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КЛ1Н1КО-ЛАБОРАТОРНЕ ОБГРУНТУВАННЯ ЗАЛЕЖНОСТ1 ЗАПАЛЬНИХ ЗАХВОРЮВАНЬ ПАРОДОНТУ В1Д СТАНУ ГЕПАТОБIЛIАРНОÏ СИСТЕМИ
Фурдичко A.I., Гасюк П. А., 1ванчишин В.В., Гасюк Н.В.
У вщповщносп до юнуючих уявлень про патогенез гепато-орального синдрому, в його розвитку виршальну роль вщграе порушення антимщобно'1 функцп печшки. У статт описаш результати дослщження стану тканин пародонту у 128 пащенив, яю включають в себе клшчш спостереження та шдексну оцшку (OHI-S, РМА, PBI), а також печшюда маркери у сироватщ кров^ За допомогою проведених клшко-лабораторних дослщжень ми переконались, що у хворих з гепатобшарною патолопею збшьшуеться ймовiрнiсть виникнення запальних захворювань пародонта, а тсля лкування захворювань печшки, пародонтолопчш показники та шдекс ппени значно знижуються. Ц даш свщчать про залежшсть стану тканин пародонту вщ стану гепатобшарно'1 системи.
Kto40bî слова: Гепатобшарна патолопя, запальнi захворювання пародонта, iндексна оцiнка.
Стаття надшшла 6.11.2017 р.
КЛИНИКО-ЛАБОРАТОРНОЕ ОБОСНОВАНИЕ
ЗАВИСИМОСТИ ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ ПАРОДОНТА ОТ СОСТОЯНИЯ ГЕПАТОБИЛИАРНОЙ СИСТЕМЫ Фурдычко А.И., Гасюк П.А., Иванчишин В.В., Гасюк Н.В.
В соответствии с существующим представлениями о патогенезе гепато- орального синдрома, в его развитии решающую роль играет нарушение антимик-робной функции печени. В статье описаны результаты иссле-дования состояния тканей пародонта у 128 пациентов, кото-рые включают в себя клинические наблюдения и индексную оценку (OHI-S, РМА, PBI), а также печеночные маркеры в сыворотке крови. С помощью проведенных клинико-лабораторных исследований мы убедились, что у больных с гепатобилиарной патологией увеличивается вероятность возникновения воспалительных заболеваний пародонта, а после лечения заболеваний печени, пародонтологические показатели и индекс гигиены значительно снижаются. Эти данные свидетельствуют о зависимости сосно-яния тканей пародонта от состояния гепатобилиарной системы.
Ключевые слова: Гепатобилиарная патология, воспалительные заболевания пародонта, индексная оценка.
Рецензент Петрушанко Т.О.
DOI 10.26724 / 2079-8334-2018-1-63-89-93 UDC 616.314.7-055.1(477)
LINEAR DIFFERENCE COMPUTED TOMOGRAPHY SIZE LARGE MOLAR TEETH IN HEALTHY MEN FROM CENTRAL REGIONS OF UKRAINE
In 64 practically healthy men aged from 19 to 35 years from the central region of Ukraine, features of the differences in the computed tomographic size of large angular teeth and their roots, depending on the type of person, were determined. The most pronounced differences in the size of large angular teeth are set on the lower jaw for height, crown height, mesio-distal dimensions of the crown and neck, as well as the length of the near and far root of the right and left first and second teeth.
Key words: odontometry, computer tomography, large angular teeth, practically healthy men.
The question of regional features of cephalometric and odontometric indices has been actively studied throughout the world during the last decade [4, 6, 11, 14]. The research is aimed at identifying not only regional features, but also administrative and territorial units, but also natural, historical zones, regions with different types and intensities of anthropogenic pollution. Many studies are aimed at identifying discrepancies
in the studied quantities among various ethnic minorities. The results of some studies have already been successfully implemented in the practice of doctors of various profiles [2, 5, 7, 8], which has a positive impact on the level of dental health of the population, which in turn increases the standard of living of the population.
The purpose of the study is to establish the peculiarities of the computer-tomographic size of large angular teeth and their roots in practically healthy men of the central region of Ukraine with different types of faces.
Material and methods. On the basis of the medical center "Win intermed LTD", 64 somatologically healthy men, in the third generation of inhabitants of the central region of Ukraine (residents from Vinnytsia, Cherkasy, Kirovograd, Poltava and Dnipropetrovsk regions), aged from 19 to 35 years from different administrative regions of Ukraine done a cone-ray computer tomography using the Veraviewepocs-3D dental cone beam tomograph (Morita, Japan). The volume of a three-dimensional image is a cylinder - 8x8 cm, a layer thickness - 0,2/0,125 mm, an irradiation dose - 0,011-0,048 mSv, a voltage and current strength - 60-90kV/2-10mA. The study of a three-dimensional model of bone structure of the tooth-jaw complex was carried out in the i-Dixel One Volume Viewer (Ver.1.5.0, J Morita Mfg. Cor.). Bioethics Committee of National Pirogov Memorial Medical University, Vinnytsya (protocol № 8 dated 10.09.2013) found that the studies fully met ethical and moral-legal requirements in accordance with the order of the Ministry of Health of Ukraine № 281 of 01.11.2000 and do not contradict the basic bioethical norms of the Helsinki Declaration, the Council of Europe Convention Human Rights and Biomedicine (1977).
According to the standard method [12] on cone-ray computer tomograms of large angular teeth of the upper (16 - right first, 17 right second, 26 left first, 27 left second) and lower (36 first left, 37 second left, 46 right first, 47 second right)jaws measurements were made: height of the corresponding tooth (HZ); length of palatine (HRZ1), vestibular of nearest (HRZ2) and distant (HRZ3) roots of large angular teeth of upper jaw; the length of the neighbor's (HRZ4) and distant (HRZ5) roots of the large angular teeth of the mandible; height of the crown of the corresponding tooth (HKZ); vestibular-lingual crown sizes (VO_K) and neck (VO_S) of the corresponding tooth; mesio-distal dimensions of the crown (MD_K) and neck (MD_S) of the corresponding tooth. The cephalometric study consisted of determining the parameters of the cerebral and facial sections of the head with the help of a large sliding compass with a scale in the real size of the Martin system and soft centimeter ribbon. Cephalometric studies were conducted taking into account the generally accepted recommendations and anatomical points [1, 3]. The value of the face index (Garson morphological index) was obtained by the corresponding formula [10]. At the meaning of the indicator by 78.9 men were grouped to very broad face; 79,0-83,9 - wide face; 84.0-87.9 - middle face; 88,0-92,9 - narrow face; 93.0 and more - very narrow face. The following distribution established: with a very wide face - 1; with a wide face -7; with middle face - 9; with a narrow face - 18; with a very narrow face - 29.
Statistical processing of the obtained results was carried out using the statistical software package "Statistica 6.1" using nonparametric methods. Mean values and their standard deviations were determined. The reliability of the difference between independent quantitative values was determined using the Man-Whitney U-criterion.
Results and its discussion. As a result of our research, we established the percentile scale (25.0 percentl and 75.0 percentl) of computer-tomographic size of large angular teeth and their roots in practically healthy men of the central region of Ukraine with different types of faces (Table 1, 2). In the analysis of computer-tomographic size of large angular teeth and their roots in men of the central region of Ukraine with different types of faces it is established: on the upper jaw - in men with a narrow face, the height of the crown of the right and left first teeth has a slight tendency to lower values than those with average (6.67 and 7.05%, p = 0.080 in both cases) face type; in men with a very narrow type of face, the mesio-distal crown size of the right first tooth tends to be lower than those with a broad (6.07%, p = 0.069) and narrow (3.50%, p = 0.063) facial types, while the length of the vestibular far root of the right second tooth is significantly lower or tends to lower values than those with broad (16.88%, p = 0.053), average (15.61%, p <0.05 ) and narrow (by 13,91%, p <0,05) face types; on the lower jaw - in men with a broad face type, the height of the right and left first and second left teeth is significantly higher or tends to be higher than those with average (5.61-7.89%, p <0.05, p = 0.064-0.078) and very narrow (only the first ones at 4.80 and 5.64%, p <0.05), the height of the crown of the left second tooth is significantly higher or tends to be higher than that of the average (9.25%, p <0.05) and very narrow (10.08%, p = 0.066), the mesio-distal size of the crown of the right and left first teeth is significantly greater than or tends to be higher than that of the average (6.43 and 10.36%, p <0.05-0.01), narrow (only the left at 6.67%, p = 0.057) and very narrow (only right 2.90%, p = 0.080) face, the mesio-distal size of the neck of the right and left first teeth is significantly greater or tends to be higher than that of the representatives with narrow (7.22 and 5.57%, p <0.05, p = 0.074) face, and the left second tooth than those with a very narrow face (3.96%, p = 0.072), the vestibular-lingual crown size of the left first tooth tends to be
larger than from the representatives with average face (5.86%, p = 0.05), the length of the near and far root of the right and left first teeth is significantly higher or has slight tendencies to higher values than those with very narrow (8.94% left, p <0.05 and right on 6.13 and 7.15%, p = 0.072-0.075) face, and the length of the far root of the left second tooth is higher than that of the representatives with an average (10.91%, p <0.05 ) and narrow (by 9.20%, p = 0.074) face types; in men with a narrow face type, the height of the crown of the left first and second teeth tends to be higher than that of the subjects with a very narrow (6.22 and 6.66%, p = 0.063-0.080) faces; in men with a very narrow type of face the mesio-distal size of the crown of the left first tooth is significantly higher than that of the representatives with an average (7.52%, p <0.01) face.
Table 1
Percentile swing odontometric indices of large angular teeth of the upper jaw in practically healthy men
Indexes | Face type
| wide | average | narrow | very narrow
25,0th perc. 75,0th perc. 25,0th perc. 75,0th perc. 25,0th perc. 75,0th perc. 25,0th perc. 75,0th perc.
17HZ 19,16 23,10 18,95 21,60 20,20 22,38 19,10 21,48
17HRZ1 10,83 15,10 9,950 13,50 11,63 14,40 11,19 13,69
17HRZ2 12,44 13,76 11,30 14,46 10,50 13,75 9,900 14,01
17HRZ3 12,27 16,51 12,30 15,01 12,10 14,67 10,39 13,40
17HKZ 6,300 7,090 6,130 6,650 6,200 7,580 5,310 7,100
17MD K 9,170 10,26 9,250 9,500 8,600 9,810 8,850 9,450
17MD S 7,790 8,750 7,600 8,360 7,130 8,300 7,460 8,400
17VO K 11,10 12,51 11,10 12,35 10,35 12,09 10,86 11,93
17VO S 5,920 9,340 8,600 9,050 6,420 8,770 7,750 9,230
16HZ 19,57 23,00 18,75 21,60 19,50 22,76 19,55 22,63
16HRZ1 10,80 15,00 12,01 13,34 11,96 14,60 11,86 13,85
16VRZ2 10,32 13,42 10,25 13,25 10,24 14,19 10,21 13,02
16VRZ3 11,13 15,00 12,06 15,50 12,19 15,18 11,23 14,00
16HKZ 6,150 7,390 6,040 6,600 6,250 7,400 5,650 7,360
16MD K 9,690 11,26 9,350 10,25 9,730 10,59 9,260 10,28
16MD S 7,670 9,500 7,880 8,350 7,750 8,350 8,180 8,500
16VO K 9,210 12,09 11,00 11,67 11,10 11,90 10,78 11,94
16VO S 7,700 11,63 10,25 10,99 10,08 11,27 10,28 10,95
26HZ 19,60 22,68 19,16 22,63 19,58 22,70 19,94 22,01
26HRZ1 10,82 15,01 11,75 13,42 12,05 13,85 11,81 14,00
26VRZ2 10,36 13,90 12,10 12,88 10,53 13,23 10,15 13,43
26VRZ3 12,86 14,96 12,15 15,75 12,16 14,98 12,35 14,29
26HKZ 6,250 7,310 6,000 6,620 6,600 7,380 5,970 7,090
26MD K 9,720 10,75 9,250 10,15 9,600 10,37 9,250 10,20
26MD S 7,640 9,100 7,900 8,200 8,000 8,67 7,940 8,480
26VO K 9,240 12,09 10,98 11,50 10,94 11,90 10,90 11,88
26VO S 7,680 11,51 10,33 11,08 10,10 10,90 10,28 11,12
27HZ 19,01 23,51 19,16 21,25 20,05 21,75 19,05 22,03
27HRZ1 12,80 15,73 12,19 13,60 11,88 13,60 12,25 14,53
27HRZ2 10,61 13,59 10,64 13,42 10,95 13,61 10,52 13,51
27HRZ3 12,24 16,52 11,25 14,97 12,17 13,84 11,00 13,63
27HKZ 6,310 7,510 5,990 6,600 6,090 7,480 5,550 7,220
27MD K 9,150 10,34 9,100 9,630 8,510 10,05 8,860 9,670
27MD S 7,790 8,340 7,500 8,340 7,230 8,250 7,480 8,130
27VO K 11,04 12,43 11,19 12,09 10,15 11,94 11,06 12,05
27VO S 10,70 11,75 10,80 11,65 9,940 11,44 10,40 11,72
Unlike the results we have obtained, V. O. Orlovsky [9] in practically healthy men of the central region of Ukraine with different types of face has found the most pronounced differences in the computer-tomographic size of small angular teeth only on the upper jaw - in men with middle face type higher teeth height than those with other types of faces, as well as larger values of palatine and cheek root length in middle-face men than those with a broad and narrow face. Comparing the obtained results with the size of large angular teeth in practically healthy men of Ukraine with different types of faces [13], it should be noted that in the general group most of the differences in the size of the teeth are set on the upper jaw (predominantly mesio-distal dimensions of the crown and neck - greater in men with a broad type of face), but on the lower jaw for height, length of the far root and vestibular-tongue size of crowns of the right and left other teeth (lower values in men with average type of face).
Table 2
Percentile sweep of odontometric indices of large angular teeth of mandible in practically healthy men _of the central region of Ukraine ^ with different types of faces (mm)_
Indexes Face type
wide average narrow | very narrow
25,0th perc. 75,0th perc. 25,0th perc. 75,0th perc. 25,0th perc. 75,0th perc. 25,0th perc. 75,0th perc.
37HZ 20,70 23,13 19,61 20,85 19,68 22,25 19,66 22,85
37HRZ4 13,95 15,57 13,15 14,10 12,95 15,50 13,35 15,23
37HRZ5 13,79 14,75 11,80 13,24 11,54 14,25 12,61 14,23
37HKZ 6,600 7,600 6,200 7,000 6,230 7,620 5,670 6,960
37MD K 10,90 11,40 10,50 11,38 10,55 11,25 10,50 11,50
37MD S 9,850 10,75 9,380 10,75 9,150 10,27 9,600 10,03
37VO K 10,43 11,28 9,970 10,67 10,32 11,02 10,23 11,50
37VO S 8,650 10,09 8,240 9,900 8,850 9,900 8,940 10,00
36HZ 22,12 23,16 19,44 22,05 20,50 22,60 20,44 22,10
36HRZ4 15,00 16,00 12,64 15,80 13,45 15,87 13,38 15,41
36HRZ5 14,88 15,51 11,84 14,68 13,13 15,10 12,50 14,85
36HKZ 6,540 7,090 6,250 7,030 6,500 7,520 5,900 7,020
36MD K 10,98 11,64 10,10 10,38 9,900 11,46 10,55 11,44
36MD S 9,500 10,34 8,880 9,500 8,730 9,840 9,100 10,06
36VO K 10,70 11,50 10,17 10,65 10,20 11,28 10,30 11,36
36VO S 9,300 9,920 8,750 9,840 8,780 9,510 9,030 9,620
46HZ 22,10 23,10 20,18 21,98 20,25 22,60 20,00 22,10
46HRZ4 14,63 16,04 12,32 15,73 13,04 15,88 13,19 15,40
46HRZ5 14,59 15,13 13,38 14,28 13,19 14,93 12,69 14,44
46HKZ 6,480 7,250 6,600 6,870 6,230 7,400 5,880 7,100
46MD K 10,94 11,61 10,30 11,20 9,860 11,61 10,52 11,47
46MD S 9,420 10,20 9,380 10,13 8,680 9,600 9,160 9,800
46VO K 10,75 11,60 10,14 11,01 10,19 11,17 10,26 11,27
46VO S 9,130 9,640 8,800 9,840 8,890 9,690 9,020 9,700
47HZ 20,61 22,67 19,60 21,10 19,60 22,18 19,42 22,13
47HRZ4 13,87 15,62 13,14 14,13 12,75 14,30 13,30 14,75
47HRZ5 13,63 14,59 11,84 14,20 11,94 14,87 12,27 14,25
47HKZ 6,570 8,010 6,300 6,990 6,250 7,550 5,880 7,630
47MD K 10,88 11,30 10,48 11,38 10,58 11,25 10,50 11,23
47MD S 9,790 10,75 9,130 10,13 9,250 10,50 9,480 10,14
47VO K 10,41 11,26 9,410 10,67 10,28 11,01 10,25 11,26
47VO S 8,620 9,780 8,500 9,910 8,850 9,770 9,270 10,17
Thus, the obtained results of computer tomographic size of large angular teeth and their roots in practically healthy men of the central region of Ukraine with different types of faces confirm the necessity of individualizing the approach to the patient in dentistry taking into account not only the features of the features of his face but also ethno-territorial affiliation. This approach is the right key, which should ensure the proper quality of dental care delivery to the population.
In practically healthy men of the central region of Ukraine with different types of faces, the most pronounced reliable or tendencies of differences in the computed tomographic size of large angular teeth and their roots are established mainly on the lower jaw - in men with a broader face the higher values of the height of the right and left first and second left teeth, as well as the height of the crown of the left second tooth than those with an average and very narrow face; mesio-distal crown size of the right and left first teeth than those with middle, narrow (only left) and very narrow (only right) face; mesio-distal size of the neck of the right and left first teeth than those with narrow faces, and the left second tooth - than those with a very narrow face; vestibular-lingual size of the crown of the left first tooth than those with middle faces; the length of the near and far root of the right and left first teeth than those with a very narrow face, and the length of the far root of the left second tooth - than those with middle and narrow face types. In men with a narrow face, the height of the crown of the left first and second teeth is greater than that of the representatives with a very narrow face; and in men with a very narrow face the mesio-distal size of the crown of the left first tooth is larger than that of the middle faces.
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В1ДМШНОСП Л1Н1ИНИХ КОМП'ЮТЕРНО-ТОМОГРАФ1ЧНИХ РОЗМ1Р1В ВЕЛИКИХ КУТН1Х ЗУБ1В У ПРАКТИЧНО ЗДОРОВИХ ЧОЛОВ1К1В ЦЕНТРАЛЬНОГО РЕПОНУ УКРА1НИ Шшкарук-Шинкарук-Диковицька М.М., Коцюра О. О., Тепла Т.О., Мельник М.П., Чайка В., Шештько К.В., Лiхiцький О.М.
У 64 практично здорових чоловшв вком вщ 19 до 35 роюв iз центрального репону Украши встановлеш особливост вщмшностей комп'ютерно-томографiчних розмiрiв великих кутшх зубiв та 1х корешв в залежиосп вщ типу обличчя. Найбшьш виражеш вщмшносп розмiрiв великих кутнiх зубiв встановлеш на нижнш щелепi для висоти, висоти коронки, мезiо-дистальних розмiрiв коронки i шийки, а також довжини ближнього i дальнього кореня правого i лiвого перших та лiвого другого зубiв.
Ключовi слова: одонтометрiя, комп'ютерна томографiя, великi кутнi зуби, практично здоровi чоловiки.
Стаття надшшла 2.11.2017 р.
DOI 10.26724 / 2079-8334-2018-1-63-93-95 UDC 616-089: 612[51+563]
ОТЛИЧИЯ ЛИНЕИНЫХ КОМПЬЮТЕРНО-ТОМОГРАФИЧЕСКИХ РАЗМЕРОВ БОЛЬШИХ КОРЕННЫХ ЗУБОВ У ПРАКТИЧЕСКИ ЗДОРОВЫХ МУЖЧИН ЦЕНТРАЛЬНОГО РЕГИОНА УКРАИНЫ Шинкарук-Диковицкая М. М., Коцюра О. А., Тепла Т. А., Мельник М. П., Чайка В., Шепитько К. В., Лихицкий А. М.
У 64 практически здоровых мужчин в возрасте от 19 до 35 лет из центрального региона Украины установлены особенности отличий компьютерно-томографических размеров больших коренных зубов и их корней в зависимости от типа лица. Наиболее выраженные отличия размеров больших коренных зубов установлены на нижней челюсти для высоты, высоты коронки, мезио-дистальных размеров коронки и шейки, а также длины ближнего и дальнего корня правого и левого первых и левого второго зубов.
Ключевые слова: одонтометрия, компьютерная томография, большие коренные зубы, практически здоровые мужчины.
Рецензент Гунас 1.В.
DEVELOPMENT OF INADVERTENT INTRAOPERATIVE HYPOTHERMIA: THE POSSIBILITIES OF CLINICAL PROGNOSIS
e-mail: [email protected]
Inadvertent intraoperative hypothermia is known to increase the risk of intra- and postoperative complications. Its prediction and subsequent prevention is an acute and clinically meaningful problem. The aim of research is to determine the predictors of inadvertent intraoperative hypothermia development. Ascertaining prospective open-label study of temperature homeostasis in 100 surgical patients has been carried out. During the study, patients were divided into two groups, depending on the presence or absence of inadvertent intraoperative hypothermia. In processing of the study results was indicated the method of normalization of intense values and risk of sign realization by E. N. Shyhan. It was found out the occurrence rate of inadvertent intraoperative hypothermia that makes up 62%, identified its prognostic criteria including time-urgent operations, midline laparotomy, duration of the operation over 60 min, medication with barbiturates, myorelaxants, artificial lung ventilation, female sex, elderly age over 60 years, body mass index below 18.5 kg/m2.
Keywords: inadvertent intraoperative hypothermia, prognosis.
The paper is a part of RSW "Optimizing the quality of anaesthesia and intensive care patients based on age and gender dimorphism clinical and functional, immune and metabolic changes", state registration number 0114U006326.
Humans are homoiothermic organisms, i.e. they are able to maintain their own stable internal body temperature regardless of external influence. However, anesthesia, even local, results in partial loss of the human body to maintain constant temperature by itself, thus, making it poikilothermic, i.e. when body
