with variable bite

Purpose: to determine the peculiarities of the dynamics of the roentgenomorphometric indices of the jaws in children during the period of mixed bite. Materials and methods. The study assessed the dynamics of radiological indices (mental index (MI), gonial index (GI), upper and lower panoramic mandibular indices (PMI-S and PMI-i)). The study used orthopantomograms of 107 children (65 boys and 42 girls) aged 6–13 years from Lvov and Lviv region. All children were divided into age groups with the preservation of a proportional and harmonious distribution, both by sex and by age. Results. After evaluating the results of the study, the age periods of active restructuring of the bone structure of the child's jaws were identified. A characteristic feature of variations in index indicators is different age phases of active changes for boys and girls. The only common period for both sexes is the age of 9–10 years, when there is an increase in almost all index indicators, which coincides with the beginning of the eruption of multi-rooted teeth. Conclusions. Evaluation of index indicators using orthopantomograms in children during the period of mixed bite is an important diagnostic criterion for detecting active morphometric changes in the bone structures of the maxillofacial region, as well as an auxiliary diagnostic criterion when planning the timing of dental or orthodontic intervention. Key words: orthopantomogram, radiological indices, mental index, gonial index, upper and lower panoramic mandibular indices.

Improving of treatment of periodontal diseases in workers of the woodworking industry of the Chernivtsi region

Goal. Improving the scheme of treatment and prevention of periodontal diseases in workers of the woodworking industry of Chernivtsi region, who in the process of professional activity have long-term contact with unfavorable factors of the production environment. Materials and methods. 70 workers of the woodworking industry with diagnosed chronic generalized periodontitis of the I degree were treated (35 people – the main group (A); 35 people – comparison group (B)), age – from 25 to 45 years. To compare the results of laboratory studies, an additional survey of 25 healthy individuals of the same age with an intact periodontium were conducted. They formed the control group (C). Clinical examination of patients was performed according to standart methods: subjective (complaints, medical history, life history) and objective (examination, periodontal indices, determination of the level of gingival attachment). Laboratory methods of research included determination of urease and lysozyme activity in saliva, degree of dysbiosis of oral cavity. As maintenance therapy, patients of the main group were prescribed the proposed composition DEPE. Results. After the treatment, a significant improvement in the hygienic status of patients in both groups was observed, but difference between groups A and B in the indicators of oral hygiene after treatment was no statistically significant (pA2–B2 > 0.05). There was a significant improvement in periodontal indices after treatment in patients of both groups (PMA index according to C. Parma, bleeding index according to Muhlemann in Cowell I. modification, Russell periodontal index, PSR-test), but the indicators in patients of the main group were significantly better – pA2–B2 < 0.05. In patients of the main group (A) the level of attachment loss decreased by 1.83 times, comparison group (B) – by 1.71 times. The difference in levels of attachment loss after treatment between groups A and B is statistically significant (pA2–B2 < 0.05). The activity of the enzyme urease in patients of the main group (A) and comparison group (B) after treatment was significantly reduced (pA1–A2 < 0.001, pB1–B2 < 0.001), but only in the main group it reached the level in the control group (C) (pA2–C > 0.05). The level of lysozyme after treatment was significantly increased in patients of both observation groups (pA1–A2 < 0.001, pB1–B2 < 0.001), and reached the level of lysozyme in patients of the control group (C) (pA2–C > 0.05, pB2–C > 0.05). The degree of oral dysbiosis in patients of the main group (A) was significantly reduced by 5.43 times (pA1–A2 < 0.001), and its difference from the degree of dysbiosis in patients of the control group (C) is statistically insignificant (pA2–C > 0.05 ). The degree of oral dysbiosis in patients of the comparison group (B) was significantly reduced by 3.04 times (pB1–B2 < 0.001), but still remained significantly different from oral dysbiosis in patients of the control group (C) (pB2–C < 0.05). Conclusion. The proposed pharmacological composition DEPE is an effective antiseptic solution and can be used in the phase of maintenance therapy to improve the treatment and prevention of periodontal disease in workers of woodworking industry. Key words: decamethoxine, propolis, ethonium, generalized periodontitis, woodworking industry.