МЕЖДИСЦИПЛИНАРНЫЙ ПОДХОД К ПРЕПОДАВАНИЮ ИНСТРУМЕНТАЛЬНЫХ МЕТОДОВ ИССЛЕДОВАНИЯ В СТОМАТОЛОГИИ: ОТ КЛИНИЧЕСКОЙ ЗАДАЧИ К ДИАГНОСТИЧЕСКОМУ РЕШЕНИЮ
DOI:
https://doi.org/10.24234/scientific.v3i53.394Ключевые слова:
Стоматология, инструментальная диагностика, лучевая диагностика, рентгенография, ортопантомография, КЛКТ, КТ, МРТ, ультразвуковая диагностика, стоматологическое образование, междисциплинарный подход, клиническое мышлениеАннотация
Современная стоматология характеризуется широким использованием инструментальных методов исследования, которые обеспечивают получение объективной информации о состоянии зубов, челюстей, височно-нижнечелюстных суставов, мягких тканей и других структур челюстно-лицевой области. Расширение диагностических возможностей, включая цифровую рентгенографию, ортопантомографию (ОПТГ), конусно-лучевую компьютерную томографию (КЛКТ), мультиспиральную компьютерную томографию (МСКТ), магнитно-резонансную томографию (МРТ), ультразвуковое исследование (УЗИ) и радионуклидные методы, предъявляет новые требования к профессиональной подготовке будущего стоматолога. Целью настоящей научо-методической статьи является обоснование междисциплинарного подхода к преподаванию инструментальной диагностики в дипломном и постдипломном образовании в стоматологии. Рассматриваются современные возможности основных методов визуализации, их клиническое значение и место в диагностическом алгоритме стоматолога. Особое внимание уделяется формированию у обучающихся навыков выбора метода исследования в зависимости от клинической задачи, интерпретации результатов и использования диагностической информации при планировании лечения. Предлагается модель клинико-ориентированного обучения, основанная на последовательности «клиническая задача — диагностическая гипотеза — выбор метода — визуализация — интерпретация — клиническое решение». Показано, что интеграция лучевой и инструментальной диагностики с терапевтической, хирургической, ортопедической стоматологией и ортодонтией способствует формированию клинического мышления и повышает диагностическую компетентность будущего врача.
Библиографические ссылки
Abu Arqub, S., Al-Moghrabi, D., Kuo, C.L., Da Cunha Godoy, L., & Uribe F. (2024). Perceptions and utilization of tele-orthodontics: a survey of the members of the American Association of Orthodontists. Prog. Orthod. 25(1): 16. https://doi.org/10.1186/s40510-024-00516-4.
Al-Buhaisi, D., Karami, S., & Gomaa, N. (2024). The role of teledentistry in improving oral health outcomes and access to dental care: An umbrella review. Journal Oral Rehabil. 51(11): 2375–2389. https://doi.org/ 10.1111/joor.13836.
Annamma, L.M., Varma, S.R., Abuttayem, H., Prasad, P, Azim, S.A., Odeh, R., George, B.T., Nair, C., & Karobari, M.I. (2024). Current challenges in dental education- a scoping review. BMC Med Educ. 24(1): 1523. https://doi.org/10.1186/s12909-024-06545-1.
Avanesov, A.M., Sedov, & Yu.G (2015). Otsenka effektivnosti konusno-luchevoy kompyuternoy tomografii v diagnostike oslozhneniy luchevoy terapii opukholey chelyustno-litsevoy oblasti (Evaluation of the effectiveness of cone-beam computed tomography in the diagnosis of complications of radiation therapy for maxillofacial tumors). Fundamentalnye issledovaniya. (1):13–16.
Bai, G., Qu, Z., Xie, Q., Jing, H., Chen, S., & Yu L. (2023). Automatic temporomandibular disc displacement diagnosis via deep learning. Journal of Displays. 77: 102394. https:// doi.org/10.1016/j.displa.2023.10239436933315.
Batra, P., Tagra, H., & Katyal, S. (2022). Artificial intelligence in teledentistry. Discoveries (Craiova). 10(3) :153. https://doi.org/10.15190/d.2022.12.
Center for the Advancement of Interprofessional Education (CAIPE). (2016). Defining interprofessional education. Elektronnyy resurs: https://www.caipe.org/about/ https://www.caipe.org/about/. (Accessed: 22.09.2026).
Dashti, M., Ghasemi, S., & Khurshid, Z. (2024). Integrating artificial intelligence in dental education: an urgent call for dedicated postgraduate programs. Int Dent J. 74(6):1466-1468. https://doi.org/10.1016/j.identj.2024.08.008.
Di Spirito, F. (2023). Integrating P4 medicine in teledentistry and M-health in oral, dental, and periodontal care. J. Pers. Med. 13(1) :111. https://doi.org/10.3390/jpm13010111.
Elledge, R.O.C. (2024). Classifications for the temporomandibular joint (TMJ): a systematic review of the literature. J Craniomaxillofac Surg. 52(8): 890-894. https://doi.org/10.1016/j.jcms.2024.04.010.
Elshenawy, H., Aly, W., Salah, N., Nasry, S., Anter, E., & Ekram, K. (2019). Influence of small, midi, medium and large fields of view on accuracy of linear measurements in CBCT imaging: diagnostic accuracy study. Open Access Maced J Med Sci. 7(6):1037-1041. https://doi.org/10.3889/oamjms.2019.232.
Erturk, A.F., Yelken Kendirci, M., Ozcan, I., & Gokcen Rohlig, B. (2023). Use of ultrasonography in the diagnosis of temporomandibular disorders: a prospective clinical study. Oral Radiol. 39(2): 282-291. https://doi.org/10.1007/s11282-022-00635-w.
Eze, N.D., Mateus, C., & Cravo Oliveira Hashiguchi T. (2020). Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation. PLoS ONE. 15(8): e0237585. https://doi.org/10.1371/journal.pone.0237585.
Ezhov, M., Gusarev, M., Golitsyna, M., Yates, J.M., Kushnerev, E., Tamimi, D., Aksoy, S., Shumilov, E., Sanders, A., & Orhan, K. (2021). Clinically applicable artificial intelligence system for dental diagnosis with CBCT. Sci Rep. 11(1): 15006. https://doi.org/10.1038/s41598-021-94093-9.
Garcia-Huidobro, D., Fernandez, J., Espinosa, P., Lustig, N., Perez, I., & Letelier, L.M. (2024). Teaching therapy decision-making to medical students: a prospective mixed-methods evaluation of a curricular innovation. BMC Med Educ. 24(1): 1533. https://doi.org/10.1186/s12909-024-06421-y.
Giraudeau, N., Bauer, M., Tramini, P., Inquimbert, C., & Toupenay, S. (2022). A national teledentistry study on the knowledge, attitudes, training and practices of private dentists. Digit. Health. 8: 20552076221085069. https://doi.org/10.1177/20552076221085069.
Görürgöz, C., İçen, M., Kurt, M.H., Aksoy, S., Bakırarar, B., Rozylo-Kalinowska, I., & Orhan, K. (2023). Degenerative changes of the mandibular condyle in relation to the temporomandibular joint space, gender and age: a multicenter CBCT study. Dent Med Probl. 60(1):127-135. https://doi.org/10.17219/dmp/147514.
Horner, K., O'Malley, L., Taylor, K., & Glenny, A.M. (2015). Guidelines for clinical use of CBCT: a review. Dentomaxillofac Radiol. 44(1): 20140225. https://doi.org/10.1259/dmfr.20140225.
Institute of Medicine. (2004). J Healthc Qual. Vol. 26. Washington, DC: National Academies Press; Health professions education: a bridge to quality, p. 54.
Interprofessional education and practice—an imperative to optimize and advance oral and overall health. (2018). Elektronnyy resurs: https://www.adea.org/policy/publications/IPE/. (Accessed: 22.09.2026).
Islam, M.R.R., Islam, R., Ferdous, S., Watanabe, C., & Yamauti, M. (2022). Teledentistry as an effective tool for the communication improvement between dentists and patients: An overview. Healthcare. 10:1586. https://doi.org/10.3390/healthcare10081586.
Kazimierczak, W., Kędziora, K., Janiszewska-Olszowska, J., Kazimierczak, N., & Serafin, Z. (2024). Noise-optimized CBCT imaging of temporomandibular joints-the impact of AI on image quality. J Clin Med. 13(5): 1502. https://doi.org/10.3390/jcm13051502.
Khabeer, A., & Faridi, M.A. (2024). Interprofessional education in dentistry: exploring the current status and barriers in the United States and Canada. Cureus. 16(10): e72768. https://doi.org/10.7759/cureus.72768.
Kim, I.H., Singer, S.R., & Mupparapu, M. (2018). Review of cone beam computed tomography guidelines in North America. Quintessence Int. 50(2): 136-145. https://doi.org/10.3290/j.qi.a41332.
Kirkwood B. (2021). Development of military teledentistry. Med. J. (Ft. Sam. Houst. Tex.). PB 8-21-10/11/12: 33–39.
Lang, M., Ghandour, S., Rikard, B., Balasalle, E.K., Rouhezamin, M.R., Zhang, H., & Uppot, R.N. (2024). Medical extended reality for radiology education and training. J Am Coll Radiol. 21(10): 1583-1594. https://doi.org/10.1016/j.jacr.2024.05.006.
Lezhnev, D.A., & Petrovskaya, V.V. (2019). Sovremennye tendentsii luchevoy diagnostiki v stomatologii i chelyustno-litsevoy khirurgii (lektsiya) (Current trends in diagnostic imaging in dentistry and maxillofacial surgery (lecture)). Radiologiya — praktika. (5): 57–73.
Li, D.T.S., & Leung, Y.Y. (2021). Temporomandibular disorders: current concepts and controversies in diagnosis and management. Diagnostics (Basel). 11(3): 459. https://doi.org/10.3390/diagnostics11030459.
Li, M., Punithakumar, K., Major, P.W., Le, L.H., Nguyen, K.T., Pacheco-Pereira, C., Kaipatur, N.R., Nebbe, B., Jaremko, J.L., & Almeida, F.T. (2022). Temporomandibular joint segmentation in MRI images using deep learning. J Dent. 127: 104345. https://doi.org/ 10.1016/j.jdent.2022.104345.
López-Arcas, J.M., González-Ballester, D., Del Castillo, J.L., & Salvador, E. (2022). Magnetic resonance imaging of the temporomandibular joint: key point in the election of treatment. Atlas Oral Maxillofac Surg Clin North Am. 30(2): 129-135. https://doi.org/10.1016/j.cxom.2022.06.006.
Mardani, M., Cheraghian, S., Naeeni, S.K., & Zarifsanaiey, N. (2020). Effectiveness of virtual patients in teaching clinical decision-making skills to dental students. J. Dent. Educ. 84:615–623. https://doi.org/10.1002/jdd.12045.
Masood, H., Rossouw, P.E., Barmak, A.B., & Malik S. (2025). Tele-orthodontics education model for orthodontic residents: A preliminary study. J. Telemed. Telecare. 31: 256–264. https://doi.org/10.1177/1357633X231174057.
Maqsood, A., Sadiq, M.S.K., Mirza, D., Ahmed, N., Lal, A., Alam, M.K., & Halim, M.S.B. (2021). The teledentistry, impact, current trends, and application in dentistry: a global study. Biomed. Res. Int. 2021: 5437237. https://doi.org/10.1155/2021/5437237.
Nascimento da Silva Mulder, J., Ramos Pinto, M., Aníbal, I., Dornellas, A.P., Garrido, D., Huanca, C., Hadda,d A.E., & Mendes Abdala, C.V. (2024). Teledentistry applied to health and education outcomes: evidence gap map. J. Med. Internet Res. 26: e60590. https://doi.org/10.2196/60590.
Németh, O., Uhrin, E., Girasek, E., Boros, J., & Győrffy Z. (2023). The impact of digital healthcare and teledentistry on dentistry in the 21st Century: A survey of Hungarian dentists. BMC Oral Health. 23: 1025. https://doi.org/10.1186/s12903-023-03770-w.
Ottersen, M.K., Abrahamsson, A.K., Larheim, T.A., & Arvidsson, L.Z. (2019). CBCT characteristics and interpretation challenges of temporomandibular joint osteoarthritis in a hand osteoarthritis cohort. Dentomaxillofac Radiol. 48(4): 20180245. https://doi.org/ 10.1259/dmfr.20180245.
Parashar, V., Whaites, E., Monsour, P., Chaudhry, J., & Geist, J.R. (2012). Cone beam computed tomography in dental education: a survey of US, UK, and Australian dental schools. J Dent Educ. 76(11):1443-7.
Patel, S., Brown, J., Pimentel, T., Kelly, R.D., Abella, F., & Durack, C. (2019). Cone beam computed tomography in endodontics - a review of the literature. Int Endod J. 52(8):1138-1152. https://doi.org/10.1111/iej.13115.
Patel, S., & Harvey, S. (2021). Guidelines for reporting on CBCT scans. Int Endod J. 54(4):628-633. https://doi.org/10.1111/iej.13443.
Pauwels, R., Beinsberger, J., Collaert, B., Theodorakou, C., Rogers, J., Walker, A., Cockmartin, L., Bosmans, H., Jacobs, R., Bogaerts, R., Horner, K., & SEDENTEXCT Project Consortium. (2012). Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol. 81(2): 267-71. https://doi.org/10.1016/j.ejrad.2010.11.028.
Popov, N.V., Khamadeeva, A.M., Ayupova, I.O., Zhdanova, M.L., Plishkina, A.A., Baymuratova L.R., & Penkina K.S. (2023). Rol ortopantomograficheskikh issledovaniy dlya skrininga novoobrazovaniy chelyustnykh kostey na pervichnom urovne mediko-sanitarnoy pomoshchi (The role of panoramic radiographic examinations in screening for jaw bone neoplasms at the primary healthcare level). Meditsinskiy alfavit. (12): 63–67. https://doi.org/10.33667/2078-5631-2023-12-63-67
Robotti, E., Daniel, R.K., & Leone, F. (2021). Cone-beam computed tomography: a user-friendly, practical roadmap to the planning and execution of every rhinoplasty-a 5-year review. Plast Reconstr Surg. 147(5): 749e-762e. https://doi.org/ 10.1097/PRS.0000000000007900.
Rouanet, F., Masucci, C., Khorn, B., Oueiss, A., Dridi, S.M., & Charavet, C. (2022). Pertinence des outils de téléorthodontie: Une revue systématique de la littérature [Relevance of teleorthodontic tools: A systematic review of the literature] Orthod. Fr. 93: 353–375. https://doi.org 10.1684/orthodfr.2022.104.
Strunga, M., Urban, R., Surovková, J., & Thurzo, A. (2023). Artificial Intelligence Systems Assisting in the Assessment of the Course and Retention of Orthodontic Treatment. Healthcare. 11:683. https://doi.org/ 10.3390/healthcare11050683.
Sujatha, P., Kanitkar, A.A., Ranjeri, S., Annu, A., Patil, A., & Biradar, J. (2024). Assessment of knowledge and attitude regarding teledentistry among dental professionals: a cross-sectional study. Cureu. 16: e55954. https://doi.org/ 10.7759/cureus.55954.
Surdu, A., Foia, C.I., Luchian, I., Trifan, D., Budala, D.G., Scutariu, M.M., Ciupilan, C., Puha, B., & Tatarciuc, D. (2025). Telemedicine and Digital Tools in Dentistry: Enhancing Diagnosis and Remote Patient Care. Medicina (Kaunas). 61(5):826. https://doi.org/10.3390/medicina61050826.
Tamimi D. (2023). Specialty Imaging: Temporomandibular joint and sleep-disordered breathing E-Book. Missouri: Elsevier Health Sciences.
Tantawi, M., Lam, W.Y.H., Giraudeau, N., Virtanen, J.I., Matanhire, C., Chifamba, T., Sabbah, W., Gomaa, N., Al-Maweri, S.A., & Uribe, S.E. (2023). Teledentistry from research to practice: A tale of nineteen countries. Front. Oral Health. 4:1188557. https://doi.org/10.3389/froh.2023.1188557.
Tay, Y.X., Foley, S.J., Ong, M.E., Chen, R.C., Chan, L.P., Killeen, R., Tan, E.J., Mak, M.S., McNulty, J.P. (2025). Using evidence-based imaging referral guidelines to facilitate appropriate imaging: Are they all the same? Eur J Radiol. 183: 111933. https://doi.org/10.1016/j.ejrad.2025.111933.
Verbitskaya, L.P., Nersesyants, S.A., Milshteyn, M.I., & Nanavyan L. A. (2015). Primenenie ortopantomografii v diagnostike zabolevaniy zubochelyustnoy sistemy (The use of panoramic radiography in the diagnosis of diseases of the dentofacial system). Glavvrach Yuga Rossii. (44): 2-4. URL: https://cyberleninka.ru/article/n/primenenie-ortopantomografii-v-diagnostike-zabolevaniy-zubochelyustnoy-sistemy.
Waheed, S., Tahir, M.J., Ullah, I., Alwalid, O., Irshad, S.G., & Asghar, M.S. (2022). The impact of dependence on advanced imaging techniques on the current radiology practice. Ann Med Surg. 78: 103708. https://doi.org/10.1016/j.amsu.2022.103708.
Wang, K., Li, C., Zhou, J., Ren, J., & You, M. (2024). Diagnostic Accuracy of Dynamic High-Resolution Ultrasonography in Assessing Anterior Disc Displacement in Temporomandibular Joint Disorders: A Prospective Observational Study. Healthcare (Basel). 12(23): 2355. https://doi.org/10.3390/healthcare12232355.
White, S.C., & Pharoah, M.J. (2019). Oral Radiology: Principles and Interpretation. 8th ed. St. Louis: Elsevier.
Zhao, R., Xiong, X., Li, Z., Zhang, L., Yang, H., & Ye, Z. (2025). Recent advances and educational strategies in diagnostic imaging for temporomandibular disorders: a narrative literature review. Front Neurol. 16: 1597312. https://doi.org/10.3389/fneur.2025.1597312.
Zotti, F., Rosolin, L., Simoncelli, F., Pappalardo, D., Cominziolli, A., & Zerman, N. (2022). Telediagnosis of dental caries: Possible or impossible? A pilot cross-sectional study. Clin. Exp. Dent. Res. 8: 1614–1622. https://doi.org/ 10.1002/cre2.663.
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