Russian Journal of Dentistry

BACKGROUND: Bone morphogenetic protein 2 (BMP-2) is increasingly incorporated into bone graft materials due to its positive effects on osseointegration and de novo bone formation. While its efficacy in bone regeneration is well established, concerns have been raised about adverse effects, including inflammation, ectopic bone formation, soft tissue swelling, and even oncogenesis. Understanding the basis of these effects requires investigation of BMP-2 impact on various cell types.

AIM: The study aimed to evaluate the biological effects of BMP-2–containing implant coatings on the human monocytic leukemia cell line THP-1.

METHODS: THP-1 cells were seeded in 12-well plates at 2 mL/well and a concentration of 250 × 10³ cells per well, with PMA (phorbol 12-myristate 13-acetate) added to a final concentration of 150 nM. The cells were incubated at 37 °C with 5% CO₂ for 4–6 h until fully adhered to the culture plastic. Experimental implants (one per well) were then added and incubated for 48 h. To detect apoptotic cells after 48-hour incubation with implants, they were stained with propidium iodide (Lumiprobe, Russia). For each sample, 1 × 10⁵ cells were analyzed. Immunophenotyping was performed using anti-CD45 monoclonal antibodies (130-113-681, clone 5B; Miltenyi Biotec, Germany). Samples were analyzed using a NovoCyte Advanteon flow cytometer (Agilent, USA), and data were processed with Flowing Software 2.

RESULTS: No significant differences in cytostatic effects were observed between implants with and without BMP-2 coating. However, culture medium alone differed significantly from the implant-containing groups, suggesting that the mere presence of an implant affects THP-1 cell behavior. After incubation with the test implant samples, the percentage of apoptotic THP-1 cells, detected by flow cytometry following propidium iodide staining (PI test), did not significantly change between groups, despite a slight increase in this parameter among coated samples. Notably, a significantly higher proportion of CD45⁺ cells was detected after incubation with coated implants.

CONCLUSION: The study showed that implants with and without coating do not differ in their cytostatic properties when incubated with THP-1 cells. When assessing the percentage of apoptotic THP-1 cells, no significant difference was observed between groups of implants with and without coating. However, the group of coated implants exhibited a significantly higher percentage of CD45⁺ cells.

BACKGROUND: In contemporary health care, including anesthesiology, pharmacoeconomic assessment is integral to evaluating clinical processes. Inhaled anesthetic xenon, known for its unique pharmacologic properties, is gaining popularity in pediatric outpatient dental practice. Evaluating the direct medical costs associated with its use is of particular interest.

AIM: The work aimed to assess the pharmacoeconomic effect of xenon administration in pediatric outpatient dental practice.

METHODS: An open-label, prospective, randomized study included 117 pediatric patients (45 girls, 72 boys). Statistical analysis was performed using Statistica 10.0. Data are presented as median and quartiles (Me [Q1: Q3]); the Mann–Whitney U test was used for intergroup comparisons. A significance level of p ≤ 0.05 was considered statistically significant.

RESULTS: With a mean anesthesia duration of 108 min, the average total xenon consumption per patient was 13 L (7 L/h), corresponding to a direct cost of 36,000 rubles (310 rubles per minute). During the filling the breathing circuit with anesthetic (anesthesia machine–patient), xenon consumption averaged 3 L over 2 min, incurring a cost of 8000 rubles (3000 rubles per minute). During the maintenance phase, xenon consumption averaged 10 L, with associated costs of 28,000 rubles (280 rubles per minute).

CONCLUSION: The highest xenon consumption rate — 1.5 L/min — and the peak cost — 3000 rubles per minute — were observed during the induction phase. The overall mean cost during the entire anesthesia session was nearly 10 times lower than during induction and did not exceed 310 rubles per minute. Future implementation of technologies aimed at reducing xenon loss to the atmosphere during induction may help lower the total cost of its use.

BACKGROUND: Detection of proinflammatory cytokines during dental treatment planning may serve as a prognostic indicator for the potential inflammatory response to integrated implants, particularly in the form of uncontrolled local bone resorption.

AIM: The work aimed to evaluate the relationship between the concentration of proinflammatory cytokines—interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and C-reactive protein (CRP) — and the condition of jawbone tissue in the area of installed dental implants, taking into account inflammatory processes in the peri-implant region.

METHODS: A total of 75 patients aged 27 to 72 years were examined. Based on cone-beam computed tomography findings, participants were divided into three groups according to the extent of vertical bone resorption around dental implants: group 1 (n = 29), resorption < 1/3 of implant length; group 2 (n = 32), resorption up to 1/2 of implant length; and group 3 (n = 14), resorption > 2/3 of implant length. The serum concentrations of IL-6, TNF-α, and CRP were evaluated, the implant hygiene index was analyzed, and a macrohistochemical assessment of inflammation in the transgingival portion of the abutments was performed.

RESULTS: Jawbone resorption and proinflammatory cytokine concentrations in group 1 were as follows: resorption 0.6 ± 0.1 mm, IL-6 concentration 0.34 ± 0.31 pg/mL, TNF-α concentration 0.5 ± 0.1 pg/mL, CRP concentration 2.6 ± 6.0 pg/mL; in group 2, resorption was 2.4 ± 0.8 mm, IL-6 concentration 1.3 ± 0.5 pg/mL, TNF-α concentration 1.7 ± 0.5 pg/mL, CRP concentration 3.45 ± 3.40 pg/mL; in group 3, resorption was 4.6 ± 1.6 mm, IL-6 concentration 2.3 ± 0.4 pg/mL, TNF-α concentration 2.3 ± 0.2 pg/mL, CRP concentration 3.0 ± 2.2 pg/mL. Comparative analysis of cone-beam computed tomography data and concentrations of IL-6 and TNF-α revealed significant intergroup differences (p < 0.001). Correlation analysis of IL-6 and TNF-α concentrations demonstrated a notable association with bone resorption across the entire sample (p < 0.001). Assessment of the relationship between hygiene levels in the transgingival portion of the abutment and the degree of inflammation established a moderate correlation across the entire sample (p < 0.001). The relationship between IL-6 and TNF-α cytokine concentrations and the severity of inflammation was also statistically significant.

CONCLUSION: The degree of bone resorption in the implant area has a direct correlational relationship with the concentrations of proinflammatory cytokines IL-6 and TNF-α. These findings may indicate the importance of assessing the concentrations of these proinflammatory cytokines to identify a risk group among patients with implants under load for five or more years, considering localized inflammation in the transgingival portion of abutments. Additionally, cytokine status can be monitored during implant planning, potentially serving as a predictive factor for forecasting the long-term stability of implants.

BACKGROUND: According to published research, COVID-19 is associated with various changes in the body, including the maxillofacial area. When assessing dental health, it is essential to analyze the main predictors of the severity of COVID-19-induced changes in periodontal tissues.

AIM: This work aimed to assess key dental parameters in patients with COVID-19 to determine potential complications.

METHODS: The study included 194 patients. Of these, 112 were admitted to COVID-19 hospitals, and 82 were relatively healthy (without serious comorbidities). Patients were divided into age groups: 18 years (age group 1), 20–24 years (age group 2), 35–44 years (age group 3), 45–54 years (age group 4), and 55–64 years (age group 5). The study assessed the stomatognathic system and overall health, as well as microhemodynamic parameters and oxygen saturation in periodontal tissues.

RESULTS: The study revealed typical general complaints and symptoms in patients admitted to COVID-19 hospitals. The most common symptoms were hyposalivation, hypogeusia, and hyposmia/anosmia. Gingival bleeding was reported in age groups 4 and 5 (20% and 18.5%, respectively). Less than 25% of patients with COVID-19 reported sensitive teeth. Microcirculation in patients with COVID-19 was significantly poorer than in the control group. Moreover, patients admitted to COVID-19 hospitals had reduced oxygen saturation. However, the acid-base balance in these patients remained normal.

CONCLUSION: The observed changes in dental health and microhemodynamics indicate a high risk of periodontal diseases in the future.

BACKGROUND: The COVID-19 infection, which emerged in 2019, brought numerous changes to our lives. COVID-19 — associated osteomyelitis of the jaw is directly related to the pathophysiological effects of SARS-CoV-2 on the human body. Post-COVID osteomyelitis in the maxillofacial region is a rare complication requiring prosthetic management to replace the defect.

CASE DESCRIPTION: This report describes a case of maxillary osteomyelitis in a female patient, N., following recovery from COVID-19. Clinical examination revealed complete edentulism and loss of the maxillary alveolar process spanning teeth 15 to 25.

Total atrophy of the anterior maxillary alveolar process, partial anterior tooth loss, impaired mastication and phonation, and visible sunken upper lip were noted upon objective assessment.

The patient was treated with a removable partial denture incorporating an elastic element to restore the anterior maxillary alveolar process.

CONCLUSION: Use of a removable prosthesis with elastic elements for a maxillofacial defect treatment enabled both esthetic restoration and functional improvement in masticatory efficiency, supporting successful prosthetic rehabilitation without surgery. A detailed approach to history collection and treatment is a critical component of a dentist’s work.

BACKGROUND: Peri-implantitis, frequently resulting from bacterial biofilm formation on implant surfaces, is a leading cause of dental implant failure. This underscores the relevance of developing and implementing effective decontamination methods that remove biofilm while preserving implant integrity and surrounding tissue.

CLINICAL CASE DESCRIPTION: This report presents a clinical case involving a 54-year-old patient with peri-implantitis at site 4.2. The treatment approach was tailored to the implant surface type and involved an Er,Cr:YSGG erbium laser (Biolase, USA) with a wavelength of 2780 nm. Laser irradiation of the anodized titanium dioxide (TiO₂) implant surface enabled efficient removal of granulation tissue and bacterial biofilm without damaging adjacent tissues and promoted subsequent regeneration. A large area of bone resorption was grafted with a xenogenic bone substitute and covered with a collagen membrane.

Clinical and radiographic evaluation at 6-month follow-up demonstrated stable bone levels and absence of inflammation.

CONCLUSION: This clinical case demonstrates the high efficacy of the Er,Cr:YSGG laser as part of comprehensive peri-implantitis management, providing atraumatic and effective implant surface decontamination while promoting bone regeneration.

Dynamic navigation (DN) allows for real-time monitoring of the position of instruments using a computer-aided system. DN uses video monitoring systems to display the position of instruments on a computer screen, enabling more precise and well-controlled procedures. This technology is especially valuable in complex, demanding interventions such as endodontic microsurgery, sinus floor augmentation, and orthognathic surgery.

This review aims to analyze published data on the use of DN in dentistry, with a special focus on implantology, endodontics, and maxillofacial surgery, as well as to highlight key benefits and drawbacks of this technique and provide recommendations for its integration in routine practice. The search in PubMed/MEDLINE, Google Scholar, and eLIBRARY.RU yielded 6,755 publications. Following screening, 88 publications were included in the review.

Using DN, clinicians can assess the patient’s anatomy prior to surgery, plan treatment with high accuracy, and control the procedure in real time. It is particularly important in complex surgeries such as dental implantation, where precise implant placement determines the success of treatment. Moreover, digital technologies reduce the risk of complications and the duration of post-surgical rehabilitation. Therefore, the use of DN in dentistry is a medical breakthrough. This technology improves the quality of medical care while making treatment safer and more comfortable for patients.

Further evolution and integration of digital technologies in dentistry will provide novel diagnosis and treatment options while also improving clinicians’ professional skills.