Features of clinical manifestations, free radical, coagulation and aggregation properties of blood in patients with craniocerebral trauma

In recent years in Ukraine, as in the entire world, there has been an increase in cases of domestic injuries with a raise in the number of patients with craniocerebral trauma and its consequences. The aim of our research was to study clinical symptoms, the state of free radical oxidation, aggregate and hemocoagulative properties of blood in patients with mild craniocerebral trauma. Materials and methods:We conducted comprehensive clinical and laboratory examination of 34 patients with mild craniocerebral trauma and 20 apparently healthy patients (the control group). The diagnosis was made under ICD-10. The verification of the diagnosis was based on data from clinical examination, neurological status of neuroimaging (computer tomography and magnetic resonance imaging). The study group included 24 men and 10 women aged from 19 to 40. In addition, 20 apparently healthy individuals of the same age were examined, who comprised the control group (14 men and 6 women). In the blood parameters of all patients, we examined free radical oxidation, hemostasis and aggregation properties of platelets. Results: The conducted study revealed clinical disturbances, changes in the parameters of free radical lipid oxidation, coagulation and microcirculatory hemostasis. Conclusions: All patients with mild craniocerebral trauma, develop disturbances in the form of symptoms of microorganic lesion of the central nervous system: convergence weakness in 100% of patients, Mann’s symptom (76.4%), disruption of the function of the cranial nerves (58.8%), signs of pyramidal insufficiency (68.4%), vestibular disorders (94.1%), autonomic vascular dysfunction (100%). Mild craniocerebral trauma is accompanied by the activation of free radical lipid oxidation processes, decreased activity of antioxidant enzymes, hypercoagulation, and increased aggregation properties of platelets

Сalix[4]arene chalcone amides effects on myometrium mitochondria

Mitochondria are a key player in a wide range of the most important functions of the cell. Calixarenes are supramolecular compounds that have been widely used in bioorganic chemistry and biochemistry. The aim of this work was to study the effects of calix[4]arenes with two (С-1012, С-1021), three (С-1023, С-1024) and four (С-1011) chalcone amide groups on the myometrial mitochondria membranes polarization, Ca2+ concentration in the matrix of these organelles ([Ca2+]m ) and on the average hydrodynamic diameter of mitochondria. It was shown that permeabilized myometrium cells incubation with calix[4]arenes containing two or more chalcone amide groups, was accompanied by an increased level of myometrial mitochondria membranes polarization. All studied calix[4]arenes increased [Ca2+]m values in the absence and in the presence of exogenous Ca2+. The values of [Ca2+]m in the absence of exogenous Ca2+ were higher at mitochondria incubation in Mg2+-containing, than in Mg2+,ATP-containing medium. Incubation of isolated mitochondria with the studied calix[4]arenes resulted in changes of mitochondria volume: at incubation with С-1012, С-1021, C-1023 the average hydrodynamic diameter was decreased, while with С-1011 it was increased. Thus, we have shown that a short-term (5 min) incubation of mitochondria in the presence of 10 µM calix[4]arenes, which contain from two to four chalcone amide groups, increased the level of mitochondria membranes polarization, ionized Ca concentration in the matrix and had different effects on the mitochondrial volume

Застосування методів симуляційного навчання на кафедрі післядипломної освіти лікарів-стоматологів

Проаналізовано методики симуляційного тренінгу для лікарів-інтернів із надання невідкладної допомоги пацієнтам у термінальних станах. Тренінг сприяє підвищенню компетенції лікарів-стоматологів у наданні допомоги в невідкладних станах, упевненому застосуванню знань для підвищення якості медичної допомоги пацієнтам.The aim is to analyze the peculiarities of emergency care to dental practitioners at the department of postgraduate education of dentistry doctors for improving the quality of manual skills of the doctor in an out-patient department. Within the framework of the program, pilot trainings are held in Poltava and Lviv on the following topics: assistance in sudden coronary and sudden cardiac death, assistance with acute cere-brovascular accident, help with hypertensive crises, help with cardiac asthma and pulmonary edema. The training is carried out according to the methodological design and it consists of the theoretical and practical part. The training is provided by a certified teacher at the regional training and training center at M.V. Skli-fosovsky Poltava Regional Clinical Hospital. The optimal number of listeners is 10-12 people. On the theo-retical part the teacher represents the purpose, the plan of the lesson and in the logical sequence the mate-rial is presented. The theoretical part is equipped with a multimedia presentation. In the process, the teacher defines the basic level of knowledge and skills of listeners. In the practical part, the teacher initially deter-mines the level of possession of clinical skills of doctors, teaches work on dummies, models real, simple and accessible to perception simulation scenarios. Doctors have to solve the tasks and practice practical skills from basic resuscitation measures. At the same time, an important place is given to work in the team.On phantoms, elements of the resuscitation brigade are worked out when providing emergency care to a patient with a terminal state (cardiac arrest) using cardiac-pulmonary resuscitation techniques (CPR).At the same time, artificial ventilation of the lungs (ventilation of the lungs) with exhalation in the mouth or the nose (mask) in the area of the head of the phantom is carried out. The modeling of the air duct is then modeled. This verifies the correctness of the laryngoscope in the oropharynx, and the introduction of the laryngeal mask. Doctors will work with Ambu's bag: the first hand fix the mask of the device in the area of the nose, the mouth of the phantom, and the other - by pressing the camera, the air is poured into the roton-nose area of the phantom with a certain frequency of pressure, followed by the use (if necessary) of an oxygen cylinder of type B. This checks the correctness of each reception. Conducting each manual reception and its effective-ness is fixed and processed by a computer program. The result is displayed on the monitor in the form of vi-tal signs of the patient. In the case of effective doctor actions, the vital parameters of the "patient" on the monitor are normalized. The evaluation of the effectiveness of the manipulations is also carried out in balls. In the beginning, the trainer-instructor shows the order and correctness of carrying out emergency assis-tance measures on phantoms. In the future, monitors the implementation of manual techniques and as-sesses the actions of interns at each individual stage, emphasizing the correct implementation of the manual action. The sequence of the manual training on the "phantom-monitor" system gives confidence to doctors in the correctness and efficiency of manual skills. At the end of the practical cycle of training certified teachers of the department summarize the practical training with doctors-dentists.Practical training with the use of modern phantoms with computer processing of results helps to increase the competence of dental practitioners in providing emergency care and to ensure the use of the knowledge to improve the quality of medical care for patients

Electromyography indicators in different periods of using of the removable dentures in patients with acrylate intolerance

Проведене порівняння кількісних показників електроміограм пацієнтів із токсико-алергічним ушкодженням указує на те, що в них змінений динамічний цикл активності й спокою жувальних м’язів у порівнянні з практично здоровими людьми, що підтверджується зростанням коефіцієнта «К»; суттєво знижується середня амплітуда вольового стиснення й довільного жування. Уже через 1 місяць кори стування протезами з профілактичним магнетронним покриттям покращуються показники електроміограм, жування стає досконалішим, що підтверджується біоелектричною активністю власне жувальних м’язів: вона розподілена рівномірніше між робочим і балансуючим боками, динаміка станів спокою й активності жувальних м’язів стає більш збалансованою, ніж у пацієнтів другої групи. Це, своєю чергою, свідчить про краще функціонування протезів із магнетронним покриттям.Despite the achievements in medical rehabilitation of patients with partial and complete absence of teeth, rehabilitation is not a definitely settled issue for orthopedic dentistry. According to the World Health Organiza-tion, about 26% of patients do not use full dentures for various reasons. The most common reasons for non-adaptive removable dentures are poor denture fixation or pain under prosthesis, which may be associated with the development of prosthetic stomatitis. We elaborated a method for the prevention and treatment of prosthetic stomatitis (toxic and allergic), using the magnetron coating with fullerene C60 surface of the pros-thesis base.The aim of the research is the study of bioelectric activity of the masseter muscle in patients with mani-festations of intolerance to acrylic base plastic after covering the prosthesis base with C60 fullerene in the observation period of up to 3 months.Material and methods of the research. We examined 29 subjects who presented to the orthopedic dentistry clinic for restoration of dentitions, using of partial and full laminar removable dentures. Patients were divided into 3 groups. The first group embraced patients with complete dentitions without dentures (9 people). The second group comprised patients who used partial and complete removable dentures with acrylic base for 1-3 months and they were diagnosed with prosthetic stomatitis (10 people). The third group included patients, implanted with partial and complete laminar removable dentures with the phenomena of prosthetic stomatitis, which underwent isolation of the prosthesis base using magnetron nano-coating with C60 fullerene (10 people).The functional state of the masseter muscles was determined by superficial electromyography, taking into account the condition of the prosthetic bed tissues and the period of using the dentures with nano-coating for 1 day, 15 days, 30 days and 2 months after denture placement.Results of the studies and their discussion. As shown by our studies, patients who used partial and complete removable prostheses with symptoms of prosthetic stomatitis (toxic and allergic stomatitis) demon-strated a significant effect on the bioelectric activity of the proper masseter muscles as compared with pa-tients in group 1. The average amplitude of volitional compression was less at 2.8 times and the averageamplitude of arbitrary chewing was less at 2.1 times, the dynamics of the states of rest and activity of chew-ing muscles was impaired. A reduction in the activity time and a slight increase in the resting time both on the working side and on the balancing side, as compared to patients in group 2 were observed in the first day af-ter prosthetics with magnetron C60 fullerene nano-coating. Patients in group 3 demonstrated an increase in bioelectric activity (the amplitude of biopotentials increased), as compared with group 2, both in volitional compression and in arbitrary chewing. On the 15th day of observation, the electromyographic pattern in pa-tients of group 3 changed and was characterized by a pronounced tendency to normalized indicators of the activity and rest time. The electromyogram amplitude of the masseter muscles increased significantly, but at this time the observations did not reach the values of group 1. One month after applying the dentures, elec-tromyograms of patients demonstrated a more pronounced alternation of activity waves with periods of rest, the amplitude of biopotentials oscillation increases. One month after denture placement, the indicators of group 3 approached the data, obtained in patients of group 1. After conducting the electromyographic study within 3 months, we found that in group 3, the values of average amplitude of arbitrary chewing and the am-plitude of volitional compression of the masseter muscles were 2 times higher than those of group 2. The time of activity and rest became more balanced and did not differ significantly from indicators in group 1

APPLICATION OF METHODS OF SIMULATION TRAINING AT THE DEPARTMENT OF POSTGRADUATE EDUCATION OF DENTISTS

The aim is to analyze the peculiarities of emergency care to dental practitioners at the department of postgraduate education of dentistry doctors for improving the quality of manual skills of the doctor in an outpatient department. Within the framework of the program, pilot trainings are held in Poltava and Lviv on the following topics: assistance in sudden coronary and sudden cardiac death, assistance with acute cerebrovascular accident, help with hypertensive crises, help with cardiac asthma and pulmonary edema. The training is carried out according to the methodological design and it consists of the theoretical and practical part. The training is provided by a certified teacher at the regional training and training center at M.V. Sklifosovsky Poltava Regional Clinical Hospital. The optimal number of listeners is 10-12 people. On the theoretical part the teacher represents the purpose, the plan of the lesson and in the logical sequence the material is presented. The theoretical part is equipped with a multimedia presentation. In the process, the teacher defines the basic level of knowledge and skills of listeners. In the practical part, the teacher initially determines the level of possession of clinical skills of doctors, teaches work on dummies, models real, simple and accessible to perception simulation scenarios. Doctors have to solve the tasks and practice practical skills from basic resuscitation measures. At the same time, an important place is given to work in the team. On phantoms, elements of the resuscitation brigade are worked out when providing emergency care to a patient with a terminal state (cardiac arrest) using cardiac-pulmonary resuscitation techniques (CPR). At the same time, artificial ventilation of the lungs (ventilation of the lungs) with exhalation in the mouth or the nose (mask) in the area of the head of the phantom is carried out. The modeling of the air duct is then modeled. This verifies the correctness of the laryngoscope in the oropharynx, and the introduction of the laryngeal mask. Doctors will work with Ambu's bag: the first hand fix the mask of the device in the area of the nose, the mouth of the phantom, and the other - by pressing the camera, the air is poured into the roton-nose area of the phantom with a certain frequency of pressure, followed by the use (if necessary) of an oxygen cylinder of type B. This checks the correctness of each reception. Conducting each manual reception and its effectiveness is fixed and processed by a computer program. The result is displayed on the monitor in the form of vital signs of the patient. In the case of effective doctor actions, the vital parameters of the "patient" on the monitor are normalized. The evaluation of the effectiveness of the manipulations is also carried out in balls. In the beginning, the trainer-instructor shows the order and correctness of carrying out emergency assistance measures on phantoms. In the future, monitors the implementation of manual techniques and assesses the actions of interns at each individual stage, emphasizing the correct implementation of the manual action. The sequence of the manual training on the "phantom-monitor" system gives confidence to doctors in the correctness and efficiency of manual skills. At the end of the practical cycle of training certified teachers of the department summarize the practical training with doctors-dentists. Practical training with the use of modern phantoms with computer processing of results helps to increase the competence of dental practitioners in providing emergency care and to ensure the use of the knowledge to improve the quality of medical care for patients

Comparative characteristics of the effectiveness of direct and indirect restorations on teeth with discoloration

Проведено оцінку і порівняння якості прямих і непрямих реставрацій зубів фронтальної групи з дисколоритами. Перша група – хворі, яким проведено лікування прямими реставраціями, виконаними світлополімерним реставраційним матеріалом «Estet X HD» («Dentsply») (50 хворих, 125 реставрацій); друга група – хворі, яким проведено лікування з використанням непрямих керамічних реставрацій, виготовлених методом пресування кераміки за високої температури («IPS Emax»). Останню групу було розділено на дві підгрупи залежно від методу лікування: 2А – пацієнти, яким непрямі реставрації фіксували за загальноприйнятими методиками на композит подвійного твердіння «Calibra» виробництва «Dentsply» (20 хворих, 70 вінірів), і 2В – пацієнти, яким вініри було зафіксовано на розігрітий композит «Gradia Direct» виробництва «GC» (20 пацієнтів, 55 вінірів).Порівняльну оцінку проводили через рік після закінчення реставрації. Визначали показники стану цих реставрацій за допомогою модифікованих критеріїв USPHS (United States Public Health Service; Ryge, G., 1980, 1981) для фронтальної групи зубів. Дослідження показали, що найвищий рівень якості спостерігається в групі, де були виготовлені непрямі реставрації (вініри), зафіксовані на розігрітий композит «Gradia Direct» виробництва «GC». Отримані результати підтверджені статистичним аналізом.The rapid development of dental industry and constant improvement of technologies in production of ba-sic dental materials contribute to the increase of the quality of rendering dental care with the obligatory con-sideration not only of functional but also aesthetic parameters during a patient's rehabilitation. However, there is still no precise indication for the use of metal-free structures for the qualitative and durable aesthetic restoration of the frontal group of teeth, white-pink aesthetics and prosthetic rehabilitation, taking into ac-count changes in the parameter of biological width of the tooth and aesthetic criteria.The aim of the research is to improve the effectiveness of treatment of frontal group teeth with discolora-tion using direct and indirect restorations by evaluating and comparing the quality of restorations.Research materials and methods.For clinical substantiation and comparison of direct and indirect ce-ramic restorations with classical fixation and the proposed method of fixation on the heated composite, 90 patients with discoloration and defects of the crown of the front teeth, aged 18 to 65 years, were examined and treated. A comparative evaluation was carried out one year after the restoration was completed.The distribution of patients into clinical groups was as follows: the first group – patients who were treated by direct restorations, performed with light- polymer restorative material Estet X HD (Dentsply) (50 patients, 125 restorations); the second group embraced patients, treated with indirect ceramic restorations manufac-tured by the method of pressing high temperature ceramics (IPS Emax). The latter group was in turn divided into two subgroups, depending on the treatment method: 2A – patients with indirect fixation by conventional methods on the Dentsply dual-cure composite of Calibra production (20 patients, 70 veneers) and 2B - pa-tients with fixation treated on the heated composite Gradia Direct by GC production (20 patients, 55 ve-neers).In order to evaluate the quality of prosthetics in patients with direct and indirect ceramic restorations (ve-neers) it has been determined the status of these restorations using the modified USPHS (United States Public Health Service; Ryge, G., 1980, 1981) criteria for the frontal teeth group. The obtained results were processed by the method of variational statistics using Student's test.Research results. During the clinical evaluation of direct restorations using the modified USPHS criteria for the frontal teeth group, the following complications were identified: tooth sensitivity was present in 5.6% of teeth, fractures, cracks, chips – in 20 restorations (16%); discrepancy between the color of restoration and the color of natural teeth – in 30 restorations (24%); the presence of defects in the texture of the surface – 30 teeth (24%). Impaired marginal adaptation was in 32 restorations, which amounted to 25.6%; loss of restora-tion gloss – in 66,4%, the presence of secondary caries – in 17 teeth (13,6%); deficiency of occlusal contact –in 13 restorations (10.4%), of approximate contact – in 17 restorations (3.6%). A detailed analysis of the condition of indirect restorations and clinical complications in the second group showed that the most com-mon defects are impairment of marginal adaptation – 16 veneers (12.8%), impairment of the integrity of ve-neers due to fractures, cracks, chips – 6 (4.8%), inconsistency of color – 13 veneers (10.4%), the presence of surface texture defects – 0, secondary caries – 3 teeth (2.4%), the position of fixing cement – 4 veneers (3.2%). Impaired occlusal contact was observed in 1 tooth (8.8%). No changes in approximate contacts were detected. The total number of complications was 17%, which indicates the need to find the optimization ap-proaches to treatment with these structures. Comparison of the status of indirect restorations, depending on the method of fixation by subgroups showed that the impaired integrity of veneers due to fractures, cracks, chips in subgroup 2A was detected in 4 teeth (5.7%), and in the subgroup 2B – in 2 teeth (3.6%). Color change in group 2A was observed in 12 teeth (17.1%), in group 2B – in 3 teeth (5.5%). Disorders of marginal adaptation in group 2A were observed in 12 teeth (17.1%), in group 2B – in 4 teeth (6.6%). Secondary caries was observed on 2 teeth (2.9%) in group 2A and in one patient in group 2B (1.8%). According to the criteria for evaluating the state of indirect ceramic restorations and recommended follow-up professional actions, the following estimates were estab-lished: 28% of restorations in the first group, 55.7% of restorations in group 2A, 85.5% of restorations in group 2B received an “excellent” rating; 33.6% of restorations in the first group, 25.7% in group 2A, 5.5% ingroup 2B received a “good” rating; a “satisfactory” rating was obtained by 11.2% of restorations in the first group, 11.7% in group 2A, 5.4% in group 2B. In the first group, 27.2% of restorations needed immediate re-placement, 11.4% – in the second and 3.6% – in the third group.The total score for the first group was 3.87±0.07, for 2A – 4.26±0.12, p.05, for group 2B – 4.73±0,1,p1˂p,05, p2˂0,05.Conclusion.Thus, our studies of direct and indirect restorations after one year of use showed that the highest level of quality was observed in the group where indirect restorations (veneers) were manufactured, which were fixed on the heated Gradia Direct composite by GC production. The obtained results are con-firmed by the statistical analysis.To evaluate the quality and duration of using direct and indirect structures with different types of fixation, it is advisable to carry out a long-term monitoring for up to 10 years

Improving students’ autonomous work at the department of nervous diseases with neurosurgery and medical genetics by usage of innovative technologies

Пріоритетною метою медичної освіти і критерієм її ефективності стають розвиток особистісного потен- ціалу та реалізація професійної складової майбутнього лікаря. Актуальність проблеми оволодіння студентами методами самостійної пізнавальної діяльності зумовлена тим, що в період навчання у виші закла- даються основи майбутньої самостійної професійної діяльності. Кафедра нервових хвороб з нейрохірургією та медичною генетикою ВДНЗУ «Українська медична стоматологічна академія» створює адекватні умови для самостійної роботи студентів, щоб у майбутньому молоді фахівці-неврологи могли впевнено працювати завдяки тим умінням і навичкам, які вони сформували за час навчання; Приоритетной целью медицинского образования и критерием его эффективности становятся развитие личностного потенциала и реализация профессиональной составляющей будущего врача. Актуальность проблемы овладения студентами методами самостоятельной познавательной деятельности обусловлена тем, что в период обучения в вузе закладываются основы будущей самостоятельной профессиональной деятельности. Кафедра нервных болезней с нейрохирургией и медицинской генетикой ВДНЗУ «Украинская медицинская стоматологическая академия» создает адекватные условия для самостоятельной работы студентов, чтобы в будущем молодые специалисты-неврологи могли уверенно работать благодаря тем умениям и навыкам, которые они сформировали за время обучения; The foreground aim of medical education and the criterion of its effectiveness become the development of personal potential and implementation of professional component of the doctor to-be. The relevance of the issue is to acquire the methods of autonomous cognitive activity determined by the fact that during the period of study at the university, the foundation for future independent professional activity is created. The aim of the study is to implement the innovative technologies for students’ autonomous work at the Department of Nervous Diseases with Neurosurgery and Medical Genetics in order to improve the development of theoretical material and practical skills. Students’ autonomous work during classes includes activities at lectures and practical exercises that vary for instance: “brainstorm”, debate, discussions of specific situations etc. Students’ autonomous work after classes includes the study of literature occupational edition, referencing literature, annotated books, articles, review the developed theoretical material, exercises, problem solving, preparing the reports, and autonomous work on the Internet (search for information on-line, organization of the dialogues online, creating thematic web-pages and web-quests). Another option in the process of students’ autonomous work at the Department of Nervous Diseases with Neurosurgery and Medical Genetics, is the educational module aimed on independent supervision of patients followed by the writing of academic case histories. The distance education technologies are of great interest over the world nowadays, which is particularly important in higher and post-graduate education. Such learning method is provided by the development of telecommunication systems and the Internet. With the aim of selfstudy of the discipline at the Department, the video films and video clips about nosology, electronic stands of topical diagnosis were developed. Students are provided with the opportunity to work at the electronic library of the Academy, which stores a large number of textbooks, monographs, manuals, educational videos, and research papers on the most difficult topics of neuroscience. A large amount of educational material is presented on the website of the Academy. The students who are the most interested in learning are able to attend students’ scientific group, meetings are held twice a month on different subjects aimed at in-depth study of neurology and acquiring and development of practical skills. At the end of academic year, some of them demonstrate research reports at students’ conference according to the topics which they have chosen and have been working on with their scientific supervisors, while the rest of students publish the theses only. The Department of Nervous Diseases with Neurosurgery and Medical Genetics of Higher State Educational Establishment of Ukraine “Ukrainian Medical Stomatological Academy” creates adequate conditions for students’ autonomous work so that young neurologists to-be could confidently pursue their profession thanks to the skills and abilities which they have obtained during the educational process

Dynamics of the level of pro- and anti-inflammatory cytokines in the crevicular fluid after direct and indirect restoration

Мета дослідження – вивчити рівень прозапальних і протизапальних цитокінів ясенної рідини після прямих і непрямих реставрацій за класичної фіксації й запропонованою методикою фіксації на розігрі-тий композит у терміни через добу і 12 місяців.Відсутність достовірних розбіжностей рівня прозапальних цитокінів через 12 місяців у групах не-прямих реставрацій свідчить про відсутність запальних явищ у маргінальному пародонті й доводить можливість застосування методики фіксації вінірів на розігрітий композит.The restoration of discolored teeth is conducted by direct and indirect restoration techniques. Impairment of marginal periodontium is possible during the stages of both direct and indirect restoration in gum retrac-tion, cofferdam application, grinding and polishing for direct restoration, removal of fixation cement residues near indirect restorations and finishing preparation of the connection boundary with the tooth. Furthermore, the restorations affect the periodontal tissues in the long term due to the formation of biofilm and dental plaque in the precervical area of the abutment teeth.One of the earliest ways to detect the inflammatory process in the marginal periodontium is to determine the level of pro-inflammatory and anti-inflammatory cytokines in the crevicular fluid.The aim of the research was to study the level of pro-inflammatory and anti-inflammatory cytokines in the crevicular fluid after direct and indirect restorations, which were performed by classical fixation and via the proposed method of fixation on the heated composite in 24 hours and 12 months. Materials and methods of the research. For clinical substantiation and comparison of direct and indirect ceramic restorations with classical fixation and the proposed method of fixation on the heated composite, we examined and collected the material in 24 hours and 12 months after treatment in 84 patients, aged 18-65, with dental discoloration and defects of the crown of the frontal teeth. All patients were divided into 7 clinical groups with 12 patients in each. Group 1 was a control, which in-cluded patients with intact dentition, without discoloration and defects of the hard tissues of the teeth of the frontal area; group 2 embraced patients who were treated by direct restoration (a day after treatment); group 3 comprised patients, treated with indirect ceramic restorations, which were fixed by conventional methods on a double-cured composite (one day after treatment); group 4 included patients, whose veneers were fixed to the heated composite (one day after treatment); group 5 embraced patients 12 months after treatment with direct restorations; group 6 included patients, treated with indirect ceramic restorations, which were fixed by conventional methods on a double-cured composite (12 months after treatment); group 7 comprised patients, whose veneers were fixed to the heated composite (12 months after treatment). The material for the study was the crevicular fluid. We determined the tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and inter-leukin 10 (IL-10).The study showed that in all three study groups in 24 hours, the significant predominance of the IL-6 con-tent as compared to the control group was observed. The presence of IL-6 in the crevicular fluid indicates in-flammation in the periodontium. The level of another pro-inflammatory cytokine, TNF-α, was higher in the groups with direct and indirect restorations, which were fixed by conventional methods to the composite of double hardening, which relates to adverse factors, since this mediator activates the processes of osteore-sorption and enhances inflammatory reactions in the periodontal tissues. When comparing the concentra-tions of pro-inflammatory cytokines TNF-α and IL-6 in the crevicular fluid between the direct and indirect res-toration group, we detected their significantly lower level in the groups where indirect restorations were per-formed, fixed on the composite cement and on the heated composite. The concentration of IL-10 in the groups with direct and indirect restoration, fixed on the heated composite, was the same, and in the group with indirect restoration, fixed on the composite cement, it increased significantly. After 12 months, the level of pro-inflammatory cytokines TNF-α and IL-6 was significantly higher in the direct restoration group as com-pared to the indirect restoration groups and with fixation on the composite cement and on the heated com-posite. The absence of significant differences in pro-inflammatory cytokines in this period for the groups of indirect restorations indicates the absence of inflammatory phenomena in the marginal periodontium and proves the possibility of applying the method of veneer fixation on the heated composite