Aesthetic Disorders Research Articles

Contraindications of using endolift subdermal lasertherapy technique in the treatment of aesthetic disorders

Introduction: Endolift subdermal laser therapy is a promising technique for reducing fat and treating aesthetic disorders on skin and subcutaneous tissue. However, its application is not riskless, and it is essential to identify contraindications to ensure patient safety during its use. Objective: This article aimed to describe the contraindications regarding the use of subdermal laser techniques (Endolift and/or Endolaser) used to treat aesthetic disorders. Methodology: This study is characterized by exploratory research presented through a narrative review, to highlight the need for and importance of rigorous selection of patients initially chosen for treating aesthetic and/or functional dysfunctions with subdermal laser. Results: The subdermal laser therapy which uses a laser beam of 1470 nm (Endolift) and/or 980 nm (Endolaser), presents important contraindications which must be considered before treatment. Among the main contraindications reported are allergies to anesthetics, blood dyscrasias, vascular disorders, use of anticoagulants, presence of biopolymers in the area to be treated, history of abnormal scarring (such as keloids), in addition to active epidermal lesions and decompensated autoimmune diseases. Conclusion: Recognizing contraindications of using Endolift is crucial for patient safety and treatment effectiveness and, therefore, careful evaluation of the patient's clinical history and pre-procedure examinations are important and, perhaps, necessary to minimize possible complications associated with the restrictions imposed by such contraindications.

Mild hyperthermia upregulates PD-L1 in the tumor microenvironment and enhances antitumor efficacy of PD-L1 blockade in murine squamous cell carcinoma.

Head and neck squamous cell carcinoma (HNSCC) has a low five-year survival rate because of its high rate of recurrence and metastasis. After surgical resection or radiation, the main treatments for HNSCC, patients sometimes experience functional or aesthetic disorders. Therefore, there is a great demand for the development of non-surgical treatment strategies to improve clinical outcomes and patients' quality of life. One such non-surgical treatment is mild hyperthermia (mHT). Many studies have investigated combination treatments with mHT and immune checkpoint inhibitors in preclinical settings. However, there have been no detailed reports on the effects of mHT on immune checkpoint molecules. Here, we investigated the effects of mHT on the tumor microenvironment (TME), particularly on programmed cell death receptor-1 (PD-1)/programmed cell death ligand-1 (PD-L1), in SCCVII cells and a squamous cell carcinoma mouse model. First, we found that PD-L1 mRNA levels and surface PD-L1 expression significantly increased after mHT. Second, a single tumor model was used to determine the effect of HT on the TME. mHT enhanced the accumulation of CD4+ and CD8+ T cells, elevated PD-L1 expression in the TME, and decreased the PD-1 positive rate of CD4+ T cells. Finally, using a bilateral tumor model, we found that anti-PD-L1 monotherapy and combination therapy resulted in longer survival than the isotype control or mHT monotherapy. Moreover, the combination therapy resulted in a significantly higher survival rate than anti-PD-L1 monotherapy. In conclusion, our findings elucidate changes in PD-L1 expression in the TME and strengthen the rationale for mHT and PD-L1 blockade combination therapy.

Analysis of the reasons for patient dissatisfaction with prosthetics on dental implants

The purpose of this study: identification of the main complaints of patients during orthopedic dental treatment using dental implants, followed by the development of recommendations to eliminate the identified errors in prosthetics on implants.
 Material and methods. The study included 19 patients (15 women and 4 men) who filed complaints in 2023 after orthopedic treatment using dental implants. 137 screw dental implants were installed in these patients. Of these, 58 implants are on the upper jaw, 79 implants are on the lower jaw.
 Results. As a result of the study, it was revealed that in 100% of cases, the patients who complained had non-removable orthopedic structures based on dental implants, and the percentage of types of orthopedic structures in those who applied was established. It was found that the most frequently recurring complaints were loose closure of the dentition, difficulty chewing food, as well as aesthetic disorders.
 Conclusions. The analysis made it possible to identify as the main complaints of patients loose closure of the dentition and difficult digestion of food. Recommendations are given to take a more careful approach to the definition of central occlusion and correction of occlusive relationships when planning treatment.

Nuclear receptor 4A1 (NR4A1) upregulated by n-butylidenephthalide via the mitogen-activated protein kinase (MAPK) pathway ameliorates drug-induced gingival enlargement.

Drug-induced gingival enlargement (DIGE) is a side effect of ciclosporin, calcium channel blockers, and phenytoin. DIGE is a serious disease that leads to masticatory and esthetic disorders, severe caries, and periodontitis but currently has no standard treatment. We recently reported that nuclear receptor 4A1 (NR4A1) is a potential therapeutic target for DIGE. This study aimed to evaluate the therapeutic effects of n-butylidenephthalide (BP), which increases the expression of NR4A1, on DIGE. In this study, NR4A1 mRNA expression was analyzed in the patients with periodontal disease (PD) and DIGE. We evaluated the effect of BP on NR4A1 expression in gingival fibroblasts and in a DIGE mouse model. RNA sequencing (RNA-seq) was conducted to identify the mechanisms by which BP increases NR4A1 expression. The results showed that NR4A1 mRNA expression in the patients with DIGE was significantly lower than the patients with PD. BP suppressed the upregulation of COL1A1 expression, which was upregulated by TGF-β. BP also ameliorated gingival overgrowth in DIGE mice and reduced Col1a1 and Pai1 expression. BP also decreased Il1β mRNA expression in gingival tissue in DIGE. RNA-seq results showed an increase in the expression of several genes related to mitogen-activated protein kinase including DUSP genes in gingival fibroblasts stimulated by BP. Treatment with ERK and JNK inhibitors suppressed the BP-induced increase in NR4A1 expression. In addition, BP promoted the phosphorylation of ERK in gingival fibroblasts. In conclusion, BP increases NR4A1 expression in gingival fibroblasts through ERK and JNK signaling, demonstrating its potential as a preventive and therapeutic agent against DIGE.

Body Harmonization: The Definition of a New Concept.

Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions.

УСОВЕРШЕНСТВОВАНИЕ КОМПЛЕКСНОЙ ТЕРАПИИ ГИПЕРТРОФИЧЕСКОГО ГИНГИВИТА У ПАЦИЕНТОВ С ПАТОЛОГИЕЙ ПРИКУСА

The prevalence of inflammatory periodontal diseases, and in particular hypertrophic gingivitis, among adolescents ranges from 50 - 99%, which is often combined with malocclusion and this combination is about 70% of cases, which is an urgent and unresolved problem of modern periodontology and orthodontics. Therefore, the study of the issues of correlation between the severity of morphological, functional and aesthetic disorders of the masticatory-speech apparatus and the severity of the inflammatory process in the tissues of the periodontal complex is important and necessary for the development of modern complexes for the treatment of adolescents with hypertrophic gingivitis and malocclusion class 1 according to Angle during the hormonal period. perestroika. The purpose of the study: to optimize the complex treatment of malocclusion in adolescents with hypertrophic gingivitis. 32 patients aged 14 to 17 years with E.H. class I malocclusion. ANGLE and mild edematous hypertrophic gingivitis were included in this study. All patients underwent orthodontic treatment using non-removable orthodontic equipment (brackets), but for periodontal treatment, patients were divided into 2 groups of 16 people, one group underwent traditional conservative periodontal treatment, and the other group of patients underwent removal of dental biofilm using GBT therapy on apparatus "PROPHYLAXIS MASTER". Before treatment, after 6 months and after the removal of orthodontic equipment, an index assessment of the state of periodontal tissues was carried out and a comparison of the average statistical data of teleradiography to study changes in the size of the facial part of the skull before and after orthodontic treatment, as well as a study of the correlation between the studied parameters was carried out for all patients. According to the results of the study, it was found that during orthodontic treatment of adolescents with malocclusion class I according to E.H. ANGLE and GBT-periodontal therapy increases the effectiveness of complex treatment for this category of patients by 40% compared to traditional therapy for inflammatory periodontal diseases at the stages of orthodontic treatment.

Masticatory myofascial pain syndrome provoked by SARS-COV-2 infection in a patient with orofacial pathology (clinical case)

Abstract. Myofascial pain syndrome (MFPS) is a chronic pain condition characterised by the appearance of myofascial trigger points (MTP) in muscles. The condition can be caused by various factors and is diagnosed through clinical examination and palpation of MTPs. Recent studies have shown that infections like SARS-CoV-2 can cause MFPS, along with other symptoms. Dentists often encounter the problem of MFPS in patients with temporomandibular joint dysfunction, but it can also develop in patients with a normally functioning joint. Symptoms include pain, sensitivity, and abnormalities in mandible mobility. In this article, the case of MFPS in a person with orofacial pathology after SARS-CoV-2 diagnosis is presented. Materials and methods of research. Describes a person who has the instability of the bite caused by the absence, destruction and disposition of the chewing teeth led to disorders of the chewing muscles. The patient was found to have appearing MFPS symptoms after COVID-19. The systematic online search of articles utilising the search terms «Coronavirus, SARS-COV-2 and Myofascial pain syndrome», published between January 2020 and October 2023, was performed. Results. The patient was diagnosed with SARS-CoV-2 in October 2021 and was hospitalised for 10 days. After discharge, she went to the dentist with complaints of headache and stiffness in the area of masticatory muscles, absence and destruction of lateral teeth, difficulty in chewing food, mobility and displacement of individual teeth, periodic bleeding gums, as well as aesthetic disorders. During the objective examination, secondary partial adentia was revealed, which led to instability of the bite, defects of the hard tissues of the chewing teeth, pathological wear of the frontal group, and traumatic occlusion phenomena. During palpation, trigger points were found in the area of the masticatory and temporal muscles. The patient underwent a series of ten trigger point injections (dry needling) in her chewing muscles, with about 30 % immediate relief. Conclusion. MFPS can be caused by various factors, including infections like SARS-CoV-2. The diagnosis is based on clinical examination and palpation of MTPs, and treatment may include trigger point injections, physical therapy, and non-invasive therapy methods. In the presented case, the patient had partial adentia, leading to instability of the bite and MFPS symptoms after SARS-CoV-2 diagnosis. Prompt diagnosis and management of MFPS are necessary to improve the patient’s quality of life.

Endolaser Treatment of Aesthetic Disorders: Clinical Experience of 4 Years

Introduction: Endolaser or Endolift, is a technique that uses a laser beam with a wavelength between 980 and 1470nm emitted through an optical fiber inserted into the subcutaneous tissue in order to tone the skin through neocollagenesis and reduce fat subcutaneous. Objective: This study aimed to describe the clinical experience of the authors after four years using the endolaser technique treating different aesthetic disorders, and to this end, it was grouped data on the most treated disorders, personal protocols and treatment results. Methodology: An exploratory research was carried out, presented in a narrative review to show the action of Endolaser used in the treatment of aesthetic disorders. The review explored scientific articles published and available in the following databases: MEDLINE (System for Analysis and Retrieval of Online Medical Literature), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library Online) and LILACS (Latin American and of the Caribbean in Health Sciences). In addition, some clinical findings obtained through a retrospective analysis of medical records were added to describe the clinical experience of the authors in using Endolaser for treating aesthetic dysfunctions. Results: It was verified that the endolaser technique is extremely effective for reducing localized fat and skin retraction, and is characterized as an eligible procedure for face and neck, as well as for the body. Still, endolaser may be indicated for the treatment of several aesthetic disorders involving lipodystrophies and dermal disarrangement, in addition, associated with other therapeutic resources such as microfocused ultrasound, cryolipolysis, chemical peeling, intradermotherapy and others. The technique is safe and has minimal side effects. Conclusion: As a conclusion, the current popularization of Endolaser is justified by its extreme effectiveness and versatility, as well as its ease usability and minimal adverse effects, producing excellent aesthetic results in the short and medium term, and can also be used alone or associated with other therapeutic resources.

Multidisciplinary approach to the treatment of children with congenital cleft lip and palate in Ukraine

Children with congenital cleft lip and palate (CLP) develop a composite complex of anatomical, functional and aesthetic disorders that increase with growth and require comprehensive and multi-stage treatment. Treatment and diagnostic measures require a multidisciplinary approach to overcome the identified problems. The main task of orthodontic support for children with CLP at the stages of primary surgical interventions is aimed at preventing orthognathic surgical correction in the future, by optimizing the choice and tactics of orthodontic treatment within the framework of multidisciplinary comprehensive rehabilitation measures. The purpose of the work is the substantiation, approval and introduction into clinical practice of a complex of medical and diagnostic measures aimed at the rehabilitation of children with CLP. It confirmed that providing the necessary conditions for sucking creates optimal conditions for surgical intervention on the lip and palate. The tactics of orthodontic treatment depended on the period of development of the dentognathic apparatus, age, type of cleft, staging, timing and volume of surgical interventions, quality and methods of surgery, severity of deformations in the transversal and sagittal planes and components of the symptom complex of anomalies and deformations complicating the pathology, psychological and emotional child state, factors of parents and patients communication with the doctor, social and economic components. Removable and fixed orthodontic appliances are used in most cases at the initial stage of treatment for the treatment of dentognathic deformities, obtaining satisfactory sagittal and vertical overlap and normalization of transversal ratios. A separate area of rehabilitation was prevention and treatment of diseases of hard tissues of teeth and periodontal tissues. Speech therapy and psychological support started from 2–3 months. The proposed complex of treatment and diagnostic measures, determined in time, terms, sequence and volume, aimed at the rehabilitation of children with CLP, made it possible to obtain positive anatomical, functional and aesthetic results in 87.6% of children. Keywords: therapeutic and diagnostic measures, orthodontic treatment, speech therapy and psychological support, rehabilitation algorithm.

Lacrimal Gland Prolapse: Case Report

Lacrimal gland prolapse is an important diagnosis to consider in patients with lateral upper eyelid fullness. Prolapse of the lacrimal gland is the descent of the lacrimal gland into the upper eyelid. It can result in blepharoptosis and a bulging “frog-eyed” appearance. This is a case report of lacrimal gland prolapse in a 19-year-old female patient treated by suture repositioning of the glands in an outpatient surgical setting. We report on non-recognition of the prolapse and in the absence of essential surgical correction, in addition to the aesthetic disorders often reported, worsening of functional symptoms such as epiphora with major discomfort. Prolapse in young patients has not been reported in the international literature consulted, E&OE.

Knowledge of scope of oral and maxillofacial surgery amongst medical students at a tertiary hospital in Kathmandu, Nepal

Background: Diagnosis and surgical treatment of varieties of traumatic, pathologic, functional, and aesthetic disorders of stomatognathic system are included in the scope of oral and maxillofacial surgery (OMFS). Although this speciality plays a significant part in dentistry and medicine; dental and medical professionals still do not fully comprehend the exact depth. Objectives: To understand the level of knowledge amongst medical students of different levels, to promote the scope of OMFS among health care communities, and establish a fair understanding of the speciality’s contribution. Methods: This questionnaire based descriptive, cross-sectional survey was done on purposive sampling technique. Data were collected from 2022 October to 2022 December among medical students and interns of Nepal Medical College via questionnaire after receiving institutional ethical clearance. Data were entered, coded, and edited using Microsoft Excel 2010 and analysed using SPSS v.20. Descriptive statistics are presented in frequency, percentage, and mean. Results: A total of 254 study participants were included of which 149 (58.66%) were male and 105 (41.34%) were female. Of all, 99 (38.98%) were first year medical students, 80 (31.50%) were second year students, and 75 (29.53%) were interns. Mean knowledge score in preclinical students was 6.27 ± 1.73 and 7.12 ± 1.85 in interns. The result shows adequate knowledge for both groups. Conclusion: Findings of this study assesses the level of knowledge of medical students at a tertiary hospital which will help to highlight the need for awareness and education regarding OMFS, promoting its development, contribution, and impact among the health care professionals.

A case of implant prosthodontic treatment for masticatory and esthetic disorders due to severe secondary caries and molar occlusal collapse

症例の概要：45歳の女性．二次齲蝕および補綴装置脱離による咀嚼困難・審美障害を主訴に来院した．上顎補綴装置除去後は暫間義歯を装着した．保存困難な9本の残存歯は抜歯した．インプラント埋入と同時に暫間インプラントを使用した暫間補綴装置を使用した．1|1 はRoot Submergence Techniqueを応用し保存した．暫間補綴装置で口腔機能・審美性に問題ないことを確認後，最終補綴装置を装着した．

ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ ТЕХНОЛОГИЙ 3D-МОДЕЛИРОВАНИЯ И ТРЕХМЕРНОЙ ПЕЧАТИ В ДИАГНОСТИКЕ И ЛЕЧЕНИИ ПАЦИЕНТОВ С ПЕРЕЛОМАМИ КОСТЕЙ СРЕДНЕЙ ЗОНЫ ЛИЦА

Nowadays, the relevance of the diagnosis and treatment of facial bones, especially the midfacial region, is undoubted. According to scientific literature, the incidence of facial bone fractures is up to 16% in the total structure of fractures [5, 10, 13]. Such injuries can lead to aesthetic disorders in the form of various post-traumatic deformities, often disfiguring the face of patients, as well as lead to functional disorders of varying severity. According to variability of traumatic injuries of the facial bones, polymorphism of clinical manifestations, as well as the aesthetic and functional significance of the area under consideration, the need to individualize the medical and diagnostic process is formed [7–9, 11, 14, 15, 17].
 The individualization of the approach to the diagnosis and treatment of patients is gaining more and more popularity and today is one of the more significant vectors for the development of practical medicine, opening new horizons for specialists in various fields of medical science. One of the most interest directions of this approach is the use of additive manufacturing technologies.
 Additive prototyping and virtual modeling open up wide possibilities for customizing diagnostics and treatment in accordance with a specific clinical situation. Modern computer modeling technologies enable representatives of various medical specialties, including maxillofacial surgeons, not only to be limited to preoperative planning using virtual prototypes of defective zones and also to model structures that replace various bone defects based on additive technologies by printing of high-precision physical models of the damaged zone. In turn, the presence of such means of visualization of injury areas already at the preoperative stage makes it possible to develop individualized augments of bony defects, taking into account all the features of the anatomical structures of a particular patient [1–4, 6, 16].
 The article deals on the results of a comparative study of the effectiveness of surgical treatment of maxillary fractures in the orbital region using an algorithm based on the use of additive manufacturing technologies and traditional methods.

PERIODONTOLOGICAL STATUS OF PATIENTS WITH DENTOMAXIMAL ANOMALIES BEFORE ORTHODONTIC TREATMENT

PERIODONTOLOGICAL STATUS OF PATIENTS WITH DENTOMAXIMAL ANOMALIES BEFORE ORTHODONTIC TREATMENT

INTERDISCIPLINARY APPROACH IN TREATMENT OF PATIENTS WITH DENTAL ANOMALIES

The article presents data on the treatment of patients with TMJ and concomitant deformities. The most important connection between the dental system and the musculoskeletal system is the temporomandibular joint, which in the presence of dental anomalies and in the period of temporary occlusion undergoes increased loads, which leads to its dysfunction. The concept of the interaction of posture and occlusion was first put forward in the early 20th century, which noted that children with glossoptosis have X-shaped legs, crooked posture and typical signs of distal occlusion. It has been theorized that occlusal disorders can alter posture in the frontal and sagittal planes and ultimately alter body weight distribution. Postural curvature causes a violation of the position of the head of the temporomandibular joint, which in turn leads to pain and joint dysfunction. Any postural disorders lead to compensatory changes throughout the body, not excluding the maxillofacial area. This is especially true for the formation of mesial occlusion (III class according to Angle). Mesial occlusion in the structure of dental anomalies is determined in 12% of cases, but the severity of the anomaly and aesthetic disorders that occur often force orthodontists to use a combination.
 Therefore, further improvement of methods of diagnosis and treatment of occlusions of occlusion of the third class according to Angle will allow most patients to get a positive treatment result and the opportunity to adapt in society. An example of coordination of specialists in the planning and implementation of treatment is the clinical case of patient K. 16 years old, who went to the clinic where on the basis of examination and special research methods diagnosed: Angle class III (skeletal form) true progeny, macroglossia. Also at inspection of a posture sharp curvature of a backbone, with signs of scoliosis is defined. From the back there is a clear asymmetry of the shoulders within 4 centimeters. Asymmetrical location of the shoulder blade and even significant hypertrophy of the right shoulder blade (in this direction the patient is determined by the displacement of the mandible).
 Asymmetry was noted in the general study of the face. Displacement of the chin to the right was noted. The asymmetry of facial structures begins with the upper third. Asymmetry of superciliary arches, orbits, wings of the nose, nostrils, and corners of the mouth was also observed. Deepened nasolabial folds were noted. The lower lip overlaps the upper one. But the profile of the face remains almost straight. Based on the data obtained, the patient was offered the following treatment plan: consultation with an orthopedist traumatologist about scoliosis, consultation with a dentist surgeon about skeletal surgery, consultation with a speech therapist. Orthodontic treatment is concerned with a brace system. The patient’s brace system was fixed on the upper jaw (“straight arch” technique was used). 38 and 48 teeth were removed. Bilateral planar osteotomy of the mandible and resection of the tip of the tongue were performed. The lower jaw brace system was fixed using oblique intermaxillary traction, which the patient used for 6 months. A course of therapy with a speech therapist was conducted to restore speech function. The total duration of the active treatment period contained 4 years. After creating the maximum occlusal contact, the patient regained chewing function. Thus, the treatment of mesial occlusion and its prognosis largely depends on etiological factors and the possibility of their elimination, as well as the severity of morphological and functional disorders, the difficulty of eliminating them during permanent occlusion. Therefore, the sacred rule of medicine "better to prevent than to cure" in relation to skeletal forms of mesial occlusion is the most relevant.

Assessment of the psychological state of children with dental anomalies

Currently, a significant proportion of children have dental anomalies (DA) and require orthodontic treatment. The effectiveness of treatment is reduced due to the age-related characteristics of the child's psyche, which lengthens the time and affects the quality of the appointment.Objective: to assess the emotional state of children with DA aged 6–12 years.Patients and methods. To study the characteristics of the psychological state of children, 122 patients aged 6–12 years (44 boys and 78 girls, mean age 9 [7; 11] years) were examined and orthodontically treated. Children's complaints, the presence of tics and obsessive habits were assessed. The psychological state of the patients was assessed using the G.P. Lavrentieva and T.M. Titarenko anxiety level in children questionnaire. Causes and factors that increase anxiety at the reception were assessed using a questionnaire developed by the authors.Results and discussion. Aesthetic defect and speech disorders were the most frequent complaints among children aged 6–12 years with DA (58 and 23%, respectively), especially among older girls (r=0.72). 91.2% of children had obsessive habits, 48% had motor tics. Three groups were distinguished: with low (59.0%), medium (19.7%) and high (21.3%) levels of anxiety. No significant associations were found between the anxiety level and gender, age, presence of tics and obsessive habits. Factors that increased anxiety in children during an orthodontist's appointment were: past personal negative experience at a dental appointment (in 27.0%); office environment (23.8%); negative experience of parents or peers (16.4%); frequent visits to medical institutions in the past (21.3%); family relations (11.5%). The most common anxiety causes were pain expectation and inexplicable fear, a little less often - unpleasant manipulations in the oral cavity and comments from the parent. The rarest cause of anxiety was a disapproving remark from an orthodontist.Conclusion. Children with DA aged 6–12 years have an increased anxiety level, independent of gender and age. These children require a special approach from the orthodontist and, possibly, a consultation with a psychotherapist.

196 Multi-omic Convergence of Human Craniosynostosis Genes Within a Developmental Bone-Dura-Brain Nexus

INTRODUCTION: Craniosynostosis (CS) is the premature fusion of the calvarial sutures and has long been considered mostly an aesthetic disorder, despite many affected children experiencing neurocognitive deficiencies and seizures. The two types of CS, syndromic and non-syndromic, present with significant genetic clinical heterogeneity, suggesting a complex interplay of genetic and environmental causes. Given the neurodevelopmental symptoms observed in CS patients, we hypothesized the genes involved in the pathophysiology of CS may play a key role in the functional development of the brain. METHODS: We applied a multimodal integrative genomic approach to examine the functional relationships as well as the spatiotemporal and cellular interactions of all currently known craniosynostosis-associated genes (CSGs) and also explored whether they are linked to other neurodevelopmental disorders (NDD). To this end, we constructed gene co-expression modules using a bulk-RNA expression dataset with 27 human brains encompassing 16 human brain regions across fetal development into early childhood. We further used scRNA-seq datasets derived from embryonic mouse meninges, calvarial sutures and developmental human brain to identify cell-types enriched with CSGs. RESULTS: The set of co-expression modules significantly enriched with CSGs were highly expressed during mid-gestation and in primary motor, somatosensory and prefrontal cortices, and the ganglionic eminence. Moreover, some of these modules were also significantly enriched with autism-spectrum disorder (ASD) and NDD genes. The most significant modules were associated with histone-3 lysine-4 methylation, neural crest differentiation, endochondral ossification and reactive astrogliosis. The mouse meninges scRNAseq analysis showed enrichment in pial and dural fibroblasts. The whole-brain scRNA-seq analysis showed CSGs were enriched in medial ganglionic eminence (MGE)-derived cortical interneurons, astrocytes and oligodendrocyte precursors during mid-fetal brain development. CONCLUSION: CSGs may contribute to pathogenesis through epigenetic dysregulation, disrupted neural crest differentiation facilitated by neuroglial cells and MGE interneuron migration very early during development. These processes are in confluence with premature suture fusion mediated by dural and pial fibroblasts.

Utility of radial flaps for defect repair after surgical excision of head and neck tumors

Introduction. Surgery at the first stage has always been the gold-standard treatment for locally advanced head cancer of almost all locations. Such patients often have significant postoperative defects that cause serious functional and aesthetic disorders. This requires simultaneous defect repair. The technique of defect repair should be chosen carefully with the consideration of its benefits and potential consequences.Objective – to evaluate the efficacy of revascularized radial flaps for defect repair after combination extensive surgical excisions of head and neck tumors.Materials and methods. This study included 67 patients with head and neck cancers of different locations who had undergone surgical tumor excision followed by defect repair using a radial flap.Results. All patients had their defects repaired using radial autologous grafts. Since this study included primarily patients with oral and oropharyngeal tumors (53 patients), we also analyzed the survival in this cohort. patients were followed-up for 2 to 7 years. fourteen patients (26.4 %) developed progressive disease during this time, including 8 individuals with recurrent primary tumor and 6 individuals with regional metastases. The mean time to nasoesophageal probe removal and restored swallowing was 12.2 days; mean length of hospital stay was 13.5 days.Conclusion. Thus, radial flap is a reliable and multifunctional material that can be used to repair complex and combination defects in patients with head and neck tumors. In some cases, it is the method of choice, since it helps to achieve satisfactory quality of life. Repair of tongue defects with radial flaps ensures good functional results.

Заболевания слизистой оболочки полости рта и твердых тканей зубов как проявление целиакии

Celiac disease, or gluten-sensitive enteropathy, is a chronic autoimmune disease characterized by immune response when taking gluten. Celiac disease is a multifactorial disorder that results from the interaction of genetic and environmental factors. The review examines the etiology and pathogenesis of celiac disease from the view of the oral mucosal lesions. Based on the data of medical literature sources, the analysis of the incidence, severity and structure of oral cavity changes in celiac disease was conducted. It has been shown that tooth enamel defects and recurrent aphthous stomatitis may be the only manifestation of celiac disease The most common oral cavity disorders in celiac disease are recurrent aphthous stomatitis, teething retention, tooth enamel defects, in particular hypoplasia. Angular cheilitis and atrophic glossitis are considered the very rare. The caries prevalence in patients diagnosed with celiac disease either does not differ from the prevalence in healthy patients, or the caries prevalence indices are significantly lower in patients with celiac disease than in the control group. Oral lesions in celiac disease can cause significant functional and aesthetic disorders, as well as worsen the patient’s life quality. KEYWORDS: celiac disease, gluten enteropathy, oral mucosa, caries, recurrent aphthous stomatitis, teething retention, cheilitis, atrophic glossitis FOR CITATION: Mazurov V.I., Gaydukova I.Z., Inamova O.V. et al. Diseases of the oral mucosa and dental tissues as a manifestation of celiac disease. Russian Medical Inquiry. 2022;6(8):451–457 (in Russ.). DOI: 10.32364/2587-6821-2022-6-8-451-457.

Peri-implantitis: explantation versus peri-implant regeneration

Peri-implantitis is a complication in implantprosthetic rehabilitation that causes morpho-functional, masticatory and aesthetic disorders. Depending on the severity it can be approached by conservative surgical or radical treatment. The aim of the paper is the comparative analysis of conservative surgical methods (implant preservation) versus radical (explantation). We studied 2 patients who came to the SRL “Omni Dent” clinic with peri-implantitis. Manifestation, treatment and evolution in both patients were compared. Analysis criteria: bone defect extension, soft tissue appearance, tissue regeneration, implant-prosthetic rehabilitation time. In RI patient there were changes in color and appearance of the peri-implant soft tissues (hyperemia, edema, purulent discharge), peri-implant radiolucency on the entire implant surface; in the TM patient there were the same clinical signs but limited to ½ implant length. RI patient underwent explantation with re-implantation in the neighboring region 2.4 after 4 months with prosthesis fixing after another 4 months. Tissue regeneration evolved without complications. In TM patient was decided to keep the implant through curettage, implantoplasty and bone addition. Prosthetic rehabilitation followed later without complications. Timely addressing would prevent the development of complications with implant loss. The insignificant loss of peri-implant tissues can be recovered with the preservation of the implant, in the extended defects the optimal solution is the explantation with the subsequent implantprosthetic rehabilitation.