The most common form of headache is tension headache. Painful indurations are found in the masticatory muscles of such patients, in the thickness of which there are areas of hypersensitivity – muscle-fascial trigger points. When examining adult patients with occlusion pathology at an orthodontist’s consultation appointment, complaints of headaches were revealed. These headaches are very common and make up the most numerous outpatient visits of patients with headache complaints. The purpose. To study the manifestations of headache in patients with occlusion disorders. Material and methods. The study covered 171 adult patients with occlusion anomalies and deformities of the dentition aged 18 to 63 years. All the patients were asked to answer the questionnaire. The data obtained were processed by standard parametric methods using the Student’s paired criterion. The Microsoft Excel application software package was used to calculate the correlation coefficient. Results. The study showed regular dependence of headache localization on the type of occlusion pathology. Headache in the region of the longitudinal suture very little depends on the type of occlusion pathology. The connection between pain in the frontal region and the pathology of occlusion is also weak. Pain in the temporal, occipital and parietal regions of the head shows a fairly high correlation with the corresponding pathologies of occlusion. Conclusions. It was found that the manifestation of headache in patients with occlusion pathology has a linear statistically significant correlation in the temporal and parietal lobes of the head. Pain in the occipital lobe has a rather high correlation with the types of occlusion pathology. Manifestations of headache in patients with occlusion pathology are poorly expressed in the frontal lobe of the head and very poorly expressed in the area of the longitudinal suture.

Relevance. This article presents the findings from studies evaluating the effectiveness of toothpastes containing 1000 ppm fluoride in clinical settings. The data demonstrates the cumulative benefits of these toothpastes on oral hygiene, the reduction of inflammatory oral manifestations, and their anticaries effects.Purpose. To assess the effectiveness of fluoride-containing toothpastes through laboratory tests and clinical trials.Materials and methods. The study evaluated the effectiveness of toothpastes containing 1000 ppm fluoride using the following parameters: Greene-Vermillion hygiene index, periodontal indices (PMA and SBI), enamel mineralization and resistance, presence and number of carious lesions at the white spot stage, enamel hypersensitivity, and antimicrobial activity against Streptococcus spp.Results. The analysis of hygiene indices demonstrated that the tested toothpastes were highly effective in cleaning, with a positive cumulative effect on participants' oral hygiene. The use of these toothpastes significantly reduced inflammatory manifestations, decreased gum bleeding, and improved periodontal tissue health. A reduction in the number of participants with early-stage carious lesions, as well as a decrease in the overall number of lesions, was observed. The toothpastes also enhanced enamel resistance to acid exposure, contributing to their anticaries benefits. Enamel hypersensitivity was reduced, and a dose-dependent antibacterial effect against Streptococcus mutans, Streptococcus gordonii, and Streptococcus sobrinus was observed.Conclusion. Toothpastes containing 1000 ppm fluoride demonstrated strong cleaning and refreshing effects, along with a positive cumulative impact on oral hygiene and a significant reduction in inflammation. Their anticaries benefits were confirmed, and they also reduced enamel hypersensitivity. The tested toothpastes were well-tolerated, with no reports of allergic reactions or irritation.

Relevance. Common physiological human suffering is headache. The prevalence of headache ranks third after back pain and joint pain in the structure of muscle-fascial pain syndromes. However, headaches and facial pains associated with muscle-fascial trigger points are much more common than headaches and facial pains caused by other causes. An extremely irritated area of skeletal muscle associated with an oversensitive palpable node located in a compacted bundle is the muscle–fascial trigger points. In the pathogenesis of headaches, a major role belongs to dysfunction or disease of the temporomandibular joint, age-related changes in the masticatory muscles, jaws and teeth and all elements of the TMJ occuring during a person’s life. In some cases, minor changes in the occlusion of teeth and jaws, as well as a stressful situation, lead to a painful spasm of the masticatory muscles. Goal. To analyze the clinical characteristics of tension headache in patients with occlusive disorders (OD) and physiological occlusion (PO). Material and methods. The study covered 210 patients with occlusion disorders and 92 patients with the signs of physiological occlusion. 141 patients from the first group and 32 patients from the second group complained of a headache. Occlusal relationships of teeth were analyzed in the position of central and dynamic occlusion. The destruction of the hard tissues of the teeth and partial adentia, as well as anomalies and deformities of the dentition were determined as the disorder of occlusion. The study of the muscles of the maxillofacial region and neck was carried out using the techniques described in the book by Travell J.G., Simons D.G. (2005). A visual-analogue pain assessment scale and a Russified McGill’s questionnaire on the nature of pain were used to identify the nature of the pain syndrome, the severity of pain. The assessment was carried out at a consultative appointment, the localization, nature, duration and intensity of pain, as well as the specificities of the pain syndrome being taken into account. When examining muscles, to quantify the data obtained the muscle syndrome index (IMS) was evaluated. The analysis of the research results was carried out using nonparametric criteria. Results. According to the severity of the pain syndrome, the use of a visual analogue scale (VAS) of pain allowed us to divide all patients into 3 groups: with mild pain, with moderate and with severe pain. According to the international classification of headaches, episodic and chronic headaches were distinguished. In patients with OD, the headache becomes chronic more often and is felt more intense than in patients with PO. Among the patients complaining of a headache, in patients with OD the IMS is higher than the IMS of the muscles of the masticatory complex, and in patients with PO the IMS is higher than the IMS of the neck muscles. Conclusions. Female patients with OD and PO suffer from tension headache more often than male patients. In patients with OD, musculo-fascial headaches are twice as common, have a more pronounced character and become chronic more often than in patients with PO. The severity of the IMS of the masticatory muscles in patients with OD is 2.5 times higher than in patients with PO.

A research using index methods for assessing the hygiene of removable orthopedic denture splints was carried out. The purpose of the article is to study the evolution of objective methods for assessing the hygienic state of removable dental and complex orthopedic denture splints. A patent and information search was carried out in the databases eLIBRARY, Pub Med, Web of Science and Scopus to achieve this goal. The search for materials from original literary resources was done by keywords. 50 resources were analyzed: 47 Russian and 3 foreign ones. The work presents the analytical review of the issues. The chronological sequence shows the existing methods of index assessment of the hygiene of removable orthopedic denture splints. Their advantages and disadvantages were described. Objective index assessment of the hygienic state of the oral cavity as a whole, removable dental and maxillofacial orthopedic denture splints in particular is quite relevant. A quick, convenient, objective and accurate assessment of the hygienic state of the oral cavity in general and removable orthopedic structures using various indices is important to prevent pathological processes that occur after the application of removable orthopedic splints to the support tissues of the prosthetic bed and their subsequent use by the patient, first of all, in the dynamics of clinical observations.

The article presents the results of a survey of young people from 18 to 30 years who have undergone COVID-19. The study conducted a quantitative and qualitative analysis of lesions of the oral mucosa in medical university students during the period of COVID-19 disease and after recovery and identified the most common lesions of the oral mucosa associated with coronavirus infection. Pathological changes in the oral cavity have been identified, including with a mild course of coronavirus infection, reducing the quality of life, health and without timely treatment, leading to serious consequences. The obtained results of the study and the high percentage of manifestations characterizing postcovid syndrome justify the need for dental examination of these patients after their clinical recovery. The relationship between the course of the underlying disease COVID-19 and the severity of the lesion of the oral mucosa was revealed. It is determined that the more complex the form of the underlying disease, the longer and more severe the duration of dental symptoms. The role of a dentist in the timely diagnosis of dental manifestations in patients who have had a coronavirus infection and the selection of the most adapted treatment regimen depending on the clinical manifestations in the oral cavity in order to prevent the development of complications and the severe course of the identified pathology is shown.

Латеральная крыловидная мышца обладает своими отличительными анатомическими особенностями и сложностью функции. В связи с этим нами изучены функции латеральной крыловидной мышцы при обследовании пациентов в клинике ортопедической стоматологии. Цель работы — исследовать проявления спазма латеральной крыловидной мышцы у взрослых пациентов в клинике ортопедической стоматологии. Обследовали 78 пациентов от 18 до 35 лет с односторонним гипертонусом латеральной крыловидной мышцы, который был выявлен в ходе консультативного приема в клинике ортопедической стоматологии. Оценивали мышечный тонус латеральной крыловидной мышцы с наличием триггерных точек. Методы диагностики включали опрос, осмотр лица, органов и тканей рта, рентгенологическое обследование, оценку состояния и функции опорно-двигательного аппарата. Для оказания первой неотложной помощи при болях и симптомах, связанных с дисфункцией височно-нижнечелюстного сустава, проводилось мануальное лечение жевательных мышц в стоматологическом кресле. Обследуемые пациенты жаловались на боли в области височно-нижнечелюстного сустава, лица, уха, шум и звон в ухе, щелчки в области височно-нижнечелюстного сустава. Особую группу составили пациенты, испытывающие боль, вызванную сдавлением ветвей тройничного и лицевого нервов. Эти пациенты отмечали онемение и покалывание с одной стороны щеки, непроизвольное подергивание нижнего века. Нами выявлены триггерные точки в верхней головке латеральной крыловидной мышцы у 79% обследованных, в нижней головке латеральной крыловидной мышцы у 100% обследованных, в височной мышце — у 96%, в медиальной крыловидной мышце — у 90% пациентов и у 96% пациентов в собственно жевательной мышце. Отмечено, если боль или болезненность была выявлена в верхней головке латеральной крыловидной мышцы с одной стороны, то и с другой стороны выявляются боль и укорочение нижней головки латеральной крыловидной мышцы. В этих случаях пациенты больше жевали на противоположной стороне. Исследование окклюзионных взаимоотношений показало значительно больше нарушений в трансверзальном направлении. Рентгенологическое обследование височно-нижнечелюстного сустава у всех обследуемых не выявило костной патологии. При постурологическом обследовании у всех обследуемых пациентов имелись признаки нарушения постуральной системы и функций опорно-двигательного аппарата разной степени выраженности, преимущественно во фронтальной плоскости. После мануального лечения всех жевательных мышц эти жалобы и симптомы исчезли. Болевой синдром при спазме латеральной крыловидной мышцы обусловлен триггерными точками в самой латеральной крыловидной мышце, невропатической болью или дисфункцией мышц, вызываемой компрессией ветвей тройничного и лицевого нервов. Боль и дисфункция латеральной крыловидной мышцы могут вызывать мышечно-фасциальную боль, проблемы со слухом — боль, шум и звон в ухе, нарушение жевания и окклюзии в трансверзальном направлении. Кроме того, при планировании лечения трансверзальных аномалий прикуса следует учитывать функциональное состояние ОДА. Due to the peculiarities of the anatomy and the complexity of the function of the pterygoid muscle we decided to investigate the state of the lateral pterygoid muscle function when examining patients in the clinic of orthopaedic dentistry. Objective: to investigate the manifestations of the lateral pterygoid muscle spasm in adult patients in the clinic of orthopaedic dentistry. . The study was carried out in 78 patients aged 18 to 35 years with unilateral hypertonicity of the lateral pterygoid muscle, which was revealed during a consultative appointment at the clinic of orthopaedic. The muscle tone of the lateral pterygoid muscle was assessed by the presence of trigger points. Diagnostic methods included taking medical history, examination of the face and oral cavity, X-ray examination, assessment of the condition and function of the musculoskeletal system. To provide first aid for pain and symptoms associated with the temporomandibular joint dysfunction, manual treatment of masticatory muscles was performed in the clinic of orthopaedic dentistry in a dental chair. . The patients examined complained of pain in the area of the TMJ, the face, the ear, noise and ringing in the ear, clicks in the TMJ area. A special group consisted of patients experiencing pain caused by compression of the branches of the trigeminal and facial nerves. These patients noted numbness and tingling on one side of the cheek, involuntary twitching of the lower eyelid. We identified trigger points in the upper head of the LPM in 79% of the examined patients, in the lower head in 100%, in the temporal muscle — in 96%, in the medial pterygoid muscle — in 90% of patients and in 96% of patients — in the masticatory muscle itself. We noted that if pain or tenderness was detected in the upper head of the lateral pterygoid muscle on one side, then pain and shortening of the lower head of the lateral pterygoid muscle were detected on the other side. In these cases, patients chewed more on the opposite side. The study of occlusal relationships showed a significantly greater number of disorders in the transverse direction. X-ray examination of the temporomandibular joint in all patients revealed no bone pathology. A posturological examination showed that all the examined patients had signs of disorders of the postural system and functions of the musculoskeletal system of varying degrees of severity, mostly in the frontal plane. After manual treatment of all masticatory muscles, these complaints and signs disappeared. . Pain syndrome in LPM spasm is due to: trigger points in the LPM itself; neuropathic pain or muscle dysfunction caused by compression of the branches of the trigeminal facial nerves. Pain and LPM dysfunction can cause: musculofascial pain; hearing problems — pain, noise and ringing in the ear; chewing disorders; violation of occlusion in the transversal direction. Also, when planning the treatment of transversal malocclusion, the functional state of the musculoskeletal system should be taken into account.

OBJECTIVE:The aim of the study is to increase the effectiveness of diagnostics of microhemocirculatory changes in periodontal tissues in anatomical and functional disorders of the mucogingival complex, based on the use of the method of discriminant analysis of ultrasound opplerography. MATERIAL AND METHODS:187 patients aged 18-44 years (young age according to WHO) were examined without concomitant somatic pathology with various variants of anatomical structures of the mucous-gingival complex, which included an assessment of blood flow in periodontal tissues by ultrasound dopplerography at rest and during a functional test of the tension of the soft tissues of the upper and lower lip, cheeks using an opt-out. After qualitative and quantitative analysis of dopplerograms, an automated assessment of the microhemocirculation of the studied structures was performed, identifying differences between groups using step-by-step discriminant analysis with the study of several variables. RESULTS:Depending on the type of reaction to the sample, a model of the distribution of patients into separate groups based on the application of the discriminant analysis method is proposed. It was found that patients of all groups were classified statistically significantly (p<0.05) and the possibility of distributing patients according to the described criteria (the ratio of the maximum systolic blood flow rate along the mean velocity curve, Vas) to a specific class corresponding to the highest value of the function was proved. CONCLUSION:The proposed method for assessing the functional state of periodontal tissue vessels allows classifying patients with high accuracy and a minimum of the probability of false results, reliably assess the degree of existing functional disorders, determine the prognosis and further tactics of therapeutic and preventive measures and can be recommended for use in clinical practice.

УДК 378.14 РОЛЬ ФОРМИРОВАНИЯ ОБЩЕКУЛЬТУРНЫХ КОМПЕТЕНЦИЙ У ИНОСТРАННЫХ СТУДЕНТОВ МЕДИЦИНСКОГО ВУЗА В ПОВЫШЕНИИ АДАПТАЦИИ К ОБУЧЕНИЮ В РОССИИ Токмакова С.И. 1

Relevance. Mouthwashes occupy a special place among the oral hygiene products range for their wide prevalence and high effectiveness. At the same time, their unreasonable use can lead to an oral microbial imbalance for the pronounced antimicrobial activity of the mouthwashes. Aim. To evaluate the effect of mouthwashes with various preservative systems on the normal oral microbiota quantity and to assess the possible risk of dysbiotic changes if used regularly for prevention purposes. Material and methods. The study examined the antimicrobial properties of nine experimental samples of mouth-washes developed for home oral care. The study included 110 healthy volunteers and collected 2 ml of unstimulated saliva from the subjects before toothbrushing and 5, 30, 60 and 180 minutes after rinsing with a test product for 1.5-2 minutes. The microbiological laboratory plated saliva samples and counted the number of colony-forming units. The results were statistically processed. Results. The analysis of the average microbiota levels for all the products at various time points revealed that the number of viable bacteria in the oral cavity decreased by no more than 1.5 orders of magnitude, except for 0.2% chlorhexidine mouthwash. This decrease is short-term, and for most mouthwashes, there were no statistically significant differences in the number of colony-forming units in 60-180 minutes compared to the baseline. Conclusion. All the tested samples of mouthwashes do not significantly affect the microbiota and, consequently, can be recommended for daily home oral care practice.

Based on literature data, this article reviews a range of problems associated with hygienic care after obturation prostheses and the oral cavity after combined treatment of malignant neoplasms. At the present time, replacing prosthetic care after maxillary resection due to malignant neoplasms using obturator prostheses is the main method for rehabilitation of oncological patients. Such methods as dental prosthetic care based on dental implants and removable dentures for elimination of partial and complete edentulism is impossible in such conditions. A defect in the maxilla, an oronasal fistula, post-operative and post-radiation jaw contracture as well as hyposalivation, impair the hygiene of the oral cavity. Acrylic plastics used for production of obturator prostheses have such substantial flaws leading to development of inflammation and progression of atrophy in the supporting tissues of the basal seat. This reduces short-term and long-term efficacy of orthopaedic dental rehabilitation procedures after replacing dental prosthetics. A conclusion has been drawn on the necessity of development and practical introduction of a special complex of dental hygienic procedures — professional and individual — adapted for oncological patients that would be implemented within the framework of dynamic dispensary observation in the setting of a dental polyclinic.

Неудовлетворительное гигиеническое состояние ротовой полости является определяющим фактором в развитии основных стоматологических заболеваний. В стоматологии все большее значение приобретают информированность и мотивация пациента к выполнению профилактических мероприятий. С целью выявления знаний в вопросах стоматологического здоровья проведено анкетирование взрослого населения Барнаула, посещающего стоматологические клиники. В результате получены сведения о гигиенических знаниях и навыках, владение которыми способствует снижению интенсивности и частоты наиболее распространенных стоматологических заболеваний. Результаты проведенного исследования свидетельствуют о недостаточном уровне гигиенического воспитания населения, что требует корректировки комплекса санитарно-просветительных мероприятий в стоматологических лечебно-профилактических учреждениях.

The preservation and long-term aesthetic effect of restoration largely depends on the quality of the finishing treatment of its surface. The aim of the study is to perform a laboratory study of the surface quality of a nanofilled composite treated with various polishing systems. Material and methods. An experimental study was conducted on 60 samples made of nanofilled composite. Depending on the polishing system used to finish the surface, the samples are divided into 6 groups. To assess the quality of polishing, visual analysis of macro photographs taken with stereo microscope (magnification 40), as well as laboratory assessment of the edge angle of wetting of the surface were carried out. Results. The results obtained during the visual evaluation were confirmed during a laboratory experiment to study the wetting edge angle. Samples treated with fine-grained and ceramic burs had higher wetting angle values and lower visual evaluation results. Polishers and finishers better polish the surface of the composite, but the perfect shiny gloss when using them cannot be achieved. The best aesthetic result is obtained when using a system of polishing discs of different degrees of abrasiveness. Conclusion. Creating a glossy finish requires a combination of several tools of varying degrees of abrasiveness and geometric shape. The results of the domestic polishing system are comparable with imported analogues.

ЦИТОКИНОВЫЙ ПРОФИЛЬ КРОВИ КРЫС ПРИ ЭКСПЕРИМЕНТАЛЬНОМ ПАРОДОНТИТЕ И ДЕЙСТВИИ ИММУНОМОДУЛЯТОРОВ

Experimental prostatitis in rats was reproduced by administering a 0.05% formaldehyde solution of 0.01 ml on the background of benign prostatic hyperplasia, which was simulated by chronic administration of sulpiride 40 mg/kg for 30 days. From the 26th to the 30th day of the course administration of sulpiride, one of the immunomodulators was injected into the animals: polyoxidonium 0.75 mg/kg, trekrezan 25 mg/kg or metaprot 25 mg/kg. Control rats received saline in an equivalent volume (0.2 ml). The volume of the prostate gland of rats under the influence of sulpiride increased 2.5 times, and after the introduction of formaldehyde into the gland - even more than 3 times. Experimental prostatitis was accompanied by a decrease (by 30-39%) in the concentrations of anti-inflammatory cytokines (IL-4 and IL-10), the immunoregulator IL-2, and IL-12 (p70), the level of interferon-γ has not changed. The pool of pro-inflammatory cytokines increased (IL-1β and IL-17 - by 33% and 75%, respectively, TNFα, IL-6, and MCP-1 chemokine - by more than 2-3 times). Against this background, the concentration of the anti-inflammatory cytokine IL-13 increased by more than 4 times. A course of administration (5 days) of immunomodulators, polyoxidonium, trekrezan or metaprot reduced the volume of the prostate gland by 28-44% and optimized blood levels of IL-1β, IL-17A, IL-13 and chemokine. The level of pro-inflammatory (IL-2, IL-12, INFα) and anti-inflammatory cytokines (IL-4 and IL-10) has become much higher. The limitation of the cytotoxic effect of IL-6, one of the leading inflammatory mediators, is noted. The effectiveness of immunomodulators was as follows: polyoxidonium > trekrezan > metaprot (in descending order of activity). Apparently, the restoration of the immunoregulatory function of anti-inflammatory cytokines IL-4 and IL-10 and the restriction of the production of pro-inflammatory cytokines is one of the sanogenetic mechanisms of the complex adaptive action of the studied drugs.

Experimental bronchopneumonia was modeled by administering turpentine to the trachea under ether anesthesia. After the operation, the solution of one of the studied immunomodulators was intraperitoneally administered to the animals for 5 days (1 time/day): polyoxidonium - 0.75 mg/kg, trekrezan 25 mg/kg or metaprot 25 mg/kg. After decapitation, the interleukin profile was determined in the blood using commercial kits (Merk). Inflammation decreased blood concentrations of both proinflammatory factors (IL-1β, IL-2, IL-12, INF-γ and chemokine MCP-1), and anti-inflammatory (IL-4, IL-10) cytokines. At the same time, the levels of TNFα and IL-6, as well as the anti-inflammatory cytokine IL-13, increased. The introduction of immunomodulators, polyoxidonium, trekrezan or metaprot substantially normalized the level of pro- (IL-1β, IL-2, IL-12 (p7), chemokine MCP-1, INFα) and anti-inflammatory cytokines (IL-4, IL-10). The anti-inflammatory effect of drugs is associated with the normalization of cytokine metabolism.