NEW SOLUTIONS IN THE EXPERIENCE OF DENTAL IMPLANTOLOGY
À.R.AGÀ-ZADEH, Î.S.SEIDBEKOV
State Advanced Training Institute for Doctors named after A.Aliyev, Baku, AZERBAIJAN
The method of dental implantation allows significant improvement of the quality of life. Dental implantation increases effectiveness of the rehabilitation of stomatologic patients by means of restoration of the function of masticatory apparatus and improvement of the esthetic view. The choice of the correct treatment plan in the absence of teeth is an important task for a clinician. The method of computer tomography (CT) opened a completely new stage of planning of operation of dental implantation. Objective of CT at the stage of preparation to the placement of intraosteal implants is the determination of the structure and density of the bone tissues, as well as the assessment of such important anatomic formations as the nose floor, maxillary sinuses and inferior dental canal. Computer tomography makes it possible to avoid mistakes of implantologic treatment, connected with incorrect spatial location of implants in relation to neighbouring anatomic formations and damages of the anatomic structures. Special 3D computer programs allow planning and implementation of operations and forecasting of results of event the most complex operations during dental implantations. The program makes its possible to accept any sections of jaws, to make measurements accurate to 0.01 mm, to determine quantitative composition and density of the bone tissue of the necessary maxillary segment. Based on the different density of tissues, the programs allows creation of 3D objects of jaws, teeth, soft tissues, future orthopedic structures. Date of the investigations of digital computer tomography are processed and a virtual model of the necessary maxillary segment is formed by using the software. Then a surgical pattern constituting an exact prototype of the jaw and reflecting the whole studies area for planning and implementation of the dental implantations is made based on this model. The implantologic pattern helps to significantly reduce the duration of operation and its traumatism. Through planning of treatment has primary importance. Extensive pre-implantation diagnosis, examintion and planning are absolutely necessary for the provision of successful treatment.
MECHANISMS OF COMPENSATION PERIPHERAL CIRCULATION DURING THE IMPLEMENTATION OF LUMBAR SYMPATHECTOMIES IN PATIENTS WITH DIABETIC ANGIOPATHIES OF LOWER EXTREMITIES
T.G. AKHVERDIYEVA, Z.M. JAFAROV, G.G. ABDULLAYEV, G.A. KERIMOVA
Scientific Surgical Center named after acad. M.A. Topchubashov, Baku, AZERBAIJAN
Obliterating atherosclerosis of lower extremity arteriesduring diabetes mellitus has a number of distinctive features. In this regard, combined treatment of patients requires especiallyrational approach to their treatment tactics. One of the non-standard methods of revascularization of the lower extremities is a lumbar sympathectomy. As to the implementation of the later in persons with obliterating atherosclerosis in general, and with diabetic angiopathy in particular, there isextreme conflictof opinions. We have aimed at the development of pathogeneticallysubstantiated tests for the selection of patients with diabetic angiopathies needing lumbar sympathectomy. We have stduies the state of the peripheral, main, collateral and microcirculatory blood flow before and after sympathectomies in 112 patients with diabeticmacroangiopathies of the lower extremities. We used the results of clinical-and-laboratory and instrumental-and-graphic examinations, as well as color and energy Doppler mapping with the application of nitroglycerin load test. The control group included 47 patients with obliterative atherosclerosis of lower extremityarterieswithout concomitant diabetes mellitus. Study group did not include persons with chronic peripheral neuropathy with associated degenerative changes of peripheral nerves, since the latter is already the reason of autodesympatisations. Assessment of compensatory and potential capabilities of peripheral circulation allowed us to come to the conclusion that lumbar sympathectomy in patients with diabetic angiopathy is the most significant way improving blood flow in lesions of vessels than the genicular artery that often occurs exactly with the combination of obliterating atherosclerosis with diabetes. Pathogenetic mechanisms of vascular changes with such combination, absolutely as in “pure” obliterating atherosclerosis are reduced to the removal of increased tone, disclosure of collaterals, extension of the distal bloodstream, acceleration of blood derivation.