Relevance. The onset of periodontal pathogen resistance to systemic antibiotics revealed a new direction in periodontics. The characteristics of local drug delivery systems allow for a prolonged impact on periodontal pocket microbiota.
Materials and methods. The non-interventional study was carried out by an analytical review of Russian and international scientific publications of independent clinical and laboratory research databases PubMed, ResearchGate, ScienceDirect, and eLIBRARY.RU for the last decade. The search was performed using the keywords: "periochip", "periodontal treatment", "the matrix", "tissue engineering", and "bioactive cryogels". The review included randomized controlled studies, controlled clinical trials, prospective and retrospective comparative cohort studies of drug delivery systems and systematic reviews.
Results. In contrast to systemic drug administration, biodegradable local drug delivery systems provide long-lasting and effective treatment at the lesion site at much lower doses and in a shorter period of time. The prolonged drug activity time combined with non-surgical treatment of inflammatory periodontal diseases results in faster soft tissue regeneration. Gels, foams, fibres, bioactive cryogels, micro- and nanoparticles, and chips may be biodegradable matrices for the extended-release drug delivery system. The basic polymer for all these forms can be of natural origin (proteins, collagen), semi-synthetic (cellulose derivatives) or synthetic.
Conclusion. Films, chips and bioactive cryogel are nowadays more common forms. Due to its unique structure, the bioactive drug cryogel can serve as a controlled and multifunctional system for drug delivery to the periodontal tissues, which determines its importance in periodontics and high interest f or further research.

Relevance. The high prevalence of periodontal diseases, late presentation of patients, especially at the early stages, the ineffectiveness of the provided treatment, and complex still-not-fully-understood mechanisms of the pathogenesis of periodontal diseases render chronic generalized periodontitis (CGP) a socio-medical problem.
The study aims to consider the pathogenic mechanisms which characterize the development of CGP.
Materials and methods. The study conducted a systematic literature search, which included publications from 2005 to 2022. The studies were found by searching electronic databases PubMed and Google Search.
Results. The dental plaque microbiota is a common cause contributing to the initiation of the inflammatory process in the periodontal tissues. But its presence alone is not enough for the manifestation of all periodontal pathological reactions. The principal role in regulating the phases of the inflammation belongs to cytokines and other mediators, the imbalance of which causes the chronification of the process. Microvascular blood flow disorders, which determine the clinical manifestations, are an important part of the pathogenesis at all stages of CGP. Cellular reactions that occur during CGP as a response to the periodontal pathogen invasion protect periodontal tissues and simultaneously induce their destruction, thereby increasing bacterial contamination.
Conclusion. The formation of intricately related several key vicious circles, including cytokine, vascular, leukocyte and reparative, is one of the most important particularities of CGP pathogenesis.

Relevance. The success and progress of medical education are inherently linked to the achievements of fundamental and applied sciences and depend on the degree of curriculum fulfilment with advanced digital technology effectiveness. The article considers new forms of learning organization based on digital platforms. Information and communication technologies (platforms) allow effective distant coordination of the academic paths for large numbers of students and strict unbiased control over the implementation of assigned tasks. The article considers the specific features of medical digital platforms, algorithmic management forms, necessity and importance of cyber-physical systems, and gives examples of single robotic element implementation used in learning platf orms.
Materials and Methods. The publication selection criteria were: papers published after 2000; relevance to the keywords "Education", "Medical Education", and "Patient Simulation"; publications included in the databases "ScienceDirect" (Scopus), "IEEE", or "NCBI".
Results. Twenty-seven scientific publications were selected by the inclusion and exclusion criteria.
Conclusion. The online learning platform formed by a set of transformed traditional curricula allows for a full access of students to learning resources and can stimulate the teaching staff competencies, which is, in general, a relevant and promising direction for improving the effectiveness of the learning process.

Relevance. Autografts are nowadays the gold standard for soft tissue augmentation and gingival recession coverage. However, as this method has a number of significant disadvantages, xenografts of various origins are more frequently used in dental practice. The study aimed to conduct a comparative morphological assessment of crosslinked and non-crosslinked xenogenous scaffold biointegration quality at different healing times.
Materials and Methods. The study used 108 Wistar rats (54 males, six months old, fat mass 462 ± 20; 54 females, six months old, fat mass 414 ± 7) and randomly divided them into three groups. Group 1 had a xenogenous collagen matrix (Mucograft) placed in the subperiosteal tunnel in the mandibular vestibule area; Group 2 had an acellular dermal collagen matrix (Mucoderm) implanted in the subperiosteal tunnel, group 3 had D-ribose crosslinked xenogenous scaffold (Ossix Volumax) placed in the subperiosteal tunnel.
Results. The studied xenogenous materials showed different integration and biodegradation extents. By postoperative day 7, Group 1 (Mucograft) showed a more pronounced inflammation. Non-crosslinked collagen materials had almost completely resorbed by the 30th day of observation, while a crosslinked collagen matrix was detected as homogenous masses. By the 90th day, all groups demonstrated the formation of new connective tissue with different functional characteristics; only Group 3 histologically revealed microfragments of the graft.
Conclusion. The study shows that the xenogenous crosslinked and non-crosslinked collagen membranes may promote an increase in soft tissue thickness to a different extent. However, it is essential to improve the available materials to reach an outcome comparable to the autologous soft tissue graft treatment result.

Relevance. Relevance. Cerebral palsy is a persistent lesion of the nervous system. Though it is stable, the consequences of the lesion are progressing. Muscle hypertonicity is one of the principal complications which may progress. The spasticity of chewing muscles limits mouth opening, which prevents the children from practising good oral hygiene and results in multiple dental diseases. Such patients need dental care with a specific approach. The relief of masticatory muscle hypertonicity should be a priority. Nowadays, there is a large variety of methods for treating spasticity.
The study aimed to comparatively analyse the effectiveness of methods for relieving masticatory muscle hypertonicity in children with cerebral palsy.
Materials and methods. The patients formed two groups: the first group used kinesio taping to reduce spasticity, and the second group was prescribed adaptive chewing muscles exercises combined with the gnathic device. The study evaluated the clinical results using the developed screening diagnosis and functional results by electromyographic examination after 14 days and three months.
Results. Both groups showed positive treatment routcomes. Children demonstrated significant improvement clinically and electromyographically. However, the short-term observation discovered a faster effect of kinesio taping, though the differences were not statistically significant. Adaptive chewing muscles exercises combined with the gnathic device are more effective in the long run, which statistical analysis of data reliably ref lects.
Conclusion. The study reliably proved the need to include both kinesio taping and adaptive myofunctional exercises in the treatment to relieve muscle hypertonicity. There were no side effects or complications. Treatment planning requires an individual approach based on the clinical situation .

Relevance. An upper lip tie causes different pathological conditions. The popular aberrant frenulum classifications are ambiguous.
The study aimed to assess different classifications of the maxillary labial frenulum in the context of a gummy smile, diastema, gingival recession and tissue ischemia relationship.
Materials and methods. Photographs documented the type of smile and the pathological conditions of 41 patients aged 9 – 39 y.o. The study measured the maxillary central incisor height on the plaster model and compared the frontal view of the smile and the teeth to the size of the central incisor and with each other. Measurements were carried out.
Results. A gummy smile is more common in individuals with a V-shaped frenulum independent of its width (61%, 14 patients, X² = 13.06; p = 0.01) or in individuals with a wide frenulum independently of its shape (83%, 19 patients). 50% of all toothy smile cases are in the narrow frenulum group (69% in the group, nine patients). All cases with a lip tie (3 patients) showed a toothy smile (X2 = 10.29; p = 0.01). The group of the I-shaped frenulum attached at the gingival level demonstrated a diastema. Tissue ischemia is more prevalent in the group with the V-form frenulum, the frenulum ischemia and the attached gingiva or insertion point ischemia. It occurs separately from gingival recession only in V-shaped frenulum cases. The gingival recession prevails in X-shaped frenulum cases in the alveolar insertion point area (87.5%, four subjects) (p ≤ 0.05).
Conclusion. The received data are paramount for decision-making about the necessary treatment technique.

Relevance. Today, inflammatory periodontal diseases are one of the most common pathologies seen at dental appointments. During the treatment of these diseases, the main goal of the therapy is to reduce the intensity of inflammatory manifestations.
Materials and methods. The article presents the results of the application of the original method of carboxytherapy to reduce the inflammatory component at the initial phase of the treatment of inflammatory periodontal diseases.
The technique suggests the injection of 0.5–1.0 ml of medical carbon dioxide into the vestibular mucobuccal fold and the dental papillae region with a special injector. The study was conducted at the department of prosthodontics of Samara State Medical University. The study divided the patients into two groups. The control group underwent professional oral hygiene, and the main-group patients had an additional carboxytherapy treatment developed by the authors. The study evaluated the effectiveness of the treatment using the OHI-S, PMA, and Muhllemann indices and the restoration of blood filling using the periodontal bloo d flow assessment method.
Results. After the treatment, the main group showed a statistically significant decrease in the assessed indices and blood circulation restoration in the periodontium, which indicates a significant effect of the method used. Allergic and toxic effects on the mucous membrane did not manifest in the carboxytherapy group during the observation period. Patients did not complain about pain and discomfort.
Conclusion. So, based on the conducted studies, we can conclude that the method of carboxytherapy is highly effective as one of the elements of the c omplex treatment of periodontal diseases.

Relevance. Today, more than 15-20% of patients suffer from chronic pain in painful temporomandibular joint disorder. Temporomandibular arthralgias are poorly treatable, excruciating, and often recurrent. Therefore, optimization of treatment is paramount in such patients.
Aim: To evaluate the invasive carboxytherapy effectiveness for the treatment of pain syndrome in the temporomandibular joint.
Materials and methods. The study diagnosed 33 patients (15 men and 18 women) aged 28 to 47 years old suffering from pain syndrome in the temporomandibular joint. Group 1 (control) patients (12 patients) received indomethacin tablets (25 mg/tid) for nine days [8]. The second (main) group (21 patients) had invasive carboxytherapy, which consisted of a 3 ml carbon dioxide subcutaneous injection administered five times every other day. The study evaluated the therapeutic effect persistence on the 15th day of observation.
Results. The invasive carboxytherapy proved to be more effective in pain syndrome relief in painful TMJ dysfunction than indomethacin prescription. The invasive carboxytherapy was 12.02%, 9.17% and 4.29% more effective than the NSAID on the 3 rd, 9th and 15th day of observation, respectively.
Conclusion. The invasive carboxytherapy is highly effective in relieving pain symptoms in pain dysfunction, which was 44.9% on the 3rd day, 83.5% – on the 9th day, and 100% – on the 15th day of observation. The advantages of carboxytherapy were noted, namely, its good tolerability with a small number of contraindications related to the general state of health, as well as the condition of the skin at the injection site. It is possible to use invasive carboxytherapy in the comprehensive treatment of patients with painful temporomandibular joint di sorder.

Relevance. Dental, periodontal and tonsillar infections remain a serious clinical problem, sometimes causing complications and requiring hospitalization. They cause purulent fusion of the face, neck tissue and distant spaces, including mediastinum.
Aim. To present a clinical case showing the successful treatment of odontogenic descending necrotizing mediastinitis.
Materials and methods. Patient medical history. The present disease history. Direct clinical evaluation. Clinical laboratory and X-ray data (SCT – spiral computed tomography). The case was diagnosed with chronic periodontitis (stage IV, grade C) and periodontal abscess of tooth 37. Floor-of-the-mouth phlegmon left parapharyngeal space phlegmon. Phlegmon within cervical space. Mediastinitis. Surgery. General anaesthesia. Extraction of tooth 37. Drainage of subgingival and parapharyngeal abscesses and drainage of phlegmons within the submandibular and the right-side cervical space. Mediastinum drainage.
Conclusion. The proposed patient evaluation technique established diagnosis and adequate surgical treatment allowed the achievement of successful treatment outcomes, confirmed by clinical and X-ray data and patient self-evaluation of the disease's internal picture (PSAF-auto-maladaptation).

Relevance. Hamartomas are common in the lungs, liver, spleen, pancreas, and kidneys. Head and neck hamartomas are rare and oral hamartomas are still rarer. The feature of hamartoma is that it consists of the same tissue elements as the affected organ; however, it is characterized by an abnormal structure. Hamartomas are most often benign tumours though there were described episodes of malignancy and development of hamartoblastomas, so the maxillofacial surgeon and the dentist should be cancer alert in this case. A small number of diagnosis cases may reflect the true rarity of the disease or may be missed, which can lead to mismanagement of the patient.
Purpose. To study the literature on oral hamartomas and present a clinica l case of hard palate hamartoma.
Materials and methods. We analyzed the world medical literature about oral hamartomas and hard palate hamartomas in particular and presented a clinical case of hard palate hamartoma diagnosis in a thirty-four-year-old woman. The immunohistochemical test evaluated the markers reflecting the tumour proliferation level.
Results. We analyzed the world literature on oral hamartomas and presented a clinical case of the diagnosis and treatment of hard palate hamartoma identified in a thirty-four-year-old woman at an appointment with a maxillofacial surgeon. After the surgical treatment, a histological examination verified the hamartoma.
Conclusion. Hard palate hamartomas are rare in the practice of the maxillofacial surgeon and dentist. Learning specific features of hamartomatous lesions is essential to understand how to plan the necessary treatment for a patient with such pathology. Immunohistochemical research methods allow for accurate histological diagnosis, which further determines the patient management strategy.