[Physical and mechanical properties of materials used in the technology of computer production of surgical templates]. / Fiziko-mekhanicheskie svoistva materialov, ispol'zuemykh v tekhnologii komp'yuternogo proizvodstva khirurgicheskikh shablonov.

OBJECTIVE: The physical and mechanical properties of samples printed from different materials subjected to post-processing in a clinic were evaluated. MATERIAL AND METHODS: Studied hardness and modulus of elasticity before and after sterilization by autoclaving. Based on the analysis of the literature and monitoring of the dental materials market, our choice fell on the most popular materials for 3D printing of surgical templates for dental implantation, such as: material 1 (FormLabs Dental SG Resin (Formlabs, USA)) and material 2 (NextDent SG (NextDent, Netherlands)). In connection with the events of recent years, we also took into the study a domestically produced polymer - material 3 (HARZLabs Yellow Clear PRO (HARZLabs, Russia)). RESULTS: As a result of the study, it was found that in each of the groups of materials studied, the values of the elastic modulus of sterilized samples are higher than the elastic modulus of samples that have not undergone sterilization. According to GOST 31572-2012 (ISO 1567:1999 Polymeric materials for denture bases, non-sterilized samples of group 2 are considered not to have passed the test, since all three samples of the studied group have a crack resistance index of less than 1 MN/m1.5. Crack resistance index of sterilized samples of the group of materials 2 is also close to 1. Samples of group 1 (both sterilized and non-sterilized) have the highest crack resistance. This group also has the highest flexural strength. On non-sterilized samples of material 1, there was no crack initiation along the cut and groove. The samples of other groups were mainly destroyed along the axis of the groove. CONCLUSION: Analyzing the obtained data and considering that all studies carried out were in accordance with dental standards, the researchers concluded that the increase in flexural strength after sterilization by autoclaving and the feasibility of using material 1 for the production of surgical templates in accordance with all manufacturer's recommendations.

[Nephrotic syndrome during pregnancy. Is it chronic glomerulonephritis or preeclampsia? Case report].

Nephrotic syndrome (NS) during pregnancy is a fairly rare pathology and its descriptions in the literature are few. For a long time, NS was associated only with an exacerbation of chronic glomerulonephritis or de novo nephritis, however, the experience of recent years has shown that NS can be a manifestation of the classical obstetric pathology - preeclampsia (PE). The appearance of massive proteinuria with the development of NS is most typical for early PE, which, of course, makes diagnosis difficult, especially if PE develops at an unusually early time (up to 20 weeks). To describe PE that does not fit into the classical criteria, the term "atypical" PE is now used, the development of which can be promoted by both obstetric and somatic risk factors. The presented clinical observation describes the development of early (within 14 weeks) severe PE with the NS at the onset of the disease in a patient with the first multiple pregnancy and complete hydatidiform mole (HM) of one of the fetuses. The progression of nephropathy with the addition of thrombotic microangiopathy and HELLP syndrome made it possible to assume the diagnosis of PE with a high probability. The rapid relief of all clinical manifestations after delivery confirmed this assumption. The role of HM as the main trigger of unusually early PE is discussed. Apparently, the patient's trophoblast disease in the form of hydatidiform mole caused the formation of a severe angiogenic imbalance already in the early stages of pregnancy, which led to the development of PE, which manifested NS as a consequence of podocytopathy due to VEGF deficiency. Thus, the development of NS in a pregnant patient without a history of kidney disease dictates, first of all, the exclusion of PE, until proven otherwise.

[Modern methods of adhesive fixation of facial epitheses]. / Sovremennye metody adgezivnoi fiksatsii epitezov litsa.

This review presents an analysis of domestic and foreign literature on the issues of fixation of facial epitheses and combined maxillofacial prostheses, such as the use of craniofacial implants installed in the zygomatic bone, brow arches, orbital walls, mastoid process of the temporal bone with beam or magnetic beam fixation systems. The advantages and disadvantages of such fastening systems are described. The analysis and systematization of available data on medical adhesive compositions that can be used in maxillofacial prosthetics to hold facial epitheses has been carried out. Much attention is paid to the chemical composition of pressure-sensitive adhesives, water-based and silicone-based. Examples of such compositions are given. The physicochemical properties of medical adhesive systems that cause adhesive-cohesive interaction are described. This review presents the results of comparative studies to assess the fixing properties of various adhesives, as well as to study the formation of biofilm on the surfaces of prostheses and skin when using different adhesives.

[Clinical efficiency of occlusive splints in the treatment of patients with temporomandibular joint dysfunction complicated by bruxism]. / Klinicheskaya effektivnost' okklyuzionnykh shin v lechenii patsientov s disfunktsiei visochno-nizhnechelyustnogo sustava, oslozhnennoi bruksizmom.

OBJECTIVE: Improving the effectiveness of treatment of patients with temporomandibular joint (TMJ) dysfunction complicated by bruxism. MATERIAL AND METHODS: 70 patients with signs of parafunction of the masticatory muscles were selected for the clinical study. The patients were divided into 2 groups of 35 people. Splints were made for patients from the groups using 2 different 3D printing methods. The treatment was monitored using clinical and instrumental studies, electromyography of the muscles themselves and computed tomography of the TMJ after 3, 6 and 12 months. RESULTS: The severity of hypertonicity of the masticatory muscles decreased by the end of 3 months of treatment with the help of repositioning occlusal splints. After 6 months of treatment, the mean BEA decreased in both study groups, but to a lesser extent than in the first 3 months. After wearing a splint after 12 months, the decrease in muscle tone was insignificant. CONCLUSION: The clinical use of positioning splints plays a crucial role in the stabilization of occlusion and is a mandatory stage of complex treatment of patients with pathology of the occlusal-musculoskeletal complex.

[Manufacture of facial prosthesis by three-dimensional printing]. / Izgotovlenie litsevykh protezov metodom ob"emnoi pechati.

The objective of the literature review was to study and analyze literature sources on the methods and means of facial prosthesis manufacture by three-dimensional printing. MATERIALS AND METHODS: An analysis of information sources covering the last 15 years was carried out, in search sources as PubMed, Elsiver and eLIBRARY and on the website of the Federal Institute of Industrial Property. RESULTS: The technology of direct production of prostheses by volumetric printing from silicone materials is the object of research for its development. Most of the materials used for the manufacture of facial prostheses using 3D printing need technical improvements, often requiring expensive equipment, which in turn does not allow the method of manufacturing face prostheses by direct method in everyday clinical practice. CONCLUSION: Based on the obtained data there is a need to develop a new structural material for the manufacture of facial prostheses by 3D printing using laser stereolithography and digital LED projection technologies.

[Development of structural material for the manufacture of facial prosthesis by 3D printing]. / Razrabotka i otsenka fiziko-mekhanicheskikh svoistv konstruktsionnogo materiala, primenyaemogo v tekhnologii proizvodstva epitezov litsa metodom ob"emnoi pechati.

THE AIM OF THE STUDY: Was to develop and evaluate the physical and mechanical properties of a structural material for the manufacture of facial epithesis using photopolymer printing technology. MATERIALS AND METHODS: The study of the physical and mechanical properties of the developed structural material consisted of measuring the Shore hardness; determination of material strength at break, conditional yield strength, relative elongation at break and modulus of elasticity; the study of the characteristics described above, after artificial aging, simulating the daily use of a prosthesis. RESULTS: According to the test results, the samples of the studied material did not have a yield strength, they were torn at a deformation of 40-60%. The values of the conditional yield strength were 0.41±0.01 MPa, regardless of the time of the aging procedure. The values of the modulus of elasticity were 2.96±0.19 MPa and 2.88±0.14 MPa for the samples that underwent the aging procedure at 6 and 12 months, respectively. CONCLUSION: The results obtained were compared with the results of similar studies of structural materials used in 3D printing technology of facial prostheses, which allowed us to recommend the developed material for clinical use after evaluating its toxicological and biological characteristics.

[Evaluation of the clinical effectiveness of the use of a navigational surgical template in the vestibuloplasty protocol in patients with periodontal diseases]. / Otsenka klinicheskoi effektivnosti primeneniya navigatsionnogo khirurgicheskogo shablona v protokole vestibuloplastiki u patsientov s boleznyami parodonta.

THE AIM OF THE STUDY: Was to evaluate the clinical effectiveness of the use of a navigational surgical template in the vestibuloplasty protocol in patients with periodontal diseases. MATERIALS AND METHODS: There were 48 people selected to participate in the study and randomly divided into 2 equal groups. The patients of the main group underwent vestibuloplasty procedure using a free gingival graft modeled using the developed protocol and a navigational surgical template. Patients in the control group underwent a similar operation using classical technology. The study assessed postoperative pain, the index of early wound healing, Doppler fluometry of the transplanted flap and flap morphometric measurements. RESULTS: The results of all conducted studies confirmed the effectiveness of the developed clinical protocol. CONCLUSION: According to objective and subjective assessments, the use of a surgical navigation template can reduce the time and invasiveness of vestibuloplasty surgery, make it more comfortable for the patient and get a more predictable clinical result.

[Clinical efficacy of hydroxyapatite and tricalcium phosphate modified with hyaluronic acid in the treatment of patients with periimplantitis]. / Klinicheskaya effektivnost' primeneniya gidroksiapatita i trikal'tsiifosfata, modifitsirovannykh gialuronovoi kislotoi v lechenii patsientov s periimplantitami.

THE AIM OF THE STUDY: Was to assess the effectiveness of the use of hydroxyapatite (HAP) and tricalcium phosphate (TCF) modified with hyaluronic acid in the treatment of patients with periimplantitis. MATERIALS AND METHODS: Clinical studies were conducted in 128 patients (44% male and 56% female) aged up to 55 years, who sought dental care with the main diagnosis of periimplant mucositis and periimplantitis. To compare the features of osseointegration of dental implants under bone remodeling three groups of patients were formed: one control and 2 main ones. In the control group the wound was managed under a blood clot, in the first main group HAP and TCF and in the second main group HAP and TCF modified with hyaluronic acid were used. X-ray examination was performed in various modes. Clinical assessment of implant stability in the operated area was carried out using subjective (percussion and palpation method) and objective method of frequency resonance analysis using the Osstell ISQ device calculating the stability coefficient of the dental implant (SCDI). RESULTS: 12 months after the periimplant zone remodeling procedure the bone resorption rates surrounding the implant were statistically significantly the lowest in the second main group (0.682±0.006 mm, p<0.001) compared with the values in the control and first main groups (1.626±0.022 and 1.025±0.034 mm, respectively). In the former groups bone resorption continued to progress during the observation period. In patients of the second main group, the average values of the SCDI for all study periods were 68.97±1.09 units which turned out to be the highest indicator and significantly differed from the values of other observation groups (p<0.05), which may be due to a tighter fit of the implants to the surface of the newly formed bone tissue. CONCLUSION: The results of the study 12 months after the periimplant zone remodeling operation procedure prove the efficacy of HAP and TCF modified with hyaluronic acid for the treatment of patients with periimplantitis.

[Digital protocol for comprehensive planning of dental treatment. Clinical case analysis]. / Tsifrovoi protokol kompleksnogo planirovaniya stomatologicheskogo lecheniya. Analiz klinicheskogo sluchaya.

The main goal of the research presented in the article was to increase the effectiveness of dental orthopedic rehabilitation of patients by developing and implementing a complex of digital planning of the initial stages of treatment, including diagnostic methods, modeling, and manufacturing of prototypes of dentures using modern computer technologies. Planning of diagnostics and treatment of a dental patient with the use of modern digital technologies was proposed to be divided into stages. A complex of digital planning of dental orthopedic treatment was formed, which is illustrated by clinical case analysis. The first stage is the planning of the rehabilitation stage, which includes the diagnosis of the patient's dental status and preparation for orthopedic treatment. The second stage is 2D virtual planning of dental rows in the smile area-includes 2D visualization in the form of mandatory use of dental digital photography protocols and 2D creation of a virtual image of a smile using digital two-dimensional planning programs. The third stage includes 3D-virtual planning (mock-up) of teeth in an aesthetically significant area-included digitalization of clinical data of patients, namely, CBCT, scanning of the dentition separately and in the bite, face scanning. The fourth stage is the computer production of prototype dentures, according to the 3D virtual functional and aesthetic layout, which includes the production of prototypes of dentures by the additive method of 3D printing. At this stage, recommendations are given for the production of prototypes of dentures by 3D printing directly-in a direct way and using a silicone key-not in a direct way, obtained from a printed model of the prototype of the patient's dentition.

[Analysis of the course and outcomes of pregnancy in patients with advanced stages chronic kidney disease].

BACKGROUND: Pregnancy in patients with advanced chronic kidney disease (CKD) is associated with a high risk of adverse outcomes for the mother and the fetus, but data on the characteristics of the course of pregnancy in these women is limited. AIM: To analyse of the course and outcomes of pregnancy in patients with CKD stages 3a4. MATERIALS AND METHODS: Thirty five pregnant women with CKD stages 34 were included: 3a 12 (34.3%) patients, stage 3b 10 (28.6%), stage 4 13 (37.1%). RESULTS: Proteinuria, serum creatinine, blood pressure in dynamics, the presence of a physiological response were investigated. Pregnancy management included blood pressure correction, antianemic, antiplatelet, anticoagulant therapy, prevention and treatment of urinary infection, correction of metabolic disorders. All pregnant women had proteinuria of varying severity, which increased towards the end of pregnancy. Seventeen (51.5%) patients had hypertension, successfully corrected with antihypertensive drugs. The average delivery term was 34.6 weeks. Preeclampsia developed in 14 (42.4%) cases, an inverse relationship was found between the presence of a physiological response and preeclampsia (p=0.009; rs=-0.463). All children were born alive and viable. After delivery in patients with CKD 3a creatinine values returned to the pre-gestational level, in patients with grade 3b and 4 progression of CKD was noted. CONCLUSION: A favorable pregnancy outcome in women with late stages of CKD is possible with constant monitoring by a multidisciplinary team of doctors with mandatory monitoring of renal function, proteinuria, blood pressure, coagulation, markers of preeclampsia and indicators of fetal health. It was proposed to consider the physiological response of the kidneys to pregnancy as a predictor of a favorable outcome.

[Comparative clinical evaluation of the prosthetic treatment quality of molars restored by chairside manufactured CAD/CAM crowns]. / Sravnitel'naia klinicheskaia otsenka kachestva ortopedicheskogo lecheniia moliarov CAD/CAM koronkami metodikoi chairside.

AIM: A comparative clinical evaluation of the results of prosthetic treatment with chairside CAD/CAM crowns for molars made from hybrid ceramics VITA Enamic, blocks of feldspatic ceramics VITABlocs Mark II, blocks of leucite glass IPS Empress CAD. MATERIAL AND METHODS: The study involved 30 patients aged from 19 to 60 years old with defects in hard tissues of molars. For clinical evaluation we used 'Clinical criteria for evaluation of direct and indirect restorations' developed by FDI in 2007, which included the assessment of several aesthetic, functional and biological parameters. We also included 2 additional criteria indicators: the condition of the antagonist tooth and the hygienic condition of the prosthesis in comparison with the hygiene of natural teeth. All patients were randomized into 3 groups of 10 people. After the treatment the clinical quality assessment was carried out in the following time intervals: 30 minutes, 1, 6, 12, 18, 24 months after the fixation of the crown. RESULTS: Clinical evaluation of the results of prosthetic treatment of 30 patients with chairside CAD/CAM crowns made from three different materials did not reveal any significant difference in the clinical criteria for evaluation of direct and indirect restorations within 24 months.