The aim: The aim of the study was to improve preventive measures aimed at preventing the formation of pathological scarring of the skin in patients after elective surgery by intra- and postoperative use of cryopreserved placental cells. Materials and methods: The research was conducted in the Department of Maxillofacial Surgery on the basis of the Municipal Enterprise «Poltava Regional Clinical Hospital. M.V. Sklifosovsky» Poltava Regional Council. A total of 60 patients took part in the study, who were hospitalized for planned surgical interventions in the department of maxillofacial surgery Results: We obtained clinical data on the processes of scar formation in patients with morning and evening chronotype on the background of local intraoperative injection of cryopreserved placenta extract into the wound. We have proved that short people with an established evening chronotype need additional preventive measures, especially on the 90th and 180th days of the postoperative period. Conclusions: From our study we can say with confidence that the drug “Cryocel” reduces epithelialization time, promotes optimal wound healing and leads to the formation of more aesthetic scars, which creates optimal both functional and cosmetic results.
The relevance of the problem. Head and neck scars resulting from the effects of various endogenous and exogenous factors are an actual problem of modern surgical stomatology. A large number of scientific researches devoted to the study of different methods of diagnosis of head and neck scars indicates that the verification of the diagnosis is a highly complicated issue. Currently, conventional algorithms for selecting methods of treating patients with scars are available. The development of such algorithm is difficult due to the uncertainty of criteria for the differential diagnosis of various types of scars. Despite significant pathogenetic and morphological differences of scarring, some of their types often have clinically similar features, resulting in a significant number of diagnostic errors. In its turn, carrying out the treatment without taking into account the clinical and morphological structure of scars usually leads to the lack of tangible therapeutic effect, recurrence and increased growth of scar tissue. That is why the development of a clear algorithm of comprehensive examination of this category of patients is of particular importance for determining the tactics of their treatment. The aim of the research is to increase the effectiveness of face scars treatment due to identification of type of scar-modified tissue by means of method of digital visualization of graphic digital images. Objects and methods of the research. Fifty patients with hypertrophic scars of face were examined. Further analysis of the structure of hypertrophic scars was performed using RGB-method of visualisation. At present, computer digital image research is widely used in histological, cytological, pathologic and immunological studies, which led us to consider the use of digital analysis of images as the initial stage of primary diagnosis in various types of postoperative scarred facial tissues. Computer imaging is still the only source for obtaining visualized qualitative and quantitative information and preserving it in digital form. Results of the research. We have studied the distribution of color constants of red, green and blue colors in 4 points: T1 – the area of intact skin, T2 – the medial and T3 – the lateral edge of the scar, and T4 – the area of the middle zone of scar. Due to the proposed method, the features of architectonic layers of the skin in the area of hypertrophic scar have been studied in detail. The obtained results allow improving the differential diagnosis of scars and expanding the possibilities to develop the pathogenetically grounded treatment of patients with head and neck scars. The analysis of the results of digital visualization of graphic digital images showed that statistically reliable differences in digital indices, being observed during visualization of hypertrophic scars, could be an important criterion of their differential diagnostics. Conclusion. Thus, examination of patients with scars of the maxillofacial region, providing the RGB-method, is an effective method of non-invasive diagnosis of hypertrophic scars allowing to evaluate the changes in scar-modified tissues in dynamics. The authors substantiated the feasibility of the use of RGB-system for the improvement of differential diagnosis of hypertrophic scars of the head and neck. Due to the proposed method, features of architectonic layers of the skin in the area of hypertrophic scar have been studied in detail. The obtained results allow to improve the differential diagnosis of scars and expand the possibilities of developing pathogenetically grounded treatment of patients with scarring of the head and neck.
To date, there is a theory that increased resistance to caries is observed in the teeth, which for any reason underwent destructive changes in the pulp. That is why there is a need to study the impact of pulp vitality on the development of the carious process. The aim of the research was to study the microscopic structure of epoxy sections of intact and carious third molars. We studied 4 intact and 6 carious third molars. For this purpose, specimens were made taking into account the free penetration of the fixative solution into the pulp. To this end, immediately after the tooth was removed, we cut off its roots almost near the crown, preserving the integrity of the latter. The method relied on the impregnation of specimens with epoxy resin, according to the method of epoxy plastination of tooth specimens, developed at the Department of Human Anatomy of Ukrainian Medical Stomatological Academy. The epoxy blocks were cut with a disk into two halves until the hard tissues of the tooth crown were exposed together with the pulp. We found that the hard tissues (dentin and enamel coating) of intact third molars did not have any structural defects. However, their pulp chamber contained mainly an amorphous substance, devoid of any typical pulp tissue structures. That is, the pulp was in a state of complete devolution. Quite the opposite presentation was observed in specimens of carious teeth. We found that their pulp chamber contained quite noticeable tissue structures typical of the dental pulp. It is interesting that in the subodontoblastic layer, in front of the carious alteration of the enamel, there was compaction of the pulp, which may be due to infiltration of perivascular connective tissue by immunocompetent cells. It was found that on the border with carious destruction of enamel, there was a compacted spot of altered dentin, whose matrix was intensely pigmented in brown colour, due to the accumulation of melanin on the dentino-enamel junction. Its excessive formation is associated with the destruction of protein-carbohydrate complexes of organic matter in the deep layers of dentin. We found that the pulp compaction and the focus of carious alteration of the enamel are projectively connected by a radial cord of altered dentin, known in the literature as “dead tracts”. Hence, there is reason to believe that the identified changes indicate a latent form of caries, with a pulpogenic mechanism of development. Thus, it can be argued that the teeth, which for any reason underwent degenerative changes in the pulp, are not prone to carious lesions, whereas in carious teeth, the pulp is active and involved in the pathogenesis of the carious process.
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