Functional Disorders Research Articles

Thalamic Nucleus Reuniens Glutamatergic Neurons Mediate Colorectal Visceral Pain in Mice via 5-HT2B Receptors.

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by abdominal pain and visceral hypersensitivity. Reducing visceral hypersensitivity is the key to effectively relieving abdominal pain in IBS. Increasing evidence has confirmed that the thalamic nucleus reuniens (Re) and 5-hydroxytryptamine (5-HT) neurotransmitter system play an important role in the development of colorectal visceral pain, whereas the exact mechanisms remain largely unclear. In this study, we found that high expression of the 5-HT2B receptors in the Re glutamatergic neurons promoted colorectal visceral pain. Specifically, we found that neonatal maternal deprivation (NMD) mice exhibited visceral hyperalgesia and enhanced spontaneous synaptic transmission in the Re brain region. Colorectal distension (CRD) stimulation induced a large amount of c-Fos expression in the Re brain region of NMD mice, predominantly in glutamatergic neurons. Furthermore, optogenetic manipulation of glutamatergic neuronal activity in the Re altered colorectal visceral pain responses in CON and NMD mice. In addition, we demonstrated that 5-HT2B receptor expression on the Re glutamatergic neurons was upregulated and ultimately promoted colorectal visceral pain in NMD mice. These findings suggest a critical role of the 5HT2B receptors on the Re glutamatergic neurons in the regulation of colorectal visceral pain.

Rapid biotransformation of STW 5 constituents by human gut microbiome from IBS- and non-IBS donors.

STW 5 is an herbal medicinal product with proven clinical efficacy in the treatment of functional gastrointestinal disorders, like functional dyspepsia and irritable bowel syndrome (IBS). The effects of STW 5 on fecal microbial communities and metabolite production effects have been studied in an experimental model with fecal samples from individuals with and without IBS. While only minor taxonomic disparities were noted between IBS- and non-IBS samples and upon treatment with STW 5, rapid metabolic turnover of STW 5 components into specific degradation products with reported anti-inflammatory, cytoprotective, or spasmolytic activities was observed, which may be relevant for the pharmacological activity of STW 5.

High Prevalence of Psychological Comorbidities and Functional Neurological Symptoms in Women With Urinary Retention.

Chronic idiopathic urinary retention (CIUR) in young women is poorly understood and a probable etiology is established only in around 40%, most commonly a primary disorder of external urethral sphincter relaxation, sometimes referred to as Fowler's syndrome. A high prevalence of psychological and functional comorbidities is reported, however these have been poorly characterized. Women consecutively referred for the assessment and management of CIUR were evaluated cross-sectionally for 13 psychological/behavioral domains using a structured clinical interview: depression, anxiety, post-traumatic stress disorder (PTSD), other psychiatric history, functional neurological disorder, other functional syndromes, childhood and adult trauma, personality disorder, and self-harm (ever/current). A total of 91 women (mean age [SD]: 34 [11] years) were evaluated. Women with Fowler's syndrome (n = 69) were younger (mean age [SD]: 32 [9] vs 40 [13] years) than women without Fowler's syndrome and reported shorter mean duration of urinary symptoms (mean [SD]: 5 [6] vs 10 [9]). A high prevalence of psychiatric and psychological comorbidities was reported (97%) including current depression (77%), current anxiety (78%), and PTSD (32%). A high prevalence of functional neurological disorder (56%) and other functional symptoms (65%) was also reported. Self-harm was reported in (14%) and personality disorder in 16%. Childhood trauma was reported in 35% of women. Young women with CIUR report a high burden of psychiatric disorders, affective symptoms, trauma, PTSD, self-harm, and functional neurological disorder, particularly in those with Fowler's syndrome. These factors can undermine the engagement with health care professionals and affect management and should therefore be addressed during the urological assessment.

Personality and psychopathological characteristics in functional movement disorders.

Aim of the present study was to assess personality and psychopathological characteristics in patients with functional movement disorders (FMDs) compared to patients with other neurological disorders (OND). In this cross-sectional study, patients affected by clinically established FMDs and OND who attended the Neurologic Unit of the University-Hospital "Policlinico-San Marco" of Catania from the 1st of December 2021 to the 1st of June 2023 were enrolled. Personality characteristics were assessed with the Rorschach test coded according to Exner's comprehensive system and the Structured Clinical Interview for DSM-5 (SCID-II). Thirty-one patients with FMDs (27 women; age 40.2±15.5 years; education 11.7±3.2 years; disease duration 2.3±2.5 years) and 24 patients affected by OND (18 women; age 35.8±16.3 years; education 11.9±2.9 years; disease duration 3.4±2.8 years) were enrolled. At the Rorschach, FMDs presented a significantly higher frequency of Popular (P) and sum of all Human content codes (SumH>5) responses and avoidant coping than OND. FMDs presented "conformity behaviors", excessive interest in others than usual a maladaptive avoidant style of coping and a difficulty in verbalizing emotional distress. These psychopathological characteristics may favor the occurrence of FMDs.

Impaired speech input and output processing abilities in children with cleft palate speech disorder.

Cleft lip and palate is one of the most common oral and maxillofacial deformities associated with a variety of functional disorders. Cleft palate speech disorder (CPSD) occurs the most frequently and manifests a series of characteristic speech features, which are called cleft speech characteristics. Some scholars believe that children with CPSD and poor speech outcomes may also have weaknesses in speech input processing ability, but evidence is still lacking so far. (1) To explore whether children with CPSD and speech output disorders also have defects in speech input processing abilities; (2) to explore the correlation between speech input and output processing abilities. Children in the experimental group were enrolled from Beijing Stomatological Hospital, Capital Medical University, and healthy volunteers were recruited as controls. Then three tasks containing real and pseudo words were performed sequentially. Reaction time, accuracy and other indicators in three tasks were collected and then analysed. The indicators in the experimental group were significantly lower than those in the control group. There was a strong correlation between speech input and output processing tasks. The performance of both groups when processing pseudo words in the three tasks was worse than that when dealing with real words. Compared with normal controls, children with CPSD have deficits in both speech input and output processing, and there is a strong correlation between speech input and output speech processing abilities. In addition, the pseudo words task was more challenging than the real word task for both groups. What is already known on the subject Children with cleft lip and palate often have speech sound disorders known as cleft palate speech disorder (CPSD). CPSD is characterised by consonant errors called cleft speech characteristics, which can persist even after surgery. Some studies suggest that poor speech outcomes in children with CPSD may be associated with deficits in processing speech input. However, this has not been validated in mainland China. What this paper adds to existing knowledge The results of our study indicate that children with CPSD exhibit poorer performance in three tasks assessing speech input and output abilities compared to healthy controls, suggesting their deficits in both speech input and output processing. Furthermore, a significant correlation was observed between speech input and output processing abilities. Additionally, both groups demonstrated greater difficulty in processing pseudo words compared to real words, as evidenced by their worse performance in dealing with pseudo words. What are the potential or actual clinical implications of this work? The pseudo word tasks designed and implemented in our study can be employed in future research and assessment of speech input and output abilities in Chinese Mandarin children with CPSD. Additionally, our findings revealed the significance of considering both speech output processing abilities and potential existence of speech input processing ability for speech and language therapists when evaluating and developing treatment options for children with CPSD as these abilities are also important for the development of literacy development.

Mendelian randomization analyses reveal causal relationships between brain functional networks and risk of psychiatric disorders

Mendelian randomization analyses reveal causal relationships between brain functional networks and risk of psychiatric disorders

Functional Neurological Disorder Presenting After Concussion: A Retrospective Case Series.

Although a majority of individuals recover from a concussion within weeks of the index injury, a substantial minority of patients report persistent postconcussion symptoms. Some of these symptoms may reflect a diagnosis of functional neurological disorder (FND). The authors evaluated the relationship between persistent postconcussion symptoms and FND symptoms. In this retrospective chart review, the authors characterized demographic and clinical information from 50 patients with a confirmed diagnosis of FND whose functional neurological symptoms started after a concussion. Patients who developed FND after a concussion had high rates of baseline risk factors for both persistent postconcussion symptoms and FND. After the concussive event, functional neurological symptoms presented abruptly or developed insidiously over time. Functional neurological symptoms ranged widely and included gait symptoms, seizures, speech and language symptoms, weakness, sensory symptoms, tremors, and vision and oculomotor symptoms. Functional neurological symptoms can arise after a concussion. FND should be considered in the differential diagnosis of individuals presenting with neurological symptoms beginning after a concussion. By failing to recognize functional symptoms, clinicians may inadvertently reinforce negative health-related beliefs regarding a patient's injured brain.

Finasteride and Dutasteride in the Treatment of Androgenetic Alopecia: Risk or Benefit?

Androgenetic alopecia, also known as male pattern hair loss or female pattern hair loss, is the most common form of alopecia worldwide and occurs due to an excessive response to androgens. Its etiology is chronic and influenced by genetic and environmental factors. For these reasons, this condition can be extremely difficult to treat. The main form of treatment currently involves the use of finasteride or dutasteride, which have the ability to inhibit the enzyme 5-alpha-reductase, responsible for the conversion of testosterone into DHT, and consequently prevent the progression of androgenetic alopecia. Concurrently with the dissemination of this treatment, various concerns have arisen regarding the potential side effects caused by this class of medication, particularly impairments in sexual function and possible psychological disorders observed in a portion of users. With the emergence of new methodologies aiming at the treatment of androgenetic alopecia, there is much debate in the scientific community about whether the use of finasteride and dutasteride is the best way to treat this condition. In this article, we will discuss how 5-alpha-reductase inhibitors act in the treatment of androgenetic alopecia, focusing on their risks and benefits.

Megacystis-microcolon-intestinal hypoperistalsis syndrome: don't forget the bladder.

Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a well described clinical condition, but reports are focused on microcolon and intestinal hypoperistalsis, while data on bladder management are scant. Aim of the study is to present urological concerns in MMIHS. Retrospective evaluation of clinical data on urological management of MMIHS patients treated in the last 10years. Six patients were enrolled (3 male, 3 female). Three girls had prenatal diagnosis of megacystis (1 vesicoamniotic shunt was placed). All patients had genetic diagnosis: 5 had ACTG2 gene mutations and 1 MYH11 mutation. All patients were addressed to our attention for urinary symptoms, such as urinary retention, urinary tract infections, acute renal injury. Two patients presented frequent stoma prolapses. All children underwent a complete urological evaluation, and then started a bladder management protocol (clean intermittent catheterization, via urethra or cystostomy-tube placement), with improvement of urinary infections, upper urinary tract dilation and stoma prolapses, if present. All patients had good renal function at last follow-up. We believe that MMIHS patients must be addressed soon and before onset of symptoms for a multidisciplinary evaluation, including an early assessment by a pediatric urologist expert in functional disorder, to preserve renal function at its best.

Lead induced cerebellar toxicology of developmental Japanese quail (Coturnix japonica) via oxidative stress-based Nrf2/Keap1 pathway inhibition and glutathione-mediated apoptosis signaling activation

Lead (Pb) is a heavy metal that has been recognized as a neurotoxin, meaning it can cause harmful effects on the nervous system. However, the neurotoxicology of Pb to birds still needs further study. In this study, we examined the neurotoxic effects of Pb exposure on avian cerebellum by using an animal model-Japanese quail (Coturnix japonica). The one-week old male chicks were exposed to 50, 200 and 500 mg/kg Pb of environmental relevance in the feed for five weeks. The results showed Pb caused cerebellar microstructural damages charactered by deformation of neuroglia cells, granule cells and Purkinje cells with Nissl body changes. Moreover, cerebellar neurotransmission was disturbed by Pb with increasing acetylcholine (ACh) and decreasing acetylcholinesterase (AChE), dopamine (DA), γ-Aminobutyric Acid (GABA) and Na+/K+ ATPase. Meanwhile, cerebellar oxidative stress was caused by Pb exposure represented by increasing reactive oxygen species (ROS) and malondialdehyde (MDA) as well as decreasing catalase (CAT), glutathione peroxidase (GPX), glutathione (GSH) and superoxide dismutase (SOD). Moreover, RNA-Seq analysis showed that molecular signaling pathways in the cerebellum were disrupted by Pb exposure. In particular, the disruption of nuclear factor erythroid-2-related factor 2 (Nfr2)/kelch-like ECH-associated protein 1 (Keap1) pathway and glutathione metabolism pathway indicated increasing cell apoptosis and functional disorder in the cerebellum. The present study revealed that Pb induced cerebellar toxicology through structural injury, oxidative stress, neurotransmission interference and abnormal apoptosis.

Antibiotic duration and gastric dysmotility in preterm neonates.

Prolonged antibiotic use after birth is associated with neonatal feeding intolerance and functional gastrointestinal disorders (FGIDs). A gastric dysrhythmia (tachygastria) with frequencies >4-9 cycles per minute, measured by electrogastrography (EGG), is associated with FGIDs. The relationship between prolonged antibiotic use and % time spent in tachygastria is unknown in preterm infants. We aimed to compare weekly changes in % tachygastria between preterm infants receiving long (>48 h) versus short (≤48 h) courses of antibiotics for early onset sepsis evaluation (initiated at <3 days of life). This was a longitudinal, prospective cohort study of 88 preterm infants (<34 weeks' gestation) with weekly EGG recordings from the first week of life until 40 weeks' post-menstrual age, discharge, or death. We calculated % of EGG recording time in tachygastria and determined the mean across weekly sessions. A mixed effects model assessed variance in % tachygastria between the short- and long-antibiotic exposure groups across all weeks. Baseline characteristics were similar between the two groups. There was no difference in % tachygastria between short and long antibiotic exposure groups across nine postnatal weeks (p = 0.08). Early, prolonged antibiotic exposure among preterm infants may not lead to significant gastric dysrhythmia. Future studies including larger sample sizes and a "no antibiotic" exposure arm are essential in elucidating this potential relationship.

EBM BLS: Kiwifruit may Improve Constipation in Patients with Functional Gastrointestinal Disorders.

EBM BLS: Kiwifruit may Improve Constipation in Patients with Functional Gastrointestinal Disorders.

Inflammatory Markers in Children and Adolescents with Functional Somatic Disorders: A Systematic Review

Functional somatic disorders (FSDs) are common in children and adolescents. Recent findings suggest that low-grade inflammation has a role in the development and maintenance of pediatric FSDs. This systematic review included studies with original data on systemic inflammatory markers in children and adolescents with an FSD compared to individuals without an FSD. The literature search identified 1374 articles. After assessment, a total of 15 studies met the inclusion criteria. In total, 41 serum or plasma cytokines were assayed in a population of 696 children and adolescents. Altered cytokine levels in patients with FSDs were reported in 12 studies, whereas three studies found no significant differences when comparing patients with FSDs and controls. The cytokine levels were significantly elevated in nine studies (i.e., IL-2, IL-6, IL-8, IL-12 (p70), CRP, hsCRP, IP-10, MCP-1, sTIM-3, sCD25 and TNF-). The findings indicate that inflammatory response may have a role in the pathophysiology of pediatric FSDs. However, the included studies showed limited quality with potential risk of bias, small study populations and a narrow spectrum of included FSDs, which limits the generalizability of the results. To further explore the potential link between inflammatory markers and pediatric FSDs, future research using a longitudinal study design is recommended.

Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study.

Current proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions. International experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter-rater agreement analyses were undertaken. Eighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%-88% of the FCD diagnoses were attributed to non-neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%-92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD. Our study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence-based interventions.

Delivering a Specialised Best Practice Service for People with Functional Neurological Disorder: An Australian Qualitative Descriptive Study

Specialised functional neurological disorder (FND) clinics are emerging as the preferred way of providing best practice care to people with FND. However, questions remain around optimal care pathways, service provision, and resources. This study aimed to identify (1) service characteristics of Australian FND models of care; (2) barriers and enablers to implementing a specialised FND service; and (3) enablers and barriers to providing best practice management for people living with FND. Clinicians were recruited from Australian public and private healthcare organisations identified as leading best practice for adults with FND. Clinicians completed a structured interview via phone. A descriptive content analysis was used. Five out of 12 healthcare organisations interviewed had a specialised multidisciplinary FND service. All specialised FND services were outpatient programs, but the structure and referral pathways varied. Barriers identified by organisations with an FND service included “funding” and “staff and service fragility,” while enablers included “engaging stakeholders” and having a clear “service driver.” “Diagnosis delay” and “insufficient access to staff” were identified as barriers to implementing best practice by organisations without a specialised FND service. Despite specialised clinics being recognised as a practical way to deliver care to people with FND, only a few services operate in Australia. Timely and educated diagnosis and access to an interdisciplinary team consisting of neurology, physiotherapy, and psychology are central pillars for FND services. Further work to establish clinically and economically effective delivery models is required to facilitate the provision of best practice care for people living with FND.

A Study of Outcome of Detethering in Delayed Presentation of Tethered Cord Syndrome

Abstract Introduction Tethered cord syndrome (TCS) is a stretch-induced functional disorder associated with tethering of caudal spinal cord to dura mater with inelastic tissue, limiting its movement. It not only manifests in childhood but also noted in adults. Here, we studied the role of detethering on delayed presentation of TCS. Material and Methods All patients of symptomatic TCS from January 2011 to December 2019 were included. Preoperative evaluation was done through X-ray; ultrasonography kidney, ureter, urinary bladder; magnetic resonance imaging spine and brain; and urodynamic studies. Detethering was done and associated pathology was excised. Preoperative and postoperative comparison was done through Necker functional score using chi-squared system. Results Age range was 8 to 30 years with mean age of 13.8 years. Most common presentation was urological manifestations in ∼61.1% of cases followed by pain in 41.6%, sensory deficits in 38.8%, asymmetric weakness in 30.5%, orthopaedic and trophic ulcers in 22.2% each, and bowel abnormalities in 13.8% of cases. Mean duration of symptoms was 5.52 years. Improvement in urological manifestations was in 71.4% patients, pain in 80%, sensory dysfunctions in 71.4%, bowel dysfunctions in 80%, motor weakness in 90.9%, and trophic ulcer in 100% patients. On comparison, chi-squared value was 25.9993 and p-value was 0.000032, which was significant (&lt;0.05). Conclusion Detethering in early ages is already proven with good results. In our study, detethering showed statistically significant improvement even in delayed presentation. So, authors recommend to surgically interfere by detethering, even if tethering is detected late with significant deficits.

Impact of Coronavirus disease 2019 pandemic in children with functional abdominal pain disorders: Data from long-term follow-up.

We aimed to compare symptom frequency and severity in children with functional abdominal pain disorders (FAPDs) and to evaluate anxiety, quality of life (QoL) and global health during Coronavirus disease 2019 (COVID-19) related quarantine and after 17 months. Children diagnosed with FAPDs between October 2019 and February 2020 at 5 different centers were enrolled and prospectively interviewed during the COVID-19 quarantine and 17 months later when schools, hospital services, and routine activities had re-opened to the public. The patients were asked to complete the Rome IV questionnaire, the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) Generic Core Scale, the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and global health questionnaires. Data about COVID-19 infection and its clinical outcome were also collected. Ninety-nine out of 180 (55%) children completed the follow-up. The number of patients reporting a worsening of their symptoms was significantly higher at follow-up when compared to the quarantine period (24/99 [24.2%] vs. 12/99 [12.1%]; p = 0.04). The PedsQL 4.0 subtotal score at follow-up significantly decreased at 17 months of follow-up (65.57 [0-100]) when compared to the quarantine (71 [0-100], p = 0.03). Emotional functioning was the most significantly reduced (Follow-up: 64.7 [0-100] vs. Quarantine: 75 [0-100]; p = 0.006). We did not identify significant differences in symptoms and QoL between COVID-19 infected children and the remaining cohort at the two time points. An improvement of symptoms and QoL was observed during the quarantine, followed by a worsening at-follow-up. These findings reinforce the hypothesis that the nest effect overweighted COVID-19 fears during the quarantine and highlight the importance of psychological factors in symptom exacerbation.

Palm oil as part of a high-fat diet: advances and challenges, or possible risks of pathology?

Nutritional status disorders have the most significant impact on the development of cardiovascular and oncologic diseases; therefore, the interest in the study of palm oil as among the leading components of nutrition has been increasing. The data examined in this review were sourced from the Scopus, SCIE (Web of Science), PubMed and PubMed Central, MEDLINE, CAPlus/SciFinder, and Embase databases; experts in the field; bibliographies; and abstracts from review analyses from the past 15 years. This review summarizes recent research data focusing on the quantitative and qualitative composition of nutrition of modern humans; concepts of the relationship between high-fat diets and disorders of insulin functioning and transport and metabolism of fatty acids; analyses of data regarding the palmitic acid (16:0) to oleic acid (18:1) ratio; and the effect of diet based on palm oil consumption on cardiovascular risk factors and lipid and lipoprotein levels. Several studies suggest a potential vector contributing to the transmission of maternal, high-fat-diet-induced, addictive-like behaviors and obesogenic phenotypes across generations. The relationship between cholesterol accumulation in lysosomes that may lead to lysosome dysfunction and inhibition of the autophagy process is analyzed, as is the progression of inflammatory diseases, atherosclerosis, nonalcoholic liver inflammation, and obesity with associated complications. Data are discussed from analyses of differences between rodent models and human population studies in the investigated different effects of palm oil consumption as a high-fat diet component. A conclusion is reached that the results cannot be generalized in human population studies because no similar effects were observed. Although there are numerous published reports, more studies are necessary to elucidate the complex regulatory mechanisms in digestive and nutrition processes, because there are great differences in lipoprotein profiles between rodents and humans, which makes it difficult to reproduce the pathology of many diseases caused by different types of the high-fat diet.

РАЗРАБОТКА НОВОЙ КОНСТРУКЦИИ АРМИРОВАННОЙ ОККЛЮЗИОННОЙ ШИНЫ С ПАРАМЕТРИЗОВАННЫМ КАРКАСОМ НА ОСНОВЕ МЕДИЦИНСКИХ И ИНЖЕНЕРНЫХ ЦИФРОВЫХ ТЕХНОЛОГИЙ

Subject. Today, the use of splint therapy is an essential part of specialized dental treatment, since in recent years the number of patients with dysfunctional conditions of the dentofacial apparatus, has increased significantly. In addition, according to recent research, the use of occlusal splints as part of complex therapy is effective in the treatment of neurological diseases, such as bruxism, chronic tension-type headache, and neuromuscular syndrome. Traditionally used designs of occlusal splints have some disadvantages, such as fragility of use, insufficient rigidity, and the impossibility of relining if the patient's dental status changes. The article provides a description and clinical and laboratory stages of manufacturing the developed new design of an occlusal splint reinforced with a titanium frame. Objectives. Increasing the effectiveness of treatment of patients with functional disorders of the dentofacial system through the development and implementation of a new prosthetic construction – a combined occlusal splint with a titanium frame, using modern intellectual and medical 3D technologies. Materials and methods. Titanium alloy (Rematitan®) was chosen as the material for the frame of the occlusal splint. Manufacturing method implies the use of additive technologies, in particular, 3D-printing for obtaining a high-precision structure with a minimum cross-sectional thickness. Hot-curing acrylic plastic was used to cover the parameterized frame; it is also possible to use a light-curing composite. Results. During the study, the expediency of introducing a reinforcing component in the form of a metal frame into the construction of the occlusal splint was determined. A new design of a combined occlusal splint and a method for its manufacture were developed. Conclusion. By reinforcing the occlusal splint with a titanium frame, high structural strength, durability of use, maintainability or relocation if necessary are ensured; at the same time, due to 3D-printing, the frame has a minimal cross-sectional thickness, which practically does not affect the thickness of the structure as a whole.

АНАЛИЗ ОБЪЕМОВ СТОМАТОЛОГИЧЕСКОЙ ОРТОПЕДИЧЕСКОЙ ПОМОЩИ ПАЦИЕНТАМ В СИСТЕМЕ ПЛАТНЫХ МЕДИЦИНСКИХ УСЛУГ

The article is devoted to the analysis of the volume of dental orthopedic care for patients in the system of paid medical services in a multidisciplinary medical organization. Various epidemiological surveys conducted abroad and in our country have revealed an unsatisfactory condition of the organs and tissues of the mouth in the majority of the Russian population. Among dental pathology, tooth loss with subsequent functional disorders occupies a significant place [2–4]. One of the important indicators of dental health of the adult population, characterizing the level of dental care, is to ensure the need for prosthetics. According to WHO, the main causes of missing teeth are periodontitis and caries. Periodontitis is noted in 75–80% of the population, of which 90% are elderly and senile people. According to A. K. Kuryanov and L. N. Babenko (1988), 75% of 1,000 examined at the age of 60 needed dental prosthetics, and complete loss of teeth in the jaw was detected in 225 cases [1]. An analysis of the volume of dental orthopedic care for patients in the provision of paid medical services in orthopedic dentistry showed that for 5 years, among all manufactured orthopedic structures, removable plate prostheses with partial absence of teeth accounted for the largest volume, single crowns in second place, removable plate prostheses in the third place with complete absence of teeth. For each type of orthopedic structures manufactured, there is a growth trend from 2018 to 2022. There was a slight decrease in the volume of orthopedic dental care in 2020, due to the unfavorable epidemiological situation in the country at that time.