S. V. Dyachenko’s research while affiliated with Volgograd State Medical University and other places

INTRODUCTION . Restricted mouth opening, parafunctional activity of the chewing muscles are a symptom of the development of many dental diseases caused by intra- and extra-articular causes. To verify the diagnosis, it is necessary to conduct an ultrasound examination, according to the assessment of the dynamics of qualitative and semi-quantitative parameters, it is possible to analyze the results of the treatment according to the BOS principle, which was the purpose of this study. AIM . The aim of the study was to conduct an ultrasound assessment of the structure of the masticatory muscles against the background of relief of myofascial pain syndrome. MATERIALS AND METHODS . 104 people were examined and treated, the relief of myofascial pain syndrome was carried out using combined treatment – injections of botulinum toxin type A, cross-taping and ozonation of the chewing muscle. Clinical criteria were evaluated – the intensity and duration of pain, the degree of mouth opening. According to the developed ultrasound criteria, the features of the structure of the masticatory muscles, the presence or absence of trigger points with diameter determination were studied. Using qualitative indicators, the length, width and depth of muscle tissue were studied. RESULTS AND CONCLUSIONS . In patients with myofascial pain syndrome, starting at 14 days and for 6 months, stable positive dynamics was achieved, as evidenced by a statistically significant change in the studied parameters. A correlation was revealed between the degree of mouth opening and changes in the width of the chewing muscles according to the ultrasound method of investigation. The inclusion of this method makes it possible to timely, accurately and non-invasively assess the condition of the chewing muscles, while studying the size changes of which it is possible to adjust the treatment.

The paper presents the results of a retrospective analysis of the prevalence of diseases of the oral mucosa. It is noted that the high prevalence of various ORS diseases is associated with a new coronavirus infection COVID-19 due to immunopathological changes in the patients body. It is known that patients with OOP diseases represent one of the most difficult groups of patients in dentistry. An increase in the frequency of occurrence of erosive-ulcerative lesions of the ROR was noted, which have different etiology and pathogenesis, while their clinical picture is quite similar. The study was carried out in the dental clinics of Volgograd clinical bases of the Department of Dentistry of the Institute of the NMFO FSBEI HE VolgGMU of the Ministry of Health of Russia. 2719 medical records of a dental patient (form 043y) were studied in the period 20192022. There was a significant dynamic growth, especially in 2022, of inflammatory-destructive pathologies of the COR, as well as the highest prevalence of COR pathologies in middle-aged people. A persistent increase in complicated cases with a generalized spread of pathological elements was revealed, which proves the relevance of searching for new methods for managing these patients.

The problem of the effectiveness of monitoring and routing of patients with diseases of the oral mucosa is relevant. Aim. To supplement and systematize the route scheme for patients with diseases of the oral mucosa using telemedicine technologies, depending on the level of the medical organization. Materials and methods. Supplementation and systematization, as well as a clinical study of an optimized three-stage routing scheme, were carried out. The study involved 32 patients who applied to dental medical organizations of the 1st level, 36 patients observed in the 2nd level of the MD, 46 patients from the 3rd level of the MD. Results and discussion. when monitoring the course of inflammatory and destructive diseases of the oral mucosa in patients observed at the place of residence, a positive trend was revealed, however, 38 patients, due to treatment failure, according to the routing scheme, were referred to dental clinics. level 3 organizations, where the clinical stabilization of the process was achieved with the use of digital methods of monitoring and treatment. Conclusions: a comparative clinical study identified the need for a routing scheme to improve the quality of dental care at the level of dental health of patients with diseases of the oral mucosa.

Background. Effective treatment of oral candidiasis is especially relevant due to the increase in patients with recurrent fungal lesions of the oral cavity caused by the growing number of Candidaspp. strains refractory to antimycotic drugs. The paper presents the results of the study on the clinical efficacy of etiotropic therapy in patients with chronic recurrent course of oral candidiasis. Objective. To assess the effectiveness of etiotropic therapy in patients with chronic recurrent oral candidiasis. Methods. A randomized controlled clinical trial was conducted in 56 patients with chronic recurrent oral candidiasis aged 45 to 74 years. Examination and treatment of patients was performed at the Department of Dentistry of Volgograd State Medical University and at Volgograd Regional Clinical Dental Polyclinic (Volgograd, Russia). Study timeline: September 2020 — November 2022. Patients were divided into 2 groups depending on the antimycotic drug used: in the main group, patients took voriconazole, in the control group — fluconazole. In addition to etiotropic therapy, patients of both groups were prescribed complex treatment aimed at stimulating the immune protection of the body, restoring vitamin and mineral deficiency, and correcting the imbalance of the oral ecosystem. The patients underwent local symptomatic therapy: antiseptic treatment with 0.06% chlorhexidine bigluconate solution, anesthesia with 15% lidocaine gel, and 3.44% retinol oil solution to stimulate epithelization. Oral sanitation and professional hygiene were recommended for patients to prevent oral candidiasis. In order to restore chewing function, patients were referred to prosthodontic treatment. The main reference point of the study was to assess the effectiveness of the therapy, both by clinical criteria and by evaluating the results of bacterial culture test in order to record the quantitative, species and susceptibility profile of Candidaspp. strains in 3 weeks, 6 and 12 months after the end of treatment. Analysis and statistical processing of the obtained data were performed using Excel program to MS Windows 10 (Microsoft Corp., USA). Results. The most common pathogenic agent of chronic recurrent forms of oral candidiasis is C. albicans (69.6%), followed by C. non-albicans species — C. krusei (10.7%), C. tropicalis (10.7%) and C. glabrata (8.9%). Analysis of the quantitative characteristics of Candidaspp. using bacterial culture test revealed a high and moderate number of Candidaspp. CFU in most clinical isolates before treatment, and no such cases in patients of the main group after treatment. The susceptibility test of yeast fungi to fluconazole and itraconazole showed the presence of isolates with dose-dependent susceptibility, and the resistance of individual samples C. krusei to fluconazole and C. glabrata (16.7% and 60%, respectively) and to itraconazole (33.3% and 100%, respectively). All Candidaspp. isolates were found to be highly susceptible to voriconazole. The efficacy of the combined treatment of an episode with voriconazole is 95.4%. Continued suppressive therapy with voriconazole resulted in relapse prevention in 98.3% of patients. Etiotropic therapy with voriconazole provided a stable clinical effect (92.7%) after a year of follow-up. Conclusion. The results of the study confirm the effectiveness of etiotropic therapy with voriconazole for chronic oral candidiasis complicated by a recurrent course, especially in case of detected C. non-albicans or fluconazole- and itraconazole-resistant C. albicans , or if it is impossible to identify the pathogenic agent.

Relevance. Currently, a significant increase in diseases of the oral mucosa, manifested by inflammatory and destructive lesions, has been revealed. To determine the correct tactics for the treatment of inflammatory and destructive lesions in lichen planus, it is necessary to comprehensively assess the situation in the oral cavity, taking into account planimetry data, the size of the inflammatory background, the presence of exudate, the severity of pain syndrome, and also include criteria for the stages of the lesion in the evaluation system, which requires a personalized and differentiated approach to patient management tactics. The purpose of this work was to develop and substantiate a hardware and software complex for the diagnosis of diseases of the oral mucosa. Materials and methods. The study involved 34 patients with erosive and ulcerative form of lichen planus. The patients were diagnosed with pathological elements of the oral mucosa using the developed hardware and soft-ware complex. Pain was determined (in points), the area of inflammation, the area of fibrinous plaque, the total area of the lesion for 14 days. Assessment of the stages of the pathological process contributed to the differentiated appointment of pharmaceuticals. According to the results of the clinical examination, the effectiveness of the hardware and software complex for the diagnosis of diseases of the oral mucosa has been proved and justified. Conclusion. During the study, it was reliably proved that the use of a hardware and software complex is advisable to include in the algorithm of examination of patients with diseases of the oral mucosa. No side effects and complications were detected. When drawing up a treatment plan, it is necessary to approach each patient individually, depending on the clinical situation.

Relevance. Diagnosis of oral mucosa diseases is very difficult. Heterogeneity of the oral mucosa disease manifestation often requires invasive diagnostic methods, which cause the pain syndrome. Timely and complete pain syndrome relief and the impact on all phases of the w ound healing process allow faster patient rehabilitation. The study aimed to examine the effect of Ketanov MD and Cifran CT on the wound process and the pain syndrome intensity after incisional and excisional biopsies to verify the oral mucosa pathology. Materials and methods. The study surveyed 30 people with oral mucosal diseases. The patients (30 subjects) formed two groups: excisional (10 people) and incisional biopsy (20 people). In these groups, we clinically evaluated the course of the wound process, the pain syndrome intensity, oedema phenomena, hyperemia, and the exudate presence. We analysed the quality of life of such patients using a validated Russian v ersion of the questionnaire. Results . On the 3rd day after the biopsy, on top of the generally accepted treatment of oral mucosal diseases and Ketorol MD and Cifran CT intake, the patients noted moderate aching and discomfort when talking and eating. After 14 days, all patients showed an improvement in qualitative and quantitative parameters, the absence of pain and the development of reinfection on therapy with non-steroidal anti-inf lammatory and antibacterial drugs. Conclusion . These drugs have a positive effect on the course of the phases of the wound process. They help reduce the pain response and contribute to faster patient rehabilitation af ter the biopsies in oral mucosal diseases.

At present, a significant increase in inflammatory-destructive pathologies of the oral mucosa has been revealed. However, despite the high prevalence and the trend towards a constant increase in the number of diseases, there is no single diagnostic algorithm for examining and managing these patients in dental practice. To solve the above problems, a complex system of a patient-oriented approach to the diagnosis and monitoring of the inflammatory-destructive process in diseases of the oral mucosa was developed. Aim. To evaluate the effectiveness of the developed complex system of a patient-oriented approach to the diagnosis and monitoring of inflammatory-destructive diseases of the oral mucosa. Materials and methods. A survey of 60 patients with inflammatory-destructive diseases of the oral mucosa was carried out, which were divided into 2 groups. In the main group, diagnostics and monitoring were carried out using the developed system, in the control group – according to the generally accepted scheme. Results. Taking into account the data of the study, we can confidently speak about the clinical effectiveness of the developed complex system of a patient-oriented approach to the diagnosis and monitoring of the inflammatory-destructive process in diseases of the oral mucosa. When managing patients using the proposed system, a personalized approach is provided, the dynamics of the course of the pathological process is objectively and accurately assessed, certain periods of clinical observation are offered in order to correct the prescribed therapy regimen. Conclusions. The use of a patient-oriented approach in the diagnosis and monitoring of the system helps to reduce the time of regeneration of inflammatory-destructive diseases of the oral mucosa, improves the effectiveness of the treatment of this pathology, and also improves the patient's quality of life.

The greatest increase in the frequency of occurrence was noted among diseases of the oral mucosa, especially lichen planus (LP). This dictates the need to study the features of LP monitoring and routing of patient data. Currently, the national project «Healthcare» implies, in addition to the main medical federal projects, organizational and digital directions for the development of the Russian Federation. The purpose of the study is to conduct a sociological study of monitoring and routing of patients with lichen planus of the oral mucosa. Materials and methods. To achieve this goal, an anonymous survey of 287 dentists was conducted on the provision of dental therapeutic care to patients with LP SP using a questionnaire developed by us, consisting of 35 questions of clinical, organizational and social aspects. Results and discussion. Specialist doctors noted the need to consult patients using telemedicine technologies, to create an objective way to monitor the pathological process in LP. Conclusion. Dental treatment, aimed not only at eliminating symptomatic factors, but also carried out from the standpoint of preventive medicine, is one of the urgent tasks today. Dentists are acutely aware of the lack of computerized methods for monitoring and routing patients with LP SBP, which should be the goal of the developed medical complexes.

Introduction. Lichen planus occupies a leading position (50-75%) in the structure of OM pa-thology in the population of the Russian Federation. Recently, the structure of diseases of the oral mucosa has undergone significant changes in the direction of the growth of erosive and ulcerative mucosal lesions. The purpose of the study is to analyze the prevalence of lichen planus of the oral mucosa in residents of Volgograd. Materials and methods. Based on a retro-spective analysis of the accounting and reporting documentation of a dentist-therapist, a study was made of 1896 medical records of a dental patient (form 043y) who applied to polyclinics for various diseases of the oral mucosa in the period 2019 - 2021. and patients referred to the advisory council on diseases of the oral mucosa of the Department of Dentistry INMFO. Re-sults and discussion. LP occupies a leading place in the overall structure of the pathology of the oral mucosa. There is a correlation with age - middle-aged patients (44-59 years) are especial-ly susceptible to this disease. There is a sharp increase in the incidence of LP OAM in 2021 with moderate rates of its growth in 2020, which can be explained by the current epidemiologi-cal situation regarding a new coronavirus infection. Conclusion. Analysis of the results of the study indicates a high prevalence of LP OAM in the middle-aged population of Volgograd. An increase in the number of patients with erosive-ulcerative form of LP in dynamics was revealed, which may be associated with disorders of the body's immune system as a result of a corona-virus infection. It is required to develop and put into practice effective and affordable methods for diagnosing and monitoring inflammatory-destructive lesions of the oral mucosa.