Проблемы стоматологии / ActuAl problems of stomAtology 2013. № 5www.dental-press.com O r i g i n a l s t u d i e s 41 ДЕТСКАЯ СТОМАТОЛОГИЯ и ОРТОДОНТИЯ / Dentistry of childhood and Orthodontics РезюмеВ статье представлены особенности диагностики и ком-бинированного лечения детей и подростков с односто-ронней и двусторонней ретенцией клыков верхней челюсти. На примере клинических случаев установлена связь данной проблемы с вариабельностью сроков смены молочных зубов у современных детей.Ключевые слова: ретенция клыков верхней челюсти, сроки прорезывания зубов.featuRes of diaGnostiCs and tReatment of impaCted Canines of teenaGeRs myagkova n.V. , Bimbas e.s. , Beldyagina m.m. , yarushina m.o. The summaryin this research features of diagnostics and the combined treatment of children and teenagers with a unilateral and bilateral impacted canines are presented. on the example of clinical cases the problem of variability terms change milk teeth at modern children is shown.

Relevance. The correct choice of the surgical technique for the treatment of the congenital asymmetric cleft lip and palate ensures the effectiveness of rehabilitation of patients with this pathology. The purpose is to present the results of the authors’ techniques for the surgical treatment of children with asymmetric cleft lip and/or palate.Materials and methods. Medical records of 687 children treated in 2015-2019 years were retrospectively analyzed at the clinic of maxillofacial surgery “Bonum” MСMC. The prevalence of asymmetric cleft lip and palate in children was determined. The prospective observation group included 84 patients with asymmetric cleft lip and/or palate. Clinical, anthropometric, statistical methods as well as patient photograph analysis and computer technologies were used during the research.Results. Prevalence of congenital asymmetric cleft lip and / or palate was determined (8.59%), classification and novel surgical techniques were offered and the results were evaluated.Conclusions. The prevalence of asymmetric cleft lip and palate is 86 per 1000 newborns with cleft lip and/ or palate. Scientific knowledge about the prevalence of asymmetric cleft lip and palate, as well as the systematization of this type of lesion in classifications, should be present in the practice of a maxillofacial surgeons and rehabilitation physicians who treat patients with this pathology. The proposed surgical techniques for the treatment of asymmetry in bilateral cleftlip and cleft palate provide positive results, excluding the need for further surgery. The reasonable choice of a surgical technique for the treatment of asymmetric cleft lip and palate is individual and may involve the use of additional nanomaterials. The authors’ techniques for the surgical treatment of asymmetric cleft lip and palate can be considered promising and aesthetically justified in view of good cosmetic results and full restoration of functions.

АннотацияПредмет. В статье показана эффективность авторского метода лечения детей раннего возраста с сосудистыми опухолями челюстно-лицевой области. Разнообразие клинического течения сосудистых опухолей и локализация их в челюстнолицевой области создают сложности и ограничивают выбор метода лечения. Авторский метод сочетает высокую эффективность, малоинвазивность, сокращение сроков реабилитации и минимальные побочные реакции.Цель -оценка опыта лечения при комбинированном использовании приема пропранолола и метода склерозирования сосудистых опухолей челюстно-лицевой области у детей.Методология. Проведено сравнение результатов лечения 120 детей с сосудистыми опухолями челюстно-лицевой области в возрасте от 2 месяцев до 2 лет, которые были разделены на три группы в зависимости от способа лечения: основную (комбинированное использование приема пропранолола и метода склерозирования), группу сравнения-1 (прием пропранолола) и группу сравнения-2 (применение метода склерозирования). Эффективность лечения оценивали по изменению объема образования, диаметра питающих сосудов и значений линейной скорости кровотока.Результаты. По результатам клинического исследования группа детей раннего возраста с сосудистыми опухолями челюстно-лицевой области в косметически значимых зонах, которые получали лечение авторским методом, продемонстрировала свою эффективность: достигнут существенный объем регресса (в 2,5 раза) по сравнению с группами сравнения. По данным УЗИ, уменьшение диаметра питающих сосудов и линейной скорости кровотока достигло нулевого значения через 6 месяцев после начала лечения, быстрее, чем в группах сравнения.Выводы. Применение комбинированного способа с использованием приема пропранолола и метода склерозирования эффективно при лечении детей с сосудистыми опухолями челюстно-лицевой области, сокращает сроки лечения, снижает риск и степень осложнений.Ключевые слова: сосудистые опухоли, челюстно-лицевая область, пропранолол, комбинированное лечение гемангиом Авторы заявляют об отсутствии конфликта интересов. The authors declare no conflict of interest. Адрес для переписки: Correspondence address:Ирина Алексеевна ЗАМЯТИНА 620146, г. Екатеринбург, ул. Академика Бардина, д. 38А Тел. +7 (343) 240-35-78

Subject. The depth of the overbite increases with age. With the loss of teeth secondary deformations of the dentition, dysfunctions, teeth wearing, periodontal disease and temporomandibular joint (TMJ) dysfunctions occurs, facial aesthetics is affected. The urgency of the topic depends on the high prevalence of anomaly and self-destruction of the orofacial system (OFS) with deep overbite in adults. The aim was to identify the factors of decompensation of the dentition in adults with deep overbite. Methodology. Clinical (questioning, examination, functional tests), anthropometric (photo analysis, casts’ analysis, Shimbachi index) methods and X-ray analysis(cephalometry, analysis of zonograms of TMJ, orthopantomography) were performed for 84 adult patients with deep overbite more than 3 mm (GRP) and Angle Class I or II. All patients were divided into 2 main groups according to the size of overjet: OG-1 ― 42 people with a normal overjet (2 ± 2 mm) between the incisors; OG-2 ― 42 people with an enlarged overjet (more than 4 mm). We used the MSUMD classification of malocclusion (1991). The results of the examination of the patients in 2 main groups were compared with each other and with the average structure of the OFS in patients with physiological occlusion. We have identified specific clinical, anthropometric, and radiological groups of symptoms of decompensation in OFS, which are common for adults with GRP. Conclusions. In adult patients with GRP the main factor of decompensation in OFS is lower jaw displacement. In the development of displacement of the lower jaw a few factors are important: transversal disproportion of the dentition; sagittal jaw disproportion; loss of posterior teeth. The loss of the teeth, the reduction of the interalveolar height and the associated functional and aesthetic problems are adaptive mechanisms for the displacement of the mandible.

Relevance. The current view of the problem of specialized care for children with congenital cleft upper lip and palate in the literature is described as a system-forming complex of medical and surgical aids. The issue of the further development of individual methods and algorithms for the rehabilitation of children of complex types of cleft, showing a pronounced asymmetry of the affected tissues, remains an urgent issue. The creation of «special» algorithms for therapeutic tactics and the choice of the method of surgical benefits of asymmetric forms of cleft upper lip and palate involves the interaction of each specialist, taking into account the variety of clinical characteristics of complex defects.Purpose. On specific clinical material describe the features of the algorithm for eliminating the asymmetric cleft of the upper lip and palate, taking into account the author’s methods of cheilorino-palatoplasty.Materials and methods. For the period 2015-2019. a group of patients (62 patients) with congenital asymmetric cleft of the upper lip and / or palate, including those with deficiency of their own tissues, was studied in the Multiprofile Clinical Medical Center «Bonum». The study used clinical, anthropometric, statistical methods, analysis of photographs of patients.Results. An algorithm has been developed to eliminate a complex variant of damage to tissues and structures of the maxillofacial region, taking into account the proprietary technologies for surgical care.Conclusions. The proposed methodological algorithm for the treatment tactics of complex clinical and anatomical variants of the cleft of the upper lip and / or palate allows us to assess the severity of damage of the maxillofacial region, establish indications for the use of additional therapeutic methods for orthodontic-surgical preparation for cheilorino-palatoplasty and adequately choose the method of surgical intervention.The use of original methods for surgical removal of asymmetric clefts of the upper lip and / or palate, including “wide” crevices with a deficit of their own tissues, increases the effectiveness of surgical and rehabilitation tactics in the general complex of specialized care for patients with complex tissue lesions of the maxillofacial region.The awareness of maxillofacial surgery doctors and rehabilitation dentistry specialists about modern methods of surgical care, about an improved methodological algorithm for eliminating asymmetric cleft upper lip and / or palate, including with deficiency of own tissues, can serve as a «road map» for the development of a specialized interdisciplinary health recovery complex this category of patients.