Relevance. Dental crowding is one of the most common forms of malocclusion, with a reported global prevalence of 30%–60% that continues to increase. In addition to causing functional problems and esthetic concerns, dental crowding may represent an important risk factor for gingivitis and periodontitis. However, the mechanisms underlying this association and the extent of its impact on periodontal health remain unclear, highlighting the need to systematically synthesize the available evidence. Objective. To systematically review the available evidence on the association between dental crowding and periodontal diseases and to examine the pathogenetic mechanisms through which the identified etiologic factors may affect periodontal tissues.

Materials and methods. This systematic review was conducted in accordance with the PRISMA guidelines. A literature search was performed in eLIBRARY.RU, PubMed, Google Scholar, and CyberLeninka for studies published between 2010 and 2024. The search strategy included the terms “crowded teeth,” “periodontal diseases,” and “periodontal disease in patients with crowded teeth,” as well as their Russian-language equivalents. Of the 875 records initially identified, nine studies were included in the final analysis after duplicate removal and multistage screening based on relevance and quality criteria.

Results. The included studies consistently indicated an association between dental crowding and poorer periodontal health. Individuals with dental crowding were more likely to have poor oral hygiene and greater plaque accumulation, which may contribute to the development of gingivitis and periodontitis. The identified factors were classified as mechanical, including limited access for oral hygiene and plaque retention; morphologic, including a higher prevalence of a thin periodontal phenotype and reduced width of attached gingiva; and functional, including occlusal trauma and premature occlusal contacts. These factors were associated with hemodynamic alterations characterized by persistent vasoconstriction, reduced vascular elasticity, and lower blood flow velocity, potentially predisposing periodontal tissues to ischemia. The available evidence also indicated that impedance plethysmography of the periodontium (rheoperiodontography) and laser Doppler flowmetry may be useful for detecting subclinical alterations in regional periodontal blood flow and microcirculation.

Conclusion. Dental crowding was associated with poorer periodontal health and may contribute to the development and progression of gingivitis and periodontitis. The periodontal changes associated with crowding appear to result from multiple mechanical, morphologic, functional, and hemodynamic factors. These findings support an interdisciplinary approach to the management of patients with dental crowding. Orthodontic correction of crowding should be considered not only a means of correcting malocclusion but also part of a preventive strategy that may improve conditions for maintaining long-term periodontal health, including regional periodontal blood flow and microcirculation. Integrated periodontal and orthodontic care may therefore be important for achieving stable long-term outcomes.

Relevance. The primary diagnosis of calcinosis and sialolithiasis remains a considerable challenge in clinical practice. Similar radiographic and clinical presentations of these conditions may lead to diagnostic errors and unnecessary surgical interventions.

Objective. To assess dentists’ awareness of calcifications in the maxillofacial region and their ability to differentiate calcinosis from sialolithiasis.

Materials and methods. A questionnaire-based survey was conducted among 53 dentists from different specialties. The specially developed questionnaire included a clinical case and multidetector computed tomography data.

Results. Only one specialist identified the correct diagnosis (1.8%). Eight of the 53 specialists (15.1%; p < 0.0001) identified a “foreign body” in the parotid gland region on the presented MDCT images. One respondent (1.8%) identified a shadow corresponding to a spherical lesion on the left side, and another respondent identified a rounded hyperdense pathological focus superiorly; both findings corresponded to the location of the calcification. Forty-five of the 53 specialists (84.9%; p < 0.0001) were aware of calcinosis, whereas 25 specialists (47.2%) had not encountered it in clinical practice. Only 8 of 28 specialists (28.6%; p < 0.0001) had independently treated patients with calcifications.

Conclusion. Dentists’ competence in the differential diagnosis of calcinosis and sialolithiasis should be improved to reduce diagnostic errors and unnecessary surgical interventions. Additional training in sialography and sialendoscopy is also needed.

Relevance. Minimizing the adverse effects of orthodontic appliances on periodontal tissues is an important objective of orthodontic treatment.

Materials and methods. The study included 73 patients aged 18–32 years with healthy periodontal tissues. All patients were divided into three groups: Group 1 included 28 patients treated for malocclusion with fixed orthodontic appliances (braces); Group 2 included 30 patients whose malocclusion was corrected using removable orthodontic appliances (aligners); and the control group included 15 patients without malocclusion who were not undergoing orthodontic treatment. Blood flow in the periodontal microvasculature was assessed using a Minimax-Doppler-K ultrasonic Doppler flowmeter (MM-D-K), NB model, with a 20-MHz probe.

Results. Group 1 showed a more pronounced decrease in periodontal blood flow parameters. Peak systolic velocity (Vas) decreased to 0.55 cm/s, whereas the vascular resistance indices PI and RI increased to 2.8 and 0.80, respectively. These changes indicate increased peripheral vascular resistance associated with the mechanical effects of fixed orthodontic appliances and altered periodontal tissue perfusion. In Group 2, hemodynamic changes were less pronounced: Vas decreased to 0.69 cm/s, and blood flow parameters showed a moderate decrease, with Qas reaching 1.17 mL/min and Qam reaching 0.77 mL/min. These changes were accompanied by only slight increases in PI to 2.1 and RI to 0.71. Comparative analysis showed that aligner treatment had a milder effect on periodontal hemodynamics than treatment with fixed orthodontic appliances, owing to the lower intensity of mechanical loading.

Conclusion. The results of this analysis help justify the choice of removable aligners for orthodontic treatment because they have a less pronounced adverse effect on periodontal tissue blood flow during treatment.

Relevance. In recent years, researchers have increasingly focused on the metabolic activity of the gut microbiota as a potential factor in the development of various diseases. The rising prevalence of autism spectrum disorder (ASD) has intensified efforts to identify additional etiological factors and develop new therapeutic approaches. Numerous studies suggest that the disturbances in amino acid metabolism and in the metabolism of gaseous signaling molecules involved in nervous system regulation observed in these patients may be partly attributable to bacterial activity.

Objective. To characterize the profiles and concentrations of amino acids and gaseous signaling molecules produced by intestinal staphylococcal and lactobacillus strains isolated from healthy children and children with ASD.

Materials and methods. Fecal samples from 12 healthy children and 12 children with ASD were analyzed using conventional bacteriological methods. Amino acid production by the bacterial isolates was assessed by high-performance liquid chromatography coupled with mass spectrometric detection, and gaseous signaling molecule production was measured by gas chromatography.

Results. Compared with strains isolated from healthy children, intestinal bacterial strains from children with ASD produced higher levels of glutamate and lower levels of leucine, isoleucine, and lysine, in line with the limited evidence reported in the literature. In addition, Staphylococcus aureus strains isolated from children with ASD produced less threonine and phenylalanine but more proline. Lactobacillus rhamnosus strains isolated from children with ASD produced greater amounts of both NO and CO than strains isolated from healthy children.

Conclusion. The gut microbiota of children with ASD differs from that of healthy children in its amino acid and gaseous signaling molecule metabolism. Further studies are needed to determine whether microbial metabolites contribute to the development of neurological disorders. These findings should be used to expand the range of diagnostic and therapeutic tools available to neurologists treating children with ASD.

Relevance. Aggressive periodontitis is increasingly encountered in clinical practice. Treatment of this condition is challenging for dental practitioners because it is characterized by progressive alveolar bone loss, while the clinical presentation does not always correspond to the radiographic findings. Cytokines are among the biomarkers that may be used to assess treatment response.

Objective. To evaluate the efficacy of a combination treatment protocol in patients with periodontitis characterized by rapid progression using immunological analysis of gingival crevicular fluid.

Materials and methods. The study included 64 young adults diagnosed with periodontitis (ICD-10 code K05.39), who underwent comprehensive clinical examination and were divided into two treatment groups. Group 1 comprised 31 patients treated according to the conventional protocol. Group 2 comprised 33 patients whose treatment regimen included topical applications of a bischofite-containing gel and injections of Cortexil into the marginal and attached gingiva.

Results. Both treatment approaches were effective, although the course of healing differed between the groups. By day 3, patients in Group 2 demonstrated statistically significant improvements in immunological parameters relative to both baseline and Group 1. On day 7, the IL-1β/IL-4 ratio was 3.4 ± 0.1 in Group 1 and 3.1 ± 0.1 in Group 2, indicating a predominance of regenerative processes over inflammatory activity and a reduced risk of a protracted disease course.

Conclusion. The combined use of Cortexil injections and topical applications of a bischofite-based gel was the most effective treatment approach in patients with aggressive periodontitis. The two agents had complementary and synergistic effects. However, serial monitoring and long-term follow-up at 1–2 years after treatment initiation are warranted to assess treatment efficacy.

Relevance. Plaque-induced gingivitis in young adults is often asymptomatic and is accompanied by early clinical, microcirculatory, and metabolic changes in periodontal tissues. Therefore, noninvasive optical and laser diagnostic methods that enable objective assessment of microcirculation and tissue metabolism are particularly relevant. Objective. To evaluate the diagnostic utility of optical and laser methods for assessing the microcirculatory and metabolic status of periodontal tissues in patients with plaque-induced gingivitis.

Materials and methods. The study included 24 participants with no clinical signs of periodontal disease and 17 patients with plaque-induced gingivitis, all aged 20–25 years. Oral hygiene and gingival inflammation were assessed using the Simplified Oral Hygiene Index (OHI-S), Approximal Plaque Index (API), and papillary–marginal–attached (PMA) index. Microcirculatory parameters were evaluated by laser Doppler flowmetry, the capillary bed was assessed by in vivo computer-assisted biomicroscopy, and tissue metabolism parameters and the porphyrin index were evaluated by fluorescence spectroscopy.

Results. In patients with plaque-induced gingivitis, the OHI-S score was 2.26 ± 0.10 versus 0.81 ± 0.10 in the control group (p = 0.001), the API was 49.9 ± 2.0% versus 30.1 ± 2.9% (p = 0.01), and the PMA index was 41.4 ± 2.2% versus 22.2 ± 1.4% (p = 0.001). Laser Doppler flowmetry showed reduced perfusion in both the marginal gingiva (14.94 ± 2.60 vs 23.04 ± 0.89 perfusion units; p = 0.007) and the interdental papilla (13.52 ± 2.10 vs 17.39 ± 0.40 perfusion units; p = 0.001). In vivo computer-assisted biomicroscopy revealed increases of 52% and 43% in the diameters of the arterial and venous capillary segments, respectively (p = 0.001). NADH fluorescence intensity was 84% higher in the marginal gingiva (p = 0.007) and 81% higher in the interdental papilla (p = 0.006). The porphyrin index increased by 67–68% (p = 0.001).

Conclusion. The combined use of laser Doppler flowmetry, in vivo computer-assisted biomicroscopy, and fluorescence spectroscopy can detect early morphological and functional changes in periodontal tissues in patients with plaque-induced gingivitis.

Relevance. This review examines how the medical assessment of temporary incapacity for work is organized in routine healthcare practice amid ongoing healthcare digitalization, with a focus on dental diseases.

Materials and methods. A literature search was conducted in PubMed, eLibrary, and the Cochrane Library. Relevant regulatory documents governing the assessment of temporary incapacity for work were also analyzed. The review included 64 sources.

Results. With the development of digital technologies and the introduction of electronic document management systems, the procedure for issuing sick leave certificates has been revised to improve the assessment of temporary incapacity for work. The article provides a detailed review of laws and regulations governing this assessment, including its application to dental diseases. Three main diagnostic categories of dental diseases were identified: odontogenic inflammatory conditions, maxillofacial injuries, and tooth loss resulting from trauma or extraction.

Conclusion. The assessment of temporary incapacity for work is an important governmental function within the healthcare system and requires clear organization at all levels. Current legislation sets out the rules governing this service. The regulatory framework for assessing temporary incapacity for work is continually updated in response to changing socioeconomic conditions and public needs. New regulations are being adopted to improve the service within the evolving regulatory framework for healthcare digitalization.

Relevance. Periodontal diseases, particularly gingivitis and periodontitis, remain a major challenge in modern dentistry because of their high prevalence, early clinical presentation, and established associations with several serious systemic diseases. In periodontitis, progressive breakdown of the gingival sulcus epithelial barrier allows periodontal pathogens to invade deeper periodontal tissues, triggering a cascade of destructive inflammatory responses.

Objective. To study and compare the clinical and proteomic characteristics of gingival crevicular fluid in periodontal health, gingivitis, and periodontitis and to identify key biomarkers associated with the risk of progression from reversible inflammation to irreversible tissue destruction.

Materials and methods. This non-blinded prospective comparative cohort study included 90 participants aged 21–65 years and was conducted from January 2024 to August 2025. Three groups were studied: periodontal health (n = 20), gingivitis (n = 20), and Stage III–IV periodontitis (n = 50). Periodontal indices and parameters were assessed, including the Gingival Index (GI), Plaque Index (PI), Papillary Bleeding Index (PBI), clinical attachment loss (CAL), and the Fuchs index. Gingival crevicular fluid (GCF) was analyzed by LC-MS/MS with label-free protein quantification (LFQ, MaxQuant). Statistical analysis included the Kruskal–Wallis test and Dunn’s post hoc test with Holm correction (p < 0.05).

Results. Progression from gingivitis to periodontitis was associated with a shift in the dominant pathogenic mechanisms: activation of innate immune factors gave way to uncontrolled tissue destruction mediated by the complement system, particularly complement factor B (CFB), and matrix metalloproteinase 9 (MMP-9). The identified panel of proteins — CFB, MMP-9, HBB, and CST4 — has considerable potential as an objective laboratory tool for differential diagnosis and risk assessment in periodontal disease progression.

Conclusion. Epithelial–mesenchymal transition (EMT) plays a key role in the pathogenesis of periodontitis and in periodontal tissue remodeling. During this process, epithelial cells lose polarity and intercellular contacts and acquire mesenchymal properties, thereby promoting cell migration and destruction of periodontal supporting tissues. Understanding the role of the epithelial barrier and EMT mechanisms is critical for distinguishing reversible inflammatory conditions from irreversible destructive disease states.

Relevance. Acromegaly is a systemic disease that commonly involves the musculoskeletal system; however, temporomandibular joint changes in these patients remain insufficiently studied. Excess growth hormone secretion and elevated insulin-like growth factor 1 levels contribute to degenerative, inflammatory, and functional changes in the TMJ, which may lead to pain, impaired masticatory function, and reduced quality of life.

Materials and methods. Twenty patients with acromegaly, comprising 10 women and 10 men, were evaluated at the I. I. Dedov National Medical Research Center for Endocrinology, Ministry of Health of the Russian Federation, and the Russian University of Medicine. Clinical evaluation included symptom assessment, medical history taking, and physical examination. All patients underwent maxillofacial cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of both temporomandibular joints. The imaging studies were assessed for changes in the morphology of the mandibular condyles and fossae, osteophytes, erosions, joint space narrowing, articular disc position, signs of synovitis, and masticatory muscle tone.

Results. TMJ osteoarthritis was present in 13 patients (65%): Stage I in 5 patients (25%), Stage II in 7 (35%), and Stage III in 1 (5%). Anterior articular disc displacement was detected in 11 patients (55%), medial displacement in 9 (45%), and lateral displacement in 5 (25%). Synovitis was detected in 13 patients (65%), while condylar osteophytes and erosions and joint space narrowing were each found in 12 (60%). Masticatory muscle hypertonicity was present in 7 patients (35%). Fourteen patients (70%) reported symptoms, most commonly pain at rest and/or during mouth opening (9 patients, 45%), clicking during mouth opening (8, 40%), TMJ discomfort (5, 25%), and restricted mouth opening (1, 5%).

Conclusion. TMJ involvement in patients with acromegaly is characterized by a high prevalence of osteoarthritis, synovitis, osseous remodeling of the mandibular condyle, and articular disc displacement. The complementary use of CBCT and MRI provides a comprehensive assessment of osseous and soft-tissue TMJ abnormalities, facilitating their early detection and informing treatment planning.

Relevance. Although major advances have been made in the reconstruction of extensive jaw defects and deformities and in subsequent rehabilitation, these injuries remain a major clinical challenge amid ongoing armed conflicts.

Case presentation. Drawing on the published literature, we reviewed Russian and international approaches to the management of combat-related maxillofacial injuries. This case report describes the full course of treatment of a patient who sustained a mine-blast injury, from initial trauma to complete functional and aesthetic rehabilitation.

Conclusion. This case underscores the importance of a staged treatment strategy, timely surgical intervention, and subsequent prosthetic rehabilitation.

Relevance. This article reviews published data on the duration of temporary work incapacity associated with different groups of dental diseases.

Materials and methods. A literature search was conducted in PubMed, eLibrary, and the Cochrane Library. Relevant regulatory documents governing temporary work incapacity assessment were also analyzed. The review included 30 sources.

Results. In some cases, patients with dental and maxillofacial conditions receive treatment and rehabilitation in different healthcare facilities. Digital environments facilitate interaction between healthcare organizations, support timely identification and documentation of emerging clinical and organizational issues, and may provide a more comprehensive understanding of the disease course. The main factors affecting the duration of temporary work incapacity due to dental diseases include the patient’s general health status, age, diagnosis, disease severity, quality of outpatient or inpatient treatment, preventive measures provided by the dentist, and the patient’s working conditions.

Conclusion. Temporary work incapacity assessment is one of the key functions of dental practice. An important step toward improving its efficiency would be the development of automated decision-support systems for assessing temporary work incapacity, with a specific focus on dental diseases. Such systems would allow the duration of sick leave episodes to be predicted and statistical analyses to be performed. Further research in this area is warranted.