Relevance. The administration of antibiotics in implantology is indicated to prevent suppurative inflammation conditions. Two regimens are commonly used: a single preoperative dose or prolonged postoperative antibiotic administration. Due to ethical constraints, certain parameters of antibiotic efficacy cannot be directly evaluated within clinical trials. These include the status of the implant-mandibular segment microbiome and the histological parameters of the tissue's inflammatory response at the implant site.

Materials and methods. This study employed a miniature pig model comprising 10 males. The cohort was equally divided into two groups of five animals each. Group 1 received a single preoperative dose of amoxicillin/clavulanic acid 2 ml per 20 kg body weight. Group 2 received the same initial dose prior to implantation, followed by a daily postoperative dose of amoxicillin/clavulanic acid at 1 ml per 20 kg body weight for five days. Each animal received six dental implants. An implant site microbiological test was performed pre-surgery, on Day 1, 3, 7 and 14 post-surgery. Core needle biopsies for histological examination of the tissues were performed on the same postoperative days.

Results. Microbiological testing revealed that Group 2 exhibited lower levels of Streptococcus spp. on Day 3 (p = 0.04) and Porphyromonas spp. on Day 7 (p = 0.04). Group 1 demonstrated reduced levels of Fusobacterium spp. on Day 1 (p = 0.02) and Porphyromonas spp. both pre-surgery (p = 0.04) and on Day 1 (p = 0.012). Comparative analysis of histological assays from the implant sites indicated identical tissue inflammatory responses, regardless of the antibiotic prophylaxis regimen.

Conclusion. Both the single-dose and the prolonged antibiotic prophylaxis regimens, using amoxicillin/clavulanic acid for dental implantation, demonstrated similar histological patterns of tissue inflammation at the implant site, along with comparable microbiota profiles within the implant site. The oral mucosa exhibited an increased population of Staphylococcus spp. and Streptococcus spp., which might contribute to the development of resistant strains, as well as Candida spp., potentially increasing the risk of candidiasis infection onset.

Relevance. Discrepancies in the bioelectrical activity of the masseter muscle were observed through surface electromyography analysis. Despite the availability of scientific literature on the morphological and anatomical variances in the mastication muscles and subcutaneous adipose tissue across different gnathic types, these differences are often overlooked in the interpretation of surface electromyography absolute values.

Materials and methods. A clinical evaluation, including the measurement of craniofacial parameters and an electromyography study of the right and left temporalis (RTA and LTA) and masseter muscles (RM and LM), was conducted on 73 individuals aged 21 to 24. Subjects were categorized based on upper and lower face gnathic type indices into three groups of 10: Group 1 (brachyfacial type), Group 2 (mesofacial type), and Group 3 (dolichofacial type). The study compared the surface electromyography-derived IMPACT index and average amplitude values of the muscles across groups, alongside analyzing the correlation between electromyographic values and gnathic type indices (GPDu.f./t-t and GPDl.f./ko-ko), with statistically significant differences noted at p ≤ 0.017.

Results. Differences in RM and LM parameters, and the IMPACT index during the "Maximal Voluntary Gnathic Clenching of the Jaws" (MVC) test were statistically significant among the groups. An increase in both the IMPACT index and average masseter muscle values was noted in dolichofacial subjects. Significant variations in LM values during the MVC test were observed between dolichofacial and mesofacial subjects. In the MVC test, groups 1 and 3 demonstrated a moderately strong positive correlation between the IMPACT index and GPDu.f./t-t and GPDl.f./ko-ko, while a strong positive correlation was identified between the RM parameter and GPDu.f./t-t and GPDl.f./ko-ko.

Conclusion. In the MVC test, the RM and LM parameters, as well as the average IMPACT index, were notably higher in dolichofacial subjects compared to other groups. A direct correlation between the mean right masseter bioelectrical activity and the average IMPACT index with the upper and lower facial gnathic indices was observed in brachyfacial and dolichofacial subjects in the MVC test.

Relevance. The metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) are significant concerns in modern medicine due to their high prevalence in the general population and their crucial role in the development and progression of inflammatory periodontal diseases.

Purpose. To investigate the association between periodontal diseases and the manifestations of metabolic syndrome and type 2 diabetes mellitus (T2DM).

Materials and methods. The metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) are significant concerns in modern medicine due to their high prevalence in the general population and their crucial role in the development and progression of inflammatory periodontal diseases.

Results. Out of 71 analysed sources, 39.1% of the studies discussed the prevalence of these metabolic diseases. In the majority of the studies (50%), the relationship between periodontal pathology and metabolic diseases related to insulin resistance and T2DM, glycaemia levels, dyslipidaemia, and fat tissue metabolism was examined. In 49.3% of the reviewed publications, data on the state of the subgingival microbiota, gingival sulcus, and saliva were presented.

Conclusion. The analysis of contemporary literature sources revealed a broad interaction between metabolic diseases and periodontal pathology, highlighting their shared pathogenetic processes and providing data on glycaemic control, the condition of the oral fluid microbiota, and periodontal pockets.

Relevance. The diagnosis of periodontal diseases, considering their severity, prevalence, progression, and staging, can be achieved by determining the levels of biomarkers or molecular imaging biomarkers in biofluids such as crevicular or sulcular fluid (GCF or GSF), saliva, and oral fluid. GCF is currently regarded as one of the diagnostically significant biological fluids for assessing the condition of periodontal tissues, not only in clinical diagnostic laboratories but also in dental offices. The implementation of sensitive, highly accurate, non-invasive, and specific methods for rapid GCF diagnosis, based on the qualitative analysis of biomarkers of cytokine imbalance, immunological disorders, changes in non-specific defence factors, and biophysical indicators, will allow for an objective assessment of the condition of periodontal tissues.

Purpose. To improve the efficiency of periodontitis prevention using a developed mathematical model for personalized prediction of the course of inflammatory periodontal diseases based on the investigated biomarkers in GCF.

Material and methods. The study included 101 patients: Group I consisted of 22 patients diagnosed with K05.10 (gingivitis), Group II included 31 patients diagnosed with K05.31 (mild periodontitis), and Group III comprised 18 patients diagnosed with K05.31 (moderate periodontitis). The comparison group consisted of 30 individuals with clinically healthy periodontium. All subjects underwent clinical and instrumental examination, determination of periodontal indices, GCF collection, and quantitative analysis of immune regulatory mediators (IL-1β, IL-6, TNF-α, IL-8, MCP-1, IL-17, VEGF, IL-1RA).

Results. The study of immune regulatory mediators confirmed the significance of increased levels of pro- and anti-inflammatory cytokines/chemokines, as well as the reduction of the anti-inflammatory biomarker IL-1RA in GCF at the early stages of inflammatory changes in periodontal tissues. This is accompanied by the appearance of signs indicating the destruction of the dentogingival junction. Using logistic regression and training a multiclass classifier based on the support vector machine method, a model was developed to predict the risk of dentogingival junction loss in patients, potentially leading to periodontitis.

Conclusion. The results of logistic regression modelling and training a multiclass classifier based on the support vector machine method demonstrate that in diagnosing the initial stages of periodontal tissue damage with the loss of the dentogingival junction (DGJ), the most effective approach is the comprehensive use of inflammatory process biomarkers and the development of multi-marker algorithms based on a computer program.

Relevance. Treating patients with comorbid pathologies of the parotid salivary glands (PSGs) and the gastrointestinal tract presents a significant clinical challenge. Sialadenosis commonly develops in acid-dependent diseases associated with H. pylori (HP) infection, often manifesting as complaints of dry mouth. This condition leads to a reduction in local immunological defense due to decreased levels of sIgA, which is predominantly sourced from parotid secretion. Gastroenterologists typically prescribe eradication therapy that includes a proton pump inhibitor (PPI), which, according to its pharmacodynamic properties, can cause drug-induced xerostomia.

Material and methods. A total of 115 individuals with sialadenosis of the PSGs and HP infection, confirmed by a positive urease rapid test in parotid secretion, aged 46.42 ± 6.21 years, were examined. The participants were randomly assigned into groups based on the prescription of absorbable gingival collagen membranes and the dose of a complex immunoglobulin preparation (CIP). The groups were as follows: Group I – 35 individuals without local therapy; Group II – 40 patients receiving 30 mg CIP; Group III – 40 patients receiving 60 mg CIP. Additionally, a control group consisting of 20 healthy individuals aged 44.46 ± 4.12 years was included. Gastroenterologists prescribed a standard triple eradication regimen, which included a proton pump inhibitor (PPI) at double dosage, 1000 mg amoxicillin, and 500 mg clarithromycin, taken twice daily for 14 days. All participants underwent comprehensive dental examinations at various stages: diagnosis, day 14 of eradication, and days 21 and 28 of observation.

Results. A significant increase in PSG sialometry and sIgA levels in parotid secretion was observed in patients using absorbable gingival collagen membranes and CIP in addition to standard treatment. At a CIP dose of 60 mg, a negative urease rapid test was determined in parotid secretion by day 14, while at 30 mg, this occurred by day 21, confirming the effectiveness of the therapy.

Conclusion. Treating patients with PSG sialadenosis undergoing eradication therapy requires a comprehensive interdisciplinary approach. It is necessary to include absorbable gingival collagen membranes and CIP at a dose of 60 mg twice daily for 21 days.  

Relevance. Despite the broader indications for the use of fluoroquinolones and imidazoles in dentistry, particularly in the complex treatment of periodontitis, the sensitivity of the principal causative agents of periodontitis, specifically anaerobic periodontopathogens, remains inadequately studied.

Purpose. Is to justify the use of a combination of fluoroquinolone (ciprofloxacin) and nitroimidazole (tinidazole) chemotherapeutic agents using modern in vitro culture monitoring methods. To provide a rationale for the use of a combination of chemotherapeutic agents from the fluoroquinolone group (ciprofloxacin) and nitroimidazoles (tinidazole) utilising contemporary in vitro culture monitoring methods.

Materials and methods. The study employed the method of automatic programmable bacterial cultivation in the "RTS-1" bioreactor (Biosan, Latvia) in vitro. The bacterial strains examined included S. consellatus, P. gingivalis and F. nucleatum.

Results. The experiments demonstrated that the combined application of drugs from the fluoroquinolone and nitroimidazole groups (using the antibacterial complex Cifran ® CT) during the cultivation of anaerobic cultures resulted in the inhibition of bacterial population growth and division at a concentration of 25/250 µg/ml, with complete absence of bacterial development. Statistically significant inhibition of growth was observed at concentrations of 6.25/625 and 12.5/500 µg/ml.

Conclusion. The use of automatic programmable cultivation methods for microbial populations of anaerobic periodontopathogenic bacteria, followed by growth curve analysis, demonstrated the superiority of the combined form of ciprofloxacin and tinidazole over the beta-lactam antibiotic amoxicillin with clavulanate sodium.

Relevance. In modern dentistry, the primary criteria for successful anaesthesia are the effectiveness and safety of the anaesthetic used. These factors depend on the type of local anaesthetic and the method of its administration in the maxillofacial tissues. Studying the impact of locally anaesthetizing solutions administered by different injection techniques on the periodontal tissues is possible by recording changes in microcirculation using the LDF method.

Purpose. To dynamically record the baseline microcirculation indicator in the tissues at the injection site when using various methods and means of local anaesthesia.

Materials and methods. The study of changes in the microcirculation of periodontal tissues was conducted among 105 patients: 67 women and 38 men aged 25 to 56 years without periodontal pathology and comorbidities, using injection methods of anaesthesia (infiltration and modified periodontal anaesthesia) with 2% and 4% solutions of articaine with varying concentrations of vasoconstrictor. Changes in the microcirculation index were recorded at the injection site: at the root apex projection during infiltration and in the gingival papilla region during MPA, with an exposure time during LDF registration of 5 minutes. To maintain the fiber optic probe, an individual key made of C-silicone with an additional corrective layer was used for repeat positioning. The most informative indicator of the study was the magnitude of the average blood perfusion flow (M) in the time interval of registration, with its changes reflected in the study results.

Results. Analysis of the dynamics of microcirculation indicators in the injection site tissues when using various methods of administering locally anaesthetizing drugs based on 2% and 4% solutions of articaine without vasoconstrictor and with epinephrine at concentrations of 1:200,000 and 1:100,000 allowed the determination of tissue ischemia depth at the injection site and the rate of blood flow restoration after anaesthesia.

Conclusion. Changes in microcirculation indicators in the tissues at the injection site of the local anaesthetic depend on the concentration of the local anaesthetic and vasoconstrictor, the method of administration used, and the volume of the drug administered.

Relevance. Chronic periodontitis is a multifactorial disease influenced by a variety of factors. Beyond periodontal pathogens and systemic conditions, important contributing factors include malocclusion, dental misalignment, and tooth loss. These conditions can compromise the tissue blood flow hemodynamics and precipitate occlusal trauma with signs of functional overload. Subsequently, this may intensify the inflammation and degradation of the alveolar bone, often leading to premature tooth loss.Correction of malocclusion is paramount in the effective management of periodontal diseases, requiring orthodontic treatment to resolve malocclusion and mitigate signs of functional overload. This treatment aims to redistribute occlusal forces uniformly, thus creating a conducive environment for successful prosthodontic rehabilitation and promoting optimal personal oral hygiene.

Clinical case description. This article outlines a personalized approach to managing periodontal inflammation in individuals with orthodontic anomalies. Patient Z., born in 2002, was diagnosed with moderate severity chronic periodontitis (K05.31), presenting with a Class I molar and canine relationship on both sides, constricted dental arches, individual tooth macrodontia, and retrusion and torsiversion of the incisors. The assessment of the patient's periodontal status and overall health was conducted using standard clinical, radiographic, and laboratory diagnostics, whereas the orthodontic assessment involved anthropometric analysis of dental casts and lateral cephalometric radiographs. The periodontal intervention included foundational non-surgical treatments such as ultrasonic scaling both supra- and subgingivally, biofilm disruption using the Vector Paro system, and specific pharmacotherapy. The orthodontic treatment aimed to widen both dental arches and correct the inclination of the upper and lower incisors, achieving a normal occlusion with fixed orthodontic appliances (Damon Q brackets) in accordance with the treatment plan. The effectiveness of the treatment was measured by examining the improvement in gingival conditions, periodontal parameters, and radiographic evidence before and after the intervention.

Conclusion. The research demonstrated that an individualized treatment protocol integrating periodontal and orthodontic care can substantially improve the overall health of the dentofacial complex, masticatory efficiency, and aesthetic aspects.

Relevance. In most cases, soft tissue defects can be addressed using standard local flap transposition methods. However, large defects and/or those with scar tissue changes, through-and-through defects involving destruction of both vestibular and palatal cortical plates, defects penetrating into the nasal cavity, and similar situations necessitate unconventional solutions utilizing external graft materials.

Clinical case description. This clinical case details the use of an autograft from the wide fascia of the thigh (Fascia lata) to repair an atypical defect of the alveolar process in the maxilla, specifically in the area of teeth 1.2 and 1.1. This defect exhibited through penetration between the vestibule of the oral cavity and the oral cavity proper, along with a significant deficiency of local tissues required for defect closure. The results of clinical, instrumental, and CT examinations conducted before and after the surgical intervention are presented.

Results. Objective clinical studies conducted three months post-operation showed complete closure of the defect in the alveolar process of the maxilla, with full epithelization in the postoperative intervention area.

Relevance. Drug-related osteonecrosis of the jaws is a serious complication of antiresorptive therapy in patients with cancer, systemic osteoporosis, and Paget's disease, significantly impacting the patients' quality of life.

Clinical case description. This article analyzes the progressive oral manifestations of a complication of antiresorptive therapy—drug-related osteonecrosis of the jaws—in a patient with breast cancer. The osteonecrosis was characterized by an exposed bone area in the upper jaw, periodontal inflammation, and a malodorous discharge from the mouth. The paper details the appropriate management strategy by the periodontist, tailored to the patient's individual characteristics.

Conclusion. Early initiation of a conservative, comprehensive, and gentle treatment regimen can reduce inflammation in periodontal tissues, including the necrotic area, thus avoiding the need for high-risk surgical procedures.

Relevance. Utilizing the Herbst appliance for managing distal occlusal relationships in patients with completed facial growth serves as an alternative to surgico-orthodontic methods. This approach, however, extends the treatment duration and necessitates stabilization of the upper molars following removal of the appliance when moving the anterior segment of the upper dentition distally.

Objective. To clinically substantiate the feasibility of combining the Herbst appliance with palatally positioned mini-screws for treating distal dental occlusal relationships in adult patients.

Description of сlinical сases. Clinical photographic documentation and diagnostic modeling of facial and dentition were conducted for two patients. This was complemented by the computation and analysis of jaw CT scans and profile cephalometric radiographs. The AMORF method was employed for a quantitative evaluation of dentomaxillofacial anomalies. Hypotheses were drawn based on the employment of a 6.0 mm micro-implant at the median suture in projection with teeth 1.6-2.6, alongside the Herbst appliance, suggesting potential stability of the upper molars during the distal repositioning of the anterior segment of the upper dentition.

Conclusion. The outcomes from the documented clinical cases suggest that integrating palatally positioned mini-screws with the Herbst appliance facilitates stable positioning of the upper jaw’s first molars during the distal movement of the anterior segment, attributed to the solid support provided by the mini-screw implant.

Relevance. Recent studies on odontoblast ultrastructure have indicated that these cells possess immune functions. Unfortunately, both domestic and international sources lack transmission electron microscopy research data that characterise the ultrastructure of odontoblasts. This gap in the literature limits the expansion of knowledge about these specific cells of the human dental pulp and their practical applications. An analysis of existing literature and our own research suggests that the organs of the oral cavity may become targets for the coronavirus. Odontoblasts, as specialized cells of the dental pulp, perform multiple functions. Their primary role is in dentinogenesis, but equally important is their participation in immune functions, evidenced by the presence of pattern recognition receptors (PRRs) on their surface. These include Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain-like receptors (NOD-like receptors, NLRs), some of which can mount an immune response to the entry of SARS-CoV-2 into the cell.

Materials and methods. This study involved a comprehensive clinical-laboratory investigation of the pulp from an intact tooth 2.8, extracted for orthodontic reasons from a patient who had recovered from a COVID-19 infection a few weeks prior to the tooth extirpation. The ultrastructure of the dental pulp was examined using transmission electron microscopy.

Results. In the ultrathin sections of the pulp specimens from the extirpated tooth, specific odontoblast cells with clearly traceable ultrastructure were identified. The electron micrographs visualized features characteristic of viral entry into the cell: initial apoptotic changes in the nucleus of the odontoblast, the presence of clathrin-coated vesicles in the cytoplasmic membrane of the odontoblast process. Additionally, clathrin-coated invaginations of the cytolemma in the terminal parts of the odontoblasts were observed.

Conclusion. The electron micrographs revealed ultrastructural changes indicative of a viral infection, suggesting the involvement of odontoblasts, equipped with the TLR3 and TLR4 system, in the antiviral defence against SARS-CoV-2.

Relevance. An essential component of the treatment and prevention of periodontal diseases is regular individual oral hygiene. Educating patients on effective hygiene practices using toothpaste with anti-inflammatory properties can significantly reduce gingivitis symptoms. Our study evaluated the impact of toothpaste containing octadecafluorodecahydronaphthalene on periodontal tissues among international students who experienced a change in residence.

Material and methods. Over 10 days, we observed a group of 26 international students studying at Kirov State Medical University, who used toothpaste containing perfluorodecalin and identical toothbrushes twice daily. The study included index assessments (OHI-S, PMA), as well as microbiological and biochemical analyses. Descriptive and analytical statistical methods were employed.

Results. Positive clinical dynamics were observed, with reductions in OHI-S and PMA indices. There was a decrease in the total microbial count and specific types of periodontopathogenic microorganisms. Additionally, clinical improvement in periodontal tissue condition (gingival mucosa) was noted, attributed to the effects of perfluorinated compounds on periodontal microcirculation. The product's anti-plaque and anti-inflammatory effects were confirmed through clinical, microbiological, and biochemical methods.

Conclusion. Daily use of toothpaste with octadecafluorodecahydronaphthalene (perfluorodecalin) had a beneficial effect on the condition of periodontal tissues, reducing inflammation by altering the microbiota structure within the biofilm and decreasing the number of periodontopathogenic microorganisms.

Relevance. Over the past few years, the popularity of nicotine-containing substances and tobacco heating systems has continued to grow, while the demand for conventional tobacco leaf cigarettes has been falling. Electronic cigarettes consist of a heating system and a liquid with various flavorings. During the operation of the heating stick, the liquid is converted into an aerosol, which the user needs to inhale. First of all, the hot steam comes into contact with the oral cavity. The aerosol components settle on the oral mucosa, the approximal surfaces of the teeth, penetrating the body with a saliva current, expose the oral cavity to prolonged exposure, causing various changes in the oral cavity and causing discomfort to the smoker. This problem is urgent and based on the above, it is necessary to study all possible effects of cigarettes and electronic nicotine delivery systems on the human body.

Purpose. To assess the impact of nicotine-containing products and smokeless tobacco on the oral mucosa.

Materials and methods. A cohort of 98 patients, aged 20 to 60, was recruited for the study. Participants were divided into four groups: Group 1 consisted of conventional cigarette smokers; Group 2, users of vapes; Group 3, users of IQOS; and Group 4 included patients who used all three device types interchangeably.

Results. The investigation identified a direct correlation between the participant's age, the device used, and their level of oral hygiene. The poorest oral hygiene was seen in Group 4, where individuals used a combination of conventional cigarettes, vapes, and IQOS. Although a majority acknowledged the harmful effects of tobacco products, only 33 participants were aware of the negative impacts associated with vapes and IQOS.

Conclusion. The lack of regulation and awareness of the health risks associated with IQOS and vaping pose substantial challenges for healthcare, indicating a need for more research into these issues.