[Assessment of microhaemodynamics and oxygenation in tissues after the vestibuloplasty with the use of a free dermal autograft in patients after the reconstructive jaw surgery with the use of the revascularized autografts]. / Otsenka sostoyaniya mikrogemodinamiki i oksigenatsii v tkanyakh posle vestibuloplastiki s ispol'zovaniem svobodnogo dermal'nogo autotransplantata u patsientov posle rekonstruktivnoi operatsii na chelyustyakh s primeneniem revaskulyarizirovannykh autotransplantatov.

Purpose of the study: to study the features of microhaemodynamics and oxygenation in soft tissues in the area of the plastically reconstructed jaw after the vestibuloplasty. MATERIALS AND METHODS: The study included 40 patients aged 20 to 65 (21 males and 19 females). The patients were divided into two groups: I group (14 patients) - patients after reconstructive surgery with the use a fibula autograft without the inclusion of a musculocutaneous «islet¼; II group (26 patients) - patients after reconstructive surgery with the use a fibula autograft with the inclusion of a musculocutaneous «islet¼. To correct the prosthetic bed soft tissues, all patients underwent vestibuloplasty with the use of a free dermal autograft. To study microcirculation in tissues, the laser Doppler flowmetry (LDF) method was used. Microcirculation status was assessed by microcirculation index characterizing the level of tissue blood flow; parameter «σ,¼ which determines the oscillability of the flow of red blood cells and by coefficient of variation, characterizing vasomotor activity of microvessels. According to the Wavelet analysis of LDF-grams the blood flow bypass was determined. An oxygenation study was carried out in the tissues of the plastically restored jaw by optical tissue oximetry, the results of which determined the oxygenation index and the specific oxygen consumption index. RESULTS: According to LDF data after vestibuloplasty, it was found that in I group, the microcirculation in soft tissues of the plastically reconstructed jaw restored in 21 days, and in II group in 2 months, which persisted at 6 months. In I group, the level of oxygenation and specific oxygen consumption normalized in 21 days, and in II group in 2 months, which persisted at 6 months. CONCLUSION: Based on the results of this functional study, it was found that before vestibuloplasty microcirculation and oxygenation indices in II group patients were lower than those in I group patients. After vestibuloplasty with the use of a free dermal autograft, microcirculation indices in II group patients restored in 2 months, while in I group patients those indices restored in 21 days.

[Hypoxia-dependent transcriptional control of activity of destructive inflammatory and malignant periodontium changes]. / Gipoksiya-zavisimyi transkriptsionnyi kontrol' aktivnosti destruktivnykh izmenenii parodonta vospalitel'nogo i zlokachestvennogo geneza.

The aim of the study was to evaluate the diagnostic value of determining the level of hypoxia-inducible factor-1α (HIF-1α) in the gingival fluid in patients with chronic generalized periodontitis (CGP) and exacerbation of inflammatory periodontal diseases in patients with cancer of the oral mucosa (OM). A clinical study was carried out with the participation of 60 patients with CGP (group 1) and 22 patients with cancer of OM (group 2) of the T1-2N0M0 stage, as well as 15 healthy individuals with no revealed periodontal pathology. CGP patients, depending on the depth of periodontal pockets (PC), were divided into two subgroups - with a mild degree (PC depth up to 3.5 mm) and an average degree (PC depth from 4 to 6 mm). Group 2 patients were also divided into two subgroups - with exacerbation of CGP (n=12) and patients with no complications (n=10). The content of HIF-1α in the gingival fluid was determined by enzyme immunoassay. The results of the study made it possible to establish that in patients of group 1, the concentration of HIF-1α in inflammatory exudate increased by 2.4 times (p<0.001) compared with the control group. The concentration of HIF-1α in the contents of periodontal pockets in patients with CGP depended on the severity of the disease: with mild CGP, it did not differ from the control group, and with moderate CGP it was 3.15 times higher (p<0.001). In patients with cancer of OM, the concentration of HIF-1α in the gingival fluid did not depend on the presence of inflammatory periodontal lesions and was determined by a multiple increase in the biomarker level (7.5 times) due to the development of a malignant process in the oral cavity. Therefore, monitoring the concentration of HIF-1α in the gingival fluid is informative in patients with CGP in assessing the severity of periodontal conditions, as well as in differential diagnosis with malignant formations of the oral cavity.

[Influence of gender, age and metabolic factors on the course of chronic generalized periodontitis in patients with metabolic syndrome]. / Vliianie gendernykh, vozrastnykh i metabolicheskikh faktorov na techenie khronicheskogo generalizovannogo parodontita u patsientov s metabolicheskim sindromom.

In a study of 537 patients with chronic generalized periodontitis and metabolic syndrome, depending on gender, age and metabolic factors, it was found that with increasing of body mass index (BMI) symptoms of chronic generalized periodontitis is becoming more unfavorable, there is a close positive relationship between the severity of chronic generalized periodontitis and BMI. Patients' with BMI ≥40 kg/m2 in 80% of cases, periodontitis was characterized by severe course. It was found that the gender of the patient becomes relevant only with correlation of age and BMI. It was proved that for the most accurate prognosis of chronic generalized periodontitis, patient's sex, age and BMI should be taken into consideration. The developed model for predicting the course of chronic generalized periodontitis depending on the sex, age and metabolic factors of a particular patient, allows to monitor the dynamics of the disease in time.

[Diagnostic value of serum osteomarkers in moderate and severe periodontal disease]. / Diagnosticheskaia informativnost' opredeleniia osteomarkerov v syvorotke krovi pri khronicheskom generalizovannom parodontite srednei i tiazheloi stepeni.

The purpose of the study was to establish the diagnostic informative value of the concentration of osteomarkers in the serum to assess the severity of the osteodestructive component in chronic generalized periodontitis (HGP) prior to surgery and the prognosis of the effectiveness of surgical treatment of the disease. 187 patients with moderate and severe HGP who underwent bone and plastic insertion during the patch operations were examined. In the blood serum, the concentration of osteoprotegerin, ligand of the soluble activator of the kappa B nucleation factor (sRANKL) was initially determined and at 8 and 12 months after the operation, bone isoenzyme of alkaline phosphatase, osteocalcin, C-terminal telopeptides of degradation of mature type 1 collagen (ß-CrossLaps). It was found that in assessing the severity of osteodestructive processes in the periodontium in HGP, the serum concentration of sRANKL and ß-CrossLaps is informative. When the sRANKL content in the blood serum exceeds 0,48 pmol/l, and ß-CrossLaps exceeds 0,795 ng/ml, it is possible to judge the high activity of osteoclasts, which is accompanied by a pronounced risk of irreversibility of the osteodestructive component and the lack of effectiveness of surgical treatment.

[Analysis of photosensitizer gel penetration through the teeth structure]. / Analiz glubiny proniknoveniia gelia fotosensibilizatora v strukturu tkanei zubov.

As a result of the studies carried out on 20 extracted frontal teeth it was reliably shown that after 10 minutes the concentration of the photosensitizer in enamel at full depth reached values sufficient for performing photodynamic teeth whitening. At the same time, the penetration of the photosensitizer into the deep layers of dentin was not detected which allows to carry out the photodynamic bleaching procedure only within the enamel and enamel-dentine boundary, thus not affecting the pulp of the tooth.

[Clinical and immunological features of oral and vermillion border precancer diseases]. / Kliniko-immunologicheskie osobennosti predrakovykh zabolevanii slizistoi obolochki rta i krasnoi kaimy gub.

Research objective was assessment of a possibility of primary diagnosis of viruses Epstein-Burr, a cytomegalovirus, a virus of herpes of the 6th type in oral liquid and also influences of herpes infection on development and the clinical course of precancer diseases of the oral mucosa and the red border of lips (RBL). Profound clinic-immunological examination is conducted to 60 patients: the first group are have made 20 patients with an erosive and ulcer form of the lichen planus, the second - 20 people with an erosive form of a leukoplakia, a third - 20 people without diseases of the oral mucosa. As a result of work detection herpes infection is revealed high (90%). The combined infection with a virus Epstein-Burr and a virus of herpes of the 6th type was observed more than at a half of patients. The imbalance of factors of local immunity of the oral cavity in the form of increase in the IgG profile, decrease in concentration of IGA, lysozyme, and increase in an indicator of Ksb three times in comparison with norm and also substantial increase of level of pro-inflammatory cytokin IL 1ß and FNO-α is found in patients with precancer diseases of the oral mucosa. Characteristic clinical feature of the precancer diseases associated with latent herpes infection is the long, recidivous current, persistent to traditional therapy. The research of oral liquid and blood on herpes viruses and consultation of the infectiologist is recommended to all patients with precancer diseases.

[The main aspects of the multidisciplinary dispensary dental care to elderly and senile population].

In the article presents the characteristics of the organization of dispensary work with patients older than 60 years. The main directions and objectives dispensary. The features of clinical supervision of dental patients belonging to the category of persons decreed by the elderly, senile age from the perspective of interaction professionals in a multidisciplinary clinic.

[The mean timing of periodontic care rendering].

The time-studies demonstrated that the periodontologist spend 30.3 +/- 2.6 minutes on the primary ambulatory visit of patient and 16.4 +/- 0.9 minutes on the revisit of patient (non-registering time spending on preventive and curative activities). Time spending on curative preventive activities in each group of patients with periodontal diseases depended on both the severity of inflammatory destructive processes in periodontium and therapy stage.

[The quality of life of patients with various forms of periodontitis].

The inflammatory diseases of periodont are a serious medical social problem. The OHIP-14, the questionnaire concerning the quality of life is one of the most applied in stomatology. In stomatology, the most frequently applied questionnaire concerning life quality is OHIP-14. The patients participated in the study were divided on three groups depending on tactics of treatment. The application of comprehensive periodontological treatment enhances the life quality on all scales both in patients with severe chronic periodontitis and in patients with aggressive periodontitis. The life quality enhanced the most in patients underwent repeatedly the supportive therapy.