Vladimir Shkarin’s research while affiliated with Volgograd State Medical University and other places

Introduction. Psychoemotional stress is currently recognized as one of the significant risk factors affecting human health. Recent studies have highlighted its role in the development of various dental pathologies, in particular disorders of occlusive relationships. The purpose of this study is to determine the frequency and severity of psychoemotional stress in patients with occlusion disorders, as well as to identify key symptoms of psychological stress that affect dental health. Material and methods: The study was conducted at the Department of Dentistry of Volgograd State Medical University and included 120 patients aged 18 to 44 years with various disorders of occlusive relationships. The patients were divided into three groups depending on the degree of tooth abrasion. The PSM-25 questionnaire (Lemyr-Tessier-Fillion), adapted for the Russian-speaking audience, was used to assess the level of psychoemotional stress. The data were subjected to statistical analysis, including correlation analysis, to identify the relationship between stress levels and the severity of occlusive disorders. Results and their discussion: The results of the study showed that all patients included in the study experienced psychoemotional stress. The most common indicators of psychological stress have been identified: bruxism, clenching, physical malaise, fatigue and sleep disorders. Correlation analysis has demonstrated the presence of a direct relationship between the level of psychoemotional stress and the severity of occlusive disorders. Patients with more pronounced clinical manifestations of occlusal imbalance also had higher stress levels. Conclusion: The study confirmed the significant influence of psychoemotional stress on the development and course of disorders of occlusive relationships. The identification of key symptoms of psychological stress in patients with occlusive disorders is important for practical dentistry, as it allows to improve the diagnosis and treatment of these conditions. However, for a more accurate and differentiated approach to diagnosis, it is necessary to take into account many risk factors and hidden relationships, which requires further research.

The article presents the results of a study of the public attitudes towards the use of mHealth apps in the context of prevention of chronic non-communicable diseases. The survey of 461 residents of Volgograd region has shown the willingness of more than 70 % of respondents in age groups under 35 years to pay for a subscription to the mHealth app under certain conditions. The most demanded features of mHealth apps were identified, as well as the factors of adherence to the use of such applications.

The paper presents data on the prevalence of viral hepatitis, global measures aimed at eliminating viral hepatitis as a threat to public health. The federal and regional regulatory framework regulating the procedure for providing medical care to this category of patients within the framework of state guarantees and sources of financing is presented. Some organizational aspects of medical care for patients with chronic viral hepatitis C in the Volgograd region are analyzed, including data on the quality, availability and effectiveness of medical care in the treatment of patients with this pathology in the day hospital. Assessment of the direct practical implementation of the approved regulatory documents revealed certain problems that require a comprehensive solution both at different stages and levels of medical care and in the sphere of its financial support. This allowed us to present proposals to optimize the organization of medical care for patients with chronic viral hepatitis C in the Volgograd region in outpatient and hospital-substituting conditions.

Relevance. Persistent tension in muscle tissue leads to overload of contractile elements, causing structural damage and the release of calcium ions from the sarcoplasmic reticulum without subsequent reuptake. Chronic muscular overload due to prolonged or repetitive contractions contributes to excessive strain and may result in temporo-mandibular joint dysfunction. To prevent disorders associated with masticatory muscle hypertonicity, therapeutic interventions should primarily target the affected muscle tissue. One non-invasive approach is the application of ozone therapy. This study aimed to conduct a comparative evaluation of the effectiveness of ozone therapy in alleviating hypertonicity of the masticatory muscles. Materials and methods. An experimental study was conducted to assess the effectiveness of the proposed therapeutic method. Hypertonicity of the masticatory muscles was induced in 30 laboratory rats, which were then randomly assigned to two groups. The first group received standard treatment, while the second group underwent direct ozone therapy targeting the masticatory muscles. After 14 days of treatment, both qualitative parameters (inflammatory infiltration area, volume density of blood vessels, muscle tissue area) and semi-quantitative indicators (inflammation severity, as well as signs of edema and necrosis) were assessed. Results. In the first group, the muscle tissue exhibited structural disorganization and fiber hypertrophy, with occasional branching, reduced volume density of blood vessels, and increased muscle fiber area due to hypertrophy. Inflammatory response and edema persisted. These findings indicated significant impairment of tissue perfusion due to sustained spasticity. In the second group, only minor focal edema and isolated vascular engorgement were observed. The volume density of blood vessels did not differ significantly from that in intact muscle tissue. No lymphocytic infiltration, necrotic changes, or tissue destruction were detected. Conclusion. This experimental study demonstrated the myorelaxant effect of ozone therapy in alleviating muscle spasticity. No adverse effects or complications were observed in either group. The treatment did not result in marked dystrophic or destructive changes in muscle tissue.

A comparative analysis of the location of occlusal landmarks on orthopantomograms and teleroentgenograms in normal and abnormal occlusion was performed, which has a high level of information content when planning orthopedic treatment in patients with defects of the dental arches and dental-alveolar occlusion anomalies. During the comparative analysis of orthopantomograms and teleroentgenograms, it was determined that the infradental-occlusal horizontal, as a rule, was parallel to the gnathic horizontal. The ratio of the alveolar-articular line (Cond-A) to the length of the segment intersected by the articular circle line on the teleroentgenogram was 1.50±0.09. On the OPG, when analyzing the linear parameters, it was noted that the ratio of the distance from the point "Cond" to the intersection with the aesthetic median vertical to the segment of the articular circle intersected by the line was 1.61 ± 0.1, which was close in value to the Fibonacci number. This circumstance allowed the use of the "golden section" principle when determining the radius of the circle in case of anomalies in the position of molars in the vertical direction. Comparative analysis of the location of occlusal landmarks on the orthopantomogram and teleroentgenogram in the norm and in case of bite pathology showed that both methods of X-ray examination can be used in the clinic of orthopedic dentistry in the diagnosis of dentoalveolar forms of occlusion anomalies and for choosing treatment methods for patients with defects of the dental arches that are not limited from the distal side of the arch. In addition, the intersection point of the occlusal lines and infradental-occlusal horizontals, which are located in the same way on both types of radiographs, attracts attention, which makes both methods of radiographic examination acceptable in the clinical practice of dental prosthetics.

To understand the processes occurring during the development of temporomandibular myofascial pain syndrome, a clear description of the anatomical components is necessary. In the literature, the term «stomatognathic system» is used for this, the elements of which are the temporomandibular joint, masticatory muscles and the dental periodontal complex. Each component of the system is influenced by a number of factors, primarily psychological, which causes the subjectivization of clinical manifestations from headaches to pathological tooth cutting and the development of temporomandibular joint dysfunction. One of the methods of treating this pathology is to inject botulinum toxin type A into the chewing muscles. However, the question of the choice of methods of administration of botulinum toxin and its dosage remains relevant. Materials and methods. Botulinum toxin injections were performed outside and intraoral in 30 patients with temporomandibular myofascial pain syndrome. The effectiveness of the therapy was evaluated on the basis of clinical examination data, analysis of the degree of mouth opening before the start of treatment, after 14 days, 6 and 12 months. Results. The high efficiency of botulinum toxin type A injections in the treatment of the above pathology has been proven. Conclusion. It is important to evaluate the effectiveness of treatment based on the developed clinical examination methods, if necessary, correct it in a timely manner at all stages of treatment and follow-up of patients with temporomandibular myofascial pain syndrome.

Complete secondary adentia is a two-sided problem for both the patient and the dentist. Patients cannot lead a full-fledged lifestyle due to impaired aesthetics and chewing functions, and dentists experience certain difficulties in performing diagnostic manipulations in this category of patients. Currently, there are no methods for determining the volume of mouth opening in toothless jaws using a hardware and software package, which was the purpose of the study. The work is based on the examination of 30 people with a diagnosis of complete secondary adentia, the control group consisted of healthy people without partial secondary adentia. For the frequency of the study, a correlation analysis of the criteria obtained using a caliper compass and a hardware and software complex was performed. The comparative analysis revealed the reliability of the data obtained using the device developed by the authors.

Orofacial pain syndrome is an urgent problem in dentistry, due to the multifactorial and polyetiological nature of the disease. One of the causes of myofascial pain syndrome is hypertonicity of the masticatory muscles, which determines the direction diagnostics and treatment. Objective. Correlation analysis of functional diagnostic methods in the dynamics of relief of hypertonicity of the masticatory muscles in an experiment. Materials and methods. To achieve this goal, an experimental study was conducted on 30 laboratory male Wistar rats. To simulate muscle hypertonicity, a 10% calcium chloride solution was injected into the area of the masticatory muscle on the right and left. In order to influence the area of hypertonicity, ozonation was carried out using the Ozotron apparatus. To assess the effectiveness of the impact, electromyographic and laser doppler flowmetry (LDF) studies were carried out before the introduction of a 10% calcium chloride solution, immediately after ozonation, after 3, 7 and 14 days. Results. Experimentally, based on the analysis of data from electromyographic and LDF-metric studies, a direct relationship between the state of local blood flow and the functional activity of the masticatory muscles has been proven. With an increase in the average amplitude of the masticatory and temporal muscles, spastic disturbances of the bloodstream are observed, thus, microcirculatory disorders play a key role in the regulation of muscle tone and the distribution of blood flow. Conclusion. The experiment proved the indirect effect of ozone therapy on the functional state of the masticatory muscles in laboratory animals, which justifies the feasibility of conducting a clinical study in the treatment of patients with muscle hypertonicity.

Methods of prosthetic treatment in the complete absence of teeth are determined by the severity of atrophy of the alveolar arches, which differ in a variety of forms. Purpose. To develop a method for determining the degree of alveolar arch atrophy and to determine the frequency of occurrence of various variants in the clinic of prosthetic dentistry. Material and methods. A two-stage cahort study included the analysis of the transversal dimensions of the dentofacial arches at the level of the second molars, which made it possible to measure tomograms in different parts of the apical basis (cervical, root, apical). The second stage of the study was carried out on models with complete edentulism. Outcomes. In the upper jaw, the cervical transversal, compared to the root transversal, was larger by (3.01 ± 0.03) mm and (6.1 ± 0.07) mm larger than the apical transversal. In the lower jaw, the cervical transversal, in comparison with the root transversal, was (3.26 ± 0.05) mm smaller and (5.96 ± 1.07) mm smaller than the interapical transversal. Conclusion. A difference in the size of the posterior alveolar width of up to three millimeters is characteristic of first-degree atrophy. A difference in the size of the posterior alveolar width of four to eight millimeters is characteristic of second-degree atrophy, and a difference of more than nine millimeters is considered to be marked third-degree atrophy of the distal alveolar arches. These differences are applicable in the clinic of prosthetic dentistry when choosing methods for modeling artificial dental arches in full removable dentures, as well as for assessing the effectiveness of treatment.

The variability in the shape of the alveolar arches is due to numerous etiological factors, which predetermines the methods of diagnosis and the choice of methods for modeling artificial dental arches in full removable dentures. Purpose. To determine the features of the diagnosis of unilateral narrowing of the superior alveolar arch and modeling of complete removable prostheses. Material and methods. The materials of the study are presented by a clinical case of a patient with unilateral narrowing of the upper jaw with the optimal size of the inferior alveolar arch. For diagnostics, a method for constructing geometric figures on scaled photographs of models of edentulous jaws is proposed. In particular, the parameters of the diagnostic triangle and the semi-ellipse made it possible to assess the deviation of the actual dimensions from the calculated indicators, taking into account the individuality of the dimensions of the gnathic part of the face. Results and discussion. The features of the shape and size of the alveolar arches in unilateral narrowing of the upper jaw determined the placement of artificial teeth along the midline of the alveolar ridge. At the same time, the shape of the dental arch did not correspond to the ellipse. The chewing teeth on the side of the narrowing of the upper jaw closed with the reverse overlap and the torchial values of the molars of the right and left sides were different. Conclusion. The results of the study made it possible to evaluate the modeling of artificial cross-occlusion with a change in the torque values of the molars on the side of the narrowing as an optimal occlusal equilibrium that provides a functional optimum of the masticatory apparatus in the complete absence of teeth in combination with unilateral narrowing of the upper jaw.