[Features of medical care provision in the profile «Maxillofacial surgery¼ in the Southern Federal District of the Russian Federation]. / Osobennosti okazaniya meditsinskoi pomoshchi po profilyu «chelyustno-litsevaya khirurgiya¼ v Yuzhnom federal'nom okruge Rossiiskoi Federatsii.

OBJECTIVE: To study the actual state of the organization of medical care for patients with the profile of «maxillofacial surgery¼ in the Southern Federal District of the Russian Federation in order to develop proposals for its optimization within the framework of a three-level system of medical care. MATERIAL AND METHODS: We analyzed accounting and reporting materials characterizing the organization of medical care in the field of «Oral and maxillofacial surgery¼ to the population in the Southern Federal District of the Russian Federation. RESULTS: The population of the Southern Federal District of the Russian Federation is currently provided with accessible round-the-clock medical care in the field of maxillofacial surgery. The forces and means at the disposal of the district government allow this to be implemented. However, the article describes a number of obstacles to the provision of high-quality medical care in the field of maxillofacial surgery and suggests ways to eliminate them. CONCLUSION: Preparation of an Order defining the functioning of a three-level system of medical care for adults and children with maxillofacial pathology in the Southern Federal District of the Russian Federation, as well as more effective use of telemedicine consultations will significantly improve the availability and quality of medical care.

[Comparative characteristics of the incidence of facial boils in military personnel and civilians]. / Sravnitel'naya kharakteristika zabolevaemosti furunkulom chelyustno-litsevoi oblasti u voennosluzhashchikh i grazhdanskikh lits.

THE AIM OF THE STUDY: To study the frequency and structure of the incidence of facial furuncle in military personnel of St. Petersburg and Leningrad region and civilians. To conduct a comparative analysis of the nature of the course, duration and outcome of the disease in military personnel and civilians (according to case histories). MATERIAL AND METHODS: From 5744 case histories of patients with purulent-inflammatory processes of the maxillofacial region treated at the clinic of the Department of ChLH and Surgical Dentistry of the Kirov Medical University and St. Petersburg State Medical Institution «City Hospital No. 15¼ from 2017 to 2019, 201 case histories of patients with facial furuncle were isolated and analyzed. RESULTS: According to the results of a study conducted from 2017 to 2019 in the clinic of the Department of CHLH and surgical Dentistry, a facial furuncle was detected in 65 cases. In the general structure of purulent-inflammatory diseases of the maxillofacial region, it was 3.1%. In the department of ChLH GB No. 15, 136 people were treated, which amounted to 3.7%. A lower percentage of the disease in military personnel is associated with early detection and timely initiation of treatment of purulent-inflammatory diseases of the skin. Weekly inspections of military personnel in military units, allow to avoid the development of complicated forms of their course. 95.0% of military personnel (47.0% of them contractors) and 51.0% of civilians were in the age group from 17 to 21 years. The main cause of the disease - hypothermia - in military personnel was 32.1%, in civilians - 20.9%. More often, the furuncle disease occurred in the spring: in military personnel in 44.6%, in civilians in 30.7% of cases. Localization of a boil in the buccal region occurred in military personnel in 15.4% of cases, and in civilians - in 20.8% of cases. CONCLUSION: To prevent the disease of facial frunculus in military personnel, it is necessary to improve methods of prevention, diagnosis and treatment of patients, to provide consultations of related specialists: dermatovenerologist, endocrinologist, immunologist. In addition, it is necessary to observe the rules of personal hygiene with the use of individual skin care products (according to the type of facial skin), hardening of the body and vitamin therapy.

[Long-term results of dental implantation in military personnel]. / Otdalennye rezul'taty dental'noi implantatsii u voennosluzhashchikh.

BACKGROUND: Currently, the use of the dental implantation method for the medical service of the Armed Forces of the Russian Federation is quite new. The method of dental implantation makes it possible to eliminate defects in the dentition of military personnel and other contingents eligible for medical care in military medical institutions of the Ministry of Defense of Russia. OBJECTIVE: The aim of the study is to substantiate the medical effectiveness of the use of dental implantation in military healthcare. MATERIAL AND METHODS: The study was conducted on the basis of the Department of Maxillofacial Surgery and Surgical Dentistry of the Military Medical Academy named after S.M. Kirov. The study is based on the analysis of long-term results of dental implantation according to medical histories and outpatient records. The study was conducted in 3 stages: stage 1 - study of the medical histories of patients who underwent dental implantation; stage 2 - examination of patients with dental implants and analysis of long-term results; stage 3 - a patient questionnaire was conducted to determine the effectiveness of dental implantation. RESULTS: The structure of complications during dental implantation was revealed. Clinical examples of long-term results of prosthetics using dental implants are presented. It has been established that due to the peculiarity of military service and the remoteness of the locations of military units from the military medical organization, it is not always possible to conduct regular medical examinations and examinations of patients. To identify early symptoms of peri-implantitis, which is more often asymptomatic, preventive examinations of military personnel should be carried out 1-2 times a year. CONCLUSION: To increase the service life of an orthopedic structure with installed dental implants, regular preventive examinations of patients to identify pathological processes are important. In favor of implantation, there is a choice for some categories of military personnel. This is especially important for flight and naval personnel, since dentures installed on dental implants are the only way to preserve their professional suitability in the military accounting specialty. The presence of teeth and the absence of removable dentures is an important requirement when performing combat missions.

[A pseudoallergic reaction involved in developing bullous oral lichen planus in patients with increased gastric acid-producing function]. / Rol' psevdoallergicheskoi reaktsii v razvitii bulleznoi formy krasnogo ploskogo lishaya slizistoi obolochki rta u bol'nykh s povyshennoi kislotoobrazuyushchei funktsiei zheludka.

Lichen planus of the oral mucosa (LPOOR) is a chronic autoimmune disease. With a complicated course of the disease, other clinical and pathomorphological signs are added to the clinical picture of the reticular form, including blisters in the bullous form of the disease. It is known that LPOOR develops mainly by the mechanism of delayed-type hypersensitivity reaction, and in complicated forms - with the addition of a true allergic reaction of immediate-type hypersensitivity. OBJECTIVE: To determine the role of pseudo-allergic reaction in the development of the bullous form of LPR in patients with increased acid-forming function of the stomach. MATERIAL AND METHODS: The level of histamine in blood was studied by high-performance liquid chromatography and blood IgE by the immunochemiluminescent method in 38 patients with the bullous form of LPOOR against the background of acid-dependent diseases and 14 patients with the reticular form of LP RR with the absence of hyperchlorhydria. For the treatment of patients with the bullous form of LPOOR, drugs were used - H1 and H2 receptor blockers and proton pump inhibitors. RESULTS: A positive result was obtained in 68.4% of cases. CONCLUSION: Thus, a pseudoallergic component has been established in the development of the bullous form of the LP of ROS against the background of increased acid-forming function of the stomach.

[Orthodontic treatment need in school-age children in the Leningrad region].

Epidemiology of dentoalveolar anomalies is undoubtedly important, but in terms of the organization of orthodontic care, greater interest are data on the needs in this type of treatment. In a situation of limited manpower and resources for the provision of orthodontic care information about needs in orthodontic treatment allows you to define a group of patients with the primary need for orthodontic treatment, and to identify priorities to optimize the organization of orthodontic care in the region. Such data can be obtained by using the Dental Aesthetics Index (DAI) and Index of Orthodontic Treatment Need (IOTN). The aim of the study was to analyze the epidemiology of various forms of dentoalveolar anomalies school-age children of Kirishi district of Leningrad region, as well as their needs in orthodontic treatment in accordance with objective evaluation indices. The study involved 734 pupils of Kirishi lyceum №1 of Leningrad region. Analysis of the prevalence of dentoalveolar anomalies, as well as needs in the orthodontic treatment was conducted in three age groups: I mixed dentition period (6-9 years), II mixed dentition period (10-13 years), and permanent dentition (14-17). To determine the needs in the orthodontic treatment were used two most common international index (DAI and IOTN). In Kirishi district of Leningrad region dentoalveolar anomalies were found in 88.8% of children of school age, which is in accordance with the indices and IOTN DAI needs in orthodontic treatment is 38.8% and 54.5%, respectively. In order to reduce unnecessarily high load volume medical institutions orthodontic profile, optimize utilization of financial resources, as well as reducing social tension it is recommended to introduce the practice of doctors-orthodontists methodology for determining the needs in orthodontic treatment by objective indices.

LOW-INVASIVE TECHNOLOGIES OF INITIAL SURGICAL D-BRIDEMENT IN POLYTRAUMA AT THE FIRST STAGE OF PROGRAMMED MULTISTAGED SURGICAL TREATMENT

The authors described the variants of initial surgical d-bridement on the basis of experience of treatment of 183 patients of multistaged treatment program.

[Surgical treatment of posttraumatic deformity of the orbital floor].

The article is devoted to an actual problem of surgical treatment of patients with posttraumatic deformities of the orbital floor. On the material of 21 observations it was shown that for the successful treatment of deformities of the orbit bottom autogenous costal cartilage graft should be used as a plastic material. Removal of enophthalmos in longstanding fractures can be reached only by reducing the volume of the orbit which can be achieved by retrobulbar placement of the graft. An analysis of the results demonstrated high efficiency of this method in the treatment of such patients.