卷 25, 编号 4 (2021)

BACKGROUND: Injury of the middle zone of the face is an actual problem of modern maxillofacial surgery. Traumatic injuries of the middle zone of the face in 10% of cases lead to disability of the victims. Fractures of the upper jaw occur in up to 5% of all traumatic injuries of the face. The greatest number of injuries (20–25%) of the middle zone of the face falls on fractures of the zygomatic-orbital complex. Fractures of the orbit are the most common injury of the middle zone of the face, accounting for 40% of all fractures of the facial skeleton. Isolated fractures of one wall of the orbit are recorded in approximately 38–40% of cases, two walls are damaged — in 30–33% of cases, three walls — in 15–20% and all four — in 5–10% of cases.

AIM — to analyze the existing classifications of damage to the middle zones of the face, taking into account clinical manifestations, modern standards and trends in the diagnosis and treatment of injuries of the middle zone of the face, and develop a classification that meets modern ideas about the treatment and rehabilitation of victims with this type of injury.

MATERIAL AND METHODS: The study is based on the results of a study of 335 case histories of patients with injuries of the middle zone of the face aged 17 to 89 years, taking into account concomitant chronic diseases, treated in the clinic of maxillofacial surgery and surgical dentistry of the Military Medical Academy named after S.M. Kirov for the period from 2014 to 2020. Also, the study took into account the results of the analysis of 335 records of radiographic signs, filled in according to the results of radiation methods of research.

RESULTS: An analysis of the classifications of fractures of the middle zone of the face was carried out and a new version of the classification was proposed, which allows the maxillofacial surgeon to assess the volume, depth, extent of damage and draw up an optimal plan. treatment.

CONCLUSION: The developed classification of injuries of the middle zone of the face allows to establish the diagnosis and severity of the general condition of the patient, which is decisive in the course of making a decision regarding the choice of a specialized hospital where the victim will be treated, and also determine the method and timing of surgical treatment.

BACKGROUND: The procedure for determining the color of teeth can be carried out visually using colors or special devices, or both methods at the same time. The visual definition of shades using popular instrumental techniques, although ubiquitous, is nevertheless very subjective. The hardware method for determining the color of teeth consists in an objective computer analysis of the image obtained under ideal optical conditions. Ambient light should not affect the color detection results obtained by spectrophotometers and colorimeters. The main advantage of the hardware method of determining the color of teeth is the elimination of subjectivity. The world scientific literature describes many studies comparing the quality of color determination by hardware and visual methods. However, these data differ, and the conclusions are not unambiguous in the choice of a particular method, therefore, the clinical effectiveness of digital technologies for determining the color of teeth, as well as the scientific justification of their use, is an urgent problem of modern dentistry.

AIM: To evaluate the accuracy of determining the color of teeth with digital dental devices in comparison with the visual assessment of color by an expert group.

MATERIAL AND METHODS: In order to achieve this goal and form the design of the study, we analyzed the sources of scientific literature. The information search was carried out in the scientific electronic databases eLibrary, Scopus, PubMed in the period from 2002 to 2020, according to the keywords of the query: methods for determining the color of teeth, comparison of methods for determining the color of teeth, hardware methods for determining the color of teeth. The results of the study of special literature on this topic have identified the most accurate and frequently used methods for determining color in practical healthcare. Of the visual methods, preference is given to determining the color of teeth using the colors VITA Toothguide 3D-Master (VITA Zahnfabrik, Germany) and VITA Classical (VITA Zahnfabrik, Germany). Of the devices, among spectrophatometers, most authors prefer VITA Easyshade (VITA Zahnfabrik, Germany) and Spectro Shade (Micro High Technologies, Italy), among hybrid devices (intraoral scanners) — 3Shape TRIOS (3Shape, Denmark). The evaluation of the accuracy of determining the color of teeth by digital dental devices was carried out on 20 natural right medial central incisors of 20 patients in a dental office. The effectiveness of these devices was determined in comparison with the teeth color indicators determined by the expert group. For each pair of the studied methods, Cohen’s kappa was determined — a statistical coefficient for determining the mutual reliability of appraisers. When calculating Cohen’s mouthguard, the results of color determination for each third of the tooth surface were compared separately by compiling multi-field tables. Statistical processing was carried out in Excel 2016.

RESULTS: According to the interpretation intervals of Cohen’s kappa values, mutual reliability of evaluators is defined as “excellent” at values from 0.75 to 1.0, “good” — from 0.6 to 0.74, “acceptable” and “bad” — from 0.4 to 0.59 and less than 0.4, respectively. The Spectra Shade device showed excellent consistency with experts in determining the color of the tooth in all three parts of the surface. Vita Easyshade V showed less consistency with the expert assessment, but its level is interpreted as good. The color detection data using the 3Shape Trios digital scanner did not agree well with the opinion of experts. The devices showed consistency between themselves in the range from acceptable to good, while mutual reliability in the Spectra Shade - Vita Easyshade V pair turned out to be better than others.

CONCLUSION: Taking into account the fact that the accuracy of the devices does not depend on the factors to which a person is exposed, such as subjectivity, illumination, time of day, eye fatigue, the color of nearby teeth, etc., it is advisable to use the Spectra Shade and Vita Easyshade V devices in clinical practice to increase the objectivity of color determination and improve patient satisfaction with dental treatment.

BACKGROUND: This study was based on the lack of literature data about the state of the function of the salivary glands in patients who underwent kidney transplantation.

AIM: To compare the state of the salivary glands and oral hygiene in patients with chronic renal insufficiency before and after kidney transplantation.

MATERIAL AND METHODS: The salivary glands of 50 patients with terminal chronic renal failure were assessed.

RESULTS: Severe impairment of salivary gland function was found in this group of patients, and xerostomia led to changes in the qualitative and quantitative indices of mixed saliva. After kidney transplantation, the salivary gland function improved, but did not fully recover to normal levels. The hygienic state of the oral cavity was improved.

CONCLUSION: After kidney transplantation, patients require follow-up observation and preventive therapy of the salivary glands to improve and restore their function.

Relevance. The high prevalence of chronic hepatitis C is a serious medical and social problem. With this disease, a high incidence of diseases of the oral mucosa is detected, which requires more careful study.

Materials and methods. A comprehensive dental examination of 48 patients with a confirmed diagnosis of CHC was carried out. Depending on the Knodell index of histological activity of chronic hepatitis, the main group was divided into 2 subgroups: 1a - with mild process activity (4-8 points) - 20 patients, 1b - with moderate process activity (9-12 points) - 28 patients.

The comparison group consisted of 30 apparently healthy individuals (16 men, 14 women aged 28 - 36 years) with a positive conclusion after a professional medical examination on the absence of somatic pathology.

Results. As a result of a comprehensive dental examination in patients with chronic hepatitis C, the most common complaints were: bleeding of the gums when brushing teeth, bad breath and erosions on the oral mucosa. Also, a high prevalence and severity of inflammation in the periodontal complex in patients with chronic hepatitis C was revealed. When studying the structure of diseases of the oral mucosa, it was determined that the most common diseases occurring with severe pain syndrome: recurrent aphthous stomatitis, candidiasis, chronic herpetic stomatitis. The performed autofluorescence study revealed preclinical signs of hyperkeratotic changes in the area of ​​teeth closing in 21.2 ± 1.6% of the main group. The frequency and severity of symptoms of dental diseases correlates with the degree of activity of the process of the underlying disease.

Diseases of the oral mucosa (COR), characterized by a violation of its cornea, constitute a vast group among the variety of diseases of COR, of particular interest is a separate group called — hyperkeratosis of the oral mucosa. Current treatment protocols include a variety of therapeutic and surgical methodologies and principles, with surgical excision of the lesion being the primary treatment measure. However, surgical treatments are often associated with increased risks of pain, swelling, bleeding and, recurrence of malignancy.

The aim of this review was to identify the optimal treatment option for oral mucosal leukoplakia. The current review included all studies focusing on the treatment of oral mucosal leukoplakia and published between 2016 and 2021.

The findings of this study showed that laser surgical treatment of oral mucosal verrucous leukoplakia resulted in statistically significant advantages in the intra- and postoperative periods.

The article discusses the issues of diagnostics and methods of treatment of patients with lichen planus of the oral mucosa, evaluates the effectiveness of the use of erbium, neodymium lasers and a scalpel in the surgical treatment of patients. The use of laser technologies, according to clinical and conducted biochemical studies, has a number of advantages over traditional treatment with a scalpel: less tissue trauma, selective effect on the lesion, a more favorable course of the postoperative period, and a shorter rehabilitation period for patients. The above factors contribute to an increase in the efficiency of surgical treatment, reduce the likelihood of recurrence and postoperative complications.

BACKGROUND: The Soviet-Finnish (Winter) War is of interest not only from the side of operational and tactical art and variety of directions of military troop operations but also from the side of material and medical support of troops and sanitary evacuation of the wounded.

AIM: To present data on military dentistry and dentists of the USSR in the Soviet-Finnish (winter) war.

MATERIAL AND METHODS: The research materials were official statistical reports on the activities of medical units, research and dissertation works, regulatory legal documents, materials of scientific conferences, books, monographs, and scientific articles testifying to the activities of medical workers during the Soviet-Finnish (Winter) War.

RESULTS: The study of archival documents made it possible to establish that the main burden on the organization of medical care for the wounded during the Soviet-Finnish (Winter) War was assigned to the Department of Dentistry of the Military Medical Academy. Given the combat experience of military dentists in the areas of Lake Khasan and Khalkhin-Gol River during the Soviet-Finnish (Winter) War, they created models of standard transport bandages for the upper and lower jaws. They also developed instructions and manuals on the surgical treatment of gunshot wounds of the maxillofacial region at the stages of medical evacuation, features of treatment, nutrition, and care of maxillofacial wounds in front conditions, which, according to eyewitnesses of that time, was a real problem.

CONCLUSION: The experience of military dentists in the combat area of the Workers’ and Peasants’ Red Army in the Soviet-Finnish (Winter) War has brought lots of new things to maxillofacial surgery and traumatology from the point of view of organizational and therapeutic.

The article presents a brief overview of scientific reports, which were heard on June 11, 2021, as part of the round table “Clinical Immunology and Dentistry,” dedicated to the 80th anniversary of the birth of the outstanding Soviet and Russian scientist, Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor Alexander Alexandrovich Yarilin (1941–2013). In addition to information on the professional activities of Professor A.A. Yarilin, reports were heard concerning the immunological aspects of dental diseases. The round table was organized by members of the scientific section “Environmental Protection and Public Health” of the International Academy of Sciences of Ecology, Human Safety and Nature.