Vladimir A. Zheleznyak

Background . Modern dental restoration relies on achieving reliable adhesion between dental fillings and hard tissues, which is largely determined by the quality of tooth preparation. Objective . To analyze the effect that the condition of working parts in Diatech and MANI diamond burs, as well as chemically different conditioners, can have on the quality of tooth surface preparation. Methods . A nonrandomized experimental controlled study was conducted using 64 intact molars that had been previously extracted for medical reasons; artificial Class I cavities of the same size were drilled in these teeth (as per G.V. Black’s classification). An air-turbine handpiece, Diatech diamond burs (with a grit size of 64–126 µ), and MANI burs (with a grit size of 106–126 µ) were used to prepare the teeth. These teeth were divided into four groups of 16 teeth each depending on the use of new or previously used diamond burs, as well as eight subgroups of eight teeth each; in half of them, the prepared surfaces were conditioned with Travex37 (Omega Dent, Russia) containing 37% orthophosphoric acid; the other half, with Multi Etchant gel containing an adhesive phosphate monomer (M-TEG-P) (Yamakin, Japan). The enamel and dentin were conditioned for 30 and 15 seconds, respectively, followed by rinsing with a jet of water and air for 60 seconds. The used burs and conditioned tooth surfaces were examined using a scanning electron microscope. The quality of conditioned tooth surfaces was comparatively analyzed through the study of electron diffraction patterns of five dentin areas obtained for each tooth; each examined surface was rated on a scale from 0 to 3. The obtained data were statistically processed using Statistica 12.0 (StatSoft, USA) and Microsoft Office Excel 2017 (Microsoft Corporation, USA). Differences were considered statistically significant at p < 0.05. Results . A comparative analysis of the electron diffraction patterns of tooth surfaces from four experimental groups revealed a relationship between the quality of a diamond bur (the presence of visually and microscopically detectable areas on the bur surface that lack the diamond abrasive layer) and the structural characteristics of a tooth surface after preparation and conditioning. The use of both new (in 62.5% of cases) and previously used (in 100% of cases) MANI burs to prepare the surfaces led to the detection of cracks in the dental hard tissues. According to the analysis of electron diffraction patterns with the use of to the developed scale, Multi Etchant gel was found to ensure better preparation of tooth surfaces for the next stage than 37.0% orthophosphoric acid as it provides a cleaner surface even in the case lower-quality diamond burs. For example, areas of dentin surface prepared with the Mani burs and conditioned with Multi Etchant scored 1 point in 72.5% of cases, while those conditioned with Travex were given a score of 1 in only 37.5% of cases. Conclusion . A microscopic examination of the previously used Diatech burs (ten cycles of use), revealed insignificant wear of the diamond coating, which manifested itself in a partial loss of the abrasive layer on the working surface. Therefore, the effect of bur wear on the quality of tooth surface preparation is insignificant, which contributes to the formation of a smooth surface during tooth preparation and a reduced frequency of crack formation.

Relevance. Digestive diseases (ICD-10, Chapter XI) consistently rank among the top five causes of temporary disability in the adult population of Russia. Publications report dental pathologies to be a major risk factor in leading to GI diseases. Healthy jaw and teeth are critical for the digestive system, with dental disorders contributing to the onset, as well as progression of digestive diseases through various pathogenetic mechanisms. Lifetime occupational health is particularly relevant for individuals exposed to various occupational hazards at work, associated with more stringent health demands.Objective. The study objective is to collect, summarize and analyze data regarding the prevalence of most common jaw and teeth diseases and pathological conditions among military contractors providing services at toxic chemical storage and destruction facilities. Another objective is to assess the co-occurrence rate for dental and digestive diseases.Methodology. The study examined 330 military contractors aged 24 to 50 years and authorized to operate toxic chemicals, including 315 men (95.5%) and 15 women (4.5%). We analyzed data from medical health records (Health Record of Military Personnel, document form no. 2) and annual medical examination results required to access toxic chemical facilities. Specific focus was made on the correlation between the GI and dental disease prevalence to highlight the demand for comprehensive systemic screening, treatment and prevention of teeth and jaw diseases, as well as digestive disorders in comorbid patients. Interdisciplinary continuity of care is essential in this respect.Results and discussion. The study results showed poor dental health, with high prevalence of co-occurring dental and GI pathology in the examined cohort. Among service members authorized to access toxic chemicals, digestive diseases were most frequently associated with partial secondary adentia, teeth and jaw abnormalities, as well as various types of advanced caries. The study allowed to outline the key factors affecting dental health in the study cohort.Conclusion. High prevalence of dental and GI comorbidity in the study cohort confirms the direct pathogenetic impact of dentoalveolar disorders on digestive disease development and progression. Our findings highlight the need for a comprehensive and systematic screening, treatment and prevention to mitigate the prevalence of digestive diseases among the Russian Armed Forces personnel exposed to toxic chemicals. The approach should include proactive treatment and preventive measures targeting teeth and jaw pathology.

The aim the study. The aim of the study was to conduct a comparative analysis of methods for determining the optimal individual position of the mandible using a hydrostatic mouth guard and transcutaneous electrical stimulation (TENS) techniques. Material and methods. The study comprised 188 patients with musculoskeletal and articular dysfunction of the TMJ. The subject of the study is cone beam computed tomography and magnetic resonance imaging of the TMJ of these patients. Before starting treatment, all patients underwent magnetic resonance imaging of the TMJ with functional tests (in the open and closed mouth position) and seizure of the masticatory muscles. Results. It was found that the results of the therapeutic and diagnostic procedure for finding the optimal position of the lower jaw using a hydrostatic mouth guard and the TENS method are comparable to each other. Conclusion. CBCT and TMJ MRI are informative diagnostic tools that can be effectively used in the diagnosis and treatment of patients with musculoskeletal dysfunction. Methods for determining the optimal position of the mandible using a hydrostatic mouth guard and TENS have shown their effectiveness at the therapeutic and diagnostic stage of rehabilitation of patients with musculoskeletal dysfunction of the TMJ.

Background: According to published data, the incidence of mandibular third molar retention is 55%. Surgical intervention in this condition is one of the most challenging inpatient surgical procedures, with the highest number of complications. Aim: To assess the postoperative course after third molar extraction using various postoperative management approaches. Methods: The study included 57 patients aged 20 to 35 years with confirmed third molar retention and displacement who were examined and received surgical treatment at the surgery unit of the General Dentistry Clinic of the Kirov Military Medical Academy. The patient were divided into four groups based on the postoperative management approach. In Group 1 (n=14), blood clots formed in extraction sockets, with complete closure of the postoperative wound; in Group 2 (n=15), blood clots formed in extraction sockets, the sockets were sutured, and a glove drain was used; in Group 3 (n=15), extraction sockets were filled with «Alvanes» material, the sockets were sutured, and a glove drain was used; and in Group 4 (n=13), extraction sockets were filled with «Alvanes» material, with complete closure of the postoperative wound. Results: Groups 1 and 4 had the most severe soft tissue edema, fever response, and pain, whereas Group 2 had the least. Group 3 had mild pain and soft tissue edema; no fever response was reported. Conclusion: Filling extraction sockets with «Alvanes» material after mandibular third molar extraction improves the postoperative course and reduces the incidence of complications. Postoperative wound drainage reduces edema and facilitates recovery in complicated cases of third molar extraction.

This article analyzes the scope of services provided by a dentist within the military medical service of the Armed Forces of the Russian Federation during a modern armed conflict. The study included two stages: a prospective stage involving patient care (preventive oral cavity examinations in citizens mobilized for military service) and a retrospective analysis of dental care provided by the military medical service during a military operation (data from preventive examinations, oral sanitation plans for armed forces personnel, and reports from senior dentists of military districts). It has been established that the need for oral sanitation among career military personnel averages 72% and reaches up to 81% among volunteers and citizens mobilized for military service, increasing the workload for both military and hospital dentists. On average, 85.4% of armed forces personnel require outpatient dental care, with each individual having an average of 5.6 teeth requiring treatment: 3.8 for caries, 0.8 needing endodontic treatment, 1 tooth requiring extraction, and 7.4 teeth needing restoration among those requiring prosthetics. It was noted that the critical factors were the nature of combat operations, the workload of medical evacuation stages, and the availability of various resources in the regimental aid station or the medical company of a brigade. These factors often hinder the full deployment of dental equipment and the ability to provide treatment for oral disorders, both on an elective and emergency basis. Satisfactory conditions for this type of medical care are achievable only in a dental office within a separate medical battalion or a special task medical detachment. To improve the provision of dental care to armed forces personnel by the military medical service of the Armed Forces of the Russian Federation during a military operation, the authors propose the following. Dental offices should be equipped with portable turbine dental units, which have proven to be highly effective in real combat conditions, and with portable dental X-ray machines to significantly improve the quality of diagnostics and treatment of dental disorders. In addition, given the challenges of restocking medical consumables, dentists should ensure their timely requisition and monitoring their receipt, since only 36.6% of medical units are equipped with standard dental consumables, necessitating urgent measures to establish a stable supply system.

The issue of restoring dental defects is relevant for modern dentistry. Restoration of the functions of the dental system is possible by partial or complete removable laminar dentures which basis is made of lamellar plastics in the most cases. It is necessary to strictly observe the temperature regime of polymerization of plastics, since structural defects in the material can form, causing complications after prosthetics. There are devices for automatic polymerization with a temperature control function, but the most common is the classical method (in a water bath) of making denture bases. Purpose of the study: compare the quality of polymerization of base plastics using the classical method and using modern equipment. Materials and methods: 8 plastic samples were made, 50% of which were polymerized using the classical method, and the other half using an apparatus for hot polymerization of plastic. An external inspection of the samples was carried out and the finishing time of the plates was estimated. After polishing, the samples were examined using an electron microscope. Results and discussion: samples, polymerized using the classical method showed signs of granular porosity, the polishing time was 8 minutes 13 seconds; electron microscopy results revealed the presence of defects, which could lead to complications. Plates polymerized by the instrumental method are homogeneous, polishing time is on average 4 minutes 42 seconds. When these plates were examined with an electron microscope, there were minor defects. Conclusion: it is recommended to polymerize base plastics using devices for hot polymerization of plastics in order to prevent complications from using removable dentures.

Introduction. During their descent under water, divers may suffer from acute toothache attacks (barodentalgia), creating an emergency that leads to the termination of diving descent. Barodentalgia can be caused by hypoxic process in the pulp of filled teeth under increased intrapulpal pressure.Objective. To reveal the peculiarities of hypoxic processes in the pulp of filled teeth under hyperbaric exposure basing on oximetry and fluorescence change parameters.Мaterials and methods. The study involved 34 male divers who underwent a dental examination at the first stage to select individuals for the second stage of the experiment. 24 subjects were selected for the second stage and evaluated for oximetric (mixed blood saturation) and fluorescent (reduced coenzyme NADH, oxidized coenzyme FAD, fluorescent oxygen consumption index — FOCI) indices of filled teeth. The evaluation was performed by optical tissue oximetry (OTO) and laser-induced fluorescence (LIF) methods before and after immersion in a barocamera at pressure of 0.4 MPa while breathing air.Results. Following exposure to increased pressure of the gas medium as compared to the initial values in the filled teeth, the following phenomena were observed: decrease in pulp saturation by 33.7% (pConclusions. The revealed changes in the indicators of mixed blood saturation, NADH, FAD and FOCI confirm the presence of hypoxic process in the pulp of filled teeth under hyperbaric exposure.

BACKGROUND: Conduct a comparative analysis of the dental status of specialists-operators of underwater technical equipment and military personnel of the St. Petersburg garrison. MATERIALS AND METHODS: A retrospective study of the dental formula of 66 contract servicemen was conducted. The main group consisted of 37 operators of underwater technical equipment aged 32 to 56 years, with average age of 44,7 ± 5,7 years. The comparison group included 29 officers of the St. Petersburg garrison aged 39 to 52 years, with average age of 46,3 ± 3,2 years. Dental status was assessed by the value of the intensity coefficient of carious process, and the level of dental care according to the generally accepted formula of P.A. Leus. RESULTS OF THE STUDY: It was found that the dental status of underwater equipment operators differs significantly in the number of decayed and extracted teeth, and although their coefficient of intensity of the carious process did not have statistical differences, it was significantly less (10 units) than in the comparison group (11 units). These features were naturally reflected in the reliable differences in the indicator of the level of dental care. In the group of operators of underwater technical means, it amounted to 92,4 ± 14,1%, and in the group of officers of the St. Petersburg garrison — 57,1 ± 18,4%. There were no significant differences in the study parameters when patients were divided into subgroups by age (young, medium). CONCLUSION: Despite the peculiarities of professional activity, the dental status and the level of dental care for underwater equipment operators are better than for officers of the St. Petersburg garrison. This can be explained not only by the higher level of medical and preventive dental care for these servicemen, but also by the better motivation to maintain dental health in connection with long autonomous trips.

AIM: To determine the qualitative structure of dental diseases and pathological conditions of the maxillofacial region and the level of their prevalence among young individuals entering higher military educational institutions in Russia. MATERIALS AND METHODS: Data obtained during the dental examination of applicants to the Military Medical Academy named after S.M. Kirov as part of a military medical examination to provide admission to a higher educational institution was comprehensively analyzed. RESULTS: The results showed a moderately high level of prevalence of diseases and pathological conditions of the oral cavity in the surveyed population. Among 589 applicants aged 16–25 years who arrived from different regions in Russia, the percentage of those in need of oral sanitation was 51.95%. The most common nosological form among the examined young people was dental caries, including recurrent and secondary forms, which ranged from 19 to 44% in various groups of examined people. Additionally, a low level of oral hygiene was identified, noted in more than 45% of applicants. CONCLUSION: The peculiarities of the obtained research results should be explained by unsatisfactory knowledge and skills in matters of individual oral hygiene (hereinafter referred to as IHPR), insufficient medical education, low level of compliance, and readiness to carry out activities to maintain dental health among young people.