Antonyshyn I. V. The role of mandible injury in the pathogenesis of biochemical and functional liver disorders caused by acute blood loss and two-hour ischemia of limbs, and the efficiency of their correction by carbacetam.

The purpose of the work was to study the activity of the carious process in people of different ages using the assessment of the Decayed, Missing, and Filled Teeth and the International Caries Detection and Assessment System index. Materials and methods. The study involved 53 people who were divided into groups: group 1 – 16 people aged 18 to 25 years, group 2 – 20 people aged 26 to 35 years and group 3 – 17 people aged 36 to 45 years. The intensity of caries was determined using the Decayed, Missing, and Filled Teeth index. The International Caries Detection and Assessment System index was used to assess the activity of carious lesions. Results. The indicators of the Decayed, Missing, and Filled Teeth index in the group of people aged 18-25 years significantly differed (p <0.05) from the indicators in the group of people aged 26-45 years. In the group of people aged 36-45 years the indicators were higher than in the group of people aged 26-45 years, but no significant difference (p˃0.05) was found. In the group of people aged 18-25 years the share of filled teeth was 61.5%, teeth affected by caries were found in 29.4%, and removed teeth – in 9.1%. In the group of people aged 26-45 years, the rate of filled teeth was lower compared to people of the 1st group, the share of carious teeth increased up to 35.0%, and the number of removed teeth increased up to 16.4%. In the group of people aged 36-45 years the share of teeth affected by caries was lower than in the 1st and 2nd groups and was equal to 27.3%, the share of filled teeth was 46.2%, which is lower than in other groups, but the share of removed teeth was the highest of the groups which were examined and was 26.5%. The results indicate a rapid increase in the intensity of caries in patients of main working age, namely persons of the 2nd and 3rd groups compared with persons of young working age of the 1st group. The study of the depth of caries in enamel and dentin according to the International Caries Detection and Assessment System showed that in patients aged 18-25 years, from all teeth which are affected by caries in 71.4% enamel caries was found, which averaged 1.81 ± 0.2 teeth and in 28.6% – dentin lesions, which was an average of 0.68 ± 0.2. In patients aged 26-35 years, codes 1-3 accounted for 41.0% of affected teeth (mean 2.05 ± 0.1 teeth) and code 4-6 accounted for 59.0% of affected teeth (average 2.95 ± 0.2 teeth). In patients of the oldest age group, the number of teeth affected by caries with a code of 1-3 was 27.9% (average of 1.12 ± 0.1 teeth) and with a code of 4-6 was 72.1% (average of 2.88 ± 0.2 teeth). Conclusion. As the age of patients increases, the proportion of filled teeth decreases, but the proportion of removed teeth increases. The highest percentage of teeth affected by caries was found in the 3rd group. As the age of patients increases, both the average number of carious teeth and the number of teeth with damage dentin increase

There are numerous domestic and foreign studies of periodontal disease in pregnant women, but there are still a number of unresolved issues. The data about the development of periodontal tissue diseases in pregnant women in terms of age is not enough. The purpose of this work was to study the development of periodontal disease in pregnant women in different age groups. Material and methods. A survey of 83 women in the ІІ and ІІІ trimesters of pregnancy, aged 19-45 years, was divided into three groups according to age. Group I (34 people) included pregnant women aged 19-25 years, group II (29 people) had pregnant women aged 26-35 years, group III (20 people) comprised pregnant women aged 36-45 years. Periodontal and hygienic indices were determined to assess the clinical signs of periodontal disease (to assess the clinical signs of periodontal disease, periodontal and hygienic indices were determined (papillary-marginal-alveolar index, degree of bleeding gums, Schiller-Pisarev test, numerical value of Schiller-Pisarev test – Svrakov's number and simplified index of cavity hygiene). Results and discussion. The obtained results indicated a high level of periodontal disease in pregnant women. Periodontal disease was found in 74.7% of subjects. The study found a significant progression of periodontal tissue pathology in pregnant women over 26 years of age, indicating that women in this age group were at significant risk of periodontal disease. The obtained data indicated that the value of the bleeding index was the lowest in pregnant women with periodontal disease of group I, and the highest in women of group III. The value of the PMA index differed 1.3 times (p˂0.05) in pregnant women of groups I and II, 1.2 times (p˂0.05) in women of groups II and III, and 1.5 times (p˂0.05) in pregnant women of groups I and III. In addition, the likelihood of developing periodontal disease increased with age of women. Conclusion. The values of the Svrakov's number had a similar tendency to increase in age groups, as well as the results of the previously described indices. Hygiene in pregnant women of all ages who had periodontal disease was not very good. Thus, special attention should be paid to the timely diagnosis, treatment and prevention of periodontal disease in pregnant women, taking into account their age

Introduction. Injuries in today's urban society are an urgent problem. In modern trauma, along with the lesion of various anatomical parts of the body increases the frequency of damages of the extremities main vessels with the development of massive external bleeding. Under these conditions, the only way to escape is to apply a tourniquet lasting up to two hours. At the same time in the structure of militant trauma and injuries in peacetime there is a tendency to increase the frequency of injuries of the maxillofacial area. The main cause of the injured people death is the development of systemic disorders with secondary lesions of tissues and organs remote from the site of direct injury. However, the role of mandible fracture in the development of systemic disorders in the case of acute blood loss and ischemia-reperfusion of the limb is insufficiently studied.Purpose: to establish peculiarities of the liver dysfunction indicators among wounded people under conditions of mandible fracture, gunshot damage of the lower extremity soft tissues with massive external bleeding.Materials and methods. Extracts from the electronic database of Medical Cards of inpatients military personnel who were treated at the National Military Medical Clinical Center "General Military Clinical Hospital" and were injured during the anti-terrorist operation / joint force operation from 2014 to 2019 were retrospectively analyzed. Among them the results of examinations and treatment of 10 wounded patients were selected, they had isolated gunshot wounds of soft tissues of the thigh with massive external blood loss and 8 wounded patients with similar gunshot wounds, and they had additional non-gunshot fractures of the mandible. All the wounded people were immediately provided with hemostatic tourniquet proximal on the injured hip.Shock index, indicators of cytolytic syndrome (activity of serum alanine and aspartate aminotransferases (ALT, AST), the content of total and conjugated serum bilirubin) and hepatodepressive syndrome (serum total protein and albumin) were taken into account from the medical records. Indicators were recorded at the time of admission to the hospital, after 6-7 days and at the time of discharge from the hospital. Additionally, the duration of patients staying in the hospital in each of the examination groups was analyzed.Research results and their discussion. At the time of admission to the hospital wounded patients of both observation groups had a significant increase of the shock index, serum activity of ALT and AST, the content of total and direct bilirubin. During treatment of the wounded patients with additional mandible fractures up to 6-7 days, serum activity of ALT, AST and direct serum bilirubin was significantly higher, and total serum protein content was lower compared to wounded patients without mandible fracture.Conclusion. Additional mandible fracture among wounded people with gunshot damage of the thigh, massive blood loss and ischemia-reperfusion of the limb significantly impairs the functional state of the liver with a maximum of 6-7 days in hospital and is an important factor in systemic manifestations of traumatic disease, which should be considered in clinical conditions.

Summary. Inflammatory periodontal diseases continue to be one of the pressing problems of modern dentistry [1]. It is known that there is a close relationship between general-somatic pathology and diseases of the oral cavity [2]. The aim of the study – to learn the effectiveness of the use of anti-dysbiotic hepatoprotector in the complex treatment of patients with periodontal inflammatory diseases on the background of chronic non-calculous cholecystitis. Materials and Methods. The main (group 1) group consisted of 106 people who suffered from inflammatory periodontal disease (IPD) with concomitant chronic non-calculous cholecystitis (CNC). The comparison group included 92 patients with IPD without concomitant pathology (group 2). To compare the research results of the patients with IPD, 30 healthy teethed individuals without periodontal pathology and without somatic diseases (group 3 or the control group) were involved. The state of the hepatobiliary system in patients of the main group was assessed by the doctors of the Gastroenterology Department of Zolochiv District Hospital of Lviv region. Results and Discussion. The symptomatic HCG and the presence of solid and soft dental deposits were diagnosed in all patients. The Green-Vermillion’s index was the highest in patients from the main group (1.67±0.01); it was probably (p <0.05) higher than that in the comparison group (1.54±0.04), as well as in the control group (0.44±0.07). The PMA index in the subgroup 1A immediately after treatment decreased by 9.7 (p <0.001) times. The index of bleeding in the subgroup 1A decreased by 10.7 (p <0.001) times. The PMA index in the subgroup 1A immediately after treatment decreased by 10.4 (p <0.001) times. The index of bleeding in the subgroup 1A under the influence of the proposed therapy decreased by 6.5 (p <0.001) times.The difference regarding the data before treatment remained lower by 2.2 times and 2.0 (p <0.001) times, however, the difference between the subgroups 1A and 1B in 3 months and 6 months was already 2.1 times in both cases. Conclusions. It was found that the clinical course of inflammatory periodontal diseases was much more difficult in these patients. The presence of pathology in the hepatobiliary system in patients increases the risk of periodontal disease. Therefore, in order to improve the efficacy of treatment, it is advisable to use this antidysbiotic drug in the complex treatment, and the results obtained in 3 and 6 months after treatment indicate a long-lasting positive effect.