Relevance. Periodontitis and metabolic syndrome are interrelated conditions that often aggravate each other through shared pathogenic mechanisms, highlighting the need for integrated immunomodulatory therapeutic approaches. Despite this, existing literature presents inconsistent data regarding the interplay between periodontitis and metabolic syndrome, as well as limited insights into the potential benefits of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) as an adjuvant therapy. Specifically, the role of ω-3 PUFAs in modulating the inflammatory response and mitigating bone resorption remains inadequately explored. Therefore, this study aims to evaluate the inflammatory response and osteoresorption in periodontal tissues under the combined conditions of periodontitis and metabolic syndrome, while also assessing the therapeutic effects of ω-3 PUFAs.

Materials and methods. This experimental study was conducted using 30 male Wistar rats, which were randomly assigned to one of five groups: a control group, a periodontitis group, a combined periodontitis and metabolic syndrome group, a periodontitis group treated with omega-3 fatty acids, and a combined periodontitis and metabolic syndrome group treated with omega-3 fatty acids. The study employed several research methodologies. Biochemical analyses were performed to confirm the presence of metabolic syndrome. Histopathological and morphometric assessments were conducted to evaluate the inflammatory response, the extent of osteoresorption, and the number of osteoclasts in the periodontal tissues. Additionally, molecular genetic analysis was used to measure the relative mRNA expression levels of key inflammatory and osteoclastogenic markers, including TNFα, IL-1β, RANK, and OPG.

Results. The data demonstrated that metabolic syndrome in laboratory animals significantly exacerbates both the pro-inflammatory response and the extent of lacunar osteoclastic bone resorption. Administration of ω-3 PUFAs at a dose of 40 mg/kg over 30 days led to a statistically significant reduction in inflammatory infiltration within the periodontal tissues (3.17 ± 0.21 in the control group vs. 1.83 ± 0.21 in the treated group, р = 0.001) and a decrease in the number of osteoclasts (3,75 ± 0,45 in the control group vs. 1,75 ± 0,35 in the treated group, р = 0.003). Additionally, there was a notable reduction in the expression levels of TNFα, IL-1β, and RANK mRNA. Similar but less pronounced effects were observed in the group with combined metabolic syndrome following ω-3 PUFA administration.

Conclusion. These findings enhance the current understanding of the interplay between periodontitis and metabolic syndrome, highlighting the potential of ω-3 PUFAs as a preventive or therapeutic intervention. ω-3 PUFAs may be effective in mitigating inflammatory responses and bone resorption, both in cases of isolated periodontitis and when accompanied by metabolic syndrome.

Relevance. Occlusal disorders are not only predictors of oral diseases but are also associated with systemic conditions such as endocrine, cardiovascular, and cognitive disorders, highlighting their broader significance in medicine. The digitization of diagnostic processes and the integration of computer technologies into traditional methods offer promising advancements in assessing occlusal status. This makes the analysis of digital methods for diagnosing occlusal relationship disorders particularly relevant.

Purpose. To evaluate digital methods and devices used for diagnosing occlusal relationship disorders.

Material and methods. A systematic review was conducted, analyzing 40 scientific publications from 2016 to 2024 that focus on digital methods for diagnosing occlusal imbalance. The study assessed electronic devices that measure occlusal force by converting mechanical force into electrical signals using various sensors. These digital methods are employed to evaluate the functional state of the masticatory system, including the detection of temporomandibular joint disorders, mandibular fractures, and occlusal deformities, as well as to monitor occlusal force dynamics during treatment. Recent advancements in portable electronic sensors suggest potential applications for their integration with control chips into dental prostheses or occlusal stabilization splints, allowing real-time monitoring of tooth compression forces, potentially enhanced by artificial intelligence.

Results. The development of new diagnostic methods and devices equipped with highly sensitive sensors for measuring masticatory pressure opens new avenues for identifying clinical parameters that were previously difficult to analyze. Recent advances in hardware technology, particularly those utilizing neural network analysis, have the potential to expedite accurate diagnosis and predict the risk of complications.

Conclusion. Both in Russia and internationally, significant progress is being made in the development of digital methods for diagnosing occlusal imbalance. These methods are poised to become a priority in the future of dental practice. However, the adoption of digital occlusal methods into routine dental practice is currently hindered by challenges related to the availability of digital equipment in clinics and the insufficient digital skills of many dentists. Addressing these challenges is crucial for improving the quality of dental care for patients with occlusal disorders.

Relevance. Recently, dental patients have been increasingly presenting with not only aesthetic, functional, and painrelated concerns, but also various otological symptoms, such as ear congestion, discomfort, and perceived hearing loss. These symptoms may be linked to underlying dental conditions, especially those involving a reduction in interalveolar distance (IAD), and must be carefully differentiated from ENT disorders and true hearing impairment.

Objective: To evaluate the auditory function in dental patients with partial tooth loss and complaints of pathological otological symptoms.

Materials and methods. The study included 357 dental patients aged 43 to 72 years, comprising 287 women (80.4%) and 70 men (19.6%) with partial tooth loss. The examination involved a functional-physiological method for determining the central relationship of the jaws using the Apparatus for Determining Central Occlusion (AOTSO) and tonal threshold audiometry.

Results. A reduction in interalveolar height of varying degrees was confirmed in 325 (91%) patients with dental arch defects, while no decrease was observed in 23 (9%) patients. All patients with otological complaints exhibited a reduction in lower facial height. Of the 87 patients with otological complaints, 37 (42.5%) were diagnosed with significant hearing loss based on tonal threshold audiometry.

Conclusion. The examination of this group of dental patients with dental arch defects, utilizing modern diagnostic methods, confirmed a reduction in interalveolar distance. Additionally, otological complaints were identified, and pathological auditory conditions, such as various forms of hearing loss, were verified through tonal threshold audiometry.

Relevance. The success of dental implant treatment in cases of reduced alveolar bone volume hinges on restoring bone to the required dimensions in each case. The guided bone regeneration (GBR) technique, which encompasses various techniques, holds a central role in oral reconstructive surgery and dental implantology due to its capacity for continuous improvement. The authors' experience with a modified GBR technique incorporating a situational Vicryl framework (SVF) has demonstrated enhanced effectiveness, with the potential to restore vertical bone volume by 5 mm or more. This study aimed to evaluate the advantages of the modified GBR technique using SVF compared to the conventional GBR technique.

Materials and methods. This study is based on a comprehensive comparative analysis of two datasets: a retrospective evaluation of dental implant treatment outcomes in 210 patients who required alveolar bone volume restoration using the classical GBR technique, and clinical data from 40 patients treated with both the classical GBR technique and the proposed modified SVF technique The oral status of 40 patients included in the clinical analysis was characterized by partial edentulism, accompanied by mild to moderate alveolar bone deformities resulting from either inflammatory resorption or natural atrophy. The retrospective group 1 (comparisons) consisted of archival data of 210 patients. Retrospective data from 210 patients and clinical data from 40 patients were subjected to statistical analysis using parametric and non-parametric methods with IBM SPSS Statistics software.

Results. A comprehensive comparative analysis of retrospective and clinical data revealed the following results. The value of the integrated "restored bone volume" parameter after vertical reconstruction in group 1 was 2-3 mm. The mean value of the integrated "restored bone volume" parameter after vertical reconstruction in group 2 was 3.20±0.96 mm, while in group 3, it was 4.60±1.63 mm for patients of both sexes. Comparison of the integrated "baseline deformation" parameter by technique showed a median deformation of 2.95 mm in group 2, treated with the classical GBR technique, and 4.95 mm in group 3, treated with the modified SVF technique. Similarly, the integrated "restored bone volume" parameter showed a median value of 2.95 mm in group 2 and 4.85 mm in group 3. The average value of the integrated "restored bone volume" parameter in group 2 was comparable to retrospective data from 210 patients in group 1.

Conclusion. The comprehensive analysis of alveolar bone volume reconstruction using two GBR techniques, based on "baseline deformation" and "restored bone volume" parameters, demonstrated a significant advantage of the modified GBR technique compared to the classical technique.

Relevance. The literature highlights the significant impact of rheumatoid arthritis (RA) on the onset of musculoskeletal dysfunction symptoms in the temporomandibular joint (TMJ). However, the risk factors that influence the clinical manifestations of TMJ disorders in RA patients remain insufficiently explored.

Objective: To examine the impact of rheumatoid arthritis on the onset and progression of TMJ disorders.

Materials and methods. At the Dental Clinic of the Central Research Institute of Stomatology and Maxillofacial Surgery, 180 patients from St. Petersburg State Clinical Rheumatology Hospital No. 25, diagnosed with rheumatoid arthritis, were examined. Standard clinical assessments and detailed medical history collection were performed.

Results. Patients with long-standing RA (over 5 years) were more likely to experience TMJ disorder symptoms, with a relative risk of 1.342 (95% CI) [1.106; 1.628]. No statistically significant correlation was found between RA activity and TMJ disorders. The symptom pattern varied by timing: prior to RA, patients predominantly experienced TMJ clicking and crepitus (66%); during RA onset, pain and restricted jaw movement were more common (80% and 72%, respectively). After RA manifestation, pain became the dominant symptom, though its intensity diminished over time (to 60%).

Conclusions. The duration of RA has a notable impact on both the frequency and nature of TMJ disorder symptoms. While RA treatment reduces symptom intensity over time, their frequency remains high.

Relevance. Recurrent aphthous stomatitis (RAS) is one of the most common diseases affecting the oral mucosa. It is characterized by the recurrent appearance of ulcers (aphthae) and a prolonged course with periodic exacerbations.

Purpose. To study the condition of the oral mucosa epithelium in patients with recurrent aphthous stomatitis undergoing treatment with antiseptics and reparative agents.

This study examined samples of buccal epithelium from 64 patients, who were randomly divided into two equal groups: the first group used chlorhexidine as a mouthwash (control group); the second group used octenidine + phenoxyethanol for 7 days. For pain relief, patients in both groups applied a gel containing lidocaine + chamomile extract. After 7 days, the therapy continued with reparative agents (a hydrogel-based material with sodium alginate, Derinat, and lidocaine, deproteinized calf blood extract, and sea buckthorn oil). Each group was further divided into three subgroups for this part of the therapy. The condition of the buccal epithelium was assessed three times: before treatment, on the 7th day, and on the 21st day of therapy. Buccal epithelium preparations were prepared and analyzed using standard methods.

Results. The analysis of cytogenetic and karyological indicators of buccal epithelial cells in patients with CRAS revealed that, at the peak of the inflammatory process, cells with micronuclei and various forms of nuclear protrusions were more frequently observed. During therapy, there was a notable reduction in buccal epithelial cells exhibiting these pathological features.

Conclusion. Before therapy, patients with RAS exhibited cytogenetic instability and various karyological anomalies in the buccal epithelial cells of the oral mucosa. These anomalies included significantly higher occurrences of micronuclei, karyopyknosis, karyolysis, nuclear vacuolization, intercellular bridges, and chromatin condensation. During the different therapy regimens for RAS, normalization of the epithelial state of the oral mucosa was observed, with the most pronounced improvements seen with the use of octenidine + phenoxyethanol in combination with a hydrogel-based material containing sodium alginate, Derinat, and lidocaine.

Relevance. While professional oral hygiene (POH) is widely implemented in dental practice, there is a notable lack of comprehensive research on its effects on periodontal tissues. This underscores the need to investigate the impact of various air-polishing systems (APS) on periodontal tissues in specific clinical contexts. Choosing the appropriate active ingredient in mouth rinses for antiseptic treatment during the final stage of professional oral hygiene is critical for dental practitioners, as the active ingredient directly affects microcirculation in periodontal tissues.

Materials and methods. A standard dental examination was conducted on 200 patients aged 18 to 25 years. Patients were divided into groups based on the active component of the APS: calcium carbonate, sodium bicarbonate, a mixture of calcium carbonate and sodium bicarbonate, trehalose, or glycine. In the second stage of the study, antiseptic treatment was performed according to the active ingredient in the mouth rinse, using one of the following antiseptics: chlorhexidine (0.20%) with hyaluronic acid; a combination of clove and fennel essential oils, bromelain enzyme, and bifidobacterium lysate; or essential oil-based rinses containing thymol, eucalyptol, menthol, and methyl salicylate. The control group used distilled water. Microcirculation dynamics in the periodontal tissues were monitored throughout the study using ultrasound Doppler flowmetry.

Results. An increase in microcirculation parameters in periodontal tissues was observed following professional oral hygiene using various APS components, both with and without ultrasonic treatment. The application of mouth rinses as the final step in antiseptic oral care contributed to the restoration of microcirculation in periodontal tissues within 1 hour of use.

Conclusion. The study identified the most effective protocol for mouth rinse application, tailored to the active component of the air-polishing system.

Relevance. Determining the antimicrobial activity of disinfectants and their impact on conditionally pathogenic microbiota (CPM), as well as justifying the selection of agents for treating dental impressions and prostheses, remains an unresolved issue requiring thorough research. The effects of quaternary ammonium compounds (QAC) on various microorganisms, particularly regarding their effective dilution in dental practice, are not well-studied despite their widespread use.

Objective. To compare the antimicrobial activity of alkaline combined disinfectants, QAC derivatives, and polyhydric alcohols at various dilutions against CPM strains in vitro.

Materials and methods. Dilutions of domestic disinfectants—"Megadez Ortho" (VladMiva), "Vendelin" (Bozon), and "Trilox" (Biotorg)—were prepared in sterile heart-brain broth (Himedia Labs, India) ranging from 1:200 to 1:200,000. Microbial growth curves were assessed using a bioreactor RS (Biosan, Latvia). The study involved three test strains of CPM: Staphylococcus aureus, Escherichia coli, and Bacillus cereus.

Results. The in vitro experiment results indicate that working solutions of the disinfectants at dilutions of 1:200 and 1:20 exhibit bactericidal activity against all test strains: S. aureus, E. coli, and B. cereus. The antimicrobial activity against B. cereus was observed at slightly higher concentrations compared to S. aureus and E. coli.

Conclusion. Based on the decrease in disinfectant activity, the preparations can be ranked in the following order of decreasing efficacy: "Trilox" → "Vendelin" → "Megadez Ortho." A notable advantage of "Trilox" is its statistically significant higher activity against spore-forming bacilli B. cereus.

Relevance. Sarcoidosis is a multisystem granulomatous disease of unknown origin, commonly presenting with bilateral hilar lymphadenopathy, pulmonary infiltrates, and involvement of the eyes, skin, gums, and oral mucosa. This clinical case illustrates the oral manifestations of this rare systemic disease. Gingival hypertrophy and soft tissue lesions on the lip mucosa were the initial signs of the condition. Following an extended diagnostic process, the patient underwent treatment by both a dentist and a rheumatologist, leading to a stable remission of the disease.

Case description. This article presents a clinical case of sarcoidosis manifesting in the mouth as gingival hypertrophy and a soft tissue lesion on the upper lip. In most cases, a diagnosis of sarcoidosis is made before any oral symptoms appear. Diagnosing a systemic disease based on primary oral symptoms poses a unique challenge, as dental professionals may not always be familiar with the oral manifestations of systemic conditions. In cases of suspected sarcoidosis, the oral mucosa should be thoroughly examined, and systemic sarcoidosis should be considered in the differential diagnosis of granulomatous lesions in the mouth.

Conclusion. Early initiation of treatment can significantly improve the patient's quality of life and prognosis.

Relevance. Accurately assessing all resection margins during the removal of parotid salivary gland tumors is crucial due to the risk of recurrence and the potential for benign processes to become malignant over time. Macroscopic specimens obtained during these surgeries are sent to the pathology laboratory in containers filled with fixative solution. During fixation, the soft tissue fragments, typically round in shape, can alter their configuration because of the tissue's heterogeneity. This can create challenges for the pathologist in properly orienting the surgical specimen, which in turn complicates the precise evaluation of the resection margins.

Materials and methods. To address this issue, the "Plate for fixing histological specimens of parotid salivary gland tumors" (patented) was developed. Twenty cases of its clinical use were analyzed: the surgical material (parotid gland tissue containing a tumor) was sent to the pathology department, fixed on this plate to preserve its original anatomical orientation. A macroscopic and histological evaluation of the neoplasms was then carried out, with special attention given to the accurate identification of all resection margins. In all 20 clinical cases, the use of this invention improved the convenience for the pathologist in handling the excised tissue block by standardizing the method and clearly identifying the resection margins.

Conclusion. The application of this invention enhances the accuracy of marking and evaluating the resection margins in parotid gland tumors.

Relevance. Recent statistics in healthcare indicate that periodontal tissue diseases rank second among all dental conditions. Currently, there is growing concern regarding the rising incidence of periodontal diseases among adolescents. This makes puberty-associated gingivitis particularly noteworthy, as it commonly develops during this age due to hormonal changes. Prompt treatment is crucial to prevent severe complications, including early tooth loss. Previously, the occurrence rate was 62%, but it has now escalated to 92%. This highlights the importance of identifying underlying causes and exploring treatment options for this condition.

Materials and methods. The study included 63 adolescents, aged 12 to 18 years, all diagnosed with puberty-associated gingivitis (ICD-10 code K05.11) and without any underlying systemic diseases. Participants received training in oral hygiene, which included supervised tooth brushing and professional cleaning. As part of the symptomatic treatment for puberty-associated gingivitis, the oral rinse “Argymax” (“Fresh Breath and Active Enamel Calcium Saturation”) was prescribed. Patients were instructed to use the rinse for 30 seconds, twice daily. The effectiveness of the treatment was evaluated using the Green-Vermillion Oral Hygiene Index (OHI-S), the PMA index to assess gingival inflammation, and the interdental papilla bleeding index (PBI) according to Saxer-Muhlemann (1971). Clinical assessments were performed under the same conditions at 2 weeks, 1 month, 3 months, and 6 months post-treatment.

Results. The treatment of puberty-associated gingivitis with the “Argymax” oral rinse (“Fresh Breath and Active Enamel Calcium Saturation”) demonstrated significant efficacy, as evidenced by improvements in clinical indices and objective data.

Conclusion. The “Argymax” oral rinse (“Fresh Breath and Active Enamel Calcium Saturation”) is recommended for widespread use in the management of inflammatory periodontal diseases, particularly puberty-associated gingivitis.