Borisova E.G.

The modern realities of implantology require combining a digital approach with technology that determines the implant loading period, taking into account the biomechanical parameters affecting osseointegration. A unified clinical and engineering process, from diagnosis and planning to surgery with prosthetic fabrication in a milling center, is implemented within the framework of fully digital automated production. The aim of this study was to familiarize practicing physicians with the technique of immediate loading of implants in completely edentulous patients. The clinical case presented by the authors concerns a completely edentulous upper jaw using a removable implant-supported prosthesis. The time from examination to temporary prosthesis installation was approximately four days. This clinical case of a completely edentulous upper jaw illustrates an innovative approach that significantly reduces patient rehabilitation time and the risk of communication errors within the specialist team. The use of a modern scanning approach improves the accuracy of the prosthetic structure's fit to the foundations of both temporary and permanent bridge structures. Implant survival monitoring after 3, 6, and 12 months demonstrates good bone regeneration and the absence of bone resorption. Predicting the implant loading period using the Dr. Student software package and the COMMUNICATOR system as a technical guide allows the entire team of specialists to follow a predetermined path, from collecting parameters responsible for implant integration and a navigation protocol to fabrication and fixation of the structure obtained after scanning on the day of surgery.

The authors have implemented a treatment protocol in clinical practice using an intelligent system that predicts the duration of orthopedic loading on implants, taking into account parameters that affect implant osseointegration. This system also utilizes digital technologies that enable all stages of diagnosis, planning, surgical intervention, prosthesis fabrication in a milling center, and its installation in the oral cavity. The aim of the study was to evaluate the survival rate of completely edentulous implants using a temporary structure with immediate loading, taking into account the predicted data of artificial intelligence. The article presents a clinical case of completely edentulous maxilla, which allowed for the patient's rehabilitation using a conditionally removable structure on implants and the restoration of chewing function in the oral cavity. The digital protocol, which was developed by the authors and implemented in clinical practice, was adjusted according to the clinical case. After three and six months, radiographic monitoring of implant survival was performed. The radiographic examination data indicate the absence of bone resorption. The obtained results suggest that this approach significantly accelerates the patient's rehabilitation time. Thus, the period from the initial examination and digital data collection to the installation of a temporary removable appliance takes only five days. Managing patients using a digital protocol for predictive rehabilitation not only reduces the likelihood of dental errors but also shortens the number of treatment stages and duration, while improving the patient's quality of life.

This study is motivated by the increasing prevalence of diabetes mellitus and the increasing demands for safe and effective prosthetic treatments for this patient population. Incorrect selection of materials can contribute to the development of diabetes-related complications, deterioration of denture tissues, and adversely affect the patient’s overall health, ultimately reducing quality of life and complicating treatment.    The aim of this study is to identify specific criteria for selecting prosthetic materials for patients with diabetes, taking into account their allergenic safety and impact on denture tissues, as well as the overall health of the patients. A study of 87 patients was conducted, including both an analysis of published data and a clinical examination. The results revealed significant differences in the degree of inflammatory changes, the severity of hyperemia, edema, and the presence of microorganisms on the denture surface, which are directly related to the physiological properties of the materials and their interaction with oral tissues. This study demonstrates the need for personalized approaches to prosthetics in patients with diabetes, increasing the effectiveness and safety of dental interventions, as well as improving the prognosis for recovery and overall health of this patient group.

Профилактические мероприятия при протезировании пациентов, страдающих лейкоплакией

The aim of this study was to evaluate the impact of different post-extraction socket management techniques in patients with a thin gingival biotype on vertical alveolar ridge resorption and soft-tissue thickness prior to planned implant placement. The study included 36 patients aged 27–43 years with a thin gingival biotype and a diagnosis of chronic apical periodontitis. Extractions were performed atraumatically under local anesthesia, after which patients were allocated to the main group (n = 20) and the control group (n = 16). In the main group, the extraction socket was filled with the collagen-based osteoplastic material Bioplast-Dent and covered with a subepithelial connective tissue graft; in the control group, the socket was managed with L-PRF and a collagen membrane. Vertical alveolar ridge resorption was assessed using dental cone-beam computed tomography 6 months after extraction, and measurements were performed in Xelis Dental Viewer 3D. Statistical analysis was carried out using the Welch t-test. Mean vertical resorption in the main group was 1.37 ± 0.36 mm (10.3 ± 1.2%), compared with 2.07 ± 0.33 mm (14.4 ± 1.4%) in the control group. Analysis taking bone density type into account showed lower vertical resorption in the main group for both D2 and D3 biotypes, with the D3 biotype exhibiting a tendency toward greater resorption. The thickness of keratinized attached gingiva did not change significantly; however, soft-tissue thickness above the planned implant site was greater in the main group (4.37 ± 0.22 mm) than in the control group (3.28 ± 0.35 mm). The findings indicate that atraumatic extraction combined with socket filling using a collagen osteoplastic material and coverage with a subepithelial connective tissue graft supports the preservation of vertical alveolar ridge dimensions and creates favorable conditions for gingival cuff formation, while minimizing the influence of bone biotype on resorption.

The modern paradigm of dental health assessment involves a comprehensive approach that takes into account a variety of internal and external environmental factors. The study of the internal environment implies an analysis of the influence of the functional state of various systems and organs, which can act as etiopathogenetic mechanisms in the formation of oral pathology. The aim of this study was to investigate the risk factors of various origins that determine the qualitative and quantitative characteristics of dental health indicators in medical students. The study included 187 students of the St. Petersburg Medical University. The work was carried out in several stages and included: an in-depth medical examination with the participation of dentists and other specialists; a social and hygienic study (questionnaire); a study of risk factors (psychoemotional, behavioral); instrumental and laboratory assessment of the functional state of the cardiovascular, nervous and endocrine systems; statistical analysis and integrative processing of a set of indicators of the medical and preventive block. The conducted in-depth dental examination of students made it possible to identify a number of negative trends in their health. The RMA calculated index revealed moderate gingivitis in 71% of cases. Oral mucosal involvement was found in almost 96.6%. The computer necrosis index indicates mild involvement in 39.7% of students. An analysis of risk factors over time demonstrated the following: as the course lengthens, a significant increase in the time students spend on computers is recorded. A progressive increase in the prevalence of chronic diseases is also noted. By the senior years, the incidence of cardiovascular, respiratory, gastrointestinal, and genitourinary diseases significantly increases. The highest incidence rates were recorded for ENT and visual disorders, likely related to the high academic workload and specific nature of the course. The data obtained indicate the accumulation of somatic problems during the course of study, which creates an unfavorable premorbid background and requires consideration of the identified systemic disorders when developing dental risk management models.

. Modern orthopedic dentistry is characterized by a steadily increasing demand for synthetic materials, the effective use of which directly depends on the degree of integration of these materials with patient tissues, including periodontal structures. Integration is a key factor in the success of treatment, ensuring reliable fixation of prostheses and long-term functionality of structures. The use of modern composite polymers, ceramic coatings, and biocompatible alloys minimizes the risk of complications, improves the aesthetic outcome of treatment, and significantly improves the quality of life of patients after dental prosthetics. Improving the technological level of production of artificial oral components contributes to an expanded range of possibilities for orthopedic interventions and guarantees the achievement of high standards of quality of medical care. This article presents the results of a morphological analysis of the tissue response of the subcutaneous tissue of laboratory animals (rats) to the implantation of various synthetic materials used and promising for use in orthopedic dentistry. Experimental studies were conducted on 16 laboratory rats. The study assessed the response of hypodermal tissue to the introduction of three types of plastic samples: ethacryl, fluorax, and colorless plastic (nylon). Studying tissue responses to synthetic polymers used in prosthetic dentistry is key to the development of new biocompatible materials. Analysis of cellular infiltrate, fibrous capsule, and inflammatory response allows one to assess the degree of material integration with surrounding tissues. The data obtained can serve as a basis for selecting optimal polymer compositions that minimize the risk of adverse reactions and promote successful prosthetic restoration. The results of the study are important for further improvement of materials used in prosthetic dentistry, with the aim of increasing the durability and functionality of prosthetic structures.

В настоящее время активно набирает обороты популяризация здорового образа жизни и физической культуры. Существуют различные спортивные направления, среди которых особое место занимают контактные виды спорта. К ним относитcя хоккей, бокс, вольная борьба и многие другие направления. Наравне с увеличением вовлеченности населения в формирование здорового образа жизни и занятие физическими нагрузками, учащаются случаи спортивного травматизма. Исследователями установлено, что травмы челюстно-лицевой области составляют 45% от общего количества обращений среди пациентов хирургического стационара. В связи с этим, в настоящее время достаточно широкое применение получили спортивные каппы (шины), осуществляющие защиту преддверия полости рта, зубных рядов, а также поддерживающие фиксированное положение нижней челюсти в период тренировок и состязаний. Статья посвящена изучению различных материалов для изготовления спортивных капп и методов их изготовления, анализу защитных свойств при механическом воздействии. В ходе исследования были выявлены наиболее эффективные и комфортные защитные каппы для спортсменов, занимающихся контактными видами спорта, с целью уменьшения количества травм челюстно-лицевой области.

The use of antibacterial therapy after tooth extraction remains a key issue in modern dental surgery. Despite a wide selection of medications and their proven efficacy against oral bacterial flora, irrational use of antibacterial therapy poses potential risks to patient health and does not improve surgical outcomes. Tooth extraction is typically a local surgical procedure, with a low risk of infectious complications in healthy patients. In the absence of risk factors, prophylactic or empirical antibacterial therapy is not justified. Excessive use of antibacterial agents can lead to microflora imbalance, the development of drug resistance, allergic reactions, and systemic side effects. The aim of this study was to review domestic and international literature to analyze the need for antibiotics, nonsteroidal anti-inflammatory drugs, and antihistamines. Materials and Methods. A review of available Russian and international scientific literature from the past 10 years has been conducted, allowing for a more comprehensive assessment of the drug use concepts proposed by many authors. Results and discussion. Rational use of antibacterial drugs is of particular importance today. Antibiotics represent a distinct group of medications with unique properties that have been thoroughly studied in medical practice. This includes not only the principles of action but also the fundamentals of clinical microbiology. Ketorolac is considered one of the most potent analgesics among nonsteroidal anti-inflammatory drugs and is widely used to relieve severe postoperative pain following tooth extraction. Second-generation antihistamines do not cause significant sedation and have a prolonged effect, making them convenient for managing swelling after tooth extraction. Conclusions. Antibiotics, nonsteroidal anti-inflammatory drugs, and antihistamines are an important part of the preparation and management of dental surgery. Their correct and rational use reduces the likelihood of adverse reactions, ensures safer tooth extractions, and improves the postoperative course.

The study is devoted to the complex therapy of chronic herpetic gingivostomatitis, the purpose of which was to increase the effectiveness of treatment of the disease in patients undergoing orthodontic treatment with aligners. It presents data on treatment methods, results of immunological control and conclusions on the effectiveness of therapy in 112 patients undergoing long-term orthodontic treatment with aligners. Patients were divided into two groups: the main group (59 people) and the control group (53 people). The main group, in addition to etiotropic treatment, received physiotherapy. Immunomodulatory therapy in the main group included the drug Meglumine acridonacetate, and in the control group, the drug Imudon. During immunological control, the activity of lysozyme and the level of secretory immunoglobulin A in saliva, as well as the level of IgG antibodies to the herpes simplex virus were measured. After processing the laboratory data, it was concluded that the main group showed more pronounced improvements compared to the control group in both lysozyme activity and s-IgA levels, and the level of IgG antibodies to the herpes simplex virus significantly decreased in the main group 2 months and 6 months after treatment compared to the control group. Treatment in the main group was more effective: it contributed to faster healing and a decrease in the level of antibodies to the virus. The results emphasize the importance of using a comprehensive approach to the treatment of herpes infection and monitoring the immune response.