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The purpose of the study was to assess the changes in the width and quality of keratinized tissue created in the area of vestibuloplasty on the lower jaw. Preliminary results of the study showed that autotransplantation method allows creating proper buffer zone with the desired mucosa thickness and is particularly justified in cases of "washing board" effect. However, the method is technically more demanding and is more expensive and painfull for patients. The use of alternative materials of artificial origin, such as "Mucograft" and "Tachocomb" simplifies the execution of operation, thereby reducing operational risk, but often does not lead to the formation of a fully keratinized gingiva.

Two hundreds and ninety eight patients were included in the study. Endo-perio lesions were revealed in 53 (17.78%) patients. Anonymous questionnaires were filled by 183 dentists of different specialties. Most of the dentists try to treat such lesions themselves while for successful treatment interdisciplinary approach is required. Results of anonymous questioning show that most of the dentists haven't enough information not only about endo-perio lesions but also about periodontal therapy and underestimate the value of periodontal therapy for this group of patients.

The study of gingival microvessels was carried out by means of computer capillaroscopy in patients with moderate periodontal disease and early symptoms of atherosclerosis of extracranial portions of cephalic arteries. The results proved the decreased density of the capillar network in the marginal gingiva, as well as of linear and volumetric blood flow velocities drop in the arterial and venular portions of capillaries in patients with periodontal diseases combined with early atherosclerosis.

Periodontal pockets microflora features by aggressive and chronic periodontal disease were studied by means of polymerase chain reaction (PCR) and mass spectrometry. The study included 14 patients aged 25-70 years without somatic pathology. The pilot study has shown the high prevalence rate in obligate periodontal pathogens in periodontal pockets revealed by PCR diagnostics, at the same time mass spectrometry has revealed the presence of other pathogens which had not been primarily included into PRC diagnosis. Pеriodontal disease, periodontal pathogenes, mass spectrometry, PCR diagnostics, periodontal pockets, microbiological flora.

By ultrasonicduplex scanning nature estimated haemodynamics in the arteriessubmentalis and facial of patients with early signs of atherosclerotic changes in the brakhiotsefalarteries and periodontal pathology of different stages - for perfection of prophylaxis of periodontal diseases by the means of investigation of prophylaxis vascular diseases. It was established, that influence of risk factors is more important than the age of patients.

Minimally invasive soft tissue augmentation is a challenging problem for dentists. Use of autogenous fibroblast of oral mucosa is a promising method. The paper represents the results of preclinical, clinical and laboratory studies on the use of autogenous oral mucosa fibroblasts (AOMF) for gum recession correction. The results confirm statistically significant gum thickness augmentation and gum recession decrease after three weekly AOMF injections. The effect lasted for at least 9 months.

Effectiveness of periodontal disease surgical treatment using hydroxyapatite with gingival autofibroblasts culture was assessed in the study by clinical and laboratory data.

A combination ofperiodontitis and pulp or periapical tissues inflammation in one tooth is known as endo-periodontal lesions. Such kind of lesion is serious problem of modern dentistry. It was found that pathogenic microflora of periodontal pocket and root canal of tooth with eno-perio lesion is almost the equal and consist of anaerobic microorganisms. Pathogenic effects have not only microorganisms but also their life products. Apical foramen, lateral and additional canals are physiological ways for pathogens migration. Inflammatory processes in these structures complicate each other. Lack of information among dentists about treatment possibilities of endo-perio lesions is a main reasons of extraction such kind of teeth. Simultaneous elimination of pathogens both from periodontal pocket and root canal is a key factor for effective treatment. Periodontal status is main factor for prognosis of tooth with endo-perio lesion, because of it treatment of endo-perio lesions should consist of two stages: infection elimination and regeneration of tooth-supported structures.

Gingival groove and dental plaque microbiosis was studied for 6 months in patients receiving orthodontic treatment. The patients were divided in two groups according to the type of used toothbrushes (manual or electric). After fixation of orthodontic appliances the increase of S. epidermidis by simultaneous decrease of E. faecium was observed in both groups. This shift was overcome one month later. Electric toothbrush showed better effectiveness for dental hygiene in patients with fixed orthodontic appliances.

Smoking appears to be one of the most significant risk factors in the development and progression of periodontal disease. Smoking is also a risk factor in the development of peripheral vascular diseases. Blood vessels in smokers are fewer and are subjected to stenosis. Clinically, it is well known that bleeding on probing, gingival exudates and redness and swelling in gingival sites of smokers are less than in non-smokers. According to previous studies, there is a relative increase in gingival blood flow immediately after smoking, while gingival blood flow itself is considerably decreased in healthy smokers in comparison with non-smokers. In this investigation, we used laser Doppler flowmetry to study gingival microcirculation in smokers with light, moderate and heavy periodontitis in comparison with non-smokers with the same diseases. Our results show, that smoking decreases gingival blood flow in smokers with periodontitis comparing to non-smokers with periodontitis. Immediately after smoking there is an increase in gingival microcirculation. In 30 minutes we observed a marked decrease in gingival blood flow in all groups, followed by gradual restoration of blood flow rate, registered before smoking. This restoration took 1.5-2 hrs in group with light periodontitis, 2 hrs in group with moderate periodontitis and more than 2 hrs in group with heavy periodontitis. We suppose, that constant changes in blood supply of periodontal tissue caused by smoking may contribute to higher prevalence and faster progression of inflammatory periodontal diseases in smokers.

With the help of polymerase chain reaction (PCR) the dynamic of species composition of anaerobic microflora in cases of generalized parodontitis was established. It was detected that disease severity increase was followed by the increase of the number of anaerobic microflora species in parodontal pocket; at that it was impossible to connect the presence of some determined type of microorganism with the inflammatory parodontal process intensity. It was shown that proteins fimbrilin and gingipain were not the only parodontitis pathogenic factors although the first one (fimbrilin) could be connected with aggressive disease flow. The suggested PCR scheme could be useful for early disease stage diagnostic and substantiation of antimicrobial therapy method selection.

The most difficult situation is a treatment of, so called, "open" injuries in the oral cavity. A method of treatment of the "open" wound is the transfer it to the "closed" one. Today resolved adhesive materials are used for a covering of the "open" injury. One of the newest materials is TachoComb ("Nycomed", Austria). An effectiveness of using TachoComb in cases of mucogingival operations of patients with somatic diseases was studied.

The use of semiquantitative determination of parodontopathogenic microflora of parodontal pockets (PP) by polymerase chain reaction (PCR) in cases of chronic generalized parodontitis of different severity degrees was investigated. 63 patients were examined - 6 with light parodontitis, 16 with parodontitis of middle severity and 41 with heavy parodontitis. The content of PP was studied. DNA of the main representatives of parodontopathogenic microflora was determined by PCR method.

The possibility of the fluorescence diagnostic method use for determination of presence and amount of dental plaque and evaluation of the plaque removal efficacy by different methods of individual and professional hygiene was substantiated in the article.

In order to optimize the way of the remedy "Traumeel S" administration there was studied by the luminol-depending chemiluminescent method immunostimulating effect of its different pharmaceutical forms on functional status of gingival blood granulocytes of patients with inflammatory periodontal diseases. The immunostimulating effect of Traumeel S depended upon only the inflammatory periodontal disease severity and not the ways of its introduction. But the use of the preparation in the pellet form gave some additional advantage: simplicity of use, painlessness, dosage accuracy and possibility not to attend doctor.

The study was made of Metrogil-denta (MD) with a stable 0.25% chlorhexidine concentration and metronidazole concentration 1.0% for prevention and 25% for inflammatory periodontal disease treatment. Results of their use in 76 patients are presented. MD with 1% metronidazole failed to eliminate aerobic and anaerobic microflora completely. Bactericidal effect of Metrogil-denta was seen only in 25% metronidazole concentration.

Comparative analysis of clinical efficacy of 3 antihomotoxic homeopathic preparations (Traumeel S, Engistol and Echinacea compositum S) with non-specific immunostimulating and anti-inflammatory effects was performed. The study showed that Traumeel S had maximal anti-inflammatory effect. In proportion as destructive process weighting the efficacy of homeopathic preparations was decreased. The preparations are indicated for comprehensive treatment of inflammatory periodontal diseases in patients with burdened allergic status or heavy concomitant pathology.

As it was shown in the clinical study local use of perftoran in patients with periodontal disease led to significant reduction of lipid peroxidation (LPO) and significant increase of antioxidant activity (AOA) in saliva. The most prominent effect was observed in patients with medium or severe degree of the disease. The data allowed to speak about perftorane influence upon tissue respiration processes, that was confirmed by the corresponding changes in LPO and AOA. The proved ability of perftorane to oxygen transportation increased oxygen delivery to the tissues around parodontal pockets, that improves local metabolism, normalizes breathing (respiration) cycle, has the influence upon anaerobic microflora. As the result of local perftorane use a decrease of active forms of oxygen was registered.

The experience of use Michigan splint for temporary splinting of the maxillary tooth at realization of flap surgery at 23 patients. Stages of clinical and laboratory procedures making the splint are described and analysed. Is appeared, that the reduction of mobility of teeth in the period following surgical intervention occurs on the average within 0.5-1 month faster, than with the patients after similar interventions, but without splinting. At the same time it is proved obvious, that the usage Michigan splint promotes normalization of functioning of muscles activity masticatory system and TMJ and helps in revealing of occlusal interferences.

The paper shows how volumetric reconstruction of jaw images can be used and analyzes the plots of planar characteristics of cortical plates in different forms of periodontitis. Clinical and X-ray parallels in this disease are discussed.

The results of inoculation of human fibroblast (strain M-22) and rabbit fibroblast cultures in standard bone defects were studied in 4 groups of rabbits 3 days to 3 months after inoculation of the cultures together with osteoplastic material (collapol KP-2). In the control groups the defects healed under a blood clot (group 1) or were filled with KP-2 (group 2). Histomorphological analysis of tissue showed that inoculation of M-22 cell culture into bone defects notably activated reparative osteogenesis in osseous wounds and stimulated healing, which was more rapid than in other groups. Inoculation of rabbit fibroblast culture in bone defects slightly inhibited the healing of bone wounds.

The effects of dicloran gel in combination with antibiotics on salivary lipid peroxidation were evaluated in 18 patients aged 23-68 years with chronic generalized rapidly progressing periodontitis. Lipid peroxidation and activity of antioxidant systems surpassed the normal values 2-4-fold in periodontitis patients before treatment. After therapy with metrogil-dent these parameters decreased (p < 0.05). Injection of dicloran gel before antibiotic therapy induced a decrease in these parameters within approximately 30 min. If dicloran gel was injected after metrogil-dent, the maximum decrease in oxidative processes and antioxidant system activity was observed as soon as in 15 min.

The results of the use of russian probiotics Acilact and Bifidumbacterin in complex treatment of gingivitis and different degrees of parodontitis are presented. The treatment of the patients of control group was added by the italien drug Tantum Verde. The effect of Acilact and Bifidumbacterin to the normalisation of Mycroflora higher in comparison with Tantum-Verde, particulary in the cases of gingivitis and parodontitis superficialis.

Fifty-two patients (22-68 years) with chronic generalized periodontitis of different severity and 223 with fulminant severe periodontitis were observed. The bacteriostatic and bactericidal effects of Metrogil-denta depended on the severity of periodontal involvement and metronidasole concentration in the drug. The maximum bacteriostatic effect was observed at 20-25% and the maximum bactericidal effect at 25% concentration of metronidasole in the preparation irrespective of periodontitis severity.

An attempt at objective evaluation of currently used classifications of periodontal diseases is made. The first classification of aggressive forms of periodontitis was offered in 1983. Classifications of 1982, 1992, 1999, and 2001 also reflect the clinical forms of atypical periodontitis.

Analysis of panoramic radiographs taken from 60 patients with rapidly progressive (RPP) and 40 patients with typical moderate-severe periodontitis (TP) revealed anatomical peculiarities. Measurement of tooth proportions showed high prevalence of morals with short narrow and short distant roots in patients with RPP as compared with TP. Also in patients with RPP the mesial surface of the first morals was involved more often than the distal one, furcations were involved particularly in molars with descent short roots. Investigation of anatomical peculiarities can be used to explain atypical forms of periodontal diseases.

A new cytomorphometrical method for evaluation of periodontal status by cytograms of gingival impressions is based on estimation of destruction index and inflammatory destructive index. This method will be helpful in the diagnosis of periodontal diseases, monitoring of the pathological process after treatment, and in solution of theoretical problems, e.g. investigation of the key factors in the pathogenesis of periodontal diseases. The authors analyze the relationship between the two major components of pathogenesis of periodontal inflammation-inflammatory infiltrative process and destructive changes.

In order to improve the efficiency of surgical treatment of periodontitis, the operative wound was exposed to nitrogen oxide (NO) during osteogingivoplasty and on days 3, 5, and 6 after it. Clinical and laboratory data making use of the cytomorphometrical method indicate that NO exposure decreased and maybe prevented secondary injury to the operation wound in up to 46.6% patients, which was confirmed by decrease and even normalization of destruction index and inflammatory destructive index on days 7 and 14, which was not observed in the reference group patients not exposed to NO.

Experimental and morphological studies demonstrated that Gore Resolute resorbable membrane can cause local inflammatory reactions similar to allergic. Collagen-based biomembranes coated with hydroxyapatite cause no local pathological reactions, but are rapidly resorbed in foci of degeneration under the effect of aggressive factors of tissue environment. Russian silicone membrane has been clinically tried with satisfactory results in patients with generalized periodontitis; the results prompt further studies of the membrane.

Clinical and immunological parameters were studied in 20 patients with rapidly progressing periodontitis (RPP). Changes in the immune status were as follows: the count of CD3+ cells in peripheral blood increased, the ratio of regulatory helper to suppressor populations (CD4+/CD8+) decreased, and the level of circulating immune complexes increased. A relationship between some clinical and immunological parameters was detected. The detected changes in the immune status of patients with RPP were virtually the same as those in adult patients with typical periodontitis. Further studies are needed for detecting stable criteria of immunological changes, typical of RPP.

The authors define the complex of criteria for analysis of cytograms of gingival impressions in health and periodontal diseases. Such criteria are needed for objective diagnosis and monitoring of periodontal status over the course of treatment. All the cellular elements were taken account of: different types of epithelial cells, including those with signs of cytopathology and bacterial contamination, connective tissue cells, mononuclears, leukocytes, and fibroblasts. The cytological picture correlated with the status of periodontium and forms and severity of pathological processes developing in it.

The most frequent mistakes in dental papers are analysed. The first part of mistakes is an incorrect use of modern classification of periodontal disease. The second--about of adequate periodontal and epidemiological and clinical investigations and very adequate controls--for providing the results most correct.

The paper presents fundamentals of comprehensive prophylaxis of periodontal diseases, based on the author's own epidemiological, experimental, and clinical findings; confirms the principal of individual differentiated complex of interventions as the only effective method for prevention of chronic destructive diseases in the periodontium.

The effects of a number of antibiotics were studied with the use of phase contrast microscopy. The time course of the qualitative and quantitative changes of the periodontal pouch microflora evidences that a mixture of trichopol with chlorohexidine is the most effective therapy for periodontal pouch sanitization.

Analysis of the time course of x-ray changes in the marginal sections of alveolar processes in patients with various periodontitis forms has shown a wave-like course of bone tissue destruction processes in less than 7 percent of the patients and a stable x-ray picture in 80-32.6 percent of patients, depending on the initial x-ray shifts. The authors present data on the frequency of rapid and slow negative time course of bone changes. The patients were followed up for 4-11 years or longer. The majority of the patients were young and middle-aged.