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Introdução: Devido à crescente demanda estética, a odontologia restauradora se renova na intenção de alcançar melhores resultados na harmonia do sorriso. Entretanto, a atenção deve voltar-se também aos tecidos periodontais, visto que há uma integração entre material restaurador e os tecidos. Objetivo: Descrever e discutir as etapas clínicas para a confecção de laminados cerâmicos, atentando-se a preparos minimamente invasivos, contorno cervical e fatores que podem intervir na longevidade do procedimento. Relato de caso: Paciente do sexo masculino, 28 anos de idade, compareceu a Associação Brasileira de Odontologia – ABO, seção de Alagoas, relatando insatisfação em relação ao tamanho dos seus dentes. Os arcos superior e inferior foram moldados para a obtenção dos modelos de estudo e enceramento diagnóstico. Ao início do tratamento foi orientado ao paciente clareamento dental pela técnica combinada. O preparo dos dentes foi guiado por uma matriz de silicone, sendo estes uniformes e conservadores, seguido de moldagem, fase laboratorial e cimentação final. Finalizado o caso foi realizado o ajuste oclusal solicitando ao paciente que realizasse movimentos de lateralidade e protrusão. Conclusões: A técnica do preparo influência na longevidade dos laminados cerâmicos, por relacioanar-se à adesão e a saúde periodontal. O preparo deve ser mínino e limitado ao esmalte dental sempre que possível, determinando assim um maior e melhor prognóstico.

BACKGROUND Periodontitis is an inflammatory disease of periodontium. The inflamed and ulcerated epithelium allows the entry of oral microorganisms, bacterial endotoxins, proinflammatory immune mediators, like Interleukin -1 (IL-1), Interleukin-6 (IL-6), tumour necrosis factor (TNF-α) and prostaglandin E2 (PGE2) into the systemic circulation, which may produce systemic effects. The present study was conducted to evaluate the effect of periodontal inflammation on haematological and liver function parameters. METHODS The clinical study was conducted among 30 patients with periodontal inflammation. Clinical parameters [plaque index (PI), gingival index (GI), probing pocket depth (PPD)], haematological [RBC count, haemoglobin (Hb) concentration, total leukocyte count and differential leukocyte count] and liver function parameters [alanine aminotransferase (ALT), aspartate aminotransferase (AST) & alkaline phosphatase (ALP)] were recorded at baseline and after 1 month of scaling and root planning (SRP). RESULTS There was significant improvement in clinical parameters (P-value < 0.001), haematological parameters (P-value < 0.001), except eosinophils (P = 0.303) and basophils (P = 0.860). Changes in liver function test (LFT) parameters were found to be significant (P < 0.05) after SRP. CONCLUSIONS There is an association between periodontal inflammation and systemic parameters. KEY WORDS Periodontal Inflammation, Haematological, LFT.

Introduction: The treatment of periodontal disease is considered complex, including, in the first phase, a non-surgical therapy, and then, eventually, a surgical therapy. The modified Widman flap presents itself as a technique that allows a decrease in the probing depth of the pockets with maximum preservation of the periodontal tissue, indicating when aesthetics is an important factor. Descrition of the case report: A 53-year-old female patient was diagnosed with periodontitis stage IV grade B. Non-surgical periodontal treatment was started, using root planing. In the revaluation consultation, it was found that the depth of probing of the pockets did not reach normality. Treatment was continued using the Widman flap periodontal surgical technique modified in the anterior sextant. Conclusions: The modified Widman flap surgical technique proved to be a treatment option, achieving stability and periodontal health.

Purpose/Aim of the study: The ultimate goal of periodontal treatment is to regenerate the lost periodontal tissues. The interest in nanomaterials in dentistry is growing rapidly and has focused on ...

Objective. To study the indicators of the dental status in professional athletes. Materials and methods. The object of the study was 200 professional female athletes representing various kinds of sport and 200 practically healthy female individuals who are not involved in sports. The total sports experience of the subjects was on average 1315 years. The prevalence of periodontal diseases among female athletes was determined using the CPITN index. The prevalence and intensity of caries was determined by the CPI index. The hygienic state of the oral cavity was determined using the oral hygiene efficiency index (PHP). In the main group, patients were administered applications of a drug based on propolis and vegetable oil for two weeks; in the comparison group, the traditional antiseptic, chlorhexidine bigluconate, was used for the same period. Results. In the control group, the prevalence of chronic generalized gingivitis was on average two times less than in the main group, in which the value of this indicator varied within 50 %. Among all the studied diseases of the oral cavity in athletes in general, the most essential and significant differences were observed in relation to the prevalence of dental caries and its complications, which were more common in the group of athletes than in the control group 95.0 1.54 %, versus 89.5 2.17 %, respectively (p 0.001). The need for treatment of moderate and severe inflammatory periodontal diseases in the main group was approximately 1.5 times higher than in the control group (77.0 2.98 vs. 42.5 3.50 %, p 0.001), and for gingivitis almost 2 times higher than in the control group (61.5 3.44 vs. 39.0 3.45 %, p 0.001). The results of the study showed that among the oral diseases in sportswomen, the most essential and significant differences were observed in the prevalence of dental caries and its complications. The intensity of periodontal tissue damage over the entire period of sports career in athletes of the older age group corresponded to moderate and severe periodontitis. The high percentage of cases of major dental diseases detected among female athletes indicates their high need for periodontal care. Conclusions. Regular use of a biologically neutral propolis-based preparation for preventive purposes leads to a relatively more pronounced improvement in laboratory and clinical indicators of the oral cavity status.

Aim: To evaluate the periodontal status before and after orthodontic treatment and to analyze the confounding factors associated with it. Materials and Methods: The present retrospective study analyzed pre- and posttreatment records of a total of 60 patients. Intraoral digital photographs before and after the orthodontic treatment were used to measure the following three periodontal variables: (a) width of the keratinized gingiva, (b) gingival recession, and (c) the status of interdental papilla. The ImageJ 46 software imaging program was used to perform the required measurements. The clinical data were then analyzed in an association with the participants’ demographic data, the type of orthodontic tooth movement, and other confounding factors. The data obtained were manually entered into the statistical package and analyzed using a significance level set at P < .05. Descriptive statistics, paired t-tests, and Pearson’s correlation analysis were used to identify differences among the studied variables. Results: Among the 60 patients, the majority (66.7%) were females. Most cases of the treated malocclusion were Class II, and most patients underwent intrusion and retrusion movements. The width of keratinized gingiva increased for most sites of upper teeth. In contrast, the lower teeth showed a mix of improvement and compromised width of keratinized gingiva. As a measure of gingival recession, the difference of clinical crown height revealed the tendency toward a reduced clinical crown height for most sites. Upper left lateral incisors and canines showed significant values with regard to keratinized gingival width measurements and tooth movements such as extrusion and intrusion movements. Likewise, with regard to the clinical crown height, upper right central incisors showed significant differences when correlated with the interincisal angle, lower incisors to the mandibular plane, and upper incisors to the NA line. The upper lateral incisors also showed significant correlations to certain cephalometric measurements. Conclusions: The orthodontic treatment was found to exert a significantly positive impact on the surrounding periodontium, particularly in the upper canine areas. Likewise, various types of tooth movement were found to positively affect the periodontium.

Hypophosphatasia (HPP) is an inherited skeletal disorder that features early exfoliation of primary teeth as a major dental manifestation. A 6Y4M Japanese girl diagnosed with childhood HPP came to our clinic. Deep probing depth for all teeth and severe mobility of primary incisors were observed. At 7Y1M, the mandibular central incisors received a traumatic injury, with no treatment performed and slight mobility observed thereafter. Such traumatic injuries were repeated, thus mouthguards (MGs) to protect weak periodontal tissue were applied, which helped to maintain stable conditions. Use of a MG may be helpful for HPP patients.

Objective This study aimed to investigate the levels of trefoil factor family (TFF)-1, TFF-3 and interleukin (IL)-1 beta in gingival crevicular fluid (GCF), saliva and serum of patients with gingivitis, stage 3 periodontitis and healthy individuals. Materials and Methods A total of 100 individuals consisting of 25 periodontally healthy, 25 gingivitis and 50 stage 3 periodontitis, were enrolled in the study. Clinical periodontal examinations were recorded and GCF, saliva and serum samples were obtained. TFF-1, TFF-3 and IL-1 beta were measured by ELISA. Results TFF-1 and TFF-3 levels in both GCF, saliva and serum were higher in periodontitis patients than healthy controls (p < .001) and gingivitis group (p < .01). The levels of these peptides in all biofluids were similar between gingivitis and healthy control groups (p > .05). GCF, saliva and serum IL-1 beta levels were also higher in periodontitis patients than the controls (p < .01). Periodontitis patients had elevated GCF and saliva IL-beta levels than gingivitis group (p < .001). Conclusion Elevated TFF-1 and TFF-3 levels both locally and systemically in periodontitis in parallel to increased IL-1 beta levels might suggest that these peptides are involved in host response during the periodontal tissue destruction., TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [ARDEB-118S216], TUBITAK, Grant/Award Number: ARDEB-118S216

The aim of the study was to study the dental health of university students in Samarkand and assess the impact of organizational, medical and social risk factors on it. A comprehensive examination of the dental health of students in the city of Samarkand was carried out. The research took place between Institutions of Higher Education. The total number of students is 574. The following universities participated: Samarkand Medical Institute and Samarkand State University among which there were 193 students of the 1st year, 175 students of the 2nd year, 206 students of the 3rd year, respectively. The prevalence of dental caries was revealed, which was 91.87 ± 1.30%. ... The intensity of the carious process was 5.31 ± 0.14 teeth at 8.34 ± 0.26 of the surface, signs of periodontal tissue diseases were revealed with an intensity of 3.88 ± 0.06 segment. 53.05 ± 2.37% of students had dentoalveolar anomalies and deformities

The dental gingivae are a unique part of the oral anatomy and an integral part of the periodontal tissues. Although the vast majority of abnormalities affecting the gingival tissues are due to a simple inflammatory reaction directly related to the presence of dental plaque, a range of non-plaque-related conditions also occur due to either local or systemic factors. Such factors include developmental abnormalities, the presence of malignancy and manifestations of underlying systemic conditions. Recognition and diagnosis of non-plaque-related gingival disease is essential for comprehensive dental health care. CPD/Clinical Relevance: This paper provides a review of the spectrum of non-plaque-related conditions that can affect the dental gingivae.

The extraction of impacted lower third molars (ILTM) is one of the most common procedures in oral-maxillofacial surgery. Being adjacent to lower second molars, most impacted lower third molars often lead to distal periodontal defects of adjacent second molars. Several symptoms may occur after extraction, such as periodontal pocket formation, loss of attachment, alveolar bone loss and even looseness of second molar resulting in extraction. The distal periodontal defects of second molars are affected by many factors, including periodontal conditions, age, impacted type of third molars, and intraoperative operations. At present, several studies have suggested that dentists can reduce the risk of periodontal defects of the second molar after ILTM extraction through preoperative evaluation, reasonable selection of flap design, extraction instruments and suture type, and necessary postoperative interventions. This review summarizes the research progress on the influence factors, interventions methods and some limitations of distal periodontal defects of adjacent second molar after extraction of impacted mandibular third molars, with the aim of opening up future directions for studying effects of ILTM extraction on periodontal tissue of the adjacent second molar.

There are numerous domestic and foreign studies of periodontal disease in pregnant women, but there are still a number of unresolved issues. The data about the development of periodontal tissue diseases in pregnant women in terms of age is not enough. The purpose of this work was to study the development of periodontal disease in pregnant women in different age groups. Material and methods. A survey of 83 women in the ІІ and ІІІ trimesters of pregnancy, aged 19-45 years, was divided into three groups according to age. Group I (34 people) included pregnant women aged 19-25 years, group II (29 people) had pregnant women aged 26-35 years, group III (20 people) comprised pregnant women aged 36-45 years. Periodontal and hygienic indices were determined to assess the clinical signs of periodontal disease (to assess the clinical signs of periodontal disease, periodontal and hygienic indices were determined (papillary-marginal-alveolar index, degree of bleeding gums, Schiller-Pisarev test, numerical value of Schiller-Pisarev test – Svrakov's number and simplified index of cavity hygiene). Results and discussion. The obtained results indicated a high level of periodontal disease in pregnant women. Periodontal disease was found in 74.7% of subjects. The study found a significant progression of periodontal tissue pathology in pregnant women over 26 years of age, indicating that women in this age group were at significant risk of periodontal disease. The obtained data indicated that the value of the bleeding index was the lowest in pregnant women with periodontal disease of group I, and the highest in women of group III. The value of the PMA index differed 1.3 times (p˂0.05) in pregnant women of groups I and II, 1.2 times (p˂0.05) in women of groups II and III, and 1.5 times (p˂0.05) in pregnant women of groups I and III. In addition, the likelihood of developing periodontal disease increased with age of women. Conclusion. The values of the Svrakov's number had a similar tendency to increase in age groups, as well as the results of the previously described indices. Hygiene in pregnant women of all ages who had periodontal disease was not very good. Thus, special attention should be paid to the timely diagnosis, treatment and prevention of periodontal disease in pregnant women, taking into account their age

The aim of periodontal regenerative therapy is to restore original architecture and function of lost periodontal tissues, as a result of trauma or following destructive periodontal diseases. This review includes the biological principles and efficacy and effectiveness of different biomaterials and factors affecting periodontal regeneration. Various human clinical trials showed a successful periodontal regeneration with different biomaterials. However, postoperative plaque control is one of the key factors influencing periodontal healing following regenerative periodontal therapy. A strong native regenerative potential of the periodontium can be conciliated by local and systemic factors. Keywords: Periodontal regeneration, Guided tissue regeneration, Bone graft/Bone substitutes.

Objective The aim of the research was to study the cellular composition of the gums in children of primary school age with normal body weight and overweight for further use of this data in the early diagnostics of periodontal diseases. Patients and methods Materials and methods: We examined 81 children aged from 6 to 12 years. Cytological examination of gingival cytograms was performed in all examined children. Results Results: Based on the analysis of the quantitative content of epithelial cells in children with normal body weight, their ratio was established, which is determined by the percentage of 0: 6: 94 (parabasal, intermediate, superficial). The obtained data completely coincide with the percentage of the differentiated ratio of epitheliocytes of multilayered squamous epithelium in children with normal body weight with inflammation and without it in the periodontal tissues. Our cytological examinations of gingival scrape smears in overweight children in contrast to the results of the study of epithelial scrape smears in children with normal body weight have some differences. Thus, in the process of calculation, the degree of differentiation of various epitheliocytes determines their percentage as follows - 3: 7: 90 (parabasal, intermediate, superficial) for children with gingivitis, and 2: 5: 93 (parabasal, intermediate, superficial) for children without inflammation in the periodontal tissues. Conclusion Conclusions: The obtained results allowed us to conclude that in overweight children, in contrast to children with normal body weight, the number of parabasal cells decreases, and the number of superficial and intermediate cells increases.

Aims Patients with chronic kidney disease (CKD) are also susceptible to periodontitis. The causal link between periodontitis and CKD may be mediated via systemic inflammation/oxidative stress. Using structural equation modelling (SEM), this cross‐sectional study aimed to explore the causal relationship between periodontal inflammation (PI) and renal function. Materials and methods Baseline data on 770 patients with stage 3–5 (pre‐dialysis) CKD from an ongoing cohort study were used. Detailed, bioclinical data on PI and renal function, as well as potential confounders and mediators of the relationship between the two, were collected. SEMs of increasing complexity were created to test the causal assumption that PI affects renal function and vice versa. Results Structural equation modelling confirmed the assumption that PI and renal function are causally linked, mediated by systemic oxidative stress. The magnitude of this effect was such that a 10% increase in PI resulted in a 3.0% decrease in renal function and a 10% decrease in renal function resulted in a 25% increase in PI. Conclusions Periodontal inflammation represents an occult source of oxidative stress in patients with CKD. Further clinical studies are needed to confirm whether periodontal therapy, as a non‐pharmacological approach to reducing systemic inflammatory/oxidative stress burden, can improve outcomes in CKD.

The study was carried out in 192 patients aged 18–25 years who underwent orthodontic treatment of dental-maxillary anomalies. We singled out 3 groups of patients who, after the orthodontic appliances being put on, were implemented various preventive measures against the inflammatory process. In the period before treatment, after 7 days, after 1, 3 and 12 months in the mixed saliva, the activity of lysozyme, the level of secretory immunoglobulin A and interleukins were determined. Measurements were performed with a vertical spectrophotometer Multiscan MCC 340. In all groups of patients, there was a gradual increase in the indicators of lysozyme activity, the level of secretory immunoglobulin A and interleukins; so by 3 months and by 1 year they came to their initial values. Rapid normalization of these indicators was noted in the third group of patients, where a full range of preventive measures was carried out using professional hygiene, antibacterial and immune therapy. The use of the appliances for orthodontic treatment is accompanied by the inflammatory process. The combined use of oral hygiene, antibacterial and immune therapy is most indicated in the prevention of the inflammatory process in the treatment of dental-maxillary anomalies.

Intracellular signaling complexes of the innate immune system orchestrate the development of inflammation. Porphyromonas gingivalis is a commensal bacterium that induces periodontal pyroptosis. The...

Introduction Matrix metalloproteinase-8 (MMP-8), and its active form aMMP-8, was identified as a potential biomarker of periodontal tissue destruction. It is present at different concentrations in various oral fluids. Material and methods Gingival crevicular fluid (GCF) samples were collected from periodontal pockets ≥ 6 mm of 24 untreated patients using paper points and clinical parameters were recorded. 12 subjects were diagnosed with periodontitis stage III grade B, and 12 others with periodontitis stage III grade C. After thorough preparations, samples were collected following manufacturers’ instructions and analyzed using a commercially available test system for aMMP-8 evaluation (aMMP-8 Test) and Periotron 8000 together with Quantikine kits for assessment of total MMP-8 concentration (controls). Microbiological evaluation of the same pockets was carried out using real-time polymerase chain reaction. Results Concentrations of both total MMP-8 and aMMP-8 in GCF were higher in the case of periodontitis grade C, compared to periodontitis grade B, but reached statistical significance only in the case of total MMP-8 (77.17 ng/ml and 18.73 ng/ml respectively; p = 0.0104). Positive correlations were found between total MMP-8 and aMMP-8 levels and the prevalence of Fusobacterium nucleatum, mean probing pocket depth of all pockets, % of pockets ≥ 6 mm, as well as probing pocket depth of pocket from which GCF samples were collected. Conclusions GCF concentration levels of both total MMP-8 and aMMP-8 correlated with severity of periodontal destruction, whereas total MMP-8 appeared to be a preferable method for differentiation of periodontal grading. However, the aMMP-8 Test was easier and more convenient to handle.

Purpose: This study was carried out to evaluate the effectiveness of different fluoride applications on periodontal health (clinical and microbiological) during orthodontic treatment with fixed appliance. Patients & Methods: The study groups were designed randomly into three equal groups using the same type of (fluoride-free) toothpaste. Group I used PERIOMED contains stannous fluoride mouthwash, group II used LISTERINE® contains sodium fluoride Mouthwash and the control group used distilled water. All patients were put onto the recall schedule at zero, 7th, 14 and 28 days. Samples were collected for detection of the interleukin-1 beta level, determination of reduction in microbial count and assessment of the following clinical parameters: pocket depth, plaque index, and gingival index. They were recorded at these time intervals mentioned. Following Orthodontic treatment for all patients, Interleukin- 1 beta and Colony Forming Units (CFUs) were measured. Results: interleukin-1beta level and bacterial count were high at the onset of periodontal inflammation at the same range with no significant differences between the studied groups. At the end of the study, group I and group II showed a marked decrease in the interleukin-1beta level and bacterial count compared to the control group, and there was a statistically nonsignificant difference between group I & II. Conclusion: Stannous fluoride mouthwash showed the best results in the level of IL-1β, since in the reduction of the bacterial count also includes improving in the clinical parameters (PD, PI, GI) compared with the other samples of the study.

OBJECTIVE The aim: Of the study is to analyze the literary data regarding evaluation of the pathogenetic mechanisms of the interaction of systemic diseases and periodontal tissue damage, conducted on the basis of scientific researches of Ukrainian and foreign scientists. PATIENTS AND METHODS Materials and methods: Bibliosematic and analytical methods were used in the research. The materials of the exploration are international experience in the study of pathogenetic mechanisms of the interplay of pathology in the cardiovascular, respiratory systems, diseases of the gastrointestinal tract and chronic generalized damage of periodontal tissues. CONCLUSION Conclusions: It is important to search for new modern methods of diagnosis and individual approach to primary and secondary prevention of changes in periodontal tissues on the background of general pathology. The only way to solve this problem is a detailed study of somatic and dental history, changes in all body systems, on the basis of which it is possible to create a reasonable set of individual preventive measures and improve the treatment of periodontal disorders.

Objective The aim: To study the clinical efficciency of the proposed scheme of gingivitis treatment in women with physiological course of pregnancy. Patients and methods Materials and methods: Clinical approbation of the proposed complex of therapeutic and prophylactic measures was carried out in 32 pregnant women with gingivitis, aged 18 to 35 years. The efficiency of the treatment was assessed by the dynamics of the clinical picture, the index assessment of an oral hygiene and the periodontium condition in each trimester of pregnancy. Results Results: According to the data of performed observations, the high efficiency of the proposed treatment scheme is shown: 84.4% in the main group versus 46.9% in the control group. It has been clinically proven that the proposed scheme of inflammatory periodontal diseases treatment in terms of therapeutic efficiency exceeds the generally accepted basic treatment. Conclusion Conclusions:The use of the proposed complex of therapeutic and prophylactic measures in the main group of patients contributed to the elimination of the inflammatory process in the periodontal tissues, suspended the progression of existing diseases, made it possible to prevent the emergence of new nosological forms, improved the condition of the oral hygiene, which makes it possible to recommend it for treatment of periodontal diseases in pregnant women.

Periodontitis is a progressive inflammation disease, the clinical management of which remains a challenge. The traditional management may control periodontal inflammation, but failed to regenerate functional periodontium. This review summarizes the most advancing regenerative techniques regarding stem cell culture and scaffold fabrication, such as cell sheeting, spheroid culture, electrospinning and 3D printing. The applications of different techniques manifest tremendous potential of regenerating the complete and functional periodontium. Albeit promising, new technologies have met with their own drawbacks such as insufficient vascularization and precision, which necessitate deeper modification. Thus, this review also points out the potential perspectives and methods aiming at their disadvantages, illuminating the directions of future researches to successful clinical scenarios.

The aim of periodontal regenerative therapy is to restore the original architecture and function of lost periodontal tissues as a result of trauma or following destructive periodontal diseases. This review includes the biological principles, efficacy, and effectiveness of different biomaterials and their limitation in periodontal regeneration. Various human clinical trials showed a successful periodontal regeneration with different biomaterials. The regenerative potential of biomaterials was assessed truly by human histological study. However, there were a limited number of human histological evidences to demonstrate the true regenerative potential of biomaterials; further human histological studies were required to establish strong evidences for application of biomaterials in the regeneration of periodontium.

Periodontal tissue engineering involves a multi-disciplinary approach towards the regeneration of periodontal ligament, cementum and alveolar bone surrounding teeth, whereas bone regeneration specifically applies to ridge reconstruction in preparation for future implant placement, sinus floor augmentation and regeneration of peri-implant osseous defects. Successful periodontal regeneration is based on verifiable cementogenesis on the root surface, oblique insertion of periodontal ligament fibers and formation of new and vital supporting bone. Ultimately, regenerated periodontal and peri-implant support must be able to interface with surrounding host tissues in an integrated manner, withstand biomechanical forces resulting from mastication, and restore normal function and structure. Current regenerative approaches utilized in everyday clinical practice are mainly guided tissue/bone regeneration-based. Although these approaches have shown positive outcomes for small and medium-sized defects, predictability of clinical outcomes is heavily dependent on the defect morphology and clinical case selection. In many cases, it is still challenging to achieve predictable regenerative outcomes utilizing current approaches. Periodontal tissue engineering and bone regeneration (PTEBR) aims to improve the state of patient care by promoting reconstitution of damaged and lost tissues through the use of growth factors and signaling molecules, scaffolds, cells and gene therapy. The present narrative review discusses key advancements in PTEBR including current and future trends in preclinical and clinical research, as well as the potential for clinical translatability.

Periodontal disease causes damage to the structure of periodontal tissue characterized by the presence of tooth mobility. Splint is one of the therapies to support the healing of periodontal tissue that aims to provide stability so that occlusal pressure can be evenly distributed to other teeth. The design of dentures that can act as splint is important to maintain the stability of the teeth that mobile while restoring the chewing function. Some designs of denture that can be used as periodontal splint, namely external removable permanent splint and internal fixed permanent splint.

Лечение заболеваний пародонта представляет собой одну из наиболее сложных и важных проблем современной стоматологии, актуальность которой обусловлена высокой частотой воспалительных заболеваний пародонта среди населения во всех возрастных группах - до 90% в популяции. Несмотря на прогрессивное развитие медицинской науки и практики, заболеваемость данной патологией сохраняется на высоком уровне не только в группах населения среднего и пожилого возраста, но при этом выявляется тенденция к ее распространению в молодом возрасте. Исследования, проведенные ВОЗ более, чем в 30 странах, выявили высокую распространенность заболеваний пародонта (свыше 60%) среди пациентов возрасте от 18 до 30 лет. Наиболее частой формой поражения околозубных тканей в молодом возрасте является хронический гингивит по классификации СКБ-10 К 05.1. Нерегулярность профилактики и эпизодические обращения к врачу-пародонтологу для лечения заболеваний пародонтита утяжеляют течение заболевания, которое при отсутствии лечения прогрессирует. В связи с этим, от пациента требуется неоднократное прохождение курсов лечения у врача-пародонтолога и выполнение в домашних условиях профилактических мероприятий по рекомендации врача. Однако установлено, что степень комплаентности пациентов молодого возраста к стоматологическому лечению недостаточно высокая, а кратность обращения к врачу-пародонтологу в 62% ограничивается выраженной стоматофобией. Известно, что развитие пародонтита является результатом дисбаланса между микрофлорой полости рта и иммунной защитой организма. Иммунологические изменения при хроническом катаральном гингивите связаны с нарушением взаимодействия факторов неспецифической резистентности организма, изменением клеточного и гуморального иммунитета и подавлением системы местного иммунитета. Поэтому с целью ликвидации воспаления применяют различные иммунокорректоры и антибактериальные средства (антисептики, антибиотики, фитопрепараты). Однако в последнее время появились формы пародонтита, обусловленные нетипичными инфекционными агентами (вирусами, грибами), либо резистентные к антибактериальной терапии. В результате нерационального применения антимикробных препаратов, которые негативно воздействуют на представителей облигатной микрофлоры полости рта, они еще больше снижают местные факторы антибактериальной защиты. Альтернативой антибактериальной терапии при заболеваниях пародонта являются различные методы биотерапевтического воздействия, предполагающие местное и системное применение пробиотиков, фаговых препаратов и других средств. Вместе с тем, такие исследования в отечественной стоматологии единичные, как и исследования по повышению степени соответствия между поведением пациента и рекомендациями, полученными от врача Treatment of periodontal diseases is one of the most difficult and important problems of modern dentistry, the relevance of which is due to the high frequency of inflammatory periodontal diseases among the population in all age groups - up to 90% in the population. Despite the progressive development of medical science and practice, the incidence of this pathology remains at a high level not only in middle-aged and elderly population groups, but at the same time a tendency towards its spread at a young age is revealed. Studies conducted by WHO in more than 30 countries have revealed a high prevalence of periodontal disease (over 60%) among patients aged 18 to 30 years. The most common form of damage to the periodontal tissues at a young age is chronic gingivitis according to the SKB-10 K 05.1 classification. Irregular prophylaxis and occasional visits to a periodontist for the treatment of periodontitis complicate the course of the disease, which progresses in the absence of treatment. In this regard, the patient is required to undergo repeated courses of treatment with a periodontist and to perform preventive measures at home on the recommendation of a doctor. However, it was found that the degree of compliance of young patients to dental treatment is not high enough, and the frequency of visits to a periodontist in 62% is limited by pronounced stomatophobia. It is known that the development of periodontitis is the result of an imbalance between the microflora of the oral cavity and the body's immune defenses. Immunological changes in chronic catarrhal gingivitis are associated with a violation of the interaction of factors of nonspecific resistance of the organism, changes in cellular and humoral immunity and suppression of the local immunity system. Therefore, in order to eliminate inflammation, various immunocorrectors and antibacterial agents (antiseptics, antibiotics, herbal medicines) are used. However, recently there have been forms of periodontitis caused by atypical infectious agents (viruses, fungi), or resistant to antibiotic therapy. As a result of the irrational use of antimicrobial drugs, which negatively affect the representatives of the obligate microflora of the oral cavity, they further reduce the local factors of antibacterial protection. An alternative to antibiotic therapy for periodontal diseases are various methods of biotherapeutic action, involving the local and systemic use of probiotics, phage preparations and other agents. At the same time, such studies in domestic dentistry are rare, as well as studies to improve the degree of correspondence between the patient's behavior and the recommendations received from the doctor

Visually impaired people usually have limitation to do their activities in maintaining oral health including the periodontal tissue. This condition leads to inadequate efforts to maintain oral health that can cause various diseases, one of which is periodontal disease. Periodontal disease will gradually develop become severe, and therefore it is necessary to take proper care in handling it. The aim of this study was to determine the periodontal health status and the level of periodontal disease care needs of blind students in SLB Jember Regency. This research was a descriptive observational study with a cross sectional approach. The research sample of 20 people were obtained using the total sampling method. The health status of the periodontal tissue and the need for treatment are examined using CPITN. Subsequent research data are grouped and distributed based on gender and age. The result showed that the most common periodontal tissue health status was score two with clinical features of subgingival calculus or supragingival calculus with a total of 50%, while the most needed treatment needs were improvement in oral hygiene accompanied by 85% professional scaling. Keywords: periodontal health status; periodontal treatment needs; CPITN; visually impaired

The development and course of periodontal disease in young people is characterized by sluggish clinical symptoms, and at the initial stage are asymptomatic, which greatly complicates its timely diagnosis. Therefore, it is especially important to find methods of early diagnosis and prediction of periodontal disease, which will allow for a rational comprehensive prevention. Among the causes of periodontal disease, the main role belongs to the microorganisms of dental plaque, which has important diagnostic value. The aim of the study. To investigate the composition of mixed microcultures of subgingival plaque bacteria in young people with different nosological forms of periodontal disease and to assess the degree of influence of microbial factors on the development of periodontal diseases. Materials and methods. The state of microbiocenosis in the subgingival zone in 104 people with periodontal disease and in 94 people with intact periodontal tissues were studied. To assess the severity of the influence of the types of selected microcultures of the subgingival zone on the development and progression of periodontal disease in young people, the method of alternative sequential analysis of Wald and Bayes’s formula was used. Results.With the development of the inflammatory process in periodontal tissues in most cases revealed cultures characterized by the presence of polymorphic gram-negative bacteria that developed, fixed on the solid phase, and in the liquid phase contained coccal microflora (53.01±5.48 %). During the development of generalized periodontitis, an increasing number of microcultures with a predominance of gram-negative microflora with pronounced adhesive properties was detected, which led to the development of these microcultures on the solid phase (61,9±10,6 %). The calculation of prognostic coefficients showed that the presence of microcultures that developed in the planktonic phase, but contained gram-negative rod-shaped bacteria and cocci were highly important in terms of the development of periodontal disease (+7.46). Conclusions.With the development of the pathological process in periodontal tissues, the state of the microflora changed in the direction of increasing gram-negative polymorphic microflora with pronounced adhesive properties that are capable of aggregation (up to 53.01 % in patients with catarrhal gingivitis, up to 90,48 % – with generalized periodontitis). The result of calculation of the severity of isolated types of microcultures from subgingival zone on the development and progression of periodontal disease in young people showed that the presence of microcultures that developed in the planktonic phase, but contained gram-negative rod-shaped bacteria and cocci were highly important in terms of the development of periodontal disease

The aim of this research was to study the activity of inducible NO-synthase (iNOS), arginase, the concentration of nitrites and ceruloplasmin, as well as the intensity of lipid peroxidation (LPO) processes of the oral fluid in overweight children of primary school age and the signs of gum inflammation. The study included 81 students without somatic pathologies. In the presence of signs of catarrhal gingivitis in children of primary school age, the activity of gNOS in the oral fluid increases by 2.08 times as compared to healthy subjects. The cNOS activity does not change statistically significantly, and the iNOS activity increases by 2.22 times. The activity of arginases decreases by 2.21 times. In the presence of signs of catarrhal gingivitis and overweight in children of primary school age, the activity of gNOS in the oral fluid increases by 1.68 times as compared to healthy subjects. The cNOS activity does not change statistically significantly, whereas the iNOS activity increases by 1.62 times. The activity of arginases decreases by 2.21 times. The inflammatory process in the periodontal tissues against the background of overweight also reduces the activity of arginases by 2.19 times as compared to the group of patients with overweight. The concentration of nitrites, ceruloplasmin and the intensity of lipid peroxidation in the oral fluid did not statistically significantly change in all study groups. Thus, the determination of the concentrations of nitrites, ceruloplasmin, and MDA in the oral fluid in pathological processes with a low involvement of the body’s systemic response is not informative. Determination of iNOS and arginase activity in the oral fluid of patients is an informative method for assessing the body’s reactivity. The limitation of our study is the lack of an assessment of the contribution of the resident microflora of the oral cavity of patients to the studied parameters and patterns. In children of primary school age with signs of catarrhal gingivitis, regardless of the presence of overweight, there is a change in the activity of marker enzymes of macrophages polarization in the oral fluid towards an increase in the activity of the pro-inflammatory enzyme – the inducible NO-synthase. Determining the activity of marker enzymes of macrophages polarization (inducible NO-synthase and arginase) in the oral fluid is an informative test of the patient’s reactivity

Objective: to determine the spread and structure of periodontal diseases in children with insulin-dependent diabetes mellitus (DM).Material and methods. To evaluate the state of the periodontal tissue in 170 children aged from 12 to 16 were examined including 130 of them suffering from DM, and 40 – without comorbid somatic pathology. The children were divided into the groups according to the level of glycemic control: those with optimal glycemic control (OGC) – 4 persons, with suboptimal glycemic control (SOGC) - 74 individuals, with glycemic control and high risk for life (HRFL) – 52 individuals, as well as duration of the disease: children suffering from DM less than 5 years – 74 individuals, children suffering from DM more than 5 years – 56 individuals.Results. Results of the stomatological examination are indicative of the fact that the number of children suffering from DM with intact periodontal tissue is considerably less (8,46±2,44)% in comparison with somatically healthy children (55,0±7,87)%. The signs of inflammatory process in the periodontal tissue in the form of CCG on an average were found in (83,85±3,23)% of DM children, which is practically twice as often concerning those without comorbid pathology – (45,0±7,87)%. CCG complications in DM children were found to be diagnosed in (2,32±1,32)% of cases, hypertrophic gingivitis – in (2,32±1,32)%, and periodontitis – in (3,08±1,52)% contrary to somatically healthy children who do not develop these forms of periodontal diseases.Conclusions. The obtained results indicate the need for further in-depth study of the pathogenetic mechanisms of periodontal diseases in children with diabetes to develop preventive and treatment measures.

The objective of this study was to assess clinical measurements related to the effectiveness of bisphosphonate (BP) administration as a supplement to conventional dental treatment in patients free of bone-related diseases using a network meta-analysis. Only randomized controlled trials (RCTs) were included that provided dental clinical measurements on human patients treated with BPs with or without similar untreated controls or treated with placebo. Information sources included a systematic search of 17 electronic databases up to August 2020, complemented by manual searches. Risk of bias assessment was performed with the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). Extracted measurements were pooled according to time of evaluation. The random-effects model by DerSimonian and Laird was used to calculate mean differences (MDs) and the respective 95% confidence intervals (CIs). Seven RCTs were included in the network meta-analysis, assessing 391 subjects reporting on periodontal treatment effects after 2 to 12 mo of BP administration. BP treatment was associated with significant improvement of most clinical measurements, compared with BP-naive controls. According to the network ranking, alendronate was more efficient in improvement of probing depth and clinical attachment gain when compared to zoledronate or alendronate/risedronate. Similarly, the local application of alendronate as a gel was more effective than the oral administration. A long-term analysis of the pharmaceutical effects was not possible due to insufficient data. The current review, performed according to existing guidelines, included only RCTs and, through appropriate statistical analyses, provided precise estimates for most assessed outcomes. However, no adverse effects or long-term treatment results were analyzed due to inadequate pertinent data. BP administration seems to be beneficial in the short term for the treatment of periodontal diseases, mainly through controlling periodontal inflammation.

Gingival retraction at the preparatory stage of orthopedic teeth restoration with fixed dental appliances is a common procedure in daily dental practice, the success of which will depend on the effectiveness of orthopedic treatment in general. Given certain shortcomings of well-known mechanical and mechano-chemical retraction techniques, the consequences of which may lead to unpredictable aesthetic results, the purpose of this work was to study changes in temperature of marginal gums around teeth at different stages of their orthopedic restoration by fixed metal-ceramic structures based on the thermography findings. The study included 54 patients aged 20 to 60 years, with partial or complete destruction of the coronal part, among whom there were 29 people (53.7%) who underwent gum retraction by diathermocoagulation, and 25 people (46.3%) who underwent retraction of the gingival groove with cotton threads "Ultrapak" (“Ultradent", USA). Measurements were performed prior the operation, during it, in 60 minutes after the completion of diathermocoagulation, and in 7 days after fixation of the cermet crown (14 days after retraction). The thermographic study showed that immediately after the procedure of diathermocoagulation retraction, the temperature of the marginal mucosa went up from 27.3° C (St.Err. 0.28) to 60.2° C (St.Err. 0.72) in the group 1, while in group 2 after mechanochemical retraction there was an increase in temperature from 27.3° C (St.Err. 0.30) to 28.9° C (St.Err. 0.3). 60 minutes after the end of the retraction, the average thermographic index in the group 1 was 28° C (St.Err. 0.28), while in group 2 it equalled to 28.1° C (St.Err.0.31). Control thermography on the 14th day after gum retraction showed a slight decrease to 27.1° C (St.Err. 0.29) in the group 1, and 26.72° C (St.Err. 0.29) in the group 2. The use of diathermocoagulation method of preparation (retraction) of abutment teeth in case of partial or complete destruction of their coronal part improves the quality of orthopedic treatment of patients by using metal-ceramic constructions of dentures. Analysis of thermodynamics in dental and periodontal tissues using the latest thermographic devices with subsequent computer processing of information obtained is of great prospects for further in-depth research.

Tissue engineering technology provides a new method for periodontal regeneration. Finding or preparing a suitable scaffold is the key to periodontal tissue engineering. Here, we use nano-hydroxyapatite-modified collagen biomimetic material (nHAC) as the packaging material, and carry fibroblast growth factor (bFGF) for the regeneration and repair of periodontal tissue. Due to its low cytotoxicity and high biocompatibility, nHAC shows unique advantages in the construction of periodontal tissue scaffolds. The nHAC periodontal tissue scaffold material has a dense and porous three-dimensional network structure, has a high loading rate of bFGF, and can firmly lock human periodontal ligament cells (HPDLCs), which is easy for cell growth and attachment. In vivo experiments have shown that, in artificial animal periodontal tissue models, the nHAC-loaded bFGF periodontal scaffold covered by Geistlich Bio-Gide (GBG) membrane is better than the simple GBG membrane and the blank group, the nHAC/bFGF-GBG composite membrane It is beneficial to promote the growth of new alveolar bone and cement formation, and realize the regeneration of periodontal tissue.

The fusion of orthodontic treatment and periodontal tissue-regeneration therapy has attracted attention. However, regenerated bone has a higher density than physiologic bone, which may cause problems including root resorption or stagnation of orthodontic movement. Therefore, the optimized periodontal regeneration for orthodontic movement (O-PRO) approach was developed with the aim of regenerating periodontal tissues with sparse bone quality. Unlike conventional methods, this concept is specifically suited for orthodontic movement. A new classification for the preoperative evaluation of periodontal tissues was also devised, and results are reported from cases where orthodontic treatment was implemented using each type of O-PRO method.

It is well described that the presence of microbial flora in the pulp space of the tooth, and the inability of the immune system to remove these pathogens, are the major sources of peri-apical and radicular inflam-mation.1 Eradication of these pathogens from the pulp and root canal space by means of cleaning, shaping, disinfecting and complete obturation is necessary to safeguard the health of the periodontal tissues from endodontic infection and subsequent breakdown.2,3 The basic objectives of cleaning and shaping of root canals include: (1) removal of all infected soft and hard tissues; (2) creating space for delivery of disinfectants and medicaments to the apical part of the canal; (3) facilitating three dimensional obturation and (4) preservation of radicular structures.4 Even modern endodontic file systems leave untouched areas on the root canal walls after preparation and show compaction of hard tissue debris.5 This debris consists of pulp tissue remnants, bacteria and dentine chips of which most is found in the apical part of the prepared root canal system.6 Aiming for a centred preparation that corresponds to the original canal anatomy accompanied by the lowest amount of canal transportation, especially in middle and apical parts of curved canals, will result in the most favourable post instrumented canal shape. The four optimal canal shaping objectives are: (1) to have a tapered funnel from orifice to apex, (2) maintenance of original anatomical canal pathway, (3) apical foramen position should remain constant and (4) leaving the apical opening as small as possible.2,7