RESEARCH
Relevance. Fractional laser technologies are very popular. The ability to create microchannels (coagulation or ablative nature) in the tissue by laser radiation stimulating its regeneration is the basis of fractional technology. The histological structure of the rabbit parietal bone during its regeneration after Laser Patterned Microcoagulation treatment was investigated by hematoxylin and eosin (H&E) stain.
Purpose. This in vivo study investigated the regeneration of the rabbit’s parietal bone after fractional laser treatment using diode lasers with wavelengths 980 nm and 1550 nm.
Materials and methods. A study was performed on the bone tissue of 10 laboratory animals (rabbits) using laser fractional treatment with wavelengths 1.55 and 0.98 μm. As laboratory animals (rabbits) were used Soviet chinchillas weighing 2.5-3 kg. 2 different lasers were used: FONALaser (Sirona Dental Systems, Germany) with a wavelength of 980 nm, a power of 5 W and a laser surgical device (LSP “IRE-Polyus”, Russia) with a wavelength of 1550 nm, a power of 25 W and a pulse width range from 60 to 250 ms.
Results. On day 21, the thickness of the periosteum in the group with a wavelength of 980 nm did not significantly differ from the thickness of the periosteum in the group with a wavelength of 1550 nm – p = 0.4000. On the 45th day of observation, there were also no significant differences in the thickness of the periosteum between both groups – p = 0.2000.
Conclusion. It was shown that the most destruction processes were noted by laser with a wavelength 1550 nm in the experiment without periosteum. The smallest changes were noted by laser with a wavelength 980 nm in the presence of periosteum. In this study, in 6 cases out of 10, the formation of young bone tissue as thin strip form at the bottom of the lesion site was noted.
Relevance. The success of treatment of periodontal diseases directly depends on the patient’s response to the therapy, therefore, the characteristics of the person’s personal characteristics can affect both the effectiveness of treatment and the prevention of relapse of the disease.
Purpose. To study the features of the internal picture of the disease in the process of complex treatment of adult patients suffering from chronic generalized periodontitis.
Materials and methods. The generally accepted comprehensive treatment of chronic generalized periodontitis in 69 middle-aged and elderly men was carried out taking into account the personal response of patients Solovyov «Psychosensory-anatomical-functional maladaptation syndrome».
Results. When patients were discharged from the hospital, there was a difference in the phenomena of maladaptation among the elderly and middle-aged: in middle-aged people, sufficient adaptation to the conditions of existence was determined; in elderly people, due to the existing comorbid pathology, a state of maladaptation was diagnosed, which was caused by the presence of complaints of defects in the dentition.
Conclusion. In elderly people, as soon as possible after completion of treatment in a hospital, dental rehabilitation cannot be considered completed, which requires the adoption of organizational measures for their timely provision of dentures.
Relevance. Symptom of bleeding in elderly age has a number of features of its manifestation, not fully associated with the severity of gingivitis and periodontitis. It is associated withpolymorbidity, polypragmasy, age-dependent involutional processes, as well as with immune system aging.
Purpose. To study the influence of confounders on the interpretation of the gingival bleeding index in elderly patients with periodontitis.
Materials and methods. The clinical and laboratory examination of 64 elderly patients with chronic generalized periodontitis, divided into 2 clinical groups, was conducted. The conventional treatment was administered in both patient groups. The patients in the second cohort, along with other medications, received Polyoxidonium.Each clinical group was divided into two subgroups: “a” and “b” (depending on the NSIADintake). The comparison group was also formed.It consisted of 25 patients of middle age with a similar degree of periodontitis. To assess the bleeding symptom, the Mühlemann-Cowell (1975) bleeding index was determined, as well as its reduction (%). The study of local immunity included gingival fluid sampling andestimation of IL-1β and IL-10 concentration (pg / ml). Clinical and laboratory examination of patients was carried out within the time constraints: before the start of treatment, after 7, 14, 21, and 30 days.
Results. During the initial examination and statistical analysis of the bleeding index mean values in elderly patients, higher values of the coefficient of variation were found (25.07%) than in the comparison group (16.24%).It confirmed the influence of confounders over this indicator.Moreover, before treatment, in both groups, significant differences between subgroups remained (which verified the effect of non-steroidal anti-inflammatory drugs), which disappeared in the subsequent stages of the examination. In further periods of observation, a decrease in the bleeding index was found, as well as the concentration of cytokines, and in the 2nd group, these indicators were statistically significantly lower than in the 1st (p < 0.05).
Conclusion. The study showed a more significanthaemostatic effect of immunomodulation compared with conventional treatment. When analyzing bleeding index in elderly patients, confounders must be considered, otherwise, the findings, which do not fully correspond to the level of inflammation in the marginal periodontium, will be incorrectly interpreted.
Relevance. Type-1 diabetes mellitus affects usual oral microbiome for active growth of periodontal pathogenic bacteria concentration in geometric progression, which leads to decrease in function of local immunity of oral cavity, inflammation of periodontal tissues and resorption of alveolar bone – the characteristics of chronic generalized periodontitis. This article provides analysis of qualitative and quantitative composition of microflora of periodontal pocket among type-1 diabetes patients before and after conservative periodontal therapy using ultrasonic treatment technique with a polishing suspension based on calcium hydroxide («Vector Paro», Durr Dental).
Purpose. To evaluate the antibacterial effectiveness of professional oral hygiene complex with the additional treatment of periodontal pockets with «Vector Paro» device among patients with type-1 diabetes and chronic generalized mild periodontitis.
Materials and methods. 30 patients with chronic generalized mild periodontitis and type-1 diabetes were examined with using analyses of periodontal pockets microflora contents. All patients underwent a standard complex of professional oral hygiene and gentle periodontal therapy with the «Vector Paro» device. Re-examination was in 4 weeks.
Results. The performed complex of conservative periodontal therapy improved periodontal status in both groups, but in control group changes were more significant.
Conclusion. Dynamic monitoring of qualitative and quantitative composition of periodontal pockets in combination with conservative periodontal therapy using the «Vector Paro» apparatus improves hygienic and periodontal status among patients with type-1 diabetes.
Relevance. Effective preventive programs cannot be developed without studying the issue using population epidemiological survey.
Purpose. Improving efficiency of dental diseases preventionbasing on the information obtained during an epidemiological survey of Izhevsk citizens.
Materials and methods. 107 residents were examined according to WHO criteria in representative age categories: n = 57 (63.3%) in the category from 35 to 44 years old; n = 50 (46.7%) - from 65 to 88 years; n = 83 (77.6%) women (54.9 ± 1.9 years); n = 24 (22.4%) men (53.7 ± 3.7 years). The study was random and voluntary, the conclusions are based on the results of statistical analysis.
Results. The respondents’ menu included products with a cariogenic effect: fruits (4.27 ± 0.09 on a 6-point scale), cookies (3.66 ± 0.11), jam or honey (3.56 ± 0.13), pies (3.48 ± 0.12), coffee (3.33 ± 0.13), tea (3.25 ± 0.13), chewing gums (3.21 ± 0.13 points), sweets (3.05 ± 0.12), beverages (3.02 ± 0.14). Respondents brushed their teeth 2 times (67.3%) or 1 time daily (30.8%), some of them used flosses (14.0%). Prevalence (p < 0.001) of positiveteeth(61.7%) and gums (72.8%) conditionappraisalmust be conceived as subjective perception. Considering “satisfactory” and “unsatisfactory” as similar critical manifestation negative assessment of the respondents reliably prevails (p <0.001). Respondents visited dentist when they felt pain (91.6%). Most of them (93.5%) advised of a partial lack of teethand the need for prosthetics.
Conclusion. Cariogenic diet, lack of interdental hygiene and a check-upculture define Izhevsk citizensas potentialdentist patients. Forming preventive programs we have to explain the importance of interdental hygiene; dental care should be refocused from the category of forced demand to the category of preventive conscious demand in the mind of citizens. Due to the high educational levelwe can hope for the effectiveness of prevention programs among Izhevsk citizens.
Relevance. Separate issues in anthropomorphic sizes of relative norm of the ideal smile, its qualitative and qualitative parameters have not been addressed to sufficiently and are not properly reflected in scientific literature.
Purpose. To determine distinguishing features in average smile parameters of the smile in male and female patients with orthognathic occlusion.
Materials and methods. A clinical and anthropometric evaluation of parameters in main smile types was carried out for 150 young males and 150 young females aged 19-24 who had identical physiological development parameters.
Results. It has been revealed that occurrence frequency of main smile types in patients with orthognathic occlusion has pronounced signs of sexual dimorphism which in over one half of the cases lies in predominance of the incisal smile type in males (52.7%) and the fascial type in females (55.3%). Occurence frequency of the cervical smile type totaled 25% among the studied patients of both genders. Average vertical size parameters in the incisal smile lies within the diapason of 3.91-4.91mm with surpassing by 1mm in males. Analogical data for the fascial smile type form the diapason of 6.21-6.73mm with surpassing by 0.52mm in females. The cervical smile type is characterised by larger vertical size forming the diapason of 7.94-8.91mm with surpassing by 0.97mm in males.
Conclusion. The results of the study have shown that the “beautiful and ideal smile” is a relative concept having varied anthropometric characteristics and pronounced signs of sexual dimorphism lying in a broad spectrum of the dentofacial system norm notion with specific vectors for individual morphological deviations.
Relevance. The main aim of this article is determining the possibilities of clinical application of the infrared thermometry method in order to identify, predict and correct early complications such as ischemic and necrotic process after vestibuloplasty surgery using free gingival graft.
Purpose. To determine the possibility of using the infrared thermometry method to study the regeneration processes of the mucous graft after vestibuloplasty surgery using free gingival graft.
Materials and methods. 34 patients with a thin biotype and a small vestibule of the oral cavity. The vestibuloplasty was indicated. Depending on the choice of the method of surgical treatment, vestibuloplasty with/ or without free gingival graft, all patients were divided into 2 groups. And the 3rd (control) group consisted of patients with similar clinical picture for control data. Particular attention was paid to the healing process in the early postoperative period on days 1, 3, 7, 14. Patients were examined using a CEM-ThermoDiagnostics infrared thermometer.
Results. The study confirmed the high clinical efficacy the both surgical methods of vestibuloplasty with/ or without free gingival graft. We did not registrate negative temperature values indicating the development of ischemic process which can lead to necrosis. We have diagnosed correlation between temperature values and clinical pictures.
Conclusion. Using of IR-thermometry is an effective method for examination of the healing process after vestibuloplasty using with/ or without free gingival graft. It can show processes of revascularization of free gingival graft and examine some inflammation. This is the additional method of research, but in combination with clinical picture, it can be proposed as an accurate criterion for predicting early ischemic complications.
Relevance. In our clinical practice we’ve noticed a substantial amount of patients seeking prosthodontic treatment with the situation where all the teeth in dental arches (maxilla or mandible) have to be extracted due to distrophic, degenerative periodontal conditions. We started to define this condition as “decompensated dental arch” (compromised dentition). However, there is no information on treatment tactics in such patients.
Purpose. To develop medical tactics in the dental treatment of patients with decompensated dental arches.
Materials and methods. We examined 211 patients (74 males, 134 females) aged from 54 to 83 years old (mean age: 72.4 ± 6.3) with 275 decompensated (compromised) upper (73) and lower (202) dental arches. We used clinical and paraclinical (additional) diagnostic methods such as ultrasound, Doppler, electromyography, CT scan, OPG evaluation.
Results. Comprehensive description of “decompensated dentition” (compromised)lead us to implementation of radical treatment approach during preparation for prosthodontic rehabilitation. First of all that approach facilitates quick transition from handicapped condition to the high quality of life in case of applying principals of immediate (including implant supported) prosthetics. Clinical experience proves that “Merciful” (tooth saving) tactics with the attempt to relative saving of some teeth with conservative approach will prolong the agony of decompensated dentition (compromised) especially in case of treating elderly patients with compromised medical condition. Radical approach helps to get long term survival of implants and prostheses.
Conclusion. That’s the reason that in cases of clinical situation of decompensated dentition (compromised) we have to focus on more radical preparation to prosthodontic -especially implant supported – rehabilitation.
Relevance. There is very little literature data on the role of viral infection in the genesis of periodontal diseases, mainly the work of foreign authors. It is believed that the mucous membrane of the oral cavity, including the gums, is the habitat of some viruses of the herpes group (Epstein-Barr, cytomegalovirus, etc.). They can be in a latent state in the salivary glands, epithelial cells of the mucous membrane of the nasopharynx, oral cavity and under adverse conditions, are activated, causing an exacerbation of the process. Currently, methods for detecting viruses using laboratory tests (PCR diagnostics) have been somewhat simplified, which made it possible to evaluate the therapeutic effect of domestic oral care products against viruses. The use of plaque control agents such as prophylactic toothpastes and mouth rinses on a regular basis helps to reduce the risk of developing inflammatory periodontal diseases.
Purpose. To study the effect of domestic oral care products on the level of oral cavity contamination with herpes group viruses in patients suffering from chronic generalized periodontitis.
Materials and methods. Under clinical supervision were 52 patients (28 men, 24 women) of middle age 31-54 years with chronic generalized periodontitis of moderate severity, divided into groups: group 1 – 26 patients who used «Asepta Sensitive» preventive toothpaste on basis of plant components. They were divided into 2 subgroups of 13 patients: subgroup «a»- only paste, subgroup «b» - paste with the additional use of rinse aid «Asepta ® Active» in the first 8 days with a further transition to rinse «Asepta ® Fresh» from 9 days of the study. Group 2 consisted of 26 patients who used «Asepta ® Active» toothpaste with a similar division into subgroups: subgroup «a» without rinsing agents and subgroup «b» with rinsing agents. The control group of patients without inflammatory diseases of the periodontium and oral mucosa included 15 people who were not treated.
Results. It was revealed that the DNA of the herpes simplex virus ½ types (HSV ½) at the beginning of the study was detected in 28.8% of patients with periodontitis, Epstein-Barr virus 42.3% of patients, and cytomegalovirus in 36.5%. When using oral care products containing antiseptics, adult patients suffering from chronic generalized periodontitis, we have achieved good results in the treatment of this disease. The effectiveness of the action of toothpaste and rinses in adults with chronic generalized periodontitis is high – a decrease in performance by an average of 1.2-2 times lower than without rinse aid. This allows, subject to the rules of individual oral hygiene, to quickly stop the main clinical symptoms of chronic generalized periodontitis and reduce the level of oral contamination by herpes viruses.
Conclusion. In the treatment of patients with chronic generalized periodontitis, no significant clinical differences were found when using various schemes for the use of oral care products. At the same time, the use of the «Asepta ® Active» rinse agent with chlorhexidine helps to reduce the frequency of detection of herpes group viruses in the oral cavity by 1.5-2.5 times and reduces the signs of periodontal inflammation in patients with chronic generalized periodontitis.
Relevance. Тhe quality of dental care is greatly influenced by the biocompatibility of the materials used. This problem is particularly acute in patients with a high level of sensitization, such as allergic rhinitis. Currently, the CAST-test is used to diagnose allergies and sensitization of the body. The method has 100% specificity and significantly complements the definition of IgE antibodies.
Purpose. To determine the individual tolerance of dental materials in patients with allergic rhinitis.
Materials and methods. 47 patients with allergic rhinitis were examined. All patients were sent to determine the test of spontaneous activation of peripheral blood basophils on dental materials: cobalt-chromium alloy; zirconium dioxide; glass ionomer cement; composite material; plastic for the basis of the prosthesis (non-monomer).
Results. The Average values of the activation coefficient of blood basophils in patients with nasal breathing disorders were revealed for a kobolto-chrome alloy – 1.29 ± 0.02, for zirconium dioxide – 1.04 ± 0.02, for glass ionomer cement – 1.11 ± 0.04, for composite dental light – curing material – 1.24 ± 0.03, for plastic for prostheses (non-monomer) – 1.19 ± 0.02.
Conclusion. The study shows the need for special attention to the planning of dental treatment in patients with nasal breathing difficulties, especially with allergic rhinitis. The frequency of detection of the coefficient of spontaneous activation of basophils test showed a 100% positive result for composite light-curing material and non-motionless plastic, in 91.5% of cases-for a cobolto chrome alloy. 100% negative result for zirconium diaxide and 82.9% of cases for glass ionomer cement.
Purpose. The goal is to study the antibacterial effect of physiotherapy methods with local delivery of exposure agents.
Materials and methods. We examined 80 patients with chronic generalized periodontitis of moderate severity, who, depending on the physiotherapy method used in the complex treatment of periodontitis, were divided into 2 groups of 40 people each: the first group used the Picasso led laser, and the second group used the Ozonedta device with combined local exposure to darsonvalization and ozone. The microbiological composition of periodontal pockets was determined before and after physical therapy. To isolate the aerobic microflora, we used the method of sector crops according to Gold (1965) with the calculation of the number of microorganisms in the obtained material. Anaerobes were identified by PCR using the «Multident» kit. The clinical effectiveness of the studied physiotherapy methods was evaluated 12 months after two courses of treatment (once every 6 months) using index indicators that characterize the state of periodontal tissues (PMA, CPI, Green-Vermillion, PPP, PDI, and the degree of gum recession).
Results. After exposure to the Picasso diode laser, the number of aerobic microorganisms sown decreases, but not significantly. While the number of aerobic microorganisms significantly decreased after exposure to the «Ozonedta» device (P ≤ 0.001). The titer of the anaerobic microflora studied after exposure to the «Picasso» diode laser on the periodontal pocket changed in the direction of reducing the content of microorganisms by an average of 2 times, and after treatment with the ozone generator «Ozone DTA Generator» in the second group decreased by an average of 4.8 times. After 12 months of maintenance therapy, all clinical indices decreased significantly in both groups, especially the PMA index in the group where the «Ozonedta» device was used.
Conclusion. Physiotherapy methods performed using the Picasso diode laser and the «Ozonedta» device for the treatment of periodontitis allow to obtain an antibacterial effect by non-drug local delivery of exposure agents in patients with chronic generalized periodontitis and significantly reduce the signs of inflammation in the periodontal tissues.
Relevance. The indispensable study of blood microcirculation of periodontal tissues in patients with localized periodontitis of traumatic etiology (LPTE) alongside with the assessment of the somatic status lets determine the degree of adaptive capacity of the organism. Laser Doppler flowmetry (LDF) allows noninvasively identify preclinical changes in the periodontal blood microcirculation and observe periodontal status at any treatment phase aiming at the confirmation of effectiveness of undertaken measures.
Purpose. The objective of this work is to evaluate periodontal blood microcirculation in LPTE for existing latent vascular flow changes and adaptation features.
Materials and methods. LDF measurements of periodontal blood microcirculation in 169 patients with mild and medium LPTE, conducted relaxed and with the use of functional cold test, were done.
Results. A decrease in the number of functioning capillaries in periodontal tissues (expressed in a decrease of the integral index of microcirculation), a decrease in blood flow variability (σ-standard deviation) and the stress of the functioning of the regulatory blood microcirculation (Cv) were found. Due to outcomes, it was registered that in mild and medium severity LPTE, normal reaction of adaptation detected at 69.6% and 43.4% cases, respectively, in the remaining cases reaction of intense adaptation and unsatisfactory response adaptation (only if the moderate degree of LPTE) were fixed.
Conclusion. Latent periodontal vascular flow changes and also adaptation characteristics are closely related with the somatic state of the body, in particular with the presence of cardiovascular disease in a group of patients.
Relevance. Nowadays an important problem in dentistry is the early diagnosis and the treatment of tumors and tumor-like lesions. One of the most frequent lesions of the orofacial region, and particularly of the periodontium, is a non-tumor lesion called epulis. Some tumors and tumor-like lesions may be both clinically and histologically similar, hence the diagnosis and the differential diagnosis of the epulis is still complicated and need to pay attention. Moreover, every type of epulis has particular histological features that make a clinician use a specific treatment in each clinical case. The treatment success and the necessity of the further observations are determined by the correct diagnosis. However, there is still controversial data about epulis diagnosis. Moreover, the reliable criteria for correct diagnosis of each type of epulis have not been discussed yet.
Purpose. The aim of this study is to determine the most relevant methods for differential diagnosis of every type of epulis and other tumor and tumor-like lesions of the alveolar ridge with the same clinical and histological descriptions was performed.
Materials and methods. In this article the review of the literature is presented. A comprehensive literature search of the studies from 1970 through 2019 in PubMed database regarding the epulis and other tumor and tumor-like lesions with the same clinical and histological descriptions was performed. 71 relevant articles were selected.
Results. “Epulis” is a term that refers to tumor and tumor-like lesions of the alveolar ridge. Due to their morphological features it is frequently necessary to carry out not only the histological studies but also use immunohistochemical and genetic analyses. It is not complicated to verify vascular epulis and fibrous epulis. If there is a plasma-cell infiltration of fibrous epulis stroma, clinician is to differ it from IgG4-assosiated diseases. In some cases to discern pyogenic granuloma and hemangioma it is necessary to carry out immunohistochemical study of the blood vessel wall components. It is also important to know diagnostics of giant-cell epulis. Here to divide peripheral and central giant-cell granulomas genetic analysis should be carried out.
Conclusion. Usually microscopic study of fibrous and vascular epulis helps to differentiate it with other lesions. The IgG4associated diseases are to exclude by immunohistochemical study. Diagnostics of giant-cell epulis may include both immunochemical and genetic studies. Methods presented in this article are important both for treatment and for prognosis of the disease.
REVIEW
Relevance. The current theory of specific bacterial biofilm fails explain why a part of patients experiences inflammatory periodontal diseases while the absence of detected specific types of “red complex” bacteria.
Purpose. To clarify the microbiological and immunological mechanisms of the influence of the viral and bacterial consortium in the etiology and pathogenesis of inflammatory periodontal diseases.
Materials and methods. Articles survey with elements of metanalisis. Literature review based on discussion of research results on the topic of 48 sources including 33 foreign ones.
Results. The review provides evidences of the possible participation of viruses of the Herpesviridae family in the development of chronic generalized periodontitis. Evidences for the role of herpes simplex viruses of type 1.2, Epstein-Barr virus, and cytomegalovirus in the development of periodontal inflammation are analyzed. It is proven that all herpesviruses induce the release of proinflammatory cytokines that activate osteoclasts and matrix metalloproteinases, as well as violate antibacterial immune mechanisms. In turn that leads to a progressive increase of periodontal pathogenic bacteria in both the biofilm and periodontal tissues.
Conclusion. It is made a conclusion that an active herpetic infection can initiate damage to periodontal tissus and participate in the development of relapses of the disease.
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