Vol 65, No 3 (1984)

The modern understanding of infectology is not limited to acute mass infections only. Currently, the importance of opportunistic bacteria is increasingly increasing; especially in the occurrence of nosocomial outbreaks of infections. They are often the cause of deaths in patients in surgical, hematology, intensive care and other departments, as well as in hemodialysis centers. It is enough to name such a currently common infection as staphylococcal sepsis, truly "staphylococcal plague", as it is now called, in order to unite the efforts of many clinicians to study this disease. According to the USA, nosocomial sepsis was observed in one year in 40,000 patients. Without developing this idea further, I would like to dwell on the importance of immunity in infectious pathology.

Traditional for the Soviet healthcare medical examination as a complex of timely diagnostic and therapeutic and preventive measures aimed at preventing diseases, their complications and undesirable consequences, occupies a worthy place in the fight for the health of the population of our country. Dentists, as well as other specialists, have accumulated solid experience in the medical examination of various contingents of the population. In the early years of the formation of the USSR, medical examination was carried out in the system of a single dispensary and covered only a relatively small circle of patients [1]. With the development and strengthening of the dental service in the post-war period, it became possible for dentists to conduct extensive medical examinations of certain groups of the population. Already in 1962, at the IV All-Union Congress of Dentists, the concept of "dental medical examination" was adopted and legalized as a set of planned measures to improve the oral cavity of various contingents of the population.

The dental service of the Zelenodolsk district of the TASSR is represented by a dental polyclinic of the first category in Zelenodolsk, dental departments in two medical units, a department in the Vasilievsky district hospital, six dental and two dental prosthetic offices in rural areas. In total, 15 general dentists or 2.5 units of a doctor per 10 thousand population work in the village. Meanwhile, Zelenodolsk district is endemic for dental caries due to the low content of fluoride in drinking water (0.2-0.3 mg/l). In this regard, there is a need to develop new organizational forms of dental care in rural areas.

Recently, thanks to extensive research, some methods of prevention of dental caries have been developed. In some cases, they are designed solely for the local effect of remineralizing drugs and hygiene products 11, 51, in others, preventive measures are carried out comprehensively, taking into account the effect of drugs on the body and teeth [4, 6, 7, 9].

In the published works devoted to sanatorium treatment, its economic efficiency is defined as the difference in the prevented damage from diseases for a certain period of time before and after treatment in a sanatorium [1] or in a sanatorium-dispensary [3, 4].

Progenia (mesial bite) refers to severe forms of dental anomalies. With this form of sagittal malocclusion, along with a change in the ratio of the jaws and dentition, functional and aesthetic disorders occur. However, there are few works devoted to the study of long-term results of treatment of progenia [1, 2, 4, 5]. This is probably due to the fact that studies require the repeated call of previously cured patients who are already reluctant to come for examination. Long-term experience has shown that long-term results of orthodontic treatment can be studied on average only in 30% of cured patients.

In the immunological system of patients with periodontal disease, changes were found concerning both humoral and cellular components [1,2]. In this regard, a study was undertaken on the effectiveness of periodontal disease treatment with bacterial allergens in order to correct the immunological status of the patient.

Currently, in the conditions of a polyclinic for dental interventions, the main type of anesthesia is local anesthesia. However, only one method of anesthesia is not able to provide oral sanitation with such a wide range of work and individual differences in outpatient patients [2]. Recently, patients with hypersensitivity to local anesthetics have become more common. In addition, there are persons with a particularly labile or defective psyche who experience an insurmountable fear of any dental intervention. When examining the oral cavity in such patients, a large number of gangrenous teeth (up to 10 or more) are detected that need to be removed or treated. Sanitation of the oral cavity in such cases becomes possible only under general anesthesia.

Differential diagnosis of cardiac and pulmonary insufficiency in a routine clinical trial is often difficult or impossible, especially in acute conditions or with a combination of heart and lung diseases. These difficulties are due to the fact that many clinical signs of cardiac and pulmonary insufficiency are identical, for example, shortness of breath, cyanosis, tachycardia, hard breathing, wheezing in the lungs, accent 11 of the top and its cleavage over the pulmonary artery. Even instrumental invasive studies (measurement of pulmonary artery pressure and venous pressure) do not allow differentiating these conditions. In this regard, in the presence of pronounced signs of right ventricular failure, the question arises whether they are symptoms of a pulmonary heart or a primary disease of the left heart.

The frequency of intestinal blockage is relatively low (1.6-9.3%), but in such patients the highest mortality is observed - 38 - 52% [7].

Among the proteins of the animal organism, fibronectin (FN) occupies a special place due to the exceptional diversity and importance of biological properties. In 1948, Morrison et al. [69] for the first time it was discovered as part of the I fraction of blood plasma by Cohn, but interest in FN increased rapidly only in the 70s after its identification with one of the proteins of the outer cell membrane. At various times, FN has been described under numerous names that determined any property of this protein or its localization, for example, large external transformation-sensitive (LETS) protein, cold-insoluble globulin, cell adhesion factor, opsonic a2-SB-glycoprotein, anti-gelatin factor, etc. Currently, these names are almost not used, and the term "fibronectin" (fibra — fiber, nectere — bind) is adopted to refer to all forms of this protein — cellular and extracellular, soluble and membrane-associated cells that form a population of immunologically related molecules with some differences in physicochemical and biological properties.

Sanitation of the oral cavity in the sanatorium is included in the list of mandatory therapeutic and preventive measures. It consists of primary examination, treatment and removal of teeth, treatment of diseases of the oral mucosa, dental prosthetics and is carried out in close contact with doctors of other specialties.

Anti-carious measures in weakened children do not always achieve the goal. Since there are various methods of fluoroprophylaxis of dental caries, it is of interest to find out the most effective method of fluoridation with weakened body resistance.

Plaque is a concentrate of microorganisms and their waste products fixed on the enamel surface. This formation is considered as one of the decisive etiological factors of caries.

512 children aged 7-8 years were under the supervision of a dentist.

In the treatment of acute deep caries of 172 permanent teeth in 163 patients aged 12 to 35 years, etonia paste was used, which has an antimicrobial, stimulating and local anesthetic effect. Molars and premolars with localization of a carious defect on the chewing surface were treated. The diagnosis was made on the basis of anamnesis, objective examination data and indicators of electrical excitability of the tooth pulp. During operative treatment, in some cases, areas of softened dentin were left at the bottom of the carious cavity. After determining the electrical excitability of the pulp, etonium paste was applied to the bottom of the carious cavity and closed with a permanent seal. The treatment was completed in one visit.

Our observations concern the treatment of chronic apical periodontitis in 220 patients aged 18 to 77 years, in whom 264 teeth were treated — 70 multi-root and 194 single-root. Chronic granulating periodontitis was detected in 170 patients, granulomatous - in 31, fibrous - in 51, radicular cysts - in 12.

Taking into account the potential danger of chronic foci of inflammation in the oral cavity, as well as modern ideas that allow us to consider some foci-conditioned diseases as diseases of immune complexes, we determined the number of circulating immune complexes (CEC) in periodontal diseases complicated and uncomplicated by pathological dentoalveolar pockets (PZD). The study was performed in 192 patients aged 19 to 62 years suffering from periodontal diseases.

We studied the effectiveness of prosthetics in 98 patients (men - 38, women- 60) with complete absence of teeth on the upper and lower jaw. There were 13 people aged 50 to 59, 39 from 60 to 69— 36 from 70 to 79 and 10 over 80.

For two years, we examined and treated 22 patients (20 women, 2 men) aged 18 to 62 years with chronic osteoarthritis of the temporomandibular joint with a clicking symptom. The patients were divided into two groups. In the 1st we included 9 people with a click in. in the joint, in the 2nd—13 people whose clicking was accompanied by pain in the joint area.

Osteomyelitis of the skull bones is a very rare disease. Usually, the bones of the cranial vault are affected a second time by spreading infection through the veins and lymphatic vessels from neighboring foci - mainly from the paranasal sinuses, much less often from the middle ear. The frontal, temporal and parietal bones are most often affected. In most cases, osteomyelitis of the skull causes intracranial complications.

The morphofunctional state of the parenchyma and the microcirculatory bed of the thyroid gland in chronic bile loss were studied. The studies were carried out on 25 cats of both sexes, in which external drainage of the common bile duct was performed from 5 to 40 days. After 7-10 days, pronounced hypertrophy and hyperplasia of the follicular epithelium were detected in the thyroid gland. Hyperplasia was extrafollicular in nature with the formation of numerous microfollicles. There was a statistically significant increase in the height of the follicular epithelium cells and a decrease in the average diameter of the follicles. On the 10th day of the experiment, the level of protein-bound iodine in serum was 0.29±0.03 °/o 131I per 1 liter of serum (Functional research methods in endocrinology. Kiev, Zdorov'ya, 1981), in the control - 0.34 ± 0.04%. Accumulation of 131I reached its maximum level after 6-10 hours.

In order to diagnose tumors of the anterior segment, the protective apparatus of the eye and postorbital tumors, as well as to dynamically monitor the treatment of tumors by cryogenic method, we used the cytological method.

Recently, there has been an increase in the frequency of inflammatory diseases and traumatic injuries of the maxillofacial region, which not only disrupt the function of the organ, but sometimes threaten the patient's life and, therefore, require urgent medical measures. Late terms of care and erroneous tactics in the treatment of such patients can lead to persistent violations of the act of chewing, swallowing and speech. Unfortunately, the issues of treatment of inflammatory diseases and traumatic injuries of the tongue have not found proper coverage in the literature. In this regard, we decided to share the experience of their therapy.

One of the most common anomalies of the dental system is a deep bite, which is observed during the entire period of formation of the dental system. Its main clinical sign is a violation of the cutting-tubercle contact with the overlap of the lower frontal teeth. Deep bite "in its pure form" is rare. Quite often it is combined with anomalies in the sagittal plane, as well as with anomalies in the position of individual teeth. Such a bite leads to a violation of the functions of the chewing apparatus and the body as a whole. However, the reasons prompting the patient to consult a doctor are most often a cosmetic defect, pain, a feeling of fatigue in the temporomandibular joints.

There are over 40 known methods of surgical treatment of progenia, which are carried out by extra-oral access. However, cosmetic operations performed on the body of the jaw leave scars, and therefore do not always satisfy patients.