[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.

[Prevention of inflammatory complications after surgical extraction of mandibular third molars]. / Profilaktika vospalitel'nykh oslozhnenii posle udaleniya tret'ikh molyarov nizhnei chelyusti.

BACKGROUND: Inflammatory complications are the most prevalent problems after surgical extraction of mandibular third molars. The main options for prevention are prophylactic antibiotics usage before surgery or in the postoperative period; a method of postoperative management of a tooth socket, implying healing by primary or secondary closure. Each of the postoperative management types has advantages and disadvantages. OBJECTIVE: The aim of the study was to compare complete suturing versus iodoform gauze packing of tooth socket for prevention of inflammatory complications after mandibular third molar removal. MATERIAL AND METHODS: A retrospective cohort study was performed. The medical records of 273 patients who underwent mandibular third molar extraction for orthodontic indications were analyzed. Data of 100 patients were included, in 50 cases the postoperative management was carried out using iodoform packing, in other 50 cases complete suturing was performed. Depending on the type of data and distribution, we used the chi-squared test, Fisher's exact test, Student's t-test, Mann-Whitney U test. A p<0.05 was needed to achieve statistical significance. RESULTS: Alveolitis developed in 8 % cases of iodoform gauze packing and 34% cases of suturing. The differences are statistically significant (p=0.003). The total rehabilitation period (days) in patients with no alveolitis using iodoform gauze packing was 8 (7; 31) (Me (Q1; Q3)), using complete socket suturing was 7 (7; 8) (Me (Q1; Q3)), the differences are statistically significant (p=0.003). CONCLUSION: The best option for the prophylaxis of alveolitis after surgical extraction of mandibular third molar is secondary closure using iodoform gauze packing. However, in the cases with no alveolitis when complete suturing was performed, healing occurred much faster, which justifies the development of an alternative method for third molar socket healing.

[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.

[Immunohistochemical diagnosis of necrotizing sialometaplasia]. / Immunogistokhimicheskaya diagnostika nekroticheskoi sialometaplazii.

The article presents a clinical case of an immunohistochemical study of a rare disease: necrotizing sialometaplasia in the hard palate. Due to the complexity of the differential diagnosis between necrotizing sialometaplasia and squamous cell carcinoma, an immunohistochemical method was used with antibodies to proteins Ki-67, P53, P63 and cytokeratins-7 and Immunohistochemical study established low proliferative activity of glandular cells in excretory ducts and metaplastic squamous epithelium for Ki-67 protein, significant expression of protein P63 was detected both in the ductal epithelium nuclei and in metaplastic areas and expression of the mutant protein P53 was approximately absent. Marked expression of cytokeratin-7 in the ducts cells and weak expression in necrotic acini of the glands and metaplastic epithelium was noted. It was shown that cytokeratin-15 homogeneously stains the peripheral zone of metaplastic epithelium, which is characteristic of a benign lesion. Thus, the panel of antibodies to proteins Ki-67, P53 and cytokeratins-7 and 15 allows to verify necrotizing sialometaplasia.

[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.

[To the question of proliferative verrucous leukoplakia malignant potential]. / K voprosu o zlokachestvennom potentsiale proliferiruyushchei verrukoznoi leikoplakii.

AIM OF STUDY: To study of neoplastic transformation of the epithelial cells of the oral mucosa with verrucous hyperortokeratosis, verrucous carcinoma and oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Oral mucous membrane biopsies of 33 patients with clinical diagnosis of proliferative verrucous leukoplakia were investigated. Histologically in 19 cases (57.6%) was revealed verrucous hyperorthokeratosis, in 8 cases (24.2%) - verrucous carcinoma and in 6 cases (18.2%) - oral squamous cell carcinoma. Tissue antigens were determined using mouse monoclonal antibodies to Ki-67 and mouse monoclonal antibodies to cytokeratin 15. RESULTS OF THE STUDY: In comparison with the proliferative activity of epithelial cells in the malpighian layer in verrucous hyperorthokeratosis (17.2±8.1%) was detected increasingof cell proliferation in epithelial growth zone in verrucous carcinoma (33.8±8.1%) and in peripheral zone of solid areas in oral squamous cell carcinoma (51.2±35.7%). A significant decrease in the expression of cytokeratin 15 in the cytoplasm of tumor cells was noted inverrucous carcinoma and oral squamous cell carcinoma in comparison with verrucous hyperorthokeratosis. CONCLUSION: The obtained results proclaim that there is no stage of epithelial dysplasia during tumor transformation of proliferative verrucous leukoplakia into verrucous carcinoma and oral squamous cell carcinoma. Verrucous carcinoma by the nature of proliferative activity, cell atypia and expression of cytokeratin 15 corresponds to carcinoma in situ.

[Immunohistochemical study of Ki-67, PHH3, and CK15 protein expression in oral epithelial malignancy]. / Immunogistokhimicheskoe issledovanie ékspressii belkov Ki-67, PHH3 i CK15 pri malignizatsii épiteliia slizistoi obolochki rta.

OBJECTIVE: To investigate the expression of Ki-67, phosphohistone H-3 (PHH3), and cytokeratin 15 (CK15) proteins in the cells of the oral mucosa (OM) according to the degree of its malignant transformation. MATERIAL AND METHODS: OM biopsy specimens from 69 patients diagnosed with focal epithelial hyperplasia, intraepithelial squamous cell neoplasia, cancer in situ, and squamous cell carcinoma were examined. Tissue antigens were determined using mouse Ki-67 monoclonal antibodies, rabbit PHH3 polyclonal antibodies, and mouse CK15 monoclonal antibodies. RESULTS: There was an increase in epithelial proliferative and mitotic activities in squamous cell carcinoma and a sharp decrease in the expression of CK15 in the cytoplasm in cancer in situ and squamous cell carcinoma of the OM. CONCLUSION: The protein CK15 can be used for the differential diagnosis between high-grade dysplasia and OM epithelial malignancy at the stage of carcinoma in situ and squamous cell carcinoma.

[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.

[Cytokeratin 15 as a diagnostic marker for oral epithelial malignization]. / Tsitokeratin 15 kak diagnosticheskii marker nachala malignizatsii épiteliia slizistoi obolochki rta.

The paper presents an example of an immunohistochemical study of malignancy in oral epithelial hyperplasia. In the described case in view of the difficulty in determining the onset of the epithelial malignancy with the usual histological technique, an immunohistochemical method was used with antibodies to proteins Ki-67, human papillomavirus (HPV) type 16 and cytokeratin 15. The results of immunohistochemical study indicated increased proliferative activity of epithelial cells, presence of papillomavirus HPV16 in their cytoplasm and synthesis of cytokeratin 15 in all layers of the epithelium. These characteristics of squamous intraepithelial neoplasia may be a diagnostic criterion for the beginning of oral epithelial malignization.

[The proliferative activity of tumor cells and the distribution of SOX2+ pluripotent stem cells in various histological types of ameloblastoma]. / Proliferativnaia aktivnost' kletok opukholi i raspredelenie SOX2+ pliuripotentnykh stvolovykh kletok v razlichnykh gistologicheskikh variantakh ameloblastomy.

AIM: to investigate the proliferative activity and distribution of pluripotent stem cells in various histological types of amelobrastoma. MATERIAL AND METHODS: The surgical and archival materials of 76 patients with ameloblastoma from the Central Research Institute of Dentistry and Oral Surgery, Ministry of Health of the Russian Federation, were used. Tissue antigens were determined using a rabbit monoclonal antibody against to Ki-67 and SOX2. RESULTS: Proliferating (Ki-67) and pluripotent (SOX2) cells were identified in various histological types of ameloblastoma. A weak significant correlation was found between tumor size, pluripotent stem cells, and cellular proliferative activity. Enhanced cell proliferative activity and extensive bone tissue destruction significantly correlated with the development of recurrent ameloblastoma. CONCLUSION: The presence of pluripotent stem cells, the proliferative activity of ameloblastoma cells, and the extensiveness of bone tissue destruction allow basal-cell and plexiform options to be considered as the most aggressive indicators.

[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.

[Retrospective study on treatment results of patients with bone destruction in lower molars roots area]. / Retrospektivnyi analiz rezul'tatov lecheniia patsientov s destruktivnymi protsessami v zone kornei moliarov nizhnei cheliusti.

The paper presents retrospective study on the efficiency of tooth protecting operations in patients with odontogenic bone destruction in lower molars roots area. The study was based on the analysis of medical records of patients treated in Central Research Institute of Dentistry and Maxillofacial Surgery from 2011 to 2016. Tooth protecting procedures because of bone destruction in lower molars were carried out in 98 patients but only 59 of them were accessible to proper follow-up. Complications were seen in 15.2% of patients and teeth were extracted in 13.5% of cases. Thus, the efficacy of tooth protecting procedures in lower molars was 86.5%, which proves their feasibility despite of complicated surgical approach.

[Immunohistochemical criteria for differential diagnostics of squamous epithelium changes in pyogenic granuloma and squamous cell carcinoma of the oral mucosa]. / Immunogistokhimicheskie kriterii differentsial'noi diagnostiki ploskogo épiteliia pri piogennoi granuleme i ploskokletochnom rake slizistoi obolochki rta.

The paper presents an example of differential diagnostic studies for pyogenic granuloma and oral squamous cell carcinoma (SCC). In the described case immunohistochemistry with antibodies to Ki-67 and Gli1 was used as conventional histological procedure proved to be inconvenient for adequate diagnostics. The immunohistochemical study established increased proliferative activity of epithelial cells specific both pyogenic granuloma and oral SCC, but intensive Gli1 protein expression in membranes and cytoplasm of epithelial cells with malignant transformation allowed differentiation of these neoplasms.

[Value of the expression of Ki-67 and membrane protein glucose transporter GLUT1 in the diagnosis of neoplastic transformation of the oral mucosal epithelium]. / Znachenie ekspressii Ki-67 i membrannogo belka-perenoschika glyukozy GLUT1 v diagnostike neoplasticheskoi transformatsii epiteliya slizistoi obolochki rta.

AIM: to investigate the expression of GLUT1 protein in relation to the proliferative activity of cells and the degree of neoplastic transformation of the epithelium of the oral mucosa (OM). SUBJECTS AND METHODS: OM biopsies from 44 patients were investigated. 14 cases (31.9%) were diagnosed with focal epithelial hyperplasia of the OM; 13 (29.5%) cases had squamous intraepithelial neoplasia (SIN) and 17 (38.6%) had squamous cell carcinoma. Ten intact MO samples were used as a control group. Tissue antigens were determined using mouse monoclonal antibodies to Ki-67 and rabbit antibodies to GLUT1. RESULTS: A direct correlation was found between the intensity of GLUT1 expression on the oral epithelial cell membranes and the proliferative activity of cells with an increase in the phenomena of cellular atypia. CONCLUSION: GLUT1 may be used as a marker for the early diagnosis of neoplastic transformation of stratified squamous epithelial cells.

[Topographic features of lingual nerve and its relationship with other anatomical structures in maxillolingual groove].

By surgical interventions in maxillolingual groove area one should consider anatomical variations and topography of vessels, glands ducts and lingual nerve to prevent their injury. At the Department of Operative Surgery and Topographic Anatomy of the First Moscow State Medical University named after I.M. Sechenov we carried out anatomical study on cadavers (men and women, n=30).The study revealed topographical features of the lingual nerve and its relationship to other anatomical structures in the maxillolingual groove. It was found out that at the level of the second molar (96%) lingual nerve "crosses" duct of submandibular salivary gland, at the level of the third molar lingual nerve is located under the duct and lateral to it, closer to the inner surface of the body of the mandible. At the level of the first molar lingual nerve is located above and medial to Wharton duct and passes along sublingual-lingual muscles (m.hyoglossus).

[Analysis of comprehensive treatment of oral leukoplakia by laser ablation]. / Analiz khirurgicheskogo lecheniya patsientov s leikoplakiei slizistoi obolochki rta metodom ablyatsii.

The article presents data statistics of surgical treatment of leukoplakia by laser ablation for 2014 were examined and operated on 12 patients with verrucous and erosive forms of leukoplakia of the oral mucosa using a diode laser. Only 5 (42%) showed positive results in 7 (58%) patients had recurrent disease, often in the localization of the lesion on the tongue. It is possible that relapse may be associated with incomplete excision of the lesion due to anatomical and morphological features of the oral mucosa in various topographical areas. The study emphasizes the need to find alternative methods of modern surgical excision, one of which can be radiofrequency excision.

[Modern wound dressings in oral surgery]. / Sovremennye ranevye pokrytiia v khirurgicheskoi stomatologii.

In this review the modern wound dressings used in surgical dentistry and maxillofacial surgery are studied. We describe the tupes of wound dressings and their properties. The results of clinical use in various surgical procedures in the oral cavity are presented.

[Scientific anatomical rationalefor lower teeth local anesthesia]. / Anatomicheskoe obosnovanie osobennostei obezbolivaniia pri lechenii zubov nizhnei cheliusti.

The article presents clinical recommendation for the choice of local anesthesia techniques in dental treatment of lower teeth based both on original research and literature review. Several localanesthesiatechniques are described for various teeth group, as well as intraosseousdiffusionoflocal anesthetic at various sites of mandible bone and possible anatomical reasons for local anesthesia failures. Theresultsofauthor's anatomical and clinical studies confirm that branches of buccal and lingual nerve can provide lower teeth innervation. Several local anesthesia techniques which may be useful for overcoming the mandibular block failure are proposed.