Infrared Spectroscopy to Analyze Sexual Dimorphism of Hard Dental Tissue Maturation at Eruption in Patients with Connective Tissue Dysplasia

The aim of this study was to research the biochemical changes in the hard tissues of the lower "wisdom" teeth, which are at the stage of eruption, with connective tissue dysplasia, depending on sex. The study involved 38 patients aged 17-25 years, who had the extraction of the lower third molars on the left and right for medical reasons. Twenty-one participants in the experiment (16 females, five males) were diagnosed with connective tissue dysplasia; the remaining 17 were healthy and made up the control group (11 females, six males). Samples of enamel, dentin, and enamel-dentin junction were dried to constant weight and examined in tablets pressed in a mixture with potassium bromide on an FT-801 Fourier transform infrared (FT-IR) spectrometer (NPF Simex, Russia) in the range of 500-4000 cm^-1. In the IR spectra of the enamel, enamel-dentin junction, and dentin, the absorbance ratio of amide I and II changed significantly and the absorbance of the absorption band of phosphate ions decreased from enamel to dentin. Differences between groups with and without connective tissue dysplasia increased in the following series: dentin, enamel-dentin junction, and enamel. With connective tissue dysplasia, a change in the ratio of the intensities of the absorption bands of amide I and phosphate ions was observed. Normally, the content of organic substances in the enamel of the teeth in the males group is lower than in the females group. Against the background of connective tissue dysplasia, the content of organic substances in the enamel in women decreased while in men it increased, which confirmed the presence of sexual dimorphism during the maturation of hard dental tissues at the eruption stage. The study confirms the opinion of many researchers about the significant role of collagen proteins, which, together with non-collagen proteins, are involved in the development and maturation of dental hard tissues, which are characterized by pronounced heterogeneity and sexual dimorphism in the group with connective tissue dysplasia.

[General ideas about the stages, classifications, pathological conditions during the lower third molars eruption in humans. Literature review. Part 2]

The article is a review of literature data on the stages, classifications, pathological conditions during the eruption of the lower third molars in humans. The authors analyzed the established knowledge about clinical and morphological changes at various stages of eruption of the lower third molars, studied new data describing the pathogenetic, histological and biochemical features of their development, packaging, movement to the occlusal plane. The literature review helped to identify a series of current trends that define a number of key hypotheses that summarize the accumulated material and indicate different opinions on the topic under study, which confirms the prospects and relevance of continuing research.

[General ideas about the stages, classifications, pathological conditions during the lower third molars eruption in humans. Literature review. Part 1]

The article is a review of literature data on the stages, classifications, pathological conditions during the eruption of the lower third molars in humans. The authors analyzed the established knowledge about clinical and morphological changes at various stages of eruption of the lower third molars, studied new data describing the pathogenetic, histological and biochemical features of their development, packaging, movement to the occlusal plane. The literature review helped to identify a series of current trends that define a number of key hypotheses that summarize the accumulated material and indicate different opinions on the topic under study, which confirms the prospects and relevance of continuing research.

[On the question of legal regulation of the organization and provision of medical stomatological care to elderly citizens]

The material of the article reflects the current state of the problem of organization and provision of medical dental care to elderly citizens. The content analysis of normative and legal sources regulating the provision of medical care to certain categories of senior citizens was carried out. The peculiarities of legal phenomena and imperfection of legislative acts are revealed which determine the further research work in this field of knowledge.

[Research of legal regulation of the voluntary medical insurance program the Russian Federation]

OBJECTIVE

The aim of the study was an analysis of changes in the legal institution of voluntary medical insurance program (and their possible consequences) in order to make proposals for the settlement of disputed issues.

MATERIAL AND METHODS

Using the content analysis method 19 sources of regulatory legal documentation on the legal phenomena of voluntary medical insurance were studied, of which 6 are federal laws and the Code, 3 are Government resolutions of the Russian Federation, 7 are regulatory legal acts of federal executive authorities, 3 are other regulatory documents. In order to search for the primary material, computer databases of the legal reference systems ConsultantPlus, Guarantor and Pravo.RU were used. The depth of the study was 32 years.

RESULTS

The considered legislative norms designed to establish legal, organizational, and economic principles in the field of voluntary health insurance, contain only general provisions without taking into account its specifics.

CONCLUSION

It is necessary to consolidate the accumulated experience and start regulating the sphere of voluntary medical insurance by the Government.

Prognostic significance of oral fluid fluoride measurement in acute pericoronitis

Oral fluid is a valuable substrate for assessing dental health and other aspects of physical status. New methods for early diagnosis and prognosis of dental diseases on the basis of oral fluid composition are in constant demand. Excessive fluoride concentrations, often oversighted by dental therapists, negatively affect organs and tissues of the oral cavity. This study aimed at development and approbation of a method for reliable measurement of fluoride ions in oral fluid by capillary electrophoresis to be used in patients with dental diseases. The fluoride ion concentrations were measured in health (2.16 ± 0.48 mg/L), in isolated acute pericoronitis (15.2 ± 2.7 mg/L) and in acute pericoronitis combined to multiple caries (18.9 ± 4.2 mg/L). By post-operative day 3, fluoride levels in the group with isolated acute pericoronitis dropped to normal values (2.28 ± 0.52 mg/L), whereas in the group with acute pericoronitis combined to multiple caries fluoride levels remained high (8.7 ± 1.9 mg/L; р < 0.0001). The developed protocol is efficient for studying fluoride ion concentrations in isolated and combined dental diseases.

[Analysis of medical records as an element of quality control and safety of medical activities]

OBJECTIVE

Studying the issue of quality control and safety of medical activities.

MATERIAL AND METHODS

The analysis of domestic literature on the quality of filling out medical documentation has been carried out.

RESULTS

A dental patient's medical record (ICSD) is not only the most important legal document, but also a certain indicator of the level of professional competence of a dentist. To find out all sorts of reasons that led to professional errors and adverse consequences after the provision of dental care, a thorough study and general analysis of medical documentation is of great importance, the maintenance and correct execution of which is also necessary for solving a number of other, including legal issues. The most common drawbacks in the design of a dental patient's medical record have been identified, which indicates a decrease in the quality of medical care provided to patients.

CONCLUSION

At the moment, there are still unresolved issues related to complete completion of medical documentation. When analyzing the literature, we did not find a purposeful study of the medical history of a dental patient during surgical treatment, which requires further research.

[The nature of metabolic processes in human dental hard tissues depending on their morphological structure]

THE STUDY OBJECTIVE

Was to give a comparative assessment of the movement of enamel and dentin fluid depending on the morphological structure of different sections of human dental hard tissues.

MATERIALS AND METHODS

The research involved 140 female subjects aged 21-30 years. Sizes, form, surface of enamel-dentin junction, enamel prisms and their crystals in superficial, middle and deep sections, width, tortuosity, facing of dentin tubules of tested teeth were analyzed by scanning electron microscope Jeol JCM-5700 and atomic force microscope NTEGRA Prima. The biochemical study examined the quantitative content of water in the samples of enamel, dentin, enamel-dentin junction by weighing sample weights before and after drying. The data obtained were processed by methods of variation statistics using standard packages Microsoft Excel 2008, Statistica 12.0.

RESULTS

The enamel-dentine junction of large-fastened type is characterized by zones of dentin integration into enamel at the distance of more than 10 mm, with regular arrangement of enamel prisms and wide dentine tubules of 3.55 to 4.70 μm in diameter; no water content reduction was found. The small-fastened type has less pronounced spots of dentin interference with enamel from 2 to 10 μm, the dentinal tubules are slightly curved with a diameter of 2.90 to 3.60 μm, the water content in dentin is reduced. In microfastened type, a linear structure with interpenetration zones up to 2 μm, enamel prisms slightly ordered, dentin tubules narrowed and curved in diameter from 1.30 to 1.95 μm, water content in enamel and dentin is reduced.

CONCLUSION

At microfastened type of enamel-dentin junction, chaotic arrangement of enamel prisms and narrow dentin tubules water movement is broken and metabolic processes are reduced that determines high probability of exposure of dental hard tissue diseases.

[Quantitative objective and subjective assessment of the quality of treatment of patients with distal occlusion]

OBJECTIVE

The aim of the study is to evaluation of the quality of orthodontic treatment by comparing the severity of signs of distal occlusion before the start of orthodontic treatment and after its completion.

MATERIAL AND METHODS

Quantitative assessment of the severity of distal occlusion in 83 patients aged 17 to 30 years before and after orthodontic treatment. Depending on the chosen treatment algorithms, the patients were divided into 3 groups. The first group - 34 people - treatment included the use of a functional non-removable orthodontic device (FNT). The second group - 21 people - the treatment was accompanied by the removal of individual teeth of the upper jaw and the retraction of a group of front teeth of the upper jaw. Patients of the 3rd group - 28 people - underwent combined orthodonto-surgical treatment. The severity of distal occlusion was assessed using 3D cephalometric analysis data. To obtain a subjective assessment of the quality of orthodontic treatment, patients were asked to fill out questionnaires before and after orthodontic treatment.

RESULTS

The severity of distal occlusion decreased as much as possible as a result of treatment of the first group in 23.07% of patients and the third group (16.63%), which is interpreted by the formulation «significant improvement» of the dental anomaly. Patients of the first and third groups had a high degree of satisfaction with the result of treatment, according to the quantitative assessment of the questionnaire. The severity of distal occlusion in the second group was reduced to a lesser extent (55.5%), compared with the first and third groups, which is interpreted as «moderately improved». Patients noted an average degree of satisfaction with the result of treatment, as the implemented treatment plan did not meet their expectations in the aesthetic aspect.

CONCLUSION

The use of FNT for the extension and normalization of the position of the lower jaw is justified in the case of refusal of patients from combined orthodonto-surgical treatment, as it allows to fully solve the functional, aesthetic and psychological problems of patients, which contributes to improving their quality of life.

[The research of the connective tissue dysplasia effect on dental eruption and hard tissues mineralization]

OBJECTIVE

The purpose of this investigation was to explore the quality of 38, 48 teeth's hard tissues at different eruption stages and mandibular bone in different postpartum ontogenesis periods.

MATERIAL AND METHODS

The research involved 102 male patients divided into groups according to their age: 15-20, 21-30 years old, they were extracted one tooth 38, 48 without inflammatory process signs and a fragment of the mandibular bone alveolar part in the projection of the teeth 38, 48 for orthodontic indications. In the comparison group (49 observations without signs of connective tissue dysplasia), in the study group (53 observations with signs of connective tissue dysplasia) we extracted teeth 38, 48 which were in the bone tissue. We analyzed condition of crown and root systems of extracted 38, 48 teeth, densitometric density of mineral component, size of enamel prisms, size of prismatic shells of organic matrix, spatial organization of collagen fibers in bone tissue, size characteristics of bone plates and mineralization centers of bone tissue. Processing of the obtained data was performed by methods of variation statistics using standard packages Microsoft Excel 2008, Statistica 12.0.

RESULTS

The paper reveals one of the surgical dentistry pressing issues related to the tething mechanism of lower human wisdom teeth, considered by the authors from the position of tissue disorders in collagen type 1 observed in connective tissue dysplasia. At age of 15-20 years in connective tissue dysplasia, the enamel prisms hypomineralized areas are generalized; at age of 21-30 years the hypomineralized areas are characterized by local changes. At the age of 15-20 years in connective tissue dysplasia the bone plates splitting is observed at the level of most fibrils, collagen fibers have insufficiently oriented direction in contrast to the age group of 21-30 years where bone plates splitting is characteristic for single fibrils and collagen fibrils are clearly oriented.

CONCLUSION

Morphological and histological changes in teeth 38, 48 and in bone tissue prevent correct and timely teething at 15-20 years and create more favorable conditions for teething at 21-30 years with a slower rate in connective tissue dysplasia, but in both groups teeth eruption occurs under unfavorable anatomic conditions.

[Study of the human enamel prisms maturation nature in different periods of postpartum ontogenesis by atomic force microscopy]

OBJECTIVE

It is necessary to study the human enamel prisms size at different periods of postpartum ontogenesis by atomic force microscopy.

MATERIAL AND METHODS

The study involved 94 males which were divided into groups by age: 15-20, 21-30, 31-40, 41-50, 51-60 years old, each examined male had one 3.8 or 4.8 tooth removed (from the fracture line in the region angle of the mandible, according to orthodontic indications) for medical reasons. The shape, roughness, length and width of the enamel prisms were studied in the Image Analysis NT-VDT program according to the method of Omsk State Medical University.

RESULTS

The enamel prisms structure at all ages has a regular, ordered shape with 6-sided and 7-sided figures. The most constant structure occurs at the age group of 41-50, 51-60 years. The fastest enamel prisms growth occurs in the direction that increases the prism length at all ages. Growth on a plane which increases the prism width is slow at 41-50 years. It is catching up with the growth rate of enamel prisms in length at 51-60 years old. Enamel prisms at 15-20, 21-30 years old stretch faster in the horizontal direction.

CONCLUSION

In maturation process, due to correct and harmonious growth, enamel prisms are timely modified from pyramidal form in the early postpartum period to a prismatic form in the late postpartum period of ontogenesis.

[Analysis of the involvement of dentist in the educational process on the portal of continuous medical and pharmaceutical education of the Ministry of Health of the Russian Federation]

THE AIM OF THE STUDY

Was to analyze the efficacy of interactive continuous medical education (CME) in dentist in the Russian Federation.

MATERIALS AND METHODS

The study assessed statistical data provided by Continuous Medical and Pharmaceutical Education Center of Pirogov Russian National Research Medical University.

RESULTS

The rate of dentists involved in CME is the greatest in Central (29%), Volga (21%) and Siberian (13%) federal districts and the lowest in North Caucasian (3%) federal district. The involvement in CME among dentists is more than 65% registered in an active five-year cycle. Most of the registered in an active five-year cycle work in state institutions. The most popular among dentists are interactive educational modules. Conclusion. Average dentist involved in CME lives Central federal district, works in a state institution, and prefers interactive educational modules to other educational elements.

[On the issue of normative legal regulation of the work of a doctor in a dental office of a multidisciplinary hospital]

OBJECTIVE

The purpose of the study is to investigate the existing normative legal documents governing the activities of doctors specializing in «dentistry», providing medical care in a multidisciplinary hospital.

MATERIAL AND METHODS

The normative legal coverage of medical workers' activities on delivering dental care for adult population with infectious diseases in stationary conditions for a thirty-year period was analyzed. The research and information method and content analysis were used.

RESULTS

The existing regulatory legal framework governing the activities of medical workers does not contain time standards for one patient who is on inpatient treatment to visit doctors specializing in «dentistry» in a multidisciplinary hospital, which does not correspond with modern requirements and does not allow determining the workload norms and standard numbers of these specialists.

CONCLUSION

Despite the presented modern possibilities of introducing the latest technologies and intensifying the activities of doctors specializing in «dentistry» on an outpatient basis, the organization of medical care and the delivering of dental services in a hospital including to infectious patients require further improvement.

[Analysis of the application of lean manufacturing tools in the dental service]

THE AIM OF THE STUDY

Synchronization of methods and tools of lean manufacturing (BP) and the possibility of their practical application in the organization of the dental service.

MATERIALS AND METHODS

The methods of synthesis and analysis of data from scientific sources and regulatory documents and the empirical method were used to study the use of various BP tools in the management of dental organizations.

RESULTS

In the course of studying the possibility of using BP tools in the dental service, their systematization was carried out on the basis of the principle of use in dental medical organizations.

CONCLUSION

The use of BP tools in the management of dental organizations allows them to correspond to a certain extent to the new model of a medical organization.

[Research of the structure of the mineral component of tooth enamel in connective tissue dysplasia by densitometry and atomic force microscopy in the early postpartum ontogenesis period]

OBJECTIVE

To give a quantitative and qualitative characteristic of the structure of the enamel's mineral component structure of impacted teeth with or without connective tissue dysplasia in different periods of early postnatal human ontogenesis using densitometry and atomic force microscopy.

MATERIALS AND METHODS

The study involved 120 males with and without connective tissue dysplasia (CTD), which were divided into 3 equal subgroups (60 people with CTD and 60 people without CTD), 20 people in each, according to age: 15-20, 21-30, 31-40 years old. Each of the examined was removed either 3.8 or 4.8 tooth. To study the inorganic component of tooth enamel, a densitometric assessment of enamel's optical density was carried out using computed tomography in the Kodak Dental Systems software (Trophy 2000) and preparation of thin sections of tooth samples 3.8 or 4.8 for atomic force microscopy (AFM) according to the methods of Omsk State Medical University.

RESULTS

The structure of tooth enamel in connective tissue dysplasia in the early postpartum period of ontogenesis is characterized by pronounced polymorphisms and an insufficient level of maturity. The ordering and orientation of the enamel prisms are disturbed due to insufficient packing density and a large distance between the enamel prisms at the age of 15-20, 21-30. The established changes indicate the incomplete nature of amelogenesis with connective tissue dysplasia at the indicated ages.

CONCLUSIONS

In case of connective tissue dysplasia in the early postnatal period of ontogenesis, an incomplete amelogenesis is observed. This process is manifested by lower values of the mineral component's optical density, low packing of enamel prisms, a large distance between enamel prisms and their irregular shape.

[Legislative framework and legal regulation of dental care organization to patients with infectious diseases]

The existing normative legal framework does not fully correspond to modern requirements for the organization and delivering dental care for adult population with various infectious diseases. The authors basing on the analysis of regulatory guidelines consider that in order to provide timely, high-quality and affordable medical care to patients in the infectious diseases departments and clinical hospitals, it is necessary to update the normative legal framework and develop criteria for monitoring the quality of dental care for infectious patients at the stages of its delivering.

[The quality of dental care: characteristics and criteria]

The paper discusses features and criteria of dental care according to legislative acts in Russian Federation. The study contains detailed assessment of safety, cost/effectiveness ratio and adequate timing as features and adhesion to standards, absence of complications and patients satisfaction as criteria for dental care quality.

[The current training system of managerial human resources for dental service]

The study provides some data confirming the need to divide labor functions of specialists in organization of health care, to differentiate the approaches for their education, to uniform the professional abilities and to implement the accumulative system of advanced training.

[Legal state of dental service in Ryazan region]

Analysis showed that the organizational-legal basis of dental service of the Ryazan region consists of limited liability companies (50.2%) and government budgetary institutions (40.3%).

[Informed consent as an essential condition for dental care providing]

The paper reviews legislation base considering informed consent as an essential condition for dental care providing.

[Review of legislation base considering requirements for oral hygiene means]

The paper reviews legislation base considering requirements for oral hygiene means in Russian Federation.

[A method for preventing and treating maxillodental anomalies related to disordered nose breathing]

Eleven children aged 5-9 years with maxillodental abnormalities were treated using positioners. Negative effects of positioners and activators (increase of dental caries, hygienic index, and acid resistance of the enamel) are analyzed.