Relevance. Granulomatosis with polyangiitis (Wegener's granulomatosis) is a rare disease in which oral cavity symptoms manifest as 'strawberry' gingivitis.

Description of the clinical case. The paper presents early oral cavity clinical symptoms of a rare systemic disease – granulomatosis with polyangiitis with the manifestation of gingival hyperplasia in 1 patient, in the form of so-called "strawberry gingivitis", in another – a non-specific ulcer on the mucous mem-brane of the soft palate. After examination, the dentist referred the patients to a rheumatologist, who confirmed the diagnosis based on additional diagnostic methods.

Conclusion. Timely initiated therapy can significantly improve the patient's quality of life and life expectancy.

Relevance. According to the latest international classification of periodontal diseases of 2018, smoking, along with diabetes mellitus, belongs to the main modifying factors of the periodontitis course. At the same time, the clinical signs of gingival inflammation in smokers are not very pronounced.

The study aimed to determine significant clinical indicators of gingival inflammation in tobacco-dependent peri- odontal patients.

Materials and methods. The study interviewed and examined 82 patients with generalized periodontitis aged 20 to 63 years. Patients with diabetes mellitus were excluded. The examination evaluated the caries prevalence (DMFT index), the degree of periodontal attachment loss, the periodontitis progression type by an indirect indicator, oral hygiene status (Green-Vermilion index), tooth mobility (D.A. Entin), bleeding on probing (Mühlemann modified by Cowell; Ainamo, Wow). Based on their attitude to smoking, patients were randomized into three groups: the first group consisted of 18 patients who smoked up to 10 cigarettes per day; the second group included 15 patients who smoked 10-20 or more cigarettes per day; and the third group (comparison group) consisted of 18 non-smokers.

Results. The oral hygiene status, caries prevalence, the number of extracted teeth, the mobility of remaining teeth and the bleeding on probing score appeared to be the same in non-smoking and smoking periodontal patients. However, the number of patients with severe periodontitis was statistically significantly higher in heavy smokers with periodontitis (more than ten cigarettes per day); every other patient had comorbidity, rapid progression of the disease, and the clinical indicator of gingival inflammation based on the prevalence of bleeding on probing was at 100%.

Conclusion. We believe that the prevalence of bleeding on probing should be the main parameter for gingival inflammation assessment in smokers, which allows for the objective follow-up of the process progression in such patients and motivation for treatment and smoking cessation.

Relevance. The study of the dental status, including periodontal, in adolescents with type 1 diabetes, has a high scientific and clinical significance in terms of early diagnosis and prediction of the pathology of the dentoalveolar system in this group of patients.

Materials and methods. The study included 54 adolescents with type 1 diabetes aged 14-17 y.o.; of which 44% were boys, and 56% were girls. The duration of diabetes was 71.2 ± 46 months. Oral cavity condition evaluation included an interview and examination using instrumental and index assessment. The index assessment included the Green-Vermilion oral hygiene index (OHI-S), the papillary-marginal-attached index (PMA), Russell’s periodontal index (PI) and the decayed-missing-filled index (DMFT). To evaluate the diabetes factor impact on the periodontal tissues, we assessed the level of HbA1c, the duration of DM1, sex, age, and the presence of microangiopathy specific for type 1 diabetes, followed by multivariate regression analysis using JAMOVI 2.3.13 software.

Results. The study established that only 11% of the examined adolescents had compensated type 1 diabetes with an HbA1c level <7%. As for the index assessment of the oral cavity condition, most patients had mild or moderate deviations, indicating initial changes, including ones in periodontium. We also established a significant adverse effect of HbA1c increase, i.e., metabolic decompensation, on all studied indices (OHI-S, PI, PMA).

Conclusion. Initial inflammatory periodontal changes in type 1 DM may occur at a fairly early age and do not depend on age, sex and the presence of vascular complications, and are associated with worse glycemic control numbers. Dental check-ups of adolescents with type 1 diabetes require periodontal index assessment and collaboration of dentists and pediatric endocrinologists.

Relevance. Currently, there is a steady increase in the development of oral mucosal diseases, and they are affecting younger people. If, at the beginning of the XX century, inflammatory and destructive oral mucosal diseases appeared in people over 60 y.o., who formed a senior dental patient group, now this pathology affects the working-age population. It is related to many reasons, including the consequences of COVID-19. However, diagnosis in dentistry is actively developing. There are quite many basic and additional examination methods, as well as in terms of cancer alertness. Based on the example of the study, the paper presents screening testing for oral mucosal diseases, which a dentist should perform at an appointment before starting treatment of the main pathology.

Material and methods. The study examined the patients who presented for dental treatment. 16 out of 113 people were diagnosed with oral mucosal diseases.

Results. The patients had poor oral hygiene, and electromyography indicated masticatory muscle spasticity in 20.3%, which may cause trauma development, including pressure ulcers.

Conclusion. A dental appointment for each patient should include screening testing, which will prevent the development of a number of dental pathologies.

Relevance. Anatomical and functional restoration of an interproximal contact point is an important step in the comprehensive treatment and prevention of periodontal disease. A lot of tools are applicable for interproximal contact point restoration. Since the first application of the first composite material in dentistry, over one hundred instruments have been proposed, with different characteristics and positive and negative features. The variety available on the market may lead to a mistake in the instrument choice, which decreases the dentist's work quality. Purpose. To systematically review the clinical experience in dental instruments used for posterior tooth interproximal contact point restoration.

Materials and methods. The review analyzed Russian and international studies on the dental instruments used for posterior tooth interproximal contact point restoration that met the specified criteria. The primary search was performed in the databases Google Scholar, ScienceDirect, PubMed, ResearchGate, and eLIBRARY.RU, using the keywords: контактный пункт, инструмент, матрица, клин, interproximal contact, matrix, wedge, dental instrument in the Russian and English languages.

Results. We selected 24 original primary prospective studies on instruments for an interproximal contact point restoration certified in Russia. All instruments were divided into two groups: matrix systems (Palodent V3, HAWE SuperMat, TOR VM) and additional instruments (Contact-Pro-2, OptraContact).

Conclusion. The experience of the instruments’ clinical application and the history of their creation have demonstrated a shift towards the anatomically-guided reconstruction of lost tissue. Thus, developing a tool for the anatomical and functional restoration of an interproximal contact point is a challenge for modern dentistry.

Relevance. Relevance. The COVID-19 pandemic posed significant challenges not only to society and the healthcare system but also to dental specialists. Hospitalization of patients with chronic generalized periodontitis associated with the COVID-19 course is known to adversely affect the overall condition and create the risk for disease severity aggravation. The study of inflammatory periodontal disease and COVID-19 correlation is relevant.

Purpose. The study aimed to determine the features of inflammatory periodontal disease (IPD) course in patients after moderate COVID-19 by determining oral fluid (OF) and blood serum (BS) biochemical parameters.

Material and methods. The study involved 165 subjects divided into three groups: Group 1 – patients with exacerbation of periodontal inflammation; Group 2 – inpatients with inflammatory periodontal disease associated with the course of verified moderate COVID-19; Group 3 – control (patients without IPD and verified COVID-19). The mean total-sample age was 32±13.0 years old, median 25.0, minimum 19 years old, and maximum 63 years old. All patients had oral organ and tissue examinations, which included only visual inspection (PMA index) and OF potential of hydrogen identification due to COVID-19 inpatients’ characteristics. Laboratory evaluation of OF and BS parameters included total protein, alanine transaminase (ALT), aspartate transferase (AST), glucose, creatinine, urea, alkaline phosphatase (AP), lactate dehydrogenase (LDH), C-reactive protein (CRP).

Results. The study results showed OF and BS threshold value correlations; in the groups, there are trends, mild and moderate correlations between parameters CRP, AST, and LDH, including oral fluid pH and PMA index.

Conclusion. The performed qualitative, quantitative, clinical and biochemical datum analysis broadens theoretical knowledge about a pathological shift in OF and BS in patients with IPD, which takes place during a moderate COVID-19 course.

Relevance. The work presents the results of a comprehensive dental examination of patients with vermilion and oral mucosa proper (OM) diseases associated with manifestations of Crohn's disease (CD) and ulcerative colitis (UC).

Aim. To determine the cause-related features of complaints and clinical manifestations of vermilion and OM diseases.

Material and methods. The comprehensive dental examination included the analysis of complaints, history, and assessment of the vermilion and OM condition and the nociceptive pain severity score according to the Visual Analog Scale (VAS).

Results and discussion. In CD and UC, the vermillion diseases clinically manifested in 51.43% and 42.85% of subjects (p < 0.01), OM chronic trauma – in 40.0% and 31.43% (p < 0.05), chronic recurrent aphthae – in 48.47% (p < 0.001) and 31.43% (p < 0.01), glossitis – in 62.86% (p < 0.001) and 25.71% (p < 0.01), glossodynia – in 31.43% (p < 0.01) and 17.15% (p < 0.05) of cases. The main complaints of patients with the detected OM pathology included unpleasant sensations, like rawness and soreness, on taking irritating foods in 100% and 65.71% and talking in 31.43% and 25.71% of cases, dry mouth in 51.43% and 25.71% of cases. The burning mouth syndrome was in 31.43% and 17.15% of patients.

Conclusion. The vermilion and the oral mucosal diseases often prevail associated with the clinical course of Crohn'sdisease compared to patients with UC. The VAS pain severity score hinges on CD and UC course (p < 0.055). The variety of clinical manifestations of the vermillion and oral mucosal diseases directly depends on CD and UC, a criterion for developing an integrated approach to their diagnosis and implementing recommendations for their prevention and treatment in practical health care.

Relevance. The issue of oral mucosa and bone tissue restoration after tooth extraction and other dental interventions determines the study's relevance. The article presents experimental study results of regeneration processes in the animal oral mucosa and bone tissue wound surface during two operations: tooth extraction without bone structure and material grafting and tooth extraction with autologous dental tissue grafting.

Material and methods. The study included 24 laboratory male Wistar rats divided into two groups. The animals of the main group underwent tooth extraction followed by simultaneous autologous tissue grafting into the extracted tooth socket. The autograft consisted of the tissues of a particulated tooth previously removed from the subject. Animals of the control group underwent tooth extraction without bone structures and material grafting.

Results. On day 21, all study groups showed complete oral mucosa regeneration in the extracted tooth area. After 1.5 months of control group observation, the socket floor was filled with mature granulation tissue, transforming into fibrous tissue. The main study group demonstrated bone formation by autograft replacement in the coarse fibrous tissue growth thickness. After three months of observation, the control group showed bone atrophy at the extracted tooth site. In the main study group, there was newly formed bone tissue, which had replaced the autograft.

Conclusion. The conducted experimental study demonstrates that autologous particulated dental tissue grafting leads to active new bone formation, which the histology results confirmed in 21 days, 1.5 and 3 months of followup observation.

Relevance. Gum recession is a pathology often encountered both in Russia and worldwide. Modern surgical methods allow for the complete elimination of recession signs when adequately choosing strategy, tactics, methodology and surgical treatment protocol; for complication prevention and stable long-term outcome. Autograft and allogeneic dura mater as a grafting material for creating/increasing the volume of the attached gingiva in recession treatment have comparable results in all clinical indications. The reason for result stability and the absence of relapse is poorly studied; the data are scarce and do not give a full understanding. In the scientific literature, we did not encounter histological tissue composition analysis in the graft placement area. In recession coverage, the graft is partially placed subperiosteally (in the tooth root area) and partially in the thickness of the soft tissues of the gum. Purpose. The study aimed to determine the histological composition of tissues in the dura mater placement area, to compare with the control group without a graft, and to assess follow-up changes in the graft and surrounding tissue reaction as a result of cellular-level surgery.

Material and methods. A laboratory histomorphological examination involved 60 laboratory rats. All underwent surgery adequate to gum recession surgical treatment technique: the control group had no graft, and the study group had allogeneic dura mater. The samples were collected on the 3rd, 7th, 14th, 28th, 90th and 107th days after surgery.

Results. In all cases, the tissue complex regenerated, and the reaction to the operation was the same. The plastic material replacement was at the same period. Bone tissue replaced subperiosteally placed graft, connective tissue intragingivally. Gingival biotype thickening was considerably due to the surgical trauma, less – from the graft material. Allogeneic dura mater stimulated earlier ossification.

Conclusion. In all cases, the use of grafting material for surgical gum recession coverage is justified if placed subperiosteally, forming a full-thickness mucoperiosteal flap surgically (with a scalpel) to preserve the cambium periosteum on the flap. Bone volume and buccal cortical plate reconstruction/ regeneration support soft tissues of the newly formed ligament of the tooth and prevent recurrent recession formation. The formation of bone and connective tissues in the dura mater placement area determines the result stability of gingival recession surgical treatment and a long-term favourable prognosis without complications and relapse.

Relevance. The COVID-19 pandemic significantly affected the stress levels of healthcare workers. Like some other medical specialties, dentists have the highest risk of infection due to close contact with the patient's oral cavity and aerosol-generating procedures.

Purpose. The study aimed to study the impact of the COVID-19 pandemic on the stress level of dentists in Novosibirsk.

Material and methods. The study involved 273 dentists of various specialties aged from 20 to 65 years. The study assessed the overall level of perceived stress, overstrain and counteraction to stress using the "Perceived stress scale" (PSS-10). The Peritraumatic Distress Inventory (PDI) evaluated the level of distress associated with the pandemic.

Results. The overall level of perceived stress is sufficiently high in all groups; the indicators increase with age from 6.9% in the younger age group to 95.7% in the older one. Older dentists are aware of the higher risks of a severe course and consequences of the disease and fear for the lives of loved ones. In the middle and younger age groups, the level of distress associated with professional activities is within the normal range. The older age group showed a high peritraumatic distress level associated with practising medicine during the COVID-19 pandemic. Gender differences in the perceived stress and distress levels were not found.

Conclusion. The COVID-19 pandemic caused an increase in the psychological stress level among dentists, especially among older age groups. The study allowed us to identify factors affecting stress levels, which must be considered when organizing effective psychological assistance to doctors during epidemics of infectious diseases and providing targeted help to those in need.

Relevance. TMDs are frequently encountered due to the wide variety and polymorphism of clinical and morphological manifestations.

Clinical case description. The  clinical example presents an algorithm for clinical and instrumental  diagnosis of the dentoalveolar system, the stages of occlusal splint fabrication and clinical monitoring of masticatory muscles, dental occlusion and dentition, based on the application of modern digital technologies for the diagnosis of the dentoalveolar system functional status. The 28-year-old patient underwent a comprehensive diagnosis, including electronic condylography, electromyography, T-scan (digital occlusal analysis), and measurement of condylar displacement from the reference point. A follow-up examination, six weeks after treatment with a mandibular occlusal splint, showed positive changes in the therapeutic process: the absence of occlusal pressure distribution imbalance (T-scan) and symmetric work of masticatory proper and temporal muscles (EMG).