Relevance. The impact of obesity, as a multifactorial and multigenic disorder, on human health is a complicated multidisciplinary and simultaneously relevant problem in modern society. Inflammatory periodontal diseases are among the multiple consequences of obesity, with adverse effects on the quality and duration of life. Aim: To analyze the prevalence of inflammatory periodontal diseases in patients with metabolic syndrome according to the body mass index (BMI).

Material and Methods. We analyzed 306 records of patients with chronic inflammatory periodontal diseases. Patients’ weight and height were stated in the questionnaire attached to the dental patient record. The patients formed five groups based on their BMI.

Results. We found a high prevalence of periodontitis in groups with increased BMI and the progress of disease severity with the increase in BMI score.

Conclusion. The obtained results evidence a high prevalence of chronic generalized periodontitis in overweight and obese patients, which allows us to conclude that overweight and obesity are risk factors for periodontal inflammatory- destructive processes.

Relevance. Clinical and radiological assessment mainly forms the diagnosis of periodontal diseases. The diagnosis now requires speed, sensitivity and specificity since determining the patient's disease stage is fundamental to effective treatment. Crevicular fluid biomarkers can help monitor the current state of the disease, the effectiveness of treatment, and possibly predict the pathological process progression. The combination of various biomarkers will allow maximum objectivity in periodontal tissue condition assessment.

Materials and methods. The study examined 72 patients with inflammatory periodontal diseases and 25 periodontally healthy subjects. We performed a conventional clinical-instrumental examination and studied pro- and anti-inflammatory interleukins (IL-1β, IL-6, IL-17, TNF-α, VEGF, IL-8, MCP-1, IL-1RA) in the crevicular fluid. The obtained materials were processed using ROC analysis.

Results. Inflammatory periodontal diseases demonstrate an increase in pro-inflammatory cytokines / chemokines (IL-1β, TNF-α, IL-6, IL-17, IL-8, MCP-1) and vascular endothelial growth factor (VEGF) in the crevicular fluid, a decrease in the anti-inflammatory cytokine, IL-1RA. The levels of pro- and anti-inflammatory cytokines, cytokines/ chemokines, VEGF are associated with the periodontal destruction severity caused by inflammation. The accumulation of VEGF, IL-6, and IL-1β in the crevicular fluid predicts the clinical course of gingivitis, VEGF, TNF-α, IL-6, IL-1β – mild and moderate periodontitis.

Conclusion. The present study allows us to confirm the diagnostic value of methods for obtaining and quantifying a group of immunoregulatory cytokines in the crevicular fluid as predictors and parameters of the disease progression and the development of osteodestructive changes in the periodontium.

Relevance. Sialometry may determine the nature of x erostomia, and the results should be representativ e. The study aimed to increase the information value of the parotid gland secretory function examination by determining saliva rheological properties during the c ontrolled dynamic sialometry.

Materials and methods. Twenty-two patients with xerostomia had a controlled dynamic sialometry in two stages with simultaneous saliva sampling using a Lashley capsule and a catheter. At the first stage, the capsule was on the right, the catheter was on the left; at the second stage their places were swapped. In 44 comparison pairs, the capsule parameters were the control, the catheter parameters were studied. The method of stimulated ductal sialometry according to Andreeva T.B. formed a basis of the study. The study eliminated the technological error of sialometry, the rheological state of saliva was determined by subtracting the catheter index from the capsule index. The study was approved by the ethics committee (No. 02-21 dated February 18, 21), voluntary. Difference significance was statistically assessed using the Student 's t-test. The results were significant at p ≤ 0.05.

Results. The analysis of 44 comparison pairs showed a priority (t = 7.317; p < 0.001) of the number of cases with large capsule scores (n = 34; 77.3%) compared catheter (n = 7; 15.9%). Therefore, capsule sialometry is more representative. Capsule sialometry (n = 44) showed hyposalivation in 11 cases (25.0%), secretion values were normal (t = 5.416; p < 0.001) in the remaining 33 cases (75.0%). Normal rheological condition of saliva was significantly more common in the hyposalivation group – objective xerostomia (t = 1.900; p < 0.05); rheological disorders were significantly more common in the group with normal secretion - subjective xerostomia (t = 7.729; p < 0.01).

Conclusion. Controlled dynamic sialometry determines the technological error and objectifies sialometry parameters; explores saliva rheological condition, which affects the performance of sialometry when using a catheter. Objective xerostomia is characterized by hyposalivation with a secondary significance of saliva rheological condition. Subjective xerostomia can occur only due to a saliva rheological disorder .

Relevance. The prevalence of oral mucosal diseases among the Russian population varies from 3% to 20% [7]. Precancerous and malignant diseases are a particular problem. More than nine thousand new cases of malignant oral mucosal lesions are registered annually in the Russian Federation, and yearly mortality rates reach 34%. Unfortunately, despite being externally located, the rate of late-diagnosed malignant oral mucosal neoplasms reaches 60%-70% in various regions of the Russian Federation [2]. Thus, one of the most urgent problems in dentistry and oncology is the early diagnosis of precancerous and malignant oral mucosal lesions. As a rule, precancerous lesions are not diagnosed at an early stage since there are no visible clinical signs, and therefore patients do not seek medical attention [8]. An accurate diagnosis requires both basic and additional examination methods. In turn, the conventional methods include traditional inspection, which largely depends on the clinician's experience. Besides the clinical examination, additional techniques are used, namely, fluorescence examination and biopsy [9-11]. Subsequently, optimizing the diagnosis of oral mucosal lesions is the most promising direction in practical healthcare, both in the dental and oncology practice, for early detection and reduction of advanced stages of malignant oral mucosal lesions. Thus, the study confirmed that the development and application of modern approaches are necessary for the early diagnosis of oral mucosal lesions. Purpose. The study aimed to improve the outcome of oral mucosal precancerous and malignant lesion diagnosis by upgrading examination methods.

 Material and methods. The study included 147 patients with oral mucosal lesions, referred to the oncologists of Samara regional clinical oncology centre by the city polyclinics. The patients were divided into two groups according to the examination methods. The control group patients, 63 people, had a conventional examination by a dentist (patient interview, inspection, palpation) and an incisional biopsy by an oncologist. The main group consisted of 84 patients, who, besides conventional dental examination, were evaluated by a new – developed and put into practice – technique with point and index score and subsequent incisional biopsy performed by an oncologist. The studied patients were comparable by gender, age and localization. The study assessed the effectiveness of the new method for the diagnosis of precancerous lesions (PL) and malignant lesions (ML) by matching the Need for Histology Verification Index (NHVI) value equal to 5 points or more and histopathology results.

Results. In the main group, 71 out of 84 patients scored 5 or more according to the new method, and 13 patients scored less than 5. Patients with a low score had a non-surgical treatment, 11 patients reached remission, and two patients were referred to an oncologist for a biopsy, which confirmed oral mucosa PL and ML. The patient complaints in both groups demonstrated that pain and bleeding were more frequent in the control group compared to the main one. The evaluation of clinical examination data revealed more erosions in the control group and nonremovable plaque and hyperplasia in the main group. The incisional biopsy detected more PL and ML in the main group (p = 0.001), and early malignant lesions were in 23% versus 5% in the control group. The new method specificity in oral mucosal PL and ML diagnosis was 55%, sensitivity – 97%, accuracy – 87%, whereas the conventional examination specificity was 28%, sensitivity – 84%, and accuracy – 60%.

Conclusion. The administered improved method for examination of patients with oral mucosal lesions and the compulsory use of autofluorescence examination and risk factor score assessment allowed us to identify PL and ML in 88% and to diagnose more PL and ML at early stages, which explains the need to use this method in the clinical practice for the early diagnosis of lesions.

Relevance. Underestimation of the importance of dental disease prevention and the occurrence or complication of physical health problems are two causally related factors. Compliance with the rules of individual and professional oral care is an important constituent to prevention, often ignored by patients of all ages and different social groups.

Materials and methods. A total of 706 persons, including 529 women and 172 men, participated in the study. According to the WHO age classification, the participants formed four age groups: 18-24, 25-44, 45-59, and 60-74 years old. In terms of social identity, these groups comprised dentists (216 persons), dental patients (274 persons) and non-dental healthcare professionals (216 persons). The study focused on the adherence to oral preventive measures performed by patients of different age, gender and social identity groups.

Results. Despite the majority of the respondents were sufficiently aware of dental disease prevention and oral care, not all turned out to be compliant with medical advice. There were differences between age and social identity groups of patients in reasons of dental visits, use of oral hygiene products and professional oral care.

Conclusion. The study confirmed the relationship between underestimation of dental disease prevention and physical pathology. Of all age groups, the lowest level of compliance with oral care practices and the highest percentage of internal diseases were in 60-74-year-old patients. Women are more adherent to oral care measures than men; healthcare professionals showed the lowest compliance with oral care measures.

Relevance. The high incidence of chronic generalized periodontitis indicates the relevance of this disease and its social significance. Treatment of chronic generalized periodontitis requires an integrated approach and should include conservative and surgical methods and elements of dental system rehabilitation. Physiotherapy procedures, which affect tissue blood supply and increase local immunity, form an important component of the complex treatment of chronic generalized periodontitis. Choosing the most effective physiotherapy method is essential for the complex treatment of chronic generalized periodontitis.

Materials and methods. The study examined and treated 104 patients with mild chronic generalized periodontitis. All patients agreed to participate in the study and signed informed voluntary consent. The treatment type determined the allocation of three groups (group 1 – periodontium exposure to d’Arsonval currents, group 2 – the combination of physiotherapy procedures, and the control group – rinsing with antiseptics). The study consisted of the following stages: initial examination, professional controlled oral hygiene, group-dependent course of treatment, follow-up immediately after the treatment, after 3 and 6 months. Each stage included an interview, clinical examination and evaluation of periodontal microcirculation using Doppler ultraso und.

Results. The study revealed a positive effect of physiotherapy procedures on the periodontal microcirculation, i.e., a significant increase in linear and volumetric blood flow rates (linear blood flow velocity – 0.411 (0.393: 0.431; 0.315-0.436) cm/s; volumetric blood flow velocity – 0.024 (0.016: 0.021; 0.015-0.019) cm³/s compared with the data of the control group patients (linear blood flow velocity – 0.305 (0.291: 0.313; 0.203-0.326) cm/s; volumetric blood flow velocity – 0.012 (0.011: 0.015; 0.007-0.090) cm³/s.

Conclusion. Physiotherapy procedures in chronic generalized periodontitis treatment allowed the achievement of not only the significant immediate result but also a prolonged re mission period.

Relevance. Diagnosis of oral mucosa diseases is very difficult. Heterogeneity of the oral mucosa disease manifestation often requires invasive diagnostic methods, which cause the pain syndrome. Timely and complete pain syndrome relief and the impact on all phases of the w ound healing process allow faster patient rehabilitation. The study aimed to examine the effect of Ketanov MD and Cifran CT on the wound process and the pain syndrome intensity after incisional and excisional biopsies to verify the oral mucosa pathology.

Materials and methods. The study surveyed 30 people with oral mucosal diseases. The patients (30 subjects) formed two groups: excisional (10 people) and incisional biopsy (20 people). In these groups, we clinically evaluated the course of the wound process, the pain syndrome intensity, oedema phenomena, hyperemia, and the exudate presence. We analysed the quality of life of such patients using a validated Russian v ersion of the questionnaire.

Results. On the 3rd day after the biopsy, on top of the generally accepted treatment of oral mucosal diseases and Ketorol MD and Cifran CT intake, the patients noted moderate aching and discomfort when talking and eating. After 14 days, all patients showed an improvement in qualitative and quantitative parameters, the absence of pain and the development of reinfection on therapy with non-steroidal anti-inflammatory and antibacterial drugs.

Conclusion. These drugs have a positive effect on the course of the phases of the wound process. They help reduce the pain response and contribute to faster patient rehabilitation af ter the biopsies in oral mucosal diseases.  

Relevance. If a foreign body is present in a maxillary sinus, it should be surgically removed. Endoscopic and radical surgery are the main methods. Clinician’s subjective feelings determine the surgical access, which can cause complications. Therefore, the search for new methods of planning and visualizing the operation stages remains relevant.

Materials and methods. Before the operation, the patient had a cone-beam computed tomography in a marker holder frame. The 3D slicer program allowed the segmentation of the foreign body and surrounding anatomical features. A marker, fixed on the patient's head, allowed transmitting information to the augmented reality glasses during the operation.

Results. The surgery was performed under local anesthesia in an outpatient facility. The diameter of the antrotomy hole was 5 mm. No postoperative complications were recorded.

Conclusion. The proposed technique provides significant visual control and minimal trauma to the sinus during surgery.

Relevance. The success of implant-supported prostheses depends on the quality of the jawbone. Traditionally, it is assessed radiographically, but this method is not only invasive but also unreliable and inaccurate for predicting the outcome of treatment.

Material and methods. The study included 80 patients (49 women and 31 men) with a mean age of 71 ± 7 years, which formed four groups. Group A (control group, n = 20) consisted of patients with healthy periodontium; comparison group B, n = 20, comprised patients with terminal dentition; the main group C (n = 20) included patients with extended rehabilitation, fixed 7-10 days before; group G (n = 20) was composed of patients with “Trefoil” implant-supported prostheses, fixed three years earlier. The blood flow of peri-implant tissues was assessed using ultrasound Doppler flowmetry (UDF). All patients (n = 20) underwent dual-energy X-ray absorptiometry (DXA) before the prosthetic treatment.

Results. The analysis of pre-prosthetic-treatment ultrasound Doppler flowmetry results showed low values of microcirculation in the alveolar ridge mucous membrane in patients with terminal dentition compared with the control group. On the 7th day after implant-supported prosthetic treatment, group C demonstrated an increase in microcirculation by 11.42% compared to the control group and by 147.36% compared to group B. Three years after implant-supported prosthetic treatment, the ultrasound data revealed a statistically significant increase in blood flow velocity 0.342 ± 0.04 (cm/s) (p < 0.01). The Pearson coefficient determined a high correlation between T-scores of DXA and ultrasound Doppler flowmetry data (r = 0.829, p = 0.0001).

Conclusion. Ultrasound Doppler flowmetry (UDF) can be the main method for studying the peri-implant tissue condition at various stages of implant-supported prosthetic treatment.

Relevance. An analogous recording of occlusal relationships (articulating paper, foil, etc.) is not sufficiently informative for precise determination of occlusal forces and sequence, which is related to the large inaccuracy, labour intensity and lower predictability of prosthetic treatment results. Aim. The study aimed to evaluate the effectiveness of fixed polymer prototype dental bridges in patients with tooth-bounded edentulous spaces and occlusal defects.

Material and Methods. The randomized controlled study comprised two study groups: control (n = 21) and main (n = 21), which included the patients with tooth-bounded posterior missing teeth (second premolar and first molar). Prosthetic treatment corresponded to the conventional protocol in the control group. The main group had the missing teeth replaced with prototype prostheses and analogous-digital analysis of occlusal relationships. Intergroup effectiveness comparison rested on the integral occlusal score (IOS) data that considered scores received with T-scan 3 system (TekScan, USA). We also performed an intragroup comparative analysis of the periodontium condition around the abutment teeth using the Doppler ultrasound integral score (DUIS) at the stages before and after the treatment.

Results. The study did not reveal statistically significant differences between the values of IOS in the control and main study groups before the treatment (p > 0.05). At the followed treatment stages, control group IOS values significantly differed from those of the main group, namely, by 65.35 % (p < 0.05) just before the replacement of the provisional bridge by the final prosthesis; by 76.19 % (p < 0.05) immediately after the final prosthesis delivery; and by 65.94 % (p < 0.05) one week after the delivery of the final prosthesis. The Doppler ultrasound integral score values reflected the statistically significant positive changes in the study groups (p < 0.05).

Conclusion. Fixed polymer prototype prosthesis placement in patients with posterior tooth-bounded edentulous spaces and occlusal defects allowed us to increase prosthetic treatment effectiveness, improve microcirculation around abutment teeth, and harmonize the occlusion, decreasing the risk of possible damage to a ceramic bridge.