Поражение височно-нижнечелюстного сустава (ВНЧС) встречается у пациентов с различными ревматическими заболеваниями (РЗ).
О Б Щ А Я Р Е А Н И М А Т О Л О Г И Я , 2 0 1 2 , V I I I ; 1 31 Т р а в м а Цель исследования -определение особенностей психологического состояния пациентов с острой травмой нижней челюс ти; сравнение психологической реакции на травму в различных возрастных группах и у лиц с признаками алкогольной зави симости. Материал и методы. В исследование было включено 37 больных обоего пола старше 15 лет. Распределение паци ентов осуществлено по возрасту и наличию хронической алкогольной интоксикации. Определение параметров психологического статуса осуществлено посредством личностных опросников: Спилберга Ханина, Zung, GHQ 28, Вейна. Результаты. У больных с травмой нижней челюсти выявлено повышение уровней ситуативной и личностной тревожности. В 29,8% случаев установлено наличие депрессивного состояния, как реакции на острую травму нижней челюсти (реактив ного генеза). Вегетативная дисфункция имела место у 62,2% пациентов с переломами нижней челюсти. Наличие скрытых патопсихологических состояний среди больных исследуемой группы выявлено в 35,1% случаев. Заключение. Основными выявленными особенностями психологического статуса больных с острой травмой нижней челюсти являлись -наличие вы сокого уровня тревожности и значительная частота встречаемости синдрома вегетативной дисфункции. Существенных раз личий по психологическому статусу и направленности реакций, связанных с возрастом пациентов, установлено не было. У пациентов с наличием хронической алкогольной интоксикации чаще развивалось депрессивное состояние, но чуть реже встречался синдром вегетативной дисфункции и менее часто выявлялись патопсихологические состояния. Ключевые слова: острая травма, нижняя челюсть, тревожность, депрессия, злоупотребление алкоголем, психологический статус.Objective: to define the specific features of the psychological status of patients with acute mandibular injury, to compare a psy chological reaction to injury in different age groups and in persons with signs of alcohol addiction. Subjects and methods. The study enrolled 37 patients of both sexes over 15 years of age. The patients were distributed by age and chronic alcohol intox ication. Psychological parameters were determined using personality questionnaires: Spielberg Hanin, Zung, GHQ 28, and Wein ones. Results. The patients with mandibular injury were found to have higher levels of situational and personality anxi ety. A state of depression as a response to acute mandibular injury of reactive genesis was found in 29.8% of cases. Autonomic dysfunction occurred in 62.2% of the patients with mandibular fractures. Occult pathopsychological states were detected in 35.1% of the study group patients. Conclusion. The main found peculiarities of the psychological status of the patients with acute mandibular injury were high anxiety and the considerable incidence of autonomic dysfunction syndrome. There were no great age differences in psychological status and the direc tion of reactions. The patients with chronic alcohol intoxica tion more frequently developed a depressive state, but the auto...
Aim. To analyse the effi ciency of osteoplastic material application in order to reduce the resorption level after tooth extraction in the preimplantation period according to the data of cone beam computed tomography.Materials and methods. The study involved 80 patients who were divided into 4 equal groups depending on the preservation material used. The fi rst group was treated with Cerabone (Botiss, Germany) xenomaterial based on natural bovine bone. Plasma enriched with PRGF growth factors obtained by the BTI Endoret (Spain) technology was used for the patients of the second group. The third group consisted of patients who underwent a socket preservation of the extracted tooth with a powdered autologous dentin matrix (ADM) obtained from their own tooth. In the fourth group, bone-plastic material based on hydroxyapatite with Collapan-L lincomycin hydrochloride (Intermedapatit, Russia) was used to prevent socket resorption. All patients had a cone beam computed tomography of the maxillofacial region before the extraction and 3 months after the preservation in order to evaluate the level of bone resorption. After the installation of dental implants, a comparative assessment of the bone resorption level in the vertical and horizontal directions before tooth extraction and in the preimplantation period was carried out.Results. The smallest level of vertical bone resorption after socket preservation was observed in group 1 (Cerabone) and group 3 (ADM). The median value of the socket resorption level in group 1 was 0.7 mm (8.54 %) in the vertical direction and 0.5 mm (9.45 %) in horizontal measurement as compared to the level of bone tissue before tooth extraction. Similar indicators were observed in the group using an autologous dentin matrix. The vertical decrease in the socket bone tissue was 0.61 mm (7.75 %), horizontal — 0.51 mm (6.2 %). The level of bone resorption was signifi cantly higher using two other materials.Conclusions. The use of three-dimensional radiation research methods allows a comprehensive assessment of the bone tissue volume to be carried out, which in turn determines the choice of the dental implant size, the need for further bone-plastic surgery to increase the width/height of the alveolar ridge. The use of cone beam computed tomography showed that the most optimal results can be obtained by introducing Cerabone material into the socket of the extracted tooth, as well as using the innovative method of preservation with the patient’s own powdered tooth (ADM).
Background. Currently, using of osteointegrated titanium implants has become a key component for restoring lost function in various areas of clinical medicine. The actual issue remains preservation or reconstruction of bone tissue for optimal use of titanium implants in traumatology and orthopedics, as well as in maxillofacial surgery. One of the most common grafts are hydroxyapatite-based material with various inclusions, for example, an antibiotic.The aim of the study is to characterize the regeneration of bone tissue of the jaws alveolar ridge using the hydroxyapatite-based material “Collapan-L” in clinical practice.Material and Methods. The study of the material “Collapan-L” (Intermedapatit, Russia) using involved 30 patients with a diagnosis “chronic periodontitis of the tooth”. Patients underwent complex surgical and orthopedic treatment to restore masticatory function. At the first stage, teeth were removed with the “Collapan-L” material used to preserve the alveolus. 4 months after extraction, dental implantation was performed with simultaneous trephine biopsy from the augmentation zone for histomorphometric analysis. At the stage of implant placement and before prosthetics the stability dynamics was measured.Results. The study involved 42 tissue samples obtained at periods from 9 to 32 weeks after removal. The morphological assessment of bone tissue from the implantation zone determined that after 4 months trabeculae from the newly formed bone, including small fragments of biomaterial, were revealed; at the same time, there were signs of biodegradation of the implanted material fragments, there was no inflammatory infiltrate. After 6 months in a significant part of cases the granules of bone material were not found, which indicates a pronounced osseointegration of the material. In its structure, the formed bone tissue differences barely noticeable from the native one, which allows us to conclude that by the time of 24 weeks, the processes of reparative osteogenesis in the alveolus are completed.Conclusion. Histological examination and assessment of changes in the stability showed that using of bone replacement material after tooth extraction can increase the regenerative potential of bone tissue, avoid additional surgical interventions to increase the volume of bone tissue in the area of future implantation, and the formed bone tissue is close in its structure to the native one.
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