TEMPOROMANDIBULAR JOINT DISORDERS AND THE WAY OF THEIR OPTIMIZATION: A LITERATURE REVIEW.

The literature review aims to investigate temporomandibular joint disorders and modern approaches to their treatment. An extensive literature search was performed using Scopus, ScienceDirect, and PubMed databases to identify the most relevant published articles. The year of publication was limited to over the past 5 years. The language was limited to English. More than 200 articles were found and analyzed. At first, abstracts were reviewed. After that 40 of the most relevant articles were selected and included. Systematical literature revision revealed that temporomandibular joint dysfunction is an essential public health issue worldwide due to its high prevalence and associated incapacity. Approximately one-third of the adult population worldwide suffers from at least one symptom of temporomandibular joint dysfunction. The etiology of this disease is considered to be multifactorial. Main risk factors include postural and parafunctional habits, several types of traumas, psychological distress, and occlusal factors. Temporomandibular disorder encompasses several pathological conditions. Based on the currently available evidence, chronic pain is frequently observed and results in lower quality of life. Proper diagnosis is crucial for successful treatment planning and outcomes of temporomandibular joint disorders. multidisciplinary treatment for the complete remission of all symptoms should be focused on the pain experience, jaw, and psychosocial functioning of the patients.

EFFECT OF SURFACE ABRASION AND TEMPERATURE TREATMENT ON METASTABLE TETRAGONAL ZIRCONIUM DIOXIDE (EXPERIMENTAL STUDY).

One of the significant drawbacks of using zirconium dioxide as a framework for prosthodontic structures is its propensity for breakage. Paradoxically, the higher the optical performance of zirconium dioxide, the more its mechanical durability tends to decrease and vice versa. A detailed analysis of the technological process has uncovered divergent opinions and significant disparities in recommendations concerning the fabrication of zirconium dioxide prosthodontic constructs. There are different recommendations regarding the need for abrasive blasting and regeneration firing. Consequently, conducting an in-depth experimental study on this matter and implementing the resulting findings will significantly contribute to addressing the challenges of prosthodontic rehabilitation for patients utilizing zirconium dioxide.

ELEMENTAL CONTENT - GENERAL AND ORAL HEALTH OF CHILDREN.

Aim of study - to determine the composition of the essential macro and microelements in the hair and dental hard tissues and to study the influence of their imbalance on the general and dental health of the child. To assess the state of dental hard tissues, 375 children aged 3 to 12 years were randomly examined in Batumi. Monitoring of the examined children was carried out using standard indices provided by the World Health Organization. To determine the composition of the chemical elements in hair and dental hard tissues, according to the caries status 48 children were chosen from the examined 375 children. We used X-ray fluorescent spectroscopy method to study the qualitative and quantitative content of the chemical elements in the hair and dental hard tissues. The comparative analysis of the dental experience (dmft/DMFT) and the composition of chemical elements in dental hard tissues showed a statistically significant difference depending on caries status. The effect of some essential elements on the general health of the child has also been identified. The study into the composition of the essential macro and microelements in the hair and dental hard tissues revealed a high coefficient of correlation both with the mineralization of dental hard tissues and with the general health of the growing body.

PREVALENCE AND RISK-FACTORS OF BRUXISM IN CHILDREN AND ADOLESCENT POPULATION AND ITS IMPACT ON QUЕALITY OF LIFE (REVIEW).

Bruxism has become more and more debatable and pressing issue all over the world last years. the etiology of bruxism has been changing diverse definitions, over the years, however recently it is defined as a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and by bracing or thrusting of the mandible. This literature review discusses the possible risk factors of bruxism in children and adolescence, among which behavioral abnormalities and sleep disturbances predominates. Moreover, it reviews pathological impact of bruxism on general health and quality of life. The literature review has been carried out using the "ScienceDirect", "Scopus" and "PubMed" databases in order to define relevant scientific works - published in English, during the last 5 years. 31 most relevant articles were chosen. Bruxism is a psychophysiological disorder that can take place during the day and/ or night, in a form of clenching and grinding. It can cause health problems such as tooth sensitivities, headaches, facial myalgia, ear ache, tightness/stiffness of the shoulders, limitation of mouth opening, sleep disruption, sleep disruption of bed partner due to noise, excess tooth mobility, inflamed & receding gums, Temporomandibular Joint Disorder, tooth wear and breakage and tongue's deformation. Considering the potential negative consequences of bruxism on dental and oral health, various clinical methods have been devised to assess it over the years. As the etiology is multifactorial, there is no exact treatment to prevent bruxism. Counselling and behavioral strategies, splint therapy, medications, and contingent electrical stimulation can be used as different ways reducing the effects of bruxism.

CORRELATION OF ORAL HEALTH STATUS WITH GENERAL HEALTH IN ELDERLY LIVING AT RESIDENTIAL HOMES IN GEORGIA.

The aim of the study was to assess oral health status and its correlations with the general health in older adults living in residential houses in Georgia. The study was conducted in 2017-2018 years based on WHO recommendations. The study got approval from bioethical council of National Center for Disease Control and Public Health, protocol #2017-039, 28.06.2017y. 300 voluntary residents from various residential houses for older people (aged 65 years and more) were observed in regions of Georgia: "Basiliada" (Tbilisi), residential home of municipality of Samtredia, (Imereti), residential home "Carefree old age" (Kakheti). Age groups were divided as following: 65-74; 75-84; 85<. Statistical Package for Social Sciences (SPSS) version 22.0 was used for statistical analysis. DMFT was assessed to be 28.74. Significantly high prevalence of needs of prosthetic treatment 91.1% (p=0.0005), full edentulism 36.2% (p=0.0049), participants with the extraction of more than 20 teeth 81.3% (p=0.0000) and unsatisfactory oral hygiene 39.3% (p=0.0003) were observed. Prevalence of systemic diseases was assessed as the following: cardiovascular disease - 56%, gastroenterologycal diseases - 6%, diabetes - 2.9%, respiratory disease - 8.4%, oncological disease - 6.7%, dementia - 24.2 %.( p<0.005). Cardiovascular system diseases appeared to be one of the most commonly encountered diseases in dental practice. Based on the study results new program was created "Improve of oral hygiene of older adults living in residential homes in Georgia" in order to increase their access to the dental care, including preventive dental care and improve oral health related quality of life.

RELATIONSHIP BETWEEN GENERAL HEALTH, ORAL HEALTH AND HEALTHY LIFESTYLE IN ELDERLY POPULATION (REVIEW).

This literature review aims to investigate how a poor oral health impacts on general health and healthy lifestyle of elderly people. The literature review was performed using ScienceDirect, Scopus and PubMed databases to identify relevant published studies. The year of publication was limited to over the past 5 years and the language was limited to English. Having considered the relevant articles' abstracts the 36 articles were selected. Systematical literature revision shows that recently, the older population has increased worldwide and it is being predicted to keep growing in near future. As age-related changes are observed in oral cavity, geriatric dentistry becomes more relevant to investigate oral disorders and to take relevant measures in elderly population. There is an urgent need to clarify the correlations between oral and general health. Unsatisfactory oral conditions lead to serious systemic diseases. Based on the currently available evidence, better collaboration between medical and dental fields is required in order to create and maintain healthy elderly population. A special association with professional group is important for implementation of new programs, in order to enhance and maintain satisfactory oral hygiene, oral health and oral health related quality of life.

EVALUATION OF EDENTULISM, PROSTHETIC STATUS AND PROSTHODONTICS TREATMENT NEEDS AMONG THE ADULT POPULATION OF GEORGIA.

The aim of the present study is to identify the level of edentulism among the adult population of Georgia, to assess the prosthodontics status and normative needs for prosthetic treatment. Cluster- stratified method was used for sampling. Overall, 2370 adults including 1289 women and 1081 men and four age groups I - 20-34, II - 35-44, III - 45-64, IV - 65-74 in nine regions of Georgia and the capital, Tbilisi, were examined. The loss of teeth due to caries or periodontitis was observed to differing extents throughout the population. One (8.3%) or more bridges (7.6%) and removable dentures (3.2-4.7%) were more frequently observed than implants (0.1%). Metal-ceramic (12.4%) and metal crowns (6.3%) were more commonly detected than zirconia ceramic crowns (0.1%). Statistical analysis of the data demonstrates a rather high normative prosthetic need of implants and bridges and less needs for removable dentures among the population due to less severity of periodontitis and not too high values of missing teeth due to caries (despite the high caries prevalence (99%) throughout the Georgian population). Edentulism is a public problem in Georgia and needs serious attention from government or healthcare centers to prevent the complications .

THE RISK FACTORS INFLUENCING THE EDENTULISM AND PROSTHETIC STATUS OF THE ADULT POPULATION IN DIFFERENT REGIONS OF GEORGIA.

The aim of the present study was to identify the level of edentulism and prosthetic status of the adult population in different regions of Georgia and to assess the influencing risk- factors. Cluster- stratified method was used for sampling. Overall, 2370 adults including 1289 women and 1081 men and four age groups I- (20-34), II-(35-44), III-(45-64), IV- (65-74) in nine regions of Georgia and the capital, Tbilisi, were examined. Statistically reliable data received showed the different extent of teeth loss in various regions of Georgia. ≤10 teeth loss were characteristic for Mtskheta (60.2%) and Samtskhe-Javakheti (50.7%),whilst ≥20 teeth lost were noticed more in Achara(2.9%), Samtskhe-Javakheti(2.6%), Shida Qartli (2,5%). Therefore, prosthetic status was mostly presented with one or more bridges or artificial crowns, removable dentures were seen less. Differences in prosthetic status is generally related to low medical education background in all regions, though lack of money was considered as essential obstacle for dental visit for Mtskheta, Imereti and Samtskhe-Javakheti population. Education and family income dictate attitudes towards prosthetic dental care and choice of crown types. On the other hand, material disparity represents the main obstacle to prosthetic procedures, especially implants.

Periodontal diseases in patients with vitamin D-resistant rickets.

OBJECTIVE: To define the risk of development of periodontal diseases at vitamin D-resistant rickets. The material for the study was based on the data from 13 children of 0-18 years with vitamin D-resistant rickets (I group), 68 children with vitamin D-dependent rickets (II group), and the control group included 61 children of the same ages. The patients were divided into 3 age groups: I group of 0-5 years (deciduous/milk teeth occlusion), II group of 6-12 of years (mixed bite), III group of 13-18 years (permanent occlusion). For the qualitative data the differences between the groups were detected by using F criteria but for the quantitative data the differences between the groups were detected by Student's t test for independent selection. Mathematical processing was performed using statistical software SPSS-22. In all three groups the gingivitis of mild and moderate forms were fixed, among them acute course was revealed only in the group of vitamin D-resistant rickets. The rate of chronic, local, catarrhal and generalized gingivitis in the group of vitamin D-resistant rickets was reliably higher in comparison with both vitamin D-dependant rickets and control groups. In addition, a mild form of periodontitis with chronic course was revealed in all three groups the rate of which was reliably higher in the group of vitamin D-resistant rickets comparing with the ones of vitamin D-dependant rickets and control groups. CONCLUSION: the rate of inflammatory periodontal diseases in children with vitamin D-resistant rickets is higher than in children with vitamin D-dependent rickets and the control groups.

The prevalence of periodontal diseases among adult population in Georgia.

The present research was conducted to estimate the prevalence of periodontal diseases in the adult population of Georgia, to study the peculiarity of their distribution within population in different regions of the country. The survey was carried out based on cluster- stratified method derived by WHO. 2370 adults including 1289 women and 1081 men distributed in 4 age groups: I - 20-34, II - 35-44, III - 45-64, IV - 65+ the residents of the city, town and village in 9 regions of Georgia and the capital Tbilisi were examined. The assessment of periodontal status and oral hygiene was based on WHO-'s recommendation. (WHO 1997 '˜Oral Health Assessment Form') Examination was done under good natural light using a mouth mirror and a periodontal index (CPI) probe for measurements of periodontal pockets depth. Questionnaires comprised questions for revealing the following risk factors: social status and family income, existence of common diseases, people'S attitude towards oral hygiene(tooth brushing, using dental floss, mouth rinsing) acceptability of dental service, sugar consumption rate, tobacco use, consumption of dairy products. The reliable statistical data received from the study relieved high prevalence of periodontal diseases in all regions: in Achara - 71.7, Mtskheta-Mtianeti - 70.8%, Imereti - 64.9%, Qvemo Qartli - 61.6%, Tbilisi - 61.8% and Shida Qartli - 60.5%, Guria - 55.9%, Samtskhe-Javakheti - 56.0%, Kakheti - 59.1%, Samegrelo - 55.2%. Despite the variability of risk factors high prevalence of inflammatory periodontal diseases in regions of Georgia was related to more extent to the low educational medical background, less dental acceptability due to not very positive attitude towards dental service and oral hygiene skills though financial problems also played substantial role. The study confirmed that periodontal diseases represent an actual problem in Georgia and need caring out serious preventive measures to enhance peoples' referral to dental service and improve medical educational background of the population.

Dental caries among children in Georgia by age, gender, residence location and ethnic group.

OBJECTIVE: To provide prevalence data for dental caries in Georgia. METHODS: This World Health Organization pathfinder survey was conducted among 1,351 (6, 12 and 15 year-old) Georgian children, representing the main ethnic groups in urban and rural locations. Caries was analysed at univariate and multivariate levels, according to age, gender, urban/rural locality and ethnic group. RESULTS: Caries experience levels among 6-year-olds were dmft = 4.57, sd 3.42 (14.8% caries-free); DMFT = 2.04 (sd 2.02) among 12-year-olds (31.1% caries-free); and DMFT = 3.51 (sd 3.14) for the 15-year-olds (17.7% caries-free). Urban children at ages 6 and 12 years were more likely to be caries-free and have both lower levels of caries-experience and higher levels of filled or restored teeth. In multivariate regression analyses, most age groups showed a significant contribution from residence location. No differences were found by age and no consistent differences were detected by ethnic group. CONCLUSION: These data should provide the baseline for formulating and conducting public oral health efforts in Georgia, with emphases on rural residence locations.

The prevalence of dental caries among adult population of different regions of Georgia.

The aim of the study was to determine the prevalence and intensity of dental caries in adult population of Georgia according to their regional distribution. The survey was carried out by pathfinder survey, based on cluster- stratified method derived by WHO. 2370 adults including 1289 women and 1081 men distributed in 4 age groups: I - 20-34 years, II - 35-44, III - 45-64, IV - 65+ years, the residents of the city, town and village in 9 regions of Georgia and the capital Tbilisi were examined. The assessment of dental status and oral hygiene was based on WHO-'s recommendation. (WHO 1997 'Oral Health Assessment Form') Examination was done under good natural light using a mouth mirror and an explorer. Questionnaires comprised questions for revealing the following risk-factors: social status and family income, existence of common diseases, people's attitude towards oral hygiene (tooth brushing, using dental floss) accessibility and acceptability of dental service, sugar consumption rate, tobacco use, consumption of dairy products. The study revealed the high prevalence of dental caries in Georgia's adult population (96-100%) Caries intensity and severity was seen as the highest in Mtskheta- Mtianeti - 13.26±5.97, Guria - 12.79±8.92, Samtskhe-Javakheti - 12.62±8.44, Shida Qartli - 12.03±7.22 and Achara - 12.23±7.89 regions, relatively lower in Tbilisi - 11.64±7.8; Qvemo Qartli - 10.96±7.07; Imereti - 10.79±7.63 Samegrelo - 10.54±7.95 and in Kakheti - 9.86±7.02. By the mean number of caries decayed teeth Mckheta-Mtianeti - 4.26±3.51, Samckhe-Javakheti - 3.52±3.51 and Imereti - 3.05±3.1 were distinguished. The mean number of caries missing teeth was noted to be highest in Guria - 5.49±7.42, Samckhe-Javakheti - 5.31±6.97 and Achara - 5.32±6.73. Mckheta-Mtianeti - 2.62±3.05, Shida Qartli - 2.39±2.8 and Tbilisi - 2.28±2.09 were the leading regions by the mean number of filled teeth, the lowest value of filled teeth variable was seen in Imereti - 0.67±1.39. In summary behavioral factors (unsatisfactory oral hygiene and less acceptability of dental service due to low medical educational background) play substantial role in occurrence and prevalence of dental caries among adult population of Georgia in all regions, though the financial problem seems to be a considerable contributor in caries prevalence. Reliable statistical data obtained in the study allowed to conclude that in spite of small differences in prevalence in different regions of Georgia dental caries is very widespread throughout the country (96-100%). It represents a major problem in Georgia and needs serious attention and preventive measures to be carried out to enhance peoples' referral to dental service and improve medical educational background of the population.

[Correlations complications after cosmetic veneer treatment with initial parameters of oral cavity].

The aim of the study was to define interrelations between complications after veneer treatment with initial parameters of an oral cavity, state of an organism, social and biological factors. 65 patients with veneers treated between 2005 and 2009 at Margvelashvili Dental Clinic (Tbilisi) were investigated. Correlation analysis on Spearmen was spent with application of the package statistical programs SPSS 11.5. Chip of veneers finds out significant positive correlation with the following factors: a crossbite - r=0.2543, p<0.0409; decompensative caries - r=0.3189, p<0.0096; exhibiting of a pathological microflora - r=0.2879, p<0.0163; discoloration - patient with age 41-60 y. - r=0.3877, p<0.0014; focal infection contamination - r=0.2599, p<0.0366; often use of coffee - r=0.2819, p<0.0229; ulitis up to veneer - r=0.2444, p<0.0498; appearance line of demarcation - with the mechanical factor - r=0.3479, p<0.0045; use of synthetic fluids, - r=0.3823, p<0.0017; recurrence caries - with gastro-intestinal pathologies r=0.2924, p<0.0181; of a focal infection contamination - r=0.2756, p<0.0263; by feeding priority by carbohydrates - r=0.2324, p<0.0625; decompensate caries - r=0.2583, p<0.0377; Exhibiting of a pathological microflora - among males - r=0.2772, p<0.0254; by smoking - r=0.3227, p<0.0087; gastro-intestinal pathologies - r=0.2365, p<0.0579; by endocrine diseases - r=0.2546, p<0.0407; by focal infection contamination - r=0.5416, p<0.0000; decompensate caries - r= 0.2530, p<0.0420; by an ulitis - r=0.4551, p<0.0001; by a hygienic index - r=0.4611; p<0.0001; periodontal index - r=0.4611, p<0.0001; PMA index - r=0.3529, p<0.0039. The correlation circuit of the factors of complications after veneers will help the practical stomatologists with realization of purposeful prophylaxis.

[Assessment prevalence and risk factors of aesthetic defects dens and need veneers in a population Georgia].

PURPOSE: definition risk - factors of aesthetic defects of dens and need veneers. The work is fulfilled on the basis of research 330 persons age from 14 till 70 years from a common population of Tbilisi. Phylum of research - case - control of Criterion of incorporation: the patients entered clinic per 2005-2009, Criterion of exception: general diseases, Diabetes, autoimmune diseases, serious forms parodontosis, called by somatopathies. Statistical Analysis spent with the help of the package of statistical programs SPSS 11.5 Is placed, that the relative chance of need veneers is defined by the following factors: smoking - OR=1.82 (95%CI=1.13-12.37); pathologies gastrointestinal of a path - OR=1.94 (95%CI=1.22-14.26); the locuses of a focal infection contamination - OR=65.57 (95%CI=8.80-76.22); the mechanical factor - OR=2.23 (95%CI=1.27-58.95); medicamental treatment - OR=2.14 (95%CI1.34-24.56); feeding mainly by carbohydrates - OR=2.89 (95%C=I.51-13.15); the often use sweet - OR=1.87 (95%CI=1.07-9.85); often use of coffee OR=1.75 (95%CI=1.10-12.51); distal an occlusion - OR =2.26 (95%CI=1.09-18.68); - subcompensated caries - OR=2.04 (95%CI1.28-23.48); a ulitis - OR=1.62 (95%CI1.02-19.20); complications after previous veneer: particulate or complete chip of a seal - OR=34.12 (95%CI7.98-52.11); discoloration a seal - OR=80.67 (95%CI19.15-509.48); appearance line of demarcation - OR=95.23 (95%CI12.86-714.61); recurrent a caries - OR=25.75 (95%CI=7.69-39.87); Ulitis - OR=11.22 (95%CI=3.22-68.99); exhibitings of a pathological microflora - OR=123.16 (95%CI=16.68-726.40).

[Immune parameters of adaptation to complete denture].

The purpose of the research is to study local immunology of mouth cavity at complete prostheses with acrylic and polypropylene bases. Immunological parameters of saliva (sIgA, IgG and IgE), lysozyme activity at complete prostheses of teeth with acrylic and polypropylene bases in 40 patients from 45 to 75 were investigated. Lysozyme activity of mixed saliva was defined by turbidimetric method, concentration sIgA, IgG, and IgE - by method Mancini. The statistical data processing included calculation of average arithmetic sizes (X) and standard deviation. The authentic distinctions in immune parameters between groups were calculated (Student's coefficient). The analysis of the data was carried out with the help of a package of the applied programs SPSS 11.5. The comparative analysis immune of parameters of a saliva after complete prostheses with acrylic and polypropylene bases has shown that in a case acrylic of basis in comparison with polypropylene base, parameters IgA and lysozyme activity there are less, is higher IgG and IgE and factor immune of equation. Thus, after prostheses with acrylic of basis it is marked immunological shifts that can be infringement allergy by action acrylic base.