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Biomedical subjects

Ricardas Kubilius

Publications and source records attributed to Ricardas Kubilius.

9 recordsLinked to original sources

[Xerostomia: clinic, etiology, diagnosis and treatment].

The aim of this article is to review the problem of xerostomia considering its clinical, etiological, diagnostic and treatment features, basing on the today's tutorials and scientific articles found in databases on the Internet. Recent epidemiologic data on the prevalence of xerostomia in different countries are introduced. There are analyzed the main aspects of clinical manifestations of xerostomia, according to the different etiology analyzed. The most common etiological factors causing xerostomia, especially the main three of them: radiation therapy, Sjögren's syndrome, and drugs, are pointed out. The most popular and accepted clinical and laboratory assays for measuring and evaluating the function of salivary glands are represented. Attention is paid to xerostomia as substantiation of the separate diagnosis and its role in diagnosing other diseases. The concept of possible treatment modalities and prognosis are discussed. The main and most common problems concerning xerostomia are revealed.

Adult↗

Chronic odontogenic maxillary sinusitis.

The aim of the present study was to estimate average age of the patients in both sexes treated for MS, distribution by sex, amount of dexter and sinister MS with and without the fistulas into the maxillary sinus, with and without the foreign-bodies, length of stay in the Department of Maxillofacial Surgery at Kaunas Hospital of University of Medicine during the period from 1999 till 2004. The retrospective data analysis of the patients' treated from chronic MS was made. 346 patients (213 females and 133 males) were treated for chronic MS. 55 cases of chronic dexter MS with a fistula into maxillary sinus, 98 cases of chronic dexter MS without a fistula, 45 cases of chronic sinister MS with a fistula, 112 cases chronic sinister MS without a fistula, 16 cases of foreign-bodies in dexter maxillary sinus, 20 cases of foreign-bodies in sinister maxillary sinus have been detected. The main age of the female was 46.6+/-15.0, the main age of the men was 42.1+/-14.4. Statictically significant difference in the age difference of the women and the men was found (p=0.0024). It was determined, that females diagnosed and treated with chronic MS were 1.6 times more than males during the period from 1999 till 2004 in Kaunas Hospital of University of Medicine. Females treated for chronic MS were 4.5 years older than males.

Adolescent↗

The relationship between general osteoporosis of the organism and periodontal diseases.

Osteoporosis and periodontitis are very prevalent diseases and are most common in middle-aged and elderly women. These diseases are related as both damage bone tissue and share common risk factors. Discussions about the association between these two bone-damaging diseases began in 1960. A hypothesis was raised that systemic imbalance in bone resorption and deposition might manifest itself in the alveolar bone earlier than in other bones. When analyzing systemic and local changes in bone density, a number of issues were investigated and attempted to answer the question of whether dental osteopenia is a local manifestation of osteoporosis having similar etiology and risk factors, or it is an independent process depending primarily on factors that cause periodontal disease. Histomorphometric and microradiographic studies showed that increasing porosity of the cortical layer in mandible resulted in the decrease in bone mass. Bone strength is best expressed through bone mineral density, and it can be called a diagnostic criterion of osteoporosis. The examination of bone mineral density is called densitometry and may be performed using dual-energy x-ray absorptiometry. Orthopantomography is a method that is widely applied in odontological practice and is also informative in determining the bone density of the mandible. It can be applied when performing orthopantomographic and vertical linear measurements, as well as in determining indices in the studies of osteoporotic changes. Since many patients attend odontological clinics, nearly all of them undergo orthopantomography. This is a good possibility to investigate osteoporotic changes in the mandible, to select individuals for further studies, and to ensure clinical benefit and good treatment results.

Absorptiometry, Photon↗

Stress distribution in bone: single-unit implant prostheses veneered with porcelain or a new composite material.

The purpose of this study was to simulate dynamic and static occlusal loading on one unit fixed, implant-supported prostheses veneered with porcelain and with GRADIA in a 3-dimensional finite element model of the human mandible to analyze and compare the resultant stresses in the superstructures and in the supporting bone. Calculation and visualization of stress, deformation, and displacement of complex structures under simulated forces were evaluated by finite element analysis (FEA) using ANSYS. The device employed was from the OSTEOFIX Dental Implant System (Oulu, Finland), and the veneering materials used were standard dental porcelain and GC GRADIA (Tokyo, Japan), a new composite material. Two different loading conditions were considered: static and transitional or impact, each delivered in three different directions: horizontal (Fh) at 0 degrees , vertical (Fv) at 90 degrees , and oblique (Fo) at 120 degrees . The proportion of the force: magnitude was fh:fv:fo = 1:3.5:7. A vertical load of 500 N, a horizontal load of 143 N, and an oblique load of 1000 N were applied. The results showed that the highest stresses in the bone-implant interface occurred in the region of cortical bone adjacent to the first thread of implants in all models and varied within 6.5%. Maximum stresses and displacements were higher (7%) in those models with statically loaded implants as compared with those that had been dynamically loading. The direction of loading played a major role in determining stress levels and they varied at up to 85%. It was shown that with dynamic loads, the peak of 1.568 mm was registered in the model with the GRADIA veneering material. This displacement was 6.5% higher than that found with the Vita VMK 68 veneers. These results suggest that the implant superstructure-fixed single crown veneering materials-porcelain and GRADIA played minor influences to the displacements and stresses in the implant supported bone with a 1% variance. One of the reasons for this element resulting in so minor a contribution to stress relief was the relatively small volume of the veneers as compared with the far greater volume and stiffness of the superstructures and implants. One of the advantages of GC GRADIA is that it reduces impact force under dynamic load up to a 6.5%.

Bite Force↗

New method of sedation in oral surgery.

Local anesthesia, the well-known method of sedation, usually is insufficient for dental implantation and the augmentation of the alveolar ridge, because the operations last for 1 to 2 hours and patients may experience fear and strain. This article examines a new complex sedation method using ketorolac, midazolam, and a local anesthetic 4% solution of articaine hydrochloride and epinephrine (Septanest) in combination with a vasoconstrictor. This method was applied to 67 patients operated on for dental implantation with screw implants or for the alveolar ridge augmentation with biocompatible materials. The control group, which consisted of 20 patients, received local anesthesia with articaine-epinephrine only. Most of the control patients were found to have experienced fear and strain during the aforementioned surgical procedures; their blood pressure and pulse rate increased, and more than half of them experienced pain. No disorders of hemodynamics or the psychoemotional status of the patients were observed during sedation with ketorolac, midazolam, and articaine-epinephrine. Furthermore, anterograde amnesia was determined for the 80% of the patients in the test group.

Adolescent↗

Comparative analysis of the effectiveness of the mandibular angle fracture treatment methods.

425 patients with mandibular angle fractures were treated at the Hospital of Kaunas University of Medicine (HKUM) Clinic of Maxillo-Facial Surgery. Treatment included the application of closed fracture fragments fixation methods (wire splint fixation, and Kirschner wire osteosynthesis), and methods of open fixation--osteosynthesis using the supra-periosteal miniplate, and osteosynthesis using supra-osseous Zes Pol plate (the latter method was modified by the authors). Relative computerized densitometry showed that closed fixation methods result in a faster healing of fractures. The findings of the pain threshold testing showed that open fixation methods more severely damage the function of the lower alveolar nerve. Using closed fixation methods, osteomyelitis occurred in 5.3% of cases, while using open fixation methods--in 15.3% of cases. Thus, the authors of the article maintain that when mandibular angle fractures, in the presence of suitable conditions, closed fracture fragments fixation methods should be given a priority.

Adolescent↗

[Peculiarities of the investigation, clinics and treatment of stylohyoid syndrome and glossopharyngeal neuropathy].

UNLABELLED: The aim of the study was to investigate the causes and the clinics of stylohyoid syndrome and its tendency to convert into glossopharyngeal nerve neuropathy; to investigate clinical peculiarities of glossopharyngeal neuropathy; to estimate differential diagnosis criteria for the glossopharyngeal neuropathy and stylohyoid syndrome; as well as to propose optimal treatment of the neuropathy. MATERIAL AND METHODS: Sixty-five patients with stylohyoid syndrome and 53 patients with glossopharyngeal neuropathy have been treated on. The diagnosis was estimated according to the data of clinical and X-ray investigation. For the localization of affected zone we performed modified facial straight plain radiograms of the patients in open bite position, facial oblique contact radiograms, orthopantomograms and cervical spondylograms. RESULTS: The majority of the patients were females; they comprised 61.5% of patients with stylohyoid syndrome and 56.6% of glossopharyngeal neuropathy sufferers. Older persons had neuropathy, younger--stylohyoid syndrome. The mean age of neuropathy patients was 63.8 years, and of stylohyoid syndrome--57.1 years. Seven years and longer duration of disease was observed in 73.3% of glossopharyngeal neuropathy patients, while duration of 7 and more years was observed in only 3.1% of stylohyoid syndrome patients. The mean duration of glossopharyngeal neuropathy was 10.9 years, and of stylohyoid syndrome--2.6 years. The analysis of etiological factors showed they are the same for both diseases. CONCLUSIONS: The core of the glossopharyngeal neuropathy pathogenesis is destruction at the glossopharyngeal nerve or at the perivascular plexus of carotid artery, because of elongation or dislocation of styloid processus in case of neck osteochondrosis and compression by ossified styloid ligament. In case of stylohyoid syndrome, inflammatory processes occur at the above-mentioned nervous elements.

Anticonvulsants↗

[Acute and chronic facial pain due to injured neural plexus of the upper teeth].

The general causes of upper dental plexus injury are tooth disturbances and the periodontal tissues diseases, the pathology of maxillary sinus, various traumatically manipulations in the area of tooth and maxilla as well. The main symptom of upper tooth neural plexus injury is acute and chronic pain in the alveolar sprout of maxilla, gums or in the area of singly tooth, which rarely spreads into neighboring maxillofacial areas. The authors recommend that the acute pain syndrome would be called the inflammation of upper tooth plexus, and the chronic pain syndrome--plexopathia of upper tooth. Study presents the differential diagnosis according to character of facial pain syndrome and the data of sensority disorders research and investigation of pain thresholds as well. The recommendations for treatment tactic and methods of analyzed indispositions are suggested.

Acute Disease↗

[Post-traumatic infraorbital nerve neuropathy].

The authors have investigated functional state of infraorbital nerve of 479 patients with zygomatic fractures. The degree of nerve damage was evaluated according to changes of pain threshold during damaged nerve stimulation. It was estimated that in 64.3% of zygomatic fractures the infraorbital nerve was affected. The nerve damage degree could be mild, moderate and severe. In 43.18% of moderate and severe nerve damage cases the neuropathy develops. The symptoms, signs and treatment of neuropathy have been described. The neuropathy with clinical symptoms as permanent soreness and paresthesias (itch, "running ant", fibrillations of cheek tissues etc.) in the infraorbital nerve innervation zone occur to 43.18% of the patients after moderate and severe damage of the nerve. The treatment of neuropathy was analysed. In cases of moderate and severe nerve damages, authors recommend to perform decompression of the nerve, because if not applied, the function of nerve does not recover.

Adolescent↗