H. R. Khumgaeva

Justification. Distal occlusion (II class according to Angle) is one of the most common dentofacial anomalies and is often combined with transverse maxillary insufficiency. In adult patients, due to completed growth, the effectiveness of classical orthodontic approaches is limited, which justifies the use of skeletal expansion methods, in particular the MARPE technology — mini-implant-associated rapid palatal expansion. Study objective — to evaluate the effect of MARPE on maxillary transverse dimensions in patients with distal occlusion by analyzing the coefficients of interpremolar and intermolar arch width compliance with Pont’s standard values, compared to traditional orthodontic therapy. Materials and methods. Sixty patients aged 18 to 35 years with a diagnosis of distal occlusion (Angle Class II) were examined. They were divided into two groups of 30 patients each. The control group received treatment using brackets only; the study group underwent preliminary maxillary expansion using MARPE followed by orthodontic correction. Diagnostic evaluation included determining the coefficients of interpremolar and intermolar arch width compliance with Pont’s standard values before and after treatment. Statistical analysis was performed using the nonparametric Wilcoxon and Mann—Whitney tests (p<0.05). Results. After completion of treatment, statistically significant increases in the interpremolar and intermolar arch width correspondence coefficients to the standard values according to the Pohn method were recorded in both groups. In the study group, the intermolar width correspondence coefficient increased from 46.80±2.02 to 70.37±11.17, and the interpremolar width correspondence coefficient increased from 59.20±9.42 to 70.00±4.99. In the control group, the intermolar width correspondence coefficient increased from 41.23±10.54 to 55.80±4.76, and the interpremolar width correspondence coefficient increased from 59.27±5.78 to 93.70±11.54. Despite higher absolute values in the control group, the expansion pattern was more variable, likely due to the predominance of the dentoalveolar component. Conclusion. The use of MARPE allows for significant and stable expansion of the maxilla through skeletal structures, ensuring a more controlled restoration of the transverse parameters of the dental arch. Analysis of the coefficients of correspondence between the interpremolar and intermolar arch widths and the standard values according to the Pont method confirms the effectiveness of this method in treating adult patients with distal occlusion and transverse insufficiency.

Purpose: to present clinical observation data and analyze the effectiveness of the orthodontic-surgical approach in the treatment of distal occlusion, taking into account the age factor. Materials and methods. The study examined 60 patients aged 18 to 45 years with distal occlusion of the dentition with narrowing of the upper jaw. The patients were stratified into control and study groups of 30 patients each, as well as into two age subgroups: the younger age group (18—25 years; n=15) and the older age group (30—45 years; n=15). In the control group, correction of distal occlusion was previously performed using a bracket system without the use of a MARPE device, whereas in the study group, treatment was performed using a bracket system in combination with a MARPE device. The control group was considered as a retrospective group. The treatment results were compared with the baseline data in the study group based on the Penn index. The main indicator of effectiveness is correction of distal occlusion, stability of achieved occlusal contacts. Results. Comparative analysis revealed that the transversal expansion of the upper jaw in patients aged 18—25 years was significantly more pronounced than in patients aged 30-45 years, both with orthodontic braces treatment and in combination with MARPE. When using only the bracket system, the increase in width was 1.2 mm in the young and 0.7 mm in the older group (p<0.001), and when using MARPE — 2.8 mm and 1.5 mm, respectively (p<0.001). The expansion was accompanied by an improvement in occlusal ratios: normalization of the position of molars and canines, reduction of the incisor gap and the formation of more uniform contacts. The achieved correction of distal occlusion remained stable during the observation period. Conclusions. The conducted research allows us to conclude that an integrated approach using the MARPE device and a bracket system provides a more pronounced transversal expansion of the upper jaw and contributes to the effective correction of distal occlusion compared with the use of a bracket system. At the same time, the patient’s age remains a significant factor influencing the outcome. The results obtained emphasize the importance of individual treatment planning, taking into account the patient’s age and morphofunctional features of his maxillofacial region in order to achieve a stable occlusal result.

Ортопедическая реабилитация пациентов на дентальных имплантатах при тяжелых случаях хронического пародонтита затруднительна в силу большого риска осложнений в виде вторичного инфицирования раны, а также нестабильности маргинальной периимплантной зоны. Цель — оценить клиническую эффективность применения универсальных flat-абатментов при реабилитации пациентов с хроническим генерализованным пародонтитом тяжелой степени. У пациента (44 года) с хроническим генерализованным пародонтитом тяжелой степени на КЛКТ обнаружена генерализованная убыль межзубной костной перегородки от 1/3 до 2/3 высоты корней зубов верхней и нижней челюстей. Проведены удаление зубов на нижней челюсти, редукция альвеолярного гребня, установка 6 дентальных имплантатов, фиксация универсальных абатментов (3.4, 3.2, 4.2, 4.4) и стандартных прямых мультиюнитов (3.6, 4.6) с дальнейшим внутриротовым сканированием и немедленной ортопедической нагрузкой. Через 12 месяцев после протезирования убыль костной ткани в области имплантата 3.6 составила 0,2 мм, в области 3.4 — 0,1 мм, в области 3.2 — 0,1 мм, в области 4.2 — 0,3 мм, в области 4.4 — 0,1 мм, в области 4.6 — 0,3 мм. Применение flat-абатментов в комбинации со сферическими абатментами позволило добиться благоприятного клинического результата в виде отсутствия послеоперационных проявлений (отека, боли, дискомфорта), высоких показателей эстетики, а также минимальной убыли маргинальной кости у пациента с хроническим генерализованным пародонтитом тяжелой степени. Orthopedic rehabilitation of patients with severe chronic periodontitis on dental implants is difficult due to the high risk of complications in the form of secondary wound infection, as well as instability of the marginal peri-implant zone. Objective — to evaluate the clinical efficacy of universal flat abutments in the rehabilitation of patients with severe chronic generalized periodontitis. . A 44-year-old patient with severe chronic generalized periodontitis showed generalized loss of the interdental bone septum from 1/3 to 2/3 of the root height of the teeth of the upper and lower jaws on CBCT. The following procedures were performed: extraction of teeth on the lower jaw, reduction of the alveolar ridge, installation of 6 dental implants, fixation of universal abutments (3.4, 3.2, 4.2, 4.4) and standard straight multi-units (3.6, 4.6) with subsequent intraoral scanning and immediate orthopedic loading. . After 12 months of prosthetics, bone loss in the area of implant 3.6 was 0.2 mm, in the area of 3.4 — 0.1 mm, in the area of 3.2 — 0.1 mm, in the area of 4.2 — 0.3 mm, in the area of 4.4 — 0.1 mm, in the area of 4.6 — 0.3 mm. . The use of flat abutments in combination with spherical abutments allowed to achieve a favorable clinical result in the form of the absence of postoperative swelling, pain, discomfort, high aesthetics, as well as minimal loss of marginal bone in a patient with severe chronic generalized periodontitis.

To date, the use of a temporary skeletal anchorage in orthodontic treatment in almost every clinical case. Despite this, there are only two variants of this surgical instrument: mini-screws and mini-plates. Both variants of the skeletal anchorage have their positive and negative qualities, which, to one degree or another, affect the result and timing of treatment. The purpose of this literature review is to describe the main methods of using temporary skeletal anchorage, in which clinical cases their use is possible and contraindicated, as well as what positive and negative aspects can be observed during and after the treatment of orthodontic patients. The search for scientific data was carried out in the PubMed database using such keywords as: orthodontic skeletal anchorage, temporary anchorage, orthodontic mini-screw, orthodontic mini-plate. A literature search revealed that temporary skeletal anchorage allows the surgeon and orthodontist to predictably make changes to the jaw bones that were previously only possible with orthognathic surgery. Before installing a mini-screw or mini-plate, careful planning in the form of an examination and x-ray examination should be carried out. Ultimately, informed consent should be obtained explaining to the patient that orthognathia may still be necessary if the skeletal anchorage method fails. Although this is still a relatively new technique, some issues need to be considered and further clinical research is needed.

Introduction. Removal of wisdom teeth is always accompanied by the appearance of collateral edema of varying severity, pain, neurological dysfunction and inflammatory contracture of the masticatory muscles.Purpose. To evaluate the use of local apparatus hypothermia and the method of three-dimensional facial scanning for the treatment of patients after extraction of mandibular third molars.Materials and methods. 60 patients had their wisdom teeth removed. Depending on the group, local apparatus hypothermia (LAH) (study group of 30 patients) and local ice hypothermia (LIH) (control group of 30 patients) were performed after surgery. Evaluation criterion: three-dimensional scanning of the face on days 3, 5, 7.Results. In the control group, on the 3rd day the size of the edema was 6.31 mm (SD 0.81), on the 5^th day – 4.88 mm (SD 0.73), on the 7^th day – 3.44 mm (SD 0.88). In the study group, on the 3^rd day the size of the edema was 5.09 mm (SD 0.80), on the 5^th day – 2.73 mm (SD 0.71), on the 7^th day – 1.28 mm (SD 0,62). In the control group, the size of edema on the 5^th day changed by 22.67% compared to the 3rd day, on the 7^th day by 30.12% compared to the 5^th day and by 45.94% compared to 3^rd day. In the study group, the size of edema on the 5^th day changed by 46.42% compared to the 3^rd day, on the 7^th day by 53.16% compared to the 5^th day and by 75.32% compared 3^rd day. Comparison of groups 3, 5 and 7 in terms of absolute values of edema size and percentage change showed a statistically significant difference (pConclusion. The use of local apparatus hypothermia in the postoperative period can reduce the severity of collateral edema in a shorter period compared to standard methods of local hypothermia.

Today, in clinical practice, the loss of marginal bone mass around dental implants in the early stages after the installation and opening of the implant is increasingly common. Early clinical publications suggested that this bone loss occurred during the first year of prosthetics. Thus, numerous attempts have been made to minimize or eliminate such bone loss. However, the timing and cause of bone loss are not always obvious. The purpose of this review was to analyze data on marginal bone loss around dental implants in terms of biological implications to help understand changes in marginal bone around dental implants. One hypothesis for bone loss around dental implants has been related with infected interface between the implant and abutment. This review article shows that bone loss of 1.5 to 2.0 mm occurred around implant-abutment junctions at the bone level. The bone loss level was correlated with implant-abatement interface size. Recent publications indicate that such dental implant systems with large prosthetic-implant gaps may cause peri-implantitis with further implant loss.