Sanitation Of Oral Cavity Research Articles

Medical-statistical indicators of dental disease prevalence among students of general educational institutions of the Ministry of Defense of Russian Federation

BACKGROUND: Currently, the Ministry of Defense of Russian Federation has 33 general educational institutions, with around 18,000 students who are part of the personnel reserve aimed at enhancing the country’s defense capability. AIM: To evaluate the medical-statistical indicators of dental disease prevalence among students, which can be used to optimize dental care in the general educational institutions of the Ministry of Defense of Russian Federation. MATERIALS AND METHODS: We analyzed the dental disease prevalence (ICD-10 codes K00–K14) among students from the academic years 2009/2010 to 2021/2022 using the reporting form 13K/MED approved by the Main Military Medical Directorate of the Ministry of Defense of Russian Federation, as well as during annual medical examinations. The level of dental disease prevalence was calculated per mil (‰).The number of those in need of and sanitized children were calculated in percentages (%). The results were tested for the normal distribution of characteristics. The text includes the mean values and their errors. RESULTS: The average annual level of total dental disease prevalence or incidence among students was 1687.9±16.0‰ and 563.4±12.2‰ for primary dental disease. This was significantly higher by an order of magnitude compared to previously examined conscripted military personnel, achieved through personalized approaches and strict medical-statistical accounting. No significant differences were observed in dental disease prevalence indicators among different age groups of students. A decrease in both total and primary dental disease prevalence rates has been observed in recent years. The average annual percentage of students requiring oral cavity sanitation was 40.9±1.2% and 75.4±1.8% of those who underwent sanitation. The proportion of sanitized students in the 16–18 age group was significantly higher than in younger age groups (p 0.001). CONCLUSION: Medical-statistical indicators should be used to optimize dental care in the general educational institutions of the Ministry of Defense of Russian Federation.

COMPREHENSIVE ASSESSMENT OF DENTAL HEALTH IN MEDICAL STUDENTS

Students are a significant part of young people who are characterized by an active lifestyle, an enhanced psycho-emotional state, an increased academic load, often leading to deteriorated health. The state of dental health of students and the need for specialized care are of particular interest. The purpose of the study is a comprehensive assessment of dental students' dental status and determination of the need for specialized care. Material and methods. 50 dental students (19 men and 31 women) of Kazan universities aged 18–33 years were examined. A clinical dental examination of students was conducted, the results of which were recorded in a purposely designed "Dental examination card of a student". Study results. 4 students (8%) with intact hard tooth tissues were identified. The proportion of students who need oral cavity sanitation was 50%, 36% of them need endodontic treatment. The intensity of caries according to the CFE index in girls was 5.34±0.2 points, in boys – 6.01±0.7 points. Gum condition according to index (GI) of H. Loe and S. Silness = 1.4+0.11 points. In the course of assessing the severity of functional disorders on the part of the masticatory apparatus, an express method was used – the Hamburg examination (2000), which revealed the percentage (60%) of dysfunctions on the part of the ­temporomandibular joint. Violations in occlusal ratios of varying severity were detected in a quarter of the examined. The percentage of examined patients with temporomandibular joint dysfunction was 60%, the ratio of frontal teeth in the sagittal plane – disocclusion – 26%, reverse incisal disocclusion was 2%, deep incisal occlusion – 20%. Conclusions. The results of the survey revealed the need of students in dental (including orthodontic) curation.

Efficiency of Adjuvant Therapies in the Management of Medication-Related Osteonecrosis of the Jaws: A Case Series and a Literature Review

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a challenging condition with no established gold standard treatment. This article presents a case series that explores a minimally invasive surgical protocol combined with various adjuvant treatments to manage MRONJ in oncologic patients. Patient and Methods: Seven patients diagnosed with MRONJ, with mandibular involvement at stages 2 and 3 were included in the case series. The treatment protocol consisted of pre-operative steps, including oral cavity sanitation, hygiene motivation, and pre-operative medical treatment. Using operative techniques, the surgical protocol involved fluorescence-guided bone debridement, curettage, and bone smoothing. Adjuvant treatments such as platelet-rich fibrin, buccal fat pad grafts, Pentoxifylline and tocopherol combination, and low-level laser therapy were used. Follow-up assessments were conducted at regular intervals, and the outcomes were evaluated. Result: Improved cicatrization and symptom relief in most cases, with complete healing achieved in all patients. Conclusion: The study highlights the outcome of the use of adjuvant therapies in the management of MRONJ, however, further research is needed in order to acknowledge the potential of adjuvant therapies for MRONJ treatment and establish a standardized protocol.

Frequency of isolation of nosocomial pneumonia pathogens from the respiratory tract of cardiac surgery hospital patients who are under extended artificial lung ventilation and efficiency of oral cavity sanitation with chlorhexidine solution

Objective. To assess the frequency and degree of bacterial contamination of the respiratory tract in patients of cardiac surgery hospital, who are on prolonged mechanical ventilation, and to evaluate the efficiency of sanitation of the oral cavity with a solution of chlorhexidine. Materials and methods. A comparative analysis of the oral and tracheobronchial tract microbiota in operated patients of cardiac surgery hospital undergoing prolonged (4872 hours) artificial lung ventilation (ALV) was carried out. Microbiological assessment of the effectiveness of the oral cavity sanation with 0.1 % aqueous chlorhexidine solution is given. Results. The oral and tracheobronchial microbiota of cardiac surgery patients undergoing prolonged ALV are represented by gram-positive (S. epidermidis) and gram-negative (K. pneumoniae, P. aeruginosa, A. baumannii) microorganisms as well as Candida fungi. It was found out that the indices of the frequency and intensity of microbial isolation from the samples of the lower parts of the respiratory tract content were comparable with those of the oral cavity. The exception was S. epidermidis, the number of which in the lower airways compared to the upper ones was low. There was a statistically significant decrease in the intensity of microbial contamination of the oral cavity in patients on ALV after the sanation procedure with an aqueous chlorhexidine solution. Conclusions. Frequency and intensity indices of opportunistic microorganisms (K. pneumoniae, P. aeruginosa, A. inaumannii, Candida fungi) isolation from the oral cavity and lower respiratory tract in patients of cardiac surgical hospital under prolonged ALV have no statistically significant differences. The exception is S. epidermidis, whose numbers in the lower airways are low compared to the upper ones. The microbiological effectiveness of 0.1 % aqueous chlorhexidine solution in the process of sanitation of the oral cavity in patients on prolonged ALV has been established.

Changes in mucosal immunity of oral cavity upon tooth loss in patients with periodontal diseases

Partial or complete loss of teeth occurs in elderly and senile people, caused, mainly, by chronic generalized periodontitis. At the same time, the impact of presence or absence of persisting teeth and periodontium, is practically not covered in the literature as a factor of balance in the oral cavity, including local immunity of the mucous membranes. Our work concerned the changes in local immunity of the oral cavity occuring with the loss of natural teeth. We have observed 45 elderly people who were divided into 3 study groups, i.e., without inflammatory periodontal pathology (1), with periodontitis (2) and with chronic periapical inflammatory processes in the absence of periodontal inflammation (3). In order to sanitize oral cavity before the upcoming dental prosthetics, the patients of study groups 2 and 3 underwent extraction of all teeth in the upper and lower jaws. Indices of local immunity of the oral cavity in the salivary fluid of patients were assessed before surgical sanitation of the oral cavity (before the teeth extraction) and 30-35 days after removal of the last tooth. We have measured the salivary levels of secretory immunoglobulin A (sIgA) as well as pro-inflammatory cytokines, i.e., interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor- (TNF), and anti-inflammatory cytokines, e.g., receptor antagonist of interleukin-1 (RAIL), interleukin-4 (IL-4), interleukin-10 (IL-10)), as well as contents of antimicrobial peptides in saliva (catelicidin LL-37 and alphadefensins 1-3 (HNP1-3). We have found that the development of inflammation in severe inflammatory periodontal diseases, in particular, chronic generalized periodontitis requiring tooth extraction for oral cavity sanitation is characterized by functional insufficiency of secretory immunity of the oral mucosa associated with decreased secretion of secretory immunoglobulin A and antimicrobial peptides of neutrophilic origin, as well as a shift in the salivary cytokine balance towards increased production of pro-inflammatory cytokines. Removal of teeth, as the main source of inflammation and the basis for maintenance of dysbiotic microbiome biofilm leads to elimination of inflammation and the restoration of immune balance in the oral cavity.

Colonization by Various Morphological Forms of Helicobacter pylori in the Gingival Sulcus and Antrum of the Stomach.

Helicobacter pylori eradication therapy can be considered effective if the result of its implementation is removed including all roots and rootlets from which surviving H. pylori can repopulate in the gastric mucosa. One of the reasons for the ineffectiveness of eradication therapy can be the continuous presence of viable coccoid forms of H. pylori in the oral cavity. Therefore, anti-Helicobacter eradication therapy should be supplemented by the sanitation of the oral cavity. The objective of this study is to determine the frequency of occurrence of H. pylori in the gastric mucosa and in the oral cavity in patients with chronic periodontitis or with chronic gastritis using immunocytochemical method and to evaluate the pathophysiological relationship between periodontitis and HP-associated acid-dependent stomach diseases mediated by H. pylori. A group of patients with chronic gastritis (70 participants, 46 women, 24 men, age: 24 - 55 years) and another group with chronic periodontitis before the start of surgical treatment (61 participants, 30 women, 31 men, age: 20 - 60 years) were examined for НР bacterial cells using immunocytochemical methods of staining gastric biopsy and exfoliate samples from the gingival sulcus surface. The participants did not take any antimicrobial medication before and during the examination. Routine staining was also performed to view microbiota in smears for both groups. The participants signed a voluntary consent agreement to undergo routine medical examinations and join the study at the Nikiforov Russian Centre of Emergency and Radiation Medicine, EMERCOM of Russia, where the ethical committee was made. Immunocytochemical method could identify all stages of bacillary-coccoid transformation of H. pylori which accounted for 63.4-67.5% of cases. HP-antigenpositive bacteria were found in the oral cavity in both groups of examined patients. It was apparent that spiral forms of H. pylori were dominant over coccoid forms in the gastric mucosa in the antrum of the stomach, whereas coccoid forms of H. pylori were frequently found more in the oral cavity. Helicobacteriosis in the oral cavity was identified in chronic periodontitis. We found certain pathogenetic connections between inflammatory lesions of the oral cavity and diseases of the internal organs of the gastrointestinal tract. Accordingly, we suggest the necessity to use proper medication for oral cavity sanitation along with anti-Helicobacter eradication therapy to influence the HP reservoir in the oral cavity and gingival sulcus. Additionally, bacterial cells of HP reside in the oral cavity in coccoid forms; therefore, the coccoid form of HP should become the second principal target in treating HP.

Correction of the State of Enamel Mineral Metabolism in Persons with Decompensated Caries at Various Times after Oral Cavity Sanitation

The aim of the study was to determine the effectiveness of brushite exposure to correct the marginal permeability of composite restorations in persons with a decompensated form of carious process activity; this study also examined the penetrating ability of brushite in the micro-cracks of the enamel-composite border Methods and Results: The study included 120 patients (age 18-40 years) with a decompensated course of the carious process, who underwent complete oral cavity sanitation with the direct composite restoration of 300 teeth. The obtained results were analyzed and interpreted in vivo (the clinical effectiveness of the restoration was assessed according to the Ryge criteria immediately after treatment and 1, 12, and 36 months after treatment) and in vitro (scanning electron microscopy of the enamel-composite joint after applying the composite and after treatment with the studied means). According to the purpose and objectives of the study, two groups of patients were formed: Group 1 (control, n=58): the prevention of recurrent caries after sanitation was carried out using a standard personal hygiene product containing fluorine; Group 2 (experimental, n=62): the prevention of recurrent caries after sanitation was carried out using a natural two-component complex for strengthening and remineralization of enamel RemarsGel. During statistical processing of the obtained data, immediately after sanitation and one month after it, the differences in the indicators of the Ryge criteria in Groups 1 and 2 were statistically insignificant. Twelve months after the sanitation, the Ryge restoration quality indicators in Group 2 were higher than in Group 1 (P≤0.001). After 36 months, the statistical significance of the difference in the restoration quality indicators increased (P≤0.0001). These results were confirmed by the data of scanning electron microscopy. Based on the results obtained, stating the state of the quality of the enamel-composite joint, it can be concluded that brushite crystals are highly effective in preventing violations of the integrity of the enamel-composite joint, which has a direct and immediate impact on the quality of restoration. Conclusion: We consider it necessary to add to the list of main indications for the use of the RemarsGel system one more, a scientifically based indication of the targeted use of the system in the presence of a significant amount of adhesive, both direct and indirect restorations in the oral cavity, especially in the decompensated course of the carious process.

Анализ стоматологического уровня здоровья в рамках социального проекта по медицинскому обследованию и обслуживанию детских домов на территории Республики Казахстан

Today, the issues of studying the dental health of children and adolescents living in various regions of the Republic of Kazakhstan remain relevant. The health of the younger generation, including dental health, is an important priority area that contributes to improving the quality of life. Aim. To study dental morbidity in children and adolescents in various regions of the Republic of Kazakhstan. Material and methods. A survey of 608 children and adolescents living in educational institutions was carried out. The results of the preventive dental examination were recorded in an electronic dental card. Passport data, subjective, objective data and data of intraoral examination were included in the electronic map for studying the prevalence. Particular importance was attached to the state of oral hygiene, the indicator of sanitized patients and the need for sanitation of the oral cavity. Results and discussion. The rationale for conducting the survey in various regions of the Republic of Kazakhstan was the study of the level of health in children and adolescents to establish risk factors for dental morbidity. Dental examination of 608 children and adolescents testifies to the high intensity and prevalence of dental caries, periodontal tissue diseases, dentoalveolar anomalies. Most children and adolescents need oral cavity sanitation, this figure was 51,9%. Undoubtedly, in educational institutions it is necessary to carry out sanitary and educational work and timely sanitation of the oral cavity. The obtained statistical data will allow us to draw up a "dental health map" of children and adolescents living in various regions of the Republic of Kazakhstan and develop a comprehensive program for the prevention of dental diseases. Conclusions. One of the main issues in dental practice is the study of the prevalence of caries in early childhood, including among children under 14 years of age, in order to prevent the development of complications, to carry out preventive measures to improve the quality of life. Dental caries is the most common among children living in educational institutions. Also, 28% of children have poor-quality fillings, decayed teeth, and due to non-observance of oral hygiene, inflammatory diseases of the periodontal tissues develop. About 35% of children need orthodontic care due to the development of dentoalveolar anomalies. Orthodontic care, which is a paid service, is not fully provided to this category of children and adolescents. Therefore, there remain a number of organizational-preventive and organizational-therapeutic measures that need to be addressed. Keywords: examination, dental health, analysis, project.

ASSESSMENT OF DENTAL STATUS OF PATIENTS WITH COVID-19

Abstract. Relevance. Most patients complain of a worsening of the oral cavity after a coronavirus infection. However, the state of the patient's dental status plays a special role in the dynamics of clinical symptoms in the oral cavity, since it is one of the criteria influencing the choice of treatment tactics by a dentist. Assessing the dental status of patients who have recovered from COVID-19 is an urgent task for clinicians. Purpose. To assess the dental status of patients undergoing COVID-19. Materials and methods. A dental examination was carried out on 48 patients aged 34 to 69 years with various diseases of the oral mucosa. The patients had a history of coronavirus infection from 2 to 6 months ago. When examining patients, clinical and laboratory methods were used. Results. Most of the patients experienced disturbances in terms of psycho-emotional status. On the mucous membrane of the lips, gums, cheeks, soft palate, pharynx and tongue, various manifestations were revealed: multiple aphthae, erosion, ulcers, plaque and plaques. The absence of oral cavity sanitation was noted - in 100% of cases. Conclusion. Correction of the dental status should be included in the treatment algorithm as a top priority to improve the efficiency of medical care for patients who have had coronavirus infection.

The acute odontogenic infection in maritime medicine: clinical and radiological parallels

Relevance. The main thing in the prevention of acute odontogenic infection in sailors during long voyages is the full implementation of the pre-voyage sanitation of the oral cavity, which provides for the elimination of chronic foci of odontogenic infection.The aimof the study was to identify chronic foci of odontogenic infection in sailors after the completion of their prevoyage sanitation of the oral cavity and before going sailing.Material and methods. Dental and X-ray (orthopantomography) examination of 169 men aged 22 to 52 years after completion of dental treatment (oral cavity sanitation) before a long sea voyage was carried out, followed by analysis of clinical and radiological parallels to identify chronic odontogenic foci of infection, which can be a potential source of microorganisms for the development of acute odontogenic infection during swimming.Results and discussion.It was found that, despite the ongoing treatment and prophylactic work on the rehabilitation of the oral cavity with the sailors in the pre-voyage period, in 30.4-77.2% of cases they retain chronic foci of odontogenic infection during a long sea voyage, which can become the cause of the development of acute odontogenic infection. For the qualitative detection of chronic odontogenic foci of infection, it is necessary to supplement the dental examination of sailors in the pre-voyage period with an X-ray examination, which will allow timely identification and elimination of chronic odontogenic inflammation of the maxillary sinuses, as well as chronic periapical and periodontal foci of odontogenic infection.

THE PREVALENCE OF SECONDARY DENTO-MAXILLAIRE DEFORMITIES ASSOCIATED WITH UNCOMPENSATED DENTITION DEFECTS IN CHILD POPULATION

The aim is to determine the prevalence of dentition defects and secondary dento-maxillaire deformities in different periods of formation of the dento-maxillary system among the child population of Kyiv and the need for their therapeutic and prophylactic prosthetics, assess the level of prosthodontics care provided to them.
 Materials and methods. To determine the prevalence of dento-maxillary anomalies, dentition defects, and secondary dento-maxillary deformities, we examined 2276 children and adolescents aged 4 to 17 years in educational institutions in Kyiv for the 2017-2018 period.
 Results of the research. The prevalence of dento-maxillary anomalies among child population is 65.2%. Angle class I holds first place with 45,8% (among the anomalies of individual teeth), Angle class II comes second with 15,2%, the third place is occupied by Angle class III with 4,2%.
 Secondary dento-maxillary deformities caused by the early loss of both permanent and especially temporary teeth have become more common among the child population. The main reason for their occurrence is timely uncompensated dentition defects, which was confirmed by mass examinations of children aged 4 to 17 years in schools and kindergartens.
 Dentition defects of various sizes and localization were observed in 359 out of 2276 children, which is 15.8% of the total number of those examined. Tooth loss is most often caused by caries, its complications, and trauma, a little less often – by retention and anodontia.
 Secondary dento-maxillary deformities (dento-maxillary lengthening of teeth that have lost their antagonists; the inclination of the teeth towards the defect with displacement) were found in 278 children, which amounted to 12.2% of the total number of examined children, and 77.4% of the detected dentition defects (359 children).
 The obtained data indicate deterioration in the organization and implementation of oral cavity sanitation among the child population, which requires immediate measures to implement programs aimed at early identification and prevention of severe morphological and functional disorders of the dentition.
 Conclusions. The results of the obtained findings show a high prevalence of dento-maxillary anomalies among the child population – 65.2% (1484 people), and only 34.8% (792 people) had no orthodontic pathology.
 Dentition defects were diagnosed in 359 people, which is 15.8% of the total number of the examined children. Secondary dento-maxillary deformities were diagnosed in 278 people of the total number of the examined children (2276 people), that is 12.2% of the total number of the diagnosed dentition defects (359 cases) – 77.4%. Most often, secondary deformities occur between 6 and 11 years of age, that is, in the mixed dentition period of occlusion.
 The main reason for their occurrence was the inefficient prosthesis of dentition defects or its absence. Dentition defects are caused by premature removal of temporary teeth due to complications of caries, trauma, retention, and congenital absence of teeth.

Diseases of the musculoskeletal complex of the temporomandibular joint: the frequency of occurrence, clinical features, etiopathogenic factors

BACKGROUND: The frequency of diseases of the temporomandibular joint (TMJ) is quite high, which requires the development of special arthrological care in various regions of Russia with the involvement of specialists in various fields.
 AIM: Study the occurrence of diseases of the musculoskeletal complex among patients of dental admission who applied for oral cavity sanitation without acute pain, and to determine the significance of various etiological factors.
 MATERIAL AND METHODS: It was examined by interviewing and dental examination of 100 patients of therapeutic reception aged from 20 to 60 years old. Based on dental complaints, three conditional groups were formed from the number of examined patients. The 1st group included 47 patients who had no complaints of discomfort and pain in the temporomandibular joint dysfunction area. The second group included 24 patients who complained of clicks in the temporomandibular joint dysfunction, sometimes difficulties and restrictions when opening the mouth. The third group consisted of 29 people who complained of pain in the TMJ, tinnitus, a sense of tension and pain in the muscles of the maxillofacial region.
 RESULTS: The study showed that the number of people with signs of temporomandibular joint dysfunction diseases among dental patients is 53.0%. Moreover, the number of people with temporomandibular joint dysfunction pathology was statistically the same among the examined people of different ages. In individuals with signs of temporomandibular joint dysfunction diseases (2nd and 3d groups) and without them (first group), there were no differences in the number of individuals with occlusion disorders (abnormal bite, disocclusion, supercontacts, loss of occlusal contacts or restored by restoration with filling materials), however, in groups with signs of temporomandibular joint dysfunction diseases, a statistically significantly higher number of patients with musculoskeletal disorders was found, while every second of the examined patients experienced emotional tension and stress.
 CONCLUSION: Due to the fact that patients with intra-articular disorders and pain syndrome of TMJ dysfunction are significantly more often identified diseases of the musculoskeletal system, the treatment of this category of patients requires consultation, and, if its necessary, treatment by an osteopath.

ОСОБЕННОСТИ СТОМАТОЛОГИЧЕСКОГО СТАТУСА БОЛЬНЫХ ХРОНИЧЕСКИМ МИЕЛОИДНЫМ ЛЕЙКОЗОМ

Subject. At the present stage of society development cancer incidence remains among the most pressing medical and social problems. In the structure of oncopathology a special place is occupied by malignant neoplasms of lymphoid and hematopoietic tissues which include chronic myeloid leukemia (CML). In some patients, the disease can appear with dental symptoms associated with a decrease in local immunity of the oral cavity — the appearance of aphthae, plaque on the oral mucosa, angular cheilosis, bleeding gums, dry mouth. It is diagnostically significant that such oral symptoms may precede general clinical symptoms, that is, they can be considered as early symptoms of CML. In addition, their severity often prompts a patient with CML to see a dentist. Thus, the importance of the professional knowledge of the dentist in general clinical and dental symptomatology of CML, the correct routing of the patient for further clinical and laboratory examination, treatment and observation by a hematologist is undeniably high.
 The goal is to study and identify the features of the dental status of patients with chronic myeloid leukemia.
 Methodology. The work carried out a comprehensive assessment of the state of the oral cavity and the need for dental treatment of patients with chronic myeloid leukemia in which patients with preserved systemic status and patients with chronic myeloid leukemia took part.
 Results. According to the results of a complex dental examination and the calculation of the main dental indices, patients with CML were found to have serious disorders in the state of their oral health. 
 Conclusions. Patients with CML showed a high need for various types of dental care, primarily in conservative oral cavity sanitation, periodontal treatment and rationalization of oral hygiene protocols (professional and individual).

Comparative analysis of oral cavity sanation in children under general anesthesia and inhalation anesthesia with nitrogen oxide

The aim of this study was to carry out a comparative analysis of the volume of dental intervention under conditions of combined endotracheal anesthesia and inhalation anesthesia of nitrous oxide in pediatric dentistry.Materials and methods. Within the framework of this study, the results of oral cavity sanitation were analyzed in 300 patients aged 2 to 5 years. The median age was 3.7 years. The participants were divided into 2 equal samples: 150 patients underwent sanitation under general anesthesia (anesthesia group), 150 under conditions of inhalation anesthesia of nitrous oxide (sedation group). In the sedation group, there were 83 (55.3%) boys and 67 (44.7%) girls, in the anesthesia group – 89 participants (59.3%) were male, and 61 (40.7%) were female. The patients included in this study had comparable dental status. Also, when performing dental interventions in both groups, according to indications, local anesthesia was performed: children under 4 years old – lidocaine, children over 4 years old – articaine.Results. Based on the results of the analysis of the data obtained, it was found that the number of visits required for full-fledged dental treatment was statistically significantly lower in the anesthesia group compared to the sedation group: thus, all patients who underwent combined endotracheal anesthesia required only one visit to the clinic for necessary treatment. But it was also found that the total time of dental treatment differed depending on the anesthetic aid used: in the anesthesia group, it usually took from 1 to 2 hours (in 98% of patients), during this time a complete sanitation of the oral cavity was carried out, and in the sedation group varied more widely, with half of the patients in the range from 30 minutes to 1 hour (14% and 36.7% of children, respectively), but the number of visits for complete oral cavity sanitation increased to 8.Conclusions. In the present work, it was revealed that dental treatment under general anesthesia in children was more effective than the same treatment under conditions of inhalation anesthesia of nitrous oxide with preserved consciousness. The use of combined endotracheal anesthesia allows to reduce the number of visits to the clinic and avoid refusals from further dental treatment. General anesthesia was also more effective than sedation in terms of the number of cured teeth with caries, chronic pulpitis and extracted teeth. Nitrous oxide inhalation anesthesia provides partial retention of consciousness, is more manageable and better tolerated by children.

Improving the effectiveness of secondary prevention caries in women during pregnancy

Aim. To evaluate the clinical efficacy of long-acting remineralizing medical means in the complex prevention of caries in pregnant women.Materials and methods. The study was conducted on the basis of the Department of Therapeutic Dentistry of the Kuban State Medical University of the Ministry of Health of Russia. A total of 87 people were examined, aged 24 to 37 years, with different levels of oral hygiene 84 patients confirmed their consent to the treatment and prophylactic measures, after which three working groups were formed depending on the long-acting remineralizing agents used “Clinpro-XTVarnish” manufactured by 3MESPE, “Schmelz-versiegelungsliquid” manufactured by HUMANCHEME, “InnoDent Repair” manufactured by InnoDent LLP respectively) and 1 control group. The assessment of the dental status of pregnant women was carried out using indices: CFE, Fedorov-Volodkina oral hygiene index (HI), gingivitis index GI (Loe H., Silness J.).Results. According to the data of a clinical study, it was determined that a high quality oral cavity sanitation with concomitant use of long-acting therapeutic and prophylactic agents increases the effectiveness of preventive measures in pregnant women.Conclusions. The data obtained indicate the achievement of a long-term preventive result, which makes it possible to recommend the investigated fluorine-containing agents for remineralization of hard dental tissues in order to control the state of the oral cavity of women during pregnancy.

Changes in dental status and peripheral blood countsof children whose temporary molars were restored using stainless steel crowns during oral cavity sanitation

Relevance. Problem of children health maintenance becomes more important nowadays. According to results of scientific researches of the last decade oral health influences general health state, therefore condition of the dentofacial system can be considered as indicator of general health.Purpose. To evaluate the effectiveness of the use of standard steel crowns for the children's oral cavity sanitation based on an analysis of the teeth condition and peripheral blood counts.Materials and methods. 77 children 4-9 years old, whose temporary molars during oral cavity sanitation after treatment of chronic pulpitis by vital pulp amputation were restored using either filling materials or stainless steel crowns were examined. Dental state was analyzed by evaluation of caries rate, caries rate’s increment and reduction of caries rate’s increment. In order to evaluate general performance status of children in research groups general blood test and immunogram were taken twice (before sanation and a year after) to estimate total concentration and percentage of different types of leucocytes, T-helpers and T-suppressors.Results. Children 4-9 years old, whose temporary molars during oral treatment were restored using stainless steel crowns demonstrate significant improvement of dental state by 54% reduction of caries rates increment. Children 4-9 years whose temporary molars were restored using stainless steel crowns had statistically significant decline of leucocytes amount (from 9,62 K/mcL to 7,35 K/mcL) and tendency to cell immunity stabilization, which definitely testify improvement of general status.Conclusions. The study shows improvement of dental state and some characteristics of peripheral blood of 4-9 year old children whose temporary molars were restored using Stainless Steel Crowns.

CEREBRAL OXIMETRY AS A NEUROMONITORING TECHNIQUE DURING ORAL SANATION IN CHILDREN UNDER GENERAL ANESTHESIA ON AN OUTPATIENT BASIS

The article presents the results of assessing cerebral metabolism in children during oral cavity sanitation under conditions of general anaesthesia on an outpatient basis. The procedure was performed by using a non-invasive technique of neuromonitoring, cerebral oximetry, aimed at detecting changes in the cerebral oxygen supply. The method of cerebral oximetry enables to diagnose reduced oxygen saturation of cerebral tissues in early stage that significantly cuts down the risk of pathological organic changes in the brain and, as a consequence, decreases the risk of functional postoperative changes. It is noteworthy that rSO2 is within the upper normal limit (74.41% ± 2.08). This is explained by the peculiarities of the circulatory system in children and vascular walls in particular (developed capillary network, elasticity, and vascular permeability), as well as by the characteristics of the structure of the brain and increased oxygen consumption by cerebral neurons, which are in the stage of active development. It is important to stress that this figure is within the upper normal limit due to ↓rSO2 by 9.4% at the preoperative stage that can be explained by the high stressing, which in most cases is associated with "cryptogenic" phobias. This is a reasonable premise for administering anxiolytics prior dental intervention under general anaesthesia in an outpatient setting to avoid sharp fluctuations in cerebral oxygen saturation. The specific weight of ↓rSO2 in the preoperative stage in group of children is ↓ rSO2 (67.21%) in 24 (17.4%) children (7.18% relative to the total indicator of the identical group and 9.67% relative to the general group), who were at the renewal treated due to acute conditions (acute pulpitis, exacerbation of chronic periodontitis, periostitis). The period between dental interventions in these children did not exceed 2 weeks. This fact causes the necessity to limit the period of recurrent dental interventions to not less than two weeks. According to the results of the study, it has been found out that dental care under general anaesthesia on an outpatient basis while maintaining spontaneous breathing has time limits. It is advisable to perform general anaesthesia for 30 ± 10 minutes in children aged 0-3 years, for 40 ± 15 min. in children aged 3-12 years, and 60 ± 15 min. in children aged 12-18 years. The choice of dental treatment modes should be based on the time and possibility of a second visit. The term of planned dental surgery under general anaesthesia in an outpatient setting while maintaining spontaneous breathing after acute respiratory diseases requires at least two week period. In order to prevent the risk of complications during the oral sanitation at an outpatient setting under general anaesthesia, a period of scheduled dental recurrent interventions should be preformed not earlier than in two weeks.

Choice of dental treatment in adolescent children based on the results of monitoring brain oxygen saturation – cerebral oximetry

To solve the problem of choosing the method of oral cavity sanitation, it is necessary to determine a safe period of time for performing dental procedures of varying severity and the number of visits. This will provide the opportunity to formulate clear indications for oral sanitation in conditions of general anesthesia in order to minimize the risk of cognitive dysfunctions against the background of hypoxic damage to the brain. The purpose of the study: to establish a safe period of time for various dental procedures in school-aged children on an outpatient dental appointment based on an objective method for assessing brain oxygen saturation – cerebral oximetry; determine the indications for the rehabilitation of the oral cavity under general anesthesia. Dental examination and dental procedures of varying severity were performed for 102 children under the age 12-18 years (424 teeth were treated) at the Dental Medical Center at the Bogomolets National medical University. In order to determine the oxygen saturation of the brain, the cerebral oximetry method was used. To predict cognitive changes against the background of organic brain disorders, we used the results of J. Meixensberger et al. (1998), where the main task of the dentist was considered to prevent a decrease in cerebral oximetry by more than 20%. Statistical processing of the results was performed using Microsoft Office Excel. It is established that the timing of the manipulations associated with preventive measures does not depend on the type of phobias. In children with a “light” temperament, it is 34'-35', with a “complex” temperament and temperament it is “warm up for a long time” – 30'. In children with an “easy” temperament, the safe period of time for conducting manipulations that are associated with the treatment of caries and its complications, regardless of the type of phobia, is 42'. In children with a temperament “a long time warms up”, a safe period of time for carrying out manipulations that are associated with the treatment of caries and its complications, regardless of the type of phobia, is 37'. In children with a “complicated” temperament, a safe period of time for conducting manipulations that are associated with the treatment of caries and its complications in the presence of “elementary” phobias is 35', in the presence of “cryptogenic” phobias – 30'. Indications for rehabilitation of the oral cavity in conditions of general anesthesia at average caries is – children with a “light” temperament, regardless of the type of phobia with a DMF ≥8; children with a “complicated” temperament and “elementary” phobias with a DMF ≥2; “cryptogenic” phobias with DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥2; for deep caries – children with a “light” temperament, regardless of the type of phobia with a DMF ≥4; children with a “complicated” temperament and “elementary” phobias with a DMF ≥2; “cryptogenic” phobias with DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥1; for chronic fibrous pulpitis – children with a “light” temperament, regardless of the type of phobia with a DMF ≥6; children with a “complicated” temperament, regardless of the type of phobia with a DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥2; at chronic periodontitis – children with a “light” temperament, regardless of the type of phobia with a DMF ≥6; children with a “complicated” temperament and “elementary” phobias with a DMF≥2; “Cryptogenic” phobias with DMF ≥1; children with a temperament “warm up for a long time” regardless of the type of phobia with a DMF ≥1. Thus, the treatment of teeth in the conditions of general anesthesia in children aged 12-18 years provides more radical methods of treatment with the obligatory follow-up consultation of the orthodontist in order to preserve the chewing, articulatory functions and to ensure the full development of the dental apparatus.

Xenon anesthesia during the oral cavity sanitation in child with consequences of perinatal brain damage

Halogenated inhalation anesthetics have some adverse effects, including the ability to have a negative effect on the developing brain in children, one of the manifestations of which are cognitive dysfunctions, especially in the younger age group. The article presents a clinical case of xenon in combined inhalation anesthesia in a child with the consequences of perinatal brain damage. During anesthesia, a spontaneous ventilation mode was applied with pressure support ventilation (PSV). There was noted high efficacy and safety xenon anesthesia in a dental treatment, the absence of the effect of anesthesia on cognitive function in a child with a compromised nervous system. It is advisable to further study the use of xenon in the pediatric dentistry anesthesia.

Перспективність надання гігієністом зубним профілактичної стоматологічної допомоги населенню м. Житомира

Preventive medicine is the basis for the development of health care systems in the European Union, and investment in prevention is recognized as the most effective investment in the industry of preserving and improving health. Prophylactic direction – one of the most important in modern dentistry.The aim of the study – analysis of treatment and prevention performance indicators of Municipal Institution Zhytomyr City Dental Hospital No.1 and defi nition of methods for improving the primary prevention.Materials and Methods. We analyzed the annual reports of internal medicine and surgical departments of Zhytomyr City Dental Hospital No. 1 for the period from 2015 till 2016; we held a poll of 115 patients of the establishment regarding the methods for teeth cleaning and using the accessories and means necessary for oral cavity care. The following methods were used: bibliosemantic, system analysis and logical concluding,interview, and mathematical processing of the collected data. Results and Discussion. Numeric materials refl ecting the work of Zhytomyr City Dental Hospital No.1 indicate that doctors employed in the establishment conduct numerous maneuvers related to oral cavity sanitation using modern fi lling materials and diagnostic methods. However (and predominantly), all the work is directed at secondary prevention. As a result, annually a lot of teeth are removed due to complex caries (23.370–23.898), and there are a lot of patients with signs of periodontal diseases (3.521–3.766). Dispensary for diseases includes 94 patients with pre-tumor pathology. Considering that public hygienic teaching and education is one of the main components of primary treatment, we held a poll involving 115 patients of Zhytomyr City Dental Hospital No. 1. Study results indicate that the patients of the dental care entity have insuffi cient knowledge on using the accessories and means necessary for hygienic procedures. All the respondents are more ready to invest into prevention care than internal medicine and surgical dental treatment. It is possible to reach an upward trend in dental health indicators only with primary caries and periodontal diseases prevention. Adding hygienist in the staffi ng list of dental care entities would allow not only for comprehensive primary prevention, but would also unload the high-class dentists enabling them to conduct more complex oral cavity operations.Conclusions. Zhytomyr City Dental Hospital No. 1 employs no hygienists, that is why its work is aimed at secondary treatment of oral cavity diseases. Low sanitary culture level of Zhytomyr residents is tightly connected with dental health indicators. Further development and reforming of dental care demands training of the new generation of highly qualifi ed junior medical staff (hygienists). Involving of hygienists in treatment care allows improving the quality of preventive dental services and decreasing dental diseases incidence rate.