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Международный научно-исследовательский журнал ■ № 7(38) ■ Август
Комлев С.С.
Кандидат медицинских наук,
ГБОУ ВПО Самарский Государственный Медицинский Университет Минздрава России КОНТРОЛЬ СОСТОЯНИЯ ТКАНЕЙ ПРОТЕЗНОГО ЛОЖА
Аннотация
Контроль состояния тканей протезного ложа осуществляется в центральном соотношении челюстей на прямой и боковой телерентгенограммах головы пациента. В отличие от ортопантомографии челюстей при телерентгенографии снимки получаются с меньшим искажением и на пациента оказывается малое количество излучения. По середине окклюзионной поверхности верхнего валика и наносят рентгеноконтрастный материал например, ортодонтическую проволоку диаметром 0,4-0,6 мм. Далее размещают на верхний и нижний восковые базисы по линиям, проходящим по вершинам гребней альвеолярных отростков нижней и верхней челюстей, приклеивают ортодонтическую проволоку. Затем проводят боковую и прямую телерентгенографии головы с сомкнутыми челюстями.
Ключевые слова: зубной протез, протетическая плоскость, телерентгенография.
Komlev S.S.
MD, Samara State Medical University MONITORING THE STATE OF PROSTETIC BED TISSUES
Abstract
Monitoring the state of prosthetic bed tissues is carried out in the central correlation of the jaws on the direct and side patient’s head teleroentgenography. On contrast to orthopantomography of jaws, teleroentgenography images are less distorted and the patient receives a small amount of radiation. In the middle of the occlusal surface of the upper roller a radiopaque material is applied, such as orthodontic wire with a diameter of 0.4-0.6 mm. Then it is placed on the upper and lower wax bases along the lines passing through the crest of the alveolar process of the lower and uppers jaws and orthodontic wire is glued. After that, side and direct teleroentgenography of the head with closed jaws is conducted.
Keywords: denture, prosthetic plane, teleroentgenography.
The invention relates to medicine, namely to the orthopedic dentistry and can be used for monitoring of the mutual position of edentulous alveolar processes, their location concerning to the prosthetic plane, the degree of atrophy of alveolar crests and mucous membrane on them. It also can be used for solution of the problem of surgical preparation of alveolar processes (partial removal or plastic of processes) before prosthetics patients with removable dentures and constructing artificial dentitions, as well as before dental implantation, i.e. to obtain significant information about dentoalveolar system.
Monitoring the state of prosthetic bed tissues is carried out in the central correlation of the jaws on the direct and side patient’s head teleroentgenography. On contrast to orthopantomography of jaws, teleroentgenography images are less distorted and the patient receives a small amount of radiation [2, 3].
There are: a method of determining the thickness of soft tissues above the crest of edentulous alveolar process (RF patent №2215497) and the method of determining the degree of atrophy of the alveolar process height under the base of removable denture (RF patent №2199974).
Both methods have two main drawbacks:
1. The state of prosthetic bed tissues is studied at ortopantomography, i.e. distorted images are obtained.
2. In both methods, a study of a single parameter is conducted (the thickness of the prosthetic bed’s soft tissues, or the atrophy of alveolar process height under the denture).
3. In addition, both methods are not related to constructing the artificial dentitions in total removable dentures, as they do not carry information about the location of prosthetic plane (the main landmark for constructing artificial dentitions).
The following method was taken as a prototype of the invention: «Method of determining the degree of atrophy the alveolar process height under the base of removable denture» (Patent №2199974).
The technical result, which the creation of the present invention aims to achieve, includes the objective studying the mutual position of hard and soft tissues of edentulous jaws in central relation, studying the degree of atrophy in individual periods while using total removable dentures. It also includes the study of the location of alveolar processes concerning to prosthetic plane for planning surgical preparation of alveolar processes before prosthetics and constructing the artificial dentitions, i.e. for obtaining a considerable information about patient’s dentoalveolar system.
The gist of invention is the following. After determining the central ratio of jaws the radiopaque material (such as thin orthodontic wire) is applied on wax bases with biting rollers of upper and lower jaws by prosthetic bed on the location of alveolar crests tops and in the middle of the occlusal surface of the upper roller. In position of central occlusion, side and direct teleroentgenography of head is received. On the obtained images is carried out a study of the location of alveolar processes with each other and concerning to prosthetic bed for planning surgical preparation of alveolar processes before prosthetics and constructing the artificial dentitions.
A method of monitoring the state of prosthetic bed tissues of edentulous jaws concerning to each other or to prosthetic plane on the teleroentgenography of head [1] is realized in the following way.
The lower biting roller is customized like upper one taking into account the height of lower portion of face. The central ratio of jaws is determined. Then, the radiopaque material such as orthodontic wire with a diameter of 0.4-0.6 mm. is applied in the middle of occlusal surface of the upper roller. After that, it is placed on the upper and lower wax bases along the lines passing through the alveolar crests tops on lower and upper jaws, as well orthodontic wire is glued. Then side and direct teleroentgenography of head with closed jaws is conducted. On the obtained images, the location of alveolar processes is
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Международный научно-исследовательский журнал ■ № 7(38) ■ Август
studied with each other and concerning to prosthetic plane for planning surgical preparation of alveolar processes before prosthetics and constructing the artificial dentitions.
Clinical example. Patient T., 63 years old, medical history №1458, appealed to the GBUZ SO SSP №3 (base of the Chair of Orthopedic Dentistry SSMU) complaining of unsatisfactory results of prosthetics by total removable dentures with different doctors. Prosthetics was conducted three times. It was decided to conduct prosthetics by new total removable dentures. In order to study the location of the alveolar processes with each other and concerning to prosthetic plane before constructing artificial dentitions patient T. was directed to make a teleroentgenography of head, according to the proposed technique. This picture with radiopaque images (radiopaque material is located on the top of the alveolar process crest of upper jaw and on the occlusal surface of upper biting roller by prosthetic plane, the radiopaque material is located on the top of alveolar process crest of the lower jaw) was used to make total removable dentures for our patient, namely for constructing artificial dentitions in total removable dentures. The patient use prostheses successfully.
The proposed technique was applied to 27 patients with a total toothless with use of total removable dentures. Results of treatment are encouraging.
References
1. Komlev S.S. et al. A method of monitoring the state of prosthetic bed tissues of edentulous jaws concerning to each other or to prosthetic plane at the teleroentgenography of head, RF patent of prosthetic bed tissues of edentulous jaws concerning to each other or to prosthetic plane at the teleroentgenography of head, RF patent №2325869, 2008, 3p.
2. Rogatskin D.V., Ginali N.V., The skill of radiography. - STBOOK. 2007, 206, p.
3. Trofimova T.N., Garapach I.A., Belchikova N.S. Radiodiagnosis in dentistry. - MIA. 2010, 192p.
Коршевер Н.Г., Сидельников С.А.
1 Доктор медицинских наук, профессор, 2кандидат медицинских наук, доцент ГБОУ ВПО «Саратовский государственный медицинский университет имени В.И. Разумовского» Минздрава РФ ОЦЕНКА МЕЖСЕКТОРАЛЬНОГО ВЗАИМОДЕЙСТВИЯ ПО ВОПРОСАМ ОХРАНЫ ЗДОРОВЬЯ НАСЕЛЕНИЯ: ОБОСНОВАНИЕ АВТОМАТИЗАЦИИ НА БАЗЕ СИСТЕМНОЙ ПРОГРАММЫ
1С: ПРЕДПРИЯТИЕ
Аннотация
Обоснована автоматизация способа многовекторной оценки межсекторального взаимодействия по вопросам охраны здоровья населения на базе системной программы 1С: Предприятие, которая позволяет решать задачи сравнения деятельности в любом числе территориальных образований (или в динамике), располагать их в порядке убывания приоритета, выбирать заданное число лучших и худших и указывать векторы и критерии, определившие ту или иную оценку.
Ключевые слова. Автоматизация, здоровье, население, межсекторальное взаимодействие.
Korshever N.G.1, Sidelnikov S.A.2
1Professor, Doctor of Medical Science, 2Associate Professor, MD Saratov State Medical University n.a. V.I. Razumovsky
EVALUATION OF INTERSECTORAL COOPERATION ON THE PROBLEMS OF PUBLIC HEALTH PROTECTION: SUBSTANTIATION OF AUTOMATIZATION ON THE BASIS OF THE SYSTEMIC PROGRAM
1C: ENTERPRISE
Abstract
There has been substantiated an automatizing method of multi-vector evaluation of intersectoral cooperation on the problems of public health protection on the basis of the systemic program 1C: Enterprise, which makes it possible to perform the tasks of activity comparison in any number of territorial formations (or in dynamics), to arrange them in the order of priority decrease, to choose a certain number of the best and worst ones and to indicate the vectors and criteria determining this or that evaluation point.
Keywords: automatization, health, population, intersectoral cooperation.
Введение. Охрана здоровья населения - важнейшая проблема современности. Её решение обеспечивается взаимодействием различных секторов государства и общества - межсекторальным взаимодействием, для реализации которого целесообразно осуществлять соответствующий мониторинг. Такой мониторинг возможен при наличии способа оценки. В работе [5] описано конструирование многовекторного способа оценки межсекторального взаимодействия по вопросам охраны здоровья населения. Вместе с тем «ручная» реализация этого способа представляется достаточно сложной, что связано, во-первых, с анализом большого числа векторов (38) - 21 простого и 17 сложных. При этом каждый сложный вектор состоит из ряда (от 3 до 12) информативных критериев. Во -вторых, необходимо определить градацию каждого вектора и информативного критерия. В-третьих, должен быть учтён коэффициент важности каждого из указанных показателей. Наконец, в-четвёртых, при таком количестве последних (более 100) существенно затрудняется интегральная оценка (вначале оценивается каждый сложный вектор, потом получается общий результат). Поэтому есть необходимость в автоматизации рассматриваемого способа.
Цель работы - автоматизировать способ многовекторной оценки межсекторального взаимодействия по вопросам охраны здоровья населения.
Материалы и методы. Проведён теоретико-методологический анализ опыта автоматизации оценки успешности различных процессов в здравоохранении. Осуществлена автоматизация рассматриваемого способа оценки на базе системной программы 1С: Предприятие.
Результаты. В ходе выполнения работы проанализирована возможность реализация ряда вариантов
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