No abstract

Orthopedic treatment is of particular difficulty in the complex therapy and rehabilitation of patients with precancerous diseases of the oral mucosa. In this regard, in patients with chronic inflammatory and destructive lesions of the oral mucosa, it is necessary to control changes in the oral cavity, taking into account clinical and laboratory data. Oral fluid is most often used as a diagnostic material in dental research, the composition and properties of which reflect functional changes in the body. However, the studies that substantiate rational orthopedic treatment in such patients are extremely insufficient: there are no data on the effect of orthopedic structures on the primary metabolism in the oral cavity in patients with precancerous diseases. In this regard, the purpose of this work was to study the biochemical parameters of the oral fluid in patients using orthopedic structures to identify the prognostic factors of precancerous conditions. In the oral fluid, the levels of total protein, total cholesterol, triglycerides, and lactate were determined. Free radical oxidation was assessed by the intensity of induced biochemiluminescence and by the levels of lipid peroxidation products. In the oral fluid of patients with mucosal precancer compared with patients in the control group, a significantly higher intensity of free radical oxidation was revealed with a corresponding decrease in antioxidant activity. The level of the end products of lipid peroxidation - Schiff’s bases - was statistically significantly increased. Among the metabolites of the oral fluid, there was a decrease in protein levels and an increase in cholesterol and lactate levels. At the same time, a positive correlation was established between the indicators of free radical oxidation and lactate, free radical oxidation and cholesterol, but negative with the levels of protein and triglycerides. Regarding the antioxidant system, there was a negative correlation between the tg (-2α) value and the lactate level and positive with the triglyceride level, as well as a positive correlation between the Z parameter and the total protein level. The obtained changes in the biochemical parameters of the oral fluid can be used to confirm the diagnosis of precancer of the oral mucosa in patients with orthopedic structures.

Purpose of the study improving the diagnosis of precancerous diseases and cancer of the oral mucosa using fluorescent immunocytochemical studies by direct immunofluorescence. A clinical laboratory examination of 111 patients was carried out: 46 patients with squamous cell carcinoma of the oral mucosa, 35 people with precancerous lesions (17 leukoplakia, 18 - oral lichen planus) and 30 healthy people. All patients underwent a traditional cytological examination and an additional immunocytochemical examination by direct immunofluorescence, the expression levels of tumor markers P53, P16 and Ki67 were determined. The data were compared with the results of histological analysis. As a result of the study, it was revealed that in patients with cancer, the expression of oncomarker P53 was four times higher than in patients with precancerous pathology. In 6.52% of cases, co-expression of markers Ki67 and P16 was found. Thus, the advantages of fluorescent immunocytochemical diagnostics were the absence of invasive traumatic intake of the biomaterial in the patient, reduction in the timing of obtaining the result, high sensitivity, and the possibility of remote evaluation of the results. Therefore, that increases the accessibility of the method, and the possibility of using this method for a screening study of population.

В последние годы, несмотря на появление различных современных методик диагностики и лечения предраковых заболеваний, наблюдается тенденция к их росту. В связи с этим максимально раннее, неинвазивное выявление признаков, способствующих развитию предикторных изменений слизистой оболочки рта (СОР) и красной каймы губ (ККГ), остается актуальной задачей современной стоматологии [2, 5, 10, 11]. В настоящее время появилось достаточно исследований, посвященных связи онкопатологии и вирусных инфекций, изучающих так называемый вирус-ассоциированный онкогенез. Было доказано, что более чем в 15% случа

The mucous membrane of the oral cavity (MMOC) and the underlying tissues have a complex anatomical structure that determines the specifics of the clinical course and treatment of tumors developing here. Malignant tumors that occur in the oral cavity, in most cases have the structure of squamous cell keratinizing cancer. In the conditions of a dental clinic, the diagnosis of precancerous and tumor changes presents serious difficulties, the main cause of which is the low oncological alertness of dentists, as well as the lack of necessary equipment and modern minimally invasive methods of early detection of cancer. Histological examination rarely is used in dentistry, as it implies a lifetime fence of the abnormal tissue (a biopsy) and has a number of disadvantages associated with the work sharp tool, the possibility of bleeding, mistakes in material sampling, waiting times result from a doctor-a pathologist. Taking into account the external localization of COR and CCG neoplasms, the procedure for collecting material for cytological research is simple and highly sensitive (the sensitivity of the method is 90-95%). Objective: to assess the possibility of cytological diagnosis in the practice of the dentist and the impact of different methods of sampling on the results of morphological analysis. Materials and methods of research. 114 samples were analyzed from 38 patients who sought dental care with complaints of tumors in the oral cavity. Material from each patient was collected in three ways, followed by cytological examination. Results and discussions. The obtained results indicate that the lowest percentage of detection of malignant changes in the cells of patients was observed when self-flushing with MMOC, and the highest percentage of pathologically altered cells was detected when sampling material by smear. The obtained results of cytological examination were compared with histological data, where different percentage matches were obtained depending on the method of material sampling. Conclusion: the use of cytological research method in dental practice with adequate sampling of the material allows to identify malignant cell changes in more than 80% of cases.