Relevance. Detection of maxillofacial pathomorphological changes in children with connective tissue dysplasia (CTD) allows identifying the nature and severity of disorders, as well as it serves the basis for selecting the best treatment options in view of the pathogenetic features. The purpose is to improve the diagnosis of periodontal diseases in children with CTD based on x-ray morphometric indices of the lower jaw and peripheral skeleton ultrasound osteodensitometry.

Materials and methods. 92 children with varying CTD severity, and 43 healthy children, underwent cone-beam computed tomogram examination with a further analysis of their X-ray morphometric (quantitative, qualitative) values and the lower jaw optical density indices. Besides, the status of the peripheral skeleton bone tissue was also determined through quantitative ultrasonic densitometry.

Results. Quantitative X-ray morphometric indices in healthy children and children with CTD revealed strong positive correlation with the Z-criterion of osteodensitometry, offering an objective reflection of the bone tissue status in the peripheral skeleton.

Conclusion. CTD progression in children correlates with the bone structure destruction intensity in the maxillofacial area, an increase in chronic productive inflammation, a decrease in the bone density, bone tissue fibrous transformation, a decrease in the thickness of cortical, and fiber-dissociation in closing, plates, of the lower jaw, prevalence of mid- and fine-meshed bone pattern, disturbed spatial orientation and thinning of bone trabeculae, as well as the development of pathologies in the periodontium.

Relevance. The steady increase in the number of inflammatory periodontal diseases (IPD) requires the search for new methods of their diagnosis, treatment and prevention. A large number of antimicrobial peptides are expressed in the oral cavity, including β-defensins, which form the first line of defense against periodontal pathogens. A more detailed study of these proteins will help us to answer the question: why this protective barrier breaks through and may we use β-defensins as markers of IPD. The aim is to study information about the role of β-defensins in the pathogenesis of IBD and to evaluate the possibility of their use as biomarkers of these diseases.

Materials and methods. Using search systems as PubMed, Google Search and eLIBRARY were found 2106 articles published between 2003 and 2020 years. According to the inclusion and non-inclusion criteria, 39 publications were selected, including in vivo, in vitro and review articles. This review presents data from the selected articles.

Results. β-defensins have antimicrobial activity against periodontal pathogens, but these bacteria can change the expression of the antimicrobial peptides or can be the cause of their destruction due to virulence factors. In addition, the concentration of β-defensins may be affected by the cytokines, synthesized during inflammation in periodontal tissues. Compared with individuals without IPD the patients with chronic generalized gingivitis, aggressive and chronic generalized periodontitis most often have changes in the expression of β-defensins both up and down, which also depends on the stage of the inflammatory process.

Conclusion. β-defensins play an important role in the antimicrobial protection of periodontal tissues from the introduction of periodontal pathogens and can be used as markers of IBD. However evaluating the concentration of defensins in the oral fluid, it is necessary to take into account concomitant factors: the presence of periodontal pathogens, the presence of certain cytokines, the stage of the disease, the presence of concomitant pathology and the genetic aspect.

Relevance. Prognostic value of PD-L1 expression in oral cavity squamous cell carcinoma (OCSCC) and its effect on survival is still controversial. It should be to determine the prognostic role of PD-L1 expression on tumor and immune cells of OCSCC and assess their effect on overall survival (OS) and progression-free survival (PFS).

Materials and methods. A prospective study included 145 patients, first diagnosed with OCSCC. PD-L1 expression on tumor and immune cells, infiltrating tumor and its microenvironment, was assessed in all tumor samples by IHC, CPS was calculated. Cut-off values were determined by ROC analysis for identification of PD-L1 expression effect on OS and PFS.

Results. Most patients with oral mucosa squamous cell carcinoma showed positive expression of PD-L1 on tumor (77.2%) and immune cells (92.4%). The median PD-L1 expression on tumor cells was 13.5% [1.0-40.0], the median PD-L1 expression on immune cells was 5.0% [1.0-11.0], and the median CPS – 18.0 [3.0-7.8]. Univariate and multivariate analyses revealed a significant negative effect of PD-L1 expression on immune cells ≤ 7% on OS (HR 0.66; 95% CI 0.45-0.93; p = 0.0498); PD-L1 expression in tumor cells ≤ 15% (HR 0.65; 95% CI 0.43-0.98; p = 0.0416) and CPS ≤ 21 (HR 0.62; 95% CI 0.44-0.92; p = 0.0183) for PFS. PD-L1 expression in tumor cells ≤ 6% (HR 0.71; 95% CI 0.47-1.08; p = 0.1096) and CPS ≤ 7 (RR 0.67; 95% CI 0.44-1.01; p = 0.0575) had a confident tendency to negative impact on OS.

Conclusion. Positive PD-L1 expression in tumor and immune cells as well as CPS are effective additional factors in the prognosis of the disease course, OS and PFS in patients with OCSCC.

Relevance. Modern literature and clinical dental practice do not provide enough information about the value of local immunity parameters for early diagnosis of inflammatory periodontal diseases in pregnant women with iron deficiency anemia. Conventional anti-inflammatory medications used to treat inflammatory periodontal disease are frequently contraindicated during pregnancy. It is important to make a reasonable choice of safe medications, prevention methods, and treatment at early stages of inflammatory periodontal diseases in pregnant women with iron deficiency anemia. The aim of the present study is to determine informative cytokine levels in gingival fluid for early diagnosis of inflammatory periodontal disease and evaluation of effectiveness of “Lysobact” medication in pregnant women with iron deficiency anemia (IDA).

Materials and methods. Cytokine levels (IL-8, IL-10; IgA, IgG) in gingival crevicular fluid were investigated in 46 pregnant women aged 18-35: among them 16 (n = 16) had mild IDA (D50), 15 (n = 15) didn't have IDA, 15 (n = 15) were non-pregnant controls. «Lysobact» (Reg. #ПN0179/01-2002) was used in pregnant women with IDA; conventional antiinflammatory therapy was used to treat pregnant women without IDA, before and after drug therapy (8-10 days) according to clinical examinations.

Results. There was determined diagnostic value of cytokine levels (IgA, IgG; IL-8, IL-10) that are of great importance for early diagnosis, evaluation of the course of the disease and effectiveness of “Lysobact” immunomodulating drug, and that significantly increase in pregnant women with IDA (IL-10 from 0.010 [1.790] to 3.050 [8.550] ng/ml) versus pregnant women without IDA (from 0.001 [1.259] to 2.900 [18.640] ng/ml) in comparison with controls (4.5 [1.13] ng/ml).

Conclusion. Clinical laboratory results in pregnant women with inflammatory periodontal disease allowed to determine diagnostic value of gingival crevicular fluid parameters (sIgA, IgG; IL-8, IL-10) that are related to clinical periodontal index levels, and are informative non-invasive method and are of practical importance for early diagnosis of inflammatory periodontal disease and effectiveness of “Lysobact” drug in pregnant women with iron deficiency anemia.

Relevance. According to the literature all over the world, there is a tendency to reduce immunological reactivity in humans, this is facilitated by the presence of chronic persistent herpes viral infection. Herpes infection has systemic immunosuppressive effects of the infection on the human body, and also highlighted the role of the virus in a slow occurrence of combined pathology of internal organs and infectious and inflammatory diseases of the oral tissues and periodontium. High interest of specialists to this problem сaused by the necessity of new methods of complex treatment polymorbidity human pathology. Purpose – to assess the degree of involvement of chronic cytomegalovirus persistence in a number of dental diseases.

Materials and methods. In 67 patients dental surgery underwent surgery removal of benign tumors of the soft tissues of the oral cavity, periodontium and jaws, had a clinical blood analysis, blood testing for serological signs of chronic persistence of cytomegalovirus infection (antibodies to CMV Ig G (anti CMV IgG), PCR for CMV in blood and saliva, and also studied the cellular composition of blood immunogram. The age of patients averaged 46 years. Рatients were divided according to the nosological principle into 4 groups. The first group consisted of patients with periapical foci of chronic odontogenic inflammation and radicular cysts of the jaws. The second group consisted of persons with oral fibroids of different localization. The third group is patients with retention cysts of small salivary glands of the oral mucosa. The fourth group – patients with poligamy various locations. All operations are performed outside the phase of acute inflammation. The material obtained after the operation underwent histological examination.

Results. Serological signs of chronic persistence of cytomegalovirus infection were revealed in all examined patients, the level of anti CMV Ig was 225 ± 25 U / ml (at the rate of 0.00-0.50 U / ml) (p 0.01). Also, all patients showed lymphocytosis of blood and this corresponded to the same type of changes in the cellular composition of the immunogram with a decrease in the quantitative parameters of B-lymphocytes (CD19⁺ CD3^- ), true natural "killers" (NK-cells) (CD3^- CD56⁺ CD45⁺ ), NK-cells cytokine-producing (CD3^- CD16⁺ Cd56brightcd45⁺ ), NK-cells cytolytic (CD3^- CD16⁺ (orhigh) sd56dimcd45⁺ ). The results of the histological study showed that focal mononuclear and lymphohistiocytic cell infiltration with giant cells with large nuclei are more often detected in areas of the oral mucosa in all patients with radical and retention cysts.

Conclusion. The Obtained results demonstrate that in patients regardless of surgical dental diagnosis, chronic persistence of cytomegalovirus with the same type of hematological, immunological abnormalities was revealed. In areas of the oral mucosa with retention cysts of small salivary glands and with radicular cysts, focal lymphohistiocytic and mononuclear cell infiltration with giant cells with large nuclei was revealed.

Relevance. Occlusal splints, made for the patients with temporomandibular disorders (TMD), influence proprioceptive sensitivity, sensory characteristics of pain, parameters of microcirculation of the pulp and periodontium of the healthy teeth. Condition of the pulp and periodontium of the healthy teeth should be assessed in patients with TMD associated with connective tissue dysplasia (CTD).

Materials and methods. The study examined 36 TMD patients aged 26.3 ± 1.3 лет (М ± m) with CTD (n = 20, main group) and without CTD (n = 16, control group); with natural teeth, without complaints of TMD, masticatory muscles and periodontal condition. Laser doppler flowmetry (LDF) helped to analyze blood flow parameters in the periodontium and pulp of the healthy teeth. Received results were statistically analyzed.

Results. Wavelet analysis revealed different microcirculatory flowmotion: high-amplitude irregular type was in patients of the main group, low-amplitude regular type was in controls. In the main group, perfusion is supported by high values of flux and vasomotion, ergotropic sympathetic effects (controlled by catecholamines) prevail, myogenic tone is reduced, elevated microvascular tone reflects possible changes in rheologic blood properties, microcirculatory signs of pain syndrome and relatively elevated ischemic index in pulp microcirculation of healthy teeth.

Conclusion. Sensory and regulatory mechanisms, reflected by the condition of periodontium and pulp blood flow, can be regarded as early signs of inflammation and chronic pain in the diagnosis of TMD in patients without complaints.

Relevance. Investigation of the root cementum ultrastructure in chronic generalized periodontitis is still relevant as changes in structure and composition of root cementum play a significant role in successful periodontal regeneration. Am is to study changes in the root cementum ultrastructure in patients with chronic generalized periodontitis.

Materials and methods. Scanning electron microscopy (SEM) was used to study the cementum surface of 9 teeth extracted due to severe chronic generalized periodontitis and 3 teeth with a clinically healthy periodontium extracted for orthodontic reasons. 3D visualization of the received SEM images was performed.

Results. The cementum of periodontally healthy teeth appeared homogeneous and regular,was covered in periodontal fibers and had a pebble-like or dome-shaped surface. In chronic periodontitis patients, the cementum surface was mostly irregular with multiple defects of various depth, areas of completely destroyed cementum, exposed dentinal tubules and a complete absence of periodontal fibers.

Conclusion. Loss of periodontal attachment and root cementum exposure to microbial biofilm may result in irreversible structural changes of the surface which may affect the regeneration of clinical attachment.

Relevance. A long-term inflammation in the oral cavity, unreasonable treatment of periodontal patients with antibiotics cause imbalance between certain types of fungal-bacterial associations accompanied by oral dysbiosis and change of local immune status. So, development and application of new comprehensive diagnosis and treatment techniques in periodontal patients, use of products for correction of microbiota and local immunity are a current and a long-term task. Purpose is to optimize the comprehensive treatment protocol of inflammatory periodontal diseases by introducing probiotics and evaluation of oral microbiome and cytokine profile.

Materials and methods. 140 patients were examined. Of these 60 patients had chronic generalized plaque-induced gingivitis and 60 patients suffered from moderate chronic generalized periodontitis. Bacterial and fungal microbiome was assessed and the host immune response was evaluated in all patients before and after the treatment. Half of the patients were treated conventionally and the other half were treated according to a modified scheme: probiotic “Bifidumbacterin Forte” was added.

Results. A large number of yeast-like fungi Candida and commensal bacteria were detected in periodontal pockets of patients with chronic generalized plaque-induced gingivitis and moderate chronic generalized periodontitis. That correlates with a significant increase of pro-inflammatory cytokines (TNF-α, IL—8), decrease of concentration of INF-γ and increase of antiinflammatory cytokine IL-4.

Conclusion. Changes in clinical, microbiological and immunological values during a modified combination therapy with a probiotic and during a conventional treatment demonstrated that effectiveness of treatment of chronic gingivitis and chronic periodontitis increased by 40% and 37% respectively.

Relevance. Effective preventive programs cannot be developed without studying the issue using population epidemiological survey. Purpose – improving efficiency of dental diseases prevention basing on the information obtained during an epidemiological survey of Izhevsk citizens.

Materials and methods. Visual and instrumental examination of teeth and periodontium was performed in 107 residents according to WHO criteria in representative age categories: n = 57 (63.3%) in the category from 35 to 44 years old; n = 50 (46.7%) - from 65 to 88 years; n = 83 (77.6%) women (54.9 ± 1.9 years); n = 24 (22.4%) men (53.7 ± 3.7 years). The study was random and voluntary, the conclusions are based on the results of statistical analysis.

Results. Examination revealed that most of the intact teeth were located on the left side (n = 617; 51.0%) of the jaws. Examination confirmed the hypothesis that on the opposite side hygienically caused diseases of the teeth and gums should prevail. On the right side of the jaw carious teeth (n = 91; 53.2%), secondary absence of teeth (n = 482; 53.2%), bleeding gums (n = 166; 51.9%), pathological gingival pockets (n = 178; 59.5%) were more common. The observations complex (n = 49) showed significantly more often (p <0.01) priority of the right side (n = 31; 62.0%).

Conclusion. The detected side property is not accidental. It occurs due to the varying effectiveness of individual hygiene. Most people are right-handed and the right side of their jaw requires more complex movements from their right hand. Permanent hygiene defects slowly turn into an additional cariogenic and periodonto pathogenic factor. The authors believe that informing right-handed (or left-handed by analogy) people about the need to control movements of their hand will help to balance the quality of hygiene on both sides of the jaws and make the teeth and periodontium diseases more rare.

Relevance. Psychoemotional stress is referred to as a disease of civilizations. When the psychophysiological state of a person is disturbed, all resources are directed to compensating for the pathological situation. With depletion and the development of adaptive capabilities, various disorders of microhemodynamics arise.

Materials and methods. In this article, psychoemotional stress is considered as a pathogenic factor in the development of post-prosthetic complications at a dental appointment. Using laser Doppler flowmetry, a comparative analysis of microcirculatory changes in the oral cavity in patients with inflammation of the peri-implant tissue was carried out.

Results. Previously, all people had a violation of the psychophysiological state. The control group consisted of healthy people. It is proved that in the comparison group microcirculatory changes occur with the development of arterial hyperemia. In this case, hyperemia was revealed by the ratio of the contribution of pulse and respiratory fluxmotions.

Conclusion. Thus, it can be assumed that it is psychoemotional stress that is the primary factor in the development of the inflammatory response in the oral cavity. What should be taken into account at the orthopedic appointment when drawing up a treatment plan for such patients.

Relevance. Changes were assessed in the clinical and laboratory parameters of the oral cavity in adolescents with plaqueinduced gingivitis when using toothpaste with 67% sodium bicarbonate.

Materials and methods. Use of toothpaste with 67% sodium bicarbonate in 23 patients aged 16-19 years with plaque-induced gingivitis was investigated in a prospective randomized uncontrolled study. Questionnaire survey was performed. OHI-S, tongue coating index, PMA index, SBI were used to evaluate the condition of the oral cavity. Tooth shade was determined according to Bleachedguide 3D-Master and short-chain fatty acids in saliva were detected by chromatography.

Results. One month use of the toothpaste revealed a significant improvement of oral hygiene by 24.56%, enamel brightening by 22.07%, decrease in the PMA index from 34.78 ± 7.89 to 22.96 ± 8.02, decrease in the sulcus bleeding index (SBI) from 1.57 ± 0.87 to 0.96 ± 0.81. Assessment of saliva short-chain fatty acids (SCFAs) detected reduction of functional activity and number of commensal and pathogenic anaerobic microorganisms and restoration of normal microbiota. At the baseline, acetic acid amounted to 0.426 ± 0.078, propionic acid – 0.086 ± 0.019, butyric acid – 0.025 ± 0.005 mg/g. After the use of the toothpaste, the level of acetic and butyric acids insignificantly changed, to 0.625 ± 0.090 and 0.058 ± 0.098 mg/g respectively. According to the questionnaire survey (on a 1 to 5 scale), the score of consumer-perceived properties of toothpaste with 67% sodium bicarbonate was 4.1 ± 1.0 for taste and 4.5 ± 0.8 for cleaning properties.

Conclusion. Investigation of clinical and laboratory parameters of the oral cavity in adolescents with plaque-induced gingivitis in use of toothpaste with 67% sodium bicarbonate showed that the toothpaste has good cleaning, anti-inflammatory, brightening and hemostatic properties. Biochemical analysis of saliva demonstrated recovery of normal values for short-chain fatty acids.

Relevance. Surgical stages of the dental implant restoration are an indispensable part of the treatment procedures. However, underestimation of residual/ available alveolar bone volume after tooth extraction may challenge implantation planning. Socket healing process might depend on either a surgical technique, or local or systemic preexisting factors, that this study should present as quantitative data. Purpose is to develop a technique for quantitative assessment of a surgical wound healing, e.g. an extraction socket.

Materials and methods. The study included 42 patients after extraction of different teeth during the preparatory procedures for further dental arch restoration with implants. Follow-ups, clinical data, laboratory and radiographic findings determined clinical, radiographic, and information values – dependent and independent variables as quantifiable clinical parameters – biomarkers; they were statistically analyzed.

Results. The conducted analysis revealed correlation dependence between selected parameters. Highly significant interrelationship allowed calculating the overall success rate of wound/ socket healing after tooth extraction. A regression model was developed to explain 76% healing success rate.

Conclusion. Thus, factors and conditions determining the healing of a surgical bone wound, e.g. an extraction socket, consistently affect each other. Numerical sequences of real-life processes characterize the extent and highly significant interrelations and allow predicting the mutual impact of the factors.