[A prospective single-cohort study of implant-supported full-arch metal-ceramic prosthesis with gold-platinum alloy framework for treatment edentulous mandible in elderly patients: 15-year report]. / Implantatsionnoe protezirovanie protyazhennymi metallokeramicheskimi konstruktsiyami s karkasom iz zolotoplatinovogo splava u pozhilykh patsientov: rezul'taty 15-letnego perspektivnogo odnogruppovogo kogortnogo issledovaniya.

OBJECTIVE: To study the effectiveness of implant-supported full-arch metal-ceramic prosthesis with gold-platinum alloy framework in elderly patients. MATERIALS AND METHODS: The study included patients with complete and/or partial loss of teeth and terminal dentition. In 2007-2008, 354 implants were inserted in 27 patients. The age of the patients was 61.31±5.08 years. Mombelli index criteria (mBI [modified Sulcus Bleeding Index]) were used. The plaque index was determined using a modified Löe & Silness method. The state of the peri-implant bone (ΔMBL) was determined by a series of OPG. The Geriatric Oral Health Index (GOHAI) was used to assess oral health in the elderly. RESULTS: Metal-ceramic full-arch implant prostheses with a gold-platinum alloy framework, based on a sufficient and optimal number of implants (6-8), showed high survival rate (100%) after 15 years. Marginal bone loss (ΔMBL) after 15 years was -1.44±1.27 mm. The survival rate of implants was 99.4%. Scores on the GOHAI scale were higher in patients after orthopedic rehabilitation (from 52.7±7.1 to 54.1±8.4, p<0.001). CONCLUSION: After 15 years, all prostheses had mechanical defects, which at the same time allowed them to be used without restrictions. Screw fixation of full-arch implant prostheses, although it was associated with mechanical complications, nevertheless made it possible to perform surgical interventions in a timely manner and stop the development of inflammatory complications. Thus, we do not see any grounds for removing metal-ceramic prostheses and replacing them with new implant prostheses even after a 15-year period of operation. At the same time, it is necessary to take into account the reduction in the possibility of individual oral hygiene in elderly patients, as well as possible restrictions on self-visiting a dentist or dental hygienist.

[Experimental design of the lower jaw functional loading for implant-supported restoration in unfavorable clinical conditions]. / Eksperimental'noe modelirovanie funktsional'noi nagruzki nizhnei chelyusti pri protezirovanii s oporoi na implantaty v neblagopriyatnykh klinicheskikh usloviyakh.

THE AIM OF THE STUDY: Was to create a finite element design to evaluate the masticatory stress distribution on the full fixed prosthesis with three supporting implants and the mandibular bone in the conditions most closely resembling the real ones. MATERIALS AND METHODS: The geometric design was created with the results of a CBCT of a real patient. The transfer of the DICOM into STL format was carried out in the Mimics Medical 21 program, in which the author's splinting device for the implant was designed. The actual thicknesses of the patient's compact and cancellous bone layers were measured with Romexis ver. 4.5.1. Scanning of the artificial dentition was performed with the iTero Element 2 Version 1.7 which created an object in STL format. Design was performed in the package for finite element analysis Ansys 19.3. Tetrahedral elements of the second order were used for calculation. The structural elements were connected in the model by a rigid «Bonded¼ contact. RESULTS: A finite element model has been created for the experimental load design on the lower jaw for immediate implant restoration with few supports in combination with a device for stabilizing the implant in unfavorable clinical conditions. It is shown that the designed finite element model takes into account the biomechanics of the prosthesis with few supports. When calculating, the entire model was fixed to the mandibular process at its base, and was loaded with a force of 500 N, distributed over the teeth. The values of the maximum stresses obtained in the elements were 51.8 MPa for the compact layer and 245 MPa for titanium elements. CONCLUSION: Thus, we created personalized geometric and finite element models for calculating the distribution of functional load on a long full fixed implant-supported prosthesis with few artificial supports, which makes the experimental results more accurate and correct.

[Automated digital superimposition of the 3D model and archival photographs of full removable dentures in forensic dentistry]. / Avtomatizirovannoe tsifrovoe issledovanie v sudebno-stomatologicheskoi ekspertize dlya sopostavleniya ob"emnoi modeli i arkhivnykh fotografii polnykh s"emnykh protezov.

THE AIM THE STUDY: The purpose of the work is to perform automated alignment of two-dimensional archival photographs of the first prosthesis and a digital model of the complete removable prosthesis by superposition in order to determine or deny their possible belonging to one user. MATERIALS END METHODS: The superposition was carried out in the Exocad program (DentalCAD 3.0 Galway) using the standard 2D-3D alignment algorithm of the «SmileDesign¼ module; in the same program. In addition, Keynote and Fusion 360, and Autodesk programs were used. Statistical measurements were carried out at the statistically significant level of p<0.05. RESULTS: A comparison of four different-angle and different-scale photographic images of a removable denture of the upper jaw teeth with a three-dimensional copy of the same version of the prosthesis of the life physician of the royal family E.S. Botkin was made. When superimposing a digital three-dimensional model and a two-dimensional photograph of the original prosthesis with marked anthropometric points (n=51), 21 of them coincided or touched each other (41.2%). Another 26 points were located side by side (distance up to 1.5 mm) (50.9%) and 4 did not coincide (distance >1.5 mm, but no more than 3.5-4 mm) (7.8%). When the reference points were combined, the contours, the configuration of the relief and the peripheral boundaries of all three objects mostly coincided. The linear longitudinal and transverse dimensions of the bases of the prostheses also mostly coincided. The exception was the distal border of the bases, and the level of the cutting edges of the anterior artificial teeth, where complete coincidence was not observed, due to differences in the degree of erasability. CONCLUSION: Comparison of the original prosthesis from Ipatiev's house and its stereolithographic model was a test for the accuracy of the matching method used. The stereotype of the compared images is proved and the consistency of the possibility of computer combination of three-dimensional and two-dimensional objects is confirmed. The use of traditional methods of forensic identification and evaluation of the results by methods of mathematical statistics allowed us to conclude that the two different complete removable dentures of the upper jaw depicted in the photographs belong to one user.

[About the possibility of using a comparative visual method for identification purposes with the participation of specialists in the field of orthopedic dentistry]. / O vozmozhnosti ispol'zovaniya v identifikatsionnykh tselyakh sravnitel'nogo vizual'nogo metoda s uchastiem spetsialistov v oblasti ortopedicheskoi stomatologii.

THE AIM OF THE STUDY: Is to determine whether dentures belong to one or different users. The results of a comparative visual comparison of two different-scale and different-angle photographs of removable dentures of the maxilla teeth are presented. The comparison was carried out by 20 experienced orthopedic dentists. The opinion of the overwhelming majority: with a high degree of probability, the dentures belong to one user. Experts based their judgment on 13 independent attributes. From a forensic medical point of view, the assessment contains elements of subjectivity. The conclusion about the possibility of solving the question posed on the basis of objective methods of forensic identification is formulated.

[A prospective single-cohort study of an immediate prefabricated three-implant-supported full-arch prosthesis for treatment edentulous mandible in elderly patients: 3-year report.]

The use of implant prosthetics in the elderly and senile patients is highly relevant. Many clinicians advocate a wider introduction of immediate implant restorations in the elderly due to the fastest restoration of aesthetics and function. The purpose of the work is to study the efficacy of implant prosthetics in elderly patients with extended replacement structures with a small number of artificial supports. The patients underwent implant restoration of the mandible with an extended metal-polymer structure «Trefoil¼ with a prefabricated standard frame and three artificial supports. The overall implant survival rate was 96%. The cumulative survival rate of patients was 93%. The cumulative survival level of prostheses was 98,3%. The high implant and prosthesis survival rates, the good condition of the peri-implant mucosa and bone three years after restoration, as well as the high level of patient satisfaction and the significantly higher level of their quality of life, along with the high medical and economic efficiency of the method, allow us to consider it a promising standard of geriatric dentistry.

[Emergency dental care for adults and children with a new coronavirus infection caused by SARS-Cov-2 at an out-patients dental clinic in a megapolis]. / Organizatsiya neotlozhnoi stomatologicheskoi pomoshchi vzroslym i detyam s novoi koronavirusnoi infektsiei, vyzvannoi SARS-CoV-2, na baze gorodskoi stomatologicheskoi polikliniki megapolisa.

BACKGROUND: In the article presented data about organization of the medical care over a period of 10 months at the Municipal Public Dental clinic in the metropolitan city such as Saint-Petersburg to the patients diagnosed with new coronavirus infection. AIM: Organization of the medical ambulatory care to the patients diagnosed with new coronavirus infection. MATERIALS AND METHODS: Layout decisions were utilized that enabled to organize the reception of patients infected with SARS-CoV-2 without disrupting the scheduled mode of treatment of the dental patients. Saint Petersburg Budgetary Healthcare Facility «Municipal Dental Clinic N 33¼ provided dental service to 191 patients with COVID-19. RESULTS: Whereas 159 patients were admitted for treatment at the contagious isolation ward, 89 patients were consulted via the use of telehealth technology and among them 39 received telemedical assistance service. Mean age of the patients treated in the isolated ward: children 8.6±3.6, adults 39.1±13.8 years. People of active working age comprised 72% of all adult patients. Males filed for dental assistance more than females (54%). ICD K04.5 was established diagnosis in 52% of cases. CONCLUSIONS: We managed to demonstrate high efficiency in utilizing telehealth technology. An issue of organizing medical dental care at the II level healthcare institution for adult population and for children diagnosed with new coronavirus infection COVID-19 in the heavy populated metropolis was solved.

[Loss of masticatory apparatus integrity - Disability or Disablement.]

We examined 408 patients (151 male, 257 female) in an age range from 54 to 85 years (mean age 73,9±4,9) performing clinical (anamnesis, visual analysis, palpation, percussion, auscultation) sociological (GOHAI), additional (chewing efficiency evaluation, phonetic analysis, weight deficit of body calculation, OPG, CBCT) assessment. Among 322 of examined subjects working syndromological diagnosis was «decompensated dentition¼ related to lower jaw in 167 cases, 65 to upper jaw, 90 to both upper and lower jaws (altogether 412 dental arches). Chewing efficiency among edentulous patients was low considering that majority of patients had dentures. Score range for Geriartric General Oral Health Assessment Index (GOHAI) was from 7 to 25 points (mean 18,23±4,19) which is attributed as low level. General syndromes among patients were rough, disfiguring, ageing changes in facial appearance, major alteration of aesthetic norms. Equally important or even more was incapacitation impact of total loss of proper mastication, speech problems, phonetic alteration, problematic food swallowing. In our research we highlighted two pathological conditions among elderly and senile age groups: decompensated dentition, and fully edentulous jaws. Taking into consideration suffering of the patients due to morphological functional and psychosocial disabling conditions, accompanying these diseases, we might consider this group of patients as handicapped and that could lead to the need to introduction of setting quotas of implant prosthetics treatment of the elderly and senile patients. The result, efficacy and efficiency of such rehabilitation are considered in compliance with the system of adequate treatment result for this part of population.

[Clinical analysis of the short-term and long-term results of the implant-supported Trefoil dental rehabilitation in Russia]. / Klinicheskii analiz blizhaishikh i otdalennykh rezul'tatov primeneniya implantatsionnogo protezirovaniya «Trefoil¼ v Rossii.

THE AIM OF THE STUDY: Was to presents the first clinical medium-term (18 months) results of implant-supported rehabilitation using this method in Russia, with the special attention paid to the assessment of the patient's quality of life on the GOHAI scale. MATERIALS AND METHODS: The authors performed a clinical and paraclinical examination of 29 patients (20 women and 9 men). The age of the patients ranged from 47 to 88 (average value - 65.45±9.7). We performed a retrospective analysis of all patients operated from June 2017 till March 2019. The patients filled in GOHAI questionnaires about their state of health and quality of life (before treatment and 6 weeks post-surgery). Patients with one or more anterior teeth present as well as fully edentulous mandibles were included in the study. The antagonist teeth could be presented as complete dentures, natural teeth, or implant-supported fixed restorations. All patients received three Trefoil implants (Nobel Biocare AB) inserted with a torque of at least 35 Ncm. The Trefoil bar (Nobel Biocare AB) was used as the framework of the Trefoil bioengineering structure. Statistical processing of the results was performed using the SPSS 23 software. The t-test for dependent samples was used to compare the results of GOHAI surveys before and after the operation and the following statistical hypotheses were suggested: H0 - the results of the GOHAI survey before the operation do not differ from the results of the GOHAI survey after the operation; H1 - GOHAI pre-op survey results are different from GOHAI post-op survey results. A comparison was made between the GOHAI results before and after surgery in male and female patients using the t-test for independent samples. RESULTS: 29 patients included in this (20 females and 9 males) with the mean age of 65 (range:47-88). The average time of operation (surgical operation, prosthetic stage including dental lab work) the Trefoil technique was 6.18 ± 0.87 hours. With the presence of teeth in the mandible, the operation took longer by an average of 45 minutes. Patients were followed for 15±6 months. No chipping of artificial teeth or fractures of the veneering was observed. The survival rate of restorations was 100%. The implant survival rate was 98.85%. The results of the GOHAI survey after surgery show a significant difference from the results of the pre-op survey. If we analyze the average values for the sample, it can be argued that the average result for the GOHAI survey before the operation (29.86) is significantly lower than the average one for the GOHAI survey after the operation (54.93). CONCLUSION: Preliminary medium-term results of the Trefoil concept for implant-supported rehabilitation of the mandible indicate high patient satisfaction results after 6-18 months of follow-up. It requires a further comprehensive study to obtain data with more patients and over a longer follow-up period.

[Dental forensic identification of the user of a complete removable denture]. / Sudebno-stomatologicheskaia identifikatsiia lichnosti pol'zovatelia polnym s''emnym protezom.

AIM: The identification of personality based on dental status of the remains of presumably Evgenii Sergeevich Botkin physician-in-ordinary of the family of the Nicholas II. We examined the scull #2 (presumably attributed to Tsar's family physician-in-ordinary E.S. Botkin) fragments of edentulous maxilla and mandible in particular, 2 stereolithographic resin models of full dentures belonged to Botkin E.S. We utilized the following examination methods: Visual evaluation (odontoscopy, morphoscopy) Anthropometric analysis (odontometric and morphometric) 3D digital scanning of the studied objects Manual and digital superimposition of their contours Digital scanning was performed with the use of optical scanner device Neway Scanway 2017 12 REV C and also with NobelProcera 2G scanner. Outline superimposition was performed with Nobel Procera Software v3.1, Exocad 2.2, Romexis ver. 4.5.1. CBCT of the objects was acquired on Planmeca Promax 3D Mid. Results of the current investigation prove the congruency and conformity of the dentures to the bony remains of the jaws and with high probability confirm the assumption of the appurtenance of the examined copy of the denture to the dentoalveolar system of the described scull #2 and the object itself - identified as the scull of the physician-in-ordinary to the last Russian Royal family Evgenii Sergeevich Botkin.

[Criterion assessment system of the actual level of expertise of dental professionals practicing implant dentistry]. / Kriterial'naia sistema otsenki real'nykh kompetentsii vrachei-stomatologov, zanimaiushchikhsia dental'noi implantologiei. Rezul'taty analiza 43 portfolio molodykh vrachei-stomatologov.

The aim of the study was to develop criterion assessment system of the actual level of expertise of dental professionals practicing Implant dentistry. The study comprised fifteen dental experts aged from 35 to 47 years with the average 15 years clinical experience. For evaluation of the clinical portfolio of the dentists we developed 10 reference points and to ensure unification of the assessment approach we organised consensus methodical conference for our expert group. Scores were applied by parity of reasoning with point-rating system applied in continuing education programs of Medical University. Assessment of 43 clinical portfolios with short term and long term results of implant supported restorations was performed. Treatment was provided with the use of Nobel Biocare implants and prosthodontic rehabilitation was achieved with the use of CAD/CAM 'Procera' technology. The study showed that dentists who practice implant dentistry from 1 to 7 years have good manual skills and clinical expertise sufficient for achieving positive treatment outcome. At the same time in general their actual diagnostic skills are not sufficient, they misapply additional diagnostic methods, do not perform risk analysis of potential clinical complications that leads to shifting responsibilities on the patients in case of complications emergence. Methods of Computer Assisted Design are widely popular during all stages of rehabilitation (diagnostic, surgical stent, final prosthesis framework). Actual level of expertise of dental professionals doesn't depend on sex distribution. Males and females who practice implant dentistry have similar levels of clinical expertise.

[Conceptual approach to classification of implant supported prosthesis for edentulous patients]. / Kontseptual'nyi podkhod k klassifikatsii protyazhennykh implantatsionnykh zameshchayushchikh konstruktsii, ispol'zuyushchikhsya u patsientov s polnoi poterei zubov.

The aim of this study was the creation of a conceptual model of the standard implant prosthetics for edentulous patients using the data of comprehensive examination and implantation prosthetics in 372 patients aged 38 to 80 years (201 women, 171 men) with 582 implant supported prosthesis of various types, supporting on implants «Nobel Replace Select/Groove¼ and «Nobel Speedy Groove¼ (3675 implants). Clinical classification of implant-supported prosthesis for edentulous patients included 5 classes: class 1 (1-2 implants) included 6.2% of implant supported prosthesis, class 2 (3-4 implant) - 19.2% of prostheses, class 3 (5-6 implants) - 30.2% of replacement structures; IV (7-10 implants) - 44%, and V - 0,3%. Restoration class was age-dependent.