For successful orthopedic treatment using dental implants, an objective diagnosis of pathological changes in teeth and periodontal tissues is necessary. The identification and optimization of occlusive disorders at various stages of preparation for dental surgery contributes to the normalization of osseointegration processes, expands indications for periodontal diseases. The aim of the study was to assess the normalization of occlusive disorders before dental implantation using analog and digital protocols. The study included 57 patients aged 30 to 65 years and divided into 3 groups: the first group –23 patients with chronic generalized periodontitis of mild severity; the second group–20 patients with nonphysiological location of individual teeth due to partial defects of the dentition; the control group–14 patients. Results. The assessment of occlusive disorders was carried out using occlusography methods and in the articulator "Stratos -300". In the first group–62.6% of supracontacts, in the second group – 49.3%. Occlusive correction of premature contacts was performed. The control was carried out by electronic axiography. Occlusal harmony of occlusal-articulatory relations has been achieved after selective polishing. A comfortable closing of the teeth and smooth movement of the lower jaw have been achieved. The qualitative and quantitative indicators of the axiogram have improved.

The relevance of the study is caused by the need to search for metabolic criteria for inflammatory destruction of bone tissue. Purpose of the study: differential diagnosis of chronic periodontitis and dental peri-implantitis according to metabolic criteria of the biological environment of the body (oral fluid). The study included patients who were divided into 3 groups: 35 people with chronic periodontitis (group 1); 30 – with dental peri-implantitis (group 2); 20 – control group. The authors studied the protein and mineral metabolism of oral fluid. The authors conducted a study of the biological environment and found that the concentrations of total protein in all groups were not statistically different. However, total albumin concentration was lower in patients with dental peri-implantitis compared to controls and chronic periodontitis (p < 0.001). The values of the effective concentration of albumin and the toxicity index in the first and second groups are significantly lower compared to the control (p < 0.001), and the albumin binding reserve in the group of dental peri-implantitis is reduced more significantly (p = 0.003). The authors found statistically significant high concentrations of calcium and magnesium in groups I and II in comparison with the control, and when comparing the groups with each other, p < 0.826. Thus, disturbances in protein and mineral metabolism during dental peri-implantitis are statistically more significant against the background of periodontal diseases, which must be taken into account when performing dental implantation.

Relevance.Modern dental practice strives, above all, to preserve teeth. A variety of operations aimed at this include dental replantation. Replantation is used in cases where there are difficulties with the root canals, such as their pathological bending or previous treatment with the resorcinol-formalin method, and also when root resection is impossible due to the risk of damage to surrounding structures, for example, the maxillary sinus or the inferior alveolar nerve.The purposeof this study was to study the osseointegration of a replanted tooth subjected to coronoradicular separation.Materials and methods.Thirty-one-year-old patient K. came to the dental clinic with the problem of pain in the projection of tooth 4.6, which occurs during chewing. A detailed examination revealed that the crown of tooth 4.6 had previously undergone restoration using a filling material that had defects. It was decided that tooth 4.6 should be removed and subsequently replanted. The tooth was extracted according to established procedures, while maximally preserving the surrounding periodontal and periosteal tissues. To preserve periodontal tissues, alveolar curettage was carefully performed. During the extraction of the tooth, it was longitudinally divided into two parts – the medial and distal roots. After this, the root canals were treated using extraoral therapy. The roots of tooth 4.6, treated with an antiseptic, were returned to their anatomical positions in the alveolus. The final stage was the creation of a control x-ray to verify the correctness of the replantation.Conclusions.After two years of observation of tooth 4.6, which was subjected to replantation, no pathological changes in root stability were detected. It was reported that the soft tissue surrounding the roots of the tooth formed a structure similar to the periodontal sulcus, which facilitated the use of retraction cord during tooth preparation.

Современные цифровые технологии и их программное обеспечение открывают новые возможности в стоматологии. Например, использование компьютерной томографии (КТ) становится все более доступным. Практически каждый стоматологический томограф имеет необходимое программное обеспечение для 3D-планирования стоматологических манипуляций. Имплантация зубов получила в нашей стране значительное развитие. Возможности хирургического оснащения позволяют устанавливать дентальные имплантаты даже при недостаточном уровне костной ткани. Цель данной статьи — обобщение различных методов планирования инсталляции дентального имплантата и изготовления хирургических шаблонов. Стоматология всегда была тесно связана с другими областями науки и промышленности, привлекая большое количество современных инноваций и разработок в своей области. В этой статье мы собрали материалы, демонстрирующие, как меняется процесс лечения в результате интеграции технологий компьютерной диагностики (КТ) и производственных (CAD/CAM) технологий. Следовательно, у нас есть более эффективные и менее травматичные системы планирования дентальной имплантации, основанные на точных данных и компьютерных расчетах, которые сводят к минимуму технологические и человеческие отрицательные факторы.

Ustanovka dental'nyh implantatov s primeneniem mekhanotronnyh ustrojstv poluchila shirokoe primenenie v nachale XXI v., naryadu s klassicheskim implantologicheskim protokolom. Oslozhneniya neredko obuslovleny nesoblyudeniem standarta hirurgicheskogo protokola provedeniya dental'noj implantacii i, kak sledstvie, povysheniem fokusa temperatury v meste sverleniya kostnoj tkani chelyustej. Cel'yu raboty bylo ocenit' fokus temperatury kostnoj tkani v oblasti ustanovki dental'nogo implantata, provodimoj po klassicheskoj metodike i s primeneniem mekhanotronnoj sistemy s razlichnoj stepen'yu ohlazhdeniya. V kachestve eksperimental'noj modeli ispol'zovali avital'nuyu skeletirovannuyu nizhnyuyu chelyust' porosenka v'etnamskoj vislobryuhoj porody. V sootvetstvii s klassicheskim hirurgicheskim protokolom bylo sformirovano vosprinimayushchee materinskoe lozhe. Issledovanie provodili v trekh rezhimah: pri otsutstvii podachi izotonicheskogo rastvora, pri neznachitel'nom ego ob"eme (25–30 ml/min) i pri oroshenii rastvorom v sootvetstvii s hirurgicheskim protokolom (75 ml/min). Temperatura podavaemogo izotonicheskogo rastvora sostavlyala 25 °S. Po rezul'tatam issledovaniya, i klassicheskaya metodika ustanovki cilindricheskih dental'nyh implantatov, i ih installyaciya s primeneniem mekhanotronnoj sistemy bezopasny pri uslovii soblyudeniya hirurgicheskogo protokola i s dostatochnym ob"emom podavaemogo izotonicheskogo rastvora.

In the early 21st century, robot-assisted dental implant surgery became a popular alternative to classic implant placement protocols. Postoperative complications are often provoked by poor compliance with surgical guidelines for implant placement, resulting in the overheating of the osteotomy site. The aim of this study was to measure the temperature of osseous tissue at the dental implant site during classic and robot-assisted dental implant placement performed at different cooling modes. Avital skeletonized mandibles of Vietnamese pot-bellied pigs were used as an experimental model. The recipient bed was prepared following the classic surgical protocol. Three cooling modes were tested: no irrigation, irrigation with sterile saline at 25–30 ml/min and standard 75 ml/min irrigation recommended by the standard surgical protocol. The temperature of the isotonic solution was 25 °С. The study showed that both classic and robot-assisted dental implant placement techniques are safe if there is sufficient irrigation and good compliance with the surgical protocol.

OBJECTIVE:To assess the species diversity of microorganisms isolated from the oral mucosa in patients with removable orthopedic structures based on dental implants.MATERIALS AND METHODS:The indicators of the species diversity of microorganisms isolated from the oral mucosa in patients of the main and control groups were studied.RESULTS:For prosthetic treatment of patients from main group we used a method of manufacturing an overlapping, frame prostheses supported by teeth and dental implants. The results turned out to be reliable for opportunistic microorganisms Streptococcus anginosus and representatives of the orange periodontopathogenic complex Streptococcus constellatus.CONCLUSION:Microbiological assessment indicates the effectiveness of prosthetic treatment and the use of Corega tablets.

BACKGROUND:The pathologies of the salivary glands are very diverse. Salivary stone disease occupies a special place among diseases of the salivary glands of a non-neoplastic nature. The incidence of salivary stone disease is extremely extensive and accounts for up to 85% of all pathologies of the salivary glands.OBJECTIVE:Improvement of minimally invasive methods of treatment of salivary stone disease, which does not lead to excision of the gland.MATERIAL AND METHODS:On the basis of the Clinics of the Samara State Medical University of the Ministry of Health of Russia, in the period from 2010 to 2020, a clinical group was formed, consisting of 193 patients with salivary stone disease of various localization. The age of the patients ranged from 16 to 84 years. All patients were therapeutically examined at the preoperative stage, voluntary informed consent was signed. Shockwave sialotripsy was performed in 95 patients of the main group (in 64 patients the calculus was located in the submandibular salivary gland, in 31 patients - in the parotid salivary gland). For lithotripsy, we used a lithotripter apparatus «Edap» (France) and «Wolf» (Germany).RESULTS:The analysis of the results obtained as a result of the study made it possible to draw a conclusion about reasonably better results of removal of calculi in the ducts of the salivary glands using the lithotripter «Swiss LithoClast® Master» (Switzerland). At the first visit and the therapeutic effect of the lithotripter, all patients suffering from bouts of salivary colic showed complete cessation.CONCLUSION:Thus, our study, which was devoted to the study of the results of various methods of treating patients with salivary stone disease, showed that sialolithotripsy using special narrowly targeted devices for crushing and subsequent excretion of salivary calculi allows to achieve the best results at present.

An objective assessment of the morphofunctional characteristics of the state of soft tissues and bone structures adjacent to the dental implant allows to control the dynamics of the processes of osseointegration in the jaw-dental implant system. The aim of the work was to investigate the level of the β-CrossLaps, С-reactive protein (CRP), osteocalcin markers after orthopedic treatment of patients using dental implant supported advanced dental restoration technologies, to perform a biochemical analysis of the oral fluid of patients after restoration using dental implants and new two-part dental implants. In patients of the index group (52 people), the removable prostheses with metal frame and fixing elements or the commercially available dental implant supported removable prostheses were installed. For the patients of the control group (12 people), the commercially available dental implant supported removable prostheses of acrylic plastics were constructed. For all the patients after 6 months the level of β-CrossLaps, CRP, osteocalcin markers in the oral fluid was analysed. In patients of the index group, the average content of β-CrossLaps was 0.0126 ± 0.002 ng/ml, in the control group it was 0.0147 ± 0.002 ng/ml. The average content of the CRP in patients of the index group was 0.358 ± 0.019 mg/l, in patients of the control group it was 0.78 ± 0.01 mg/l. In patients of the index group, the average content of osteocalcin was 1.46 ± 0.25 ng/ml, in the control group it was 1.98 ± 0.31 ng/ml. It has been shown that biochemical markers of the oral fluid can be used to predict complications after the dental implants installation. Restoration with two-part dental implants of modern design is associated with fewer complications.

Currently, the standard of implant quality is the use of cylindrical or cone-shaped dental implants. The strength with which the implant is inserted should not be more than 45-50 Ncm. Osteointegration occurs 3-4 months after implantation on the lower jaw and 4-6 months on the upper. When setting up a dental implant, you should observe the permissible angle of inclination of their axis - up to 5-7. Deviation from this range creates difficulties in the subsequent prosthetics, as well as violates the aesthetics and functionality. If the implant loading is incorrectly calculated, there are changes in the bone tissue surrounding the implant, up to its resorption. Materials and methods. The collection of clinical material was carried out on the basis of the SFM of SamSMU in the period from 2015 to 2018. Implantation was performed in 32 people using the free hand technique. Negative results of implantation were observed in patients entering the age group of 45-65 years. Periimplantitis was observed in the projection of the missing tooth 2,2 (d implant 3,75*8,0), tooth 3.5 (d implant 3,75*11,5). All implanted implants belonged to MISS. Conclusions. As a result of the analysis of the obtained data, it can be concluded that the largest distribution of angular deviations was observed in the sagittal plane, in contrast to the frontal, which is probably due to the peculiarities of the anatomical structure of the wrist joint.

Проблема осложнений, возникающих после проведения дентальной имплантации, остается актуальной. Целью работы было исследовать влияние различных видов съемных конструкций и дентальных имплантатов на микробиоценоз полости рта при ортопедическом лечении 64 человек: 12 пациентов 1-й основной группы, 40 пациентов 2-й основной группы и 12 человек группы контроля. Через 6 месяцев после установки имплантатов в результате микробиологического исследования полости рта были выявлены различия в качественном составе микрофлоры слизистой оболочки вокруг шейки дентального имплантата. В основной группе 1 преобладали представители нормальной микрофлоры. В 100% случаев выделен Streptococcus vestibularis, более чем у половины пациентов выделены S. oralis, S. mitis, Rothia mucilaginosa, S. gordonii выделен у одного пациента. В основной группе 2 отмечено значительное разнообразие видов микроорганизмов, включая энтеробактерии, которые были выделены у 22,5% обследованных. В контрольной группе помимо представителей нормальной микрофлоры слизистой оболочки полости рта обнаружены S. vestibularis (75,5%), S. oralis (50,0%), Neisseria subflava (66,7%) и Haemophylus parainfluenzae (50,0%). У всех пациентов контрольной группы были выделены S. gordonii, а также другие виды потенциально патогенных стрептококков — S. anginosus и S. constellatus по 66,7%. Вид используемых съемных конструкций и дентальных имплантатов влияет на состав микрофлоры полости рта, а, следовательно, на дальнейший прогноз и риск развития осложнений. Съемные ортопедические конструкции с металлическим каркасом и фиксирующими элементами, телескопическими коронками и замковыми креплениями с опорой на разборные дентальные имплантаты менее других видов конструкций изменяют качественный состав микрофлоры слизистой оболочки полости рта вокруг шейки дентального имплантата.

Relevance. According to WHO, the absence of teeth occurs in various regions of the globe in 75 % of the population [1]. In the Russian Federation, tooth extraction in 35–44 years is 5.50 %, in patients older than 44 years is 17.29 % of the total number of people applying for dental treatment. Purpose. To analyze the theoretical basis for the positioning of dental implants. Materials and methods. The authors of the article carried out a retrospective analysis of the literature data on the theoretical basis for the positioning of dental implants. It was revealed that modern implantology successfully solves many problems of rehabilitation of patients with dentition defects. The conclusion. Improper positioning of dental implants entails a number of surgical and orthopedic problems, leading to disruption of the osteointegration of dental implants and, consequently, the inability of the dental implant to function.

One of the most common complications of caries is chronic apical periodontitis. The microbial factor plays a leading role in the development of this pathological process. Consequently, the main task of endodontic treatment of chronic apical periodontitis is the qualitative antibacterial treatment of the root canal. At present, the use of ultrasound and laser is a promising direction for disinfection of root canals. With the help of a microbiological study of the microflora of the root canals of the teeth, a comparative evaluation of the antimicrobial effect of ultrasound and erbium-chromium laser was carried out before and after antibacterial treatment.

ОРГАНОСОХРАНЯЮЩИЕ ТЕХНОЛОГИИ КАК АЛЬТЕРНАТИВА ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ А.В. Иващенко

The problem of complications arising after dental implantation is still relevant. The aim of the work was to investigate the effect of various types of removable appliances and dental implants on the oral microbiocenosis during orthopedic treatment of 64 people: 12 patients of the first index group, 40 patients of the second index group and 12 people of the control group. 6 months after the implants were installed, as a result of a microbiological study of the oral cavity, the differences were found in the qualitative composition of the microflora of the mucous membrane around the neck of the dental implant. In the first index group representatives of normal microflora prevailed. In 100% of cases Streptococcus vestibularis was isolated, from more than half patients S. oralis, S. mitis, Rothia mucilaginosa were isolated, S. gordonii was isolated from one patient. In the second index group, a significant diversity of microbial species was observed, including enterobacteria, which were isolated from 22.5% of the examined patients. In the control group, in addition to representatives of the normal microflora of the oral mucosa S. vestibularis (75.5%), S. oralis (50.0%), Neisseria subflava (66.7%) and Haemophylus parainfluenzae (50.0%) were found. From all patients of the control groups S. gordonii was isolated, as well as the other potentially pathogenic streptococci species, S. anginosus and S. constellatus by 66.7%. The type of removable appliances and dental implants used affects the microflora composition of the oral cavity, and, consequently, the further prognosis and the risk of complications. Collapsible dental implant supported removable prosthetic appliances with a metal frame and fixing elements, telescopic crowns and clasps less than other types of prosthetic appliances change the qualitative composition of the microflora of the oral mucosa around the neck of the dental implant.

Наиболее распространенной сложностью при постановке имплантатов является затрудненный выбор пространственного положения имплантатов. При интеграции имплантатов в полость рта две трети успеха операции зависят от того, насколько точно врач выберет позицию и угол наклона имплантата. Одной из важных проблем при установке имплантатов является их позиционирование в костном ложе. Целью работы было провести сравнительный анализ угловых отклонений дентальных имплантатов, установленных по классической методике, по «методу свободной руки» («free hand»). Использовали следующий алгоритм исследования. В декартовой системе координат на КТ-снимке в плоскости XОY (горизонтальная плоскость) определяли координаты шеек сравниваемых имплантатов у 34 исследуемых пациентов. Затем находили координаты апикальных частей всех исследуемых имплантатов. Полученные координаты помещали в разработанную нами программу ЭВМ № 2018661716 «Программа расчета угловых отклонений дентальных имплантатов», которая автоматически вычисляла угловое отклонение между осями установленных имплантатов. Расчет угловых отклонений между осями дентальных имплантатов у пациентов в послеоперационном периоде показал в 87% случаев значительное отклонение угла (до 27°) между осями имплантатов по сравнению с общепринятыми в дентальной имплантологии пределами (до 7°). В 100% изучаемых случаев не было отмечено параллельной установки дентальных имплантатов; анализ результатов дентальной имплантации в 1-м секторе выявил угловые отклонения в 27° 4`.

Accuracy is a common challenge in dental implant placement. A successful clinical outcome is largely determined by accurate positioning of the implant at the prepared site and proper angulation. This study aimed to compare the divergence between the axes of the implants installed using a classic freehand technique. Cartesian coordinates of implant necks were determined on the CT images of 34 patients in the XOY (horizontal) plane, followed by the coordinates of implant apices. The obtained data were submitted to the original software developed by the authors (patent 2018661716) that automatically computed an angle between the insertion axes of the installed implants. We found that in 87% of cases, this angle was significantly greater (up to 27°) than recommended by implantation dentistry guidelines (7°). In 100% of the studied cases, the implants were not parallel; in sector 1, the deviation was 27° 4`.