Olga L. Polyakova

The aim of the presented study was to identify the features of the quantitative formation of axoplasmic organelles with a primary analysis of the components of the axonal cytoskeleton (microtubules and neurofilaments) of myelinated and non-myelinated nerve fibers in the dental pulp during the eruption of permanent teeth in humans. Material and methods. The neurovascular bundle of dental pulp was studied in children aged 5, 10 and 14 years. On ultramicrographs of pulp sections at a magnification of ×40000, the diameters of myelin and non-myelin conductors were measured; per 1 µm2 of axoplasm of nerve conductors, the density of axoplasmic organelles, the number of microtubules and neurofilaments were calculated. The reliability of differences between groups was assessed using multivariate analysis of variance (MANOVA), the significance of average values was assessed using the Tukey test, correlation analysis was carried out using the Pearson criterion. Results. The process of eruption of permanent teeth was accompanied by a gradual increase in the number of organelles per unit cross-sectional area of the nerve, regardless of its characteristics (myelinated or nonmyelinated fiber type). The highest density of organelles was observed in large-diameter fibers of both myelinated and non-myelinated conductors throughout the indicated segment of ontogenetic development. The presence of myelin in the nerve sheath correlates positively with microtubule saturation in fibers of large (r=0.267, p=0.001) and small (r=0.314, p=0.000) diameters, and negatively in fibers with medium diameter (r=-0.246, p=0.002). The proportion of neurofilaments represented among the axoplasmic organelles of the neuroplasm as a whole was especially high in myelinated and unmyelinated nerve fibers of small diameter, averaging up to 70%. The presence of the myelin sheath and fiber diameter are not associated with neurofilament density with the exception of medium-diameter fibers (r=0.195, p=0.001). Conclusion. The process of eruption of permanent teeth is accompanied by an increase in the number of organelles, cytoskeletal elements in the axoplasm of nerve fibers innervating the dental pulp, providing the morphological substrate of neuroplasticity, which must be taken into account, for example, in the process of dental implantation and dental prosthetics.

The timing, duration and quality of permanent teeth eruption are directly dependent on the morphological characteristics of dental tissues, whose formation is determined by the conditions of formation. The aim is a histomorphological study of the pulpodentin complex of a tooth during permanent teeth eruption in children and adolescents living under environmental and technogenic stress conditions. Materials and methods. The object of the study is the dental material of children and adolescents of Udmurtia at the age of 5 years (eruption beginning) and at the age of 14 years (eruption completed). The material was collected with the voluntary written consent of the child and his parents. Groups of children were formed based on the conditions of their residence in relatively prosperous settlements and areas with increased environmental and technogenic stress on the basis of data presented in the State Report «On the State of Sanitary and Epidemiological Welfare of the Population in the Udmurt Republic». Scientific research was approved by the Committee on Biomedical Ethics of the FSBEI of HE «Izhevsk State Medical Academy» under the Health Ministry of the Russian Federation (application № 391 dated 05.11.2013). Histological preparations of the pulpodentin complex were stained with hematoxylin and eosin, picrofuxin, photographed and subjected to a qualitative assessment. Results. The dental pulpodentin complex in children living under environmental and technogenic stress conditions at the time of permanent teeth eruption (5 years old) corresponded to the indicators of morphological maturity. Minor deviations were represented by single obliterated tubules, heterogeneity of the dentine layer, and the presence of fields with poorly calcified dentine. By the time when permanent teeth eruption was completed (14 years old), areas of reactive-altered dentin, zones of the basic substance dilution with a predominance of inter-tubular dentin, areas with alternating layers of mineralized dentin, uneven arrangement of dentine tubules, the presence of dilated blood microvessels with the phenomena of stasis of shaped elements were formed. Conclusions. Permanent teeth eruption in children and adolescents living under environmental and technogenic stress is accompanied by negative changes in the dental pulpodentin complex. Data on the peculiarities of pulp formation in adverse developmental conditions should be taken into account in pediatric dentistry in the treatment of children and developing the algorithm for preventive or corrective procedures.

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.

   The aim of the study was to reveal associations between the number of functioning microvessels and formation of adrenergic control (nerve endings containing catecholamine) of the dental pulp in children and adolescents of Udmurtia during the period of permanent teeth eruption.   Material and methods. The study included neurovascular bundle of the pulp of teeth extracted for medical reasons at the age of 5 to 14 years. At the light-optical level, the number of functioning capillaries was counted; an electron microscopic technique was used to qualitative assess the microvascular bed. Identification of catecholamines and counting the number of adrenergic nerve endings were performed histochemically using glyoxylic acid.   Results. The process of permanent teeth eruption is accompanied by an intensively increased number of functioning capillaries and an increased density of adrenergic nerve endings. The number of functioning microvessels increases significantly (by 3.36 times) during childhood (from 5 to 9 years); the number of capillaries stabilizes in adolescence. The increased number of nerve endings by the end of the childhood period (9 years) is 45.2 ± 12.4 % compared with the age of 5 years. Notably, adrenergic nerve endings modify qualitatively: a pronounced variety of mediatorcontaining forms is replaced by their isomorphic phenotype. With age, predominant distribution of nerve endings along the vessels of the microvasculature tends to increase.   Conclusion. Active formation of the microvascular bed during the eruption of permanent teeth is accompanied by an age-dependent increase in the density of localization and qualitative restructuring of adrenergic nerve endings, which provides full catecholaminergic control from the sympathetic nervous system.