PREDPOSYLKI I CEL' ISSLEDOVANIYa: Deti, stradayuschie nesovershennym amelogenezom (amelogenesis imperfecta, AI), ispytyvayut mnozhestvo trudnostey v otnoshenii polosti rta, vklyuchaya povyshennuyu chuvstvitel'nost' zubov i esteticheskuyu neudovletvorennost'. Spektr metodov lecheniya detey s AI ogranichen, a potomu cel'yu dannogo issledovaniya yavlyalas' ocenka specializirovannoy programmy lecheniya s tochki zreniya ee effektivnosti v takih aspektah, kak profilakticheskoe i restavracionnoe lechenie. ISSLEDUEMYE KLINIChESKIE SLUChAI: Ocenivalas' nerandomizirovannaya udobnaya vyborka iz 12 pacientov s AI. Snachala po kazhdomu pacientu byl sobran vsestoronniy anamnez, zatem provedena klinicheskaya i rentgenograficheskaya ocenka sostoyaniya zdorov'ya polosti rta. U 8/12 pacientov byla diagnostirovana gipoplasticheskaya forma AI, v 2/12 sluchaev bylo otmecheno giposozrevanie (gipomaturaciya), i v 2/12 sluchaev gipokal'cifikaciya. Zhaloby pacientov v osnovnom svodilis' k neudovletvoritel'noy estetike i povyshennoy chuvstvitel'nosti zubov. U 8 pacientov nablyudalsya aktivnyy karies. Takzhe u bol'shinstva pacientov otmechen gingivit, hotya uroven' gigieny polosti rta udovletvoritel'nyy. Nakonec, u 9 pacientov zafiksirovany anomalii zubov, ne svyazannye s emal'yu. MATERIALY I METODY LEChENIYa: U vseh pacientov v pervuyu ochered' provedena tschatel'naya profilaktika. Nachal'nye etapy neposredstvennogo lecheniya vklyuchali v sebya mery, vybiraemye v zavisimosti ot tipa AI i obschego urovnya zdorov'ya polosti rta pacienta. Vo vremya perehodnogo perioda provodilos' lechenie zhevatel'nyh zubov s ispol'zovaniem kak tradicionnyh, tak i modificirovannyh kompozitom stekloionomernyh cementov, a takzhe restavracionnyh stomatologicheskih kompozitov. Dlya uluchsheniya vneshnego vida zubov frontal'noy gruppy byli vypolneny pryamye restavracii iz kompozitnyh materialov. U 4 pacientov potrebovalos' kompleksnoe dolgovremennoe lechenie, vklyuchavshee v sebya ortodonticheskuyu terapiyu, ustanovku metallokeramicheskih koronok i chastichnyh fiksirovannyh protezov, a takzhe vypolnenie pryamyh kompozitnyh restavraciy. POSLEDUYuSchEE NABLYuDENIE: Sroki izucheniya otdalennyh rezul'tatov issledovaniya var'irovalis' ot 2 do 11 let. Vseh detey vyzyvali na povtornye osmotry s periodichnost'yu raz v tri mesyaca. Na protyazhenii vsego nablyudaemogo posleoperacionnogo perioda chastota sluchaev razvitiya kariesa u pacientov ostavalas' nizkoy, i vse pacienty otmetili svoyu udovletvorennost' provedennym lecheniem. VYVODY: AI soprovozhdaetsya mnogimi anomaliyami, ne svyazannymi neposredstvenno s emal'yu, a potomu trebuet kompleksnogo lecheniya. Pri planirovanii lecheniya sleduet prinimat' vo vnimanie vozrast pacienta, tip i tyazhest' zabolevaniya, a takzhe obschiy uroven' sostoyaniya zdorov'ya polosti rta pacienta. Rannyaya diagnostika, profilakticheskie mery i svoevremennoe lechenie imeyut vazhneyshee znachenie dlya uluchsheniya sostoyaniya zdorov'ya polosti rta u detey, stradayuschih AI.
nesovershennyy amelogenez, zdorov'e polosti rta, stomatologicheskoe lechenie.
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