Subject. The article discusses the possibilities of cone-beam computed tomography in the study of the anatomy of the mental foramen: size, shape, topography, as well as the optical density of bone tissue at the mental foramen. The goal is to investigate the size, shape and topography of the mental foramen, as well as the optical density of bone tissue in it using cone-beam computed tomography. Methodology. The computed tomograms of the lower jaws of 26 patients were analyzed, according to which the vertical and horizontal dimensions of the mental openings were measured on the right and left, the number and sizes of additional mental openings, their location according to the Tebo and Telford classification, and the bone mineral density under the mental opening were determined. Statistical analysis was carried out using Microsoft Excel, Windows 9. Results. The resulting average dimensions of the right (4.01x3.93 mm) and left (3.81x3.95) mental holes confirm the results of more extensive studies done earlier. In the first case (1.9 %), an anatomical variation of the mental opening was revealed: 3 holes with dimensions 2.1×2.1 mm, 2.0×0.9, and 1.9×2.4. The symmetrical location of the chin foramen was found in 15 patients (57.7 %). In most cases, types III (25 %) and IV (53.84 %) of the location of the mental opening were identified. The average optical density of bone tissue under the mental foramen on the right side was 1618.9±145.1 HU, on the left ― 1571.64±159.64. There were no significant differences in the optical density of bone tissue for types II―IV of the location of the mental foramen. Conclusions. A significant variability in the topography of the mental foramen was revealed, in this regard, methods of mental anesthesia with a personalized approach, for example, the method of anesthesia of the intraosseous part of the chin nerve, are becoming relevant (authors Rabinovich S.A., Vasiliev Yu.L., Tsybulkin A.G.). High values of the optical density of bone tissue at the mental foramen confirm the ineffectiveness of diffusion of anesthetics through the cortical plate.
Subject. Mineralization of hard tissues of teeth affected by radiation caries in patients after radiation therapy of malignant neoplasms. Objectives. To develop a digital method for diagnosing radiation caries based on Raman fluorescence technology. Methodology. The study was conducted at the Department of Orthopedic Dentistry and Orthodontics of South Ural State Medical University. The study was conducted on two groups of people (cohorts) comparable in sex and age, who voluntarily agreed to take part in it. The main group consisted of 20 people (patients with radiation caries), the comparison group – 20 people (without radiation caries). The main research method was the study of Raman fluorescence of tooth areas using the «InSpectr» hardware-software complex with diagnostic sensitivity according to the integral concentration of aerobic-anaerobic microbial suspension up to 109 KOE/ml. A study was made of teeth in the pathological area in patients of the main group, and in the intact area in patients of the comparison group. Results. Raman fluorescent diagnostics of the intact tooth surface and the surface with a pathological focus made it possible to clearly see the difference in mineralization in digitized indicators. So, for example, according to the indicators of patients with damage to the teeth by radiation caries, it can be concluded that the indicators of mineralization in the focus affected by radiation caries ( y = 172 ± 0.04, x = 963 cm-1) are lower than those of the intact area (y = 1174 ± 0.071, x = 963 cm-1) Conclusion. The method of Raman fluorescence diagnostics can be used in the diagnosis of radiation caries, since there is a potential difference between the healthy and the affected areas of the hard tissues of the tooth. On the basis of the study, the author recommends using the «InSpectr» hardware-software complex for diagnosing radiation caries.
АннотацияПредмет. В настоящий период времени в стоматологии появляется тенденция на командную комплексную работу с использованием всех возможностей стоматологии и смежных специалистов, а также ресурсов орга-низма. Для выбора правильной тактики окклюзионной реабилитации пациента с трансверзальной патологией прикуса и сочетанным расстройством височно-нижнечелюстных суставов необходимо провести предвари-тельный обратимый не инвазивный диагностический этап: создание множественной окклюзии в терапев-тическом положении на каппе с круглосуточным режимом использования до устранения всех симптомов и стабилизации структур ВНЧС.Цель. Рассмотреть альтернативные пути решения устранения асимметрии лица до получения приемле-мого эстетического и функционального результатов, используя компенсаторные возможности организма, не прибегая к челюстно-лицевой хирургии.Методология. Представлен клинический случай пациента с боковым смещением нижней челюсти и кли-никой дисфункции ВНЧС, который отказался от возможного хирургического вмешательства в силу возможных рисков и осложнений.Результаты. Через три месяца после начала предварительного этапа шинотерапии получено новое ста-бильное соотношение челюстей, в котором отсутствуют боли и щелчки в височно-нижнечелюстных суставах, сформирована привычка двухстороннего типа жевания, отмечен отличный эстетичный результат: устранено смещение подбородка влево, получен неожиданный эффект в нормализации положении глаз (пожеланием пациента было сохранить анонимность, поэтому положение полоски, закрывающей глаза, максимально повторяет зрачковую линию). В связи с окончанием этапа и получением определенности в соотношении челюстей пациенту предложено несколько возможных вариантов окклюзионной реабилитации.Выводы. Данный пример показывает большие компенсаторные возможности организма человека, которые можно и нужно использовать. При этом предварительный этап диагностики, который позволил найти альтер-нативные пути челюстно-лицевой хирургии, имеет множество преимуществ: низкую стоимость, обратимость, возможность оценить результат до начала основного лечения. Образно говоря, мы имеем определенный «тест-драйв» планируемой эстетики лица.Ключевые слова: нехирургическая пластика лица, дисфункция ВНЧС Авторы заявляют об отсутствии конфликта интересов. The authors declare no conflict of interest. Ортопедическая стоматология Orthopaedic Dentistry
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