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RETROSPECTIVE ANALYSIS OF THE STATE OF DIRECT DENTAL RESTORATIONS AFTER ENDODONTIC TREATMENT
Get PDFEndodontic treatment is accompanied by the loss of a significant amount of tooth crowns, which leads to a significant decrease in their strength characteristics. The restoration of endodontically treated teeth, as a rule, is carried out by the direct method, however, a unified approach regarding direct or indirect restoration has not yet been determined.
The aim – retrospective analysis of the clinical condition of direct restorations of endodontically treated teeth.
Materials and methods. 284 patients aged 25 to 60 years were examined; they studied the state of 888 previously performed direct restorations of the anterior and posterior teeth after endodontic treatment in a period of 2 to 10 years. Restorations were evaluated according to the adapted clinical criteria “integrity of the restoration”, “marginal fit of the material”, “marginal staining”, “anatomical shape”, “colour correspondence for the restoration”, “roughness of the surface of the material”, as well as the criterion “condition of the contact point” for located on the contact surfaces of the teeth of the restorations.
Results. Of the 888 examined direct restorations, 760 restorations (85.6±1.18 %) were located in the posterior teeth, with 562 restorations in the molars (63.3±1.62 % of the total) and 198 in the premolars (22 , 3±1.40 %), and 128 restorations (14.4±1.18 %) were detected in the anterior teeth, while in the incisors - 80 restorations (9.0±0.96 %), in the fangs – 48 (3.5±0.76 %). 720 restorations (81.1±1.31 %) were made from photocomposite materials, 97 restorations (10.9±1.05 %) from chemical curing composites, 71 (8.0±0.91 %) from glass-ionomer cements . The most common violations were colour mismatch – in 511 restorations (57.5±1.66 %), marginal staining - in 470 restorations (52.9±1.68 %), surface roughness - in 357 restorations (40.2±1.0, 65 %). More often than others, in the reconstructions of their photocomposites and glass ionomers there was a colour mismatch, and surface roughness for chemical composites.
Conclusions. For direct tooth restoration after endodontic treatment in 81.1±1.31 % of cases, photocomposite materials are used, less often chemical curing composites and glass ionomers. Of the violations of such restorations, the most frequent are colour mismatch, surface roughness and edge staining
JUSTIFICATION OF SELECTION OF MEANS AND METHODS OF THE ORAL CAVITY HYGIENE IN CHILDREN WITH CYSTIC FIBROSIS
Get PDFCystic fibrosis (CF) promotes the development of gingivitis in children.
The high prevalence and early manifestation of gingivitis is due to a combination of many factors. The pathogenic mechanisms of cystic fibrosis lead to disruption of normal physiological processes in the oral cavity, in particular, to a decrease in the level of salivation, to an increase in the viscosity of saliva, to a suppression of local immunity. Therefore, poor oral hygiene contributes to oral diseases.
The aim of the study was to determine the level of oral hygiene in children with CF as one of the reasons for the development of gingivitis, and to select dental hygiene products that active towards factors that affect plaque.
Material and methods. A total of 24 children with CF in the Ukrainian population participated in the study. The hygienic index OHI-S (J. C. Green, J. R. Wermillion, 1964) was calculated. The data were analyzed using Student’s criterions. The analysis was performed with a confidence level of 95 %.
Results. The level of hygiene of the oral cavity was unsatisfactory among patients (OHI-S=2.19±0.11). Hygiene methods and dental hygiene products, to taking into account the manifestation of the pathogenesis of somatic disease, were selected. A follow-up study after 3 months revealed a significant positive trend in indicators of oral hygiene.
Conclusions. This study has shown the low level of oral hygiene in children with CF. Hygienic education and motivation of these patients could help them achieve a higher level of oral health knowledge and are important starting points for the treatment and prevention of gingivitis. There was a significant improvement of the oral hygiene level after training children and after the proper selection of hygiene products. The dentists should use means and methods that have not contraindicate in patients of this category. It is recommended to monitore the hygiene indices to establish the effectiveness of the measures and necessity for individually therapy correction
INTERRELATIONS BETWEEN GROWTH DIFFERENTIATION FACTOR 15, P-SELECTIN AND GALECTIN-3 AND CLINICAL COURSE IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS
Get PDFThe aim of our study was to determine the base levels of Growth Differentiation Factor 15, P-selectin and Galectin-3 in blood plasma in patients with AH and T2DM and to assess their association with the diseases clinical course.
Materials and methods. A total of 121 patients were included in our study (60 female and 61 male, mean age 64.7±10.6 years, with AH and/or T2DM).
Patients were divided into three groups: 1st group with AH only (51 patient), 2nd group with AH and T2DM (57 patients) and 3rd group with T2DM only (13 patients, control group). GDF-15, Galectin-3 and P-selectin tests were performed using standard enzyme-linked immunosorbent assay kits (ELISA).
Results. Compared with AH without T2DM and T2DM only groups, AH with T2DM group had a statistically significant higher level of GDF-15. Grade 3 hypertension group had a significantly lower level of GDF-15 compared with Grade 1&2 hypertension groups. P-selectin mean level was significantly higher in Grade 3 hypertension group GDF-15 compared with Grade 1&2 hypertension groups. We observed weak correlation between Galectin-3 and GDF-15 in blood plasma, which was confirmed by linear regression analysis.
Conclusions. A combination of hypertension and type 2 diabetes mellitus revealed a significant increase of GDF-15 levels in compare with patients with only hypertension or type 2 diabetes mellitus, which may be due to a greater response to oxidative stress and low-intensity systemic inflammation.
P-selectin mean level was higher in patients with grade 3 hypertension, which reflects a greater platelet activation as a part of the systemic inflammatory response.
Galectin-3 mean level was higher in patients with stage 3 hypertension compared with patients with stages 1 and 2 due to possibly more pronounced fibrosis progression
COMPARATIVE ASPECTS OF PLACENTAL DYSFUNCTION IN WOMEN USING DIFFERENT METHODS OF CONTRACEPTION IN ANAMNESIS
Get PDFThe aim. To reduce the incidence of perinatal pathology in women who have used various methods of contraception, based on the study of the functional state of the fetoplacental complex (FPS), as well as improving diagnostic measures and tactics of pregnancy.
Materials and methods. 140 pregnant women were studied with their division into control and 3 test groups depending on the method of contraception in the anamnesis, using clinical, laboratory and instrumental research methods during pregnancy and childbirth.
Results. The study found that women with a history of intrauterine contraception (IUC), in contrast to combined oral contraception (COC) and combined oral contraception containing folate (COC+F), had a higher incidence of complications during pregnancy and childbirth, as well as fewer newborns with a satisfactory condition at birth. Assessment of folic acid levels at 6-8 weeks of gestation showed significantly better results among women with a history of COC+F, compared with IUC and COC. In the group of women with IUC in the anamnesis, significantly worse mean endocrinological values prevailed, and there was also a greater number of pregnant women with disorders of fetal-placental blood flow. More pronounced dystrophic changes in the placentas of women in this group were pathomorphologically confirmed.
Conclusions. The presence in the anamnesis of IUC is accompanied by a high proportion of pregnant women with various pathological conditions and is a risk factor for FPS dysfunction. The use of COC+F in the anamnesis is the best option for women of different risk groups
RESISTANCE OF S. AUREUS ATCC 25923, E. COLI 055K59 NO. 3912/41 AND P. AERUGINOSA 27/99 TO THE WASH-DISINFECTANT «MILKODEZ»
Get PDFThe aim of the work – the article presents the results of determining of the resistance of S. aureus ATCC 25923, E. coli 055K59 No. 3912/4 and P. aeruginosa 27/99 test cultures in planktonic form and in biofilm to our developed «Milkodez» acid detergent.
Materials and methods. Microbial biofilms were grown on MPB in 5 cm disposable plastic Petri dishes. To determine the effect of disinfectants on microbial biofilms, 3 Petri dishes with biofilms of each of the test cultures were used. One of the Petri dishes served as control and she had for 15 minutes made 5 cm3 of saline NaCl solution, in the second – 5 cm3 of hot water (t=70±5 °C), and in the third – 5 cm3 of acidic detergent «Milkodez». Microbial biofilms were fixed for 10 min. 96º with ethyl alcohol for 10 min. were stained with a 0.1 % solution of crystalline violet, and the remnants of the unabsorbed paint were removed with phosphate buffer. The biofilm dye was extracted with 96º of ethyl alcohol, which was photocolometrically investigated at 570 nm to establish the density of the formed biofilms. The density of the formed microbial biofilms was considered low in optical density of the extract up to 0.5 units, average – from 0.5 to 1.0 units; and high – over 1.0 units
The resistance of planktonic forms of test cultures of microorganisms to disinfectants was determined in sterile tubes, which made 10 cm3 (t=70±5 °C) of 0.5 % of their working solutions and 0.1 cm3 (1 billion microbial bodies) of the standard test – cultures. The culture was maintained for 15 min. and made ten – fold plantings on IPA in Petri dishes.
Incubation of mesophilic microorganisms was carried out in a thermostat at a temperature of 30 °C, and psychrophilic – 20 °C. After 48 hours the calculation of the growing colonies were carried out. The results were expressed in colony forming units (CFU).
Results. Due to the impact on microbial biofilms formed by the test cultures of S. aureus ATCC 25923, E. coli 055K59 No. 3912/41 and P. aeruginosa 27/99 for 15 min. 0.5 % solution of acid detergent «Milkodez» the optical density of the solutions was respectively 0.64, 0.72, 0.45 units. The results obtained indicate that the melkodez caused a decrease in the biofilm–forming ability of S. aureus ATCC 25923 3.2 times, in E. coli 055K59 No. 3912/41 – 1,7 times and in P. aeruginosa 27/99 – 2.8 times, compared to control. However, the density of one – day microbial biofilms formed by S. aureus ATCC 25923 and E. coli 055K59 No. 3912/41 was medium, and P. aeruginosa 27/99 was low. It has been proven that the «Milkodez» acid detergent developed is more effective than the prototype «Hypracid», since it caused the death of 100 % of planktonic test cultures and the number of S. aureus ATCC 25923, E. coli 055K59 No. 3912/41 and P. aeruginosa 27/99 formed in the biofilm that survived after its application was 2.7, 3.2 and 1.4 times lower, respectively.
Conclusions. It was found that the test cultures were able to form high – density biofilms, since the optical density of the extract in the control was in the range from 1.28 to 2.05 units, which is greater than 1.0 units. Acid wash detergent «Milkodez» for 15 minutes of exposure causes the formation of S. aureus ATCC 25923, E. coli 055K59 No. 3912/41 and P. aeruginosa 27/99 biofilms of low and medium density and reduces their biofilm capacity by 3.2, 1.7 and 2.8 times, respectively. Its use provides the death of 100 % of the planktonic forms of the test cultures under study and reduces their number in the biofilm by 2.7, 3.2 and 1,4 times more, respectively, compared to «Hypracid» detergent.The article presents the results of the study of the resistance of test cultures of S. aureus ATCC 25923, E. coli 055K59 No. 3912/4 and P. aeruginosa 27/99 in planktonic form and formed in biofilm to the developed acid detergent «Milkodez» and registered in Ukraine prototype detergent acidic «Hypracid». Microbial biofilms were grown on MPB in 5 cm disposable plastic Petri dishes. To determine the effect of disinfectants on microbial biofilms, 3 Petri dishes with biofilms of each of the test cultures were used. One of the Petri dishes served as control and she had for 15 minutes made 5 cm3 of saline NaCl solution, in the second – 5 cm3 of hot water (t = 70±5 °C), and in the third – 5 cm3 of acidic detergent «Milkodez». Microbial biofilms were fixed for 10 min. 96º with ethyl alcohol for 10 min. were stained with a 0,1 % solution of crystalline violet, and the remnants of the unabsorbed paint were removed with phosphate buffer. The biofilm dye was extracted with 96º of ethyl alcohol, which was photocolometrically investigated at 570 nm to establish the density of the formed biofilms. The density of the formed microbial biofilms was considered low in optical density of the extract up to 0,5 units, average – from 0,5 to 1,0 units. and high – over 1,0 units
The resistance of planktonic forms of test cultures of microorganisms to disinfectants was determined in sterile tubes, which made 10 cm3 (t = 70±5 °C) of 0,5 % of their working solutions and 0,1 cm3 (1 billion microbial bodies) of the standard test – cultures. The culture was maintained for 15 min. and made ten – fold plantings on IPA in Petri dishes.
Incubation of mesophilic microorganisms was carried out in a thermostat at a temperature of30 °C, and psychrophilic –20 °C. After 48 hours the calculation of the growing colonies were carried out. The results were expressed in colony forming units (CFU).
It was found that the test cultures were able to form high – density biofilms, since the optical density of the extract in the control was in the range from 1,28 to 2,05 units, which is greater than 1,0 units. Acid wash detergent «Milkodez» for 15 minutes of exposure causes the formation of S. aureus ATCC 25923, E. coli 055K59 No. 3912/41 and P. aeruginosa 27/99 biofilms of low and medium density and reduces their biofilm capacity by 3,2, 1,7 and 2,8 times, respectively. Its use provides the death of 100 % of the planktonic forms of the test cultures under study and reduces their number in the biofilm by 2,7, 3,2 and 1,4 times more, respectively, compared to «Hypracid» detergent
CLINICAL EVALUATION OF DIRECT PHOTOCOMPOSITIONAL DENTAL RESTORATION IN DIFFERENT CONDITIONS OF LIGHT POLYMERIZATION OF ADHESIVE SYSTEM
Get PDFPhotocomposite materials and adhesive systems are used for direct tooth restoration, among which 5th generation systems are most often used. To ensure curing, they are exposed to the light flux of the dental photopolymerizer, but the requirements and conditions of such exposure are insufficiently studied.
The aim – clinical evaluation of direct photocomposite restorations of teeth performed using an adhesive system, the curing of which was carried out in different light conditions.
Materials and methods. 185 people aged from 19 to 44 years were examined, in which 185 lateral teeth with carious cavities of the 1st class according to Black for medium and deep caries were restored by direct method from nanophotocomposite material. In patients of group 1 during the restoration of 62 teeth the polymerization of the adhesive system of the 5th generation was performed with a light flux of constant intensity 1500 mW/cm², in patients of group 2 were restored 60 teeth with polymerization of the same adhesive system with light flux by "soft start" with a final intensity of 1500 mW/cm², 63 teeth in persons of group 3 were restored with a gradual light effect of 1500 mW/cm² on the adhesive system at the bottom and each of the cavity walls using an additional device. The state of recovery was examined after 12 and 24 months.
Results. Within 12 months, the largest total number of disorders according to the clinical criteria "marginal adhesion", "marginal staining", "postoperative sensitivity" and "secondary caries" was found in patients of agroups 1 and 2, violations were found in 10 and 13 restorations, respectively (16.1±4.9 % and 21.7±5.8 % of the number of restorations in each group). In persons of group 3, disorders were identified in 3 restored teeth (4.8±2.6 %), which is statistically significant (p<0.05) better. After 24 months, statistically significant (p<0.05) the best indicators were again in patients of group 3, violations were found only in 4 restorations (6.7±3.2 % of them in this period). The worst was the state of recovery in persons of group 2, they had disorders in 20 restorations (42.6±10.4 %), in patients of group 1 – in 16 restorations (30.8±8.0 %).
Conclusions. Direct restoration of teeth from nanophotocomposite material, performed using the 5th generation adhesive system under the condition of its gradual polymerization at the bottom and each of the walls of the carious cavity of сlass 1 according to Black, showed high clinical efficiency, which in 12 and 24 months amounted to, respectively, 93.7±3.4 % and 88.9±3.5 %
FEATURES OF SURGICAL ACCESS DURING VIDEOTHORACOSCOPY OPERATIONS IN THE WOUNDED WITH CHEST TRAUMA
Get PDFThe aim. To improve the treatment of wounded with combat chest injury by optimizing low-traumatic surgical access using video thoracoscopy.
Materials and methods. In the period from 2014 to 2019, 103 injured were treated with video-assisted thoracoscopic surgical interventions in case of chest trauma. According to the objectives of the study, two clinical groups of victims were formed. The comparison group included 54 (52.4 %) victims, the main group – 49 (47.6 %). The wounded accounted for 72 persons (69.9 %), injured – 31 (30.1 %). In case of wounds to the chest, the selection of victims for VTS surgical interventions and the timing of their implementation was carried out taking into account the location, type of injury and trauma, the severity of the condition of the patients, the presence of a combined wound, the possibility of two or one-lung ventilation during the intervention, the timing of admission to a medical institution with the moment of injury, the technical capabilities of military-technical operations. In staging trocars during combat chest injury, we adhere to the general rules for video-assisted thoracoscopic interventions on the chest – the rules of the “triangle”. When a chest injury is involved, the port setting has its variability, which is based on the type of injury and the purpose of the surgical intervention. You can use both standard points of installation of thoracoports, and non-standard individual ones that will correspond to the set clinical goals.
Research results and discussion. High efficiency in visualization of the operating area and the technical convenience of surgical techniques have been established. This allows a rational and consistent audit of the anatomical zone of the wound. With a chest injury, the most rational sequence for conducting a pleural cavity audit is on the principle of paramount importance.
Conclusions. Features of online access – port setting for injuries to the chest depends on the area of the inlet of the gunshot. When setting ports, it is not necessary to adhere to standard points, the introduction of a thoracoport is possible at any point on the chest wall, but with the obligatory observance of the triangulation rule. The number of input ports for combat trauma to the chest depends on the technical need for a full operation. In the vast majority of military-technical operations, 3 thoracoports are enough
PHENOTYPICAL CHARACTERISTICS OF THE BIOLOGICAL PROPERTIES OF STAPHYLOCOCCI WITHDRAWN FROM PATIENTS WITH ALLERGIC DERMATITIS
Get PDFAtopic dermatitis, eczema, allergic dermatitis occupy the main place among dermatoses, where the allergic component is leading in the onset and development of the disease. The most common complication of allergic dermatitis is the attachment of a secondary pyococcus infection, which is associated with a decrease in the antimicrobial resistance of the skin surface. Therapy of infectious lesions is complicated by the increasing resistance of the main pathogens of pyoderma - Staphylococcus aureus and Staphylococcus epidermidis - to widely used antibiotics.
The aim of the research: to determine the phenotypic features of staphylococci extracted from patients with allergic dermatitis to assess their pathogenic potential.
Materials and methods. The object of the study was 369 staphylococcus isolates removed from affected and intact skin sections of patients with allergic dermatitis, as well as from representative skin sections of healthy individuals undergoing inpatient treatment at the Department of Dermatology of “Institute of Dermatology and Venereology of NAMS of Ukraine”. Biochemical identification and biological properties of staphylococci were determined using methods of classical bacteriology.
Results. As a result of the conducted researches, it is established that the complex of phenotypic traits of the removed staphylococcus cultures indicates the presence in the pathogen of factors related to the resistance of the host protection mechanisms and determines the intensity of the alterative action of the infectant in relation to the host organism, the phenotypic manifestation of the studied factors was higher in the staphylococcus isolates removed from the affected skin areas of patients with allergic dermatitis.
Conclusions. The level and frequency of phenotypic expression of pathogenicity factors are more pronounced in microorganisms obtained from patients from affected and intact areas compared to controls, which confirms their pathogenetic role in the burden of the disease, which in turn can be used as an auxiliary differential diagnosis criterion
SELECTION OF FLAVOUR ADDITIVES AND METHOD OF THEIR INTRODUCTION IN THE COMPOSITION OF COMPRESSED MEDICATED CHEWING GUMS
Get PDFAn important characteristic of oral medicines, which include medicated chewing gums, is their pleasant taste. This can be achieved by adding taste coregents to their composition.
The aim: to choose rational flavour additives and justify the method of their introduction to the compressed medicated chewing gums that are being developed.
Materials and methods: mint (Natural Mint Flavor SD, Kerry Inc., Malaysia), apple (Nat Apple FlavorWonf, Kerry Inc., Malaysia) and banana (Banana FLV, Kerry Inc., Malaysia) have been used as powdered flavour additives. As flavourings – oil solutions: Peppermint Natural WonfFlavor, Kerry Inc., Malaysia), Apple (Nat Apple FlavorWonf, Kerry Inc., Malaysia), Strawberry (Strawberry FlavorWonf, Kerry Inc., Malaysia), Melon (Chemical-Food Aromatic PlantLLC, Russian Federation) and Lemon (Chemical-Food Aromatic Plant LLC, Russian Federation). Aerosil brand 380 (Evonik Resource Efficiency GmbH, Germany), Syloid® 244FP (Grace Discovery Sciences, USA) and Neusilin® ULP 2 (Fuji Chemical Industry Co. Ltd, Japan) have been taken as carriers. The choice of flavour additives and flavourings was made using organoleptic methods of coregents evaluation according to A. I. Tentsova and I. A.Yegorov. The technological and physicochemical properties of the samples were studied according to conventional methods of the State Pharmacopoeia of Ukraine.
Results and discussion. In determining the taste of medicated chewing gums samples with different coregents, the combination of powder additive and liquid flavouring "Apple" has got the highest mark. In order to substantiate the rational method of liquid flavouring introduction in the composition of the compressed chewing gums, it is proposed to introduce the adsorbents Aerosil 380, Syloid® 244FP and Neusilin® ULP 2, which also play the role of moisture regulators and glidants. Microscopic analysis of adsorbents mixtures with flavouring, as well as physicochemical and technological investigations of the mass for pressing have revealed that the best adsorbing, moisture-regulating and flow properties has Syloid® 244FP.
Conclusions. As a coregent in medicated chewing gums was selected a combination of powdered (2.0 %) and liquid (0.6 %) flavours “Apple”. The method of introducing the oil flavouring into the composition of the compressed gums has been chosen – by spraying on the adsorbent with subsequent mixing. Based on the studies, Syloid®244FP at a concentration of 1.0 % was chosen as the rational carrier
CARDIORESPIRATORY SYSTEM AND ANTIHYPOXIC RESISTANCE STATE IN ELDER CORONARY HEART DISEASE PATIENTS
Get PDFThe aim of the study. Evaluation of cardiorespiratory system and microcirculation state in elder CHD patients with different resistance against hypoxia.
Methods. The author has carried out a retrospective analysis of 103 CHD 60+-patients, their deaths have occurred due to cardiovascular events. Two patient groups have been formed including patients (68 persons) having kept their resistance to hypoxia (their blood SO2 level was never below 80 %) and patients (35 ones) with decreased resistance to hypoxia, their blood SO2 level having been dropped below 80 %.
Results: The life span of patients with decreased hypoxia resistance is lower comparing to ones having kept such resistance. The patients with decreased hypoxia resistance demonstrate decreased ejection fraction, increased mass of left ventricle myocardium as well as increased left ventricle volumes. Such patients show also significant increase of mean daily values of systolic, diastolic, and mean arterial pressure. Generally, the micro-circulation state in patients with decreased anti-hypoxic resistance is lower comparing to persons having kept this resistance. Simultaneously, the endothelial function of persons with decreased anti-hypoxic resistance is significantly worse. The pulmonary ventilation system patency and bronchial patency in these persons are also lowered comparing to these indices in patients with kept anti-hypoxic resistance.
Conclusions: The decrease of anti-hypoxic resistance leads to the shorter life span on elderly CHD patients. Such decreased resistance is accompanied by worsened potency of cardio-respiratory system, microcirculation, and endothelial system functioning