Relevance. The success of medical treatment in the elderly often depends on the doctor’s ability to find an individual approach to a patient, including their personality characteristics, comorbidities and compliance level.

Materials and methods. A systematic search of the literature was carried out of studies published between 2000 to 2020 in the online databases: PubMed, Google Search, and eLibrary. The articles were reviewed if the criteria for inclusion and exclusion were met.

Results. The primary electronic search found 4,314 studies. Upon removing the duplicates and checking the publications for the title and abstract availability, 1,013 studies were selected, whereas the remaining 3,301 publications were excluded as not meeting the above requirements. Subsequently, in exploring the titles and abstracts, full-text of 509 studies was assessed. Of these, 455 publications were excluded for the lack of doctor-patient interaction evaluation. The systematic review included 54 studies for assessment and numerical comparison in this study.

Conclusion. The success of dental treatment in the elderly depends on the patient’s personality profile, their preparedness to follow doctor’s recommendations, and dentist treatment skills and psychological competencies in approaching patients of this age group.

Relevance. Implant-supported prostheses are currently one of the most popular rehabilitation methods in partially or fully edentulous patients. Peri-implant soft tissue thickness is one of the principal determinants to achieve an aesthetic result and prevent the development of mucositis and peri-implantitis.

Material and methods. The study included 30 partially edentulous patients with a lack of soft tissue thickness in the planned surgery site. 15 patients underwent augmentation using a collagen matrix (group 1) and 15 patients – with a free connective tissue graft (group 2). The primary endpoint was the assessment of soft tissue thickness gain three months after the surgery. The secondary endpoints were the thickness assessment of keratinized attached gingiva (three months after the surgery), swelling and pain severity (on the 1^st, 3^rd, 5^th, 7^th day, 1 and 3 months after the surgery) and quality of life evaluation (OHIP-14) (before the surgery, seven days and three months after the surgery).

Results. The soft tissues thickness gain was 1.181 ± 0.11 mm in group 1, 1.55 ± 0.11 mm – in group 2. The surgery took 8.4 minutes less (from 3.737 to 13.06) in group 1 than in group 2. The swelling assessment on the next day after surgery showed that the mean value was 2.73 ± 0.3 in group 1, 1.87 ± 0.74 – in group 2 (р = 0.0139). There were no statistically significant differences in the change in the width of the keratinized attached gingiva, pain syndrome and changes in patients' quality of life (p > 0.05)

Conclusion. Collagen matrix, like a free connective tissue graft, is an effective way to increase the soft tissue thickness around dental implants.

Relevance. Microcirculation disorder is one of the leading mechanisms in the pathogenesis of inflammatory and degenerative periodontal diseases. Modern medicine assesses the blood flow by the Doppler ultrasound, which has some essential advantages for a researcher. However, the possibilities of interpreting Doppler ultrasound data remain scarcely enlightened in the scientific literature.

Materials and methods. Forty patients of both sexes, aged 18–25 years, with clinically intact periodontium, underwent a Doppler ultrasound test to investigate microcirculation in the area of tooth 1.6 at the levels of free gingiva, attached gingiva and mucobuccal fold, to study the integral characteristics of a Doppler ultrasound of tissue blood flow. The obtained data were statistically analyzed using the method of principal component analysis.

Results. The principal component analysis demonstrated that Vam and Qam were the parameters closest to the integral blood flow velocity, and the attached gingiva was the optimal point for transducer position.

Conclusion. The principal component analysis allowed obtaining an integral parameter of blood flow velocity (PC 1) and its features in various areas of the periodontium on tooth 1.6. Further studies are necessary due to the possible variability of periodontal microcirculation on other maxillary and mandibular teeth.

Relevance. Oral microbiocenosis, a multi-component system, has specific characteristics during dental and systemic disease development.

Material and methods. The study examined 32 patients with β-thalassemia major and 30 systemically-healthy periodontal patients. The average age of the examined patients was 13-17 years and ≥18 years. We determined the nature of microbiocenosis, which is identified by the spectrum, frequency of occurrence and number of some microorganisms, to establish quantitative and qualitative parameters of normal, commensal and pathogenic oral microorganisms in both groups.

Results. Based on the received data, the mixed oral fluid microbiocenosis structure is qualitatively and quantitatively sufficiently stable in practically healthy subjects; microorganisms are represented by four main genera, namely, Lactobacillus spp., Streptococcus spp., Staphylococcus spp. and Enterobacteriaceae. The oral microflora associated with the development of thalassemia undergoes significant pathological changes with the development of systemic and local immune disorders and dysbiosis. Structural analysis of local defense factors and species representatives of microflora in patients with β-thalassemia major showed that salivary flow rate significantly decreases and the commensal and pathogenic microorganism quantitative and qualitative parameters significantly increase, associated with the comorbidity.

Conclusion. Salivary flow rate significantly decreases, and quantitative and qualitative parameters of commensal and pathogenic microorganisms increase associated with β-thalassemia major. Such conditions lead to the appearance and development of major dental diseases, including inflammatory periodontal diseases.

Relevance. Iron deficiency anemia (IDA) has various clinical manifestations, including those in the oral cavity, connected with depressed humoral and cell-mediated immunity. However, there is no clear understanding of the character of the cytokine storm in the oral cavity of these patients. Hence, the study aimed to investigate the amount of pro- and anti-inflammatory cytokines in the oral cavity of patients with iron-deficiency anemia before and after iron therapy.

Material and Methods. The study included 168 females aged 29.6±1.65 years old, who formed three groups: the main group comprised the patients with IDA, the comparison group included patients with inflammatory periodontal diseases without systemic diseases, and the control group contained the patients without oral inflammatory and systemic diseases. We examined all the patients, determined DMF index, OHI-S (Greene-Vermillion), PBI (Muhlemann-Saxer), gingival inflammation by the РМА index modified by Рarma and determined the level of IL-1β, IL-6, IL-4 and INF-γ in the oral cavity by enzyme immunoassay.

Results. The study determined the clinical signs of periodontal inflammation in all patients with IDA before treatment. Inflammatory periodontal diseases and IDA combination caused a significant decrease of pro-inflammatory cytokines IL-1β and IL-6 (9.67 pcg/ml and 20.52 pcg/ml, respectively) in the oral fluid of all the examined compared to the periodontal patients without systemic diseases. Patients with IDA demonstrated an increase of IL-1β (40.58 pcg/ml) and a decrease of IL-4 (25.18 pcg/ml) and INF-γ (46.93 pcg/ml) in the oral fluid after the completion of the iron therapy course.

Conclusion. A decrease in pro-inflammatory cytokine IL-1β and IL-6 levels in patients with IDA and oral inflammation evidenced the changes in the immune response compared to the group of periodontal patients without systemic diseases, which may lead to an unfavourable prognosis. After the iron therapy course, the oral cytokine concentration in patients with IDA corresponded to the oral fluid cytokine profile of comparison group patients, which indicated the compensation of secondary immune deficiency.

Relevance. The article considers three stages in the development of dentistry specialty in Russia: 1) the stage of dental treatment; 2) the stage of biomedical dentistry; 3) the stage of biopsychosocial dentistry. The beginning of the second stage – biomedical dentistry – is associated with Professor A.K. Limberg, the organizer of the first odontology department at the Women's Medical Institute in Russia in 1897. L. Engel, who wrote about the biopsychosocial approach in the journal Science (1977), was the forerunner of biopsychosomatic dentistry.

The concepts of psychosocial-anatomic-functional (PSAF) maladjustment syndrome and the primary express diagnosis method of its severity and structure, developed at the First Saint-Petersburg State Medical University, facilitated the introduction of a biopsychosocial approach into dentistry. The authors regard the PSAF maladjustment diagnosis as the biopsychosocial approach first step to the study of the human health status that will help individually approach comprehensive customized treatment and rehabilitation program planning.

Propose. To show diagnosis possibilities of PSAF maladjustment primary express diagnosis in order to introduce the biopsychosocial standpoint into the diagnosis and treatment of dental patients.

Conclusion. The earliest possible beginning of teaching dental students (first-year students) the skill of PSAF maladjustment express diagnosis has proven to be necessary.

The article presents four clinical cases of PSAF maladjustment express diagnosis application at a dental appointment among patients of different profiles.

Relevance. The article presents positive clinical outcomes of using a modified reconstructive technique around 20 implants in 14 patients. Its effectiveness was statistically assessed using linear regression analysis.

Material and methods. Clinical data of 20 patients treated from 2014 to 2021 for chronic peri-implantitis around 27 teeth provided the basis for the study. The patients formed two groups: control (6 patients (7implants)) and study (14 patients (20 implants)) groups. A staged treatment approach was applied to all patients and included anti-inflammatory, reconstructive and maintenance stages. In the control group of patients, we finished the treatment at the first stage, as stable clinical remission was achieved after the surgery. In the study group, there were two stages: anti-inflammatory treatment and reconstructive treatment with a modified reconstructive technique. Before and after treatment, we isolated biomarkers specific to surgery results, represented by independent and dependent variables. The received data were statistically evaluated using linear regression analysis (Gretl) to assess the effectiveness of a new surgical technique by studying numerical relationships between two groups of variables.

Results. The modified reconstructive technique as a part of a staged approach increased the effectiveness of chronic peri-implantitis treatment up to 74%. The statistical analysis demonstrated a significant influence of the baseline bone resorption level (vr1), defect shape (fd) and inflammation level (s) on the formation of new tissue attachment around the implants (gz2). The intensity of surgically induced stress response (str) directly correlated with surgery injury (hm) and baseline inflammation level (s). Surgical wound healing (pk), most closely related to implant survival (del), did not have a meaningful relationship with surgery-induced stress response intensity (str), which indicates the crucial role of the microbial fac tor in surgical wound healing around implants.

Conclusion. A new modified surgical technique increases the effectiveness of chronic peri-implantitis treatment to 74% due to the stability of a pedicled vascularized submucoperiosteal flap in the inflammation area. The study did not detect the direct impact of the periosteal reparative-regenerative potential on the radiological bone level restoration. However, it demonstrated clinically significant positive results. Inability to fully control microbial biofilm on the implant surface remains the main problem of chronic peri-implantitis treatment.

Relevance. Modern literature reports various side effects and functional and anatomical disorders in periodontal tissues, up to pathologic tooth migration in 32-50% of cases associated with orthodontic tooth movement. The development of new diagnosis capabilities for periodontal tissue condition monitoring and types of orthodontic appliances in the appearance and progression of the pathology of tooth-supporting apparatus is currently relevant.

Purpose. To increase the objectivity and periodontium condition control degree during the planning and orthodontic tooth movement.

Material and methods. A prospective randomized controlled clinical trial was conducted, which, based on inclusion and non-inclusion criteria, included 60 patients aged 25-35 years and allocated them to groups with healthy (2) and damaged (1) periodontium for orthodontic treatment of malocclusion. Orthodontic appliances for the comparison groups were identical (aligners, buccal and lingual passive self-ligating brackets). Prior to the orthodontic treatment, we determined the alveolar bone thickness by the patients’ CTs superimposed on the program for digital modelling of the result; and estimated the optical bone density in Hounsfield units (HU). Clinical parameters for periodontium condition assessment – the simplified oral hygiene index (OHI-S), the Russel and CPITN periodontal indices, and gingival recession level – were determined before the treatment, after the active periodontal treatment, including resection surgery (in group 1), and after the orthodontic treatment in the c omparison groups.

Results. After the orthodontic treatment, group 1 patients experienced fewer periodontal complications – 42%, versus 54% in group 2, with initially healthy periodontium with a thin alveolar bone; 18% and 23% - with a thick alveolar bone. The aligner subgroup demonstrated the best results – 16% and 18% for groups 1 and 2, respectively; the worst result was in the lingual brackets subgroup – 50% and 55%, respectively. Gingival recession was the most common periodontal complication. The method of patient CT scan evaluation by superimposition on the digital modelling of the final result allo wed the achievement of orthodontic treatment success.

Conclusion. The increase in the objectivity of examination and orthodontic treatment planning, and the ability to control the alveolar bone condition, allows moving the teeth to the desired position with a minimum of side effects and complications.

Relevance. The present review combines studies carried out by Russian and international scientists on the causes of oral mucosa and vermilion lesions arising in association with COVID-19, its complications and during treatment of coronaviral infection.

Aim. The study aimed to analyze the causes and clinical picture of oral mucosa and vermilion lesions related to COVID-19, its complications and arising during coronavirus infection treatment.

Materials and methods. The literature data in the databases: PubMed, Scopus, eLibrary, and Google Scholar, were analytically reviewed. The study included articles in Russian and English and searched the articles published from 01.01.2019 to 01.01.2022.

Results and discussion. According to the literature, the loss of smell and taste are the early manifestations of COVID-19, caused by the direct virus impact on the mucous membrane of the tongue and oral cavity. The information is now available about secondary infections and various lesions of the oral muc osa and vermilion zone, ranging from ulcers to destructive fungal infections. These lesions can be classified as secondary complications of COVID-19 or as complications related to drug therapy.

Conclusion. The review will help develop an algorithm for timely diagnosis, routing and treatment of oral mucosal lesions associated with SARS-CoV-2 depending on their cause of origin to prevent the development of more severe pathology and chronification of the process.

Relevance. Inflammatory and destructive periodontal diseases occupy one of the leading positions in the structure of major dental diseases. The search for effective methods of treating this pathology remains relevant to the present time. In recent years, physical methods of therapy have become the most important in the practice of a dentist. One of these methods is the use of a diode laser. The use of a laser makes it possible to offer the patient a wide range of periodontal services, both surgical and therapeutic, which, in turn, meet the high standards of dental patient care. The specialized literature presents the results of studies on the clinical effectiveness of laser therapy in the dental practice, and states that the diode laser has a wide range of indication s, high reliability, efficiency and ease of operation.

Purpose. The article presents the experience of using a diode laser in the example of a clinical case describing the stages of treatment of a patient with chronic generaliz ed periodontitis.

Materials and methods. The cross-sectional study focused on patient N., born in 1964, with a diagnosis of K05.31, chronic generalized periodontitis, and K06.1, hypertrophy of the gingiva. We assessed the patient’s periodontal and sysemic statuses by generally accepted clinical, radiological and laboratory methods. The conventional pathogenetic therapy included a diode laser with a wavelength of 810 nm (optical fibre with a diameter of 400 microns, power 0.5 W, radiation mode – constant). The condition of the gums before and after treatment and the changes in periodontal indices became evaluation criteria for the obtained results.

Results. The study results showed that a diode laser inclusion in the complex therapy of inflammatory periodontal diseases improves the quality of life by reducing pain and lack of restrictions, rapid rehabilitation and recovery while significantly reducing the duration of treatment.