Peculiarities of endodontic treatment of chronic symptomatic periodontitis on oncological disease and chemotherapy

Providing dental care to cancer patients has been and remains very relevant. Studies of the oral cavity in this category of patients have found a high prevalence of dental disease and, as a consequence, a significant need for dental care. Chemotherapy can cause complications such as stomatitis, mucositis, exacerbation of chronic pulpitis, and periodontitis. Patients with an unsanctioned oral cavity run the risk of developing these complications, unlike patients who regularly visit the dentist. The aim of our work was to study the features of endodontic treatment of patients with malignant neoplasms receiving chemotherapy treatment and to confirm the use of atraumatic and conservative methods of treatment of periapical inflammatory processes. The results obtained confirm that the elimination of infection in the root canal of the teeth leads to the regeneration of periapical lesions of bone tissue. The size of the lesion does not affect the tactics of treatment.

Classification of options of the temporomandibular joint during muscular-articular dysfunctions

The article presents the rationale for a differentiated approach to diagnostics in order to improve the quality of treatment of patients with musculoskeletal dysfunction of the temporomandibular joints according to the degree of dysfunctional manifestations. Clinical and radiological features of different types of dysfunction are described, which makes it possible to improve the differentiated approach to the choice of treatment method for dysfunctional disorders.

Improvement of modern teaching methods at the department of orthopedic dentistry KHNMU

he article analyzes the teaching methods at the Department of Orthopedic Dentistry of KNMU, taking into account the modern needs of the development of teaching and reforming the healthcare system of Ukraine. At present, when the process of Ukraine’s integration into the European space is on going, the European integration of medical education is the introduction of the European credit transfer system (ECTS) into the educational process, which helps to achieve the quality of medical education and is by introducing standards, recommendations and basic tools for the adaptation of our students and teachers to the system of education and teaching in European universities. At the Department of Orthopedic Dentistry, various teaching methods are used, namely: practical exercises that use modern pedagogical systems; various forms of presentation of lecture material, taking into account modern methods; phantom-simulation system for work-out of practical skills; consolidation of the gained practical and theoretical knowledge in the process of industrial practice on the basis of the University Hospital. Teaching students the skills of finding and using information in Internet resources. Teaching in English and writing methodological instructions on the subject allows you to attract students from different countries to study and to be involved in communication at the same level with the international dental community.

Current views on the treatment of deep dental caries

A generalized analysis of the data of contemporary foreign and national scientific literature on a widespread pathology – the treatment of deep dental caries is carried out. This article sets out the views of scientists on the pathogenesis and treatment of this disease. It was concluded that the treatment of deep caries according to the «gold standard» does not guarantee in the future the absence of recurrence and complications of caries. Therefore, the justification and development of new more effective methods of treating deep dental caries are promising.

Features of phantom-simulation training in the discipline “Orthopedic Dentistry” at the stage of postgraduate education

The article describes in detail the importance of simulation training in the training and advanced training of dentists, in particular, orthopedic dentists. The goals and principles of using stimulant simulators for learning practical skills and new technologies are described. The importance of maximum closeness to the real working conditions of the doctor with absolute safety for the patient’s health is emphasized.

Carotid chemodectoma: treatment experience

The article presents the results of the examination and treatment of 6 patients with carotid chemodectomies who were treated at the clinic of maxillofacial surgery at Kharkov National Medical University. An analysis of the results of treatment. On the example of the results obtained for the differential diagnosis and selection of the optimal nature of surgical intervention when patients approach the maxillofacial surgeons, it is necessary to use ultrasound and computed tomography, and in doubtful cases selective angiography.

The use of biomarkers in planning orthopedic rehabilitation of patients with diseases of periodontal tissues

According to WHO, up to 75% of the population in different regions of the world are affected by the partial absence of teeth. Clinical observations show that in most cases, the cause of adentias is generalized periodontitis. According to researchers, from 5 to 20% of the population suffers from severe periodontitis, and from the mild to moderate periodontitis, the majority of adults. Moreover, periodontitis is associated with other serious conditions such as coronary heart disease, head and neck carcinoma, and chronic obstructive pulmonary disease. The aim of our study was to establish prognostically significant molecular biochemical criteria in the planning of implantological and orthopedic treatment of patients with periodontal tissue disorders and defects in the dentition. 40 patients were selected for the study. Among them, 10 healthy patients comprised the control group and 30 major patients with periodontal tissue disorders. Among them are 10 patients with grade I, 10 patients with grade II, 10 patients with grade III parodontitis and dentition defects. Determination of the level of biological markers of the oral fluid is a promising diagnostic method, does not require special training from a dentist, is a minimally invasive technique, and will allow to evaluate the current state of prosthetic bed tissues, which will allow rational planning of the type of orthopedic rehabilitation of dental patients.

Mechanisms of remodeling oral soft tissues (literature review)

Based on the analysis of modern literature, a systematization of information of the soft tissues of the oral cavity remodeling mechanisms after surgical interventions was carried out. Priority area in modern medical practice is the development and use of such methods and drugs that combine maximum safety and high biological activity in relation to body tissues. A number of scientists have proposed and introduced into practical medicine the technology of programmed scar remodeling. According to this technique, injections of antihomotoxic substances directly around the surgical wound are required, which reduce the duration of edema in the tissues. A number of authors have studied the use of a minimally invasive microsurgical method based on fractional laser photothermolysis to initiate the regeneration of gums and oral mucosa. As a result of the study, it was found that microscopic thermal wounds in the form of damage islands surrounded by normal viable tissue contribute to stimulation of regeneration, which leads to complete restoration of the tissue without scar formation. Recently, methods of using directed tissue regeneration have been widely introduced into practice. In this technique, cellular structures are used that increase the activity of regenerative processes - fibroblasts, platelet plasma. Great importance in the processes of regeneration of the oral mucosa has the epidermal growth factor EGF. It is a globular protein, acts like a strong mitogen on cells of endodermal, ectodermal and mesodermal origin. The epidermal factor stimulates cell proliferation and, in combination with other cytokines, is a factor that accelerates wound healing and angiogenesis. For the treatment of patients with periodontal tissue damage, a number of scientists have proposed a method for using an adhesive protective wound cover created with biotechnological high molecular weight hyaluronic acid. Thus, the analysis of literary sources and the systematization of the available information proves the relevance of further studying the features of the mechanisms of remodeling of soft tissues of the oral cavity. Needs of modern maxillofacial surgery requires morphological study for improvement of existing and development of new treatments for patients.

Key to success in endodontics (part 2)

Plenty variants of the teeth endodontic structure requires a thorough study of the root canal anatomy and morphology peculiarities, which will make it possible to estimate the volume and complexity of future endodontic intervention, make a prediction of the treatment result, and forecast possible complications. For an objective assessment of the tooth root system anatomical and morphological features, the main method is x-ray examination. Endodontic treatment planning requires the doctor to estimate his capabilities (in difficult cases, it is necessary to refer the patient to a specialized clinic), calculate future working time (it takes more time to treat a tooth with complex anatomy), and to have all the necessary set of endodontic instruments. If endodontic treatment is impossible, then it’s necessary to consult with a dental surgeon to select a combined approach for treatment (root apex resection, root amputation, tooth hemisection). Purpose of the study. To analyze different variants of roots and root canals anatomical structure of the lower jaw teeth according to literature sources and by X-ray pictures of the authors’ own observations. Materials and research methods. Variants of the anatomical and morphological features of the lower jaw teeth’ roots and root canals structure were analyzed according to literature sources and 405 x-rays of our own observations. The results of the study. The information presented in this article allows to deepen the clinician knowledge concerning the tooth cavity size and shape, the roots and root canals anatomy, the presence of additional channels, as well as the degree of the root canal curvature, and to choose the right channel instrumentation technique and the necessary tools. Often, the proper full working length root canal treatment depends on the degree of curvature and its location. The X-ray analysis of anatomical and morphological features of the lower jaw teeth’ roots and root canals, enables us to identify both common and individual features of a tooth anatomy. When analyzing radiographs of the lower jaw teeth, it is necessary to take into account the projection of the tooth cavity on the outer surface of the crown, as well as signs that may change due to age, caries, non-carious lesions, restorations, and trauma; also anomalies of the position of the tooth in the arch, individual anatomy of the roots, the number of roots and type of root canals, the shape of their cross section (from the orifice to the apex), the direction and length of the roots, the angle of curvature, the number of bends, their localization. For the right choice of the root canal treatment technique and the necessary tools, it is important for the clinician to know the degree of bending of the root canal. Each case requires an individual and skilled approach. Therefore, to assess the possible structural features of the tooth root system, it’s efficiently to use the most modern tools, equipment, and X-ray tactics. The literature data and the analysis of our own radiographs allow us to solve successfully and predictably difficult clinical problems of both primary treatment and retreatment endodontic cases.

ПОРІВНЯЛЬНА ОЦІНКА ЯКОСТІ ВІДНОВЛЕННЯ ЖУВАЛЬНОЇ ЕФЕКТИВНОСТІ ПРИ ЛІКУВАННІ ПАЦІЄНТІВ ЗНІМНИМИ ОРТОПЕДИЧНИМИ КОНСТРУКЦІЯМИ ВИГОТОВЛЕНИМИ ЗА РІЗНИМИ ЛАБОРАТОРНИМИ ТЕХНОЛОГІЯМИ, НА ПІДСТАВІ ДАНИХ ЕЛЕКТРОМІОГРАФІЧНОГО ДОСЛІДЖЕННЯ

В Україні виготовлення знімних пластинкових протезів з жорстким базисом сягає 80%. За даними літератури, від 20 до 26% пацієнтів не користуються знімними протезами, а 37% – незадоволені якістю ортопедичного лікування ними. Крім того, в 52% випадків знімні конструкції мають недостатню фіксацію та стабілізацію на протезних ложах. У 64% пацієнтів під базисами протезів розвиваються захворювання слизової оболонки травматичної етіології (В.А. Лабунець). Тому дослідження процесу адаптації до нового протезу важливо для розуміння засобів контролю жувальної мускулатури і може дати цінну інформацію для визначення подальшого шляху вирішення проблем, що заважають хворим досягнути повної адаптації до протезів. Аналіз електроміографічної активності і кінетики жувальних рухів потрібен для розуміння системи рухової активності та жувальної ефективності. Метою дослідження є порівняльна характеристика терміну/якості адаптації пацієнтів до знімних пластинкових ортопедичних конструкцій, виготовлених за різною лабораторною технологією, за допомогою електроміографічного дослідження жувальних м’язів. Для досягнення поставленої мети було обстежено та проліковано 80 пацієнтів з частковою втратою зубів у віці 45–65 років, яким показано заміщення дефектів зубних рядів частковими знімними ортопедичними конструкціями. Пацієнти, що брали участь у дослідженні, були розділені на три групи: пацієнтам першої групи протези було виготовлено з акрилової пластмаси термоінжекційним методом; пацієнтам другої групи протези були виготовлені з акрилової пластмаси гарячої полімеризації компресійним методом; третю групу складали пацієнти, протези яким були виготовлені з нової вітчизняної акрилової пластмаси методом вільного лиття з послідуючою полімеризацією під тиском. Головним показником адаптації пацієнтів нашого дослідження є нормалізація функції жування, що оцінюється за допомогою електроміографічного аналізу жувальних м’язів. Виходячи с показників середнього коефіцієнта відношення показників електроміографічного дослідження, ми можемо стверджувати, що адаптація пацієнтів групи, де протези виготовлялися за технологією лиття з послідуючою полімеризацією під тиском, є більш послідовною та якіснішою, ніж у груп пацієнтів, де використовувалися інші лабораторні технології виготовлення знімних протезів. Таким чином, електроміографічне дослідження показало, що методика лиття з послідуючою полімеризацією під тиском при виготовленні знімних пластинкових протезів більш якісно відновлює жувальну функцію та спонукає на нормалізацію та адаптацію м’язової системи до жування.