[Reparative potential of bone tissue and associated influencing factors]. / Reparativnyi potentsial kostnoi tkani i vliyayushchie na nego faktory.

OBJECTIVE: The aim of the sthudy. To study the influence of general and local factors on the regenerative potential of bone tissue to optimize augmentation mechanisms in the treatment of jaw atrophy. MATERIALS AND METHODS: The influence of general and local factors on the regenerative potential of the bone during the augmentation operation of the alveolar process (part) of the jaw in 68 patients was studied. The survival rate of dental implants and the incidence of complications after completion of dental rehabilitation in the long-term follow-up period (more than 5 years) were evaluated. 18 indicators were studied, which were evaluated by qualitative and quantitative methods. The study of the effect of indicators on regeneration was carried out using an accurate Fischer test for conjugacy tables. The assessment of the strength of the influence was calculated as the ratio of the chances of developing an unfavorable outcome of bone grafting and dental implantation. RESULTS: He highest chances of developing adverse outcomes were found in smoking patients with diabetes mellitus, high body mass index, low survival of bone walls, severe bone atrophy (5.6 and higher class according to Cawood & Howell), three-dimensional bone defect, in the absence of 3 or more bone walls, the presence of subcompensated and decompensated psychological state the patient. In the course of histological examination, the influence of these factors on the mechanisms of reparative osteogenesis morphologically manifested a lower degree of progress of regenerative processes and a lower degree of maturity of bone tissue. CONCLUSION: To reduce the chances of developing an unfavorable outcome, in the presence of negative general and local factors, it is not advisable to use dental implantation simultaneously with bone augmentation procedures. In order to reduce the pathophysiological impact of negative factors during sinus lifting, increase the proportion of autosteal material for potentiating the metabolic activity of bone tissue, as well as prescribe antioxidant, antihypoxant and membrane stabilizing therapy before surgery and in the early postoperative period.

Carboxytherapy for the elimination of pain symptoms (or arthralgia) among the elderly persons with the pathology of the temporomandibular joint.

Temporomandibular arthralgia is difficult to treat, painful and often relapses. 48 patients (19 men and 29 women) aged 61-72 years, suffering from the syndrome of pain dysfunction of the temporomandibular joint, were under observation. In 1st (control) group of patients (18 people), NSAIDs indomethacin in tablet form of 25 mg 3 times a day were used for 9 days. In patients of the 2nd (main) group (30 people), the method of invasive carboxytherapy was used, consisting in subcutaneous injection of carbon dioxide with a volume of 3 ml of 5 procedures every other day. On the 3rd, 9th and 15th days of follow-up, invasive carboxytherapy was more effective than the use of a nonsteroidal anti-inflammatory agent by 8.9; 36,5 and 37%, respectively. The high efficiency of the method of invasive carboxytherapy for the elimination of pain symptoms in pain dysfunction was shown, which was 22,86% on day 3; 64,29% on day 9 and 68,16% on day 15 of observation. The method of invasive carboxytherapy can be used in the complex treatment of patients with pain dysfunction of the temporomandibular joint.

[Physical rehabilitation for ankle joint injuries in elderly and elderly people (Stage 1).]

A multidisciplinary approach to recovery after injuries of the ankle joint in elderly and senile people by specialists of various profiles using drug and non-drug methods is especially relevant today. It is required to develop and put into practice various options for the combined use of physical rehabilitation means at different stages of the rehabilitation treatment of elderly and senile patients with this pathology. The study revealed no significant complications and side effects when using this technique, which allows us to recommend it as a means of secondary prevention and injuries of the ankle joint, especially with contraindications to the use of non-steroidal anti-inflammatory drugs and glucocorticosteroids. A significant difference was found in goniometry parameters after the recovery period in patients in the main and comparison groups. Despite the fact that in both groups the difference in values was probably significant, but in the main group it was much larger (almost 1,5 times). The technique can be recommended for use in fitness centers, athletic halls and medical and physical education dispensaries.

[Physical rehabilitation for ankle joint injuries in elderly and elderly people (Stage 2).]

The main part of the injuries of elderly and senile patients as a result of physical activity falls on the lower limbs, due to the increased load during movement. Ankle injuries have a multifactorial etiology involving the interaction of compensatory spinal and leg biomechanics, environmental factors, and shoe selection. In this regard, it is necessary to prepare a complex of rehabilitation measures, including physical therapy, with the possibility of implementing the recovery process not only on an outpatient basis, but also at home, thereby improving the quality of life and preventing disability. The patients of the comparison group received standard complex therapy, including orthopedic methods of treatment, drug therapy, myostimulation, and massage. For patients of the main group, in addition to the traditional complex, the exercise therapy technique according to the claimed method was added. The study revealed no significant complications and side effects when using this technique, which allows us to recommend it as a means of secondary prevention and injuries of the ankle joint, especially when conservative and targeted therapy is contraindicated. A significant difference was found in goniometry parameters after the recovery period in patients in the main and comparison groups.

[Periodontal status and possibilities of its optimization in elderly patients.]

The study consists in studying the state of oral hygiene and periodontal tissues in elderly patients during dynamic follow-up for 12 months. Patients aged 61-74 years with inflammatory periodontal diseases and partial absence of natural teeth in both jaws were under observation. The study showed a significant improvement in oral hygiene and the condition of periodontal tissues in the elderly when using therapeutic and prophylactic products of domestic production for individual intraoral hygiene and professional oral hygiene at least four times a year.

[Physical rehabilitation for osteochondrosis of the cervical and thoracic spine in elderly and senile people (Stage 3).]

The concept of a multidisciplinary approach to the treatment of osteochondrosis in elderly and senile patients by specialists of various profiles using medicinal and non-medicinal methods is especially relevant today, therefore, it is necessary to develop and put into practice various options for the combined use of physical rehabilitation means at different stages of rehabilitation treatment of elderly and senile patients with osteochondrosis of the cervical and thoracic spine. The dynamics of clinical manifestations of osteochondrosis after rehabilitation treatment relative to the age of patients in groups showed that the effectiveness of the technique is much higher in elderly patients, in contrast to senile patients and centenarians. The study revealed no significant complications and side effects when using this technique, which allows us to recommend it as a means of secondary prevention of diseases of the cervical and thoracic osteochondrosis, especially in the presence of contraindications to the use of non-steroidal anti-inflammatory drugs and glucocorticoids. The technique can be recommended for use in fitness clubs, athletic halls and medical and physical education dispensaries.

[Physical rehabilitation for osteochondrosis of the cervical and thoracic spine in elderly and senile people (Stage 2).]

The main and most frequently used means of physical rehabilitation for osteochondrosis of the cervical and thoracic spine is motor rehabilitation. The goals of physical rehabilitation of persons suffering from osteochondrosis are to strengthen the muscles of the back, reduce the load on the intervertebral discs, improve blood circulation, restore a normal motor stereotype and, as a result, reduce pain. The use of means of motor rehabilitation is scientifically substantiated, the mechanisms of their effect on the functional state of the body have been studied, and the effectiveness of their use is beyond doubt. However, the lack of multidisciplinary programs, at the heart of rehabilitation measures specifically for elderly and senile people with osteochondrosis of the cervical and thoracic spine, in practice leads to the widespread use of drug and targeted therapy, involving the use of only drugs that reduce pain and muscle tension. The lack of an individual approach, group exercises for physical therapy, handing out to patients advertising brochures, schemes for physical therapy, without practicing exercises in practical classes, lead to negative consequences and relapses of diseases and a negative attitude of patients towards the discipline as a whole. In this regard, it is necessary to develop and introduce into practice various complexes of physiotherapy exercises for elderly and senile patients with osteochondrosis of the cervical and thoracic spine.

[Professor V.A. Dunaevsky (on the occasion of the 100th anniversary)]. / Professor V.A. Dunaevskii (k 100-letiyu so dnya rozhdeniya).

The purpose of the work is to highlight the scientific, clinical, pedagogical and social activities of the famous dentist, participant of the Great Patriotic War, Doctor of Medical Sciences, Professor Vladimir Arsenievich Dunaevsky in connection with the 100th anniversary of his birth, and also to note the peculiarities of his personality, character and merits in the organization dental care to the population.

[Bioregulation therapy in the treatment of age-related osteoarthropathy of the temporomandibular joint.]

The study consists of clinical and radiological parallels between the severity of functional pathology of the temporomandibular joint, bone density of the joint elements and the effect of bioregulatory therapy on it at different ages. Male patients (35-74 years old) with functional pathology of the temporomandibular joint were under observation. The study showed a significant decrease in bone density and correlation of this index with the severity of the disease course in all patients with temporomandibular joint dysfunction compared with the control group of healthy subjects. After a course of bioregulatory therapy the bone density and functional pathology index of the temporomandibular joint indicate a change from the severe course to a form of moderate severity in the group of elderly patients. The correlation correlation between the severity of the course of functional pathology and the decrease in the density of bone structures of the temporomandibular joint has been revealed, increasing with age. Use of bioregulatory therapy in complex treatment of functional pathology has favorable influence on a course of functional pathology of a temporomandibular joint at elderly patients.

[Evaluation of the effectiveness of the third stage of rehabilitation after a knee joint injury in persons of older age groups by means of physiotherapy exercises.]

The main task in the rehabilitation of athletes with traumatic injuries of the knee joint and surrounding soft tissues is effective and painless recovery at all stages of treatment. The aim of this work is to introduce a set of physical exercises for the treatment and prevention of traumatic injuries of the knee joint in middle-aged and elderly patients at the third stage of rehabilitation treatment (ICD-10: S80-S89). To date, there is no single regulated program for the management of middle-aged and elderly patients at the outpatient stage. The article describes the third stage of the organization of medical rehabilitation assistance in the late rehabilitation period, the period of residual symptoms of the course of the disease, without relapses. Physical exercises, presented in this complex, give the patient independence in everyday life in the implementation of self-service, independent movement, in the presence of the prospect of restoration of function (rehabilitation potential) confirmed by the results of the examination. The proposed technique was tested on 148 patients who underwent all 3 stages of rehabilitation treatment, in whom the duration of remission was 12-36 months.

[Geriatric aspects of teaching maxillofacial surgery and surgical dentistry.]

Competence-based approach plays an important role in the training of a modern doctor. Considering that the strategy of dental care for older age groups is determined not only by the demographic situation and its development, but also by the justified need for effective dental care, it is important to implement the teaching of gerontostomatology in a medical university based on the results of evidence-based medicine and a personalized approach. The aim of the work was to develop a methodology for teaching geriatric aspects according to the curriculum of a specialist in the discipline of maxillofacial surgery and surgical dentistry. Based on the study of scientific works on various aspects of gerontostomatology, the author's position is indicated in the work and methodological foundations for modern teaching of the gerontostomatology section are presented according to the curriculum of a specialist in the main areas of training in the field of maxillofacial surgery and surgical dentistry. Particular attention is paid to the methodology of teaching pyoinflammatory diseases and injuries of the maxillofacial region, salivology, pathology of the temporomandibular joint, masticatory muscles and oncostomatology.

[Traumatic defeats of the oral mucosa among people of the senior age groups: occurrence, consequences and treatment.]

Traumatic damages to the oral mucosa are the main predisposing factor for the development of the oncostomatological pathology among the old people. The aim of the investigation was to study the occurrence of traumatic lesions of the oral mucosa among people of old age groups and estimate the effectiveness of their treatment using modern domestic remedies. 967 people (569 males and 398 females) from 19 to 82 years old were examined to determine the occurrence of traumatic oral mucosal pathology. Value of effectiveness while treatment of 83 elderly patients using modern domestic agents «ASEPTA® adhesive balm for gums¼ and «ASEPTA® gel for gums with propolis¼ was assessed in comparison with vinylin for internal use. It is found that 9,41 and 9,52% of cases are traumatic lesions of the oral mucosa respectively among elderly and senile people respectively. The cause of them in 96,7-97,1% cases are traumatic factors while using removable dental prostheses; the untimely treatment of these factors in 7,9% leads to the formation of prosthetic fibroms. A comparative evaluation of the treatment effectiveness of prosthetic-etiology-traumatic lesions of the oral mucosa showed the advisability of using modern domestic agents like «ASEPTA® adhesive balm for gums¼ during the first 2 days from the start of therapy and then «ASEPTA® gel for gums with propolis¼ until complete healing of traumatic injuries, compared to the using of vinylin for internal use for the same purposes, which efficiency remains high. Timely detection and treatment of the traumatic defeats of oral mucosa are an important factors of prevention of oncostomatological pathologies among elderly and senile persons.

[Evaluation of the efficiency of therapeutic gymnastics for knee joint injuries in athletes of the senior age groups.]

The introduction and scientific substantiation of methods for organizing sports events with optimal motor loads for citizens of middle and senior age groups should be based on two principles: general (pedagogical) principles of physical education and sports training, adapted to the specifics of health-related training; analysis of physiological and psychophysiological effects that are created by physical activity of various types and directions in the human body. The importance of this topic is due to the fact that knee injuries occupy a special place in the sports of veterans, and severe injuries and injuries in this area can restrict an athlete in his professional activities. The problem of rehabilitation of athletes of older age groups with knee injuries is not only a medical problem, but also has an important socio-economic significance. The results obtained in the work will make it possible to more objectively approach the creation and implementation of rehabilitation treatment programs without surgical interventions. Therefore, the assessment of the effectiveness of the complex of medical gymnastics for the rehabilitation and prevention of traumatic injuries of the knee joint (ICD-10: S80.83, M17.23, M94.2) in comparison with the traditionally used exercise therapy exercises for patients of older age groups on the first stage of rehabilitation treatment is an urgent task.

[Doctor, scientist, teacher, personality. On the 100thbirthday of Professor L.M. Perzashkevich]. / Vrach, uchenyi, pedagog, lichnost'. K 100-letiyu so dnya rozhdeniya professora L.M. Perzashkevicha.

The purpose of the work is to highlight the scientific, clinical, pedagogical and social activities of a famous dentist, veteran of the Great Patriotic War, doctor of medical sciences, Professor Leonid Matveevich Perzashkevich in connection with the 100th anniversary of his birth.

[Age-related and post-extraction atrophy of the jaws and modern possibilities for restoring the masticatory apparatus in the elderly people.]

The data of clinical examination of 3 329 people (1 760 men and 1 569 women) living in various regions of the Russian Federation (St. Petersburg and Leningrad region, Moscow and Moscow region, Krasnodar Territory) are presented. The aim of the investigation was to study the frequency of tooth loss and clinical manifestations of atrophy of the alveolar processes (parts) of the jaws in patients of older age groups to assess the possibility of dental rehabilitation using orthopedic structures on dental implants. The study of the prevalence and degree of atrophy showed that in the older age group, patients of senile age were more dominated by 4 and 5 degrees of atrophy, the frequency of their occurrence was about 20-30%. The incidence of grade 6 atrophy was also higher than in other age groups, it was found in 17,22% of men and 17,81% of women in the upper jaw and 22,18% and 15,79% in the lower jaw, respectively. Despite the fact that the number of patients in older age groups with complete or partial loss of teeth does not tend to decrease, at the present stage of development of dentistry and dental implantology, the possibility of restoring the integrity of the masticatory apparatus with the use of artificial supports is possible in virtually all clinical cases. The presence of comorbid or multimorbid pathology is not an absolute contraindication, but is only a temporary factor that postpones dental rehabilitation until the general somatic status of the patient is stabilized.

[Efficiency of rehabilitation in persons of middle and elderly age with knee joint injuries.]

Traumatic injuries of the knee joint of middle and elderly age account for the majority of injuries of the lower limb. There is a large number of developments in the rehabilitation of the knee joint after injuries, but unified approaches to the rehabilitation algorithm have not been formed. The purpose of this work was to evaluate the effectiveness of a set of physical exercises for the treatment and prevention of traumatic injuries of the knee joint in middle-aged and elderly patients (ICD-10: S80-S89). The claimed complex has been tested in 148 patients in whom the duration of remission was 12-36 months. The early use of physical exercises for injuries of the knee joint in middle-aged and elderly people is associated, first of all, with the anticipation of probable complications, stimulation of compensatory-adaptive reactions of the activity of organs and systems of the body.

[Tatiana Strelyukhina is an outstanding dentist, scientist, researcher (on the occasion of the 100th anniversary)]. / Tat'yana Fedorovna Strelyukhina ­ vydayushchiisya stomatolog, uchenyi, issledovatel' (k 100-letiyu so dnya rozhdeniya).

The purpose of the work is to present materials on the history of Russian dentistry in connection with the 100th anniversary of an outstanding scientist, clinician, one of the patriarchs of Russian dentistry, a veteran of the great Patriotic war, associate Professor Tatyana Strelyukhina who was at the origins of the specialty and was among the first to create domestic dental materials science.

[Modern approach and geriatric aspects of teaching gerontostomatology in training specialists under the specialty program.]

The strategy of dental care for older age groups is based not only on the priorities determined by the demographic situation, guided by its development, epidemiologically justified need for dental care, but also by its effectiveness, which should be conditioned and based on the results of evidence-based medicine and a personalized approach, in the implementation of which it is important a competence-based approach plays a role in the process of teaching gerontostomatology students at a medical university. The aim of the work was to create a modern methodological basis for teaching the section of gerontostomatology in accordance with the modern curriculum of a specialist in a medical university. Based on the study of scientific works devoted to various aspects of gerontostomatology, the work presents the methodological foundations for modern teaching of the section of gerontostomatology on a specialist in a medical university in the main areas of specialist training, taking into account the modern curriculum in the field of cariesology, non-carious dental lesions, endodontics, periodontology, diseases of the mucous membrane of the cavity and the basics of providing orthopedic dental care to elderly and senile people.

[Geriatric aspects of modern plastic surgery.]

Aging of the human body is a natural physiological process. In the last century, the main reasons for people turning to plastic surgeons were congenital and acquired deformities, as well as age-related changes in the skin of the face. Nowadays, a person's appearance has become the main factor in his success in society. The work determines the motivation of elderly and senile people to perform plastic surgeries, and also analyzes the work of clinics in performing plastic surgeries for people of older age groups. It was found that 96,4% of men and 86,9% of women in older age groups have a fairly complete understanding of plastic surgery. Among the elderly and old people, 27,7% of men and 17,2% of women have a desire to perform plastic surgery for themselves, however, women are 10,9 times more likely to go to plastic surgeons. Analysis of the plastic surgery clinics showed a steady trend of increasing the number of elderly and senile people, regardless of gender, to plastic surgeons to perform operations aimed mainly at improving the aesthetics of the face, neck and body shaping by eliminating gravitational ptosis and removing excess subcutaneous fat. deposits on the trunk. The main reason for refusal to perform the operation desired by the patient and recommended by the plastic surgeon is the lack of funds.

[Saint Petersburg memorial and sign places related to distinguished dentists and maxillofacial surgeons of Russia]. / Memorial'nye i pamyatnye mesta Sankt-Peterburga, svyazannye s deyatel'nost'yu vidnykh stomatologov i chelyustno-litsevykh khirurgov Rossii.

The article presents data on Saint Petersburg memorial and sign places related to distinguished dentists and maxillofacial surgeons of Russia.