[The condition of the mandibular bone regenerate in the remote period after compression-distraction osteosynthesis]. / Sostoyanie kostnogo regenerata nizhnei chelyusti v otdalennom periode posle kompressionno-distraktsionnogo osteosinteza.

THE STUDY OBJECTIVE: Was to assess the qualitative and quantitative characteristics of the bone regenerate in the distant period following compression-distraction osteosynthesis. MATERIAL AND METHODS: Results from the treatment of 30 patients with mandibular micrognathia, were analyzed. Compression-distraction osteosynthesis (CDO) was performed in the area of the mandibular angle. The patients were divided into two groups: group 1 consisted of 16 patients with congenital micrognathia, and group 2 comprised 14 patients with acquired (post-traumatic) micrognathia. For the assessment of qualitative and quantitative characteristics of the bone regenerate, three-dimensional modeling, morphometric measurements of the regenerate, and evaluation of bone density using the Hounsfield scale through multislice computed tomography were used. RESULTS AND DISCUSSION: The study of the bone regenerate parameters in group 1 yielded the following results: the length of the bone regenerate decreased by 2.14%; the thickness of the bone regenerate increased by 8.75%; the height of the bone regenerate increased by 1.75%. In group 2, the values were 3.14; 3 and 3.76%, correspondingly. In patients of group 1, the length of the mandibular branch increased by 4%; the length of the mandibular body increased by 5.35%. In group 2, the length of the mandibular branch increased by 1.94%; the length of the mandibular body increased by 2.2%. The density of the cortical bone of the regenerate corresponds to the density of the intact bone, while the density of the cancellous bone is slightly reduced. CONCLUSION: Qualitative and quantitative characteristics of bone regenerate in the long-term period after CDO correspond to the parameters of intact bone. CDO can be considered not only as a preparatory stage for reconstructive operations after the growth of the skull bones has completed, but also as an independent stage of treatment.

[The use of magnetic therapy in the treatment of children with lower micrognathia using compression-distraction osteosynthesis]. / Primenenie magnitoterapii pri lechenii detei s nizhnei mikrognatiei metodom kompressionno-distraktsionnogo osteosinteza.

PURPOSE: To study the effect of magnetic therapy on the formation of distraction regenerate of the lower jaw in patients with lower micrognathia. MATERIALS AND METHODS: The study comprised 159 patients with inferior micrognathia of congenital and acquired etiology. The patients were divided into 2 groups. The main group consisted of 112 patients who received magnetic therapy: 55 patients with congenital micrognathia and 57 patients with acquired micrognathia. The control group included 47 patients who did not undergo magnetic therapy: 20 patients with congenital micrognathia and 27 patients with acquired micrognathia. Magnetic therapy was performed daily starting from day 1 or 2 after surgery. Ultrasound monitoring began on the 7th day of distraction and was carried out every 3-4 days, which made it possible to assess the dynamics of the formation of the distraction regenerate. RESULTS: Ultrasound examination on the 7th day of distraction revealed that in the main group the number of distraction regenerates of the normotrophic type was 36.5%, hypotrophic type 18%, hypertrophic type 54.5%. In the control group, the corresponding rates were 53%, 31% and 22%. CONCLUSION: Magnetic therapy induces osteogenesis and accelerates the maturation of the distraction regenerate. This makes it possible to accelerate the pace of distraction without reducing the quality of the regenerate.

[A clinical case of piloleiomyoma]. / Klinicheskii sluchai piloleiomiomy.

The article describes a clinical case of a benign tumor from smooth muscle cells - piloleiomyoma. The incidence of leiomyoma in the skin is 3-5% of all leiomyomas. A 27-year-old patient applied to a medical institution with complaints about an intradermal formation in the ear region that occurred repeatedly within 5 months after surgical treatment. After the first surgical intervention, the patient was consulted in various medical organizations, where the following diagnoses were made: «nodular fasciitis¼, «smooth muscle tumor without signs of malignancy¼ and «non-epithelial spindle cell neoplasm¼. According to ultrasound examination, the formation with dimensions of 11×9×5 mm reached the mastoid process of the temporal bone and was characterized by increased internal blood flow. After surgical removal of the neoplasm, taking into account the difficulties of differential diagnosis, an immunohistochemical study was conducted. An accumulation of smooth muscle cells was detected in the surface layers of the dermis under the epidermis by the immunohistochemical study with the use of the marker SMA. A study on CD34 protein revealed a high density of blood capillaries and the absence of its expression in smooth muscle cells. The proliferative index (Ki-67) and mitotic activity (PHH-3) of cells was also studied. The index of proliferative activity was less than 2%, mitoses were isolated. Thus, the results of immunohistochemical study proved the conclusion of piloleiomyoma.

[Ultrasound anatomy of masticatory muscles. (Experimental and clinical study)]. / Ul'trazvukovaya anatomiya zhevatel'nykh myshts. (Eksperimental'no-klinicheskoe issledovanie).

PURPOSE: To describe the ultrasound anatomy of the masticatory muscles based on a comparison of the results of macroscopic and ultrasound studies of the masticatory muscles in vitro. MATERIAL AND METHODS: In the experimental part, a macropreparation of the masticatory muscle was studied; in a clinical example, an ultrasound of the masticatory muscles was performed on a patient with normal occlusion using the author's methods for analyzing echograms. RESULTS: The ultrasound anatomy of the masticatory muscles is described based on a comparison of data from the study of a macroscopic specimen and ultrasound images of the masticatory muscle of an experimental animal. Using a clinical example of a patient with normal occlusion, the results demonstrate the usage of the authors' developments in describing ultrasound images of the masticatory muscles. CONCLUSION: The study resulted in an algorithm for describing ultrasound images of masticatory muscles, including methods for qualitative and quantitative assessment of ultrasound images using proprietary developments involving elements of artificial intelligence technologies.

[The possibility of obtaining bone autograft from the anterior palate to restore limited bone defects]. / Vozmozhnost' polucheniya kostnogo autotransplantata s nebnoi poverkhnosti al'veolyarnogo otrostka verkhnei chelyusti dlya ustraneniya ogranichennykh kostnykh defektov.

OBJECTIVE: Determination of the optimal zone of the alveolar process of the upper jaw for bone autograft sampling according to cone-beam computed tomography. MATERIAL AND METHODS: A study was conducted to assess the possibility of taking a bone autograft from the palatine surface of the alveolar process of the upper jaw. The criteria for inclusion of patients in the study were the presence of a complete dentition and the absence of removed teeth in the upper jaw. A total of 50 patients participated in the study. Determination of the optimal zone for bone autograft sampling was carried out using cone-beam computed tomography (CBCT) of the upper jaw. RESULTS: The optimal area for bone autograft sampling is the area of the palatine surface of the alveolar process in the projection of the frontal group of teeth and the area of the upper jaw mound. When taking bone autograft in he projection of the frontal group of teeth and the area of the upper jaw mound with a probability of 95.11%, a 4 mm long trepan can be used. In 39.6% of cases, the parameters of the alveolar process allow the use of standard trepans with a diameter of 3.5 mm, which makes it possible to obtain a bone cylinder with a diameter of 3 mm. At the same time, in the area of the alveolar process of the frontal group of teeth, it is possible to pick up bone autograft more by 16-23 mm3 than in the the area of the upper jaw mound. CONCLUSION: The palatine surface of the alveolar process can be used for bone autograft sampling when planning to eliminate limited defects of the upper jaw. The CBCT method makes it possible to determine the optimal bone autograft sampling zone and the available bone volume, which minimizes injury to the patient.

[X-ray evaluation of the design features of stump pin tabs]. / Rentgenologicheskaya otsenka osobennostei konstruktsii kornevykh shtiftovykh vkladok v prakticheskoi stomatologii.

OBJECTIVE: Carrying out an objective assessment of the quality of performance of the technique of prosthetics with stump pin tabs of the upper and lower molars. MATERIALS AND METHODS: A retrospective assessment of the quality of dental preparation and modeling of root pin inlays was carried out by analyzing CBCT studies using the RadiAnt program. Measurements were carried out and 80 CBCT studies of patients who had tabs in their molars performed in various clinics of the city of Moscow were studied. RESULTS: Restoration of defects in the hard tissues of teeth with cast root pin tabs has specific features related to the anatomy of the roots and the distribution of the chewing load. An analysis of the practical implementation of the prosthetics technique and the compliance of the quality of the tabs with the requirements of clinical recommendations showed that they are performed only in 47.5% of cases with respect to modeling the length of the pin part of the tabs (relative to the length of the tooth root), in 40.0% of studies - on the quality of root canal filling; in 36.3% - on the residual thickness of the walls of the tooth root. The requirements for the ratio of the foliar and pin parts of the tabs were not met in any of the cases. In the case of tab modeling, the requirements for maintaining a safe zone in the area of root furcation and tooth tissue thickness of at least 1.0 mm were met only in 36.25 (32.50±3.75)% of cases. CONCLUSION: Improving the quality of prosthetics using tabs lies not only in the plane of a more responsible approach to determining indications for this type of prosthetics, performing techniques and algorithms, using modern tools, but also in the field of working out the methodology for manufacturing tabs in multi-root teeth taking into account the anatomy of the roots of chewing teeth, the distribution of chewing pressure and the number of pin parts of tabs.

[Lymphotropic therapy in the treatment of patients with postoperative secondary lymphedema of the maxillofacial region]. / Limfotropnaya terapiya pri lechenii patsientov s vtorichnoi limfedemoi chelyustno-litsevoi oblasti.

OBJECTIVE: The aim of study was to improve the effectiveness of treatment of patients with secondary postoperative lymphedema of the maxillofacial region using lymphotropic therapy. MATERIAL AND METHODS: During 2020-2021 8 patients aged 40 to 70 years with secondary postoperative lymphedema of the maxillofacial region were treated in the Central Research Institute of Dentistry and Maxillofacial Surgery. The article presents the clinical and ultrasound results of a study of the effectiveness of the lymphotropic therapy in the treatment of patients with secondary lymphedema of the maxillofacial region. RESULTS: Six patients with an early stage of lymphedema had a complete regression of edema and normalization of the ultrasound picture of the soft tissues of the maxillofacial region. In 2 patients with late-stage lymphedema there was a regression of edema, but the preservation of residual swelling of soft tissues and signs of fibro-fatty transformation of soft tissues were revealed on ultrasound examination. CONCLUSION: Lymphotropic therapy with antifibrotic and anti-inflammatory drugs is one of the effective methods of treating postoperative secondary lymphedema of the maxillofacial region at the early stages of the disease.

[Clinical picture and ultrasound manifestations of secondary lymphedema of the maxillofacial region]. / Klinicheskaya kartina i ul'trazvukovye proyavleniya vtorichnoi limfedemy chelyustno-litsevoi oblasti.

OBJECTIVE: The aim of the study is to determine the main clinical symptoms and ultrasound manifestations of secondary lymphedema of the maxillofacial region. MATERIAL AND METHODS: This study is based on the study of a comprehensive examination and the effectiveness of treatment of 15 patients diagnosed with lymphedema of the maxillofacial region, who are on outpatient treatment at the Federal State Budgetary Institution "National Medical Research Centre for Dental and Maxillofacial Surgery" of the Ministry of Health of the Russian Federation from 2020-2021 at the age of 18 to 70 years. The examination of patients included the study of complaints, anamnesis of life, anamnesis of the disease, external examination and examination of the oral cavity, palpation of soft tissues of the maxillofacial region, X-ray examination (if necessary). All patients underwent ultrasound examination of the soft tissues of the maxillofacial area. RESULTS: When examining patients, it was revealed that the main clinical symptoms of lymphedema of the maxillofacial region are the presence of edema, a feeling of heaviness and stiffness of movements in the area of edema and the absence of symptoms of inflammation such as fever, hyperemia and pain. 100% of patients had the following ultrasound manifestations in the area of lymphatic drainage disorders: an increase in tissue thickness, impaired tissue differentiation into layers, a diffuse increase in tissue echogenicity, and the presence of dilated lymphatic vessels. CONCLUSION: Lymphedema of the maxillofacial region is a polyetiological disease that is difficult to diagnose, requiring a thorough examination of the patient, including basic examination methods, radiography, and mandatory ultrasound examination of soft tissues.

[Head and neck lymphedema. Literature review]. / Limfedema golovy i shei. Obzor literatury.

The article is a review of the latest literature data on lymphedema of the head and neck, its etiology, pathogenesis, classification and main clinical manifestations. The main methods of diagnosis and treatment of this pathology are indicated.

[Improving the effectiveness of treatment of the adult patients with dentoalveolar anomalies and deformities using Er,Cr:YSGG laser: a clinical study]. / Povyshenie effektivnosti lecheniya vzroslykh patsientov s zubochelyustnymi anomaliyami i deformatsiyami zubnykh ryadov s pomoshch'yu Er,Cr:YSGG lazera: klinicheskoe issledovanie.

THE AIM: Of the work is to develop and substantiate the method of minimally invasive complex orthodontic treatment of patients with constriction and deformation of the upper jaw in the period of permanent bite with the combined use of a bracket system, orthodontic devices for the expansion of the upper jaw and fractional photothermolysis to improve the effectiveness of complex treatment. MATERIALS AND METHODS: The results of complex treatment of patients with the deficiency of the upper jaw in the period of permanent bite are presented. Complex treatment consisted of orthodontic treatment using a bracket system, laser corticotomy, orthodontic devices for the expansion of the upper jaw. Ultrasound examination before and after the procedure was performed to obtain reliable results of laser impact on bone tissue. RESULTS: After conducting a clinical and radiological examination (using cone-beam computed tomography) of all patients and analyzing the data obtained, we have developed algorithms for therapeutic measures. As a result of orthodontic treatment aimed at the expansion of the upper jaw patients who underwent fractional photothermolysis procedure achieved the expansion of the upper jaw at both the dentoalveolar and skeletal levels. CONCLUSION: It was found that a comprehensive approach with minimally invasive effects can improve the effectiveness of treatment of patients with constriction and deformation of the upper jaw during the period of permanent bite and achieve stable treatment results.

[Lymphatic therapy and its importance in the complex treatment of patients]. / Limfaticheskaya terapiya i ee znachenie v kompleksnom lechenii bol'nykh.

The article presents literature data on the use of lymphatic methods therapy in complex treatment of patients with diseases of various nosologies in general surgery and dentistry. Clinically and experimentally obtained data on the advantage of lymphatic therapy compared with other methods of drug administration are indicated.

[X-ray assessment of the position of the lower jaw heads in different types of face]. / Rentgenologicheskaia otsenka polozheniia golovok nizhnei cheliusti pri razlichnykh tipakh litsa.

AIM: To increase the efficiency of diagnosis and orthodontic treatment of patients with temporomandibular joint dysfunction based on the study of the relationship between the features of the position of the heads of the lower jaw and various face types in patients aged 25 to 44 years according to cone beam computed tomography. We examined 100 people who were divided into two main groups (50 males, 50 females). To study the formed groups index method for diagnosing facial types according to Isar was used. The facial indicator was determined: the percentage of physiognomic height to the morphological width of the face. The structural features and relative positions of the TMJ bone structures in patients with TMJ dysfunction in various face types were studied in the Avantis 3D computer program. It was noted that the upper position of the lower jaw heads in women and men with a narrow type of face was observed in 50% and 40% of cases, respectively; the distal position of the lower jaw heads in women and men with a wide type of face was observed in 50% and 42.3% of cases, respectively. The results of the study indicate that there is a relationship between different types of face and the position of the lower jaw heads in the lower jaw, which should be considered in comprehensive treatment planning. The most at risk of temporal dysfunction is the TMJ of a woman with a narrow type of face, in which dominates the upper position of the lower jaw heads and a woman with a wide type of face with the distal position of the lower jaw heads. Before orthodontic treatment it is necessary to investigate the position of the TMJ heads with the help of CBCT and make a mandatory correction before the beginning of orthodontic treatment.

[Orthodontic treatment of a patient with a thin gingival biotype and malocclusion]. / Ortodonticheskoe lechenie patsientki s tonkim biotipom desny i anomaliiami okkliuzii.

Description of the clinical case of the patient with narrowing and deformation of the dentition of the upper and lower jaw and crowded teeth in the frontal part of the lower jaw in combination with a thin gingival biotype. The combined use of diagnostic methods: colorimetric probe, ultrasonic scanning and cone-beam computed tomography, followed by computer 3D-modeling of the treatment plan made it possible to competently plan and implement orthodontic treatment of the patient without complications from periodontal tissues. Combined application of colorimetric probe, ultrasonic and cone-beam computed tomography methods with digital 3D-modeling of the treatment plan allowed to plan and carry out orthodontic treatment of a patient with a thin gingival biotype without periodontal complications.

[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.

[Capabilities of contrast-enhanced ultrasound for preoperative assessment of regional lymphatic basin in patients with early oral cavity squamous cell cancer]. / Vozmozhnosti ul'trazvukovogo issledovaniia s kontrastnym usileniem dlia predoperatsionnoi otsenki sostoianiia regionarnogo limfaticheskogo kollektora u patsientov s rannim ploskokletochnym rakom polosti rta.

This review paper describes the possibilities of visualization of regional lymph nodes using contrast-enhanced ultrasound. Discussed is the experience of contrast-enhanced ultrasound implication for differential diagnosis of regional metastases of squamous cell carcinoma of the oral mucosa. The basics of the technique of contrast-enhanced ultrasound examination of the neck lymphatic basin are described.

[The effectiveness of tooth-preserving surgery in various forms of inflammatory and destructive lesions in mandibular molars area]. / Éffektivnost' zubosokhraniaiushchikh operatsii pri razlichnykh formakh vospalitel'no-destruktivnykh protsessov v oblasti moliarov nizhnei cheliusti.

The aim of the study was to analyse the effectiveness of tooth-preserving surgery in various types of odontogenic destructive lesions in lower molars area treated in the outpatient surgical department of Central Research Institute of Dentistry and Maxillofacial Surgery from 2011 to 2017. The study defined th percentage of complications and positive outcomes depending on the type of distribution of inflammatory-destructive process.

[Algorithm of radiological examination of patients with inflammatory and destructive bone changes in lower molars area]. / Algoritm rentgenologicheskogo obsledovaniia patsientov s vospalitel'no-destruktivnymi protsessami kosti v oblasti kornei moliarov nizhnei cheliusti.

The study presents the analysis and comparison of orthopantomogram (OPG) and cone-beam computed tomograms (CBCT) of 62 patients with inflammatory-destructive processes of bone in the lower molars area. The analysis resulted in an algorithm of radiological examination of patients with selected pathologies for diagnosis and definition of further treatment tactics.

[The mesialization of molars of the lower jaw after performance surgical manipulation with using miniscrew anchorage approach]. / Mezializatsiia moliarov s pomoshch'iu breket-sistemy posle provedeniia p'ezokortikotomii.

Process of the mesialization of molars in the lower jaw is long-time, moreover the molars are not frequently bodily translation. Conduction of the corticotomy reduce to regional acceleration phenomen that permit to accelerate the tooth movement avoiding negative inclination. PURPOSE: To improve the effectiveness of the treatment using piezocorticotomy and miniscrew anchorage approach in cases of third and second molar mesialization when first molar is missing. MATERIAL AND METHODS: 24 patients (10 men/14 women) aged 25-40 years with a fixed vestibular braces and the absence of molars on the lower jaw. Cone-beam computed tomography was performed before and after orthodontic treatment, as well as immediately after the piezokortikotomy (79 Cone-beam computed tomography). Miniscrews was placed in the area between roots of the first and second premolars (27 miniscrews) and surgical manipulations was performed using device VarioSurg (NSK, Japan). Depending on width of the alveolar ridge piezocorticotomy was performed (16 piezocorticotomies) or splitting using piezosurgery approach (11 splitting). RESULTS: Mesialization speed of molars in patients with support of piezocorticotomy is equal to 1.1±0.1 mm/mo that is higher than in patients without surgery only with miniscrew approach (0.33±0.006 mm/mo Roberts et al, 1996). Mesialization speed of molars in patients with support of splitting is equal to 1.6±0.15 mm/mo. However, we observed that after corticotomies surgery, the speed was increased only within the first 4.5 months, after splitting, the speed was increased only withing 2.5 months, after that period the speed gradually decreases. Bone density after surgery decreased, but at the end of treatment gradually restored. CONCLUSION: Piezo surgery with corticotomies is an effective method to accelerate the mesialization of molars in the lower jaw, that conduce to reduction duration the treatement and to allow to almost bodily translation of the molars.

[Radiographic manifestations variants of odontogenic inflammatory destructive lesions in lower molars]. / Varianty rentgenologicheskikh proiavlenii odontogennykh vospalitel'no-destruktivnykh protsessov v al'veoliarnoi chasti nizhnei cheliusti v oblasti moliarov.

The analysis and comparison of clinical and radiographic manifestations of odontogenic destructive processes in the area of molars of the lower jaw 54 patients, treated at the outpatient department of surgical dentistry CRID and MS. Set the main features of clinical manifestations depending on the distribution of the destructive process of the bone.

[Clinical and radiological features of inflammatory lesions in the lower molars area]. / Kliniko-rentgenologicheskaia kharakteristika vospalitel'no-destruktivnykh protsessov v oblasti moliarov nizhnei cheliusti.

The study objective was to analyze clinical manifestations by various forms of inflammatory destructive lesions in lower molars area. The study included 54 patients aged 20 to 66 years with odontogenic alveolar bone defects in lower molars area. Typical clinical and radiological signs are described for each type of destructive lesions. Sinus tract located more coronal and 'areolar' bone resorption may indicate root perforation. Clinical and radiological features may help in choosing optimal surgical tactic.