Masna-Chala O.Z., Chelpanova I.V. Density and mintral content analysis of the bone tissue of the lower jaw and peculiarities of the posttraumatic dynamics. Danylo Halytsky Lviv National Medical University ABSTRACT. Background Bones fractures today occupy one of the prominent places among traumatic lesions. In dental practice, more than 50% of extractions of teeth are accompanied by the destruction of bone tissue of the alveolar areas of the jaws. A necessary condition for an adequate diagnosis of bone tissue quality deviations from the norm is the knowledge of the standard parameters of this indices, both intact bone and after surgical injury. As the quality of the bone tissue depends not only on its structure but also on the mineral content, the deficiency or excess of any of the mineral elements substantially changes the physical properties of the bone -strength, hardness, elasticity. Objective. The aim of our study was to determine the normative indices of the density of bone tissue of the lower jaw of the rat and its mineral content in intact animals, as well as to determine the regularities of the dynamics of these indices after surgical injury. Methods. The study was performed on 20 sexually mature, outbred male rats with a body weight of 180-200 g and a 3.5-month old age. The injury was modeled by breaking the integrity of the bone tissue of the mandible in the area of molars with the help of dental drill. The operation was performed under thiopental anesthesia. Control of the quality of bone tissue in the injured area of the mandible was performed using a dental radiovisiographer Siemens with the software Trophy Radiology. The unit of measurement of tissue density was taken to be the conventional unit of gravity (CUG). To determine the mineral content of the bone tissue of the rat's mandible, the method of atomic absorption spectral analysis (AASA) was used, which allowed to detect the contents of eight mineral elements (calcium (Ca), phosphorus (P), magnesium (Mg), sodium (Na ), potassium (K), iron (Fe), strontium (Sr), zinc (Zn)). Concentration of the investigated elements in bone tissue samples was indicated in mg/g. Investigation of the quality and mineral content of the bone tissue of the mandible was carried out in 1, 2 and 3 weeks after injury (5 animals at each time of the experiment), another 5 animals were in the control group. Results. The conducted study showed the presence of expressed dynamics of quality of the bone tissue of the mandible within three weeks after the bone injuries were caused. Within two weeks after injuries, the bone density of the mandible in the injured area gradually increases, increasing twice to the end of the second week compared to normal. During the third week after the injury, the investigated index is reduced, but remains slightly higher than in intact animals. The analysis of the mineral content of the bone tissue of the body of the mandible of the rat in norm and after the surgical trauma has made it possible to determine the quantitative content of all invest...
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Background. The problem of restoration the integrity of the dentition after tooth loss remains one of the most problematic dental issues. Мodern dental technologies open a promising direction in its solution, in particular - the method of dental implantation. Objective. The aim of our work was to study the changes that occur in the bone tissue of the mandible after implantation of titanium foam and to determine the effect of shock wave therapy (SWT) on its structure restoration. Methods. The study was performed on 15 adult rabbits aged 6-7 months, weighing 2.5-3 kg. The animals from the experimental groups were implanted with titanium pin, 3 mm long. The pin was implanted under combined anesthesia bilaterally into the body of the mandible. One day after the operation, the animals received SWT 500 pulses with a frequency of 5 Hz and a maximum pressure at the wavefront of 1.2 Bar per implantation site using the device Storz Medical Master Plus MP 100. The animals were removed from the experiment on 15-th day, after which the mandible was disarticulated and radiographically performed. The obtained results were statistically significant. The differences at p<0.05 were considered significant. Results. The results showed that the bone tissue of the jaws during implantation undergoes traumatic injury, the results of which, two weeks after surgery on radiographs we can clearly see a violation of the bone tissue structure and a significant increase in its density. Using the SWT method, we obtained a positive dynamics of bone density after titanium pin implantation and slight Rh-changes in bone structure compared with normal. Conclusion. Аfter implantation with titanium pin the bone density of the rabbit lower jaw body is significantly reduced, X-ray shows the heterogeneity of bone structure, areas of sclerosis are expressed. Shock wave therapy helps to restore the quality of bone tissue, this is confirmed by the fact that the density indicators are close to the norm and X-ray shows some separate small areas of restructuring of bone tissue heterogeneity, mainly due to merging the pattern of the bone trabeculae of the bone cancellous part.
The article "Problems of deontology in modern medicine" provides: inoculation of deontology in the learning process, the word of the doctor, deontology of medicinal treatment, deontology in pediatric, deontology of family medicine, deontology of hospice, deontology of euthanasia and abortion, deontology of transplantation, medical error. By accumulating experience of treatment for thousands of years, doctors have constant problems with solving the moral and ethical principles of their profession: responsibility to themselves and to society for their professional activity in choosing the means and methods of treatment; donation and transplantation; artificial interruption of pregnancy and euthanasia, and many others. Today there is a fantastic progress in medicine, medical technology and the invention of effective therapeutic agents. However, fullfledged medical activity is possible only on condition of accordance with the rules of medical ethics, deontology. Future physician should receive the first notions about the deontology from the first days of studying at a university, before arriving at clinical departments. We mean the moral and ethical principles of the educational process in the dissecting room, during the educational experiments with test animals, and especially-in the study course "Caring for the sick." Only on this condition, the student, having come to the clinical department, will have the opportunity to be correctly orientated in the studying deontology. The issue of deontology, especially in our time, needs to be given considerable attention throughout the course of postgraduate education, that is, when passing courses of perfection, precertification cycles. In the healing of a sick person, the word of the doctor is very important. A good doctor starts treatment with a good word. The words and behavior of the doctor in communicating with the patient should Problems of deontology in modern medicinebe chosen so thoughtfully, carefully and balanced, as in the situation with selecting the doses of potent drugs. The confidence and perseverance of the doctor, shown in a friendly and soft form, also help to establish an optimal contact. By showing an appropriate respect to the patient, the doctor must still maintain a certain distance, prevent the backslapping. Summing up reflections on the problem of medical errors, it will advisable to give such advice: "Do not be afraid to trust your common sense, keep in the heart love to your patient and did not be afraid to make an error, really humane doctor almost do not make it".
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