Subject: Inflammatory periodontal diseases are one of the most common dental diseases in the world. To ensure successful treatment and a stable period of remission, it is necessary to take into account the etiopathogenesis of the disease. One of the main roles in the development of inflammatory periodontal diseases is played by the immune response of the body to the action of periodontal-pathogenic micro-organisms. Objective ― to study the current literature indicates about the role of immunological processes in the development of inflammatory periodontal diseases, as well as the possibility of their correction Material and methodologies: Data from the scientific literature on the etiopathogenesis of inflammatory periodontal diseases was used in the study. To achieve this objective the databases of the Tyumen State Medical University Library, electronic libraries (eLibrary, Cyberleninka, PubMed, Googl.Scholar), official sites of scientific publications were used. Results: the review of the literature presents information on the immunological processes developing in inflammatory periodontal diseases. The role of cellular and humoral elements in pathogenesis, the role of pro and anti-inflammatory cytokines in the chronization of the inflammatory process is described. The possibilities of local immunological correction in the treatment of inflammatory periodontal diseases are considered. Conclusions: The concept of cytokine development of inflammatory periodontal diseases has been formed and substantiated in modern scientific literature. The evaluation of the cytokine profile of the oral and gingival fluid allows to establish the activity and severity of the disease. The established immunological and molecular genetic mechanisms of the development of inflammatory periodontal diseases associated with the influence of cytokines make it possible to adjust the complex treatment of inflammatory periodontal diseases, determine the direction of personalized therapy of patient, determine the effectiveness of the treatment and the prognosis of the disease.
АннотацияПредмет. Реализуемая в настоящее время государственная программа Российской Федерации «Развитие здравоохра-нения» включает направление «Первичная профилактика стоматологических заболеваний среди населения Российской Федерации». Для достижения ожидаемых целевых показателей необходима разработка региональной программы про-филактики стоматологических заболеваний среди населения Тюменской области, основанной на научно-обоснованных данных, с учетом региональных особенностей.Цель. Создание информационно-аналитической основы для разработки региональной программы первичной про-филактики стоматологических заболеваний среди населения Тюменской области.Методология. В соответствии с картами для регистрации стоматологического статуса (ВОЗ, 2013) проведена оценка стоматологической заболеваемости населения Тюменской области и ряда факторов, влияющих на ее формирование: общей заболеваемости населения региона по данным Медицинского информационно-аналитического центра; распро-страненности фенотипических признаков синдрома недифференцированной дисплазии соединительной ткани; содер-жания фторида в питьевой воде; особенностей пищевого поведения, гигиенического воспитания путем анкетирования. Статистическая обработка результатов осуществлялась в программе Vortex 10.7.3.Результаты. Распространенность кариеса зубов в исследуемых группах населения высока и в ряде случаев значи-тельно отличается от целевых показателей программы развития здравоохранения в Российской Федерации. Интенсив-ность кариеса у детей 12 лет, проживающих в городе Тюмени и Тюменском районе, составила 2,51; в северных районах области -4,41; в южных -2,4 (целевой показатель -2,3). Интенсивность кариеса среди взрослого населения (35-44 года) центральных и северных районов области составила в среднем 15,52 (целевой показатель -стабилизация на уровне 14,4). Признаки поражения пародонта у подростков 15 лет выявлялись в среднем в трех секстантах (целевой показатель -5 секстантов со здоровым пародонтом). Выявлены высокая распространенность сопутствующих заболе-ваний и синдрома недифференцированной дисплазии соединительной ткани, низкое содержания фторида в питьевой воде, недостаточный уровень гигиенического воспитания.Выводы. На основании данных ситуационного анализа разработан проект региональной программы первичной профилактики стоматологических заболеваний населения Тюменской области.Ключевые слова: стоматологическая заболеваемость, интенсивность кариеса, первичная профилактика стома-тологических заболеваний, фтор, синдром недифференцированной дисплазии соединительной ткани. 22-27Терапевтическая стоматология / Therapeutic dentistry Оригинальные исследования / Original research papers
Предмет. В связи с сопряженностью стоматологических заболеваний с системной патологией и морфо-конституциональными особенностями интерес представляет недифференцированная дисплазия соединительной ткани. Формирование проявлений недифференцированной дисплазии соединительной ткани зависит не только от генетической несостоятельности соединительнотканных структур, но и от влияния факторов внешней среды. Условия Крайнего Севера отличаются неблагоприятными экологическими, климатическими и социальными факторами, что может служить основой манифестации признаков. В литературе отсутствуют сведения о распространенности недифференцированных форм дисплазии соединительной ткани и ее отдельных признаков среди населения тюменского севера, особенностях стоматологического статуса лиц с диспластическими фенотипами. Цель. Сравнительная оценка стоматологического статуса подростков с диспластическим фенотипом и без такового, проживающих на территории Ханты-Мансийского и Березовского районов ХМАО-Югры. Методология. Обследованы подростки 12-16 лет, проживающие на территории Ханты-Мансийского и Березовского районов. Стоматологическое обследование осуществлялось в соответствии с рекомендациями ВОЗ, данные заносились в Карту для оценки стоматологического статуса (2013). Устанавливалось наличие фенотипических признаков недифференцированной дисплазии соединительной ткани в соответствии с «Национальными рекомендациями Российского научного медицинского общества терапевтов по диагностике, лечению и реабилитации пациентов с дисплазиями соединительной ткани» (2016) и фенотипической картой Glesby (1989). Анализ показателей проводили с использованием критерия Стьюдента. Использовались процедуры описательной статистики. Результаты. Выявлена значительная распространенность (62,7 %) диспластических фенотипов. Наиболее распространенными признаками-фенами являлись астенический тип конституции, потеря нормальной осанки, миопия, готическое небо и положительный симптом «запястья», положительный симптом «большого пальца». Распространенность кариеса зубов достигает 95 %, воспалительных заболеваний пародонта-57 %, аномалий прикуса-85 %. Выводы. Распространенность основных стоматологических заболеваний и аномалий прикуса у подросткового населения в исследуемых местностях высока и характеризуется более значительными показателями среди лиц женского пола с диспластическим фенотипом. Ключевые слова: диспластический фенотип, стоматологический статус, стоматологическое здоровье населения севера, распространенность и интенсивность кариеса, заболевания пародонта, аномалии прикуса.
The problem of oncological and precancerous diseases of the oral mucosa is urgent, because the prevalence of these diseases is high, as well as malignant neoplasms of this localization are among the most aggressive and difficult to treat human neoplasms, characterized by a high percentage of mortality. These facts determine the increased importance of primary prevention of precancerous and cancerous diseases, the purpose of which is to identify and eliminate predictive factors of the development of these pathologies. Objective of the study is to conduct a systematic analysis of modern Russian and foreign literary sources in the aspect of predictive factors of the occurrence of precancerous and cancerous diseases of the red border of the lips and oral mucosa and their main mechanisms. Methodology. The research is based on the search and analysis of modern Russian and foreign original sources on the topic in the databases eLibrary, Pubmed, Crossref. Results. The development of precancerous and oncological diseases is a complex multifactorial process that proceeds under the influence of a number of prognostic factors that have both isolated and synergistic effects on the human body at the local or general level. Conclusion. We have analyzed the scientific literature, which indicates a significant contribution of a wide range of modifiable and unmodifiable factors in the development of precancerous and oncological processes. Identification and correction of probable risk factors for the occurrence of precancerous and oncological diseases of the oral mucosa can help prevent the development of these diseases.
Object. Dentoalveolar anomalies contribute to the development of morphological and functional disorders in the temporomandibular joint, and also lead to changes in aesthetics, chewing functions and speech formation. This report presents the results of a study of the prevalence and structure of dentoalveolar anomalies in adolescents of the indigenous minorities population of the Khanty-Mansiysk Avtonomniy Okrug ― Ugra. Data on the epidemiology of dentoalveolar anomalies are necessary for planning regional measures for the prevention of dental anomalies and deformities in the study area. The goal ― is to study the prevalence and the structure of dentoalveolar anomalies among adolescents of the indigenous minorities population of the Khanty-Mansiysk Avtonomniy Okrug ― Ugra. Methodology. Expedition and exploration method carried out a comprehensive dental examination adolescents of indigenous minorities population in a number of areas of the Khanty-Mansiysk Avtonomniy Okrug ― Ugra. Evaluation of dental status was carried out according to the criteria of the World Health Organization. In the section “dento-alveolar anomalies”, the density of teeth and gaps, as well as the main types of malocclusion, were recorded. Results. The prevalence of dentoalveolar anomalies among the surveyed was 35,4 %. The proportion of crowded teeth in the overall structure of the dental-alveolar anomalies is 30,3 %, the proportion of diastema is 2,1 %. The frequency of occlusion anomalies against the background of connective tissue dysplasia is 3,5 times higher. Summary. The high prevalence of dentoalveolar anomalies among adolescents of the indigenous minorities population of the Khanty-Mansiyskiy Avtonomniy Okrug ― Ugra was revealed. Most often, dental-alveolar anomalies were occured in the form of crowding of the upper and lower teeth, the gaps between the incisors and canines, the abnormal position of the incisors on the upper and lower jaw, changes in the closure of the molars. Dental-alveolar anomalies were more often recorded in the group of adolescents with signs of CTD.
Object. Causes of failure of endodontic treatment and causes of tooth extraction with a diagnosis of chronic apical periodontitis. Purpose ― to analyze the causes of failure of endodontic treatment and the causes of tooth extraction with a diagnosis of chronic apical periodontitis to determine ways to improve the effectiveness of conservative treatment. Methodology. A retrospective analysis of 864 medical records of a dental patient and 532 results of x-ray examinations of patients who underwent tooth extraction was carried out. 198 dentists-therapists of the city of Tyumen and the South of the Tyumen region were interviewed to determine the shortcomings of endodontic treatment. During the survey, doctors expressed their subjective opinion about the main reasons for the failure of therapeutic treatment of teeth with apical periodontitis and the reasons for their subsequent tooth extraction. Results. According to the survey, the failure of conservative treatment is most often associated with non-compliance with treatment protocols and the complexity of the anatomical structure of the root canals, as well as the inability to adequately clean the root canal system. A retrospective analysis of the data related to tooth extraction revealed that the main cause of tooth extraction is chronic apical periodontitis, which accounts for 69 %. The main reason for the removal of teeth diagnosed with chronic apical periodontitis was a significant destruction of the crown. Summary. In the course of this work, we justified the need to improve existing methods of conservative treatment of apical periodontitis. Improvement of endodontic treatment should be aimed at the development and implementation of effective methods of root canal cleaning and irrigation solution activation. In order to improve the prognosis of endodontic treatment and reduce the proportion of tooth extractions for periodontitis, it is necessary to improve the quality of the final restoration and to monitor its tightness.
The lack of information on the relationship between the indicators of micro, macronutrient and dental status of adolescents living in Yamal was the basis for analyzing these indicators. A comprehensive dental examination of 112 adolescents aged 12 and 15 years, from among the indigenous peoples living in the territory of the Yamalo-Nenets Autonomous District, an assessment of the actual nutrition and elemental composition of blood serum was carried out. The analysis of the data showed that the prevalence of dental caries among the examined exceeds 99 %. The CPI index ranged from 4,6-7,7. The imbalance of micro- and macroelements involved in ontogenesis and providing the processes of remineralization of hard tooth tissues was revealed. Correction of the elemental status should be included in the complex of therapeutic and preventive measures that increase caries resistance.
Background. The high prevalence of inflammatory periodontal diseases in young people determines the relevance of the study of the diagnosis and treatment of pathologies. Chronic generalized periodontitis of moderate severity is a General medical and socio-economic problem. Mobility and loss of teeth, the presence of a focus of chronic infection in periodontal pockets, gum recession and bad breath lead to psychological discomfort associated with difficulty in communicating, eating, daily life. Thus, the quality of life of patients due to dental health is an important indicator of the subjective evaluation of the effectiveness of therapeutic measures. Objectives ― study of the dynamics of quality of life in patients with chronic generalized periodontitis on the background of traditional therapy Methods. In the course of the study, the treatment of chronic generalized periodontitis of moderate severity was carried out using the traditional treatment regimen, and the long-term indicators of the quality of life due to dental health were studied on the basis of the OHIP-14-RU questionnaire. Results. As a result of our study revealed a significant improvement in the quality of life due to dental health in patients with chronic generalized periodontitis of moderate severity in the long term. At the same time, after 12 months, some patients in the questionnaires recorded problems in communication, after 6 and 12 months – problems in everyday life. Conclusions. Our study demonstrates an improvement in the quality of life due to dental health in patients with chronic generalized periodontitis of moderate severity against the background of traditional treatment. However, the emergence of problems in communication in the long term after therapy suggests the need to optimize treatment aimed at their elimination.
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