Relevance. Diabetes mellitus (DM) ranks as the most prevalent non-communicable chronic disease worldwide, associated with severe complications, high mortality, and significant disability. One of these complications is systemic angiopathy, which includes angiopathy of the periodontal tissues and contributes to the development of periodontitis. The prevalence of inflammatory periodontal diseases in individuals with DM reaches 98%. Substantial evidence supports a bidirectional association between periodontitis and type 2 diabetes (T2DM), which accounts for 95% of all DM cases. Since hyperglycemia adversely affects periodontal health, regular monitoring of glycated hemoglobin A1c (HbA1c)—the gold standard for assessing glycemic control in patients with diabetes—is critical. Several researchers have also reported that treatment of chronic periodontitis improves glycemic status and may may help maintain consistently lower HbA1c levels.

Objective. To synthesize, qualitatively analyze, and summarize findings from previously published studies investigating the effect of periodontitis treatment on HbA1c levels in adults with diagnosed type 2 diabetes mellitus.

Materials and methods. A literature search was performed across PubMed, eLIBRARY, supplemented by snowball sampling of references. The search encompassed publications from 2009 to September 2024. Inclusion criteria were restricted to randomized controlled trials involving adult T2DM patients that assessed HbA1c level changes following periodontitis treatment. Methodological quality was appraised using the Cochrane Risk of Bias Tool for Randomized Trials.

Results. The initial search yielded 226 records. After duplicate removal, title/abstract screening, and full-text assessment, eight studies met the eligibility criteria. The mean baseline HbA1c level across participants was ≥7.06%.

Conclusion. All studies reported a reduction in mean HbA1c levels in the treatment group six months after treatment of periodontitis. This review supports the hypothesis that non-surgical treatment of periodontitis (scaling and root planing, SRP) combined with optimized oral hygiene can lower HbA1c in T2DM patients. However, further high-quality randomized controlled trials are required to assess the efficacy of combining non-surgical treatment methods with adjunctive pharmacological interventions for periodontitis.

Relevance. According to the World Health Organization, periodontitis and gingivitis are among the eleven most prevalent conditions globally. A major contributing factor in the development of these diseases is the presence of periodontal pathogens. This study is based on the premise that differences in the periodontal microbiome between individuals with and without mental disorders may play a meaningful role in understanding the connection between mental and oral health.

Objective. To identify and evaluate the periodontal microbial profile in patients with mental disorders residing in psychiatric long-term care facilities.

Materials and methods. This cross-sectional study analyzed the periodontal microbial profiles of 135 patients with mental disorders living in psychiatric long-term care facilities in Arkhangelsk and 96 individuals without diagnosed mental disorders. The assessment included evaluation of periodontal status and microbial composition. Statistical analyses were performed using Stata 17.0 software. The Shapiro–Wilk test was applied to assess the normality of quantitative data. Pairwise comparisons were conducted using the Mann–Whitney U test, and multiple comparisons using the Kruskal–Wallis test. Associations between categorical variables were evaluated using Pearson’s chi-squared (χ²) test, while correlations between quantitative variables were analyzed using Spearman’s rank correlation.

Results. The prevalence of periodontal pathogens was 90.8% in the main group and 49.4% in the control group. The Mann–Whitney U test revealed statistically significant differences in the detection rates of periodontal pathogens between patients with mental disorders and those without (P. gingivalis, P. intermedia, T. forsythia, T. denticola, A. actinomycetemcomitans – p < 0.001; C. albicans – p = 0.009). An association was observed between the presence of a mental disorder and the detection of periodontal pathogens (Pearson’s χ², p < 0.001).

Conclusion. Patients with mental disorders showed a significantly higher prevalence and colonization of periodontal tissues by periodontal pathogens compared to controls. Furthermore, the presence of mental disorders and the associated use of antipsychotic medications were linked to a higher risk of harboring these bacteria in the periodontal microbiome.

Relevance. Undifferentiated connective tissue dysplasia (UCTD) is a background condition that reduces the body's adaptive potential and increases the risk and severity of various diseases. The condition of the buccal epithelium reflects systemic homeostasis and its changes under the influence of local and systemic factors. The aim of this study was to assess the cytomorphological characteristics of buccal epithelial cells in patients with UCTD and their alterations in the presence of periodontal inflammation.

Materials and methods. The study protocol included an assessment of phenotypic signs of connective tissue dysplasia and an evaluation of periodontal status, based on which four groups were identified: Group I – individuals without signs of UCTD or periodontal inflammation (n = 15); Group II – individuals without UCTD but with periodontitis (n = 20); Group III – individuals with UCTD but without periodontitis (n = 20); and Group IV – individuals with both UCTD and periodontitis (n = 34). A cytomorphological analysis of superficial buccal epithelial cells was performed, including an assessment of microorganism adsorption by epithelial cells.

Results. Buccal cytograms of patients with UCTD showed a significantly higher frequency of nuclear aberrations, including micronuclei (10.7-fold increase; p < 0.001), binucleation (3-fold; p = 0.007), perinuclear vacuoles (3.2-fold; p < 0.001), and karyolysis (3.5-fold; p = 0.017). There was also a 3-fold increase in anucleate cells (1.47 ± 0.15%; p < 0.001) and a rise in the cytogenetic index. In patients with both UCTD and periodontitis, the proportion of binucleated cells was 1.3 times lower (p = 0.005) compared to those with UCTD alone. The mean apoptosis index in this group was 17.6 ± 1.1, which was 2.2 times higher than in UCTD patients without periodontitis (p < 0.001) and 1.8 times higher than in patients with periodontitis without UCTD (p < 0.001). The mean cytomorphological coefficient was relatively lower in the UCTD group, although this difference was not statistically significant (p = 0.374).

Conclusion. The study identified distinct cytomorphological characteristics of buccal epithelial cells in patients with UCTD, as well as their modifications in the presence of periodontitis.

Relevance. Modern approaches to diagnosing and monitoring oral health are being increasingly shaped by digital technologies. As remote monitoring tools continue to evolve, increasing attention is being paid to the clinical effectiveness of mobile applications for self-monitoring oral health.

Materials and methods. The study included 300 university students aged 18–29 years. Standard index-based assessment methods were applied (DMFT, Hygiene Index, Occlusogram Index), along with the Dental Scope mobile application. App-based results were compared with clinical data. Follow-up assessments were carried out after two years in 235 participants. Descriptive statistics, the Wilcoxon signed-rank test, and paired t-test were used to assess changes in the measured indices.

Results. Both the main and control groups showed improvements in most parameters following treatment. The mean app-based score increased from 7.4 to 9.3 in the main group and from 7.9 to 9.1 in the control group (p < 0.001). Positive changes were observed in the DMFT index, hygiene levels, and Occlusogram Index (OGI). These changes correlated with clinical data, confirming the diagnostic value of the digital tool.

Conclusion. The results demonstrate a strong agreement between the dynamics recorded by the mobile application and those observed through conventional clinical assessment. This supports the use of the Dental Scope app as an effective tool in preventive and follow-up dental care.

Relevance. Dental plaque is a major etiological factor in caries and periodontal diseases, yet it is often invisible to the naked eye, making it difficult for patients to remove thoroughly during routine brushing. Plaque-disclosing agents are used to stain plaque and highlight areas requiring improved cleaning. They come in various forms (tablets, gels, solutions, etc.), but it remains unclear which form is most effective and patient-friendly.

Aim. To evaluate and compare the effectiveness of tablet and gel forms of Plack Test disclosing agent for dental plaque visualization.

Materials and methods. A randomized crossover trial was conducted with 100 volunteers (18–45 years). Each participant tested both a disclosing tablet and a disclosing gel in sequence (in two groups with opposite order). The Simplified Oral Hygiene Index (OHI-S) was measured before and after using each agent to quantify plaque levels. After each disclosure, participants completed a questionnaire rating the ease of use, taste, perceived effectiveness, and any adverse sensations. A final survey determined overall preference.

Results. Both the tablet and gel significantly reduced plaque index scores after use (mean OHI-S decreased from ~2.5 at baseline to ~0.5 post-cleaning with aid of disclosure, p < 0.001). There was no significant difference between the tablet and gel in objective plaque reduction (p>0.05). However, subjective ratings favored the tablet: participants found it easier to use (4.5 ± 0.6 vs 4.0 ± 0.8 out of 5, p < 0.05) and better-tasting (4.2 ± 0.5 vs 3.5 ± 0.8, p < 0.05) than the gel. Perceived effectiveness was high for both (4.7 vs 4.6, p > 0.05).

Conclusions. The conducted study demonstrated that both tablets and gel used for dental plaque disclosure are comparably effective in terms of objective performance, as confirmed by the OHI-S index. However, participants' subjective assessments strongly favored the tablet form, which was rated higher due to its ease of use, more pleasant taste, and fewer side effects. A significant positive correlation was also found between participants’ subjective evaluation of effectiveness and the actual reduction in plaque levels. As a result, the vast majority of participants (85%) preferred the tablet form as the disclosing agent.

Relevance. One of the key research areas in periodontology is the investigation of the pathogenetic role of individual periodontal pathogens and their microbial associations. With the advent of sequencing technologies and metagenomic analysis, the list of periodontal pathogens continues to expand, and new key pathogens, such as Filifactor alocis, are being identified. Analyzing the virulence factors and interactions of F. alocis with other biofilm-forming bacteria, especially early colonizers such as Streptococcus gordonii, remains an important task.

Objective. The aim of this study was to characterize the pathogenic factors of Streptococcus gordonii and Filifactor alocis in the oral microbiomes of patients with inflammatory periodontal diseases.

Materials and methods. The study involved samples of gingival sulcus contents from healthy individuals (n = 25) and patients with gingivitis (n = 15), as well as samples of periodontal pocket contents from patients with mild (n = 30) and moderate (n = 39) chronic periodontitis (CP). Based on 16S rRNA gene sequencing, the microbial composition of each sample was determined. DNA extracted from the samples was also used as a template for polymerase chain reaction (PCR) to amplify the GspB gene (encoding a serine-rich repeat glycoprotein) and the hsa gene (encoding a sialic acid-binding adhesin) of Streptococcus gordonii, as well as the FtxA gene (encoding an RTX toxin protein) of Filifactor alocis, using primers selected by the authors. Statistical analysis was performed using Statistica 10 software. Cramér’s V coefficient was applied to assess associations between bacterial species occurrence within the oral microbiomes and patient group classification.

Results. 16S rRNA gene sequencing identified Filifactor alocis and Streptococcus gordonii in the microbiomes of patients; these microorganisms were not detected in the microbiomes of healthy individuals. PCR analysis showed that in patients with gingivitis, only the GspB gene was detected (in 6.7% of cases). In patients with mild and moderate chronic periodontitis, both S. gordonii genes (hsa and GspB) were detected in 20% and 28.2% of cases, respectively, and the F. alocis FtxA gene was found in 13.3% and 23.1% of cases, respectively. However, none of the groups exhibited all three genes simultaneously.

Conclusion. S. gordonii and F. alocis are part of the oral microbiota associated with inflammatory periodontal diseases. Identifying their pathogenic factors helps elucidate the mechanisms by which these microorganisms contribute to the onset and progression of periodontal pathology. This knowledge may facilitate the development of more accurate and sensitive early diagnostic tools and support the identification of new therapeutic targets.

Relevance. Dental implantation is currently regarded as the most effective approach to restoring the continuity of the dentition. However, individuals with a history of chronic periodontitis face a significantly increased risk of inflammatory complications, particularly peri-implant mucositis and peri-implantitis. Developing effective prevention and treatment strategies requires accurate, timely risk assessment to identify at-risk patients.

Objective. To develop a risk classification model for peri-implantitis in patients with chronic periodontitis based on clinical and microbiological markers, using a decision tree algorithm.

Materials and methods. The study included 177 patients with chronic periodontitis, evenly divided into three groups (n = 59 each): without dental implants, with implants and no clinical signs of peri-implantitis, and with implants and diagnosed peri-implantitis. Clinical examination, microbiological analysis, and PCR testing of subgingival plaque from periodontal pockets were conducted to identify clinical and microbiological markers associated with peri-implantitis risk. Based on these parameters, a machine learning model was developed using the CART (Classification and Regression Tree) algorithm with the Gini index as the splitting criterion.

Results. The most prominent clinical signs observed in patients with peri-implantitis were dentin hypersensitivity, halitosis, exudate, and gingival margin overgrowth. Among the identified microorganisms, the most predictive for peri-implantitis risk were R. mucilaginosa, S. mitis, R. dentocariosa, A. odontolyticus, S. australis, P. gingivalis, F. nucleatum and A. actinomycetemcomitans. The classification model demonstrated high discriminative ability, with an accuracy of 0.75, F1–score of 0.7243, and a ROC–AUC of 0.74.

Conclusion. A comprehensive clinical and microbiological evaluation, supported by statistical analysis and machine learning methods, provides an effective approach for predicting the risk of peri-implantitis in patients with chronic periodontitis. The findings highlight the importance of integrating microbiological diagnostics into standard clinical protocols to enable early identification of high-risk individuals and to guide personalized preventive and therapeutic strategies.

Relevance. The prevalence of dental conditions that may lead to a reduced occlusal vertical dimension (OVD) is relatively high, reaching 85% or more in patients aged 35 to 60 years. The incidence of malocclusion resulting from various pathological processes ranges from 75% to 95%. During clinical examination of dental patients with occlusal disturbances that alter the jaw relationship, otological complaints – hearing loss, tinnitus, and ear congestion— are frequently reported. These symptoms may be associated with ENT disorders involving true auditory pathologies or may reflect functional disturbances of the auditory analyzer secondary to dental conditions. Differentiating between these etiologies is essential for effective treatment and comprehensive rehabilitation of this patient population.

Objective. To evaluate the functional state of the auditory analyzer in dental patients with reduced OVD using tympanometry.

Materials and methods. The study included 50 patients aged 34 to 73 years (mean age: 50.6 ± 2.7 years), comprising 28 women (56.0%) and 22 men (44.0%). The study group consisted of patients with reduced OVD resulting from primary dental conditions and presenting with otological complaints. The examination involved determining the central jaw relationship using a functional-physiological method with the Apparatus for Determining Central Occlusion (AOTSO). Tympanometry was used to assess middle ear function.

Results. All patients in the study group with clinical signs of reduced OVD and otological complaints were found to have objectively confirmed reduction in interalveolar distance. Analysis of tympanometric parameters – including residual volume of the external auditory canal, tympanic membrane compliance, middle ear pressure, and gradient – in habitual and optimal occlusion revealed a statistically significant reduction in the asymmetry indices for compliance, pressure, and gradient following the establishment of optimal occlusion.

Conclusion. Tympanometric assessment is a valuable component of the comprehensive diagnostic approach for dental patients with altered occlusal relationships who report symptoms such as tinnitus, ear congestion, and hearing loss. The findings demonstrate a significant decrease in asymmetry coefficients of major tympanometric parameters after occlusal correction, indicating improved functional performance of the auditory analyzer.  

Relevance. A key manifestation of oral aging is the onset and progression of periodontal disease. In elderly patients, gingivitis and periodontitis often develop in the context of low-grade chronic inflammation. Individual oral hygiene plays a critical role in the management of gingivitis and periodontitis and in maintaining long-term remission. Given the clinical and pathogenetic characteristics of chronic periodontitis in older adults, oral hygiene products for this population must meet specific functional requirements.

Objective. To conduct a clinical and laboratory evaluation of the effectiveness of a custom-formulated toothpaste and commercially available formulations in elderly patients diagnosed with gingivitis or periodontitis.

Materials and methods. The study enrolled 175 elderly patients diagnosed with chronic periodontitis (ICD-10: K05.3; EFP, 2018 classification: Stage I–II, Grade A–B). All participants underwent a comprehensive dental examination along with laboratory analysis of oral fluid and buccal epithelium. Patients in Study Group 1 used a custom-formulated toothpaste based on a glycerolated silica blend; those in Study Group 2 used a commercially available therapeutic formulation; the comparison group received a placebo toothpaste.

Results. Use of the toothpaste containing honeysuckle extract, xylitol, and bromelain resulted in a 43% reduction in the Simplified Oral Hygiene Index (OHI-S) and an 18% reduction in the PMA index. The custom-formulated toothpaste achieved a 23% reduction in OHI-S and a 5% reduction in the PMA index. Furthermore, the effectiveness of the toothpaste containing honeysuckle extract, xylitol, and bromelain was supported by a 58% decrease in C-reactive protein (CRP) levels in oral fluid and a 51% reduction in the apoptosis index.

Conclusion. Clinical and laboratory findings in elderly patients showed that the therapeutic toothpaste containing honeysuckle extract, xylitol, and bromelain exhibited the most pronounced cleansing and anti-inflammatory effects.

Relevance. Squamous cell carcinoma of the oral mucosa is a highly aggressive malignancy with a poor prognosis, primarily due to delayed diagnosis. A high index of suspicion among dentists of all specialties facilitates early detection and timely referral to oncology specialists.

Clinical case description. This article presents a case report of squamous cell carcinoma affecting the mandibular alveolar ridge and sublingual mucosa in a female patient. For six months, she had been receiving dental treatment for a painful oral ulcer, gingival bleeding, and tooth mobility.

Conclusion. Thorough patient evaluation and timely recognition of signs of malignant transformation are essential for dental practitioners, enabling earlier intervention and potentially less extensive oncologic surgery.

Relevance. The Root Shield Technique (RST) is becoming increasingly relevant in immediate implant placement, particularly in esthetically sensitive regions, due to its ability to preserve the buccal bone plate and support favorable soft tissue contours.

Materials and methods. The study involved 15 patients who underwent immediate implant placement in the maxilla or mandible using the Root Shield Technique. Clinical outcomes were assessed based on bone resorption, soft tissue condition, and the incidence of complications.

Results. Implant integration was achieved in all cases. The mean bone resorption was approximately 1 mm. Gingival recession was observed in two patients. No major complications were reported.

Conclusion. The Root Shield Technique demonstrated high predictability and a low rate of complications. It may be recommended in cases where strict clinical indications are met.

Relevance. This study presents results of a comprehensive dental assessment in patients with carious lesions of dental hard tissues associated with metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM).

Objective. To assess dental caries risk based on glycemic status in patients with components of metabolic syndrome.

Materials and methods. The dental examination included evaluation of caries experience using the DMFT index and assessment of caries prevalence. Salivary pH was measured using litmus paper. Glycemic status was evaluated using fasting and 2-hour postprandial venous blood glucose measurements. Glycated hemoglobin (HbA1c) levels were determined using high-performance liquid chromatography.

Results. Dental caries risk correlated with glucose levels in both venous blood and saliva. Patients with metabolic syndrome and impaired glucose metabolism showed a moderate positive correlation (Spearman’s ρ = 0.49 and ρ = 0.55, respectively), while T2DM patients demonstrated a strong correlation (ρ = 0.62 and ρ = 0.69, respectively). HbA1c levels were significantly associated with caries experience: ρ = 0.46 in MetS patients without glycemic dysregulation, ρ = 0.51 in those with impaired glucose metabolism, and ρ = 0.75 in the T2DM group. The caries risk assessment method showed 77% sensitivity and specificity in T2DM patients, and 50% in patients with MetS components.

Conclusion. Patients with T2DM have a significantly higher risk of dental caries, which correlates strongly with blood and salivary glucose levels. Elevated HbA1c levels are associated with more carious teeth, indicating the need for extended dental treatment in T2DM patients. These findings highlight the importance of educating poorly controlled T2DM patients about their increased caries risk. Additionally, dental visits may provide a cost-effective opportunity for early screening of T2DM and metabolic syndrome components.