Clinical Dentistry (Russia)

Antiadhesive and antimicrobial effect of titanium oxide coating with anatase structure in in vitro experiments for medical implants

Wed, 02 Oct 2024 00:00:00 +0300

The combination of strength characteristics of titanium alloys, in particular Ti6Al4V, as well as the pronounced bioactive properties of titanium oxide coatings are of significant interest for their joint use in medical structures, which makes necessary to examine their anti-adhesive and antimicrobial properties. This problem takes priority in prosthetics of joints (hip, knee), complex prosthetics in the maxillofacial region (for gunshot and shrapnel wounds), as well as in orthopedic correction after head and neck surgery. Purpose of the study — determination of adhesion of microorganism strains to samples of titanium alloy Ti6Al4V ELI (ASTM F136 standard) with various types of the surface treatment, including titanium oxide coating with an anatase crystalline structure obtained via atomic layer deposition.
Materials and methods.
Properties of titanium alloy Ti6Al4V samples with various types of surface treatment, including the growth of a TiO2 coating with an anatase crystalline structure (samples prepared by CONMET LLC, Moscow), were studied, which are considered as likely candidates for complex orthopedic treatment of patients of various profiles (in particular, using dental implants and artificial joints). Microbiological and molecular biological methods were used, which make it possible to quantify the indicators of microbial adhesion in vitro to the test samples.
Results.
For the first time, the results of a comparative assessment of adhesion degree of sanitary-important microorganisms (Staphylococcus aureus, Escherichia coli, Candida albicans) and anaerobic bacteria (Actinomyces israelii, Porphyromonas gingivalis, Fusobacterium necroforum) to samples made of Ti6Al4V alloy with titanium oxide anatase coating have been obtained.
Conclusion.
The lowest adhesion values for all tested strains of microorganisms, including periodontal pathogenic species of anaerobic bacteria and yeast fungi of the genus Candida, were detected when using Ti6Al4V alloy samples covered with a TiO2 anatase coating, which can be interpreted as the bactericidal and fungicidal properties of this coating.

The effect of hyperglycemia in type I diabetes mellitus in children aged 7–12 years on the condition of periodontal tissues in acute periodontitis

S.N. Gontarev, I.S. Gontareva, A.A. Bogdanova, A.I. Stepanova — Wed, 02 Oct 2024 00:00:00 +0300

In the pediatric population, acute periodontitis is an urgent dental pathology, the risk of which increases significantly against the background of type I diabetes mellitus. However, the effect of different levels of hyperglycemia on the parameters of dental indices in children aged 7—12 years with type I diabetes mellitus has not been sufficiently studied. The aim of the study was to study the effect of hyperglycemia in type I diabetes mellitus in children aged 7—12 years on the condition of periodontal tissues in acute periodontitis.
Materials and methods.
The study was conducted among 85 children aged 7—12 years with acute periodontitis and type I diabetes mellitus (the main group) and 82 patients of the same age with acute periodontitis without type I diabetes mellitus. The level of hyperglycemia was determined by the amount of glycated hemoglobin. When assessing the condition of periodontal tissues, the following were used: gingival inflammation, Green-Vermillion index, tooth mobility, bleeding during probing, determined by a generally accepted method.
Results.
In patients with acute periodontitis with type I diabetes mellitus and without the latter, the values of gingival inflammation, the Green-Vermillion index, and bleeding during probing were statistically significantly higher, amounting to 1.8±0.3 and 1.9±0.2 points, 0.5±0.04 minutes and 0.7±0.2 points, 1.2±0.1 points, 0.1±0.06 minutes (p<0.01), respectively. An increased glycemic level of more than 8.4% had a more negative effect on all dental indices with a reliable association and 95% confidence intervals, with the exception of dental mobility, which had a relative risk of 0.83 (p<0.357).
Conclusion.
The amount of hyperglycemia over 8.4% in type I diabetes mellitus in children aged 7—12 years significantly worsens the condition of periodontal tissues according to most dental indices.

Experimental assessment of abrasive wear of hard the reference ceramic sample when using various dental prophylactics

S.K. Matelo, S.V. Apresyan, A.G. Stepanov, A.V. Akulovich — Wed, 02 Oct 2024 00:00:00 +0300

The analyzes the essence of the interpretation of the results of the values of abrasive wear of hard dental tissues obtained during research using the developed technique with the values of the relative dentin abrasion index (RDA — Relative Dentin Abrasivity). Using a patented rotary machine, comparative studies were conducted on accelerated cleaning of ceramic samples using brushes of different hardness and buffer compositions with different content of abrasive particles and a certain abrasion time. It has been proven that with an increase in the abrasiveness of toothpastes, the abrasive wear of hard tooth tissues increases.

Evaluation of the long-term results of the effect of different application adhesive agents in the complex of local treatment of recurrent aphthae of the oral cavity in patients against the background of clinical manifestations of classical and mediated hypersecretory diseases of the gastrointestinal tract

Wed, 02 Oct 2024 00:00:00 +0300

The goal of the study is to evaluate the long-term results of local treatment and to identify risk predictors of increased recurrence rate of aphthous stomatitis after treatment in patients against the background of clinical manifestations of classical and mediated hypersecretory diseases of the gastrointestinal tract.
Materials and methods.
Fifty-eight individuals with recurrent aphthous stomatitis (K12.0) against the background of clinical manifestations of classical and mediated hypersecretory diseases of the gastrointestinal tract (GI) have been selected by the method of a monocentric observational uncontrolled prospective study. Poisson regression has been used to identify risk predictors of increased recurrence rate of aphthous stomatitis after treatment.
Results.
The recurrence rate of aphthous stomatitis 2 times a year prevails in patients against the background of manifestations of classical and mediated hypersecretory GI diseases. Among men, clinical manifestations of recurrent oral aphthae with a frequency of once a year have been detected in 56% of cases, twice a year in 33% of cases, and 3 times a year in 11%. In women, these indicators are as follows: once a year — 35%, twice a year — 55%, 3 times a year — 10%. The synergistic effect of the complex possessing a pronounced antiseptic, antimicrobial, antifungal, anti-inflammatory effect due to the adhesive property of Cholisal and diode laser, epithelization and regeneration of the oral mucosa due to the powdered form of platelet autologous plasma in the aggregate had a significant advantage over the well-known treatment, and also influenced the reduction of the recurrence rate. The treatment complex proposed in subgroups with chronic hypersecretory gastritis and duodenitis contributed to the absence of recurrences (p<0.001) as compared to the patients with chronic pancreatitis with hyperacid gastric secretion (p<0.05) during the follow-up period of up to a year. In the clinical subgroups using the well-known method, no effect has been achieved in reducing the recurrence rate during one year of follow-up. The Poisson regression identified risk predictors of increased recurrence rate of aphthous stomatitis within one year of treatment: duration of GI disease (HR=1.259, 95% CI: 1.187—1.338), presence of classic GI disease in a patient as compared to the presence of mediated disease (HR=1.150, 95% CI: 1.083—1.221), the treatment complex proposed as compared to the well-known treatment (HR=0.941, 95% CI: 0.912—0.969).
Conclusion.
In patients with recurrent aphthous stomatitis (K12.0) manifested against the background of classical and mediated hypersecretory diseases of the gastrointestinal tract, the applied three-stage complex of local treatment in conjunction with supportive and antiretroviral therapy contributes to the reduction of the recurrence rate.

Peculiarities of functional activity of antioxidant enzymes in oral fluid of patients with aphthous stomatitis during therapy

Wed, 02 Oct 2024 00:00:00 +0300

Chronic recurrent aphthous stomatitis (CRAS) Is a chronic inflammatory disease of the mucous membrane of the oral cavity. Patients with CPAS are characterized by an increase in the activity of pro-oxidant processes and decreased function of the antioxidant system. The aim is to study the functional activity of antioxidant enzymes in the oral liquid of patients with CRAS on the background of therapy with antiseptics and reparants.
Materials and methods.
The oral fluid of 60 people with the diagnosis of CRAS was studied with the diagnosis of CRAS, divided into 2 equal groups: in the group I patients used chlorhexidine for rinsing (control), in group II — octenidine+phenoxyethanol for 7 days. After 7 days the treatment was continued with reparants (Kolitex-gel-DNA-L, deproteinized dialysate from the blood of healthy dairy calves, sea buckthorn oil, sea buckthorn oil), calves, sea buckthorn oil), for which each group of patients was divided into three subgroups. To assess the enzyme link of the antioxidant system we determined activity of superoxide dismutase, catalase, glutathione reductase and glutathione peroxidase on the 1st, 7th and 21st days of the study in oral fluid.
Results.
In patients of control group I on the 7th day the activity of catalase increased by 20,9%, SOD activity — by 22,2%, GR activity — by 20,4%, GP activity — by 56,4% of the initial value. 56.4% of the initial value, and in group II patients the activity of catalase increased by by 28.2%, SOD activity — by 30.8%, GR activity — by 25.5%, and GP activity — by 82.7% of the initial value.
Conclusions.
In patients with aphthous stomatitis the functioning of the of antiradical defense enzymes in oral fluid is in imbalance. At The use of antiseptics with an anesthetic together with various reparants in patients with CRAS, there is a restoration of the activity of enzymes of antiradical defense enzymes in the oral fluid, which plays an important role in the therapy of chronic inflammatory diseases of chronic inflammatory diseases. The use of antiseptics and reparants helps to equalize oxidative stress and improve the overall condition of the oral cavity of the oral cavity in patients with CRAS.

The effect of glazing and thermocycling on microhardness of different milled ceramic laminate veneers with SEM observations

F.R. Ahmedbeyli, R.M. Ahmedbeyli, M. Ersoy — Wed, 02 Oct 2024 00:00:00 +0300

CAD/CAM technology is one of the fastest growing areas of digital restorative dentistry. The aim of the study was to evaluate in vitro the effect of glazing and thermocycling on the microhardness of ceramic veneers under the assumption that there is a significant difference between the microhardness values of different glazed and unglazed CAD/CAM materials.
Materials and methods.
The microhardness of 80 veneer specimens from four different ceramic CAD/CAM materials were measured: 1) IPS E.max CAD lithium disilicate ceramic (Ivoclar, Germany); 2) IPS Empress CAD leucite glass ceramic (Ivoclar); 3) Cerec feldspathic ceramic (Dentsply Sirona, Germany); and 4) Cerasmart hybrid ceramic (GC, Japan). All specimens were divided into 4 equal groups, and in each group, half (10) of the veneers were glazed. All veneer specimens were subjected to 10,000 thermocycles to simulate one year of service. Vickers microhardness values were measured at three stages: after milling, after glazing, and after thermocycling. SEM images of the surface of the samples after milling and after thermocycling were also obtained.
Results.
Statistically significant differences between microhardness values of different materials after glazing and thermocycling were revealed. Microhardness values after glazing decreased by 5% for E.max, by 7—9% for Empress and Cerec, and by 34% for Cerasmart. E.max specimens showed higher microhardness values after glazing (601±13 MPa) compared to Empress (575±12 MPa), Cerec (453±16 MPa), and Cerasmart (76 MPa; p<0.05). Glazed surface analysis also revealed statistically significant differences after thermocycling (p<0.05). Tamhein's T2 post hoc test confirmed that the microhardness values of the E.max group were significantly higher after thermocycling compared to the Cerasmart, Empress and Cerec groups (p<0.05). The effect of thermocycling was also evident for unglazed samples where the E.max group showed higher microhardness values (641±7 MPa) compared to Cerasmart, Empress and Cerec groups (p<0.05).
Conclusion.
Glazing and thermocycling reduced the microhardness of veneers made of the investigated materials. E.max and Empress samples showed the highest microhardness of about 600 kgf/mm2. Comparable values of about 500 kgf/mm2 were shown by Cerec feldspathic ceramics. The microhardness of Cerasmart samples was much lower, in the order of 100 kgf/mm2 (p<0.05). The study highlights the importance of glazing and thermocycling in evaluating the microhardness values of ceramic CAD/CAM materials, revealing the peculiarities of their behavior in clinical use. Thermocycling did not significantly decrease the microhardness.

Influence of intracanal drug therapy on the content of proinflammatory interleukins in root canal exudate in teeth with experimental apical periodontitis

A.P. Pedorets, A.G. Pilyaev, V.A. Klyomin, O.V. Shabanov, S.I. Maksyutenko — Wed, 02 Oct 2024 00:00:00 +0300

Material and methods.
The content of proinflammatory interleukins IL-1β and TNF-α in the exudate of the root canal of teeth with preserved and artificially destroyed apical orifice (AO) in the modeling of experimental periodontitis on 12 premolars of the lower jaw of dogs was studied in this work. Interleukins (IL-1β and TNF-α) were determined in root canal exudate by enzyme immunoassay. The dynamics of interleukin content changes after intracanal medical therapy with the calcium hydroxide-based preparation Calasept was analyzed separately in teeth with preserved and artificially destroyed apical foramen.
Results.
The mean IL-1β content in root canal exudate of teeth with destroyed AO was 5.56±0.96 pg/mL, which was significantly higher (p<0.05) than in teeth with preserved apical orifice (2.83±0.43 pg/mL). TNF-α content was not different in teeth with preserved and destroyed AO (p>0.05). Despite significant differences in mean values, IL-1β content was not obligatorily related to AO status (χ2=0.34; p=0.59). As a result of intracanal therapy, in teeth with preserved AO, IL-1β content was 1.41±0.68 pg/mL, which was significantly lower than baseline (t=1.76; p<0.05). In teeth with artificially destroyed AO the IL-1β content was 6.16±1.02 pg/mL, practically did not differ (t=0.43; p>0.05).
Conclusions.
The decrease of IL-1β content in root canal exudate after intracanal medical therapy may be an indirect evidence of the effectiveness of endodontic treatment only in teeth with preserved AO. In teeth with destroyed AO, intracanal medical therapy was not obligatorily associated with a reduction in the inflammatory response in the periodontium.

Comparative assessment of the quality of dental canal filling with domestic and foreign materials

V.Y. Vashneva, L.Yu. Orekhova, T.V. Porkhun, M.S. Evchenko — Wed, 02 Oct 2024 00:00:00 +0300

The favorable outcome of endodontic root canal treatment is significantly influenced by the choice of obturation material. Epoxy resin-based sealants are among the endodontic materials widely used in clinical practice. It is important to consider such properties as polymerization time, flowability, adaptation to dentin, and strength when selecting a sealant. In addition, materials may differ in terms of biocompatibility and availability. An important aspect is the availability of sealants in the Russian market. Therefore, it is necessary to study the products of domestic manufacturers in order to find analogues of foreign materials. The aim was to perform a comparative evaluation of the quality of root canal obturation with epoxy resin-based sealants.
Materials and methods.
Forty-five one-, two-, and three-root extracted teeth with untreated root canals were selected for the study. Their root canals were treated mechanically and medically according to a standard protocol. The teeth were then randomly divided into 3 groups and filled using the lateral condensation method: Group I — “AH Plus” (USA), group II — “Epoxidine” (Russia), group III — “ViEdent” (Russia). The tightness of root canal obturation was compared by staining with 2% methylene blue and by SEM.
Results.
SEM showed that “AH Plus” and “ViEdent” had better sealing ability than “Epoxidine”. Methylene blue staining showed that the lowest dye penetration was observed when root canals were obturated with “AH Plus”.
Conclusion.
The best sealing ability was obtained by “AH Plus”, the second place was held by “ViEdent” and the third place by “Epoxidine”.

Analysis of the causes and features of the course of gum recession in various clinical conditions

Wed, 02 Oct 2024 00:00:00 +0300

Dentist’s patients are increasingly making high aesthetic demands, striving for a successful and attractive image. One of the obstacles to a beautiful smile is the problem of gum recession, which in many cases is associated with diffraction defects, hypersensitivity of dentin, gingival inflammation and bruxism. The problem of predicting the course of gum recession and planning adequate comprehensive treatment remains an acute issue. The purpose of the study is to summarize the available data and analyze the causes and features of the course of gum recession in various clinical conditions.
Materials and methods.
A systematic review of the literature data was conducted, 7456 publications were found, presented in international electronic databases: PubMed, Google Search, Ebsco, Embase, Web of Science, ScienceDirect, SciELO and eLibrary from 2013 to 2023. Based on the selection criteria, 43 publications were selected, which included the results of studying the etiology, pathogenesis, prevalence, diagnosis, clinical course, features of treatment and prevention of gum recession. The methodology of this study meets the requirements for systematic reviews and meta-analyses of PRISMA.
Results.
The study analyzes the causes of gum recession: the role of traumatic and microbial factors is evaluated, the features of periodontal biotype, structure, position and function of teeth, features of jaw bone tissue, features of the anatomical structure of gum tissues and the influence of somatic pathology are described. The clinical conditions associated with gum recession are considered: smile aesthetics, dentin hypersensitivity, root caries, non-carious lesions of hard tissues of teeth, orthodontic treatment. Special attention is paid to the probability of progression of gum recession.
Conclusions.
The presented detailed systematic analysis showed that the problem of gum recession today has a high prevalence and has not been sufficiently studied. The authors agree that it is necessary to build a clear system of primary prevention of gum recession and the clinical conditions accompanying it. The periodontal status of the patient should be carefully studied already at the planning stage of orthodontic, therapeutic, orthopedic and surgical treatment. The data obtained during the study can help dental practitioners and researchers in rational planning and an integrated approach to the treatment and prevention of gum recession.

The effect of vaccination against COVID-19 on the condition of periodontal tissues

A.A. Remizova, J.I. Tingaeva, M.G. Dzgoeva, G.G. Mar'in, A.K. Fardzinova — Wed, 02 Oct 2024 00:00:00 +0300

Despite an in-depth analysis of the symptoms of the new coronavirus infection, the mechanism of the effect of vaccination on the condition of periodontal tissues has not been sufficiently studied.
Materials and methods.
We examined 290 patients treated in COVID-hospitals: 140 patients underwent (Group I) and 150 people were not vaccinated against COVID-19 (Group II). The control groups included 204 individuals without comorbidities: 101 vaccinated (Group III) and 103 unvaccinated (Group IV). The examination included measurement of microcirculation and oxygenation index in periodontal tissues by laser Doppler flowmetry.
Results.
In unvaccinated patients, previously treated in COVID-hospitals, statistically significantly decreased microcirculation index (17.3—22.6 BPU) and hemoglobin oxygen saturation level (78.3—84.9%) were revealed in comparison with vaccinated ones (22.5—27.9 BPU and 82.3—88.7%, respectively). In patients who had previously undergone a new coronavirus infection, a statistically significant decrease in the microcirculation and oxygenation indices of periodontal tissues compared to the control groups is preserved in the distant periods. A pronounced decrease in microcirculation and saturation indices is observed in patients re-hospitalized for a new coronavirus infection, and this is natural in view of the proven disorders of hemostasis and endothelial dysfunction in this pathology. The analysis of the obtained results allows us to speak about the absence of influence of the fact of vaccination on the state of periodontal tissues in the persons of control groups.
Conclusions.
In the distant results of the studies in vaccinated and unvaccinated COVID-19 patients treated in the red zone, reliable differences in the changes of microcirculation in periodontal tissues were revealed. It was found that in 8.6% of cases, unvaccinated patients were hospitalized after reinfection with COVID-19 and 1.3% died, while in vaccinated patients hospitalization in COVID wards was 0.7%.

Analysis of the stress-strain state in the restoration of a missing clinical crown

Wed, 02 Oct 2024 00:00:00 +0300

The destruction of the clinical crown of a tooth is a common issue that is often encountered during a dental appointment. In order to restore the missing part of the tooth, dentists typically use pin structures, such as stump pin tabs or pin teeth, which are covered with artificial crowns. Currently, doctors have the ability to compensate for lost tooth crowns using indirect inlays and overlays, utilizing the walls of the pulp chamber as a support. However, the success of orthopedic dental treatment depends not only on the strength of these structures. The way the chewing force is distributed, as well as the combined stresses and deformations that occur when this force acts on the repaired teeth, significantly impact the long-term outcomes of prosthetics. The purpose of this study is to examine the stress-strain situation when using different orthopedic structures for restoring a completely lost clinical tooth crown.
Materials and methods.
The modeling of geometric models was performed using the Ansys SpaceClaim CAD software. Two variants of chewing force direction were simulated: vertical and at a 45° angle to the occlusal surface of the clinical crown. As a result of the calculations, a stress distribution pattern in the volumetric structure was obtained. Three orthopedic structures were selected for the study: 1) a cast stump post with a pin covered with an artificial zirconia crown (Group I); 2) an all-ceramic endocoronal restoration with a box-like cavity and a 10° inclination angle of the side walls (Group II); 3) — an inverted truncated cone-shaped all-ceramic restoration with converging lateral surfaces towards a smaller base at a 3° angle, with the perimeter of the small base being rounded (Group III).
Results.
The maximum stresses occurring in tooth tissues under vertical and oblique loads were highest in Group I and amounted to 9.46 and 14.58 MPa respectively. These values were 22 and 36% lower than in Group II, where maximum stresses under vertical and oblique loading were 7.42 and 9.28 MPa. In Group III, the lowest values of stress were observed under both vertical and oblique loads, at 4.46 and 5.21 MPa respectively. In addition, the use of all-ceramic endocorn implants resulted in a redistribution of forces and the elimination of concentrated stress zones at the implant-tooth interface, potentially reducing the risk of crack formation.
Conclusion.
The use of pinless endocorns, which are supported on the walls of the pulp chamber, allows for a significant redistribution of chewing forces and a reduction in the loads placed on the tooth stump, thus reducing the risk of fracture of the natural tooth tissues.

Features of the bioelectric activity of the masticatory and temporal muscles proper in patients with different levels of anxiety with dysfunction of the temporomandibular joints

S.V. Beinarovich, O.I. Filimonova, M.A. Izosimova, V.A. Fanakin, D.A. Tezikov — Wed, 02 Oct 2024 00:00:00 +0300

The aim of the study was to investigate the functional activity of the masticatory and temporal muscles according to surface electromyography (EMG) data at rest and with maximum clenching of the teeth in patients with different levels of personal and situational anxiety, suffering from dysfunctional disorders of the temporomandibular joint (TMJ).
Materials and methods.
The study involved 45 patients, 33 women and 12 men aged 19 to 36 years. The main cohort consisted of 33 patients with signs of dysfunction of the TMJ and masticatory muscles, the comparison group — 12 participants without signs of functional disorders. Based on the results of TMJ MRI, the patients of the main cohort were divided into 3 groups: I — 12 patients with dislocations of the TMJ articular discs without reposition; II — 10 patients with dislocations of the TMJ articular discs with reposition; III — 11 patients without intra-articular changes of the TMJ, but with clinical manifestations of muscle dysfunction (extra-articular dysfunction). To determine the level of anxiety in all participants, the Spielberger—Khanin method was used. Using EMG of the temporal and masticatory muscles, the maximum and average amplitude of bioelectrical activity of the masticatory muscles in a state of physiological rest and jaw compression were measured, the symmetry index of the temporal muscles and the symmetry index of the masticatory muscles were calculated.
Results.
In patients with dysfunction of the TMJ and masticatory muscles, the levels of situational and personal anxiety were 3.5—3.9 and 3.5—3.8 in group I, 3.5—3.9 and 3.5—3.8 in group II, 2.5—2.8 and 2.3—2.9 in group III, which was significantly higher compared to the anxiety levels of patients in the comparison group (1.5—1.9 and 1.3—2.0; p<0.01). The maximum and average amplitudes of biopotentials of the temporal and masticatory muscles in patients with TMJ dysfunction and masticatory muscles (850—911 and 55.4—58.3 mV at rest, 1289—1398 and 372—380 mV during jaw clenching, respectively) were significantly higher than the corresponding amplitudes of biopotentials of these muscles in patients of the comparison group (631—690 and 15.4—18.3 mV at rest, 954—1063 and 312—320 mV during clenching, respectively; p<0.01). In patients of groups I and II with intra-articular TMJ disorders, the most pronounced imbalance of functional activity between the masticatory muscles of the right and left sides was observed. The symmetry index of the temporal muscles in patients of groups I and II (80—81.2 and 77.7—103%) was significantly lower than in patients of groups III and IV (85—85.5 and 85.7—93.7%; p<0.01). The symmetry index of the masticatory muscles in patients of groups I and II (95.2—100 and 98.6—100%) was also significantly lower than in patients of groups III and IV (100%; p<0.01).
Conclusion.
Patients with dysfunction of the TMJ and masticatory muscles have increased and asymmetric bioelectrical activity of the masticatory muscles. In this regard, it is recommended to conduct EMG of the masticatory muscles to monitor the functional activity of the masticatory muscles and assess the effectiveness of therapeutic measures. In addition, it is recommended to conduct psychological testing of patients with TMJ dysfunction to determine the level of anxiety in order to include the help of a psychologist or psychotherapist in a comprehensive treatment plan.

The statistical characteristics of the electrical activity of the masticatory muscles in their functional impairments and pathology of the supporting tissues of the teeth

Wed, 02 Oct 2024 00:00:00 +0300

The aim of the study is to investigate changes in the electrical activity of the masticatory muscles in patients with various forms of parafunctions and combined dental arch deformity, characteristic of periodontal diseases.
Materials and methods.
Three groups of individuals with muscle parafunctions were examined: 1st group (n=21) — patients with teeth clenching, 2nd group (n=19) — individuals with teeth grinding, 3rd group (n=16) — subjects with both teeth clenching and grinding. A control group consisted of 15 physically healthy volunteers. To identify and evaluate neurotic conditions, the K.K. Yahin, D.M. Mendeleevich clinical questionnaire was used. The activity of the masticatory muscles was studied using concentric electrodes on the “Viking Quest” electromyograph. Morphological abnormalities of the temporomandibular joint were identified on series of magnetic resonance imaging.
Results.
Increased abrasion of the hard tooth tissues during jaw clenching is more pronounced in the lateral segments of the dental arch and has a cup-shaped form (100% of patients); grinding of the teeth results in uneven abrasion across the dental arch (more than 85% of patients). Vegetative disorders, obsessive-phobic, and conversion disorders were observed in half of the cases among patients with various forms of masticatory muscle parafunction. All forms of parafunctional activity were accompanied by denervation processes of muscle fibers and an increase in activity amplitude. On the pain side of the temporomandibular joint, a 1.84-fold increase in indicators above the control level was observed in group 1, 1.48-fold in group 2 and 1.61-fold in group 3. On the opposite side, the prevalence of values was 1.58 times in the 1st group; 1.32 times in the 2nd group and 1.46 times in the 3rd group. Jaw clenching was found to shorten the duration of potentials on the painful side — 8.1% and on the opposite side — 3.8%; while grinding teeth, the increase in this indicator was 8.9% and 12.9%, respectively. Displacements of the articular disks in patients with jaw clenching are more often observed in the anterior direction (38% of cases), while during teeth grinding, they occur in the anterolateral vector (42% of cases). Due to the transfer of the vector of increased load from muscles to hard tissue elements of the joint, a compensatory reaction occurs in the form of accumulation of synovial fluid (37% of cases). The clinical picture worsened in the case of developed periodontitis.
Conclusion.
Increased abrasion of the hard tooth tissues has characteristic features depending on the clinical forms of the masticatory muscle’s parafunctions. An ecological momentary assessment of the chewing muscles condition can serve as a tool in the differential diagnosis of clinical forms of muscle parafunctions and to assess the frequency of their manifestations. Disorders of neurotic genesis occur in patients with various forms of parafunction of the masticatory muscles in half of the cases. Muscle parafunction, regardless of its shape, is accompanied by the processes of denervation of muscle fibers in their motor units and an increase in the amplitude of activity. Lateral dislocations of the articular discs are most characteristic in patients with teeth grinding, in the anterior direction — in persons with jaw clenching.

The relationship between TMJ dysfunction and the anatomy of the lateral pterygoid muscle

Wed, 02 Oct 2024 00:00:00 +0300

Possible causes of TMJ dysfunction are changes in the position of the condyle in the fossa, disc hypertrophy, inconsistencies between central occlusion (CO) and central ratio (CR) at the joint level, excessive articular effusion, altered bone morphology of the condyle, jaw injury, somatic diseases. Some studies indicate the effect of muscle attachment on the displacement of the articular disc, and also establish a correlation between pathological changes in the masticatory muscles themselves and disc displacement. The purpose of this study is to determine the role of attachment of the lateral pterygoid muscle and pathological changes in the masticatory muscle in the displacement of the articular disc. We have produced evaluation of MRI studies of 49 patients. The studies were performed on an Avanto superconducting MR tomograph with a field strength of 1.5 T. When comparing static images, the presence of motor artifacts was assessed, the volume of movements of the mandibular head was analyzed and the location of the articular disc at its various positions. The results of our study confirm that the lateral pterygoid muscle has different attachment patterns. The study revealed the presence of a third muscle head in 28% of cases. A statistically significant relationship has been established between the type of attachment of the lateral pterygoid muscle and the type of displacement of the articular disc.

Mechanical properties of aesthetic nickel-titanium wires before and after clinical use

A.S. Patil, M. Gera, S. Sharma, P.D. Hemgude, A. Sabane — Wed, 02 Oct 2024 00:00:00 +0300

The objective of the study was to compare the mechanical properties of aesthetic orthodontic Ni-Ti wires before and after clinical use.
Materials and methods.
The experimental group consisted of 75 0.014" coated Ni-Ti wires — 15 from each of the 5 companies selected, namely Group I — D-tec, Group II — JJ Orthodontics, Group III — OSL, Group IV — American Orthodontics, and Group V — Koden. The control group consisted of two groups with 25 coated 0.014" Ni-Ti, 5 from each company (without clinical use) and 25 non-coated 0.014" Ni-Ti 5 from each company (without clinical use). The experimental wires were retrieved from the patient’s mouth after one month and tested in the laboratory, for their mechanical properties which included: load deflection, flexural modulus, and microhardness.
Results.
Mean micro-hardness of experimental samples is significantly lower in Group III (303.9±8.9; p=0.001). The mean micro-hardness of coated control samples is significantly lower in Group I (309.8±18.2; p=0.674). In Groups I, II, IV and V, the mean micro-hardness of experimental, coated and non-coated control samples was not statistically significant.
Conclusion.
On comparison of mechanical properties like load deflection, flexural modulus, and hardness of aesthetic orthodontic Ni-Ti wires, it was observed that there was a significant difference among five different types of Ni-Ti wire. Also, difference was observed among the experimental group, the coated control group and the non-coated control group. A significant difference was seen in Ni-Ti wire before and after clinical use.

Combined treatment of children with class III malocclusion (combination of traditional therapy and kinesiological taping)

D.S. Bulycheva — Wed, 02 Oct 2024 00:00:00 +0300

The traditional treatment method of patients with class III malocclusion in early childhood involves the use of appliance for skeletal expansion of the upper jaw in combination with a facial mask. However for patients with class III malocclusion temporal and suprahyoid muscles hypertension is often observed. In this regard, the development of algorithms for using of kinesio tapes in orthodontics to increase the effectiveness of bite correction and achieve optimal work of the muscles of the maxillofacial region is of scientific interest. An extract from the medical history of patient N., 6.5 years old, whose parents visited the orthodontics clinic due to class III malocclusion is presented. In addition to classical therapy with the help of McNamara appliance and face mask, the patient was prescribed an applications of kinesio tapes because of temporal and suprahyoid muscles hypertension. After 7 months of therapy, an optimal incisor overlap was obtained and first permanent molars relationships began to correspond to class I by Angle. After achieving the correct bite and thanks to the therapy with kinesio tapes the electromyography results of the studied muscles returned to normal.
Conclusion.
The developed method of using of kinesio tapes in patients with malocclusions in order to normalize the masticatory muscles tone has a number of qualities that favorably distinguish the technique from other known methods: firstly, the effect of kinesio tapes is carried out throughout the entire application time; secondly, the technique has practically no side effects and complications; thirdly, because of the simplicity of using, it is possible to teach the patient of self-applying; fourth, it is necessary to note the low cost of kinesio tapes; fifth, the method has no restrictions on the age and gender of patients.

Population-epidemiological randomized clinical study of harmonious development of the lower face height by 3D cephalometry. Part I. Individual rate

I.P. Panaiotov, A.B. Slabkovskaya, R.R. Magomedov, L.S. Persin — Wed, 02 Oct 2024 00:00:00 +0300

Objective: To assess the average values of parameter ranges across the population that may influence the vertical dimensions of the lower face height (LFH) in individuals with normal occlusion (NO), considering different types of craniofacial growth, with the aim of establishing adequate cephalometric standards for reference in orthodontic therapy and orthopedic rehabilitation.
Materials and methods.
The study population consisted of male and female subjects aged 16—45 years with normal occlusion and different cranial growth types, who underwent general diagnostics of the dentofacial system (DFS) and temporomandibular joint (TMJ). A 3D cephalometric calculation and analysis of 35 CBCT scans were conducted. The study focused on analyzing parameters characterizing the morphological features of the facial skull using 3D cephalometry.
Results.
When comparing the obtained values with the norm, 6 significant parameters influencing LFH were identified. In individuals with a horizontal cranial growth type, two parameters had statistically significant effects: the posterior height of the lower face (SNP—Go) and the occlusal plane angle relative to the skull base (Ocp/NSL), with p<0.05. One parameter, the lower face height angle between points SNA/Sat/Me, had a highly statistically significant influence, with p<0.01. In individuals with a vertical cranial growth type, two parameters had highly statistically significant effects: the incisal-tuberal (alveolar) wall of the maxilla (IMS—MT) and the lower face height angle by Ricketts (Xi), with p<0.01. Additionally, one parameter, the lower face height angle between points SNA/Sat/Me, had a statistically significant influence with p<0.05. Conclusions: The study demonstrated differences in the identified parameters in individuals with normal occlusion. Using the proposed analysis method, it is possible to determine the average parameter ranges across the population that influence the vertical dimensions of the lower face height in individuals with normal occlusion, considering different cranial growth types. The cephalometric analysis of 35 CBCT scans confirmed that normal occlusion of teeth is not associated with cranial growth type.

The problem of early rehabilitation of patients with injuries of the maxillofacial region and their complications (review)

L.U. Valieva, A.S. Pankratov, O.R. Orlova, I.V. Baryshnikov — Wed, 02 Oct 2024 00:00:00 +0300

Mandible fractures, which are the most frequent type of damage to the bones of the facial skeleton, are accompanied by functional disorders that are not completely eliminated even a year after the injury, despite the restoration of bone anatomy and consolidation of fragments. This, in turn, is a provoking factor in the development of a number of diseases of the maxillofacial region, for the prevention of which it is necessary to introduce medical rehabilitation programs, the systematization of which was the purpose of this work. The literature data for the last 20 years devoted to various methods of influencing certain links of the pathological process caused by trauma are analyzed. At the same time. a comprehensive rehabilitation program for patients with mandibular fractures based on a sufficient evidence base has not been developed, which requires continued research on this problem.

Post-traumatic deformation of the mandible caused by secondary displacement of fragments. Clinical case

Wed, 02 Oct 2024 00:00:00 +0300

To date, the number of traumas of the maxillofacial region (MFR) remains at a high level with a tendency to increase. According to the data of domestic and foreign authors, the number of patients with maxillofacial traumas varies from 3.2 to 8% of the total number of traumas. Here is a clinical case of treatment of a patient with bilateral fracture of the mandible on tooth 3.2 with displacement and on the condyle on the right side without displacement. At the ambulant stage, a bicuspid splinting and extraction of tooth 3.2 from the fracture gap was performed. The patient was again hospitalized in the maxillofacial surgery department with the diagnosis of “posttraumatic deformity of the mandible on both sides: in the area of the mandibular branch on the right and in the chin region on the left; posttraumatic deformation of the zygomatic arch on the right side”. Under endotracheal anesthesia, tooth 3.3 was extracted from the fracture gap, refracture on both sides and fixation of the fragments with domestic titanium plates under bite control.
Conclusions.
It is necessary to develop a unified algorithm of medical care for the profile of mandibular fracture taking into account clinical recommendations.

Clinical case: complicated crown-root fracture of a tooth with an immature root

E.O. Bochkovskaya, N.L. Marienko — Wed, 02 Oct 2024 00:00:00 +0300

According to the latest WHO estimate, dental trauma affects 1 billion people worldwide, and its prevalence among children under 12 years of age is 20%. Dental trauma accounts for 5% of all types of traumas. Dental injuries are the fifth most common disease. This article shows the importance of choosing tactics for the treatment of traumatic dental injuries in children; an example is given of the rehabilitation of a patient of primary school age with a crown-root fracture of a tooth with an immature root. The purpose of the study is to evaluate the results of delayed observation after treatment of a complicated crown-root fracture of a permanent tooth with an immature root using the method of vital amputation.
Materials and methods.
A clinical case of diagnosis and treatment of a complicated crown-root fracture of a permanent tooth with an immature root is described. Thermal diagnostics of the tooth, radiation diagnostics using cone-beam computed tomography and radiovisiography were carried out. Under conditions of general anesthesia, the working field was isolated using a rubber dam system, deep amputation of the pulp was performed, and vital pulp was isolated using the biocompatible cement Biodentine (calcium silicate-based cement). Temporary tooth restoration with composite material Estelite Asteria.
Results.
Based on the results of observation of the patient for 2 years, the completion of the growth of the roots of teeth 1.1 and 2.1 in length was revealed, the stage of closure of the apical foramen of the root was determined, no visible pathological changes in the bone tissue were determined. The cold test of teeth 1.1 and 2.1 is positive and passes quickly. During 2.5 years of observation, the patient did not report any pain in the area of the injured teeth. The color of the teeth is not changed, percussion is painless, the restorations are satisfactory, the mucous in the area of tooth 1.1 is without pathological signs, painless on palpation.
Conclusion.
When treating a complicated crown-root fracture of a permanent tooth with an immature root, it is important to choose methods that preserve the vital pulp in order to create conditions for continued growth of the root in length and improve the long-term prognosis after treatment.

Minimally invasive treatment of enamel defect

E.V. Kochurova, E.O. Kudasova, O.N. Risovannaya, K.G. Seferyan, O.L. Polyakova — Wed, 02 Oct 2024 00:00:00 +0300

The esthetic disbalance of a smile is an important and integral part of human socialization in life. Popular position is that beautiful smile can be reflection of the successful personality. Also, a smile is a natural reaction of the body to positive emotions, which are necessary for psychological stability. Tooth enamel is a protective layer of hard tooth tissues from external environmental factors and prevents the occurrence of premature carious process. Modern tips, even with minimal vibration during operation, form cavities that go beyond healthy tissues. Thus, the protection of hard dental tissues by minimal invasive dissection and aesthetic restoration of facial appearance is an important problem of modern dentistry. This article presents a clinical case of restoring the integrity of the vestibular surface of the central incisor within the enamel-dentine border (junction) and the aesthetic balance of the smile in a young patient using modern minimally invasive technologies for the preparation of vital teeth. The description of the clinical stages of cavity preparation and layered aesthetic restoration of the frontal tooth, as well as dynamic monitoring after 24 hours, 1, 3, 6 months and 1 year using modified Ryge‘s criteria. The data obtained proved the possibility of using minimal invasive preparation to work with the included enamel defect.

Clinical Dentistry (Russia)

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The relationship between TMJ dysfunction and the anatomy of the lateral pterygoid muscle

Mechanical properties of aesthetic nickel-titanium wires before and after clinical use

Combined treatment of children with class III malocclusion (combination of traditional therapy and kinesiological taping)

Population-epidemiological randomized clinical study of harmonious development of the lower face height by 3D cephalometry. Part I. Individual rate

The problem of early rehabilitation of patients with injuries of the maxillofacial region and their complications (review)

Post-traumatic deformation of the mandible caused by secondary displacement of fragments. Clinical case

Clinical case: complicated crown-root fracture of a tooth with an immature root

Minimally invasive treatment of enamel defect

Experimental assessment of abrasive wear of hard the reference ceramic sample when using various dental prophylactics