Investigation of the variability of the pterygomandibular space from the point of view of the target point of the inferior alveolar nerve block.

INTRODUCTION: A thorough knowledge of the anatomy and variability of the pterygomandibular space (PMS) is essential to the success of local anesthesia. This study is aimed at determining the volume of the PMS depending on the shape of the skull, face and mandible using the computed tomography (CT). MATERIALS AND METHODS: anonymized computed tomograms of 48 adult patients were analyzed, the indicators of the cranial index (CI), facial index (FI) according to Yzard, the high lengthy index of the mandible (HLI), the latitudinal-altitude index of the mandible (LAI), the longitudinal latitude index of the mandible (LLI) were calculated. RESULTS: Differences in the volume of the PMS were found depending on the shape of the skull, face and mandible. When determining the CI, the largest volume of space on the right was observed with brachycrania (2.05 ml), on the left - with mesocrania and brachycrania (2.0 ml each). With regard to the FI, the largest volume of space was obtained with medium face on the right side (2.03 ml) and broad and medium types of faces (2.0 ml each) on the left. When calculating the indicators for the shapes of mandible, the largest volume of space was found in the brachygenic (2.05 ml), leptogenic (1.98 ml) and platigenic (1.97 ml) shapes on the right and leptogenic and platigenic shapes on the left (2.0 ml each). There were statistically significant differences in the volume of the right side of the PMS between different shapes according to the cranial index (F = 5.075; p = 0.0095). The most pronounced difference was present between samples with brachycrania and dolichocrania: 0.35 mm³ (95% CI 0.05-0.65); p = 0.0188. There was a statistically significant correlation with sex for parameters on both the right and left sides. The values of indicators in men exceeded those of measurements obtained from women. CONCLUSION: The data obtained determine the differences in the volume of the PMS in individuals with different shapes of the skull, face and mandible, as well as sex differences. Thus, indicating the need to take into account these features when choosing the required amount of anesthetic in clinical practice. The average volume of the PMS space, according to our data, is 1.8-2.0 ml, which is consistent with the clinical data described in the literature.

[Primordial odontogenic tumor in children]. / Pervichnaya odontogennaya opukhol' u detei.

Primordial odontogenic tumor (POT) is a rare benign mixed epithelial and mesenchymal odontogenic tumor that has been included as a new nosological form in the latest classification of the World Health Organization (WHO 2017). The first two clinical cases of POT treatment in children in Russia are presented. A comprehensive examination and surgical treatment of POT were carried out. The diagnosis was confirmed morphologically. OBJECTIVE: To inform maxillofacial surgeons and dentists about the clinical, radiological and morphological features of POT on the example of clinical experience and literature data.

[Magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease]. / Magnitno-rezonansnaya tomografiya v diagnostike oslozhnenii povrezhdenii pochek i mochetochnikov v razlichnye periody travmaticheskoi bolezni.

OBJECTIVE: To assess the possibility of magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease. MATERIAL AND METHODS: There were 139 patients with kidney and ureteral injuries between 2015 and 2019. We clarified the MR-signs of renal complications in different periods of traumatic disease. RESULTS: We analyzed the effectiveness of MRI in identification of renal complications compared to ultrasound, excretory urography, computed tomography, intraoperative and follow-up data. High diagnostic accuracy of MRI for early and late manifestations of traumatic disease was demonstrated.

[Periodontal status evaluation in adolescents with hereditary rickets-like diseases]. / Otsenka sostoyaniya tkanei parodonta u podrostkov s nasledstvennymi rakhitopodobnymi zabolevaniyami.

BACKGROUND: Hypophosphatemic rickets (HPPR) and hypophosphatasia (HPP) are hereditary pathologies accompanied by phosphorus metabolism problems and rickets deformities of the skeleton. Periodontal diseases, their diagnostic methods and factors affecting the progress of periodontal tissue damage are the least studied among the dental manifestations of HPPR and HPP. OBJECTIVE: The aim of present cohort study was evaluation of periodontal tissue status in adolescents with HPPR and HPP. MATERIALS AND METHODS: A dental examination of 20 adolescents aged 12 to 18 years with genetically and biochemically confirmed hereditary rickets-like diseases (E83.3 Disorders of phosphorus metabolism and phosphatases: hypophosphatemic rickets (HPPR) and hypophosphatasia (HPP)) was performed at the Pediatric Dentistry Department of Moscow State University of Medicine and Dentistry. In the present study clinical examination and cone-beam computed tomography (CBCT) data of patients were analyzed. RESULTS: According to the clinical examination data, a strong direct correlation was found between patient's age and the periodontal diseases severity (correlation coefficient r=0.87) in the study group. CBCT revealed the significant alveolar bone hypomineralization in adolescents with HPPR and HPP in comparison to control group (p<0.05). According to the measurement results obtained a strong inverse correlation between alveolar bone mineral density and alveolar bone reduction (correlation coefficient r= -0.74) in adolescents with hereditary rickets-like diseases was revealed. CONCLUSION: The diagnostic options of CBCT allow to begin comprehensive dental treatment of patients with HPPR and HPP at an early stage of periodontal disease preventing further development of pathology.

[Comparative characteristics of root formation and mineralization features in the permanent teeth according to cone beam computed tomography data]. / Sravnitel'naya kharakteristika osobennostei formirovaniya kornei i ikh mineralizatsii v postoyannykh zubakh po dannym konusno-luchevoi komp'yuternoi tomografii.

AIM: Studying features of root formation and mineralization in permanent teeth of children and adults. MATERIAL AND METHODS: The root formation features were studied in 2800 children's permanent teeth aged 6-15 in Moscow and Moscow region; cone beam computed tomography was performed according to the orthodontic indications. CBCT method was also used to study the apical foramen diameter, width of the permanent teeth periodontal fissure, perform clinical examination and treatment of youngsters and young people (aged 12-25, n=180) with pulpitis (K04.03), apical periodontitis (K04.5) and uncompleted processes of hard tissues mineralization and hard tissues with different degrees of maturation; as well as groups of adults (aged 30-50, n=170) with pulpitis (K04.03) and apical periodontitis (K04.5) in permanent teeth with completed processes of hard tissues mineralization. RESULTS: CBCT is objective for visualizing teeth of both jaws which allows determining root formation stages in children's permanent teeth and high precision during one examination visit. Teeth Youngster's and young peopl's teeth have expressed anatomical and structural features during 5-6 years after root formation completion: apical foramen diameter of 0.71±0.004 mm, periodontal fissure width of 1.01±0.004 mm, hard tissues density in apical part of root is 12282.71 units HU, which is different from analogous readings in people over 25 where they make 0.61±0.004 mm (p<0.05); 0.71±0.003 mm (p<0.05); 1428.6±0.89 units HU (p<0.05) respectively. CONCLUSION: CBCT is a useful tool for visualization of dental roots allowing precise definition of root developmental stage in permanent teeth in children by one diagnostic imaging procedure.

[Lower jaw myxoma in an early age pediatric patient: comprehensive rehabilitation aspects]. / Miksoma nizhnei chelyusti v rannem detskom vozraste: osobennosti kompleksnoi reabilitatsii.

The article presents a clinical example of the removal of myxoma in a 14-month-old child with half resection of the mandible, disarticulation and one-stage replacement of the defect with a «Carbopol¼ endoprosthesis. The period of postoperative follow-up was 6.5 years, during which there were no signs of relapse. 2 years after the operation, complete coverage of the endoprosthesis with bone regenerate was determined, the configuration of which corresponded to the healthy branch of the mandible. The remodeling of the condylar and coronoid processes by this regenerate was noted, as well as the formation of the tooth germ 3.8 above the endoprosthesis.

[Magnetic resonance imaging for diagnosis of acute appendicitisin pregnant women in multi-field hospital]. / Vozmozhnosti magnitno-rezonansnoi tomografii v diagnostike ostrogo appenditsita u beremennykh v usloviiakh mnogoprofil'nogo statsionara.

OBJECTIVE: Tooptimize MRI protocol in pregnant women with suspected acute appendicitis. MATERIAL AND METHODS: There were 44pregnant women (gestation period 11 - 36 weeks)with suspected appendicitis. RESULTS: Fat-suppressed T2-weighted and diffusion-weighted imaging (DWI) was the most valuable to diagnose inflammation of appendix and surrounding tissues. Sensitivity, specificity and accuracy were 100, 90 and 97.8%. CONCLUSION: MRI was useful to assess appendix and differentiate appendicitis with biliary and urinary diseases.

[The use of cone beam computed tomography for diagnostics of chronic suppurative otitis media].

The objective of the present study was to estimate the potential of cone beam computed tomography of the temporal bone as a diagnostic tool for chronic suppurative otitis media. This method was employed to study the temporal bones of 33 patients presenting with chronic suppurative otitis media (18 cases of one-sided and 15 cases of two-sided inflammatory process). The results of the total of 48 sessions of beam computed tomography of the temporal bones were available for analysis. The age of the patients varied from 16 to 80 years. Seven of them presented with chronic suppurative otitis media in combination with cholesteatoma. The clinical symptoms of chronic suppurative otitis media were revealed by cone beam computed tomography in conjunction with the peculiarities of visualization of bone tissue destruction using this technique (both in the presence of cholesteatoma and without it). The rationale has been developed for the use of cone beam computed tomography in diagnostics of chronic suppurative otitis media.

[Diagnosis of chronic pancreatitis according to miagnetic resonance imaging data].

OBJECTIVE: To estimate the informative value of magnetic resonance imaging (MRI) and MR cholangiopancreatography for diagnosing changes in the parenchyma and duct system of patients with suspected and/or diagnostically established chronic pancreatitis (CP). MATERIAL AND METHODS: MRI was carried out in 120 surgical patients with suspected and/or diagnostically established CP, by using a Siemens Magnetom Impact 1.0 T MRI system. The study protocol encompassed standard gradient sequences and MR cholangiopancreatography. RESULTS: No visual signs of changes were found in the pancreatic parenchyma and main pancreatic duct (MPD) in 7 (5.8%) patients. There were undetectable MR changes in the pancreas and duct system in 12 (10.0%) patients. Mild changes in the pancreas were visualized in 17 (14.2%). Its moderate changes as diffusely reduced signal intensity, gland irregularities, and dilated MPD with uneven ecstasized and shortened side branches were revealed in 24 (20.0%) patients. Most examinees (n = 60 (50.0%)) had obvious pancreatic changes. CONCLUSION: Standard MRI and MR cholangiopancreatography in evaluating CP can visualize pancreatic parenchymal signal changes and altered ducts particularly in patients with suspected CP, the signs of pancreatic parenchymal atrophy and fibrous changes and estimate pancreatic sizes and duct system changes.

[Capabilities of current tomographic technologies in the diagnosis of midfacial injuries and posttraumatic deformities].

OBJECTIVE: To study the diagnostic capabilities of cone-beam and multislice spiral computed tomography (CT) in patients with midfacial injuries and posttraumatic deformities. MATERIAL AND METHODS: Fifty patients with midfacial injuries sustained in different periods underwent clinical and radiation examination involving an analysis of the bone and soft tissue structural images obtained with multispiral and cone-beam CT techniques, by applying maximally informative studies protocols. RESULTS: Cone-beam and multislice spiral CT showed the same informative value in detecting bone traumatic changes and a low informative one in identifying comorbidity. CONCLUSION: The findings permit one to recommend cone-beam CT for diagnosis and preoperative planning in patients with midfacial injury and posttraumatic deformities only when multislice spiral CT cannot be performed.

[Developmental anomaly of parotid and submandibular glands ducts].

Authors based upon multispiral computer tomography with building up multiplanar 3D-reconstructions disclosed earlier not described developmental anomaly of salivary glands: rudimentary ducts running beyond capsule of parotid and submandibular glands.

[Syndromic approach in the radiodiagnosis of maxillofacial injuries].

Radiodiagnosis of maxillofacial injury (MFI) is a topical problem of modern medicine. A complex of currently available highly informative methods, which comprises spiral computed tomography, digital X-ray study, and ultrasonography, used on the basis of a syndromic diagnostic approach substantially increases the informative value of a radiodiagnostic stage, provides a clear picture of the pattern of lesions, and defines, on the findings, an adequate treatment policy.

[Radiodiagnosis of multiple and combined mechanical injury of facial structures].

Increasing traumatism due to various causes in the population is one of the characteristics of today. The number of facial structural injuries, which amount about 40% of all types of injuries and tend to increase by an annual average of 2%, is also on the rise. Introduction of current radiodiagnostic techniques into clinical practice makes it possible to optimize a diagnostic stage and to increase the informative value of radiation study, and to plan surgical treatment as well.