The state of antitumor immunity of patients with oral cavity and oropharyngeal cancer during treatment (radiation and chemoradiation therapy), which additionally included α/β-defensin immunotherapy, was studied. In all three study groups, where preparation α/β-defensins was used, there was a more pronounced dose-dependent decrease in the relative number of lymphocytes in the blood than among those receiving cytostatic therapy in mono mode. Patients of group I received radiation therapy and immunotherapy, group II - chemoradiation and immunotherapy, group III - radiation therapy with immunotherapy in increased doses, VI - radiation, V - chemoradiation. Thus, in group І the decrease in the absolute number of lymphocytes was by 0.6×109/l, in group II - by 0.82×109/l, and in group III - by 0.93×109/l; by 8.51% there was a decrease in the relative number of lymphocytes in group I, by 15.52% in group II and in group III - by 14.32%. A significant decrease in the absolute number of CD3+ T cells in the blood was registered with a combination of radiation- and immunotherapy: in group I from 1141×106/l to 682×106/l and in group III - from 871×106/l to 309×106/l. At the same time, there was an increase in the relative number of natural killers in the blood of patients undergoing radiation therapy in combination with immunotherapy, also with a dose-dependent effect, the growth in group I is from 16 to 17% and group III - from 13.4 to 19.5%. Among patients undergoing cytostatic therapy, there were significant differences in the absolute number of NKT cells in the combination of radiation and immunotherapy, groups I and III, by reducing the number of these lymphocytes in the blood from 86 to 57 and from 62 to 31, respectively. α/β-defensins have been shown to have a dose-dependent adjuvant effect on cytostatic treatment – radiation, and chemoradiation of patients with cancer of the oral cavity and oropharynx. Simultaneously with the use of the drug α/β-defensins associated additional immunomodulatory effect in the form of the restructuring of the subpopulation of lymphocytes due to an increase in the relative number of natural killers in the blood.
Today, an interdisciplinary approach to solving the problems of implantology is key to the effective use of intraosseous dental implantations. The functional properties of restoration structures for the dentition depend significantly on the mechanical stresses that occur in the structural elements and bone tissues in response to mastication loads. An orthopedic design with a bar fixation system connected to implants may be considered to restore an edentulous mandible using an overdenture. In this study, the problem of the mechanics of a complete overdenture based on a bar and four implants was formulated. A mathematical model of the interaction between the orthopedic structure and jawbone was developed, and a methodology was established for the analytical study of the stress state of the implants and adjacent bone tissue under the action of a chewing load. The novelty of the proposed model is that it operates with the minimum possible set of input data and provides adequate estimates of the most significant output parameters that are necessary for practical application. The obtained analytical results are illustrated by two examples of calculating the equivalent stresses in implants and the peri-implant tissue for real overdenture designs. To carry out the final assessment of the strength of the implants and bone, the prosthesis was loaded with mastication loads of different localization. In particular, the possibilities of loading the prosthesis in the area of the sixth and seventh teeth were investigated. Recommendations on the configuration of the distal cantilever of the overdenture and the acceptable level and distribution of the mastication load are presented. It was determined that, from a mechanical point of view, the considered orthopedic systems are capable of providing long-term success if they are used in accordance with established restrictions and recommendations.
The paper is aimed at increasing the efficiency of surgical treatment by using a combination of platelet-rich fibrin, a synthetic hydroxyapatite Kergap, minimizing the body’s response to operative wound, and improving diagnostic and therapeutic approaches in surgical treatment of stage II-III generalized periodontitis. The objective of the research was to study the efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap, magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis at various stages and in different depths of the periodontal pockets. Materials and Methods. The efficiency of surgical treatment was evaluated using clinical (periodontal pocket depth, attachment level, gingival bleeding, tooth mobility) and laboratory methods (X-ray, computed tomography) 3, 6, and 12 months after surgical treatment. Results. The clinical picture was characterized by positive changes in all clinical indicators 3, 6 and 12 months after treatment. The best results by clinical and laboratory findings were obtained in case of an average pocket depth of 5-7 mm. Conclusions. There was demonstrated a high clinical efficiency of using the combination of platelet-rich fibrin, synthetic hydroxyapatite Kergap and magnesium preparation in comprehensive treatment of stage II-III generalized periodontitis.
The article presents a clinical case of the prosthodontic treatment of the mandible edentulousness. Edentulousness is a widespread pathology that depends on the social and economic situation in the country, the demographic situation, the level of dental care and prevention organization. The current worldwide trend of population aging leads to an increase in the number of the elderly, and this number is expected to increase in the future. According to the WHO, today about 600 million people are people over 60, and this number will have doubled by 2030 and will constitute 2 billion in 2050 mostly in developed countries. The situation in Ukraine is not better. Functional and aesthetic rehabilitation of patients with edentulousness requires a comprehensive approach to the prosthodontic treatment planning. Complete removable laminar dentures on the mandible have a number of disadvantages. Insufficient fixation, stabilization, diction problems, aesthetic problems, decreased self-esteem of the patient are among the key ones. Modern protocols of the prosthodontic treatment require the manufacture of dental prostheses based on intraosseous dental implants. Complete dentures based on intraosseous dental implants have a number of advantages over the fixed dentures. Compensation for deficient bone support of the facial soft tissues occurs by means of the basis. Patients’ possibility to remove a secondary restoration by themselves lead to proper hygiene of the oral cavity and peri-implant area in particular. The clinical research conducted by S. Wolfart (2016) showed the possibility of fixed/removable dental prosthesis fixation in 14-31 days (early loading) after the surgical stage of implantation provided that 4-6 intraosseous dental implants were installed. The maximum mobilization of the patient to comply with the recommendations and prescriptions is the main task considering the limited postoperative period before the dental prosthesis fixation. Our publication describes the treatment of a patient born in 1967, who was diagnosed with a mandible complete absence of teeth. Diagnosis, examination and treatment were performed on the basis of the Department of Dentistry Postgraduate Education of Ivano-Frankivsk National Medical University. The described prosthodontic treatment plan involves the manufacture of a complete denture with bar system based on four intraosseous dental implants according to the early loading protocol in a patient with primary treatment of mandible edentulousness. The choice of treatment plan was based on the results of past medical history, the patient’s disease, basic and additional methods of examination, analysis of individual indications and contraindications and readiness for the selected treatment plan. This treatment protocol has its advantages over the protocol of manufacturing a fixed prosthesis based on intraosseous dental implants such as a higher level of proprioceptive sensations, increased level of hygiene, lower complexity of clinical and laboratory stages, affordability. The term of clinical and laboratory stages of manufacturing (from the surgical stage of implant treatment to the fixation of the dental prosthesis) constituted 16 days. Additional opportunities for success in clinical and laboratory stages of treatment, the accuracy of manufacture and minimization of complications in the future were created as a result of the combination of digital and analog treatment methods in dental prosthesis manufacturing.
Aim of the research. Study the features of microcrystallization of oral fluid in children; monitor the relationship between the level of anxiety, the type of microcrystallization and the mineralizing potential of children's oral fluid. Materials and methods. 75 adolescents aged 15 years of Ivano-Frankivsk region, which belongs to the regions with iodine deficiency in the environment, were examined. Among the examined teenagers there were 25 people with low, medium and high levels of anxiety. The morphological type of microcrystallization was studied by the method of dehydration of a drop of oral fluid. Evaluation of the level of mineralizing potential of saliva was carried out on a 5-point scale, taking into account the nature of crystal formation in three fields of vision, and the average value was calculated. The assessment of the psycho-emotional state was carried out on the basis of the results of questionnaires of children using the "Scale for assessing the level of reactive and personal anxiety" by Ch.D. Spielberger and Y.L. Khanina (State-Trait Anxiety Inventory, STAI). Results. The study of the crystallographic pattern of oral fluid of adolescents revealed the predominance of type II crystals (44.00±5.73% of cases). Crystals of the most favorable type I occurred in 30.67±5.32% of cases, and crystals of type III, the most unfavorable in prognostic relation to the occurrence of dental caries, occurred in 25.33±5.02% of cases. We have studied the type of oral fluid crystals in children, taking into account the level of anxiety. In the mixed saliva of children with a low level of anxiety, type I crystal formation predominated (52.00±9.99%). Crystal formation according to the second type was recorded in 40.00±9.80%, and according to the III type - in 8.00±5.43% of cases. In children with an average level of anxiety, the number of cases of observation of type II crystals did not change (40.00±9.80%). In addition, a 1.3-fold decrease in the specific gravity of type I crystals was noted from 52.00±9.99% to 40.00±9.80%, p˃0.05, resulting in 20.00±8.00 % of cases, type III crystals occurred in the oral fluid. In children with a high level of anxiety, the specific weight of type II crystals increased from 40.00±9.80% to 52.00±9.99%, p˃0.05, and the specific weight of type III crystals increased from 20.00±8.00 % to 48.00±9.99%, p<0.05. On the other hand, not a single case of crystal formation according to type I was recorded. In this group of children, extremely unfavorable type III crystals dominated in the oral fluid. The evaluation of the mineralizing potential of saliva revealed that its average value was 2.48±0.12 points. This testified to the satisfactory level of this indicator. We investigated the mineralizing potential of oral fluid in children, taking into account the level of anxiety. Among adolescents with a low level of anxiety, the MPS was rated as satisfactory, and the average value was the highest (3.04±0.16 points). In children with an average level of anxiety, the MPS was also satisfactory, but the average value was slightly lower - 2.76±0.21 points (р˃0.05). In adolescents with a high level of anxiety, the MPS had the lowest value (1.64±0.14 points), which was interpreted as low (р˂0.05). It was found that with an increase in the level of anxiety, there was a tendency to a decrease in the specific gravity of type I crystals, an increase in the specific gravity of type III crystals, and a decrease in the mineralizing potential of mixed saliva. The lowest indicators of mineralizing potential were at a high level of anxiety. Conclusions. Analysis of the morphological picture of mixed saliva in children with different psycho-emotional states showed that adolescents with a high level of anxiety in the oral fluid are predominantly type III crystals, and the mineralizing potential is low. Reduced mineralizing properties of oral fluid lead to demineralization with subsequent progression of the carious process. Therefore, there is a need for differential prevention measures for children with different psycho-emotional states.
Thirty patients with completely edentulous jaws (the main group) and 30 patients without denture defects and treated oral cavity (the control group) were examined in order to study oral stereognosis. Standard H. Landt sets were used. The rate of tactile assessment of the objects shape in the oral cavity of the patients with completely edentulous jaws was established to decrease by 2.6 times on average in comparison with the control group, and the percentage of correctness of the sample determination decreased by 44.4%. After one month of prosthodontic treatment of the patients with completely edentulous jaws with the use of complete laminar dentures, the rate of tactile assessment of the objects' shape increased by 18.3% and the index of the correctness of the sample determination increased by 31.5%. The results of the oral stereognosis study showed that the duration of collecting and analysis of receptor signals of oral mucosa in the patients with completely edentulous jaws was longer than in the patients without denture defects. However, the tactile sensitivity of the oral mucosa had the ability to recover in one month after prosthodontic treatment with complete laminar dentures.
Vascular disorders play a significant role in the development of dystrophic inflammatory process. There is a direct correlation between the degree of damage to blood vessels in the jaw and a depth of the destructive process in periodontal tissue. A certain role is played by endogenous factors, such as: age, vitamin deficiency, diabetes mellitus, essential hypertension and others. Clinical and epidemiological studies using pathological techniques showed significant changes in vascular wall of the artery in the periodontium, the interdental artery in particular. Atherosclerosis, essential hypertension and periodontal pathology were proven to occur in individuals older than 40 years. The objective of the research was to determine periodontal tissue status in patients with stage II hypertension and generalized periodontitis of II degree of severity. Materials and methods. The study involved 36 patients with stage II hypertension and generalized periodontitis of II degree of severity (the main group). The patients' age ranged from 35 to 54 years. The control group included 10 patients of corresponding age without generalized periodontitis and somatic pathology. To assess the status of periodontal tissues, we applied the Papillary-Marginal-Attached Index and the Community Periodontal Index of Treatment Needs. When diagnosing periodontal disease, the classification of M.F. Danilevskyi was used.Results. The analysis of the indicators of the Community Periodontal Index of Treatment Needs index showed the following results: in patients of the main group, the index was 2.38±0.07 points (p<0.001) pointing out a need for a course of professional oral hygiene. In patients of the control group, the index was 0.5±0.17 points indicating that there was no need for treatment, however, there was a need for improving oral hygiene. The indicators of the Papillary-Marginal-Attached Index in the main group were 55.49±1.96 points pointing out a severe degree of gingivitis. Conclusions. According to the analysis of the indicators of the Community Periodontal Index of Treatment Needs index (2.38±0.07), the patients of the main group had low hygiene level requiring a course of professional oral hygiene. Keywords Problem statement and analysis of the recent researchPremature vascular ageing is considered to play a key role in the formation of an unfavorable prognostic profile in patients with arterial hypertension. Vascular ageing is a physiological process when changes which gradually occur in vessels correspond to the person's age. However, when risk factors are present (smoking, dyslipidemia, hyperglycemia, etc.), structural and functional changes in the arterial wall develop earlier and more rapidly, vascular function becomes abnormal. These premature changes in the structure and function of blood vessels can provoke high blood pressure and complicate its control. Physiological ageing of blood vessels due to arterial hypertension manifests itself as the same changes at the artery level [5,8]. The earliest morphological manifest...
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