The restoration of discolored teeth is conducted by direct and indirect restoration techniques. Impairment of marginal periodontium is possible during the stages of both direct and indirect restoration in gum retraction, cofferdam application, grinding and polishing for direct restoration, removal of fixation cement residues near indirect restorations and finishing preparation of the connection boundary with the tooth. Furthermore, the restorations affect the periodontal tissues in the long term due to the formation of biofilm and dental plaque in the precervical area of the abutment teeth. One of the earliest ways to detect the inflammatory process in the marginal periodontium is to determine the level of pro-inflammatory and anti-inflammatory cytokines in the crevicular fluid. The aim of the research was to study the level of pro-inflammatory and anti-inflammatory cytokines in the crevicular fluid after direct and indirect restorations, which were performed by classical fixation and via the proposed method of fixation on the heated composite in 24 hours and 12 months. Materials and methods of the research. For clinical substantiation and comparison of direct and indirect ceramic restorations with classical fixation and the proposed method of fixation on the heated composite, we examined and collected the material in 24 hours and 12 months after treatment in 84 patients, aged 18-65, with dental discoloration and defects of the crown of the frontal teeth. All patients were divided into 7 clinical groups with 12 patients in each. Group 1 was a control, which included patients with intact dentition, without discoloration and defects of the hard tissues of the teeth of the frontal area; group 2 embraced patients who were treated by direct restoration (a day after treatment); group 3 comprised patients, treated with indirect ceramic restorations, which were fixed by conventional methods on a double-cured composite (one day after treatment); group 4 included patients, whose veneers were fixed to the heated composite (one day after treatment); group 5 embraced patients 12 months after treatment with direct restorations; group 6 included patients, treated with indirect ceramic restorations, which were fixed by conventional methods on a double-cured composite (12 months after treatment); group 7 comprised patients, whose veneers were fixed to the heated composite (12 months after treatment). The material for the study was the crevicular fluid. We determined the tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and interleukin 10 (IL-10). The study showed that in all three study groups in 24 hours, the significant predominance of the IL-6 content as compared to the control group was observed. The presence of IL-6 in the crevicular fluid indicates inflammation in the periodontium. The level of another pro-inflammatory cytokine, TNF-α, was higher in the groups with direct and indirect restorations, which were fixed by conventional methods to the composite of double hardening, which relates to adverse factors, since this mediator activates the processes of osteoresorption and enhances inflammatory reactions in the periodontal tissues. When comparing the concentrations of pro-inflammatory cytokines TNF-α and IL-6 in the crevicular fluid between the direct and indirect restoration group, we detected their significantly lower level in the groups where indirect restorations were performed, fixed on the composite cement and on the heated composite. The concentration of IL-10 in the groups with direct and indirect restoration, fixed on the heated composite, was the same, and in the group with indirect restoration, fixed on the composite cement, it increased significantly. After 12 months, the level of pro-inflammatory cytokines TNF-α and IL-6 was significantly higher in the direct restoration group as compared to the indirect restoration groups and with fixation on the composite cement and on the heated composite. The absence of significant differences in pro-inflammatory cytokines in this period for the groups of indirect restorations indicates the absence of inflammatory phenomena in the marginal periodontium and proves the possibility of applying the method of veneer fixation on the heated composite.
In the clinic of orthopaedic dentistry, diseases of the mucous membrane caused by wearing removable dentures occupy a special place because the frequency of their occurrence and according to various authors varies from 15 to 70% of patients. Denture stomatitis is a complication resulting from wearing laminar dentures made of acrylates, which contain residual monomers having a chemical-toxic effect. The purpose of the study is to determine the mass coefficient of internal organs in order to assess the toxic effect of C60 fullerene on the body of rats and subsequent introduction of the material into the clinic of orthopedic dentistry. Objects and methods. The study was carried out on male rats divided into three groups of six animals each: I group included intact control rats; II group included animals received food with C60 fullerene; III group included animals received injectable methyl methacrylate. Conditionally therapeutic dose of fullerene C60 and methyl methacrylate was 1 ml/kg each. The studied samples were administered to rats through a metal probe every day once a day for 21 days. The state of peripheral blood, the functional state of the liver and the mass coefficient of the internal organs of the studied animals enable to evaluate and compare the toxic effect of fullerene C60 and methyl methacrylate. Results. The study has shown the introduction of C60 fullerene did not cause visible signs of intoxication and lethal consequences in the experimental animals. No animals of the main group (fullerene C60) and the comparison group (methyl methacrylate) died after the 21-day study. There were also no significant violations of the general condition and behaviour of the animals. The physiological state of experimental rats did not differ from control rats. In the group of intact control males, a significant increase in the body weight of rats compared to the initial values was noted by 8% in the 2nd week and by 20% in the 3rd week of observation. In groups of animals that were injected with fullerene C60 and methyl methacrylate, the body weight dynamics as a whole was similar to the body weight dynamics of intact control animals. The obtained indicators point out the absence of a harmful effect of the studied drug on the physiological processes of rats. Administration of the nanopreparation did not have a harmful effect on internal organs (liver, heart, lungs, spleen, adrenal glands), with the exception of the kidneys and thymus, where certain changes were observed. The relative mass of the kidneys decreased statistically significantly when fullerene C60 was used, and the mass of the thymus, on the contrary, increased. Despite the statistical differences between the groups, the values of the kidney mass coefficient for the use of the nanopreparation are within the physiological range and cannot be considered critical. An increase in the mass of the thymus against the background of fullerene use probably occurs as a result of the activation of the immune system upon the introduction of the investigated agent. However, hematological studies did not reveal pathological deviations in the leukocyte blood formula and significant activation of immunological processes, so it can be assumed that the increase in thymus mass coefficient is not a consequence of the toxic effect of C60 fullerene. Conclusion. The use of Fullerene C60 for 21 days, based on the results obtained, does not have a toxic effect on the organs and systems of male rats, does not cause any intoxication reactions and does not lead to fatal consequences.
At the present time, the actual problem of dentistry is the study of the issues of the syndrome of pain dysfunction (SPD) of the temporomandibular joint (TMJ), which is found in 14-20% of teenagers and significantly increases with age (Siemkin V.A, Rabukhina N.A., 2000 ; Khavatova VA, 2005). The pathology of TMJ dysfunction was detected in 80% of the examined patients (Bezrukov V.M, 2002). Separately allocated dysfunction of TMJ in dysplastic-dependent form of joint pathology, thereby emphasizing that dysfunction is a characteristic manifestation of dysplasia of connective tissue in the maxillofacial area (Statovskaia Ye.Ye, 2005; Kozlov D.L., Viazmin A.Y., 2007). According to observations of A.I Mirza, I.V. Mikheieva, V.M. Novikov and according to our data, in more than 90% of people, pathological phenomena in the area of the temporomandibular joint have nothing to do with the inflammatory processes of this combination. At the same time, various dysfunctions and pain spasm of separate areas of chewing muscles occupy the main place. The aim of the work was to analyze the causes and clinical symptoms of patients with SPD. In this regard, as it turned out from the anamnesis, many patients had been undergoing inappropriate treatment for a long time. The cavity of the temporomandibular joint was repeatedly injected emulsion hydrocortisone acetate, antibiotics and other medications, which do not work in case of SPD of the temporomandibular joint. In some cases, after such therapy, dysfunction of the mandible occurred, leading to an even greater disruption of the joint function and increased pain. A number of patients with SPD of the temporomandibular joint due to a false diagnosis for a long time received treatment for neuralgia of the trigeminal nerve by drugs, Novocain blockade or alcoholization of sensitive branches of the trigeminal nerve. These patients often had neuritis, which greatly worsened the patient’s condition and the prognosis of the disease. The clinical picture of the SPD of the temporomandibular joint and a number of such diseases (syndromes of Slider, Sikara, etc.) is often so obscure and confusing that a large clinical experience is needed to evaluate individual symptoms. In addition, it should be noted that dysfunction of the mandible occurs with lesions of any part of the temporomandibular complex. Thus, limitation of the mobility of the mandible usually develops with arthritis of the temporomandibular joint, abscesses and phlegmons of the parotideomasseterica, temporal regions, pterygomandibulare, parapharingenal space, jaw-tongue groove and osteomyelitis of the branches of the mandible. Diagnostic difficulties often increase due to the fact that it is not always possible to find out the atypical etiological origin of the SPD of the temporomandibular joint. Against the background of the listed objective adverse factors, the presence of diagnostic errors largely contributes to insufficient knowledge of dentists who have clinical questions and questions on treatment of the SPD TMJ due to the difficulty in differential diagnosis, which is not fully covered in textbooks on dentistry. Control of correctness of the established diagnosis is the blockade of the motor branches of the trigeminal nerve subcutaneously using the Yehorov's method, which results in the removal of muscle spasm, stops pain and improves the mobility of the mandible. Conducting additional paraclinical examination methods such as dynamic MRT, 3-D MRT, CT and electromyography should be done.
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