DEVELOPMENT AND PRESCRIPTION OF THE FUNCTIONAL FOOD DIET TO THE PATIENTS WITH DENTAL PROSTHESIS

Till present times nutritiology and dietology in dental practice are at rudimentary level. At the same time it is a well-known fact the chewing efficiency is much higher in case of having fixed prosthesis comparing with their removable denture counterpart. As for elderly population nourishment it is important to take into consideration the complexity of receiving of all the necessary nutrients. Quantity and quality of the food diet will directly affect their quality of life. Aim. Development of the functional food diet ration for specific groups of dental patients Materials and Methods. We surveyed 244 patients (84 males, 160 females) in the age range from 60 to 85 years (mean value 75.4+/-2.4) with different types of implant supported prostheses. We used clinical, sociological, nutritiological evaluation methods. Besides that we used GOHAI questionnaire and modified Wolfart questionnaire. Results. We defined basic groups of dental patients who have indications for prescribing functional food diet: a) patients utilizing removable dentures, especially full dentures, in the situation where antagonists would be intact dentition or dental arches with conventional or implant supported fixed bridges; b) patients treated with immediate removable dentures, fixed implant supported prostheses, especially in case of big span bridges with limited amount of fixtures; c) patients using removable implant supported overdentures; d) Patients older than 70 years of age. We established food rations based on intaking soft low viscosity liquid meal. High GOHAI scores (56.1+/-1.49) were the prove of the high efficiency and efficacy of the rehabilitation per se and also of the functional diet regimen recommended to the examined patients. Conclusions. We developed functional food diet taking into consideration the short and long term period after finishing the implant supported or conventional, immediate or delayed prosthetic rehabilitation with the use of total prosthesis predominately for edentulous patients. Incorporation of these types of diet regimen in the rehabilitation plan oriented towards increasing the efficiency of the main treatment arrangements.

SEARCH ASSOCIATION OF POLYMORPHISM rs3918242 IN MMP9 GENE WITH GUM RECESSION OF CHILDREN

Subject. Gingival recession is a complex multifactorial disease, the development of which is influenced by the interaction of many genes and environmental factors (orthodontic and mucogingival anomalies, bad habits, muscle hypertonicity). Since, in addition to environmental factors, genes also influence the development of this pathology, the study of the molecular genetic basis of gum recession is an urgent task of modern dentistry. Such studies can make a decisive contribution to the creation of a concept describing the development of gingival recession, will help determine the prospects for its personalization and will allow the development of scientifically based comprehensive programs for the prevention of periodontal pathology. The aim is to study the association of the rs3918242 of the metalloproteinase 9 (MMP9) gene in children with the development of gum recession citizensof the Republic of Tatarstan. Methodology. The study sample included 284 patients, of which 200 relatively healthy ones constituted the control group (intact periodontium) and 84 - the observation group (gingival recession). DNA was isolated from buccal epithelial cells. Further genotyping of the rs3918242 polymorphism of the MMP9gene was performed using real-time polymerase chain reaction on a CFX96 amplifier (BioRad, USA) in accordance with the manufacturer's instructions (Sib-DNA, Novosibirsk). Statistical analysis was performed to assess the differences between the study groups. Results. There were no statistically significant differences in the frequency of alleles and genotypes of the rs3918242 polymorphism of the MMP9 gene between the study groups (p > 0.05). Conclusions. The role of the rs3918242 polymorphism of the MMP9 gene in the development of gum recession in children living in the Republic of Tatarstan has not been established using the case-control methodological approach.

FEATURES OF THE CLINICAL STATE OF PERIODONTAL TISSUES IN YOUNG PEOPLE

Relevance of the research topic. The authors found that various risk factors play a leading role in changing the clinical state of periodontal tissues. The aim is a comparative assessment of the clinical condition of periodontal tissues based on the correlation of hygienic and periodontal indices depending on age. Material and methods. A comprehensive clinical examination of 765 young people was conducted. The main group consisted of 70 (66.6%) patients with diagnosed chronic gingivitis and 145 (33.35%) patients with mild initial periodontitis due to the presence of conditionally pathogenic and periodontopathogenic types of microorganisms in the microbial biofilm. The control group was formed by 83 patients whose index evaluation revealed the condition of periodontal tissues in the form of clinically healthy gums with intact periodontal and clinically healthy gums with periodontal tissue loss, respectively, in 61.4 and 38.6% of cases of observations. Study results. In 61.4% of persons forming groups with clinically healthy gums, hygienic and periodontal indices are within normal values, in 38.6% of cases of persons there is a tendency to change them from the norm. In 47.7% and 52.3% of cases of individuals with gingivitis and in 48.3% and 51.7% of individuals with initial periodontitis, the OHI-S index correlates with the indicators of PMA, GI and SBI (p < 0.001, p = 0.315). Conclusions. Thus, the revealed changes in the indicators of hygienic and periodontal indices (the Chuprov conjugacy coefficient is 0.64 (p = 0.012), the Kraskel-Wallis criterion (H = 7.89, p < 0.05) makes it possible to clearly determine the clinical condition of periodontal tissues corresponding to modern European criteria.

FEATURES OF IMMUNOLOGICAL REACTIVITY OF PATIENTS WITH LICHEN PLANUS OF THE ORAL MUCOSA

Lichen planus is considered as a multifactorial disease. Various factors play a role in the development of lichen planus of the oral mucosa: genetic, dental materials that are used for restoration, prosthetics of teeth, Helicobacter pylori, viruses, psychological stress, somatic pathology and others. The pathogenesis of oral lichen planus is based on an autoimmune process. The aim of the study was to determine the immunological reactivity in patients with various clinical forms of lichen planus of the oral mucosa. The study carried out clinical, laboratory examination of 75 female patients aged 29 to 75 years old with red lichen planus of the oral mucosa. All patients were divided into three groups depending on the clinical form of the disease. The control group consisted of 30 women aged 39 to 70 years old without red lichen planus of the oral mucosa. The phagocytic activity of neutrophils, the level of immunoglobulins of classes A, M, G and circulating immune complexes in the blood serum were evaluated. The humoral link of immunity in patients with exudative-hyperemic form of OLP was characterized by hyperimmunoglobulinemia of classes A, M, G, an increase in circulating immune complexes, in patients with erosive-ulcerative form of hyperimmunoglobulinemia of class M against the background of hypoimmunoglobulinemia A, G and an increase in circulating immune complexes. In patients with a typical form of OLP, only an increase in the level of circulating immune complexes was noted. When assessing the immune reactivity in patients with OLP, the relationship between the manifestations of the "dysphagocytosis" syndrome, disorders in the humoral immunity system with various clinical forms of the disease was established. This fact allows us to conclude about the pathogenetic role of an imbalance in the system of mechanisms that ensure the elimination of pathogens, including infectious nature in the occurrence of a disease with the formation of an autoimmune component.

COMPREHENSIVE STUDY OF DENTAL ORTHOPEDIC MORBIDITY IN ELDERLY PEOPLE AND THE WAYS TO ELIMINATE IT

Social longevity of elderly people is largely determined by their dental health. The ability to talk freely without feeling socially awkward due to bad breath or visible absence of teeth greatly facilitates the lives of elderly people engaged in work. Unfortunately, the majority of elderly people have compromised dentitions, restored by dental prosthetic structures that meet social and functional requirements to varying degrees. The high need of elderly people in stomatological orthopedic treatment and the demand for comprehensive dental rehabilitation determined the relevance and purpose of this publication. Research methods. The object of the study was elderly people aged 60-74 years who sought dental orthopedic care in dental medical organizations, the sample size was 408 persons. Results. The maximum number of patients in the 60-74 age group was found to have complete absence of teeth – 26.5%, the total number of patients with the first, second, third and fourth classes according to Kennedy classification was 13,3%, 24,7%, 24,9%, 10,6% accordingly. The total number of patients with the first Kennedy subclasses (class 1-3) was 135 persons (33.1%), with the second subclasses – 69 persons (16.9%), with the third subclasses – 53 persons (13.0%). Conclusions. All types of orthopedic dental structures were manufactured for elderly patients. The choice of the dental prosthetic design used in orthopedic dental rehabilitation was determined by the type of dentition defect and met the principles of rational prosthetics.

EFFICIENCY OF PREVENTION OF DISEASES OF THE ORAL CAVITY IN CHILDREN. THE IMPORTANCE OF THE ISSUE FOR VISUALLY IMPAIRED CHILDREN

Subject. Dentine pathology is widely prevalent among children in many countries around the globe, which determines the relevance of consideration, organisation and performance of different forms of health education activities for this part of the population. Programmes for dental disease prevention are represented by different methods and means, the purpose of which is creation of correct skills and abilities aimed at preservation and maintenance of oral cavity health. For blind and hyposeeing children, there is absence of special technology for teaching dental culture and rational hygiene of the oral cavity. Aim – studying and analysis and literature related to forms and methods of health education activities for children with consideration for their somatic status. Methods.The study was carried out based on the search for and analysis of original articles devoted to issues of dental disease prevention among children and adolescents in the following databases: ELIBRARY, PubMed, Medline, Cyberleninka. A total of 45 sources have been analysed (25 by Russian and 20 foreign authors). Conclusions. Preventive dental care programmes for conventionally healthy children at the modern stage of development are sufficiently effective, diverse in their contents, point at the necessity of further introduction of individual preventive care activities. Few organisational forms of health education activities have been developed for children with health limitations. There is no special method for organisation of health education activities for blind and hyposeeing children. These circumstances point at the necessity of development and introduction of correction methods for primary prevention of oral cavity diseases for this category of subjects.

THE NEED FOR COMPREHENSIVE PREVENTION OF HYPERESTHESIA AFTER THE TEETH WHITENING PROCEDURE

Relevance: people's need for teeth whitening is growing every year. At the same time, during various bleaching procedures, changes in the structure of the surface of the teeth may occur and as a result, there is an increased sensitivity (hyperesthesia) of the teeth, which in some cases leads to the rejection of bleaching. At the same time, there is little data in the scientific literature today about the features of hyperesthesia after teeth whitening, in particular about the ratio of hypersensitivity to various factors (chemical, thermal, mechanical). Also, the predominance of dental hyperesthesia, depending on their localization, has not been studied. Purpose: to analyze the features of hyperesthesia after teeth whitening. Methodology. In this study, using the index of the intensity and prevalence of hyperesthesia, the features of hyperesthesia after teeth whitening were analyzed in 100 patients. For the study, patients with the enamel color of the red-brown group A (Vita Classic), namely to the colors A2 and A3, were selected.All patients underwent chemical teeth whitening using the Opalescence Boost PF whitening system. Comparison and analysis of the results of the conducted study were performed in the IBM SPSS Statistics 23 program. The Student's t-test was used to assess the statistical significance of the differences between the samples. The differences were considered statistically significant at p < 0.05. Result. As a result, it was revealed that hyperesthesia after bleaching prevailed in the frontal part of the lower jaw teeth. Hyperesthesia of teeth after bleaching was characterized by a generalized form and tended to decrease in intensity after 2 weeks. At the same time, the reaction to stimuli was preserved. Conclusions. The above dictates the need for comprehensive prevention of hyperesthesia after the teeth whitening procedure.

FEATURES OF DENTAL STATUS OF PATIENTS WITH SARS-COV-2

At the end of 2019, an outbreak of a new coronavirus infection occurred in the People's Republic of China with an epicenter in the city of Wuhan [26]. The causative agent was given the temporary name 2019-nCoV. The World Health Organization officially named the infection-COVID-19 on February 11, 2020. The official name of the causative agent of infection SARS-CoV-2, was assigned by the international committee on the taxonomy of viruses [22]. A number of authors have established that the main role is played by receptors of angiotensin converting enzyme 2 (ACE2) in the penetration of the virus into target cells [19]. It is known that the transmission of SARS-CoV-2 occurs more often by airborne droplets during close contact with infected patients [15], as well as through direct contact with infected people and infected objects [17, 18, 20]. For healthcare professionals, SARS-CoV-2 has set tasks related to the rapid diagnosis and provision of medical care to patients. Currently, information on the clinical features, epidemiology, prevention and treatment of this disease is limited [13, 14]. To date, there is a limited amount of literature describing the dental status in patients diagnosed with SARS-CoV-2. Thus, the purpose of this study was to study the state of oral mucosa and substantiate its changes in patients with a laboratory-confirmed diagnosis of SARS-CoV-2 of mild to moderate severity, with or without concomitant oral coinfection. On the other hand, knowledge of the peculiarities of the dental status of Sars-CoV-2 patients and timely rational treatment of diseases of the oral cavity should constitute an important stage in the algorithm for their specialized therapy [2]. The work carried out a comprehensive assessment of the state of the oral cavity and the need for dental treatment in patients with Sars-CoV-2. The conclusions are based on the results of a simple observational clinical study, in which a comparative assessment of dental status indicators was carried out in 40 patients with Sars-CoV-2 and 20 somatically healthy individuals of the same sex and age.

ESTIMATION OF PERIODONTAL MICROCIRCULATION, JAW AFTER INJECTION OF ANTI-RESORPTIVE DRUG IN EXPERIMENT

Importance. Determining the influence of different medications in the development of different diseases is a prerequisite for adequate comprehensive treatment of patients. At present, there is insufficient data on the influence of anti-osteoclastic drugs on the microcirculation, which may have an impact. The aim. To study the effects of the monoclonal antibody denosumab on the development of osteonecrosis of the jaw of rats. Methodology. The study was carried out on 36 Wistar Line rats in the Department of Pathophysiology with the course of clinical pathophysiology First Pavlov State Medical University. The osteonecrorosis of the jaws of rats was induced by the extracted of a lower first molar. The observation was carried out with diagnostic studies of microcirculation (doppler), bone structure (3D computer tomography of jaws), followed by statistical processing of the data. Results. It has been shown that the greatest decrease in blood flow rate and the greatest bone defect is determined in the group of rats with the maximum dose of the monoclonal antibody preparation of denosumab by the time of 4 weeks, 0.5 mg/kg intravenous administration. Also, there has been evidence of a difference in blood flow reduction between the histological layers of the lower jaw. Thus, the intrabone blood flow was damaged much more, than the layer of mucous membrane of the gum. Conclusions. The combined method of dopplerography allows the determination of blood flow status on different histological layers. It is possible to determine the extent to which different pharmacological preparations influence the rate of blood flow in the local area without invasive interventions. The study of monoclonal antibodies is an acute problem in the world of surgical dental practice, which requires further study.

THE USE OF A DIODE LASER IN THE TREATMENT OF DRUG-ASSOCIATED OSTEONECROSIS OF THE JAW (CLINICAL CASE)

Object of research. Drug-associated osteonecrosis of the jaw is a complication of therapy with osteo-modifying agents. Several theories of its pathogenesis have been deduced, but there is no uniform treatment plan that would reduce the risk of relapse and allow timely prevention. The research aims to demonstrate the effectiveness of the intraoperative use of a diode laser in the treatment of drug-associated osteonecrosis of the jaw. Methodology. The article presents the case of treatment of 60-year-old patient with drug-associated osteonecrosis of the jaw. The underlying medical condition is Bence-Jones myeloma, Stage III on the Durie-Salmone Staging System, with the Th1 – Th12, L1 – L5 involvement. A laser surgical device with a diode laser with a wavelength of 980 nm, power of 0.1-20 W, with a continuous pulse type was used intraoperatively for ablation of residual granulations. An APRF clot was placed at the bottom of the wound. On the 5th and 10th days, autologous plasma injections were performed in the area of surgical treatment. Results. Low pain syndrome during the postoperative period, immediate agglutination, no relapse a month after surgery, closure of the cortical plates according to the control CT scan results. Conclusion. Thus, the first case of clinical use of a diode laser in the treatment of drug-associated osteonecrosis of the jaw has demonstrated its effectiveness. It cannot completely replace the traditional methods, but diode laser is an important auxiliary instrument which contributes to the rehabilitation of the focus of infection, stimulates reparative processes both in the mucous membrane and in the bone. Its future application in the treatment of drug-associated osteonecrosis of the jaw is promising and might prove its effectiveness in reducing the frequency of relapses.