Ekaterina Vladimirovna Kochurova

The aesthetics of composite restoration are determined not only by color and shape, but also by the optical properties of the surface — gloss, transparency and refraction. High-quality polishing forms a uniform microstructure with minimal roughness, restores gloss comparable to natural enamel, and increases biocompatibility and durability of treatment. The most stable aesthetic result is provided by multi-stage polishing systems based on aluminum oxide, capable of evenly removing both the matrix and the filler of the composite.; their effectiveness depends on the processing steps, the type of composite, the particle size of the filler, the hardness of the abrasive and the compliance of the system with the manufacturer's recommendations. However, data on the cumulative effect of polishing and the comparative effectiveness of specific rotor systems remain limited. The aim of the study was to evaluate the cumulative effect of the surface polishability of a microhybrid nanocluster light-curing composite in a comparative aspect of rotary tool systems. Materials and methods. The surface of the enamel of natural teeth was used as a reference. 80 samples of a microhybrid nanocluster light-curing composite with five levels of transparency were produced: opaque dentin, dentine, enamel, cutting edge and transparent liquid-flowing material. The rotary multi-stage polishing system was tested at each transparency level. Polishing was carried out as standard, according to the instructions, without cooling, with the measurement of heat release from the surface. Statistical processing was performed in Microsoft Office Excel 2024 and Statistica 13.3 with the calculation of M, m, SD; The differences were considered significant at p0.05. The study was approved by the Local Ethics Committee of Sechenov University. Results. The surface of the Dentlight composite after polishing by all systems significantly differed from the standard of natural enamel (p0.01), regardless of the transparency level. RoundFlex and RoundFlex T formed a more hydrophilic surface (θw 73.53°-84.25°), but caused heating to 70°C. StarFlex/Septum provided the most hydrophobic values (104.39°-112.64°, except for the cutting edge — 79.11°) when heated to 35-45°C. Enforce Pin showed the smallest wetting angle on the enamel (67.48°) and minimal heat generation (27-30°C on the transparent layer). Ensmart Pin stably formed hydrophobic surfaces (all values 101°) at 30-45°C. Diamond Sun was characterized by moderate hydrophobicity (78.68°-94.15°) and the most gentle temperature regime (no higher than 40°C; 28-32°C on opaque dentin), Diamond Moon — higher θw (up to 108.66°) and heating up to 45°C. Conclusions. None of the polishing systems reproduced the reference parameters of the enamel surface (p0.01). More hydrophobic surfaces were formed by StarFlex/Septum and Ensmart Pin, while hydrophilic surfaces were formed by RoundFlex and RoundFlex T (heating to 70°C). The Enforce Pin provided the smallest wetting angle on the enamel (67.48°), but did not reproduce the standard on other layers. Diamond Sun was characterized by the most gentle temperature regime (no higher than 40 °C). The data obtained substantiate the need for a differentiated selection of the polishing protocol, taking into account the restoration layer and a comprehensive assessment of systems not only in terms of smoothness and wettability, but also in terms of thermal safety.

Background: Joint dislocations/subluxations are an extremely common serious problem confronting athletes. Repeated joint injuries lead to the development of chronic musculoskeletal diseases and early disability. An important factor in preventing joint re-dislocations/subluxations is the early identification of an underlying predisposition to joint injuries. Therefore, it seemed relevant to identify diagnostically significant morpho-functional musculoskeletal dysplastic signs associated with repeated joint dislocations/subluxations and to assess their diagnostic value in identifying individuals with joint re-injury. Methods: Comprehensive clinic-phenotypic examination was conducted on 538 young adults (aged 18–35 years) involved in mass sports. The study was reported in accordance with the STROBE and STARD 2015 guidelines. Results: The repeated sports-related joint dislocations/subluxations were observed in 10.4% (95% CI: 8.0–13.3). All 56 participants with recurrent joint dislocations/subluxations had connective tissue dysplasia syndrome, compared with 71.2% of those without them (p < 0.001). The dysplastic severity discriminated participants with and without joint re-dislocations/subluxations (AUC = 0.839; 95% CI: 0.773–0.906, p < 0.001). A total connective tissue dysplasia score of 35.91 or higher raised the probability of a joint re-dislocation/subluxation history from 10.4% to 28.9% (sensitivity 78.6%, specificity 77.6%, positive likelihood ratio 3.5), whereas a lower score made it unlikely (negative predictive value 96.9%). The dysplastic phenotype associated with a predisposition to joint dislocations/subluxations has characteristic dysplastic signs, which, when considered together, could form the basis for the developing screening method to identify individuals prone to such recurrent joint instability. Conclusions: The obtained results provide a practical tool for sports practitioners to identify athletes who need closer assessment and, after prospective validation, to implement preventive measures in a targeted manner supporting personalized strategies to preserve musculoskeletal health in young athletes.

Introduction. Diagnosis of neoplasms of the maxillofacial region remains one of the most acute and widely discussed problems in modern medicine. Despite the visual accessibility of this area, a significant part of malignant tumors are detected only at stages III–IV. In such cases, medical care is often focused only on palliative care, and radical intervention leads to severe functional defects and aesthetic disorders that require complex multidisciplinary rehabilitation. Aim. To determine the significance of certain biomarkers of the tumor process in unstimulated oral fluid (saliva) for the possibility of non-invasive diagnosis of tumors of the maxillofacial region at a dental appointment. Materials and methods. The study included patients with neoplasms of the maxillofacial region, divided into three main groups based on clinical, dental and morphological data. The object of the study was unstimulated oral fluid. The material was collected 30 minutes before or after a meal using disposable instruments in containers made of ultrapure polypropylene. Results. The study confirms that the composition of the oral fluid varies depending on the morphological type of the maxillofacial tumor. The combination of biomarkers MMP-8, TIMP-1, TIMP-2, NSE, CYFRA 21–1, AFP and CEA has high sensitivity and specificity (≥80 %), which makes them promising for the diagnosis and monitoring of the development of tumor processes. Conclusion. The use of saliva as a biomaterial for the determination of tumor markers is a highly effective and clinically justified method for diagnosing neoplasms of the maxillofacial region.

Inflammation of the submandibular region occurs quite often in dental practice. The ethology and clinical manifestations of this pathology are diverse and despite the great possibilities of conservative therapy, in some cases it is necessary to perform surgical intervention. The causes of inflammation in the submandibular region are odontogenic diseases, lymphadenopathies, sialorrhea, neoplasms of submandibular salivary glands and sialolithiases. The odontogenic abscesses (88.9 % of cases) and phlegmon (2.7–3.4 % of cases) of the maxillofacial region account for 88.9 % of oral infections. Odontogenic diseases are accompanied by impaired colonization resistance of the oral cavity and are of a big problem. Lifadenopathies in the submandibular region occur in 70 % of cases, while surgical treatment is required for 4 % of patients with this pathology, intensive postoperative medical therapy – 1.7 %, lethality occurs in 0.12 % of cases. Sialorrhea often develops in patients with mental retardation, cerebral palsy, autism, and neuromuscular or sensory dysfunctions. with low efficacy of anticholinergic drugs or botulinum toxin arministration, the main treatment is submandibular resection. Benign neoplasms of the submandibular salivary glands occur in 13 % of cases and are malignancies more often than tumors of the parotid gland. Neoplastic diseases of the submandibular glands of the maxillofacial region account for 34 to 54 %. The most common pathology of these glands is salivary stone disease which occurs in 80–90 % of cases.Aim. To analyze the main causes of inflammation in the submandibular region, requiring surgical intervention

Presence of the prosthetic dentures in the human oral cavity for a long time has an effect on the oral fluid and the condition of the oral mucosa. In return, it is not always objective to determine the adaptive ability of each individual. All of it is also burdened by the difference between the prosthetic structures and the materials used. The aim of the study is to determine the effect of orthopedic structures of dental prostheses on the tissues and organs of the maxillofacial region by the expression of biomarkers of oral fluid. Material and methods. The study group included 65 people without diseases of the oral system as a reference range group, and 80 patients without a general somatic problems but who had not previously received dental Prosthetic treatment and in need of it, as a clinical study group. To determine the effect of orthopedic structures on the tissues and organs of the maxillofacial region, 80 structures of orthopedic prostheses were made for patients. With a partial defect in the dentition, 38 bridges, 18 partially removable plate prostheses and 9 clasp prostheses were installed, as well as 15 complete removable plate prostheses in the absence of teeth. To identify the adaptive properties and the effect of orthopedic structures on the tissues and organs of the maxillofacial region, a clinical and dental examination and determination of the expression of biomarkers of the oral fluid by immunological methods were used enzyme immunoassay. To identify the informative value of the diagnostic test, we used the definition of diagnostic sensitivity (Se), as the ability to detect a disease in people who actually have this disease. Results. The adaptive ability to prosthetic structures of the patients of the clinical comparison group was manifested by an increase in the expression of oral fluid biomarkers MMP-2, MMP-8 and TIMP-2 in the early adaptation period and a decrease of MMP-8 after 3 months of operation (p<0.05). Conclusions. The data obtained indicate the possibility of determining and evaluating the adaptive ability of tissues and organs of the maxillofacial region to orthopedic prosthesis structures in patients, which is manifested by the reaction of biomarkers in the oral fluid.

Introduction. Despite visual accessibility of the elements of tumor lesions in the oral mucosa, patients with this pathology rarely seek medical help. Regeneration of the mucosa is a long process taking varying time depending on the location of the lesions. Asymptomatic tumor process leads to its diagnosis at late stages.Aim. To develop clinical and proteomic approach to diagnosis of malignancies of the oral mucosa at the stage of out-patient dentist appointment.Clinical observations. Examples of extended clinical, dental and immunoenzymatic monitoring in patients with elements of tumor lesions of the oral mucosa with long-term course are presented.Conclusion. The use of extended clinical, dental and immunoenzymatic analysis of oral fluid in patients with elements of tumor lesions of the oral mucosa allows to diagnose this pathology early.

Эстетический дисбаланс улыбки — важная и неотъемлемая часть социализации человека в обществе. В ряде случаев красивая улыбка является визитной карточкой успешной личности. К тому же улыбка — это естественная реакция на положительные эмоции, которые необходимы для психологической устойчивости человека. Эмаль зуба защищает твердые ткани зуба от внешних факторов среды и препятствует возникновению преждевременного кариозного процесса. Современные турбинные стоматологические наконечники даже с минимальной вибрацией при работе с твердосплавными борами формируют полости, выходящие за пределы здоровых тканей. Таким образом, защита твердых тканей зубов минимально инвазивным препарированием и эстетическое восстановление благообразия лица остаются важными проблемами современной стоматологии. В данной статье представлен клинический случай восстановления целостности вестибулярной поверхности центрального резца в пределах эмалево-дентинной границы (соединения) и эстетического баланса улыбки у пациентки молодого возраста с помощью современных, минимально инвазивных технологий препарирования витальных зубов. Представлено описание клинических этапов подготовки полости и послойной эстетической реставрации фронтального зуба, а также динамический мониторинг через 24 часа, 1, 3, 6 месяцев и 1 год с применением модифицированных критериев Рюге. Полученные данные доказали возможность применения минимально инвазивного препарирования для работы с включенным дефектом эмали. 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.

Качество жизни пациента напрямую связано с эстетическим благообразием лица, возможностью вести социальную жизнь, а также с такими базовыми функциями, как прием пищи. Для принятия решения при разработке плана индивидуальной стоматологической реабилитации большое значение имеет не только этиология заболевания, но и анамнез. Цель данной работы — проведение стоматологической реабилитации пациента с онкологическим анамнезом при концевом дефекте и сниженной межальвеолярной высоте. В данной статье представлен клинический случай восстановления жевательной активности и эстетики пациентки с онкологическим анамнезом и нестандартными клинико-анатомическими данными для реабилитации. Представлено описание клинико-лабораторных этапов, обосновано их применение. План ортопедического стоматологического лечения пациента со сниженной межальвеолярной высотой представлен сложным комплексом плотного взаимодействия отделения и зуботехнической лаборатории. Разработан и проведен анализ ортопантомограммы, одонтопародонтограммы, электромиографии и др. Динамический мониторинг клинико-стоматологического здоровья и качества жизни пациента учитывали в течение 18 месяцев со дня окончания реабилитации. Полученные данные доказали правильность выбора конструкции и расчета жевательной нагрузки. The patient’s quality of life is directly related to the aesthetic appearance of the face, the ability to lead a social life, as well as with such basic functions as eating. To make a decision when developing an individual dental rehabilitation plan, not only the etiology of the disease, but also the anamnesis is of great importance. The aim of this work was to execution of the dental rehabilitation of a patient with an oncological anamnesis, with the end defect and a reduced interalveolar height. This article presents a clinical case of restoration of chewing activity and aesthetics of a patient with an oncological history and non-standard clinical and anatomical data for rehabilitation. The description of clinical and laboratory stages, justification of their application is presented. The plan of orthopedic dental treatment of a patient with a reduced interalveolar height is represented by a complex complex of close interaction between the department and the dental laboratory. The analysis of orthopantomogram, odontoparodontogram, electromyography, etc. was developed and carried out. Dynamic monitoring of the patient’s clinical and dental health and quality of life was taken into account within 18 months from the date of completion of rehabilitation. The data obtained proved the correctness of the design choice and calculation of the chewing load.

Introduction. The manifestation of oncological alertness during dispensary observation by a dentist is very important. The most accessible options for preventing malignancy of the oral mucosa are sanitation, regular professional oral hygiene, as well as educational work among doctors and the population. However, despite the visual accessibility of tissues and organs of the oral cavity, there is an annual increase in malignant neoplasms in this area. In this case, most patients are diagnosed with a tumor process of the last stage. malignant neoplasms of the head and neck organs require special attention due to high risk of disability even at an early stage. Aim. To evaluate a correlation between malignancy of the oral mucosa and the burdened dental status of patients. Materials and methods. A controlled study was conducted which included 142 patients with cancer of the oral mucosa without sequential or parallel inclusion of patients in groups. Dental status was assessed at help-seeking stage or during clinical examination, as planned, by evaluation of main dental indices. The morphological diagnosis was established using histological verification. Results. The majority of patients with oral tumors had hard dental plaque (81.7 % of cases). The condition of the soft tissues, in addition to presence of the mucous membrane lesion, was characterized by bleeding (69 % of cases). moderate periodontal pathology was detected (19 % of cases). patients with the cavity tumors had an acute traumatic edge of hard tissues (70 % of cases), extensive caries (26 % of cases) and the presence of removable dentures (82 % of cases). Conclusion. The values of parameters evaluated in patients in the study with squamous cell carcinoma of the oral mucosa show its relation to aggravation of general somatic status. All patients in the study required dental treatment and training in oral hygiene care.

В ежедневной практике врач-стоматолог встречается с заболеваниями слизистой оболочки полости рта, при этом некоторые поражения потенциально злокачественны. Предопухолевые поражения слизистой оболочки полости рта, например лейкоплакии, красный плоский лишай, хроническая трещина нижней губы и т.д., при отсутствии должного лечения малигнизируются с высокой степенью вероятности. Осложняет ситуацию бессимптомное течение рака полости рта, до тех пор пока опухоль не прогрессирует до неоперабельной стадии. Зачастую пациенты не обращаются за помощью, пока не появится болевой симптом или опухоль не увеличится в размерах. Все это и многие другие факторы приводят к тому, что злокачественные опухоли данной локализации выявляются на III—IV стадиях заболевания, что, несомненно, сказывается на эффективности лечения. Провели ретроспективный анализ заболеваемости опухолей головы и шеи на базе Ивановского онкологического диспансера по данным учетно-отчетных форм за 2010—2020 гг. и историй болезней за период 2010—2017 гг. Оценивали структуру, распространенность и стадийности злокачественных новообразований (ЗНО) полости рта, выделены основные жалобы пациентов при обращении в онкодиспансер, определен уровень активного выявления патологии врачами-стоматологами. Почти 70% случаев ЗНО были выявлены на поздних стадиях (III—IV) онкологического процесса по классификации TNM. В 14,7% случаев диагностирован распространенный процесс с метастазированием в лимфатические узлы (рT3N1M0, рT4N1M0, рT3N2M0, рT3N2M0). В 91,8% случаев встречаются эндофитные формы рака дна полости рта. В результате заболеваемости снижается качество жизни пациентов. Доля активного выявления ЗНО полости рта стоматологами в Ивановской области за 2021 г. составил 22%. Приведенные данные подтверждают низкую обращаемость пациентов за стоматологической помощью на ранних I—II стадиях рака полости рта и недостаточный уровень онкологической настороженности врачей-стоматологов In daily practice, a dentist encounters diseases of the oral mucosa, while some lesions are potentially malignant. Premalignant lesions of the oral mucosa, such as leukoplakia, lichen planus, chronic fissure of the lower lip, etc. in the absence of proper treatment, they are malignant with a high degree of probability. Complicating the situation is the asymptomatic course of oral cancer, until the tumor progresses to an inoperable stage of the process. Often, patients do not seek help until a pain symptom appears or the tumor increases in size. All this and many other factors lead to the fact that malignant tumors of this localization are detected at III—IV stages of the disease, which undoubtedly affects the effectiveness of treatment. . On the basis of the Ivanovo Regional Oncology Center, in accordance with descriptive and evaluative methods of epidemiological research, a retrospective epidemiological analysis of the structure, prevalence and stage of oral cancer was carried out. We used data from 429 medical records of patients in the surgical department of head and neck tumors from 2010 to 2017 and accounting and reporting forms from 2011 to 2021. The main complaints of patients when visiting the oncology clinic were identified, and the level of active detection of pathology by dentists was determined. . Almost 70% of cases of a malignant process were detected at late stages (III—IV) of the oncological process according to the TNM classification (p<0.05). In 14.7% of cases, a widespread process with metastasis to the lymph nodes (pT3N1M0, pT4N1M0, pT3N2M0, pT3N2M0) was diagnosed. In 91.8% of cases, endophytic forms of cancer of the floor of the mouth occur. As a result of morbidity, the quality of life of patients decreases. The level of active detection of MNs of the oral cavity by dentists using the example of the Ivanovo region for 2021 was 22.0%. . These data confirm the low level of patients seeking dental care in the early stages of oral cancer (I—II) and the insufficient level of oncological alertness of dentists.