Treatment of Fissure Caries of Children with Severe Rheumatic Diseases with Difficulty in Opening the Mouth

Background

Pediatric dentists face difficulties in treating tooth decay of children with difficulty in opening the mouth. This is especially true, as the main disease is accompanied by such symptoms as arthritis, osteoarthritis, myositis, myalgia, sclerosis, and oral atrophy.

Aim

The aim was to increase the level of treatment of fissure tooth decay for children with rheumatic diseases, using the silicone key method (SKM).

Materials and Methods

A dental examination of 82 children was carried out, with diagnoses: systemic lupus erythematosus, juvenile systemic scleroderma, juvenile dermatomyositis, and juvenile rheumatoid arthritis. Evaluation of the intensity of caries using indices: decayed, missing, and filled teeth (DMFT)(average). Assessment and measurement of the degree of mouth opening (MMO) by Sh. M. Batashvili. The SKM was used to treat fissure tooth decay.

Results

During the dental examination of the oral cavity of all children with RD, multiple caries lesions were found. In the first age group of index indicators (DMFT) (on average) - 4.88, in the second age group DMFT (on average) - 7.58 - these values corresponded to high scores for the degree of dental caries, which requires frequent appointment to the dentist. Oral hygiene of children with difficult opening of the mouth is unsatisfactory, which leads to a rapid increase of caries. Restriction of moth opening <4 mm was found in 57 children with RD (69, 51%) that made it difficult to treat caries.

Conclusion

Using SKM will improve the quality of caries treatment and provide a stable result of treatment in patients with difficulty opening the mouth in severe somatic pathologies.

Ultrasound Screening of Temporomandibular Joint Pathology in Children with Chronic Kidney Disease

Background/Objectives: Chronic kidney disease (CKD) influences different organs including the temporomandibular joint (TMJ). This study aims to identify structural and functional TMJ changes in children with CKD using ultrasound as the least invasive and most accessible method. Methods: TMJ changes were examined using ultrasound screening in 40 children. The first group (control, n = 10) included children with normal occlusion without TMJ complaints. The second group (n = 10) included children with CKD stage 1 and 2. The third group (n = 10) included patients on hemodialysis after renal transplantation. The forth group (n = 10) included patients at least 6 months after renal transplantation. Results: The size of the anterior section of the right TMJ gap in the third group was the largest among all the groups studied (1.085 mm) and statistically significantly different from the first group (0.570 mm; p = 0.001) and the second one (0.665 mm, p = 0.001). The width of the middle section was also greatest in the third group and statistically significantly different when compared to the first and second groups (0.390 mm; p = 0.023 and 0.340 mm; p < 0.001, respectively). A posterior articular gap width differences between the individual patient groups under study were not statistically significant in a posteriori comparison with Bonferroni correction. Statistical significance of differences between all groups when comparing the gap width was found in all sections of the left TMJ. The frequency of anterior disc displacement between groups ranged from 50 to 100% in all groups studied and was not statistically different when comparing right and left TMJs between groups (p = 0.084 and p = 0.662, respectively). Conclusions: CKD children have different TMJ changes, so TMJ ultrasound could screen joint pathology at early stages, and dental specialists can start timely rehabilitation.

[Assessment of patient satisfaction with orthodontic services provided in medical organizations of various forms of ownership]

OBJECTIVE

The study of expectations and satisfaction with the quality of orthodontic care provided to children in public and private dental organizations.

MATERIAL AND METHODS

The study was conducted at the clinical bases of the Borovsky Institute of Dentistry of the Sechenov First Moscow State Medical University, Vladimirsky Moscow Regional Research Clinical Institute, Videntis LLC in the period from January to April 2022. An anonymous questionnaire was developed for the study: "Questionnaire for patients to assess the quality and conditions of orthodontic medical services in a medical organization". All data are processed using the statistical software SPSS v. 20.

RESULTS AND DISCUSSION

According to respondents, the quality of service in both public and private dental organizations depends on the material and technical equipment of the medical organization, the attitude of medical personnel, the duration of treatment and the qualifications of orthodontists. Satisfaction of orthodontic care in public dental organizations corresponded to a high level in 73.4% of cases, an average level of 15.6% of cases, a low level in 11.0% of cases; in private dental organizations, a high level was noted in 98.8% of cases, an average level in 1.2% of cases, a low level in 0% of cases (in private dental organizations, not a single respondent noted the quality of services provided as low). Among the main reasons for dissatisfaction with the service of patients, the lack of diagnostic equipment, the unfriendly attitude of the secondary medical and administrative staff, as well as the duration of treatment should be highlighted.

CONCLUSION

A sociological survey to assess patient satisfaction is a tool for determining the effectiveness of any medical organization, while the assessment of the quality of service of respondents depends on the material and technical equipment of the dental organization, the attitude of medical personnel, the duration of treatment and the qualifications of orthodontists. In this regard, it is very important to apply this method of satisfaction assessment when providing high-quality orthodontic care to children both in public and private dental organizations in order to improve the quality of service in a dental medical organization.

[Stomatologic status of children 12 years old suffering from allergic pathology]

Stomatologic status of 77 children 12 year old suffering from allergic pathology was determined. Results of the study shown that in children with allergy there were high figures of dental caries experience (both frequency and intensity), of dentomaxillary anomalies, of systemic dental enamel hypoplasia, of different oral membrane diseases and of inflammatory changes in parodontal tissues. The conclusion was drown of the necessity of preventive programme development directed to reduction of stomatological morbidity in children with allergic pathology.

[Prevalence of acute dental trauma and its peculiarities in children living in educational institutions]

THE AIM

The of study was to assess the prevalence and features of acute dental trauma in children living in educational institutions.

MATERIALS AND METHODS

131 medical records of children from orphanages who suffered dental injuries in the period from 2017 to 2021 were studied. The analysis of the relationship of the type of acute dental injury (ADI) with the gender, age of patients, history, and the timing of medical care access was carried out. A dental examination was also performed on 52 healthy pupils of the Center for the Promotion of Family Education in Moscow (study group) with ADI. The control group consisted of healthy children living in families (n=52). The dental aesthetic index DAI was determined in patients of both groups.

RESULTS

Based on a retrospective analysis of the medical histories of children in educational institutions, 38.2% had a tooth luxation, 61.8% had a tooth fracture. The timing for medical care provision was characterized by a large range of values, an asymmetry of distribution (Me=4.5 days). The prevalence of ADI was higher in children from orphanages compared with children of the control group. In the case of a history of tooth injury, the DAI index was on average 5.2 points higher (p=0.016).

CONCLUSION

Dental examination of children in orphanages revealed a higher prevalence of OTD compared to children living in families. The DAI b index in patients of both groups is on average 5.2 points higher (p=0.016) in the case of a history of ADI. The study highlights the need to improve dental care and prevent dental injuries among children in educational institutions.

[Evaluation of the efficiency of the method of biological feedback in complex therapy of patients with hypertonus of the chewing muscles]

The aim the study. Evaluate the effectiveness of biofeedback therapy in the complex rehabilitation of masticatory muscle hypertonicity in patients with a high level of anxiety.

MATERIAL AND METHODS

The study included 40 patients aged 20 to 32 years with complaints of fatigue and discomfort in the area of chewing muscles, teeth compression during the day, nocturnal bruxism, crowding of teeth. Two groups were formed: the study group, whose patients underwent splint therapy in combination with biofeedback therapy trainings; in the control group, patients received treatment with splint therapy without the use of biofeedback therapy. Electromyography of the masticatory muscles at rest and during compression were used to diagnose hypertonicity of the masticatory muscles. To assess the psycho-emotional state, a medical and social questionnaire was conducted using questionnaires: «Health Questionnaire», Beck Depression Inventory, Spielberger-Khanin Anxiety Scale, SF-16 Quality of Life Scale.

RESULTS

A decrease in the level of depression, anxiety was revealed with the stabilization of emotional sensitivity in relation to other people, emotional involvement in everyday life, and an increase in the quality of life. When comparing electromyographic data at rest and during clenching of teeth in patients of the study group the indicators were lower than in the control group.

CONCLUSIONS

The effectiveness of biofeedback therapy at the stages of orthodontic treatment using splint therapy was established in the form of a decrease in the activity of masticatory muscles in patients of the study group. In the control group, the index of masticatory muscle activity decreased to a lesser extent. Biofeedback methods have shown a high level of effectiveness in reducing the symptoms of anxiety and depression, improving the quality of life.