[Development of a program for automatic collection and archiving of clinical data of patients with dysfunction of the temporomandibular joint]. / Razrabotka programmy avtomaticheskogo sbora i arkhivirovaniya klinicheskikh dannykh patsientov s disfunktsiei visochno-nizhnechelyustnogo sustava.

OBJECTIVE: Development of a program for the automatic collection and archiving of clinical patients with TMJ dysfunction. MATERIAL AND METHODS: Based on the clinical examination of 50 patients aged 18 to 30 years with temporomandibular joint dysfunction and the presence of an articular disc dislocation verified by magnetic resonance imaging, 80 signs were identified and terminologically formalized and were divided into 13 groups. RESULTS: This was the basis for the development of a detailed questionnaire for this contingent of patients, which the authors consider as the primary source of systematized data for processing in the program for automatic collection and archiving of clinical data. For graphical (animation) support for patient questioning, a library of "virtual patient" graphic files has been created, which includes static and dynamic animation explanations of the questions. CONCLUSION: An algorithm for optimizing the patient interrogation system based on the principle of excluding irrelevant units has been developed and implemented in the program.

[Influence of different type of toothbrushes on gingival fluid proteolytic potential during orthodontic treatment]. / Vliyanie zubnykh shchetok razlichnogo tipa na proteoliticheskii potentsial desnevoi zhidkosti v dinamike ortodonticheskogo lecheniya.

THE AIM: To study the effect of toothbrushes of various types on the accumulation of plaque and the proteolytic potential of gingival fluid as a pathogenic factors in long-term orthodontic treatment of patients with a distal permanent bite. MATERIAL AND METHODS: We examined 63 patients of both sexes aged 11-18 years. Orthodontic treatment was carried out for the close position of the teeth with a distal permanent bite (K07.2) and cleft palate and lips (Q37.1). Patients were divided into three groups depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, «Spazzolificio Piave¼, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush ("Oral-B Pro-Expert, «Procter & Gamble¼, USA). RESULTS: The amount of soft plaque was assessed by the Silness-Loe hygiene index in the subgingival region. The activity of proteolytic enzymes - elastase, collagenase, and a α-inhibitor of proteinases was determined by the enzymatic method using a XL 200 biochemical analyzer («Erba Lachema¼, Czech Republic). The accumulation of plaque in the gingival region on both jaws during the entire period of orthodontic treatment is most pronounced when using a manual brush compared to ultrasonic and electric brushes. An increase in proteolytic activity in the gingival fluid with a simultaneous decrease in antiprotease potential with long-term orthodontic treatment of patients was observed when using a manual orthodontic brush, which can be regarded as an increase in the activity of the pathogenic factors for the development of local inflammatory and destructive changes. CONCLUSION: To prevent inflammatory and destructive changes during prolonged orthodontic treatment of patients, the use of ultrasonic and electric toothbrushes in daily oral hygiene is justified.

[Influence of different type of toothbrushes on the incidence of enamel demineralization and gingivitis in the course of orthodontic treatment]. / Vliyanie ispol'zovaniya zubnykh shchetok razlichnogo tipa na veroyatnost' razvitiya demineralizatsii emali i gingivita v khode ortodonticheskogo lecheniya.

The aim of the study was to determine the likelihood and frequency of complications, the impact of the use of various types of toothbrushes in the dynamics of orthodontic treatment with fixed appliances in patients with a distal permanent bite. The clinical study was conducted on 63 patients of both sexes, aged 11-18 years. Patients received long-term orthodontic treatment for a close tooth position with a distal permanent bite (K07.2) and cleft palate and lip (Q37.1). Three groups were conditionally distinguished depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, Spazzolificio Piave S.p.A, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush (Oral-B Pro-Expert, Procter & Gamble, USA). According to the Kaplan-Meier method, the probability of developing complications of orthodontic treatment was calculated as patients wear braces, and the impact on the effectiveness of orthodontic treatment of using toothbrushes of various types was evaluated. A frequency analysis of the complications of orthodontic treatment for the entire period of wearing fixed orthodontic structures revealed a difference only in respect to enamel demineralization. In group 1, enamel demineralization was more common (42.9%) compared with 2 (9.1%) and 3 (25%) groups (p=0.039). The likelihood of developing gingivitis was higher in group 1, the timing of the development of inflammatory processes in periodontium was also shortened in group 1 compared with groups 2 and 3. The frequency and timing of the development of gingivitis and enamel demineralization depended on the type of toothbrush used in daily oral hygiene. A marked deterioration in the oral hygiene during orthodontic treatment using a manual brush was accompanied by a more frequent development of gingivitis and enamel demineralization.

[Maxillofacial manifestations in children and adolescents with neurofibromatosis 1]. / Stomatologicheskie proyavleniya neirofibromatoza I tipa u detei i podrostkov.

The aim of the study was to summarize literature data on oral and maxillofacial manifestations of neurofibromatosis I (NFI) and to analyze clinical case in with dentist had the leading role in proper diagnosis of the disease. Literature review showed main oral alterations in NFI to be: neurofibroma formation seen in 8-14% of children and adolescents, dysplastic «orthodontic¼ phenotype with shortened mandible, maxilla and sphenoid bones; radiologic signs including alveolar nerve canal and mental foramen widening in almost one third of patients; lesions of cranial nerves (mainly trigeminal, facial and glossopharyngeal), with non-specific paralysis clinic. These symptoms, however, develop gradually throughout the life and may be evident only in late adolescents. The most pathagnomic sigh is café-au-lait spots as they present in 95% of children at birth. The described clinical case demonstrates the difficulties in diagnostic of NFI in children in the absence of mutilating plexiform neurofibromas. The disease provoked significant functional disorders in maxillofacial area which resulted not only in lower quality of life but also mimicked iatrogenic complications of routine dental treatment.

[The role of restorative oral rehabilitation in orthodontic treatment of cleft lip and palate patients]. / Ortopedicheskaya sostavlyayushchaya v ortodonticheskom lechenii patsientov s rasshchelinoi guby i neba.

The purpose of the study is improving the effectiveness of rehabilitation of adolescents with a cleft lip and palate based on the orthopedic technologies implementation aimed at replacing the tooth-alveolar defect in the area of the alveolar ridge cleft at the active orthodontic treatment stage. MATERIALS AND METHODS: In the period from 2013 to 2020, 44 patients aged 10 to 18 years with unilateral and bilateral cleft lip and palate were observed. During orthodontic treatment with active appliances all patients received a removable plastic prosthesis with an artificial tooth (or several teeth) in it covering the defect of the alveolar process in the cleft area. An experimental dental alveolar model was made in a 1:1-scale, based on an axial computed tomographic section of the upper jaw, examined in polarized light on the installation with a source of scattered white light with a 1600-2000 cd/m2 brightness to study the distribution of stresses in the dental alveolar complex using an active orthodontic arch. The assessment of chewing efficiency was carried out on the evaluation of the nut (hazelnut) crushing degree. RESULTS: The study of the experimental tooth-alveolar model with a bracket system with an active orthodontic arch with an included defect in the dentition in the area of the cleft of the alveolar process showed an uneven and deviant distribution of stresses in the tooth-alveolar complex, the vector of which depends on the presence or absence of a rigid connection between the alveolar fragments (imitation of the presence or absence of bone regenerate in the cleft). The use of a restorative construction reduces the time when performing a chewing test and increases the efficiency of chewing in patients with unilateral (p=0.02) and bilateral (p=0.008) cleft. It is associated not only with the restoration of the continuity of the dentition with an orthopedic structure, but also with the activation and structuring of the function of the tongue when performing chewing movements. CONCLUSION: The use of a proposed restorative appliance allows: to create the continuity of the upper dentition that harmonizes the distribution of forces from the active orthodontic arch; increases the stability of the teeth in the areas of the upper jaw adjacent to the cleft (incisors and canines) and prevents their unwanted displacement; promotes directional movement of the teeth; in the retention period, to maintain the achieved expansion of the dentition while maintaining space for the future fixed prosthesis; isolate the mouth of the anterior palate; hold the achieved position of the fragments of the upper jaw until bone grafting.

[Dental complications of the mandibular distraction osteogenesis]. / Dental'nye oslozhneniya kompressionno-distraktsionnogo osteogeneza nizhnei chelyusti.

THE AIM OF THE STUDY: Was to reveal the prevalence of dental abnormalities in children after mandibular distraction osteogenesis (MDO). MATERIALS AND METHODS: The study comprised 75 children aged 5-16 years (42 boys and 33 girls, mean age 9.8±4.2 years) who underwent MDO because of mandible underdevelopment associated with hemifacial microsomia (n=42), Robin syndrome (n=6), Treacher Collins syndrome (n=6), Hallermann-Streiff syndrome (n=1) or acquired conditions (n=16). The mean age at MDO was 6.3±4.4 years. Controls involved 25 children with mandibular underdevelopment (19 with hemifacial microsomis, 4 - with Robin syndrome and 2 with Treacher Collins syndrome, mean age 6.7±3.6 years) receiving orthodontic treatment and with no history of MDO. RESULTS: In the study group abnormalities of lower molars were revealed in 42 children from 75. The prevalence of the affected first and second molars was 24.7% and 20.5%, respectively. Every tenth child (9.6%) had disorders of both molars. The risks for the first molar developmental defects after MDO was 12 times higher than in controls (OR=12.4; CI=95%). In 21 children delayed eruption or impaction of the first molars was observed. Second molars abnormalities more often included germs displacement and follicular cyst formation (OR=10.4). The age at MDO was significantly higher in children with no dental abnormalities (p<0.01). CONCLUSION: MDO is associated with significant risk of molars disorders. The younger a child is at MDO the more probable and prominent are the dental complications.

[Creating the conditions for skeletal traction in mandibular condyle fracture in children and adolescents]. / Sozdanie uslovii skeletnogo vytyazheniya pri perelome myshchelkovogo otrostka nizhnei chelyusti u detei i podrostkov.

In this article the possibility of using the Clark appliance (Twin-block) for creating conditions for skeletal traction in case of fraction of mandibular condyle in children and teenagers is presented. The proposed method of using the double-jaw orthodontic appliance Twin-block in case of mandibular fractures with condylar displacement promotes release of traumatized condyle and mandible replacement to correct position, promotes optimal conditions for myofunctional balance, fragment consolidation and remodeling of affected temporomandibular joint.

[Modern approach to the treatment of children with constant teeth avulsion]. / Sovremennye podkhody k vedeniyu detei s polnym vyvikhom postoyannykh zubov.

THE AIM OF THE STUDY: Was to analyze treatment outcomes in children with constant teeth avulsion treated in Central Research Institute of Dentistry and Maxillofacial Surgery (CRIDMS). MATERIALS AND METHODS: The study comprised 39 children aged 7-16 years treated in CRIDMS in 2015-2020. In 38 cases from 39 replantation was performed more than 24 hours after trauma. Because of delayed replantation endodontic treatment was needed in 35 cases from 38 (in one case the avulsed tooth was missing). In all 38 cases replantation was followed by splinting with either resin splint made according to original technique proposed by the authors or semi-flexible splints from orthodontic wire fixed with resin composite. RESULTS: In one case from 39 the avulsed tooth was missing because a dentist the child first consulted was unaware of the possibility of replantation. In 38 children followed-up for 6-57 months the replanted teeth survived and were clinically asymptomatic. There were, however, obvious radiological signs of replacement resorption in 27 (71.1%) cases. Inflammatory resorption was detected in two cases (5.2%) with immature teeth undergoing apexification with calcium hydroxide. CONCLUSION: Replacement root resorption after tooth avulsion may be seen as relatively favorable outcome preserving more bone tissue than early tooth removal. The rate of replacement resorption, however, would be less in less delayed replantation. The study results proved the necessity for additional education of parents and pediatric dentists on the first aid and treatment tactics for teeth avulsion.

The role of external aetiological factors in dental anomalies in non-syndromic cleft lip and palate patients.

AIM: The hypothesis tested was whether proper tooth development in cleft lip and palate (CLP) patients is affected by early orthopaedic treatment (EOT), primary surgical interventions and palatal defects after primary palatoplasty. METHODS: The prospective study groups comprised 369 CLP children (aged 11.0 ± 4.5 years) and 500 healthy children (aged 11.1 ± 3.8 years) aged > 6 years without any diseases associated with increased risk of dental anomalies. Patients were examined clinically and radiologically. Primary treatment details and outcomes were extracted from the hospital records registry and analysed to evaluate the role of possible external aetiological factors in dental abnormalities. RESULTS: Selective tooth aplasia was the commonest dental abnormality with upper lateral incisors missing in 33.9% of CLP patients and 3.4% of controls. Central incisor agenesis was restricted to early primary periosteoplasty cases. Lateral incisor aplasia on the cleft side was significantly associated with palatal defect (P = 0.0003) and primary lip surgery type (P = 0.008). The prevalence of developmental enamel defects (DEDs) correlated with primary surgical procedure (P = 0.002), palatal defect and lack of EOT (P = 0.03 and 0.04, respectively). CONCLUSIONS: Surgical trauma during early primary periosteoplasty, reduced blood supply associated with palatal defects and absence of EOT significantly increase the prevalence of frontal tooth anomalies. The prevalence of dental abnormalities in CLP patients depends on treatment protocol.

[The prospects of collagen as a basis for curable and activated osteoplastic materials]. / Perspektivy ispol'zovaniia kollagenovogo gidrogelia v kachestve osnovy dlia otverzhdaemykh i aktivirovannykh kostno-plasticheskikh materialov.

In the review, the structure and biological properties of collagen, variants of its production from natural sources and purification are considered. Methods for modifying the physico-mechanical properties of collagen to create a curable, highly purified collagen hydrogel are described. The advantages of a cured highly purified collagen hydrogel as a basis for osteoplastic material and a means of delivery of growth factors are indicated. The registered osteoplastic materials based on the curable highly purified collagen hydrogel are described, and their comparative analysis is carried out. On the basis of the obtained data, a conclusion was made about the prospects of using collagen as a basis for curable and activated osteoplastic materials.

[Resorbable vs nonresorbable fixation in alveolar bone grafting in unilateral cleft lip and palate patients]. / Otsenka éffektivnosti rezorbiruemoi i nerezorbiruemoi fiksatsii transplantata pri kostnoi plastike verkhnei cheliusti u detei s odnostoronnei rasshchelinoi guby i neba.

The aim of the study was to evaluate the resorbable vs nonresorbable fixation efficiency in bone grafting for unilateral cleft lip and palate (UCLP) patients. Thirty eight UCLP patients aged from 7 to 17 years (mean 11.5±3.1 years) were divided in two groups with different types of cortical graft fixation: group 1 ─ titanium screws (22 patients), group 2 ─ resorbable pins (16 patients). The Bergland and Chelsea scales were used to evaluate the outcomes 8 months after surgery. Additional authors' original scales were introduced: bone volume scale and pyriform rim restoration scale. The Bergland and Chelsea scales have shown good results in groups 1 and 2 in 91 and 81% of cases, satisfactory in 4.5 and 19% of cases, respectively. Upon the bone volume scale good results were achieved in groups 1 and 2 in 64 and in 75% of cases, satisfactory results - in 18 and 19% of cases, respectively. Upon the pyriform rim restoration scale good results achieved in 59 and 88% of cases, respectively. We also took into consideration the influence of age, diagnosis, post-op complications. No statistically significant difference between groups was found, with neither age nor diagnosis showing any influence. Only postsurgical complications and the stability of the orthodontic design seem to be important for good bone formation after alveolar bone grafting.

[Neurologic disturbances in children with cleft lip and cleft palate]. / Nevrologicheskie narusheniya u detei s rasshchelinoi guby i neba.

AIM: Neurological symptoms of genetic syndromes, including congenital cleft lip and palate (CLP) are well-studied while neurological characteristics of patients with non-syndromal CLP are not described. The authors studied neurological disturbances in CLP. MATERIAL AND METHODS: Twenty-one patients with CLP, mean age 12.0±4.7 years (the main group) were compared to healthy people (the control group). RESULTS AND CONCLUSION: Elements of bulbar syndrome (atrophy and deviation of the tongue, sagging of the soft palate, specific speech disturbances) and mimic innervation abnormalities (hypomimia or hypermimia, face asymmetry), microfocal neurological symptoms occurred significantly more frequently (p<0.01) in patients of the main group. Bulbar disorders, identified in 100% of the patients, were most characteristic of CLP. The neurological features of patients with CLP demonstrate the involvement of the brain stem, mimic innervation, bulbar cranial nerves and defects of the development of the neural tube.

[Risk factors for teeth aplasia and hypoplasia in cleft lip and palate children].

The aim of the study was to assess the significance of environmental risk factors for teeth aplasia and hypoplasia in cleft lip and palate children. Two hundred and forty-seven cleft lip and palate (CLP) children were enrolled in the study including 105 (42.5%) with bilateral CLP and 57.5% with unilateral CLP. The mean age was 11.2±4.9 years. Teeth condition was assessed clinically and radiologically. The impact of risk factors for teeth anomalies was analyzed by retrospective data obtained from computer database (absence of preoperative orthopedic treatment, palatal defects after primary palatoplasty and type of primary procedures). Surgical trauma by early periosteoplasty (at the age of 3-4 months), excessive scarring and tissue traction due to absence of early orthopedic treatment and palatal defect were associated with significantly higher incidence of incisors hypoplasia (both developmental enamel defects and microdentia) and aplasia of central incisors not seen in the other study subgroups. Incisors aplasia and hypoplasia in CLP patients do not always have disembryogenic origin but may depend on external environmental factors, including surgical trauma.

[Modern approach to early orthopedic treatment in cleft lip and palate children].

The aim of the study was to enhance the quality of early orthopedic treatment in cleft lip and palate (CLP) children. Thirty-six infants aged 1 to 6 months were included in the study. The new method of early CLP orthopedic treatment using set of consecutive splints showed some advantages in compare with existing methods for alveolar bone deformity correction. The elaborated technology for CAD/CAM splints fabrication allows precise positioning of maxillary fragments thus improving overall outcome and making it more predictable.

[Prenatal cleft palate diagnostics by structural and functional peculiarities of the tongue].

The aim of the study was to assess tongue position and function in cleft lip and palate children in order to use them for ultrasound prenatal diagnostics of this malformation. The study included 258 cleft lip and palate patients, as well as 2078 pregnant women (20-22 gestation weeks). The ultrasound scans of 39 cleft palate fetuses were evaluated retrospectively. All cleft palate patients exhibited tongue configuration disorder, tongue asymmetry, low tip and high dorsum position. These signs may be useful for prenatal cleft palate diagnostics which fact is proved by assessment of ultrasound pictures of cleft palate pictures including that of 8 patients revealed prospectively.

[Morphofunctional tongue features revealed by multispiral CT in cleft lip and palate patients].

Tongue structure and position as well as oral cavity volume were analyzed by means of multispiral CT in 82 cleft lip and palate patients and 27 healthy children. The study revealed microglossia and anomalous position and form of the tongue causing tongue tip to be pressed to the incisal part of the lower alveolar bone not exerting physiological impact on the upper alveolar bone. These results confirm the tongue position to be one of the factors for occlusion abnormalities in cleft lip and palate patients.

[Tongue structure, position and function in cleft lip and palate children assessed by ultrasound examination].

The aim of the study was to examine the position and function of the tongue in cleft lip and palate (CLP) patients and to reveal their impact on alveolar bone development. Two hundred and fifty-eight CLP children and 50 healthy children as control group were included in the study. Tongue function and position were assessed by ultrasound examination. In CLP patients the dorsum of the tongue was deformed and the asymmetry of some tongue structures was also found out (mainly the massive of the tongue muscles). Low tip and high dorsum position were specific for CLP children as well as discoordinated tongue movements. Both in static and dynamic condition the tongue was pressed to the lower alveolar bone thus disturbing its development. The obtained data showed tongue position and function to be one of the causes for lower promacrognathy and lingual inclination of incisors in CLP patients. The absence of tongue impact on the upper alveolar bone should be seen as one of the factors for upper retromicrognathy.

[Echographic evaluation of anatomical bone structures peculiarities in children with two-sided cleft of upper lip and palate before and after early prosthetic treatment].

Ultrasound study of maxilla was performed in 74 patients with one-sided cleft of upper lip and palate (CULP) of the age from 1 month to 1.5 year. 49 patients with two-sided clefts got early prosthetic treatment with ultrasound investigation before the treatment beginning and after its completion. Cleft width, distance between alveolar process side fragments, height of alveolar process side fragments, angles of maxillary palatine processes origin from alveolar process side fragments, convergence angles of maxillary palatine processes and convergence angles of alveolar process side fragments were measured as well as intermaxillary bone mobility was determined. It was shown that echographic study in patients with CULP gave additional information that necessary for treatment planning and objective assessment of its results.

[Ultrasound study possibilities in evaluation of anatomical structures in children with congenital cleft of upper lip and palate].

Congenital cleft of upper lip and palate (CCULP) is one of the most widely spread and complicated developmental malformation of maxillofacial region, its frequency makes up for 16.4% of the total number of inherited defects. Ultrasound study (USS) let receive clinically significant information about anatomical structures peculiarities of upper lip, alveolar process and palate in patients with crest CCULP that could be important for surgical and prosthetic treatment planning and also significant for assessment of immediate and postponed treatment results. Verification of the received during surgical interventions and orthodontic manipulations data showed high diagnostic reliability of the USS results.