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Vol 26, No 3 (2022)
- Year: 2022
- Published: 28.09.2022
- Articles: 11
- URL: https://rjdentistry.com/1728-2802/issue/view/5408
- DOI: https://doi.org/10.17816/dent-2022.26.3
Experimental and Theoretical Investigation
Accuracy of the landing of the original and non-original supraconstructions on implants
Abstract
BACKGROUND: An integral part of modern orthopedic dentistry is the rehabilitation of patients with partial or completely missing teeth using intraosseous implant prosthetics. Despite the high success rate of implant integration, practicing dentists continue to encounter biological and technical complications during prosthetic treatment. One of the reasons for the resulting complications is inaccuracies in the design of orthopedic components. Since today the Russian dental market offers a wide range of suprastructures from different manufacturers and price categories, there is a need to compare the accuracy of their designs.
AIM: To identify the difference between the accuracy of fit of original and non-original suprastructures presented in the Russian dental materials market by studying microgaps between these components and original Straumann implants.
MATERIAL AND METHODS: Seven bone-level implants and six tissue-level Straumann implants were used. The original Straumann titanium bone-level and tissue-level bases were used as control superstructures. The following non-original components were used as test specimens: cast cobalt–chromium bone and tissue-level bases from GeoMedi, plastic burnout bone-level abutments from NT-trading, and non-original titanium bone- and tissue-level abutments from GeoMedi, Zirkonzahn, and NT-trading. Cobalt-chromium abutments for tissue-level to a soft state were obtained from GeoMedi. Cobalt–chromium specimens, namely, cast-to-fabricate and pre-smooth abutments from GeoMedi and a plastic burnout abutment from NT-trading, underwent a full technical cycle of metal-ceramic crown fabrication. All specimens were pressed in epoxy using a SimpliMet 1000 automatic hot press. Specimens were ground using a Buehler Beta-1 grinding and polishing machine with an automatic Vector attachment. Grinding was conducted layer by layer in three steps with a step of 1 mm. The contact area was examined with a Tescan Mira LMU scanning electron microscope.
RESULTS: Segments between the implant and abutment and between the abutment and screw were considered in calculating the study results. Using a scanning electron microscope (Tescan Mira LMU), the length of the gap sections not exceeding 1 µm and the length of each gap section exceeding 1 µm were measured on each segment. For each gap, the area percentage was calculated, with the gap width not exceeding 1 µm.
CONCLUSION: For Straumann bone- and tissue-level implants, the original Straumann titanium bases had the highest fit accuracy, but for Straumann bone-level implants, the non-original titanium abutments from GeoMedi and Zirkonzahn also had a similar fit. The fit of the non-original cobalt–chromium bases from GeoMedi and the burnout plastic abutment from NT-trading did not meet the criteria for an accurate fit of the superstructures.
181-190
Clinical Investigation
Frenula of tongue and lips: are there or not?
Abstract
BACKGROUND: The absence, hypoplasia, or hyperplasia of the frenula of the lips and tongue is suggested as a sign of some diseases. This study assessed the presence of frenula among patients with orthodontic concerns.
AIM: This study aimed to analyze the prevalence of the absence of the frenulum of the tongue and lips to determine the possibility of using the absence of frenula as a diagnostic criterion for other pathologies.
MATERIALS AND METHODS: A retrospective analysis photographs of 391 patients was performed.
RESULTS: In total, 100% of the patients have a maxillary frenulum. The inferior labial frenulum was absent in 67.02% of the patients, and 252 patients (95% CI 62.27–71.77%) had multiple strands of the mucosal membrane. Hypoplastic mandibular frenulum was found in 109 (28.99%) patients (95% CI 24.4–33.58%). Absence of lingual frenulum was noted in 6 (1.68%) patients (95% CI 0.35–3.01%) and hypoplasia in 33 (9.24%) (95% CI 6.24–12.24%).
CONCLUSIONS: The absence of inferior labial and lingual frenulum cannot be a diagnostic criterion for other pathologies without specifying the method of displacement of the lower lip.
191-197
Clinical efficacy of occlusive splints manufactured by computer modeling and volumetric printing in patients with bruxism: research results and a clinical case
Abstract
BACKGROUND: Among dental diseases, various types of musculoskeletal dysfunctions occupy a special place. The myogenic theory of temporomandibular joint dysfunction is interesting, where the fundamental role is assigned to the parafunctional state of the masticatory muscles. Analysis of the results of electromyographic studies has shown that patients with TMJ disorders complicated by muscle hypertension have significant functional disorders of the masticatory muscles. Also, the causes of TMJ dysfunction include bruxism, which can occur against the background of parafunctions of the masticatory muscles. To date, there are a large number of methods for the treatment of TMJ dysfunction: splint therapy, occlusive and immobilizing splints. CAD/CAM computer technologies have also become widespread, which are used for the manufacture of these structures. But there are no uniform treatment standards, therefore, studies and comparisons of different techniques are relevant.
AIM: the effectiveness of treatment of patients with bruxism by developing a clinical protocol for the use of an occlusive splint made by volumetric printing.
MATERIAL AND METHODS: To evaluate the effectiveness of occlusive splints manufactured by computer milling and 3D printing in patients with bruxism. All study participants at the stage of formation of clinical groups underwent a comprehensive dental examination, which included a clinical and instrumental examination, surface electromyography of the masticatory muscles, computer monitoring of occlusion, cone-beam computed tomography of the TMJ. To exclude the somatoform component from the pathogenesis of bruxism, an electroencephalogram (EEG) was performed in all patients at the stage of formation of clinical groups. At the first stage of treatment, all patients underwent selective grinding of centric and eccentric interferences under the control of a T-scan computer occlusion monitoring device, after which the therapeutic position of the mandible was determined, stabilizing nocturnal occlusal splints made by volumetric printing were manufactured and fixed. Monitoring of treatment results included clinical and instrumental examination and surface electromyography of the masticatory muscles, carried out 3.6 and 12 months after the start of treatment. Upon completion of treatment, an assessment of the integrity of occlusal splints was carried out.
RESULTS: According to the results of the performed myography, at the time of the start of treatment, the PU coefficient was 74%, after 3 months, it significantly decreased by 6%, after 6 months, its decrease was recorded by 11%, and after 12 months — by 16%. The assessment of the integrity of the occlusal splint was carried out at the end of treatment after 12 months, by combining virtual tire models in a computer program before and after the start of treatment obtained by laboratory scanning. When analyzing the comparison of virtual tire models, their almost complete identity was revealed, with the exception of one area on the occlusal surface, which is 0.044 mm, which is not critical in the general treatment concept.
CONCLUSION: Taking into account the positive result of clinical testing of the proposed technology, it is advisable to conduct a randomized study to evaluate the effectiveness of the use of occlusive splints made by computer modeling and volumetric printing from domestic material in the treatment of patients with musculoskeletal dysfunction complicated by bruxism.
199-211
Changes in the periodontal microhemocirculation during the treatment of generalized periodontitis using polarized light
Abstract
BACKGROUND: Chronic generalized periodontitis is one of the main causes of tooth extraction, significant decrease in chewing efficiency, deterioration in the quality of life, and progression of comorbidities. Research in the field of modulating the response of the macroorganism (host therapy) to pathogenic factors is a huge player in solving the problem of effective treatment of chronic generalized periodontitis, along with an active study of methods influencing the periodontal microbiome.
AIM: To examine changes in microhemocirculation in the periodontium in the treatment of chronic generalized periodontitis of moderate severity using polarized, incoherent, polychromatic radiation.
MATERIAL AND METHODS: Microhemocirculation parameters in periodontal tissues were obtained and analyzed in the treatment of moderate periodontitis in 90 patients using polarized, incoherent, polychromatic radiation (piler-light therapy) and a nonsteroidal anti-inflammatory drug (lysine salt of ketoprofen) as modulators of the regional host response. Analyses were conducted within 1 year using clinical and radiological methods and laser Doppler flowmetry.
RESULTS: In the treatment of moderate chronic periodontitis, single-component pharmacotherapy using an antimicrobial gel containing metronidazole and chlorhexidine has a positive effect on clinical symptoms and microhemodynamics in periodontal tissues only for 3 months.
CONCLUSIONS: The combined use of the gel and lysine salt of ketoprofen increases the duration of positive changes in the microhemodynamics of periodontal tissues for up to 6 months. By its inclusion in the algorithm for the treatment of chronic periodontitis of moderate severity, along with antimicrobial and anti-inflammatory drugs, piler-light therapy allows for maintaining the improvement in hemodynamic parameters in the periodontium within 1 year and makes the disease in remission.
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Сlinical characteristics and diagnosis of chronic generalized periodontitis in patients with connective tissue dysplasia
Abstract
BACKGROUND: At present, the detection of periodontal pathology is not very difficult, especially in unfolding disease stages. Moreover, determining the clinical course and differentiating the diagnosis of nosological forms, prognosis of disease development, its interrelation with the general condition of the patient and the bone system as a whole are more complicated tasks that require further close study. The bone is an active metabolic system that is constantly self-renewed by the processes of resorption and formation. This study focused on the peculiarities of the course of generalized periodontitis (GP) in 104 patients with differentiated and undifferentiated connective tissue dysplasia (UCTD).
AIM: To diagnose and study the clinical course of chronic GP (CGP) in patients with CTD.
MATERIAL AND METHODS: This study analyzed retrospective and prospective data obtained in 2016–2020 as a result of monitoring patients with different severities of CTD: differentiated CTD (DCTD) + CGP (group 1, n=56), undifferentiated (UCTD) + CGP (group 2, n=48), and control group (CG, n=34) with CGP but without signs of musculoskeletal dysplasia. The study included a total of 137 patients aged 18–37 years.
RESULTS: In group 1, the average caries intensity was 18.2±0.5; non-carious dental lesions, 9.0±0.4; periodontal tissue pathology, 90.6±0.6. In group 2, the corresponding values were 16.7±0.8, 4.5±0.3, and 85.5±0.8, respectively. In CG, the incidence of these pathologies as 20% to two times less. By sex groups, a more severe form of periodontal tissue inflammation was noted in women, and after age 45 years and onset of menopause, it increased to 66.6%. The minimal thickness of the cortical layer was recorded in patients with decreased bone mineral density (BMD) of the jaw bones, with 5.8±0.4 mm in group 1, 5.2±0.6 mm (p <0.001) in group 2, and 2.8±0.3 mm (p <0.001) in СG.
CONCLUSIONS: Thus, in groups 1 and 2, the state of hard tissues against the background of reduced BMD is characterized by high rates of extracted teeth. In addition, specific changes in periodontal tissues were noted, i.e., aggressive disease course, deterioration of all periodontal indexes, increased attachment loss, and higher degree of bone tissue resorption, which are characteristic of severe periodontal pathologies. In addition, an imbalance in the calcium-regulating hormone system was noted in middle-age adults in groups 1 and 2 of both sexes. In our opinion, the cause was a disorder of the bone remodeling cycle in the presence of an imbalance in calcium-regulating hormones.
219-228
Frequency of error in the diagnosis of neoplasms of the salivary glands at the pre-hospital stage
Abstract
BACKGROUND: In connection with the growth of oncological pathology in the oral cavity, especially salivary gland neoplasms in the Kirov region, the diagnostics of this pathology was analyzed. Salivary gland neoplasms are more common in women (65.6% of cases). This morbidity peaks in middle and old age. Puncture biopsy is more frequently used for pathology diagnostics at the pre-hospital stage.
AIM: To examine the error rate in the diagnostics of salivary gland tumors at the pre-hospital stage.
MATERIAL AND METHODS: This study retrospectively analyzed case histories and results of pathohistological examination of biopsy materials in 160 patients with salivary gland neoplasms. Data were statistically analyzed using Microsoft Office 2007 by methods of descriptive statistics.
RESULTS: Medical history data and results of pathohistological examination of biopsy specimens indicate the frequency of errors in the diagnostics of salivary gland neoplasms and difficulties arising when preparing and performing surgery in patients with salivary gland neoplasms.
CONCLUSIONS: The study revealed the necessity of conducting a complex examination of patients by all available instruments, such as ultrasonography, computed tomography, magnetic resonance imaging, and sialography, without morphological verification.
229-235
Organization of Healthcare Service
Evaluation of the results of surgical treatment of adult patients with neoplasms of the parotid salivary glands
Abstract
BACKGROUND: The issues of the early differential diagnosis of patients with neoplasms of the parotid salivary glands (PSG), choice of the correct tactics of surgical treatment, tumor recurrence, and postoperative complications have remained relevant for many years.
AIMS: To retrospectively analyze medical records of adult patients with neoplasms of the PSGs.
MATERIALS AND METHODS: We analyzed a sample of patients who were hospitalized at the Maxillofacial Hospital for War Veterans of the Department of Health of the City of Moscow for the period from January 2017 to April 2022.
RESULTS: The study included 302 patients (men, 38.41%; n=116; women, 61.59%; n=186). The mean age of the patients was 52.27±0.23 years. The study group was divided into three subgroups: the first group had benign neoplasms (n=258), the second group had malignancies (n=24), and the third group had tumor-like lesions (n=20). The article presents the main characteristics of these patients. Some features of diagnostics and planning were revealed. The authors discuss the choice of tactics of surgical techniques.
CONCLUSIONS: Despite the significant development in diagnostic and surgical techniques, discrepancies between clinical and pathohistological diagnoses (28.15%) and unwanted postoperative complications remain relatively high.
237-246
The study of the impact of the introduction of self-isolation and the mandatory wearing of personal protective equipment on oral hygiene
Abstract
BACKGROUND: The availability of medical facilities, and as a result, the possibility of receiving medical care has decreased due to the announcement of quarantine in several countries. An untimely request for dental care entails a change in the CPI index (the sum of teeth on which caries, a filling or a tooth has been removed), resulting in partial or complete loss of teeth. The complete absence of teeth is accompanied by morphofunctional changes in all elements of the dental system, a significant decrease in chewing ability. Thus, the decrease in public attention to dental hygiene and treatment in dental clinics for examination and treatment negatively affected dental health.
AIM: The aim is to assess the impact of the introduction of self—isolation and mandatory wearing of personal protective equipment on oral hygiene of students of higher educational institutions of Ryazan and the Ryazan region and foreign universities (universities).
MATERIAL AND METHODS: The research materials were the results of a survey conducted among Russian students and students living outside the Russian Federation. A total of 397 students (English speakers – mainly India, Egypt, Canada; French speakers – mainly Morocco, Lebanon, Tunisia), who were divided into several study groups. In total, 397 students took part in our study (42% were girls, 58% were young people), 123 of them were Russian-speaking students, 120 English-speaking students and 154 French-speaking students.
RESULTS: A comparative assessment of the results of the study showed a positive state of oral hygiene in the majority of respondents, and there was an increase in interest in the use of additional personal hygiene products of the oral cavity (chewing gum, irrigators, rinses, single-stick brushes, toothpicks, etc.).
CONCLUSION: In general, oral hygiene, being an integral part of daily care, was not forgotten during self-isolation. Students regularly brushed their teeth, used additional means, but, as the study showed, students went to the dentist less often due to compliance with the self-isolation regime.
247-256
Help a Practical Doctor
Innovative method for determining the central ratio of the jaws as an effective clinical method for improving the quality of full removable dental prosthetics
Abstract
BACKGROUND: In modern conditions, in the widespread clinical practice in the prosthetics of patients with complete edentulism, the anatomical and physiological method and its modifications have become popular. However, for all its reliability and ease of use, this method is not without drawbacks.
AIM: Improving the effectiveness of complete removable dentures. By developing a new method for determining the central ratio of the jaws.
MATERIAL AND METHODS: An innovative method for determining the central ratio of the jaws was created by improving the functional-physiological method for determining the central ratio of the jaws, using a gnatometer and teleradiographic examination.
RESULTS: 100 prostheses were made by this method for 74 patients. A comparative correlation analysis of teleradiographic images with old prostheses before treatment, with a gnatometer in the oral cavity during treatment, and with new prostheses 2 months after treatment was carried out.
CONCLUSION: The proposed method for determining the CSF allows highly accurate, in accordance with individual anatomical parameters and features, to determine the bite height and central occlusion of the patient as a model for the reconstruction of the future dentition, taking into account and in accordance with Angle’s skeletal class.
257-265
Reviews
The role of the human papilloma virus in the development of potentially malignant diseases and squamous cell carcinomas of the oral mucosa
Abstract
The prevalence of HPV in potentially malignant diseases of the oral cavity is 22.5%. Different types of HPV are characterized by genotypic variations in the DNA base sequences E6 and E7. It is these genotypic differences that make it possible to divide the oncogenic phenotype of the virus into types of high and low cancer risk. There are local and general risk factors for HPV infection. Local risk factors include poor oral hygiene, the use of complete dentures in combination with old age. A significant correlation between oral hygiene and viral load has been confirmed. This review presents the possible role of human papillomavirus (HPV) in the development of potentially malignant diseases and squamous cell carcinomas of the oral cavity. The epidemiology, risk factors and mechanisms of human papillomavirus infection development are given. Clinical and morphological differences between HPV-positive and HPV-negative forms of oral cancer are considered. The issues of HPV infection prevention and the pathogenetic therapy development of this disease are reviewed. Literature search was carried out in search engines Medline, Elibrary, Scopus, PubMed, The Cochrane Library, RSCI.
267-276
Memory pages
Military physician D.E. Tanfiliev: life and contribution to the development of military dentistry
Abstract
On the memory pages among the Russian dentists and maxillofacial surgeons, it is impossible not to remember the prominent scientist and clinician, the candidate of medical sciences, associate professor, colonel of the medical service David Evseevich Tanfiliev.
Research is to illuminate the scientific, clinical, pedagogical and social activity of the prominent military dentist and maxillofacial surgeon of the candidate of medical sciences, associate professor, colonel of the medical service David Tanfiliev.
On the basis of the analysis of the domestic literature, and also life, professional activity and scientific labors of the candidate of medical sciences, associate professor, colonel of the medical service D.E. Tanfilyev to present his role in the development of the domestic stomatology and military medicine in Russia.
The information about the life of the military dentist D.E. Tanfiliev, the candidate of medical sciences, associate professor, colonel of the medical service is represented. His activity during the Soviet-Finnish (winter) and the Great Patriotic War is marked. The main directions of his scientific activity in the issues of the development and improvement of the techniques of tooth extraction, treatment of difficult wisdom teeth eruption, odontogenic maxillary sinusitis, gunshot fractures and osteomyelitis of the upper jaw are examined. It is shown, that D.E. Tanfiliev has specified the function of the maxillary sinuses and physiological significance of its walls, described an age and functional rearrangement of the maxillary sinus bone tissue under the maxillary sinus floor and its significance for direct prosthesis. Received by D.E. Tanfiliev the information about age anatomy of maxillary sinuses is important for the practicing dentist, not only for facilitating diagnostics and therapy of this or that pathology, but also for knowing the genesis of old age and struggle for prolongation of active longevity. It is no coincidence that today special importance is given to dental rehabilitation of patients with severe atrophy of the alveolar processes and jaw parts using dentures on artificial supports He has improved the therapy of maxillary sinusitis in connection with the age-related features of the maxillary sinus structure and the types of bone structure of the upper jaw. He paid special attention to the clinical picture and treatment of concomitant gunshot injuries of the upper jaw.
It is underlined that D.E. Tanfiliev was one of the pioneers of the national military stomatology.
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