Vol 26, No 6 (2022)

BACKGROUND: Complications characterized by necrosis of the nasal mucosa and the hard palate, as well as the middle and lower nasal concha with exposure of the alveolar process, destruction of the posterior wall of the maxillary sinus and the bottom of the orbit caused by a fungal infection were noted during the COVID-19 pandemic. By January 2022, such cases had been documented in 18 countries worldwide. The main predisposing factors for this condition are diabetes mellitus and inadequate use of corticosteroids. Rhinocerebral mucormycosis or zygomycosis is a rare disease caused by filamentous fungi affecting the nose, paranasal sinuses, and brain.

AIM: To present the treatment strategy for patients with deep mycoses of the maxillofacial region against a background of transferred COVID-19 in the State Clinical Hospital named after F.I. Inozemtsev DZM.

MATERIAL AND METHODS: Fifteen patients with a cerebral form of mucormycosis of the maxillofacial region arose against a background of a new coronavirus infection associated with SARS-CoV-2.

RESULTS: The study shows the importance of timely initiation of radical surgical treatment for the rhinocerebral form of mucormycosis in the maxillofacial region, which arose against the background of SARS-CoV-2, to prevent the spread of osteomyelitic foci in bone tissue.

CONCLUSION: Early diagnosis of mucormycosis, timely treatment with antipsychotic medications and surgical intervention, control of the level of glycemia, and reasonable use of corticosteroids prevented the development of complications.

BACKGROUND: Patients with chronic non-correctable periodontal disease, leading to loss of teeth, can be rehabilitated using immediate dentures. However, removable dentures often produce excessive mechanical pressure on the underlying prosthetic bed tissues.

AIM: To evaluate the effectiveness of various options for immediate dentures and their effects on the rate of wound healing in patients with a complete absence of teeth due to surgical removal for chronic periodontitis.

MATERIALS AND METHODS: Early prosthodontics treatment was conducted on 30 patients after extracting multiple teeth at the Department of Orthopedic Dentistry and Orthodontics of the Ryazan State Medical University. The patients were divided into 3 groups depending on the options for immediate dentures: 1) combined construction of acrylic, non-monomer and elastic polymer, 2) hot curing acrylic polymer, and 3) thermoplastic plastic. Treatment effectiveness was measured by the objective state of the wound area with a planimetric assessment of wound healing. Pain sensitivity when using the prosthesis was rated according to a numeric rating scale for pain. The stability of prostheses was assessed according to the Mirgazizov method, an assessment of the safety of the drug based on the prosthesis. Diagnostic observations were carried out for 21 days.

RESULTS: Postoperative rehabilitation was faster in groups 1 and 3, than in group 2. By day 21, inflammation persisted only in group 2, which was confirmed by the largest wound size (8.3±1.1 mm) compared with that of groups 1 (5.1±1.9 mm) and 3 (6.3±2.4 mm). Complaints of pain during the use of prostheses were noted in half of the patients in groups 2 and 3, whereas only slight discomfort persisted in 3 patients in group 1. The stability of the prostheses deteriorated in group 3 by day 21 (5.9±1.4 points), indicating lower adaptability of thermoplastic prostheses to changes in the relief of the prosthetic bed than with the combined construction (6.7±1.4 points). The acrylic prostheses demonstrated the lowest adaptability (3.2±1 points). The indicator of daily preservation of drugs under the bases of dentures in group 1 patients was 36.8±2 mm², that in patients of group 3 was 30.3±1.8 mm², and that in patients of group 2 was the lowest at 24.4±1.4 mm².

CONCLUSION: The principle of combining polymeric materials to create immediate dentures was the method of choice for prosthodontics treatment of patients with a complete absence of teeth due to surgical removal, as this category of patients is most sensitive to inflammatory complications during the postoperative period.

RELEVANCE: An artificial gum recession defect was created in 50 Wistar rats. SANS MOTS oil containing marque blanche phytoconcentrate with phytosterols was applied to the defect area for 20 min. 5 times, with a 2-day interval.

AIM: To evaluate the effectiveness of the treatment method.

MATERIAL AND METHODS: An experimental gum recession model was created by mechanically excising periodontal tissues in a V-shape. Fifty white female rats were used as the model. Surgical intervention was performed on the lower jaw in the incisor area. The animals were divided into 2 groups depending on the planned treatment method. The control group consisted of 10 rats with healthy gums. The SANS MOTS oil was applied to the defect area for 20 min, 5 times, with an interval of 2 days in the other group. The effectiveness of the treatment was evaluated by the proposed method.

RESULTS: Complete restoration of the dentoalveolar papillae and regeneration of periodontal tissues occurred in the experimental gum recession area during the first 28 days. At the same time, the main group developed no signs of inflammation (hyperemia, edema, bleeding gums), which confirms the therapeutic effect of the SANS MOTS oil.

CONCLUSION: The SANS MOTS oil had a beneficial effect on gum recession. The decrease in the intensity and prevalence of gingival inflammation began on day 14. There were no signs of inflammation by day 28 after applying the oil. In addition, there was a noticeable increase in regeneration of the gingival margin by day 24 in the gum recession model, and complete restoration of the gingival papillae and no gum recession were noted by day 38.

BACKGROUND: Electrochemical reactions can occur in the mouth of patients with prostheses made of metal alloys. The phenomena of galvanism reflect the hidden process of corrosion of structural alloys in oral fluid, which makes it necessary to analyze the chemical contents of prostheses under clinical conditions in patients with implants and experimental conditions.

AIM: Comparative analysis of the trace element content in the oral fluid from prostheses in implants in the clinic and an experiment.

MATERIALS AND METHODS: National Research Technological University “MISIS” analyzed artificial saliva after prostheses were in contact with grade 4 and grade 5 implants for 3 months. Titanium, cobalt, chromium, aluminum, vanadium, molybdenum, tungsten, manganese, nickel, and iron were determined by spectrometry. The same chemical elements were analyzed using an identical spectrometric method in 32 patients with fixed dentures on implants.

RESULTS: Under the experimental conditions, nine trace elements were found in the container around one grade 4 implant with a crown, including titanium (0.4 µg/l), cobalt (3.8 µg/l), chromium (0.5 µg/l), aluminum (2.6 µg/l), vanadium (<0.6 µg/l), molybdenum (1.5 µg/l), tungsten (3.0 µg/l), manganese (0.9 µg/l), nickel (0.5 µg/l), and iron (<0.6 µg/l). The grade 5 implant was characterized by a greater degree of diffusion of aluminum, nickel, and manganese into artificial saliva. Mass spectrometry of the oral fluid in patients with dental implants revealed more trace elements than experimental data. The difference in the concentration of microelements from the prostheses under clinical conditions and in the experiment ranged from 0 to 128 times the minimum.

CONCLUSION: Fixing experimental prostheses on implants for 3 months in artificial saliva was accompanied by the diffusion of microelements from the prostheses and implants into the environment, particularly cobalt, aluminum, and vanadium. Prostheses on implants with a lower titanium content are characterized by a greater degree of diffusion of aluminum, cobalt, nickel, and manganese. More significant diffusion of microelements occurred from the prostheses into the saliva under clinical conditions, according to the spectrometric data.

This article presents a review of the advantages of using ormokers rather than composite filling material from a chemical point of view. Ormokers are a modified type of hybrid organo-inorganic dental material. They were developed to reduce the shrinkage of filling material from polymerization, improve edge adaptation and abrasion resistance, and increase biocompatibility (compared to composites). The new matrix is based on inorganic polymers, which are polycondensed siloxanes (triblock copolymers). The formation of an inorganic chain of molecules occurs by hydrolysis and polycondensation of Si(OR) groups. Unstable organosilanols are formed from chlorine-containing silanes, as at least two hydroxyl groups are associated with one carbon atom. Such compounds do not exist, as they are rapidly isomerized to form carbonyl compounds (aldehydes and ketones). The resulting organosilanols are then oligomerized to form polysiloxanes with polymerized groups. The basis for the production of ormokers is the sol-gel process. The classical approach involves the formation of an inorganic grid by hydrolysis and condensation of a monomeric organic alkoxy compound followed by crosslinking of the introduced reactive groups (e.g., ultraviolet polymerization). The traditional synthesis of ormokers begins with the finding that alkoxysilanes are functionalized by metal alkoxides to form Si-O-Si nanostructures. One of the metals that functionalizes alkoxysilanes is titanium. In addition to titanium alkoxide, zirconium- or aluminum-alkoxides can be used. These oligomers replace traditional methacrylic monomers in composites. Composite filling materials available today based on the ormoker technology are not pure ormoker systems. Traditional methacrylate monomers-diluents are used to regulate the viscosity of the condensate, which does not improve biocompatibility. The presence of an amide group in the structure of the ormoker increases their biocompatibility with protein compounds in dental tissues.

Among the outstanding domestic maxillofacial, reconstructive, and plastic surgeons, one of the outstanding figures in the world of medicine and practical healthcare is Doctor of Medical Sciences, Professor Natalya Ivanovna Butikova.

The purpose of this study is to highlight the scientific, clinical, pedagogical, and social activities of the maxillofacial and plastic surgeon, Professor N.I. Butikova.

Based on an analysis of the domestic literature, we present the role of Professor N.I. Butikova in the creation and development of domestic maxillofacial and plastic surgery. Information on the life of a well-known surgeon in our country, one of the patriarchs of Russian pediatric traumatology and maxillofacial surgery, Professor Natalia Ivanovna Butikova, who turned 110 years old in 2020, is presented. The development of N.I. Butikova as a doctor, researcher, and teacher, and her activities during the Great Patriotic War are noted. The main direction of her scientific activities is in the development and improvement of methods for treating gunshot injuries of tissues in the maxillofacial region and neck and the rehabilitation of wounds with defects in the jaws and tissues of the oral region using bone autoplasty and Filatov’s stalk. Natalya Ivanovna has improved the treatment of facial and neck burns and their consequences, as well as the surgical methods for eliminating mimic muscle paralysis. Her role in the development of oncostomatology, combustiology, pediatric traumatology, and orthopedics is revealed. N.I. Butikova has developed surgical methods to treat syndactyly in children < 1 year using zigzag incisions, improved the free tissue grafting and plasty methods with split skin grafts, and proposed an apparatus for preventing secondary contraction of skin grafts during transplantation. She is one of the pioneers of domestic maxillofacial surgery. N.I. Butikova, as a founder of domestic surgery, a creator of the school of pediatric traumatologists and orthopedists, as well as maxillofacial surgeons, is recognized as one of the patriarchs of national healthcare.