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V Международный конгресс стоматологов
brow ptosis in
pseudoblepharochalasis can improve the aesthetic component of blepharoplasty
operations with involutional deformities of the upper eyelids and adjacent areas.
Practical recommendations.
For the maximum-objective and accurate
assessment of the state of the aligned tissues in patients with deformations, defects of
the eyelids and soft tissues of the periorbital region of various etiologies in the complex
"Orbit-eye-eyeline-periorbital area", the use of advanced classifications is shown. The
modified rotational buccal-zygomatic flap is recommended for the elimination of
extensive defects, including the eyelids, two or more anatomical areas located in the
central parts of the face, a vascularized frontal flap - for isolated multilayer eyelid
defects, a full-layer free skin flap - for superficial defects of the eyelids and surrounding
areas combined with the strengthening of the supporting structures of the century. To
eliminate limited superficial defects of the eyebrow, it is recommended to use
autotransplantation of graft flaps containing 1-2 hair follicles, with a large defect in the
eyebrow region - a vascularized temporal flap on a hidden vascular pedicle, which
improves the efficiency of surgical correction.
FEATURE OF TREATMENT FOR RECURRENT AFTHOUS
STOMATITIS OF THE OROPHARYNGIAL REGION IN PATIENTS WITH
CHRONIC CHOLECYSTITIS
Kamilov Kh.P., Ibragimova M.Kh., Ubaydullaeva N.I., Fozilova L.
Tashkent State Dental Institute
Introduction.
Chronic recurrent aphthous stomatitis (CRAS) is a chronic
inflammatory disease of the oral mucosa and characterized by the appearance of
aphthous ulcers with a long course and periodic remissions and exacerbations. Much
attention is paid to somatic diseases, besides that psychological stress, anxiety and
depression that aggravate the course of CRAS were assessed in patients with recurrent
aphthous stomatitis and compared with normal patients. V.A. Epishev observed chronic
recurrent aphthous stomatitis in 15.2% of cases and according to G.V. Banchenko - only
in 12% cases. According to modern concepts, the leading agent determining the
commonality of the adaptation mechanism and pathology in inflammation is intestinal
endotoxin, which is formed during the death of gramnegative intestinal microflora,
namely, Escherichia coli. It is known that when microorganisms die, they release
bacterial endotoxins that have both antigenic and toxic properties. The increased process
of tissue alteration during the activation of catabolic processes is one of the causes of
endogenous intoxication. A 36-year-old woman had refractory ankylosing spondylitis.
In 2010, she had ulcerations of the oral cavity during the treatment of the main disease,
in 2016, due to an exacerbation of intestinal ileopancolitis, aphthou lesions of the oral
mucosa appeared again. After corticosteroid therapy, the aphthae had a favorable
course, suggesting an immunological factor between the two episodes. The location of
aphthaes in CRAS, according to different authors, occurs on the buccal mucosa (45.6%),
transitional
V Международный конгресс стоматологов
58
folds (45%), the tip and lateral surface of the tongue (6.1%-14%), the sublingual region
(4%-7%), upper and lower lips (41.2%), soft palate (2%). However, sometimes patients
are treated with chronic recurrent aphthaes located in the posterior part of the oral
cavity, palatine arch, posterior parts of the soft palate, i.e. oropharyngeal region, near
the uvula. The unusual location of the aphthae is combined with the unusual shape of
the aphthae. Clinically, aphthae are large and on average from 1.8-2.0 mm or more,
irregular shape, very painful, covered with a white or grey coating and does not heal for
a long period. In thestructure of general somatic pathology of patients with CRAS from
37 people with gastrointestinal tract pathology (100%), 17
(45.9%)
had
chroniccholecystitis, S.Yu. Kosyuga et al., (2015).
Moreover, aphthous stomatitis in the background of this group of patients develops of
not so much asingle, but as a combined gastroduodenal pathology.
Materials and methods of research.
The material for the analysis and
conclusions were the data of examination of 96 patients who clinically had one systemic
pathology. Amongst all of the examined patients, 54 (main group) had chronic recurrent
aphthous stomatitis (CRAS) of the oropharyngeal region combined with chronic
cholecystitis, 42 (comparison group) had chronic recurrent aphthous stomatitis (CRAS)
of the oropharyngeal region combined with chronic cholecystitis. As indicators of the
norm, we used the results of a survey of 20 healthy individuals of comparable gender
and age, which are controls.
Clinical and biochemical studies were carried out. Clinical examination of
patients began with clarification of complaints and collection of anamnesis. The oral
mucosa was assessed by the presence of lesion elements, their number, localization,
severity of inflammation, and their size. The examination of the oral cavity was carried
out on the recommendation of the WHO. Biochemical studies included determination
of average mass molecules (AMM), reflecting thepresence of unidentified substances
of variouschemical nature and characterized by a molecularweight of 300 to 5000 D.
Oral fluid and blood were used as material forbiochemical research. The oral fluid was
taken in the morning on an empty stomach; the patient must first rinse the oral cavity
with saline. Blood was taken from all patients in the morning on an empty stomach by
puncture of the ulnar vein with a needle, from which plasma was subsequently obtained.
It has been proven that in patients with chronic cholecystitis, products of free radical
lipid oxidation (MDA, catalase, glutathione peroxidase and SOD) and intensive
proteolysis of medium molecular weight peptides (MSM E254 and MSM (E280) lead
to an aggravation of the clinical course of CRAS in the oropharyngeal region;
it was found that in patients with CRAS with chronic cholecystitis, the level of
opportunistic microflora increases: fungi of the genus Candida; Staphylococcus aureus,
as well as a weakening of the potential of salivary protective factors (sIgA, lysozyme
titer, phagocytosis index);
the relationship of clinical changes in the diameter of aphthous lesions, the
composition of microbiocenosis and indicators of local protective factors has been
established, which is a new link in the pathogenesis of CRAS in chronic cholecystitis;
a new complex pathogenetic treatment of CRAS patients with chronic
V Международный конгресс стоматологов
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cholecystitis was substantiated by normalizing the MSM parameters E254 and E280;
peroxidation processes: MDA, catalase, glutathione peroxidase, SOD; elimination of
dysbiosis: fungi of the genus Candida, Staphylococcus aureus and secondary
immunodeficiency of local protective factors by increasing the level of sIgA; titer of
lysozyme, an indicator of phagocytosis.
Литература.
1.Камилов, X., Кадырбаева, А., Бахрамова, Ф., & Мирзаев, X. (2021).
Клиническая картина, диагностика и лечение хронического рецидивирующего
афтозного стоматита. Stomatologiya. (2 (83)). 64-67.
2.Алимова, Д. М., and X. П. Камилов. Повышение эффективности лечения
рецидивирующего афтозного стоматита с применением озона. Diss, автореф.
дис.... д. ф. н.—Ташкент: ТГСИ, 2018.—25—41 с, 2018.
3.Ибрагимова, М. X., and С. Р. Камилова. "Состояние микробиоценоза и
местного иммунного статуса больных ХРАС при хроническом калькулезном
холецистите." Актуальные проблемы стоматологии Материалы. 86-92.
4.Алимова, Д., Абдуллаева, М., Юлдашева, Н., & Таджиева, К. (2021).
ОПТИМИЗИРОВАННЫЕ ПОДХОДЫ К КОМПЛЕКСНОМУ ЛЕЧЕНИЮ
ПАЦИЕНТОВ С ХРОНИЧЕСКИМ РЕЦИДИВИРУЮЩИМ АФТОЗНЫМ
СТОМАТИТОМ. Stomatologiya, 1(1 (82)), 53-56.
5.Khabbazi, Alireza, et al. "A comparative study of vitamin D serum levels in
patients with recurrent aphthous stomatitis." The Egyptian Rheumatologist 37.3 (2015):
133-137.
6.Камилов, X., M. Ибрагимова, and H. Убайдуллаева. "Современный взгляд
на этиопатогенез, диагностику лечение хронического рецидивирующего
афтозного стоматита при хроническом холецистите (обзор литературы)."
Медицина и инновации 1.1 (2021): 80-86.
7.Алимова, Д. М., and У. А. Шукурова. "Перекисное окисление и
антиоксидантная система слюны у больных рецидивирующим афтозным
стоматитом." Врач-аспирант 41.4.2 (2010): 265-269.
METHODS FOR DIAGNOSTICS OF INFLAMMATORY - DESTRUCTIVE
PERIODONTAL LESIONS
Kamilov Kh.P., Takhirova K.A., Abduganiev U.B., Fozilova L.
Tashkent State Dental Institute
The purpose of the research.
The aim of the study is to expand the capabilities
of clinical laboratory medicine, improve diagnostic panels, significant progress in the
field of fundamental sciences, the effectiveness and consistency of interdisciplinary
interaction, the widespread introduction of modern technologies create prerequisites for
revising the role of oral fluid (OM) in the life processes of the div (A.V. Avdeev ,
