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.
The aim of the research is to study the physical and mechanical parameters of the bases in removable laminar dentures after modification of their surface. Materials and methods: the studied samples were divided into two groups (group I – acrylic plastics, and group II – acrylic plastics with fullerene С60 nanocoating), 50 samples in each group. The coefficients of water absorption, water solubility, microhardness and deformation characteristics of materials were studied. Results and conclusions: The material covered with fullerene С60 has a lower coefficient of water absorption and water solubility, which amounted to 0.55% and 0.23% respectively, from the initial weight of samples, as compared with acrylic plastics without coating (0.71% and 034%, respectively). The strength parameters of samples of group ІІ were higher by 13.5% as compared to group І. The given results of water absorption and water-solubility show that acrylic plastics with fullerene С60 molecules coating has a lower coefficient of water absorption and water solubility, in comparison with acrylic plastics without coating. This indicates a higher degree of resistance to biodegradation of the modified surface material, in turn reducing the washing-out of residual monomer from the denture, which directly improves the strength parameters of the acrylic plastics and can prevent the development of denture stomatitis.
Over 25 years the staff of the department of postgraduate education of dentists of the "UMSA" has been preparing the interns. The formation of independent clinical thinking in youth specialists, the ability to systematize, analyze and apply both traditional and newest methods of dental pathology diagnosis and treatment are key issues of education process. As suggests long experience, the conduction of clinical conferences is an effective method of combining theoretical and practical training of specialists. Such kind of independent work includes direct work with the patient, search of modern scientific and practical information, introduction of new methods and technologies of treatment, analysis of the results of treatment, physician-patient and health team communication, writing abstracts, articles, which allows to develop the practical skills more qualitatively. The individual approach to the patient is the most important part of clinical work. We aimed to survey the clinical conference’s role in formation of professional competencies at the internship education. From the time of foundation and till now the department’s executives regularly handles clinical conferences. Under the leading of teachers, interns are involved in research works based on the principles of evidence-based medicine. During research and treatment, they prefer to use modern methods of clinical and laboratory diagnostics and treatment. Interns have opportunity to be engaged in the research work of the department or into individual research work. The preparation of the report involves the presentation, which should represent the relevance of the problem, based on the data of literary sources in the last 5-10 years, the purpose of the study, materials and methods of research, analysis of the results, conclusions. Next must be presented in the clinical case - the purpose of the study, the etiological factors, the pathogenesis of the disease, diagnostic methods, differential diagnosis, modern classifications, clinical symptoms, methods of treatment and the prognosis of the disease. The clinical cases allow interns to profoundly work material out, apply knowledge from interrelated specialties, learn new experiences, try to avoid mistakes and wrong actions, make the right decisions after the example of medical errors that have been identified. During the examination of the patient the knowledge of internal diseases, the pathophysiological substantiation of the symptoms, the use of paraclinical examination methods in the structure of the diagnostic algorithm and the development of the correct tactical and therapeutic approach to the patient are updated. The speaker is appointed to report. His task is to systematize the material in the final presentation. The main methodological feature of a clinical conference is not only the active participation of interns preparing the report, but also interaction with students. After the report the discussion of the presented material took place, when each recipient can ask questions and participate the discussion on issues. During the discussion, an in-depth discussion of the issues of etiology, pathogenesis, morphology, differential diagnosis, treatment and prevention of a specific disease is possible. A properly constructed report and discussion allows interns to memorize the material better, induces further research and work on investigation the problem, since such a range of issues, associations, logical constructions should arise from the doctor in his day to day work. Thus, a weighed combination of different methods and forms of training, complement it with modern innovations and technical capabilities - the way to the formation of specialists with the necessary competencies. The clinical conferences are effective method of theoretical training and acquiring practical skills by interns and way to be involved in communication in the medical society.
A dental cosmetic is actual for everyone. Whitening of teeth can be the method of lab treatmen. Whitening facilities which are used with this goal often contain peroxide, hydrogen, carbamide peroxide, and combinations of peroxides hydrogen with sodium perborate. The treatment of 3 patients with discoloration of non-vital teeth was done. In two cases the reason of color change was the use of paste containing resorcinol-formalin. Discoloring of root of the tooth was caused by necrotic damage of the pulp. Clinically satisfactory results were received after 1-4 visits in 1-2 days. Use of the bleaching method with further aesthetic restoration of tooth crowns allows avoiding significant weakening of the tooth crown in comparison with prosthetic methods of treatment. The main whitening agent was 30-40% hydrogen peroxide in combination with sodium perborate. The positive cosmetic results were achieved in short terms. Clear compliance with of manufacturer’s recommendations and the use of technology allow achieving success of treatment.
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