Maxillofacial Region In Children Research Articles

Clinical and epidemiological analysis of odontogenic inflammatory diseases of the maxillo-facial area in children

Children of the Karaganda region have a high prevalence of odontogenic inflammatory diseases of the maxillofacial region. For this purpose, epidemiological material was collected and analyzed from 426 children aged 1 to 17 years inclusive; distribution of medical records of an inpatient was carried out depending on the nosological form of the inflammatory process and covered the period from 2018 to 2022. in the SOE «Multiprofile hospital named after Kh. M. Makazhanov» (Karaganda city), nosological forms: acute purulent periostitis; acute odontogenic osteomyelitis, abscess and phlegmon. In the comparative structure of odontogenic inflammatory diseases of the maxillofacial region, acute odontogenic osteomyelitis of the jaw predominates – 41.8 %, the second place is occupied by odontogenic phlegmon – 36.6 %, followed by acute purulent periostitis – 15 %, odontogenic abscess – 6.6 %.Studies on the level, structure and prevalence of odontogenic inflammatory diseases of the maxillofacial region in children, depending on the place of residence, revealed that in children of urban areas the highest incidence rate was found for acute odontogenic osteomyelitis. Whereas in rural children odontogenic phlegmon and odontogenic abscess occurred on average 2.2 times more often than in urban children, which indicates the severity of the development of odontogenic inflammatory diseases of the maxillofacial region in them.Thus, in our studies, a relationship was found in the prevalence of odontogenic inflammatory diseases of the maxillofacial region between the age characteristics of children and their place of residence.

The morphological peculiarities of the maxillo-facial region in children with cleft lips and palate

Considerable variation in malocclusion was found in children with cleft lip and palate. Class III malocclusionwere found more frequently due to congenital factors, such as maxillo-mandibular growth potential as well as the severity of the defect.Material and methods. In this study, 15 cephalometric x-rays were analyzed according to the methods proposed by McNamara, Tweed, Roth-Jarabak and Steiner, and 30 cephalometric parameters were calculated for each patient with complete unilateral cleft (so many on the left and so many on the right). The data obtained from the measurements are presented in the tables corresponding to each method. Results. Maxillary and mandibular length (Cond-A, Cond-Gn) statistically significantly reduced compared to normal mean values. The threshold of significance registered for these indices demonstrates significant deviations of the previous height of the face was statistically significantly reduced by the value p<0.01 compared to the normal values (Sna-Me). The posterior vertical skeletal deficit is confirmed by the reduced value of the Hp parameter (posterior height, p<0.01), which compared to Ha, reveals a type of posterior facial rotation. The enlarged lower anterior face is demonstrated by the increased value of the anterior height index, (Sna-Me) which registered an average deviation of 6.57 mm and an increased Ha/Hp ratio (p<0.01). Conclusions. In the result of the analysis of the cephalometric analysis of the x-rays according to the McNamara, Roth-Jarabak, TweedMerriefield and Steiner methods, it was found that the cranio-facial morphology in children with unilateral cleft lips and palate was different from normal values due to the lack of growth of the facial part of the cranium both in sagittal and vertical planes.

Functional activity of the maxillofacial region muscles in children with arthrogryposis multiple congenita

BACKGROUND: Disorders of the maxillofacial region in children with аrthrogryposis multiplex congenita can be congenital or occur as secondary changes. The lower jaw and associated muscles play important roles in the functioning and development of the maxillofacial region. In children with аrthrogryposis multiplex congenita, the functional activity of the muscles of the maxillofacial region has not been studied.
 AIM: To estimate the functional activity of the muscles of the maxillofacial region in children with аrthrogryposis multiplex congenita.
 MATERIALS AND METHODS: Surface electromyography was used to examine the masticatory and facial muscles of 47 children aged 317 years with arthrogryposis (main group) and 20 healthy children with orthognathic bite (control group). The main and control groups were examined by a dentist and had not previously received orthodontic treatment. The bioelectric activities of the temporalis and masseter muscles on the right and left sides were simultaneously registered at rest and during functional tests (opening of the mouth, moving the lower jaw forward, jaw compression, and chewing). The average activity amplitudes were taken into account, and asymmetry coefficients were calculated. The obtained data are statistically processed.
 RESULTS: Electromyography results, according to different functional tests, revealed disorders in 65%88% of children with аrthrogryposis multiplex congenita. In all samples, the tonic activity of the masticatory muscles increased at rest, the amplitude of the activity of masseter and temporalis muscles decreased, signs of an imbalance of the masticatory muscles such as the hyperactivation of the temporalis muscle compared with the masseter muscle with jaw compression and chewing were noted, and muscle asymmetry indices increased. The frequency and degree of functional muscle disorders prevailed in children with deciduous and temporary occlusion.
 CONCLUSIONS: Arthrogryposis multiplex congenita in children is characterized by a high frequency of impaired functional activity of the muscles of the maxillofacial region, which can negatively affect bite formation, chewing function, and articulation.

Методи лікування кіст щелеп у дітей. Ретроспективний аналіз

Odontogenic cysts of the jaws are one of the most common tumour-like neoplasms of the maxillofacial region in children. Today, there are various methods of treating cysts, but in childhood, the problem of choosing a treatment method is relevant and at the same time difficult, as some authors prefer cystectomy, while others prefer cystotomy. Purpose - to analyze the methods of treatment and management of jaw cysts in children depending on the type of cyst. Materials and methods. A retrospective analysis of 286 case histories of patients with jaw cysts aged 4 to 17 years was performed. The case histories were analysed according to the developed examination chart. Results. A retrospective analysis of 286 case histories of children with jaw cysts was performed. The age of the children ranged from 4 to 18 years. Radicular dentoalveolar cysts were diagnosed in 35% (n=100) of cases, radicular cysts - in 36% (n=104), follicular cysts - in 15% (n=43), suppurative cysts - in 5% (n=14), residual cysts - in 5% (n=14), primary bone cysts - in 3% (n=7), polycystic cysts - in 2% (n=4). Cystotomy was performed in the vast majority of cases - 58% (n=166), cystectomy - in 42% (n=120). Tamponade was performed in 63% (n=181) of cases, and in 37% (n=105) it was not performed. Conclusions. Radicular cysts are the most common odontogenic cysts of the jaws. Cystotomy and cystectomy are variable methods of cyst treatment. The most common method of treating cysts in children is cystotomy. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Phenotypic signs of connective tissue dysplasia in adolescents

Introduction. Connective tissue dysplasia (СTD) is a group of polymorphic pathological conditions caused by hereditary or congenital defects in collagen synthesis and accompanied by a violation of the functions of the musculoskeletal system and internal organs, which is considered as a factor in the development of pathology of the maxillofacial region in children: dystrophic forms of periodontal diseases; anomalies of shape, size, teething; pathology of the temporomandibularthe mandibular joint. There are diffi culties in determining the pathogenetic relationship between CTD and individual nosological forms of dental diseases, which is important for determining the prognosis of their course and the choice of methods of rehabilitation of children. It is important to improve the methodology of preventive examinations in relation to the early detection of phenotypic signs of CTD, including in the maxillofacial region. Substantiation of the connection of CTD with dental diseases will make it possible to develop examination and medical examination schemes, increase the effectiveness of comprehensive prevention of dental diseases and rehabilitation of adolescents with combined pathology.The aim is to study the incidence of CTD in adolescents and its relationship with dental diseases in order to develop a scheme of examinations and medical examinations, increase the effectiveness of comprehensive prevention of dental diseases and rehabilitation of adolescents with combined pathology.Materials and methods. A survey of 140 male adolescents aged 15–18 years, students of schools in Smolensk was conducted. When examining the somatic status, generally accepted markers of CTD were taken into account: bone (asthenic type of constitution, scoliotic deformity of the spine, hallux valgus, chest deformities), skin (increased skin extensibility of more than 3 cm), articular (hypermobility of joints) and visceral (changes from the cardiovascular system — prolapses of the heart valves, abnormally located chords; changes from the respiratory organs — polycystic lung disease, trachiobronchial dyskinesia; changes from the urinary system — nephroptosis, kidney doubling; changes from the gastrointestinal tract — visceroptosis, gallbladder anomaly; changes from the blood system — thrombocytopathy, hemoglobinopathy). When examining the dental status, the following generally accepted markers of CTD were taken into account: malocclusion (prognathia, deep bite, their combination), narrowing of the dentition, anomalies of the position of individual teeth, anomalies of soft tissue attachment, gum recession, chronic gingivitis. The diagnosis of CTD and the health group was established by a pediatrician on the basis of clinical recommendations and the order of the Ministry of Health of the Russian Federation № 621 dated 30.12.2003 «On a comprehensive assessment of the health status of children». Factor analysis was used to form a set of signs combining signs of CTD and dental diseases.Results. Of the phenotypic signs of СTD, bone and joint changes were diagnosed in 79,3 % (95 % CI 72,6– 86) of adolescents. In second place in frequency 35 % (95 % CI 27,1–42,9) were signs of СTD of the cardiovascular system and the organ of vision (myopia). 40 % (95 % CI 31,9–48,1) of the examined adolescents were diagnosed with chronic gingivitis, gum recession. Deep bite and prognathia were more common than other malocclusions: in 40,7 % (95 % CI 32,6–48,9) and 17,1 % (95 % CI 10,9–23,4), respectively. The use of factor analysis allowed us to identify four most informative factors (the fi rst of them is the most signifi cant) to characterize the relationship between the signs of CTD and its dental manifestations.Conclusion. The incidence of CTD in males in the age group of 15–18 years is 43 %. The most informative prognostic factor was the relationship of tracheobronchial dyskinesia with prognathia, deep bite, narrowing of the jaws, generalized gingivitis. The interrelation of signs of СTD of the cardiovascular system and bone-joint changes with gum recession, chronic gingivitis, prognathia and deep bite was also revealed.

ОСТЕОСАРКОМА И САРКОМА ЮИНГА ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ У ДЕТЕЙ: ПОДХОДЫ К ТЕРАПИИ И ОСОБЕННОСТИ ХИРУРГИЧЕСКОГО ЛОКАЛЬНОГО КОНТРОЛЯ

Authors analyze bibliographical data on the treatment of osteosarcoma and Ewing's sarcoma of the maxillofacial region in children and adolescents. The role of surgical treatment in the primary lesion of this localization is analyzed in detail as well as the complex therapeutic approaches.

Paediatric Mandibular Fracture Management - A Seven Year Retrospective Study.

Mandibular fractures are one of the most frequent and complex types of traumatic injuries of the maxillofacial region in children. Given significant long-term sequelae of inappropriate healing, adequate diagnosis and choice of management, which takes into account the patient's age and fracture characteristics, are paramount. The data for this study were obtained from the medical records of patients treated in the Department of Surgical Dentistry and Paediatric Maxillofacial Surgery of the Bogomolets National Medical University from 2014 to 2020. Age, gender, fracture pattern and surgical treatment methods performed in these patients were recorded and analysed. A total of 302 children with 376 traumatic fractures of the mandible were managed during the study period. The largest number of fractures was found in the condylar processes region, 42%, and in the body of the mandible, 40%. The majority of patients were males and in the 13-17 age group (147 [49%] cases). Tigerstedt's maxillary-mandibular fixation splint was used in the majority of cases, alone or in the combination with open or internal fixation. Whilst the most common type of immobilisation in children in our series was Tigerstedt's maxillary-mandibular fixation splint, its use is limited to the variable bite period. Alternative fixation options are discussed.

Рентгенологічна діагностика переломів виросткового відростка нижньої щелепи в дітей

Mandibular fractures are one of the most common and complex types of traumatic injuries of the maxillofacial region in children and account for 18-66% of the total number of facial fractures. Among which, fractures in the area of the condylar processes of the mandible (CP) occur in 25-40% of cases. Purpose - to reveal the radiological features of CP fractures in children and to determine the most informative diagnostic methods. Materials and methods. A retrospective analysis of 25 case histories of children with traumatic fractures of the VGNP aged 4 to 18 years was carried out. The analysis of case histories was carried out according to the developed survey map. Under our supervision there were 25 children with traumatic fractures of CP. The age of children ranged from 4 to 17 years, the average age was 10.04 years (±4.09). All children were divided into groups, among which the largest group consisted of children aged 7-12 years - 52% (n=13) of children. Results. Unilateral fractures were detected in 84% (n=21) and bilateral in 16% (n=4) of children, among them with displacement in 92% (n=23). CP fractures in the region of the head were diagnosed in 36% (n=9), the base in 32% (n=8), the neck in 28% (n=7) and the combination of the base and neck in 4% (n=1). Conclusions. The only method that allows obtaining maximum information about various injuries in the bone structures of the joint is CT and spiral 3D-CT. The latter, in turn, allows you to detail any changes in the bone elements of the temporo-mandibular joint for diagnosis, selection and planning of individual treatment tactics, which reduces the time of surgery and the child's stay under anesthesia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Clinical evaluation of the treatment complex of acute odontogenic periostitis in children on the base of diffused non-toxic goiter

Inflammatory diseases in the maxillo-facial region in children occupy a leading place in the work of a polyclinic doctor. At the same time, their diagnosis is imperfect and they often occur on a premorbid background. The clinical features of acute odontogenic periostitis against the background of thyroid pathology in children were studied to improve the effectiveness of treatment. We examined 38 children, formed two groups of observations. Children of both groups were given generally accepted treatment. Children of the main group were additionally prescribed means "Imupret" and "Calcemin advance" to normalize the main protective indicators of oral fluid. Statistically assessed the degree of probability of the obtained results. The results of clinical observation of children showed the absence of pain on the 7th day of observation in both the children of the main group and the comparison group, indicating the pronounced anti-inflammatory and analgesic effects of drugs in complexes treatment. On the 7th day of treatment, clear hyperemia was not diagnosed in children of the follow-up groups, but patients with moderate oral mucosa hyperemia in the main group were in 2.22 times less than in the comparison ones (5.0% vs 11.11%, respectively). Minor swelling and exudation on the 7th day of observation were found only in children of the comparison group. Oral hygiene at the time of completion of treatment in all children was within satisfactory values. Analysis of the periodontal index of PMA showed the presence of catarrhal gingivitis in a third of children of both observation groups. Thus, the obtained results of clinical indicators of the state of the oral cavity of children indicate the effectiveness of our proposed method of treatment of acute purulent periostitis in children, which is confirmed by the stabilization of microvascular circulation, namely a decrease in the phenomena of edema and exudation. Due to local immunocorrective action, wound healing conditions are also improved and postoperative complications are prevented. Keywords: acute odontogenic periostitis, children, thyroid disease, Imupret, Calcemin advance.

Features of acute purulent lymphadenites and maxillofacial adenophlegmons course in children

Objective. The purpose of the research was to study the features of the course of acute purulent lymphadenites and adenophlegmons of the maxillofacial region in children, to describe the species composition of pathogens, to determine their sensitivity to antibiotics of various groups.
 Materials and methods. The medical histories of 147 patients were analyzed; microbiological studies were carried out (microscopic examination of clinical specimens with gram stain, cultural method, determination of sensitivity of isolated pathogen to antimicrobial drugs).
 Results. Most often, acute purulent lymphadenites and adenophlegmons were observed in the submandibular tissue space (40.1 %) and in the neck (38.1 %). The main causative agents of the inflammatory process were Staphylococcus aureus (38.1 %) and Streptococcus agalactiae (BHSA) (14.3 %). Staphylococcus aureus strains had the highest sensitivity to beta-lactam antibiotics in 83 %, to macrolides in 60.4 %, to fluoroquinolones in 56.6 %; 3.8 % showed resistance to lincomycin, 1.9 % to beta-lactams. The strains of Streptococcus agalactiae (BHSA) were 100 % sensitive to beta-lactams, 73.7 % to macrolides, they were resistant to lincomycin and macrolides (10.5 % each).
 Conclusions. The data obtained are of great practical importance, since they allow to correctly orient doctors in the choice of rational antibiotic therapy.

АНАЛИЗ СТРУКТУРЫ ХИРУРГИЧЕСКИХ ЗАБОЛЕВАНИЙ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ В УСЛОВИЯХ ГОСПИТАЛИЗАЦИИ ДЕТСКОГО И ВЗРОСЛОГО НАСЕЛЕНИЯ ЮЖНОГО УРАЛА

The reforms carried out in the country in health care redefine the tasks and functions of health care management, including the dental service. In recent decades, there has been a clear tendency towards an increase in dental morbidity in Russia against the background of a decrease in its availability and the level of preventive work, primarily due to an increase in the volume of medical care. In connection with the increase in the segment of non-state dental clinics, a change in the structure of the network of medical and prophylactic institutions of a dental profile is registered, while an increase in the number of patients seeking dental care for the first time at the stage of the disease requiring treatment in inpatient conditions is revealed. The aim of the study was to study the structure of surgical pathology of the maxillofacial region in children and adults in the Chelyabinsk region. To solve this goal, a retrospective study of the incidence and structure of surgical diseases of the maxillofacial region was carried out in patients of all age groups who received inpatient treatment in specialized departments for the period from 2016 to 2020. In the course of the study, it was revealed that in the Chelyabinsk region there is a consistently high need to provide assistance to patients of different ages with surgical pathology of the maxillofacial region in hospitalization — both among adults (18883 people were treated for the 5-year period under study), and during the analysis. data of pediatric patients (from 873 to 1070 children were treated per year). The majority of adult patients undergoing treatment in the conditions of the departments of maxillofacial surgery were admitted on an emergency basis with inflammatory processes (most often diagnosed with odontogenic phlegmon (L03.2)) and traumatic lesions of the face and neck (the vast majority — patients with fractures of the lower jaw (S02.6)), then in descending order — neoplasms, deformities and congenital pathology of the maxillofacial region followed; in children, after inflammatory diseases, neoplasms of the orofacial zone were recorded, followed by congenital pathology and facial injuries.

The Prevalence of Odontogenic Inflammatory Diseases in Frequently ILL Children

Many questions of etiology, pathogenesis, prevention and treatment of purulent-inflammatory processes of the maxillofacial region remain unresolved to this day, which explains the constant interest and attention of researchers to them (Roginsky V. V., Korinskaya N. N., 1996; Ushakov R. V. 1995; Kawai T. etal., 1998, etc.). Meanwhile, it is known that acute inflammatory processes of the maxillofacial region in children often develop with reduced immunological reactivity of the body, and the course of the disease and the likelihood of complications are largely determined by the initial indicators of immunity. In the structure of this pathology, a special place is occupied by odontogenic inflammatory diseases and their complications against the background of reduced immunity due to recurrent respiratory infections in children (Zuev V. P. 1994; Kazimirsky V. A. ssoavt, 1996, Henderson, 1995; Henderson, Wilson, 1995, 1996, etc.). The course of odontogenic infection in children has a number of features due to the relative immaturity of the child's organs and tissues, imperfection of immunity, abundance of lymphatic tissue, the presence of anatomical and physiological features of the structure of teeth and jaws, ease of damage and increased permeability to microbes of natural protective barriers, etc.

Maxillofacial Region in Children with Cerebral Palsy

Maxillofacial Region in Children with Cerebral Palsy

ИЗМЕНЕНИЯ ЦЕФАЛОМЕТРИЧЕСКИХ ПОКАЗАТЕЛЕЙ У ДЕТЕЙ С ГЛУБОКОЙ ДИСТАЛЬНОЙ ОККЛЮЗИЕЙ

Object. A cephalometric analysis was performed in children with deep distal occlusion.
 The aim of the study — To determine the age-related changes in the vertical parameters of the face in children with deep distal occlusion.
 Methodology. The article is devoted to the analysis of cephalometric parameters in patients with deep distal occlusion at different age periods in the groups: 7-9, 10-12, 13-15 years. The calculation of 15 parameters of lateral teleroentgenograms was carried out, of which 12 characterized the vertical development of the facial skeleton and the tooth-alveolar region. The analysis was performed using a computer program for automated analysis of skull radiographs.
 Results. The study revealed age-related changes in the parameters that characterize the vertical development of the maxillofacial region in children with deep distal occlusion.
 Conclusion. Changes with age in the parameters of the angles NSL/ML, NSL/NL, anterior and posterior height of the face are early signs of a genetically determined developmental anomaly. An increase in the depth of the incisal overlap with age, a deepening of the Spee occlusal line are interrelated with an increase in the tooth-alveolar height in the incisor region and with a decrease in the tooth-alveolar height in the region of the first molars, especially in the lower jaw. The sagittal position of the upper and lower incisors in distal occlusion does not change with age and corresponds to the average normal values. Established age-related changes in the parameters of the facial skeleton in deep distal occlusion make it possible to determine the area of influence of orthodontic treatment at the stages of bite development — tooth-alveolar, in the vertical plane.

Morpho-functional state of the maxillofacial region in children with cerebral palsy

The problem of cerebral palsy is one of the most urgent problems of medicine. The social significance of this problem is so great that it is quite natural that there is an increasing interest in it. In the available literature, there is no comprehensive data on the study of the frequency of dental anomalies among children with cerebral palsy, depending on the etiofactor, and on improving methods for their prevention and early treatment.

Analysis of treatment methods for children with bilateral complete cleft of the lip and palate in mixed bite

Relevance. According to the World Health Organization, it was found that cleft lip and palate cases ranges from 0.6 to 1.6 cases per 1000 newborns. According to the severity of the lesion, bilateral cleft lip and palate takes the first place, however, it occurs much less common – 15-25%.Purpose – to analyze methods of treatment in children with bilateral cleft lip and palate during the period of the mixed dentition.Materials and methods. An analysis of 51 sources Russian and foreign articles for the period from 1951 to 2019 was carried out. The features of the development of occlusion in children with bilateral cleft lip and palate during the period of a changeable occlusion, as well as methods of treating this pathology, are considered.Results. It was found that the main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during the period of a changeable bite are -narrowing of the upper and lower jaws, the presence of soft tissue scars. The main methods of treatment for such children are reconstructive surgery, including the closure of a hard palate defect using a mucoperiosteal flap cut out in the lateral part of the hard palate, as well as orthodontic treatment methods, the main purpose of which is to expand and extend the dentition using single jaw removable plate apparatuses, fixed plate apparatuses.Conclusions. Taking everything into account, surgical reconstructive operations, as well as complex orthodontic treatment, the main purpose of which is to expand and extend the upper and lower jaws, are the integral methods of treating such children. Orthodontic treatment should be aimed at eliminating myofunctional disorders with the helpof orthodontic trainers and elastopositioners. Conducting a comprehensive surgical and orthodontic treatment can reduce the rehabilitation time of children with bilateral cleft lip and palate.

Современные аспекты междисциплинарного лечения детей с расщелиной губы и нёба

According to the World Health Organization incidence of cleft lip and palate ranges from 0.6-1.6 cases per 1000 newborns per year. Thus, bilateral full cleft lip and palate occurs less frequently around 15–25%. Purpose: to analyze treatment methods for children with bilateral cleft lip and palate during the period of a removable bite. A review of 51 literature sources from 1951 to 2019 was carried out. Occlusion development features in bilateral cleft lip and palate patients during mixed dentition period were analysed. Main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during mixed dentition period is narrowing of the upper and lower dental arches as well as presence soft tissues scars of the upper lip. The main methods of treatment for such children is surgical reconstructive operations, including the elimination of the anatomical defect of the hard palate using mucoperiosteal flaps from the lateral parts of the hard palate combined with orthodontic treatment methods. Thus, an integral method of treating children with bilateral cleft lip and palate during mixed dentition period is a comprehensive approach, including surgical reconstructive operations, as well as orthodontic treatment, the main purpose of which is to expand and extend dental arch, which results in normal occlusion therefore eliminating myofunctional disorders. Key words: cleft lip, cleft palate, mixed dentition, occlusion features, orthodontic treatment

ИССЛЕДОВАНИЕ МАЗКОВ-ОТПЕЧАТКОВ ГНОЙНЫХ РАН ПРИ ИСПОЛЬЗОВАНИИ МАЗИ С ФУРАЦИЛЛИНОМ, ЛИДОКАИНОМ И ДИБУНОЛОМ ДЛЯ ЛЕЧЕНИЯ АБСЦЕССОВ И ФЛЕГМОН ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ У ДЕТЕЙ

Importance ― study of microscopic imprints of the wound surface of purulent wounds in inflammatory diseases of the maxillofacial region in children.
 Objectives ― cytological research of microscopic imprints of purulent wounds in inflammatory diseases of the maxillofacial region in children
 Methods. The study included 60 children from 5 to 16 years old who were treated for abscesses and phlegmon of the maxillofacial area. Patients were divided independently into 2 groups. The main group included 30 children. For their treatment we used ointment with Furacilin, Lidocaine and Dibunolum. The control group included 30 patients. For their treatment used ointment Levomecol. To compare the effectiveness of the healing of purulent wounds in the main and control groups, we studied cytology of microscopic imprints of purulent wounds at 3, 7 and 10 days.
 Results. A microscopic examination of the imprints of the wound surface of the control group on the 3 day revealed a predominantly inflammatory type of cytogram, on day 5, the type of cytorgamy was replaced by inflammatory-regenerative, which persisted on the 7th day of the study. Microflora was represented in small quantities. In the main group, in the study of microscopic imprints on the 3ed day, inflammatory-regenerative type of cytogram was also observed. On the 7th, the cytogram shifted to the regenerative type. Cell infiltrate was poor, containing macrophages and lymphocytes. Seeding by microorganisms was not observed.
 Conclusions. Thus, based on the morphological studies of microscopic imprints of the wound surface, we recommend the use of ointment with Furacilin, Lidocaine and Dibunolum for the complex treatment of abscesses and phlegmon of the maxillofacial region. Since the ointment reduces the time of wound healing and reduces bacterial contamination of the wound.

Congenital cleft of the lip and palate in children: pathogenetical significance of matrix metalloproteinases

There are presented data about the prevalence offormation of congenital cleft lip and palate (CCLP) - one of the most common birth defects of the maxillofacial region in children. According to WHO the occurrence of children born with CCLP in the world is 0,6-1,6 cases per 1,000 live births, and varies greatly from the region to region and ethnic group residing there. At the same time, in 63,1% of patients there were established chromosomal abnormalities, and in 36,9% - non-chromosomal syndromes. In Russia, every year there are occurred from 3,5 to 5 thousand children with such defects that requires the development of new methods ofprevention of these malformations. There are reported modern views on the pathogenetical and potent diagnostic significance of the evaluation of the content of tissue matrix metalloproteinases (MMPs) and their inhibitors in mechanisms of the formation of CCLP, shown the probable associations of changes in the expression or activity of MMP and TIMP with various forms of malformations of the palate and upper jaw.

ОПЫТ ЛЕЧЕНИЯ ДЕТЕЙ С СОСУДИСТЫМИ ОПУХОЛЯМИ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ

Subject. The article shows the effectiveness of the author's method of treatment of young children with vascular tumors of the maxillofacial area. The variety of the clinical course of vascular tumors, their localization in the maxillofacial area create difficulties and limit the choice of treatment method. The author's method combines high efficiency, minimally invasiveness, reduction of rehabilitation time and minimal adverse reactions. Objective ― evaluation of the experience of treating vascular tumors of the maxillofacial region in children using a combination method - taking propranolol and hardening. Methodology. The results of the treatment of 120 children with vascular tumors of the maxillofacial area aged 2 months to 2 years have been evaluated. Compared the results in 3 groups of children who were treated by various methods: combined - taking propranolol and hardening (FG); propranolol (HS-1); sclerotherapy method (HS-2). The efficacy of treatment was assessed by changing the volume of formation, the diameter of the supply vessels and the values of the linear velocity of blood flow. Results. According to the results of our clinical study, a group of young children with vascular tumors of the maxillofacial area in cosmetically significant areas that received treatment by the author's method, has demonstrated its effectiveness. A significant amount of regression was achieved (2.5 times) compared with the comparison groups. According to the ultrasound, the reduction in the diameter of the supply vessels and the linear velocity of blood flow reached zero after 6 months after the start of treatment, faster than in the comparison groups Conclusions. The use of the combined treatment - taking propranolol and hardening - is effective in treating children with vascular tumors of the maxillofacial area, reduces the treatment time and reduces the risk and degree of complications.