Khomenko pediatric dentistry. Introduction to pediatric therapeutic dentistry

Name: Therapeutic dentistry of children.

The textbook presents all the main sections of pediatric therapeutic dentistry, provided for by the relevant state educational standards. The state of the children's dental service, modern methods of examining patients, and the characteristics of the child's body are described in detail; The latest data on the ethnology, pathogenesis, diagnosis, treatment and prevention of dental caries and its complications, non-carious lesions, periodontal diseases and the oral mucosa are presented. The book is intended for dental students medical universities, pediatric dentists.

Pediatric dentistry is the youngest branch of dentistry and as a science did not arise immediately. Its development and formation was facilitated by the accumulation of knowledge in dentistry in Russia, the study of the heritage of outstanding doctors of our country, other countries, as well as doctors and healers of the ancient world.
Hippocrates described the clinic of teething in the chapter “De dentitione” of the famous book of aphorisms: he noted that during the period of teething, itching in the gums, fever, and diarrhea are observed, especially in children with a tendency to constipation.
One of the creators of Russian medical terminology, A.A. Maksimovich-Ambodik, in his work “The Art of Weaving or the Science of Babich’s Business,” outlined the issues of pediatric dentistry, namely: many useful information on child oral hygiene, description of diseases of the teeth and oral mucosa.
N. Timofeev developed approaches to surgical treatment cleft lip in children. He performed many successful operations for that time.
Ivan Fedorovich Bush - Russian surgeon, one of the founders of domestic traumatology, academician of the Medical-Surgical Academy in St. Petersburg, published a “Guide to the teaching of surgery” in 1807, in this work he outlined the reasons for improper teething, types of anomalies, and methods for their elimination.

CONTENT
- Chapter 1. The state of children's dental services in Russia
History of the development of pediatric dental service
Organization, structures and tasks of pediatric dentistry in new economic conditions
- Chapter 2. Facial development and oral cavity
Facial development
Development of the oral and nasal cavities
Language development
Development of salivary glands
Dental development
Tooth histogenesis
Histogenesis of hard dental tissues
Enamel histogenesis
Dentin histogenesis
Histogenesis of cement
Histogenesis of the periodontal fissure
Jaw development
Dental development
Upper jaw
Lower jaw
- Chapter 3. Anatomy physiological characteristics child's body
Structural features maxillofacial area baby
Anatomy of children's teeth
Anatomical structure of the oral mucosa
- Chapter 4. Psycho-emotional status in different age periods and preparing the child for research
Psycho-emotional status of the child
- Chapter 5. Methods for examining children with dental diseases
Determination of the child’s general condition
Methods for identifying allergic conditions in children
Biopsy
Cytological examination
Oral Environment Study
Study of electrical excitability of dental pulp
X-ray examination of the dentofacial system in children
- Chapter 6. Anesthesia in pediatric dentistry
Mechanism of toothache
Pain relief at the level of nerve receptors
Pain relief at the level of the pathways
Pain relief at the level of the cerebral cortex
Errors and complications during pain relief
- Chapter 7. Non-carious lesions of teeth
Classification
Dental lesions that developed during the period of formation and mineralization of teeth (before eruption)
Non-carious lesions that developed after eruption
- Chapter 8. Dental caries
General information
Classification of dental caries
Clinical picture of dental caries
Influence of microorganisms
The role of saliva
The role of nutrition
- Chapter 9. Treatment of caries in children
Treatment of initial caries
Treatment of superficial caries
Treatment of baby teeth
General pathogenetic therapy
- Chapter 10. Pulp diseases
General information
Blood supply to the pulp
Nerves of the pulp
Inflammation of the tooth pulp
Classification and diagnosis of pulpitis
Pathological anatomy
Peculiarities clinical course
Treatment of pulpitis
- Chapter 11. Periodontal inflammation
Etiology
Pathogenesis
Classification of periodontitis
Periodontitis of baby teeth
Periodontitis permanent teeth
Acute and aggravated chronic periodontitis milk and permanent teeth
- Chapter 12. Endodontic intervention for pulpitis and periodontitis
Mechanical and medicinal treatment of root canals
Methods of filling (obturation) of the root canal
- Chapter 13. Modern filling materials for restoration and filling of root canals
Filling materials for temporary fillings
Filling materials for permanent fillings
Filling materials for permanent filling of root canals

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Description: The textbook covers clinical issues, diagnosis and treatment of major dental diseases in children. The sections of the textbook correspond to the curriculum and standard curriculum specializing in Pediatric Dentistry.
Set out modern views on the etiology and pathogenesis of caries, its complications, periodontal disease, diseases of the mucous membrane of the stripes and mouth in children, etc. Special attention given modern methods diagnosis of dental diseases in children. The classification and principles of treatment of non-carious lesions of hard dental tissues are presented.
According to modern requirements, the textbook includes test tasks corresponding to all sections of the discipline “Pediatric therapeutic dentistry”.
The text of the textbook is accompanied by rich illustrative material. For dental students, interns and dentists.

"Therapeutic dentistry for children"

Development of temporary and permanent teeth

• Development of primary teeth
• Development of permanent teeth

Anatomical structure of temporary and permanent teeth

• Anatomical structure of temporary teeth
• Anatomical structure of permanent teeth

Histological structure of hard tissues of temporary and permanent teeth

• Enamel structure
• Structure of dentin
• Structure of cement

Methods for examining children with dental diseases

• Clinical examination methods
• Physical diagnostic methods in a pediatric therapeutic dentistry clinic
• Laboratory research methods in a pediatric therapeutic dentistry clinic
• Blood tests in a pediatric therapeutic dentistry clinic
• Immunological examination methods

Defense mechanisms of the oral cavity

Prevention of dental diseases in children

• General (endogenous) prevention
• Local (exogenous) prevention

Dental caries in children

• Etiology, pathogenesis and pathological morphology caries
• Clinic, diagnosis and differential diagnosis of caries of temporary teeth
• Clinic, diagnosis, differential diagnosis of caries in permanent teeth
• Treatment of caries of temporary teeth
• Treatment of caries of permanent teeth, more details on the website https://deti-euromed.ru/specialist-and-prices/priem-detskogo-stomatologa/
• Errors and complications in the treatment of dental caries in children

Dental filling materials used in pediatric therapeutic dentistry

• Filling materials for permanent fillings
• Temporary filling materials
• Padding materials

Non-carious lesions of teeth

• Enamel hypoplasia
• Fluorosis (endemic fluorosis)
• Hereditary dental malformations

Pulpitis of temporary and permanent teeth

• Structure and functions of the pulp
• Etiology and pathogenesis of pulpitis in children
• Pulpitis of temporary teeth
• Pulpitis of permanent teeth
• Treatment of pulpitis of temporary teeth
• Treatment of pulpitis of permanent teeth
• Errors and complications in the treatment of pulpitis of temporary and permanent teeth in children

Periodontitis of temporary and permanent teeth

• Structure and functions of periodontium
• Etiology, pathogenesis and classification of periodontitis of temporary and permanent teeth in children
• Clinic for periodontitis of temporary teeth
• Clinic for periodontitis of permanent teeth
• Treatment of periodontitis

Practical endodontics in pediatric dentistry

• Topographical morphological features root canal systems in children
• Instrumentation for root canal treatment
• Providing access to root canals and initial canal cleaning
• Determination of working tooth length
• Instrumental treatment of the root canal of a tooth
• Medication support for instrumental treatment of root canals
• Medicinal effects in root canals
• Permanent obstruction of root canals
• Endodontics of temporary teeth
• Endodontics of permanent teeth with unfinished

Traumatic dental injuries

• Classification of traumatic dental injuries
• Clinic and treatment of injuries to permanent teeth
• Injuries to primary teeth in children

Periodontal diseases in children

• Anatomical and morphological features of periodontium
• Classification of periodontal diseases
• Etiology and pathogenesis
• Clinical diagnosis of periodontal disease
• Gingivitis
• Periodontitis
• Idiopathic diseases with progressive lysis of periodontal tissue
• Prevention of periodontal disease in children

Diseases of the oral mucosa

• Structures of the oral mucosa and its features in childhood
• Classification of diseases of the oral mucosa
• Principles and methods of diagnosis verification for diseases of the oral mucosa
• Traumatic damage to the oral mucosa
• Viral diseases of the oral mucosa
• Changes in the oral mucosa during acute viral and infectious diseases
• Fungal diseases of the oral mucosa
• Allergic diseases of the oral mucosa
• Manifestations on the mucous membrane of the cavity in some systemic diseases
• Anomalies and independent diseases of the tongue
• Cheilites

The manual covers organizational issues dental care children. The diagnosis and treatment of dental caries, diseases of the oral mucosa and periodontium, trauma to the teeth and jaws, tumors, etc. are considered. Issues of pain relief during diagnostic and therapeutic measures. Restorative filling materials are described. Much attention focused on oral hygiene issues, hygiene education children, prevention...

The textbook outlines the clinical and biological aspects (rationale) of pediatric prosthetics as the main element of pediatric dentistry in modern stage. The relevance of the publication is due to the fact that, despite the urgent need for children's dental prosthetics, there are practically no textbooks on this important section of dentistry. The textbook covers different aspects orthopedic treatment in children: psycho-emotional state child at different age periods, psychological...

Basic literature

1. Khomenko L.O. and spiv. Therapeutic dentistry of the pediatric age, Kiev, Book Plus, 2001.- 524 p.
2. Propaedeutics of children's therapeutic dentistry (edited by Prof. L.O. Khomenko). – K.: “Book Plus”, 2011. - 320 p.
3. Khomenko L.A., Ostapko E.I., Bidenko N.V. Clinical and radiological diagnosis of dental and periodontal diseases in children and adolescents. - Kyiv: “Book Plus”, 2004. - 200 p.
4. Khomenko L.A., Bidenko N.V. Practical endodontics tools, materials and methods. - Kyiv, Book Plus, 2002. - 216 p.
5. Bidenko N.V. Glass ionomer materials and their use in dentistry. –Moscow: “Book Plus”, 2003. –144 p.
6. Khomenko L.A., Savichuk A.V., Bidenko N.V., Ostapko E.I. and others. Prevention of dental diseases: textbook. – Part 1. –K.: “Book Plus”, 2007. –127 s.
7. Khomenko L.A., Savichuk A.V., Bidenko N.V., Ostapko E.I. and others. Prevention of dental diseases: textbook. – Part 2. –K.: “Book Plus”, 2008. –132 s.

Dodatkova literature

1. Borisenko A.V. Therapeutic dentistry. T 2. Caries. Pulpit. Periodontitis. Oral sepsis – K.: Medicine, 2010.- 560 p.
2. Borisenko A.V. Therapeutic dentistry. T 3. Periodontal disease K.: Medicine, 2011. – 613 p.
3. Borisenko A.V. Therapeutic dentistry. T 4. Sickness of the mucous membrane of an empty mouth - K.: Medicine, 2010. – 639 p.
4. Borovsky E.V., Ivanov V.S., Maksimovsky Yu.M., Maksimovskaya L.N. Therapeutic dentistry. – M.: Medicine, 1998. – 736 p.
5. Borovsky E.V., Zhokhova N.S. Endodontic treatment. –M., 1997. –64 p.
6. Borovsky E.V., Danilevsky N.F. Atlas of diseases of the oral mucosa. – M.: Medicine, 1981. - 288 p.
7. Borovsky E.V., Leontyev V.K. Biology of the oral cavity. – M.: Medicine, 1991. – 198 p.
8. Vinogradova T.F. Pediatric dentistry (a guide for doctors). – M.: “Medicine”, 1987.- 528 p.
9. Vinogradova T.F. Medical examination of children at the dentist./2nd ed., revised work. and additional – (B-k of a practical doctor. Critical questions dentistry). – M.: “Medicine”, 1988 – 256 p.
10. Groshikov M.I. Non-carious lesions of tooth tissue. –M.:Medicine, 1985.–176 p.
11. Granitov V.M. Herpes virus infection. – M.: Medkniga, N. Novgorod: publishing house NGMA, 2001. – 88 p.: ill.
12. Grigoryan A.S., Grudyanov A.I., Rabukhina N.A., Frolova O.A. Periodontal diseases. Pathogenesis, diagnosis, treatment. – M.:MIA, 2004. – 320 p.
13. Daggel M.S. et al. Atlas of restoration of baby teeth. Institute “Lori”, Moscow, 2001.
14. Danilevsky M.F., Sidelnikova L.F., Rakhniy Zh.I. Pulpit. – K.Zdorovya, 2003. – 168 p.
15. Danilevsky M.F., Nesin O.F., Rakhniy Zh.I. Sickness of the mucous membrane of the empty mouth; per ed. Prof. M.F. Danilevsky – K.: “Health”, 1998. – 408 p.
16. Dєltsova O.I., Chaikovsky Yu.B., Gerashchenko S.B. Histology and embryogenesis of the organs of the oral cavity: a basic textbook. - Colomia: VPT “Vik”, 1994. – 94 p.
17. Diseases of the mucous membrane of the oral cavity and lips / ed. prof. E.V. Borovsky, Prof. A.L. Mashkilleyson. – M.:MEDpress, 2001.- 320 pp., ill.
18. Ivanov V.S., Vinnichenko Yu.A., Ivanova E.V. Inflammation of the dental pulp. – M.: MIA, 2003. – 264 p.
19. Klyueva S.K., Moroz B.T. Basics of genetics for dentists. – SPb.: LLC “MEDI publishing house”, 2005. – 68 p.
20. Kolesov A.A. Pediatric dentistry. – 4th ed. -M.: Medicine, 1991. – 464 p.
21. Korchagina V.V. Treatment of dental caries in children early age. – M.:MEDpress-inform, 2008. –168 p.
22. Kostromskaya N.N., Glotova O.N. Therapeutic and insulating pads in dentistry. – M.: Medkniga, N. Novogorod: Publishing House of NGMA, 2001. – 80 p.
23. Kuryakina N.V. “Therapeutic dentistry of children” M.-MIA, 2007.- 632 p.
24. Treatment and restoration of baby teeth (illustrated guide to the treatment and restoration of carious baby teeth): Per. from English / M.S. Duggal, M.E.J. Curzon, S.A. Fail, etc. - M.: MEDpress-inform, 2006. - 160 p.
25. Maksimovaskaya L.N., Roshchina P.I. Medicines in dentistry: Directory. – 2nd ed. - M.: Medicine, 2000. – 240 p.
26. Makeeva I.M. Restoration of teeth using light-curing composite materials. – M., 1997. –72 p.
27. Marchenko A.I., Kononovich E.F., Solntseva T.A. Treatment of diseases in pediatric therapeutic dentistry. – K.: Health, 1988.-160 p.
28. Marchenko O.I., Kazakova R.V., Dichko E. N., Rozhko M.M., Gevkalyuk N.O. Disease of the mucous membrane of the empty mouth in children. – Ivano-Frankivsk, 2004. – 134 p.
29. Nikolaev A.I., Tsepov L.M. Practical therapeutic dentistry: Tutorial/A.I.Nikolaev, L.M.Tsepov. – 8th ed. – M.:MEDpress-inform, 2008.- 960 p.
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Childhood

Lecture (methodological development)

For 4th year students, specialty pediatric therapeutic dentistry

SUBJECT:
Introduction to pediatric therapeutic dentistry. Anatomical and physiological characteristics of teeth in children. Methods of examining a child.

PURPOSE: (to promote the formation of a system of theoretical knowledge on pediatric therapeutic dentistry).

LECTURE TIME: 2 hours.

MAIN QUESTIONS:

1. Periods of development of pediatric dentistry

2. Pediatric therapeutic dentistry, its sections and tasks.

3. Anatomical and physiological features of the structure of primary and permanent teeth in children.

4. Examination of children in a pediatric dentistry clinic. Completing medical documentation.

LECTURE PREPARED BY: Ass. G.

The methodological development was approved at the department meeting No.___ from “____”

Head department_______________________________________ (full name)

Pediatric dentistry is the youngest branch of dentistry.

For the first time in Russia, a free school dental outpatient clinic was organized in 1886 by Alexander Karlovich Limberg, who can rightfully be called the founder of children's dentistry. He was the first to develop the basis for planned sanitation of the oral cavity in students. In the 20s and 30s 20 th century N.I. Agapov scientifically substantiated in principle new method planned sanitation of the oral cavity in children.

However, pediatric dentistry as an industry began to actively develop in the 60s of the 20th century.

In 1963, the first department of pediatric dentistry was organized at MMSI, headed by Alexander Alexandrovich Kolesov.

In 1968, the V-All-Union Congress of Dentists took place, which was entirely devoted to issues of pediatric dentistry.

A huge contribution to the development of pediatric dentistry was made by T. F. Vinogradova, who headed the department for more than 30 years. pediatric dentistry at TsOLIUv and was the main pediatric dentist in the country.

At the DSMA, the Department of Pediatric Dentistry was organized in 1985. For more than 10 years, it was headed by Viktor Vasilyevich Schwartz and made a great contribution to the development of pediatric dentistry in Dagestan.

Pediatric dentistry is a complex and multicomponent specialty.

It includes pediatric therapeutic dentistry, all types of maxillofacial surgery, orthodontics and pediatric prosthetics.

A pediatric dentist must know all its sections and understand their organic relationship, taking into account the growing and developing child’s body. He must have sufficient general pediatric knowledge to understand the patterns of occurrence and development of major dental diseases in children of different ages.

“A child is not a miniature adult. The development of a child’s organs differs in a number of features during periods of both health and illness; in the process of development children's body undergoes not only quantitative but also qualitative changes,” pointed out back in 1847, S. F. Khotovitsky in his work “Pediatrics”.

Pediatric therapeutic dentistry deals with the peculiarities of the course and treatment of diseases of the hard tissues of teeth, periodontium and the oral mucosa in children.

Anatomical and physiological characteristics of teeth in children.

The term children's teeth refers to the teeth of the primary, secondary and permanent dentition in children. For pediatrician For the dentist, the anatomical and physiological features of the structure of teeth that are related to the course of the carious process, the spread of inflammation in the pulp and periodontium, and those data that are directly related to dental treatment acquire important practical significance.

These are, first of all, the characteristics that distinguish dairy and permanent teeth. Age-related features of the structure of enamel, core, pulp chamber and roots. Stages and timing of the development of the roots of primary and permanent teeth and, naturally, the physiological characteristics of the crown and root pulp and periodontitis in teeth with incomplete development and formed teeth.

Dental development is a very complex process that begins at 6-7 weeks. intrauterine development fetus and continues for several years after the tooth erupts in the oral cavity.

Tooth enamel is formed from the epithelium of the enamel organ. The formation of enamel (amelogenesis) occurs as a result of the activity of ameloblasts and is divided into 2 phases: the formation of the enamel matrix and the maturation of enamel. Moreover, the maturation of enamel does not end before the eruption of the tooth, but continues for a certain time after its eruption (maturation of the enamel) in the oral cavity. When the enamel reaches its final thickness and calcifies, the role of the enamel organ is not fulfilled. Despite the fact that with age the crystal lattice of enamel becomes denser, in each person, as a result of chewing load, physiological abrasion of the enamel occurs, i.e. the enamel layer decreases.

Dentin and pulp are formed from the mesenchyme of the dental papilla.

Odontoblast cells participate in the formation and calcification of dentin. The activity of odontoblasts continues after teething, as a result of which the size of the pulp chamber and the lumen of the root canals decrease with age.

Tooth development can be observed using x-rays.

Dental germs look like an oval-shaped clearing with a clear compact plate, the beginning of calcification - in the form of darkened areas. Using the R-gram, you can also observe the stages of formation of tooth roots and periodontal tissue.

An important role in the process of development and teething is played by the state of the nervous system, endocrine system metabolic processes etc. A sign of correct eruption is the paired eruption of symmetrical teeth in a certain sequence.

Milk (temporary) teeth differ from permanent teeth in the size of the crown (smaller) and color (white-blue, while for permanent teeth it is white-yellow).

The thickness and degree of mineralization of the hard tissues of baby teeth and permanent teeth with unformed roots is small, so they are more susceptible to caries. Moreover, in these teeth the dentin layer is not only smaller, but the dentinal tubules are much wider and shorter, the size of the tooth cavity (pulp chamber) is larger, and the root canals are wider. As a result, when a carious process occurs, microorganisms and their decay products quickly penetrate into the dental pulp, causing inflammation, sometimes acute, accompanied by pain, and more often - an imperceptible, primary chronic course.

Methods of examining children in a pediatric dentistry clinic

A clinical examination technique is a certain algorithm of actions that a doctor must follow when examining a child.

1. Getting to know the child - establishing a relationship between the little patient and the doctor.

The patient and the doctor must establish a relationship of trust (contact). In children, the feeling of fear can be associated with both unpleasant personal experience, and with the stories of others. Therefore, the doctor, with his personality and behavior (calm, trusting, confident, friendly, sometimes strict), should try to reduce the feeling of fear.

2.Basic examination methods: - questioning and examination

Survey– must be purposeful. The patient's complaints can be very diverse: pain, aesthetic dissatisfaction, bleeding gums, bad smell from the mouth, etc.

The most common complaint is pain. In this case, it is necessary to find out the nature of the pain, duration, what causes or intensifies, the irradiation of pain, at what time of day the pain most often occurs.

Next, it is necessary to find out the development of the present disease, general state health (presence of chronic dental diseases of the liver, kidneys, ENT organs, blood diseases, neuropsychiatric diseases, endocrine diseases, viral hepatitis, tuberculosis, AIDS)

Inspection:

External examination: study of posture, examination of the face, identification bad habits, study of the function of breathing, swallowing, speech, closing lips.

Condition of regional lymph nodes

Oral examination:

Condition of the lips and perioral area

Vestibule of the oral cavity (depth in N from 5 to 10 mm, size and shape of frenulum, cords)

Condition of the gingival margin

Oral hygiene status

Shape of dentition and jaw relationship

Condition of the oral mucosa

Condition of dental tissues (hypoplasia, fluorosis, etc.)

Condition of teeth, presence of carious, filled and extracted teeth.

The teeth are examined using a mirror and a probe in a certain order - starting with the teeth upper jaw from right to left and to lower jaw from left to right.

The received data is entered into dental formula in the form of symbols (caries - C, filling - P, tooth to be removed - U).

Milk teeth are designated by Roman numerals, and permanent teeth by Arabic numerals.

Currently, international standards are used to determine the identity of a tooth. digital system tooth designations proposed International Organization Standards (ISO). According to this system, each tooth is designated by two numbers, the first of which determines whether the tooth belongs to one of the four quadrants, and the second - the number of the tooth within this quadrant. Quadrants are designated by Arabic numerals from 1 to 4 in permanent dentition and from 5 to 8 in the primary dentition clockwise, starting from the upper jaw, on the right. Teeth within each quadrant are numbered one to eight (permanent) and one to five (deciduous) from the midline distally; numbers must be pronounced separately. For example, the designation of permanent canines sounds like this: one-three (13), two-three (23), three-three (33), four-three (43).

Additional research methods for caries

1.Probing, percussion, palpation

2. Temperature tests

3. Determination of the hygienic state of the oral cavity (G.I. according to Fedorov - Volodkina, G.I. according to Yrecn - Wermillion)

4. Vital staining (Borovsky method - Aksamit)

5.Evaluation of acid resistance of enamel - TER - test (Okuneko, Kosareva, 1983)

6. Determination of the rate of reminarization - KOSRE-test (Rednikova, Leontyev, Ovrutsky, 1982)

7. Luminescent study

8.Electroodontrometry (EDI)

Electroodontodiagnosis (EDD)– a method for assessing the excitability of the sensory nerves of the tooth when they are irritated by electric current. EDI allows you to presumably assess the condition of the dental pulp. Pulp intact healthy teeth responds to current strength within 2-6 μA. To determine the electrical excitability of a tooth, devices OD-1, OD-2M, EOM-3, IVN-1, etc. are used. The study is carried out by a doctor together with an assistant. The reliability of the testimony largely depends on the psycho-emotional mood of the patient. Electroodontodiagnostics for caries in children is rarely used. The electrical excitability of primary teeth has not been sufficiently studied, which is explained by the difficulties of obtaining objective information in children aged 3-5 years. The electrical excitability of permanent teeth varies: during the period of eruption, it is reduced, as the roots grow and form, the excitability increases, reaching normal numbers by the time the root formation is completed. With caries, sensitivity to electric current does not change noticeably (2-6 μA). At deep caries, especially in children with III degree activity, there is a decrease in the sensitivity of the dental pulp to 10 μA . The most sensitive points for electrode placement are the middle of the cutting edge of the anterior teeth, the apex of the buccal cusp of the premolars and the apex of the anterior buccal cusp of the molars. In carious teeth, indicators are taken from the bottom of the carious cavity, cleared of necrotic decay. Today, very compact devices have been developed to determine the vitality (viability) of the pulp (for example, the Digitest pulp condition tester). They allow us to state only two states of the pulp: it is alive (normal) or necrotic.

EDI, like traditional thermal diagnostics, is a relative and subjective method of additional research.

Electrometric The method for diagnosing caries (C.) is based on the ability of dental hard tissues affected by caries to conduct electric current of varying magnitudes depending on the degree of their damage.

9. X-ray - when diagnosing dental caries in children, it is used much more often than in adults, since it is the most reliable method when examining a small patient. This research method is used when there is a suspicion of the formation of carious cavities on proximal surfaces and when the teeth are closely spaced, when the hard tissue defect is inaccessible to inspection and probing. Using an x-ray, one can judge the depth of the carious cavity, the size of the pulp chamber, and the condition of the roots and periodontal tissues, which is very important when carrying out the differential diagnosis of caries and its complications.

The radiographic research method allows you to determine:

Condition of hard tooth tissues (presence of hidden cavities, enamel cracks);

Condition of the root canals (length, width, degree of passage, quality

filling, stage of root formation, state of the growth zone, stage of resorption of the roots of baby teeth);

Condition of the peri-apical tissues and periodontal tissues (expansion of the periodontal gap, rarefaction of bone tissue);

Position of teeth;

The structure of neoplasms, sequestra, stones in the salivary glands;

Condition of the temporomandibular joints.

In dentistry, radiography is used:

Intraoral:

a) close-focus contact;

b) contact in the bite.

Extraoral:

a) panoramic;

b) orthopantomography;

c) tomography;

d) contrast radiography.

Radiovisiography (digital radiography).

10.Method for indicating carious dentin. Carious dentin consists of two layers. The first layer (outer) is infected. The second layer (inner) is uninfected, partially demineralized, capable of remineralization. In the treatment of caries outer layer must be deleted, the internal one must be saved. To indicate the layers, use the “Caries Detector” preparation, which is a 0.5% solution of basic fuchsin or a 1% solution of red acid in propyleglycol. A tampon with dye is inserted into the carious cavity for 15 seconds. In this case, the outer, non-viable layer is painted, but the inner one is not. Analogs of the drug: Caries Marker (Voco), Color test No. 2 (Vlad-Miva).

11. Laboratory research methods

The data obtained during the examination of the patient is entered into medical card dental patient (account form No. 000/u) and, based on the real dental situation, draw up a treatment and treatment plan preventive measures acceptance. One of the important tasks initial examination is to develop parents' responsibility for the oral health of their child. It is necessary to note the importance of their participation in the implementation of the program of treatment and preventive measures, in particular in matters of oral hygiene, compliance with doctor visits, monitoring the implementation of prescriptions, and much more. Only complete mutual understanding between all participants in the process - doctor, child (patient), parent - is the key to the success of treatment.

Pediatric therapeutic dentistry studies the characteristics of the clinical course, treatment and prevention of major dental diseases in children (caries and its complications, periodontal and mucous membrane diseases, as well as diseases of the hard tissues of non-carious teeth). A pediatric dentist must know all sections of pediatric dentistry and understand their organic connection, taking into account the growing and developing organism. During the examination, it is very important to follow a certain sequence to know the variants of the norm, in order to early detection developing pathology. The key to the success of treating a small patient is complete mutual understanding between all participants in the process - doctor, child (patient), parent.

QUESTIONS AND TASKS FOR STUDENTS' SELF-TEST.

1. Where and when was the first department of pediatric dentistry organized? Who led it?

In 1963 In MMSI

A. A. Kolesov

2. What signs are characteristic of the normal process of teething?

Pairing, symmetry, sequence and order at certain times of eruption

3. In what sequence are the dentitions examined?

4. What cells are involved in the formation of dentin?

Odontoblasts

5. Define the term “enamel maturation”

Final mineralization of enamel that occurs in the oral cavity in the presence of oral fluid

LITERATURE.

1. B. Therapeutic dentistry of children. M. “Medical book”, N. Novgorod. Publishing house NGMA, 2001.

2. S., M., V. Pediatric dentistry M. “Medicine” 2003.

3. MacDonald, Avery. Dentistry for children and adolescents. M. Medical information agency. 2003.

4. E. Pediatric dentistry. Practical guide. Rostov-on-Don Phoenix 2006.

5. P., Yu. Pediatric therapeutic dentistry. Guide to practical classes. M. GEOTAR – Media 2012.