The aim was to compare characteristics of medical and immunological risk factors for congenital Up and palate in children. It was established that in Navoi region on 620 newborns falls 1 child with congenital lip and palate (X=l, 62), while in Bukhara province 890 infants 1 child with congenital lip and palate (X = 1. 12). The development of secondary immunodeficiency in children with congenital lip and palate characterized by a deficiency of T-mediated immunity, the imbalance of the main classes of immunoglobulins. The status of cytokine synthesis observed shifts IL-Ip, TNF-a and IFN-y.
The aim was to compare characteristics of medical and immunological risk factors for congenital Up and palate in children. It was established that in Navoi region on 620 newborns falls 1 child with congenital lip and palate (X=l, 62), while in Bukhara province 890 infants 1 child with congenital lip and palate (X = 1. 12). The development of secondary immunodeficiency in children with congenital lip and palate characterized by a deficiency of T-mediated immunity, the imbalance of the main classes of immunoglobulins. The status of cytokine synthesis observed shifts IL-Ip, TNF-a and IFN-y.
Endoscopic examination of nasal cavity was performed in 76 subjects aged 1 to 15 years with congenital unilateral upper cheiloschisis and uraniscochasma before and after cheilo- and urano-plasty. All infants were divided into 3 groups for terms of surgical intervention and results of orthodontic treatment. They were the following: 1st group formed 27 children have been operated before 3 years age and received orthodontic treatment. 2nd group formed 25 children have been operated 3 years age later and received orthdontic treatment and 3rd group - 24 children operated after 5 years and not received orthodontiv treatment. Results of endoscopic exammation of nasal cavity in subjects with congenital unilateral upper cheiloschisis and uraniscochasma evidenced that pronounced deformations of external nose and changes in topography of nasal cavity following cheilo- and uranoplasty- in patients in the third group were observed.
Nowadays number of births of children with congenital unilateral cleft lip and palate highest by frequency combined incidence of cleft lip and palate fall off 50% and 82% of unilateral congenital cleft [2]. Analized literature of recent years shows that today used more than a hundred species of hcyloplastics. Most clinics arc more widely used methods proposed Tennison (1952) and Obukhov (1954), and the method proposed by Millard (1958). Each of these methods has its advantages and disadvantages, so the surgical practice often uses a combination of these methods. The aim of this study was to compare the long-term results of three different surgical techniques - Obukhov-Tennyson (triangular flap), R. Millard (rotary flap) and Millard with an element of Obukhov (a combination of a rotary flap with a triangular flap above the red portion of the lips) -which arc used for the treatment of congenital unilateral cleft lip and palate.
The frequency and prevalence of the birth of children with congenital cleft lip and palate. Congenital cleft lip and palate (CCLP) in the structure of congenital anomalies
development of the maxillofacial region in frequency takes the first place, and among all types of congenital anomalies 4-7 place and are among the most severe malformations leading to significant anatomical (cosmetic) and functional disorders (V.I. Ismailo- va, 2000, Jr. Coleman, 2001, A. A. Mamedov, 2002, G. I. Ochneva, 2002, A. Khemprikh, 2002, S. Sh., Murzabaeva, 2004, V. V. Sutulov, 2006,
I.V. Dvoryakovsky, 2007; A.Yu. Kugushev, 2012; O.V. Nelyubina, 2012).
Congenital clefts of the upper lip, alveolar process and palate are accompanied by severe anatomical and functional disorders of all structures of the middle part of the face. From birth, they cause a violation of such vital functions as sucking, breathing, swallowing and speech. Negatively affect the appearance of the child, which leads to serious changes in then- emotional and psychological state, social maladjustment of the patient, which forms the actual medical and social problem. The article presents the possibility of using platelet-rich fibrin as a membrane in plastic repair of the alveolar process defect in children with congenital cleft lip and palate.
Cicatricial wound healing after surgery causes palatopharyngeal insufficiency and other disorders. The study included 24 children aged 2-7 years with congenital deft lip and palate, which made uranoplasty operation. Investigation of the morphology of the mucosa of the hard palate shell after surgery showed that healing of the surgical wound is one side of the adaptive-compensatory reactions of the organism. All this makes it necessary to be included in the complex of therapeutic measures antihypoxants.
An analysis of the treatment of 122 patients with various types of congenital clefts of the upper lip and palate was performed on the basis of the 2nd clinic of the Samarkand State Medical Institute. As a result of our studies, it was found that congenital clefts of the upper lip and palate are found in combination with developmental abnormalities of other organs. The main ones were short frenulum of lips and tongue in 76 patients, low body mass index in 97, vertebral deformity in 6, clubfoot in 19, congenital flat feet in 5, congenital dysplasia of the hip joint in 2, defects in the development of the urinary system in 19, prenatal encephalopathy in 46, congenital muscle failure in 15 children. Analysis of the study showed that to achieve a high level of medical care for children with this pathology, a clear and uniform, interconnected tactics of all specialists involved in the treatment of a child with congenital cleft lip and palate is required.
Currently, there is an increase in the number of patients with drug allergies in dentistry.
The article deals with the methods of treatment of children with cleft lip and palate with the use of stimulation of biologically active points on the background of traditional drug therapy As a result of treatment it is possible to mobilize own reserve resources of an organism of the patient.
This method can be used in various stages of rehabilitation of patients with cleft upper Up and palate.
Congenital cleft lip and/or palate (CCLP) are severe human malformations and are accompanied by complex anatomical and functional disorders of the body (Fig. 1) [2, 4, 6]. Statistics indicate that the prevalence of congenital cleft lip and palate ranges from 1:1000 to 5.38:1000 [5]. In our Republic, the birth rate of children with congenital cleft lip and palate remains at a high level: 1 case per 745 newborns [3].
In 68 children aged 5 to 18 years with a congenital cleft palate, an endoscopic examination was performed to determine the anatomical, topographic, functional state of the nasal cavity and the cause of deformities characteristic of this anomaly. Children were divided into 3 groups: I group consisted of children with a through cleft palate (n = 23); Group II children with an isolated cleft palate (n = 25) and group III children with a hidden cleft palate (n = 20). The results of the study showed: in the first group - the mucous membrane is thin, bleeds quickly, the inferior turbinate is cyanotic; in the second group, the mucous membrane is hypertrophied, rough, has additional folds; and in the third group of children, the state of the mucous membrane is similar to that of healthy children. The condition of the nasal barrier after surgery for a defect in the palate depends on the timing and method of surgery.
Описан случай из клинической практики. У пациентки имели место сочетанные нарушения формы и функции губы, связанные с недостатком тканей на малом фрагменте верхней губы после рехейлопластики по поводу односторонней врожденной расщелины верхней губы. Рехейлопластика предложенным авторами способом позволила устранить имеющиеся недостатки.
Ключевые слова: зубочелюстные аномалии, вторичные деформации верхней губы, односторонняя хейло-пластика, эстетический результат.
M Dusmukhamedov, L Boltakhadzhaeva, D Dusmukhamedov, N Bobonazarov
In the present study included children with congenital cleft lip and palate, who were under the supervi-sion of the department of surgery and planned surgery newly-born RSSPMCP in the period from 2009 to 2013. Of the 50 patients observed in 29 children, he was given a cleft upper lip, and 21 patients with cleft lip combined with more true-term cleft of sky. The patients' age at the time of surgery ranged from 1 month to 3 years. All children enrolled in the constituent-stage surgical treatment, check-marked original cardiocycles sympathicotonia. Held preoperative preparation for correction of iron deficiency, lipid disorders, and aimed at improving the microcirculation it possible to obtain better results in the near and long-term periods due to improved performance of vegetative balance and indicators of microcirculation of the soft tissues of the up-per lip.
Modern data about a problem of a plastic material choice for osteoplastic restoration of congenital defect of alveolar bone at congenital through clefts upper lip and palate patients are analyzed considering data of leading world centres and own experience.
The article reports on the study of the structure of the congenital cleft lip and palate of sick children on the materials of the Fergana regional hospital specialized in maxillofacial surgery. Monitoring at the beginning of the year and compliance with the basic principles of rehabilitation of children with congenital cleft lip and palate requires long-term comprehensive treatment with the participation of many specialists. It is necessary to predict the expected results and a clear plan for the various stages. The list of activities carried out during the main stages includes early orthopedic treatment of the first days of the child's life, reasonable planning of surgical interventions. Orthodontic treatment, speech therapy training, rehabilitation measures together with the period of growth and development of the upper lip and palate, are pivotal in the main stages of surgical treatment, not only greatly improves the stages of surgical treatment, not only greatly improves the aesthetic and functional the results of treatment, but also minimizes the number of repeated corrective operations.
According to WHO, the birth rate of children with congenital cleft palate in the world averages 0.5-1.5 per 1000 newborns. Despite the mandatory set of measures taken at an early age, adult patients with congenital cleft palate have severe morphological and functional disorders that grossly impair aesthetics, phonetics, chewing and swallowing functions [8]. Congenital cleft palate is a common multifactorial malformation and occupies a leading place among all congenital malformations of a person. According to experts, congenital pathology of the maxillofacial region ranks 3rd-5th among all congenital malformations in humans and, on average, one child is born with a cleft palate for 600-1000 newborns [5].
During the examination investigated the condition of connective and muscle tissue and epithelial layer of 46 children with upper lip and cleft palate in three age groups. The results of own investigations allow to establish that surgical performance shouldbeen held in early period when the structural charges are minimal.
Мягкое небо выполняет целый ряд необходимых для человеческого организма функций: разобщает ротоглотку от носоглотки, направляет пищевой поток и жидкости в пищевод, регулирует поток воздуха придыхании и формировании звуков речи. Язычок представляет собой продолжение мягкого неба в виде отростка, свободно висящего над корнем языка. Основу язычка составляют гладкие мы-щцы, покрытые слизистой оболочкой [1,3,4].
В системе комплексной реабилитации детей с врожденной ресщелиной неба одной из основных задач, стоящих перед хирургом, является устранение расщелины с восстановлением анатомо-функционального состояния мягкого неба, в том числе и язычка. Как показали наши наблюдения, используемые способы уранопластики не всегда позволяют восстановить форму мягкого неба и в часности язычка. Отдаленные результаты обследования детей после пластики неба показали, что у ряда детей язычок отсутствует или он короткий, деформирован, неправильно расположен [2,5,6,7].
On the basis of inspection of 75 children with a congenital through unilateral crevice of an upper hp and the sky in 2 groups positive influence of early complex orthopedic treatment from two stages palatoplasties in comparison with traditional a nasal partition on a vertical is established. The estabhshment of a nasal partition, with edge of the palatal plate, healthy the parties on one vertical line promotes the maximum narrowing of defect within a hard palate after plastic soft palate.
On the basis of an analysis of cone beam computed tomography, 50 people (25 men and 25 women) of mature age (from 32 to 59) the study examines the structural features of the dentoalveolar segments in 13, 14, 15, 16, 23, 24, 25 of the upper jaw and 34, 35, 36, 44, 45, 46 of the lower jaw, the retromolar space of the mandible, the frequency of the presence of growths of the mucosa (Schneider membrane) lining the walls of the cavity of the upper jaw, the frequency of perforation of the bottom cavity of the upper jaw by the root tips of the fangs, premolars and first molars, odontometry of 1.3, 1.4, 1.5, 1.6, 2.3, 2.4, 2.5 of the upper jaw and 3.4, 3.5, 3.6, 4.4, 4.5, 4.6 of the lower jaw. The height of the lower jaw bone in men was greater due to the alveolar tissue. The total length of teeth 3.6, 4.6 of the lower jaw, 1.3, 1.4, 1.6, 2.3, 2.4, 2.6 of the upper jaw, the size of the base of the retromolar fossa were observed to be larger in men.The frequency of perforation of the bottom of the upper jaw cavity by the tops of the canine roots and first premolars was higher in men, the size (AP diameter and height) of the maxillary sinuses was larger in men. The study found that the height of the upper jaw bone in men and women did not differ, and the teeth 1.4, 2.4, 1.6, 2.6 of the upper jaw were larger in men, which can be attributed to the coronal section. The obtained data will help improve the procedure of immediate dental implantation and augmentation of the alveolar bone.
The proposed method in plastics congenital cleft alveolar process can create a pouch, which inside of consist of periosteal flap, which cut on sides of alveolar process defect, outer surface makes from flag of the mucosa of the upper lip and it provides a hermetic covering of the defect of alveolar process from outer surface.
Forms and types of secondary and residual deformations of lips and nose were studied in 171 patients with unilateral congenital cleft lip and palate operated in different hospitals. Study of patient history and careful questioning of patients (or parents) indicates the absence of special preparation, both before and after the operating periods.The degree of severity depends on the shape of the cleft, primary surgery techniques, equipment runtime operation.
Цель работы: провести анализ развития стоматологической помощи детям с врожденной расщелиной верхней губы и нёба (ВРГН) по результатам работ ученых Узбекистана.
In the period from 2004 to 2014 in the Clinic itself 2- MI were treated 41 patients with ССLandP. Of those with unilateral cleft - 35, two - six patients; girls - 14, boys respectively - 27. For effective correction of congenital cleft lip and palate in children requires a long complex treatment involving many specialists. Firstly, this early orthopedic treatment with the first days of life, carrying out massage and myogyms moth-er's participation. Secondly, it is a careful preoperative preparation and reasonable tactic-stage surgery with a properly conducted postoperative period. Postoperatively, after each stage of correction should be prescribed orthodontic treatment, speech therapy training, physiotherapy massage, Improved sanitation activities pedia-trician, otolaryngologist, dentist.
Clinic radiological and anthropometric studying of results of surgical treatment of patients with a congenital cleft lip and palate treated have been researched. All children required orthodontic treatment and orthognatis surgery.