Relevance. Periodontal diseases, being an extremely common, do not only cause tooth loss and significantly affect the patients’ quality of life, but are also a risk factor for many systemic diseases and may subsequently aggravate their course. Non-alcoholic fatty liver disease (NAFLD) is one of the relatively understudied pathologies associated with periodontal diseases.
Materials and methods. A non-interventional study analytically reviewed Russian and international scientific publications, which presented the results of independent clinical and laboratory studies on the topic from 2011 to 2021.
Results. Scientific literature data evidence that NAFLD manifests by impaired lipid metabolism in liver cells, linked with mechanisms regulated by the liver nuclear receptors (LXR), and leads to such life-threatening conditions as liver cirrhosis and hepatocellular carcinoma. The information on the role of periodontal pathogens in NAFLD development has been accumulated by now. The example of such principal periodontal pathogen as Porphyromonas gingivalis experimentally demonstrated that it can integrate into the intestinal microbiome, migrate through the bloodstream to the liver, survive in hepatocytes and influence the nuclear receptors of these cells affecting the lipid metabolism and contributing to NAFLD development.
Conclusion. A detailed study of the link between periodontal disease and non-alcoholic fatty liver disease may contribute to the development of new effective strategies for the diagnosis and treatment of these pathological conditions.

Relevance. Currently, researchers are actively searching for genetic markers of periodontitis. Their detection will allow identifying risk group patients long before the manifestation of the first signs of the disease, predicting the disease course and intensively carrying out preventive measures to eliminate negative environmental factors.
Aim – to classify the available data on the genes associated with the development of aggressive and chronic generalized periodontitis.
Materials and methods. We found 214 publications published from 2005 to 2020 in the electronic databases PubMed, Google Search and eLibrary. One hundred and thirty-five publications were selected, among which are clinical studies and meta-analysis data.
Results. Chronic inflammatory diseases such as periodontitis are typically polygenic. The disease-associated genes are predisposition genes. The presence of an allele associated with the disease in an individual is not an absolute diagnostic sign for the development of the disease. However, it reflects the risk of disease development. The search for genetic markers of periodontitis assigns a crucial role to genes, which encode proteins significant at different stages of the pathogenesis of inflammatory periodontal diseases. Defensins, interleukins, Toll-like receptors, collagen type I α1 chain and others are among them. To date, the researchers have studied about 300 polymorphisms and have associated some of them with the development of periodontitis.
Conclusion. The exact genetic marker of periodontitis is currently unknown. Further search for the candidate genes and additional knowledge of the pathogenesis of inflammatory periodontal diseases are necessary. Determining the disease predisposition will improve the quality of dental care and preventive measures even before the manifestation of the disease.

Relevance. Depending on the researcher’s purpose, science can solve local and fundamental problems. Periodontists solve local problems conditioned by the patient complaints presented at a specific time. The fundamental problems of medicine, for example, the evolution/ reduction of organs and tissues, are considered, by the scientific community, a set of local problems formed under the influence of geographical, social and other factors. Progress in solving fundamental problems is insignificant, which is explained by the fallacy of the scientific knowledge formation within the framework of individual disciplines of physics, biology, etc.
Materials and methods. The subject of the study is the dialectical unity of the biological fluid filtration direction and contamination of the deep periodontium by planktonic biota. The object of the study is hydrodynamic disturbances following a decrease in the consistency of proximal contacts as a cause of periodontitis. The study rested upon the logic of multidirectional evolutionarily determined changes in the conventional and proposed components of the periodontium.
Results. The study presented the arguments evidencing the necessity to supplement the solid-state periodontal model proposed by N.N. Nesmeyanov (1905) with new components – biological fluid and biofilm.
Conclusion. Based on the parallel fundamental processes of coevolutionary improvement of biofilm and reduction of skull bones, the study showed the unity of our views on the problem of the etiology of periodontitis with the views of V.N. Kopeikin.

Relevance. Reconstructive periodontal surgery is one of the most effective methods of restoring tooth-supporting apparatus damaged by microbial inflammation and destruction. For this purpose, they use non-resorbable and resorbable biomaterials, which act as a temporary barrier between the tissues with different mitotic potential during early healing. Since the properties of barrier membranes determine the degree of invasiveness and postoperative morbidity, and, finally, the success of the surgery, it is relevant to study the outcomes of periodontal reconstruction with one of the modern collagen membranes cross-linked by ribose.
Purpose. To comparatively assess the outcomes of periodontal reconstructions with a resorbable and non-resorbable barrier material.
Material and methods. The study is a prospective randomized blind controlled clinical trial. The study included 37 patients (14 men, 23 women) aged 45-65 years, who, after the initial therapy, underwent 62 guided tissue regenerations using e-PTFE and resorbable collagen membrane cross-linked by ribose. The study compared the clinical and radiographic results before and 18 months after the surgery. We evaluated the probing depth (periodontal pocket), gingival recession level, loss of clinical attachment level, width and height of periodontal infrabony defects, gain in clinical attachment level. The material was statistically processed using StatSoft STATISTICA 10.0.1011 for Windows. The statistical unit is a periodontal defect.
Results. In the postoperative period, the main (31%) and control (42%) groups exhibited the areas of membrane exposure; 16 periodontal defects, only in the control group, demonstrated the extensive membrane exposure, of which 11 membranes were prematurely removed due to infection of the reconstruction site. In the main group, fibrin allowed exposed area healing in the usual time without medical assistance. After 18 months, the gain in the clinical attachment level was 3.5 mm in the main group versus 2.8 mm in the control group (at p=0.03) with a significant decrease in the probing depth compared to that before treatment; the level of recession also changed positively, although not significantly. The type of periodontal defect (the parameter is higher in three-wall and two-wall defects) appeared to remarkably influence the gain in clinical attachment level.
Conclusion. The study evidenced that the resorbable cross-linked collagen membrane demonstrated clinically acceptable outcome of the damaged periodontium reconstruction due to, first of all, increased predictability of the course of the early postoperative period, a significant reduction in morbidity and invasiveness of intervention.

Relevance. Ageing is an important factor causing various diseases and functional failure. Ageing markers help to characterize the ageing process comprehensively. Currently, molecular and genetic human ageing markers are the most promising (Molecular / DNA-Based Markers).
The study aimed to identify the relationship between age-related dental syndromes and some oral predictors of ageing.
Materials and methods. The study included 200 elderly patients, aged 60-74 years, according to the WHO classification. The patients were divided into 3 groups based on the detected clinical dental syndrome (occlusive, periodontal, dystrophic). In all patients, we collected non-stimulated oral fluid. The oral fluid immunochemical examination determined BCL-2 (B Cell Lymphoma 2), Caspase 3, Cytochrome C, GAPDH (Glyceraldehyde 3-Phosphate Dehydrogenase), Cleaved PARP (Poly (ADP-ribose) polymerase) and p53, using the method of the multi-parametric fluorescent analysis with magnetic microspheres.
Results. According to the immunochemical study, the patients with dystrophic syndrome demonstrated the highest concentration of apoptosis markers, with the occlusal syndrome – the lowest. Periodontal syndrome exhibited a moderate level of oral fluid ageing predictors.
Conclusion. Determining the apoptosis marker level in the oral fluid may have practical clinical use in the customized diagnosis of predisposition to the principal age-related dental syndromes, as well as systemic comorbidity. Early diagnosis of diseases at the initial stage allows us to give patients timely recommendations to correct their lifestyle, habits, medication intake.

Relevance. Over the past decade, manufacturers of oral care products have expanded the possibilities of solving the problem of hypersensitivity of teeth due to a variety of new modern technologies, which provides an opportunity to increase the effectiveness of active oral care product components. The study aimed to investigate desensitizing, remineralizing and anti-caries effectiveness of Asepta Extra Sensitive toothpaste to confirm the toothpaste properties stated by the manufacturer.
Material and methods. Forty-nine people, aged from 24 to 58 years, participated in the clinical testing of the toothpaste. The study used the Orekhova – Ulitovskiy tooth sensitivity index to evaluate the desensitizing toothpaste and determined the severity of dental hyperesthesia using diagnostic tests. We objectively assessed the functional state of the enamel using the Okushko – Kosareva enamel resistance test. The study evaluated the electrical conductivity of the dentin hypersensitivity to investigate the anti-caries effect.
Result. The desensitizing effectiveness increased to 64.59 ± 5.72% by the end of the study, according to the Orekhova – Ulitovskiy sensitivity index. The dentin hypersensitivity hypersensitivity decreased, according to the diagnostic tests. The tooth sensitivity reduction effectiveness increased – 62.22 ± 6.84%, according to the tooth tactile sensitivity assessment by linear advancement of the probe along the tooth surface. The analysis of the remineralizing parameter showed positive changes in the enamel resistance test. The remineralizing parameter value amounted to 21.49 ± 1.91%, and the remineralizing effectiveness reached 61.05 ± 2.98%. The values of anti-caries action and anti-caries effectiveness were 3.31 ± 0.52 mA and 29.72 ± 1.92%, respectively, according to the method of dentin hypersensitivity electrical conductivity evaluation with Asepta Extra Sensitive toothpaste. The desensitizing, remineralizing and anti-caries results of Asepta Extra Sensitive toothpaste use were high.
Conclusion. The development of dental health strengthening measures determines the significance of oral care products in tooth sensitivity prevention in the population, which plays a leading role in planning individual programs to prevent major dental diseases.

Relevance. The authors established that classical and mediated acid-related gastrointestinal disorders affect the change in microbiota and the development of mucosal disease.
Purpose. The study aimed to investigate the characteristics of oral microbiota in patients with mucosal disease associated with classical and mediated acid-related gastrointestinal disorders.
Materials and methods. The study included 58 patients with the oral mucosal disease associated with chronic gastritis and duodenitis, pancreatitis secondary to gallstones associated with stomach hypersecretion. The comparison group consisted of 25 subjects without oral mucosal disease, with previously diagnosed acid-related gastrointestinal disorders and eradicated Helicobacter pylori as of the clinical examination time.
Results. The study detected a pH shift towards the acidic end of the scale in the oral fluid samples of subjects with oral aphthous ulcers compared to the group without oral mucosal disease (comparison group) (p < 0.001). The composition ratio of the studied microbiota from the surface of the oral aphthous ulcers in the main groups showed an increase in the number of Candida spp. by 1.7 and 3.2 times (p > 0.2), Enterobacteriaceae spp. – 1.7 and 2.6 times, (p > 0.2), Actinobacillus spp. – 1.4 and 2.0 times (p > 0.2), Staphylococcus spp. – 1.3 and 1.5 times (p > 0.2), Enterococcus spp. – 2.6 and 3.5 times (p > 0.2), and a decrease in Neisseria spp. by 1.9 and 3.1 times (p > 0.2). The studied microbiota of main group II (PSG associated with SH) demonstrated a significant increase in the above species, p < 0.05, and a significant decrease in Neisseria spp., at p<0.05.
Conclusion. The studied aphthous ulcer surface microbiota, obtained from subjects with pancreatitis secondary to gallstones associated with stomach hypersecretion, revealed a significant overrepresentation of Gram +, Gram– facultatively anaerobic and opportunistic microorganisms contributing to the aggravation of the oral mucosal disease clinical features.

Relevance. Resistance of periodontal diseases to conservative therapy may constitute up to 7% of all clinical cases and may be due to specific pathogens. Active infection caused by Candida spp. and bacterial infection (formerly known as mycosis) caused by Actinomyces spp. are possible clinical options. Both the absence of described specific clinical manifestations and pathogen variety, ability to morphological transformation and similar unconventional approaches to microbiological diagnosis determine the continuity of the pathological process. At the same time, both the available scientific literature and our clinical work evidenced the detection of a diagnostically significant quantity of Candida spp. and Actinomyces spp. in pockets of patients with a worse response to periodontal therapy. However, most available studies used non-morphological diagnostic methods, which are hard to interpret assess ing the effect of the infectious process on the course of periodontitis. Possible options include the following: from significant etiological reasons, aggravating factors, background process or marker of systemic or local disorders to the dysbiosis caused by antibacterial therapy.
Propose. To draw the attention of dental practitioners to the peculiarities of the course of the infectious process in patients with resistance to periodontal therapy.
Conclusion. The paper presents specific characteristics of differential diagnosis, risk group assessment, comprehensive approach to local and systemic therapy based on the data from modern literature, our analytics and particular clinical cases.