Recurrent aphthous stomatitis / Шинэ санаа Шинэ нээлт

@#Aphthae are common oral lesions that affect approximately 10% to 20% of the population. Recurrent Aphthous Ulcers (RAU) are usually classified into three different types: minor, major and herptiform RAU. The etiology of aphthous stomatitis is unknown but according to increasing evidence, its development has an immunogenic process that causes the ulceration of the involved oral mucosa. Similar-appearing lesions may arise in following systemic disorders: 1. Behcet’s disease 2. Sweet’s syndrome 3. Cyclic neutropenia 4. Benign familial neutropenia 5. MAGIC syndrome 6. A periodic syndrome with fever and pharyngitis 7. Various nutritional deficiencies with or without underlying gastrointestinal disorders Several studies from the UK, United States, and Spain have demonstrated that hematinic deficiency (iron, folic acid, or vitamin B12) are twice as common in RAS patients than incontrols. Case report: A 10 year old male patient presented a 3-year history of episodes of multiple minor recurrent Ulcers, this year major aphthae on the anterior ventral surface of the soft palate. Patient had difficulty in eating and in speech. Clinical examination revealed multiple symptomatic ulcers with a perilesional erythematous halo covered with a pseudomembrane. The size of major aphthae was than 20 mm in diameter. The ulcers were not associated with any type of discharge. The ulcers were tender on palpation. The medical history and the family history were non-contributory. A clinical diagnosis of major aphthous ulcers was made on the basis of the history and the clinical examinations. The patient was subjected to a therapeutic regimen consisting of daily topical application of Prednizoloni 0.05%, topical lidoksor and systemic vitamin and Cefatoxime Natrii, Immunomodulators Biferon, Amphotericin B. Recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU) remains a common oral mucosal disorder in most communities of the world. Proper systemic evaluation is important before prescribing the medication.

The risk factor and clinical type of tongue cancer / Шинэ санаа Шинэ нээлт

@#The incidence of oral cancer is differed in the world. Oral cancer incidence was high in Melanesia, South-Central Asia, East and Central European countries,3 while it was likely to be low in Africa, East Asia, and Central American countries. Our study purpose was to determine the risk factor of tongue cancer and to study between correlation T, N stage and type of tongue cancer. The study was carried out by retrospective method, by using the medical reports obtained from the National Cancer Center of Mongolia. This study, based on retrospective method was conducted from medical reports of 68 patients who were diagnosed with squamous cell carcinoma of the tongue and at the Department of Head and Neck Surgery, Radio and Chemotherapy of the National Cancer Center of Mongolia between 2005 and 2014. The data was analyzed using SPSS 20.0 software; descriptive and detailed statistical analysis was made. Assumptions were examined by H2 testing method; it shall be statistically significant when P value is less than 0,05. The median age of the 68 patients at diagnosis was 58 years (range=31-85 years) and were 57% (39) men, 43% (29) women with a male to female ratio of 1.3:1. Of 37 patients who were tobacco users 66.7% (26) were male, 37.9% (11) were female, among the alcohol consumers (35.9% (14) were male, 10.3% (3) female). This difference between male and female consumption was significantly different according to the test Pearson p=0.019 for tobacco, p=0.016 for alcohol. There was trend toward more higher N stages in endophytic tumors, with 69.3%, in ulcerative tumors, with 66.7% of these cases presenting with nodel involvement, 45% of patients with exophytic tumors. Our study showed that oral tongue cancer in majority occur in fifth and sixth of life and with a male predominance. Smoking and drinking alcohols are two major risk factors for SCC of tongue cancer. Although not significant, it has been suggested that endophytic tumors have a higher propensity to metastasize to cervical lymph nodes than exophytic tumors.

ADULT ORTHODONTICS WITH DAHL TECHNIQUE FOR BETTERFUNCTION AND AESTHETICS / Шинэ санаа Шинэ нээлт

@#BACKGROUND. The Dahl Concept refers to the relative axial tooth movement that is observed when a localized restorations are placed in supra-occlusion in dental hard tissue worn anterior area and posterior full arch occlusal contacts re-establishes over a period of time irrespective of age and gender. The literature reports that the objectives of the Dahl concept are achieved in the majority of cases (94%-100%). Some minor and transient adverse events, such as initial difficulty with mastication could develop. If dental arch is crowded and some of the teeth are pushed away, they tends to be pushed more even they were visually aligned by a heavy preparation under the ceramic restorations such as crowns and veneers. To avoid these costly and teeth-harmful treatment options for patients with anterior crowding and who wants straighter and beautiful looking teeth, we use a conservative approach of Align+Bleach+Bonding technique. MATEREALS AND METHOD. For tooth alignment we used Inman Aligner, Clear Aligner and Clear Smile Braces (fixed ceramic braces with super elastic Ni-Ti wires) or their combination. After short orthodontics a Dahl concept was applied to improve patients’ functional occlusion and anterior guidance. A “free-hand” and “no-any-drill” composite restoration technique was used to restore worn anterior teeth. For proper orthodontic diagnosis, assessment and treatment planning Spacewise analysis and Digital Caliper measurement were performed using models, their digital scans and intra/extraoral photos. We use Inman Orthodontic Lab in Florida for Inman Aligner fabrication and IAS Laboratory in London for Clear smile braces set up. Clear aligners (Scheu Dental, Germany) are planned and fabricated at the Digital Dental Office’s Clear Aligner certified laboratory. All treatments are start only after thorough diagnostic analysis, case discussion and acceptance from technical experts and orthodontists from UK, USA and Germany and acceptance of planned results from the patients. A course of home bleaching was then performed followed by resin bonding of anterior teeth edges to stabilize anterior guidance. RESULTS. More than 200 cases of upper and lower anterior crowding have been treated in comparably short period of time. From those we are introducing 3 different cases which were treated using above mentioned three appliances as an example. Average orthodontic treatment lasted 8-16 weeks depending on degree of crowding and type of appliances used. The arch crowding were less than 4 mm in all of them. No any teeth were extracted. After orthodontic treatment patients had double retentions (fixed+clear retainers). Dahl concept was performed in patients with anterior attrition and few patients experienced minor difficulty with chewing for their first week only. To control results of molar extrusion we measured space between occlusal surfaces of opposing molars in the SAM 3 articulator positioned in the centric relation. CONCLUSION. In order to get a long term proper stability of dento-facial function with a bonus of beautiful smile the concept of keeping own teeth and its structure became essential in cosmetic and restorative dentistry. The good thing of Dahl technique is its simplicity if it is done properly and its cost effectiveness. And as it was described the edge bonding itself could be a permanent retainer which prevents a future relapse in ortho-aligned teeth. Moreover patients were highly satisfied due to fast alignment, opportunity of keeping their teeth untouched and getting aesthetically pleasant result with a stable function.

EFFICACY OF NATURAL BIOPOLYMER CHITOSAN MEMBRANE FOR GUIDED TISSUE REGENERATION / Шинэ санаа Шинэ нээлт

@#BACKGROUND. Periodontal regeneration is the reconstruction of periodontal tissues and restoration of functions, which is achieved through techniques, such as soft tissue grafts, guided tissue regeneration, bone replacement grafts, root bio-modification, and a combination of these techniques. Chitosan is a natural biopolymer with several beneficial properties, including excellent biocompatibility, low toxicity and corresponding degradation rates and hemostatic activities. This systematic review assessed the efficacy of biopolymer membrane (chitosan) for guided tissue regeneration (GTR) in animal and human studies. MATERIAL AND METHODS. The Cochrane Oral Health Group specialist trials, PubMed, MEDLINE, and EMBASE databases were searched for articles published before January 2017. Animal and human studies that used chitosan for GTR, which had a follow-up period of ≥6 weeks and 6 months, respectively, were retrieved. The following outcomes were analyzed: new bone (NB) and new cementum (NC) formation for animal studies and probing pocket depth and clinical attachment level changes for human studies. RESULTS. After a full-text review,six animal studies and three human studies were found to be eligible for this study. All included animal and human studies demonstrated that the use of chitosan for GTR exerts a positive effect on periodontal defects. Subgrouping meta-analysis outcomes of three dog studies revealed that GTR with pure chitosan membranes has a positive effect on NB (14.36%) and NC (10.21%) formation. CONCLUSION. Within the limitations of the present study, there is little evidence to demonstrate the efficacy of chitosan for GTR either in animal or human studies. Chitosan should rather be used as an adjunct component for membrane production.

COMPARISON STUDY OF MOUTH SORES AND IMMUNOLOGICAL CHANGES AMONG PEOPLE WITH HIV INFECTION / Шинэ санаа Шинэ нээлт

@#BACKGROUND. To identify the prevalence of oral lesions in HIV positive group of patients, and to compare their CD4 cell count and viral load to stages of disease progress. MATERIAL AND METHODS. In the present study, we evaluated 30 HIV+ adult patients, attended to the AIDS/STI Department of National Center for Communicable Diseases, Ministry of Health Mongolia. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by Flow Cytometry, as well as viral load by RT-PCR (Amplicor HIV- RNA, TM test 1.5, Roche) RESULTS. 46% of all examined HIV/AIDS patients had oral lesions. Oral Candidiasis constituted the most common lesion, representing 35%, Herpes 22%, followed by Oral Leukoplakia 17%, Necrotizing ulcerative periodontitis 9%, Aphthous Recurrent Stomatitis 13%, Kaposi’s sarcoma 4%. The patients, who have a viral load high exhibited oral lesions related to HIV, independent of CD4 cell count, although patients with CD4+ levels of 233 cel/mm3 were more susceptible to develop these lesions. СONCLUSION. The most common oral lesion was Oral Candidiasis, followed by Oral Leukoplakia and Necrotizing ulcerative periodontitis. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+cell count..

STUDY OF “AKHIZUNBER” SOLUTION FOR THE TREATMENT OF INFLAMMATORY ORAL STOMATITIS / Шинэ санаа Шинэ нээлт

@#ABSTRACT. Recurrent aphthous stomatitis, or RAS, is common oral disorder of uncertain etiopathogenesis for which only symptomatic therapy is available. This article reviews the current clinical features of RAS among study patients and the result of therapeutic effects of the herbal preparation Akhizunber. Over the past four years we have treated 61 RAS patients with different clinical forms by herbal preparation Akhizunber or Alumekatin. The distribution of clinical forms RAS RAS among study patients were minor aphthae -75.4%, major aphthae -16.4% and herpetiform ulcers -8.2% respectively. The healing time of treated Akhizunber was in minor aphthae -9.28±4.82 days, major aphthae -14 days and herpetiform ulcers -12 days. Of the total study participants, the patients treated by Akhizunber reported a rapid and complete recovery from RAS during treatment compared with treated patients by Alumekatin. Treatment with herbal preparation Akhizunber can be effective for patients suffering from RAS in any clinic form, regardless of their ulcer number and size.

THE EFFECT OF OIL-PULLING AGAINST ON ORAL BACTERIA / Шинэ санаа Шинэ нээлт

@#BACKGROUND In recent years, the new treatment and technology developing quickly however, the disease prevention therapy necessary investigate in preventive dentistry. Oil pulling is a traditional Indian folk remedy and Researchers et al previously first time investigated this method. Asokan S, Emmadi P, Chamundeswari et al have indicated the antibacterial activity of sesame oil against on oral microorganisms and found the bacterial growth decreased 20%. In our country, this has not been investigated thus . AIM The aim of this study to assess the antimicrobial efficacy of sunflower oil for reducing micro bacterial count in the oral cavity. METHODS The present study was a parallel design, double-blind, randomized clinical trial with two groups which collected from 162 dental students at the MNUMS, School of Dentistry. The participants rinsed a mouth by 10 ml oil 5 min twice a day after meal and all participants used the same teeth paste during the study period. Oral health status and plaque index were obtained and assessed at baseline and after 30 days of oil therapy . RESULTS However, the Oral health status index not reduced after 30 days. The baseline bacterial count mean of treatment group: a) 0-15 colons subgroup increased from 40.4% to 55.4%, b) 16-200 colons subgroup reduced from 33.3% to 28.6% and c) >201 colons subgroup reduced from 26,3% to 16.1%. In the control group no differences the bacterial count means on baseline and after therapy. CONCLUSION The oil rinse therapy can be used as valuable preventive agents in maintaining and improving oral health furthermore reduced plaque formation and bacterial colonization 15%.

CLINICAL FEATURES AND SITE DISTRIBUTION OF TONGUE CANCER / Шинэ санаа Шинэ нээлт

@#BACKGROUND: The incidence of oral cancer is differed in the world. Oral cancer incidence was high in Melanesia, South-Central Asia, East and Central European countries,3 while it was likely to be low in Africa, East Asia, and Central American countries. METHODS: The study was carried out by retrospective method, by using the medical reports obtained from the National Cancer Center of Mongolia. This study, based on retrospective method was conducted from medical reports of 68 patients who were diagnosed with squamous cell carcinoma of the tongue and at the Department of Head and Neck Surgery, Radio and Chemotherapy of the National Cancer Center of Mongolia between 2005 and 2014. The data was analyzed using SPSS 20.0 software; descriptive and detailed statistical analysis was made. Assumptions were examined by H2 testing method; it shall be statistically significant when P value is less than 0,05. RESULTS: The median age of the 68 patients at diagnosis was 58 years (range=31-85 years) and were 57% (39) men, 43% (29) women with a male to female ratio of 1.3:1 The most common cancer sub-sites reported were lateral border (60%) Considering the composite stage of the disease, 25% patients were in early stages (I-8.8% and II-16.2%) whereas 75% were in advanced stages (III- 36.8%, IVA- 20.6%, IVB-17.6%). At the time of presentation, majority of the patients had T3 lesions 44.1%, followed by T1 in 11.8%, T2 in 29.4%, T4 in 14.7%. Regional lymph node involvement was present in 54.4% (N1-25%, N2-17.6%, N3-11.8%) Considering the correlation between tumor size and cervical lymph node metastasis was present in 25% of of T1 tumours, 45% of T2 tumours, 66.7% of T3 tumours 60% of T4 tumours. There was no correlation between the tumor size at the primary site (T-status), and the presence of lymphatic spread (N-status) p=0.357. CONCLUSION: Our study showed that oral tongue cancer is majority occur in fifth and sixth of life and with a male predominance. Tongue cancer had more occurred at the lateral border (60%) and majority of the incidence (75%) is in the advanced stages III or IV. Based on the data in this study, it is possible to conclude that health education and health promotion must be encouraged by public health policies in order to diagnose in early stage and reduce the incidence and mortality rates of tongue cancer.