Relevance. Immunomodulation is becoming increasingly relevant in geriatric dentistry. The administration of this therapy cannot be empirical and requires the study of the corresponding immunological parameters. The study of the gingival crevicular fluid composition allows evaluating not only the immune system ageing processes and their influence on the periodontitis course but the effectiveness of the treatment. The study aimed to evaluate the effectiveness of transcranial electrostimulation (TES) for the treatment of periodontitis in elderly patients and to prove the value of gingival crevicular fluid laboratory testing during immunomodulatory therapy.
Materials and methods. We conducted a clinical, prospective, controlled, randomized, unblinded, comparative study. We examined two groups of periodontal patients (68 subjects), aged 60-74, and equally treated them. But the patients in the second group additionally received transcranial electrostimulation (TES). The research included the follow-up assessment of IL-1β, TNF-α, IL-10, sIgA and LDH in the crevicular fluid and periodontal index reduction: SBI and PMA (%), before the treatment and on the 7th, 14^th, 21^st and 30^th day.
Results. The study established that the periodontal treatment scheme, which includes TES (immunomodulation), is more clinically effective than conventional treatment. There were statistically significant differences in the clinical and laboratory parameters between the 1st and the 2nd patient groups after the 14^th day (p < 0,05). On the 30^th day of observation, the described trend persisted: the parameters of crevicular fluid in both groups continued to decrease. Moreover, their mean values were significantly lower in the 2^nd group than in the 1^st. The level of IL-1β (pg/ml) was 16.9 ± 0.33 and 18.8 ± 0.38;
TNF-α (pg/ml): 11.9 ± 0.37 and 14.4 ± 0.4; IL-10 (pg/ml): 11.0 ± 0.35 and 12.9 ± 0.36, respectively (p < 0.05).
Conclusion. In elderly patients, TES (as a part of a comprehensive treatment) is more effective clinically than the conventional periodontal treatment alone. In geriatric dentistry, it is of primary importance to test gingival crevicular fluid composition and properties in a laboratory and to select the most significant immunological and biochemical components: IL-1β, TNF-α, IL-10, sIgA, LDH. It allows a periodontist to confirm the changes in the manifestations of periodontitis in the elderly patients and to verify the clinical effectiveness of immunomodulation.

Relevance. The study examines the possibility of using a mathematic model of an artificial neural network (ANN) for comparative quantitative morphological assessment of revascularized autograft remodeling after reconstructive surgery in patients with jaw defects.
Materials and methods. Jawbone biopsies of 30 patients were histologically examined during the implant placement stage, 6, 9, 12 months after the reconstructive surgery with a revascularized fibular graft. Histology images were analyzed using a mathematic model created on the basis of GoogLeNet and trained on morphological images of bone maturation. Histology slides were digitized by a scanning microscope Leica SC2 and streamed through the neural network model.
Results. During the follow-up period, jaw defect areas demonstrated relatively mature bone tissue formation with various intensity rates of remodeling and maturation of the newly-formed bone. At that, the results of the descriptive histology were consistent with the quantitative results of the ANN mathematic model, created on the basis of the softwarehardware system developed by the authors. The confirmed significance level is 95% or higher.
Conclusion. Pathomorphological data of biopsies were studied using an ANN mathematical model, built on a softwarehardware system, which allowed analyzing all microscope fields of view of a histological slide, bypassing random samples, as well as the evaluation by a pathologist of individual microscope fields of view, to exclude the possibility of unrepresentative sampling and the influence of human factor, which significantly increases the significance of the received results.

Relevance. The studies which assess the quality of the implant-supported prostheses in elderly patients as well as the impact of the immediate loading on the peri-implant bone are scarce and inconclusive. Various automatic assessment software is known and applied in the clinic. A compact, informative and flexible software is obviously necessary for daily use and continuous control of the quality of the prosthetic treatment. The aim of studies was to improve the automatic quality assessment of implant prostheses in older adults and elderly patients.
Materials and methods. 408 responders (151 male and 257 female subjects) aged from 54 to 85 (mean age 73.9 ± 4.9) participated in the clinical testing of the ROZA questionnaire. The conceptual (construct) validity included convergent, divergent and discriminant subtypes. In convergent validity, comparison with a battery of equivalent tests with similar requirements was used: Geriatric Oral Health Assessment Index (GOHAI), Oral Health Impact Profile-14 (OHIP-14) questionnaire, visual analogue scale (VAS) set and two related expert prosthesis quality assessment programs TREVOL and TRESIM.
Results. Cronbach’s alpha, that confirms reliability and internal stability of the studied instrument, was 0.82 which is a good level. The correlation of the authors’ technique was low and insignificant (r = 0.242; p = 0.257) compared to the discriminant tests, which demonstrated the target focus of the studied technique.
Conclusion. The studied questionnaire ROZA was highly sensitive, reliable for the examination of elderly patients with different implant-supported prostheses. It can be used to assess the quality of the prostheses in elderly, among others to evaluate the quality of the prosthetic treatment.

Relevance. The pathogenetic mechanisms, which initiate oral mucosa cancer in patients with lichen planus, have not been entirely studied yet. However, endogenous factors, including matrix metalloproteinases (MMP), can be crucial in malignization. The study aimed to analyze the levels of MMP-8, tissue inhibitor of matrix metalloproteinase (TIMP)-1 and MMP-8/TIMP-1 ratio in the oral fluid of patients with various forms of lichen planus.
Materials and methods. We examined and treated 24 women, aged 35-70 years old, with reticular (14 patients) and atrophic (10 patients) oral lichen planus. The study determined the concentration of biological markers MMP-8 and TIMP-1 in the oral fluid before and after the treatment. The local treatment consisted of anti-inflammatory therapy with antiseptic solutions as oral baths with an exposure of 1 minute, application of vitamin A and E oil solutions on the gauze for 15-20 minutes, immune-corrective therapy was applied. We followed up with the patients at the diagnostic stage, after 14 days of treatment and 3 months later.
Results. The study revealed statistically significant differences in the ratio of MMP-8 and TIMP-1 levels in the oral fluid of lichen planus patients compared to the controls (p = 0.006). 11 patients exhibited an increase of MMP-8/TIMP-1 ratio in comparison with the ratio maximum in control (p = 0.006).
Conclusion. To assess the course of the disease in patients with various forms of oral lichen planus, the clinicians should evaluate the concentration ratio of biological markers MMP-8/ TIMP-1 in the mixed saliva. Clinicians should monitor the changes in the level of MMP-8/TIMP-1 in the oral fluid at least once every three months.

Relevance. Recent-years research specifies the influence of body internal environmental factors on the development and maturity of hard dental tissues. The negative impact of which causes severe amelogenesis disorder, with the formation of immature enamel, the hypoplastic phenotype of different intensity. The timing of tooth eruption in humans has become unpredictable as the child development accelerates and new orofacial dysplastic phenomena appear or are inherited. Tooth eruption with localized or generalized hypomineralization is little studied. The study aims to compare the rate of dental enamel mineral component maturation in males and females of different ages by electron and atomic force microscopy.
Materials and methods. The study involved 90 female and male subjects, aged 15-20, 21-30, 31-40 years. Impacted teeth 38 were extracted on medical grounds in all patients. The study analyzed the shape, packing and the 3D surface of enamel prisms using a Jeol JCM – 5700 scanning electron microscope and an NTEGRA Prima atomic force microscope according to Omsk State Medical University methods. The variation statistics methods processed the received data using standard packages Microsoft Excel 2008, Statistica 12.0.
Results. The enamel prisms in females aged 15-20, 21-30 years are not closely spaced, compared to similar ages in the male group, as indicated by the distance between enamel prisms (15-20 years U = 9.3496, p = 0.0035 between males and females; 21-30 years U = 10.6949, p = 0.0018 between males and females). In women aged 15-20 and 21-30 years, the enamel prisms are chaotically organized: a 6-sided or 7-sided prism of larger size often squeezes a less mature 5-sided prism, providing the characteristic appearance of an immature prism with ugly outlines in various geometric shapes. In 31-40-year-old women, the enamel prisms are more densely spaced.
Conclusion. There are local and total hypomineralised areas of the enamel prisms in females under 30 years old and in males under 20 years old.

Relevance. Patients with diabetes are prone to complications which negatively affect their quality of life. In such patients, several comorbidities may develop. One of the complications of diabetes mellitus is an impaired wound healing. Oral wound healing associated with the constant chronic trauma by sharp edges of teeth and prostheses is not an exception. Such wounds are characterized by a long, persistent, sluggish process of restoring the integrity of the oral mucosa epithelium.
Materials and methods. In this paper, a comparative analysis of the effectiveness of wound treatment was carried out in 52 patients with diabetes mellitus. All patients were randomized into two equal groups. In the first group of patients, wounds were treated with traditional methods of pharmacotherapy, while in the second group, the oral mucosa was exposed to ozone and ozonated oil was applied. The patients were monitored and followed up for 14 days and as the reparative function was restored. The area and depth of the wound, the nature and amount of exudate, destruction, the edges of the wound and the surrounding connective tissue were taken into account.
Results. The positive wound healing process was noted in both groups during the follow-up period. However, the inclusion of the ozone therapy in the treatment protocol favored faster restoration of the epithelium integrity.
Conclusion. The present data will help dentists monitor and treat the wound process, which in turn will prevent malignancy as well as improve the prognosis for patients with diabetes.

Relevance. This article evaluates the effectiveness of vacuum therapy in the comprehensive treatment of glossodynia by assessing tongue tissue oxygen saturation and oral fluid noradrenaline content.
Materials and methods. 65 patients with glossodynia, aged from 42 to 70 years old, comprised control (n = 32) and comparison (n = 33) groups. The control group received only medication therapy, while the comparison group also received vacuum therapy. Medication therapy included antianxiety drugs, antidepressants, vitamins and dental gel. The study used a CAP-“Periodontist” unit for physiotherapy treatment. Vacuum acted upon painful tongue areas with pressure 0.35-0.45 atm during 1.5-8 min daily (time and vacuum gradually increased within the specified range). The treatment cycle consisted of 7 sessions. We assessed the pain level by VAS (visual analogue scale). We evaluated parameters of peripheral oxygen saturation by pulse oximetry. We checked noradrenaline in the oral fluid by high-performance liquid chromatography using a liquid chromatograph with an electrochemical detector.
Results. In the control group, values of peripheral oxygen saturation, noradrenaline content in the oral fluid and pain level after treatment differed from the corresponding values in the comparison group (p < 0,001).
Conclusion. Comprehensive treatment of glossodynia, with vacuum therapy, is effective and significantly decreases tingling and numbness, improves microcirculation and patient psychoemotional condition due to pain relief.

Relevance. In type II diabetes mellitus, hyperglycemia contributes to the endothelial dysfunction. It leads to hypercoagulation and significant microcirculation disorders, which cause periodontal tissue ischemia and inflammation. The study aimed to determine hemostatic parameters of endothelial dysfunction and evaluate its role in the origin of periodontitis in type II diabetic patients.
Materials and methods. We examined 40 people aged 50-80 years with compensated type II diabetes mellitus and chronic generalized periodontitis of various severity during planned hospital admission. The control group consisted of 26 practically healthy people of comparable age and sex. We assessed blood on patient admission to the hospital.
Results. Type II diabetic patients with chronic generalized periodontitis demonstrated pronounced changes in endothelial function. Compared to the controls, the patients with moderate-severe periodontitis exhibited a statistically significant (p < 0.05) increase of D-dimer (10.5 times), factor XIIa (8.4 times), and von Willebrand factor (2 times) in the blood serum; the increase of fibrinogen by 64.8%, the elevation of INR and antiplasmin by 19.7% and 12.7% respectively, the decrease of antithrombin by 17%.
Conclusion. The study confirms that type II diabetic patients show pronounced endothelial dysfunction. The detected changes in the coagulation system correlate with the severity of periodontitis.

Relevance. Modern studies demonstrate that the combination of smoking and coffee drinking adversely affects the whole body, not only the oral mucosa. The study aimed to investigate the impact of coffee consumption and smoking in the oral mucosa and periodontal tissues.
Materials and methods. We examined 60 dental patients, mean age of 22.1 ± 0.3 years old. The first group included nonsmoking coffee drinkers, the second – non-coffee-drinkers-smokers, the third – smokers- coffee-drinkers. In all patients, we determined hygiene and periodontal indices: PMA (papillary-marginal-attached) index Parma, Muhlemann sulcus bleeding index (SBI) modified by Cowell, simplified Green-Vermillion Oral Hygiene Index (OHI-s). The study examined microcirculation in periodontal tissues using Doppler ultrasound. We took patients’ blood pressure and heart rate to study salivary flow rate, pH and viscosity according to the Redinova-Pozdeev technique.
Results. The combination of coffee consumption and smoking affects the dynamics of the blood flow (BP, HR). The study of periodontal tissue blood supply revealed a significant increase in microcirculation in non-smoking coffee drinkers. Smoking negatively affected periodontal blood supply, namely periodontal circulation decreased, while general circulation parameters increased after smoking. In all studied groups, salivary flow rate increased, and saliva pH and viscosity decreased. The third group exhibited the most significant changes in these parameters.
Conclusion. Combined coffee consumption and smoking deter periodontal microcirculation, cause significant adverse changes in the oral fluid, and may take their toll on dental health.

Relevance. Our study aimed to determine the main differential diagnosis criteria for temporomandibular joint (TMJ) pain dysfunction syndrome (temporomandibular disorders, Costen's syndrome) and cerebellopontine angle tumours.
Materials and methods. We examined 22 people (19 women and three men), aged 21 to 74 years (mean age 37.2 ± 5.1 years), who presented to the prosthodontic clinic with facial pain.
Results. The study proposed the following differential diagnostic criteria for TMJ pain dysfunction syndrome and brain tumors: different nature of pain, unilateral ear noise; distal displacement of the mandibular head diagnosed by cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), as well as articular disc displacement (detected by MRI) in temporomandibular disorders. Unilateral facial burning pain indicated meningioma of the cerebellopontine angle, which head MRI confirmed.
Conclusion. The proposed table for evaluating clinical and paraclinical study methods for patients with facial pain helps to differentiate the cause of pain properly and proceed with the optimal treatment method.

Relevance. Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed in dental practice to relieve pain and swelling. This study reviews information on NSAIDs, with a particular focus on those aspects that are relevant to the practice of dentistry.
Materials and methods. A systematic literature search was conducted, which included studies dating from 1970 to June 2021. The search in the electronic databases e-LIBRARY.ru, Embase, Pubmed and Medline identified the studies. Articles were reviewed by meeting the inclusion and non-inclusion criteria.
Results. Initially, the electronic search identified 589 studies. After reviewing the titles and abstracts, 69 potentially relevant studies were subject to full-text evaluation. Of these, 34 studies were excluded based on study design, research question, or lack of numerical data on all variables to be assessed in this study, so 35 studies with a detailed list of such data could be included in the quantitative comparison.
Conclusion. The use of non-steroidal anti-inflammatory drugs may alter the inflammatory response in the treatment of oral diseases. The conducted studies have brought up questions about the effectiveness and alternative ways of NSAID delivery in dentistry, namely, dispersible formulation.