[Dystrophic calcification of the parotid salivary glands in Sjogren's disease]. / Distroficheskaya kal'tsifikatsiya okoloushnykh slyunnykh zhelez pri bolezni Shegrena.

This article discusses a rare clinical case of differential diagnosis between salivary stone disease and calcinosis, which developed against the background of autoimmune pathology. Diagnosis of these pathologies causes difficulties for practitioners, and treatment methods have fundamental differences. In this regard, the description of this case is relevant and significant. The algorithm of the main and additional research methods to confirm the diagnosis is described.

[The use of augmented reality technology in endoscopic removal of a maxillary cyst]. / Primenenie tekhnologii dopolnennoi real'nosti v kachestve navigatsionnoi sistemy pri endovideoassotsiirovannom udalenii kisty verkhnei chelyusti.

This article describes the use of augmented reality technology for the removal of an odontogenic cyst of the upper jaw. By combining the image of computed tomography, anatomical formations and the tip of the endoscope in mixed reality, a navigation system was created for performing cystectomy and resection of the tip of the molar root for a volumetric cyst of the maxillary sinus. For the first time, a system for tracking the position of an endoscope in mixed reality in real time was used.

[Ductoplasty of the post-traumatic stricture of a parotid duct]. / Duktoplastika posttravmaticheskoi striktury protoka okoloushnoi slyunnoi zhelezy.

A report on the primary application of the modern technique of plastic removal of stricture of the Stenonic duct. A clinical case of surgical intervention in the localization of stricture and salivary stone is considered. The analysis of the patient's medical history, ultrasound diagnostics, multispiral computed tomography of the maxillofacial region was carried out. Based on the results of the examination, the choice of the surgical intervention technique was made.

[Invasive mucormycosis affecting maxillofacial region in oncohematological patients undergoing chemotherapeutic treatment and transplantation of hematopoietic stem cells]. / Invazivnyi mukormikoz s porazheniem organov chelyustno-litsevoi oblasti u onkogematologicheskikh bol'nykh na fone khimioterapevticheskogo lecheniya i transplantatsii gemopoeticheskikh stvolovykh kletok.

The aim of the work is to attract the attention of specialists: dentists, oncologists, hematologists to thorough sanitation of the oral cavity of patients preparing for chemotherapy treatment, to transplantation of hematopoietic stem cells. Two clinical cases described in the article were observed at the R.M. Gorbacheva First Saint-Petersburg State Medical University from 2010 to 2019. They confirm the possibility of the occurrence of infectious complications with damage to the maxillofacial region caused by rare pathogens of invasive mycosis, which debuted as an odontogenic inflammatory process. The success of the treatment of Invasive Mycosis depends on early diagnosis and antimycotic therapy; active surgical tactics in relation to the affected tissues in a controlled course of the underlying disease and the restoration of effective hematopoiesis.

Influence of the cumulative effect of zoledronic acid on periodontal microcirculation in rats.

PURPOSE: To evaluate the effect of repeated administration of zoledronic acid (ZA) on the development and severity of osteonecrosis of the jaws. METHODS: In the experiment, 36 rats were used, which were divided into 4 groups: group 1 was injected with saline for 6 weeks, group 2 was injected with ZA once, group 3 was injected zoledronic acid for 3 weeks once a week, group 4 was injected with ZA for 6 weeks once a week. While taking medications, the tooth was removed. The volumetric blood flow rate was studied using laser and high-frequency ultrasound Doppler in the area of the periodontium of an extracted tooth in rats with the application of acetylcholine. Bone tissue was examined out using CBCT. RESULTS: In group 2, there was a violation of blood flow in the mucous membrane, bone microcirculation, but no reliable data was obtained in the bone defect in comparison with group 1. In groups 3 and 4, there was significantly disrupted blood flow. This led to an increase of the osteonecrosis (maximum at the 4th group), which was confirmed by data obtained using CBCT. An inverse relationship was observed between the blood flow of bone tissue and the size of the defect after tooth extraction. CONCLUSION: The introduction of ZA in a dose-dependent fashion resulted in impaired endothelial vasodilation and impaired blood flow to extraction sockets. These findings might explain the development of osteonecrosis of the mandible following removal of a first molar.

[Augmented reality in the treatment of sialolithiasis]. / Dopolnennaya real'nost' pri lechenii slyunnokamennoi bolezni.

In a clinical case we report on the primary application of modern methods of visualization using augmented reality in the treatment of patients with sialolithiasis for the localization of salivary stone in the parenchyma of the parotid salivary gland. Impression was taken and individual splint with radiopaque marker and a cutout for a probe was made. The splint was used for spiral CT of the head and neck. In surgical intervention under endotracheal anesthesia with intubation through the nose, the splint was placed in the mouth with a tap and a surgeon visualized the projection of the stone on the skin using glasses. The method allows to visualize salivary stone at all stages of surgery, regardless of the type of access or hydrotreatment. However, this technique does not make it possible to estimate the depth of the stone, as well as if the salivary stone is not fixed in the duct there is a risk of changing its position. In this regard, the use of augmented reality has a promising direction and requires further research.

Disorders of microcirculation in the mechanism of bisphosphonate osteonecrosis: preliminary study in rats.

We investigated the possibilities of angioprotection and the reduction of osteonecrosis in rats that had been given bisphosphonates. In our experiment, 27 rats were divided into three groups: Group 1 was injected with saline; Group 2 was given zoledronic acid for six weeks; and Group 3 was given zoledronic acid for six weeks, with added doses of sulodexide after three weeks. After that we constructed a model of how the teeth should be extracted. The velocity of linear blood flow in the periodontal area of an extracted tooth in rats was studied using laser and high-frequency Doppler ultrasound (with the application of the vasoactive substance acetylcholine 3% for 1min). We evaluated changes in the structure of the bony tissues of the head using computed tomography, comparing the control group with the saline group. A rapid reduction in microcirculation was detected during the use of zoledronic acid for six weeks. A smaller reduction in microcirculation was detected after three weeks of treatment with sulodexide and zoledronic acid. There was a reduction in blood flow in the mucous membranes and, to a greater extent, in bony tissue. Zoledronic acid causes significant impairment of the periosteal blood flow to the mucous membranes because of a complex of disorders, which includes both the cellular component (impaired endothelium-dependent vasodilation of the mucous membrane vessels) and by reducing the intensity of microcirculation in the mucous membranes and bony tissues. Sulodexide, however, improves the restoration of blood flow and reduces the severity of osteonecrosis.

[Heerfordt-Waldenström disease. Report of two clinical cases]. / Diagnostika sindroma Kheerfordta-Val'denstrema. Dva klinicheskikh sluchaia.

The article presents two clinical cases of patients with Heerfordt-Waldenström disease demonstrating diagnostic difficulties and the need for holistic treatment approach.

Experimental model of osteonecrosis of the jaw in rats treated with zoledronic acid.

We have examined the development of medication-related osteonecrosis of the jaws (MRONJ) in rats with no previous accumulation of zoledronic acid in the mandible. Ten male Wistar rats (weight 350-400g) were anaesthetised with chloral hydrate 450mg/kg intraperitoneally and the first and second mandibular molars on the left side were extracted. The five experimental rats were given six injections of zoledronic acid 0.18mg/kg over the next four weeks (total dose 1.08mg/kg). Two injections were given at once as an intravenous bolus injection (0.36mg/kg). Then rats were given 4 injections (0.18mg/kg) with 1 week interval over the next four weeks, after which they observed for a further four weeks. The five control rats were injected with saline. At the end of the eighth week, the animals were killed by asphyxiation in a carbon dioxide chamber, and their bone structure was visualised using cone-beam computed tomography (CT) and Galaxis software. We then studied the mandibles histopathologically to investigate the incidence of necrosis and infiltration of inflammatory cells. The cone-beam CT images in the experimental group showed deficiencies in the bone structure in the extracted molar area of the lower alveolar ridge. The histological findings in the mandibles of the group given zoledronic acid showed necrosis and infiltration of inflammatory cells, which were not present in the control group. We conclude that the immediate effect of zoledronic acid on the bone tissue during regeneration is an important factor in the development of MRONJ, in addition to the previously reported effects of the duration of treatment with zoledronic acid.

Role of C-reactive protein concentration of blood plasma in assessment of the severity and the effectiveness of treatment in patients with squamous cell carcinoma of the oral cavity mucosa.

The purpose of this study was to determine the prognostic significance of dynamics of C-reactive protein concentration in blood plasma as a marker for the progression of squamous cell carcinoma of the oral cavity mucosa. From January 2014 to August 2014 there were under the observation 35 patients with squamous cell carcinoma of the oral cavity mucosa. All patients were divided into 2 groups: group 1 - primary patients who had been diagnosed with malignant lesions of the oral cavity mucosa for the first time (17 people); group 2 - patients with recurrent disease (18 people). All 17 patients of group 1 received induction polychemotherapy by PF scheme and 18 patients of group 2 - curative polychemotherapy by the following schemes: PF, DCF, TC. In all patients there was performed an assessment of the level of C-reactive protein in blood serum at the stage prior to drug treatment and before each subsequent cycle of chemotherapy. An assessment of the level of C-reactive protein before treatment showed that in 17 patients of group 1 its level was in the normal range. Patients of group 2 had an increased concentration of C-reactive protein in blood plasma. Analysis of obtained data allows concluding that the level of C-reactive protein may be effectively used as a prognostic marker in patients with this pathology.