Vol 27, No 4 (2023)

BACKGROUND: The treatment of chronic apical periodontitis is directly related to the successful impact on the biofilm in the root canal system. Despite recent advances in understanding the effects of bacterial biofilm, there are still many questions concerning bacterial inactivation, and more research in these areas is needed.

AIM: To investigate approaches to improve the effectiveness of treating chronic apical periodontitis by combining an antimicrobial drug with sound activation.

MATERIALS AND METHODS: The biological material of 40 teeth was obtained as a result of removal according to guidelines to create a model of the process of obturation of a tooth’s root canal with a calcium hydroxide paste. In the main group, we used the EndoActivator (Dentsply Sirona, USA) system intracanally after introducing the resultant paste with the help of canal filler. The root canal filling was performed using canal filler in the comparison control group. The filling was assessed using a radiovisiograph (Schick Technologies Inc., USA), and the filling of macrocanal and microcanal of the tooth root was examined using a scanning electron microscope.

RESULTS: The average score per tooth in the main group was 0.5 points/tooth. The average score per tooth in the control group was 2.05 points/tooth, which was significantly higher than in the main group (p <0.001). A comparison of the proportions of teeth with a certain number of points recorded in the compared groups revealed that teeth with a score of “0” (80%) predominated in the main group, whereas the proportion of such teeth in the control group was 15%; the differences are statistically significant (p <0.001). The data showed that the effectiveness of the root canal filling method with the canal filler and activation of the EndoActivator system resulted in the least complications.

CONCLUSION: The use of sonic vibrations of the EndoActivator system causes a dynamic movement of the material in the root canal, aimed at improving its flow and distribution into the dentinal tubules, and contributes to the uniform homogeneity of the filling material in the lumen of the root canal and the absence of voids between the root filling and the walls of the root canal of the tooth.

BACKGROUND: Restoration of the height of the crown part of the tooth in the decompensated form of pathological abrasion includes measures for reconstructing the general aesthetic appearance, restoring functional components, and correcting temporomandibular joint manifestations. However, even high-quality crowns are not always able to meet the needs of patients while in use. Deformation of orthopedic structures is common, and fractures of the roots used as support for the orthopedic structure are often possible. To prevent negative consequences in the manufacture of orthopedic structures for dentures, specialists who manufacture these prostheses must be familiar with not only the anatomical and topographic features of the teeth’s roots, the state of the alveolar process of the upper and alveolar parts of the lower jaw, the mobility of the mucous membrane, the correctness of determining the central ratio of the jaws, determining the correct position when modeling teeth, and taking into account the functional features of the dentoalveolar system but also the technical, technological, microbiological, and precision characteristics and parametric data of future artificial crowns fixed in the oral cavity. The use of reverse engineering methods allows the traditional technique of manufacturing dentures to be transferred into the digital technology framework and to create a biomechanically sound individual orthopedic design using software and hardware tools, such as CAD/CAM, Exocad, and Ansys. The application of mathematical modeling allows for a more in-depth analysis and, in some cases, the acquisition of strictly individual information about the studied prosthetic structure and the process of its interaction with human biological tissues. All of this will allow orthopedic structures to be built as close to the dentoalveolar system as possible, increasing the period of operation. This paper presents a study of the stress–strain state (SSS) of tooth roots, stump pins, and jaws. Various suprastructure design variants and various materials of stump pins are investigated. A comparative analysis of SSS for various materials of pins and crowns was performed.

AIM: To optimize the design of crowns and pin structures to reduce the load on the remaining roots of the teeth and the surrounding bone structures of the alveolar process’ crest.

MATERIALS AND METHODS: A comparative analysis of the SSS of the jaw with three variants of suprastructures was performed. Option 1: separate single suprastructures, where each is fixed to the root of the tooth. Option 2: a suprastructure combined into a single block by groups of teeth (premolar–molar segments from canine to canine). Option 3: a suprastructure combined into a single block as a “horseshoe.”

RESULTS: For each option, SSS were obtained for various materials of the stump pin inlays.

CONCLUSION: The developed methodology and calculation program enabled three sets of calculations for three options for constructing suprastructures with step displacement along the jaw and a comparative analysis of their SSS.

BACKGROUND: Diseases and processes of microbial nature in the oral cavity, such as caries, the hygienic condition of the oral cavity, and its biotopes, in terms of their diagnosis and sanogenetic therapy, are still an important concern in dentistry. The present ad oculum methods are subjective and have a 200%–400% error.

AIM: To conduct pathogenetic and clinical substantiation using an objective digital express method of Raman-fluorescence diagnostics to assess the dental status of the oral cavity in situ in patients with cardiac arrhythmia who are taking anticoagulants.

MATERIALS AND METHODS: One hundred fifty people aged 35 to 55 yr with cardiac arrhythmia on the background of taking anticoagulants or without them (in a comparative aspect) were examined using a hardware and software complex of the “InSpectrM” type. The patients were divided into two groups. Before and after controlled and/or uncontrolled oral hygiene treatment, the indicators of oral homeostasis at the metabolic, morphometric, functional, and clinical levels were assessed in each group using both the digital method and the classical ad oculum method. Aerobicity/anaerobicity of tissues, type of metabolism, saliva volume and index of microbial contamination of saliva, digitized Schiller–Pisarev sample, index of oxygenation, mineralization, and periodontal and hygienic indices were determined and presented in the form of a pie chart to assess the visibility of the results in their relationship. The observation was carried out for 6 months.

RESULTS: It is shown that the proposed digital express Raman-fluorescent technology for assessing the dental status of the oral cavity eliminates the presence of errors ranging from 200% to 400% when measuring the hygienic status of the oral cavity ad oculum and enables the acquisition of results in the relationship of all elements of oral homeostasis, which is confirmed both experimentally and clinically. It is shown that the hygienic condition of the oral cavity is close to the norm indicators in patients taking anticoagulants with controlled hygienic treatment than in patients with noncontrolled hygienic treatment (p <0.05). At the same time, all of the indicators evaluated had a positive dynamics at p <0.05. The need for remineralizing therapy after each hygienic treatment of hard tooth tissues is substantiated. It is evident that for a complex hygiene assessment, it is required to use the Raman-fluorescent diagnostics method and separate ad oculum methods (periodontal index, the index of bleeding), which complement each other in interrelation.

CONCLUSION: Based on the studies presented, it is shown that the Raman-fluorescent digital diagnostics method allows for simultaneous and multifactorial digital online assessment of the totality of all indicators of the dental status of the oral cavity in patients with cardiac arrhythmia while taking anticoagulants at the metabolic, morphometric, functional, and clinical levels.

Patients with a complete lack of teeth, severe maxillary atrophy and midface deformity create the most unfavorable conditions for their rehabilitation according to traditional protocols, including bone grafting, sinus lifting and implantation, which forms a complex clinical challenge. Today, zygomatic implants are successfully used as an alternative option for rehabilitation of patients with severe upper jaw atrophy, allowing to reduce the volume of surgical interventions, as well as to shorten the rehabilitation period. Until now, the question of finding an optimal treatment protocol with the use of zygomatic implants remains relevant.

We proposed an integrated protocol of rehabilitation of patients with severe maxillary atrophy, based on the use of analog-digital diagnostic tools and treatment outcome planning, as well as including the stages of surgical and prosthetic treatment using the developed technology of zygomatic implant placement and immediate loading with prosthetic jaw prosthesis constructions.

This work presents a clinical case of the patient (62 years old), whose rehabilitation was performed in accordance with her own protocol: preoperative digital planning according to computer tomography data (Blue Sky Bio Plan, USA), virtual modeling and manufacturing of surgical template for positioning four zygomatic implants (Nobel Biocare, USA), installation of zygomatic implants and immediate fixation of temporary dental prosthesis. Based on the results of follow-up examinations, including X-ray assessment of the zygomatic bones over a period of 6 years, no complications were detected.

Most older patients use removable dentures, and the need for these dentures increases every year. Improving oral hygiene and denture hygiene is required in 42% to 76% of cases. Maintaining good oral hygiene is the prevention of various dental diseases and the long-term preservation of dental treatment results.

The review aimed to examine the status of the issue on methods of disinfection of removable dentures (partial and complete) at home.

A literature search was conducted on methods of disinfection of complete and partial removable dentures using Scopus, PubMed, Web of Science, eLibrary, and disserCat.

Search criteria: review articles, scientific articles and patents (in Russian or English), published no earlier than 2013, by keywords: “removable dentures”, “oral microbiota of patients with removable dentures”, “hygiene of removable dentures”, “denture stomatitis” and “methods of hygienic treatment of dentures”.

A total of 218 articles were studied. After a full-text analysis, 30 papers that met the search criteria were selected.

The use of toothpaste for cleaning dentures has been studied in 17% of scientific studies (n=5). The use of special disinfectant solutions was investigated in 53% (n=16). Approximately 20% (n=6) of the literature reviewed methods for disinfecting dentures using special devices. Methods of covering dentures with protective varnish were described in 10% (n=3) of the articles.

Existing methods for home denture care show a wide range of effectiveness, often with contradictory data. The selection of adequate methods of denture hygiene at home is an important issue that requires further study.

BACKGROUND: The current gold standard for diagnosing a masticatory muscle condition is electromyography (EMG). This method allows us to evaluate the bioelectric potential of the muscle selected for diagnosis, bioelectric rest, the average amplitude of the biopotentials, the time of one chewing cycle, and the number of chewing movements performed. EMG is used in dental practice, and the electrodes are attached to the skin with glue or an electrically conductive gel. Installation often takes a long time and the reliability of the results decreases due to the movement of the sensors. Furthermore, when conducting several EMG studies on a patient at various stages of treatment, the motor point may not be in the same place, suggesting that the data obtained and any comparisons are inaccurate.

AIM: To design and develop a personalized device for performing masticatory muscle EMG with accurate repetition.

MATERIALS AND METHODS: Analysis of information in the literature made it possible to develop and produce a device for conducting EMG.

RESULTS: The technical result was a simplification of the methodology, including improved fixation of the sensors, which reduced the EMG time, and the ability to repeat the study at various stages of a patient’s treatment.

CONCLUSION: This device and EMG method provide a simplified way to obtain an accurate result in a shorter time. Thus, the data obtained would be representative if the study was repeated.

Pyotr Fedorovich Fedorov, an outstanding Russian dentist and private associate professor of Odontology, graduated from the Gatchina Nikolaevsky Institute and, in 1976, entered the Imperial Medical and Surgical (later Military Medical) Academy (IMHA, IVMA), from which he graduated from in 1881 and worked for more than 20 yr. He was the creator of the system for training dental specialists, as well as the inspiration for the establishment of his own Department of Odontology in IVMA. After graduating from IVMA, P.F. Fedorov decided to follow his fate with the sea and serve as a naval doctor in Arkhangelsk. The Academy’s Conference decided in 1891 to establish a private doctorate in dental diseases, the head of which was appointed Pyotr Fedorovich. As the initiator of this event, P.F. Fedorov is today recognized as the creator of the Russian Military Dentistry, and 1891 marks the official birth of military dentistry as a distinct clinical discipline. P.F. Fedorov in 1892 developed a training program for teaching dental disease treatment. Lectures for IVMA students were later initiated. P.F. Fedorov worked hard to establish the Department of Dentistry of the Academy and the system for training medical specialists for the Russian Army and Navy.