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Vol 26, No 5 (2022)

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New column in the journal — Digital Dentistry

Arutyunov S.D., Olesova V.N., Lebedenko I.Y.


The modern way of life is rapidly transforming from an analog environment into a digital one. For the most part, these transformations take place in the field of healthcare and medicine. Dentistry is the branch of medicine in which digital transformation has provided opportunities for the implementation of tasks that were previously impossible for a practicing physician. Computerization made it easier for the dentist to diagnose, plan, and treat and allowed him/her to transfer preventive measures to a new high level, thanks to smart gadgets. Dental and orthopedic treatment has reached a new engineering level, incomprehensible for the 20th century, in designing devices and prostheses, as well as facial epitheses, and analyzing the durability of such structures. The machine production of dental products in the rapidly approaching future will undoubtedly make expensive therapeutic and prophylactic devices and prostheses, as well as facial epitheses, economically affordable for the majority of the population with disability in the Russian Federation. The flow of new but, unfortunately, not always reliable scientific and educational information sometimes misleads researchers and dentists. The creation of the heading “Digital Dentistry” is aimed at sharing the experience of novice researchers, practicing dentists, and recognized specialists, as a reference in the field of digital dentistry. We hope that the information collected will be useful for the Unified Medical Information and Analytical System, constantly updated with new arrays of information available to a wide range of users. This approach will bring dental care to a new and more effective level.

Russian Journal of Dentistry. 2022;26(5):367-369
pages 367-369 views

Clinical Investigation

Clinical condition of teeth and dentition in children and adolescents with cerebral palsy

Gafforov S.A., Hamroev F.S., Kuldasheva V.B., Shamsiyeva M.O., Madaminova N.S.


BACKGROUND: Literature and statistical data reveal the increasing incidence of psychoneurological diseases (PND) and thus dental pathologies with PND in children and adolescents. Thus, the authors examined the structures and frequency of dental defects and deformities in patients with PND. Children and adolescents with PND aged 7–18 years are at high risk for the development of dental pathologies, and oxidative stress and immune system disorder present major associations with the pathogenesis of dental pathologies.

AIM: To determine the structure and frequency of dental defects and deformities in children and adolescents with PND and study the etiopathogenetic factors and mechanism of pathology formation to guide the development of preventive measures.

MATERIAL AND METHODS: The study comprehensively analyzed the data of 299 patients aged 7–18 years, of which 143 were diagnosed with PND based on the International Classification of Disease 10th Revision (main group; МG) and 156 somatically healthy patients with dental pathologies (control group; CG). The participants were divided into two subgroups: 75 patients aged 7–12 years (52.44%; МG-1) and 68 patients aged 13–18 years (47.55%; МG-2) from the main group (MG) and 65 (41.66%; CG-1) and 91 (58.33%; CG-2) patients from the CG of the respective age groups.

RESULTS: The incidence rates of caries in the temporary teeth of MG-1 and CG-1 were 97.33% and 84.61% and in the permanent teeth of MG-2 and CG-2 were 95.58 and 87.91%, respectively. In the pre-eruptive period, the rates of dental lesions were as follows: hypoplasia, 20.97%; impaired dentition, 49.65%; primary adentia, 47.55%; anomalies of the completeness of teeth, 64.33%; endemic fluorosis of teeth, 2.79% in patients with PND; and 12.17%, 12.17%, 26.92%, 11.53%, and 0.6% in children and adolescents in CG, respectively (p < 0.0001): disappearance of dental hard tissues, 9.09%; dental injuries, 24.47%; enamel necrosis, 7.7%; enamel erosion, 17.5% of patients with MG. In children and adolescents of CG, only tooth trauma was noted in 7.7% and enamel necrosis in 1.3%. In patients with PND, 49.6% had distal occlusion; 37.8%, cross occlusion; 31.6%, neutral occlusion; 29.9%, deep incisor occlusion; 25.9%, deep incisor malocclusion; 54.5%, narrowing of the lower dentition; 43.3%, crowding of teeth in the lower jaw; 26.6%, diastemas; and tremas, 23.8%.

CONCLUSION: Non-carious lesions of the teeth and a shift in the timing of the development of temporary and permanent teeth are more common in MG than in CG and lead to impaired dental anatomy and disrupt the aesthetics of smiles, speech, etc. Moreover, hypertrophic gingivitis and local periodontitis were characteristic of children with severe PND, who are at high risk for dental pathologies associated with oxidative stress and genetically related immune system disorders, especially in older children with PND.

Russian Journal of Dentistry. 2022;26(5):371-379
pages 371-379 views

Changes in the oral microbioty with losing teeth

Malyshev M.E., Kerimkhanov K.А., Iordanishvili A.K., Bumay A.О.


BACKGROUND: The influence of the presence/absence of teeth and periodontium preserved at their existence as a balance factor in the oral cavity including the local immunity of the mucous membranes is practically not reported in the literature.

AIM: The study aimed to examine the microbial community of the oral cavity at the loss of natural teeth.

MATERIAL AND METHODS: Forty-five individuals aged 61–74 years were under observation and divided into three study groups. The control group had partial loss of natural teeth. Group 2 had partial loss of teeth on both jaws and suffered from severe chronic generalized periodontitis. Group 3 had partial tooth loss on both jaws and suffered from chronic periapical inflammatory processes (chronic granulomatous periodontitis) in the absence of acute, chronic, or exacerbation of the chronic inflammatory process in periodontal tissues. In this study group, all upper and lower jaw teeth were extracted for oral sanitation before orthodontic treatment. The microbiota was assessed before surgical sanitation of the oral cavity (before tooth extraction) and 30–35 days after the last tooth extraction, i.e., at complete tooth loss on the upper and lower jaws.

RESULTS: On initial examination, the detection frequency of five red complex periodontopathogens (Prevotella intermedia, Bacteroides forsythus, Treponema denticola, Actinobacillus actinomycetemcomitans, and Porphyromonas gingivalis) ranged from 27% to 53%, which was significantly higher than that of the control group (13%–27%). In 1 month after complete tooth extraction, the detection of these microorganisms in the experimental groups (with periodontitis and periodontitis) reliably decreased (P. intermedia, 20%; B. forsythus, 20%; T. denticola, 20%; A. actinomycetemcomitans, 20%; P. gingivalis, 33%), which was not significantly different from that of the control group.

CONCLUSION: Complete extraction of teeth did not affect the presence of Staphylococcus spp. and Streptococcus spp. in the saliva of patients with periodontal diseases but led to a significant reduction in the presence of periodontopathogens and Candida sp. in the saliva of older people.

Russian Journal of Dentistry. 2022;26(5):381-387
pages 381-387 views

Long-term results of the restoration of the mobility of the mandible after fractures and prolonged immobilization

Valieva L.U., Pankratov A.S., Ivanov S.Y., Khandzratsyan A.S., Kogay V.V.


BACKGROUND: Fractures of the lower jaw accounts for up to 85% of the total number of fractures of the facial bones. Its damage leads to the formation of temporary and persistent functional disorders of the stomatognathic apparatus. Understanding the regularities of the processes of restoring the motor functions of the mandible and chewing apparatus is necessary for planning and improving rehabilitation programs in these patients.

AIM: To examine the degree and rate of restoration of the amplitude of movements of the mandible in the long-term period of the rehabilitation stage of patients with mandibular fractures.

MATERIAL AND METHODS: A prospective study was conducted on 40 patients with unilateral and bilateral mandibular fractures, who made up two groups depending on the volume of treatment according to current clinical protocols: group 1 included 22 people who underwent double-jaw splinting during treatment, and group 2 included 18 people who, according to indications, also underwent osteosynthesis of the mandible with subsequent intermaxillary immobilization in the postoperative period. One year after the removal of splinting structures, all mobile patients underwent a clinical assessment of the range of motions of the lower jaw.

RESULTS: Even 1 year after the successful treatment of patients in the acute period of trauma, despite the implementation of myogymnastics in the rehabilitation period, the range of motions of the lower jaw remains limited. In group 1, after 1 year of observations, the average values correspond to the lower limits of the norms according to literature data: opening, 4.35 cm; with protrusion, 0.78 cm; laterotrusion with unilateral fractures in the damaged side, 0.95 cm; intact, 0.91; bilateral, the damaged side 1 (right), 0.86 cm, damaged side 2 (left), 0.86 cm. In group 2, during the observation period, these indicators remained significantly lower, not reaching the limits of the norm in any case. Moreover, in both groups, their values were significantly lower than those of the healthy volunteers

CONCLUSIONS: Data obtained on the patterns of restoration of the range of motion of the lower jaw after sustaining a fracture and prolonged immobilization in the long-term justify the need to develop and conduct mandatory early comprehensive rehabilitation measures. Their clinical effectiveness should be confirmed from the standpoint of evidence-based medicine, which enables the comprehensive assessment of the function of the stomatognathic apparatus. This study established indicators that can be considered control criteria when performing relevant studies.

Russian Journal of Dentistry. 2022;26(5):389-396
pages 389-396 views

Detection and effectiveness of treatment of myofascial pain and temporomandibular joint pathologies in adult patients with orthodontic pathology

Fazylova T.A., Ilyin A.A., Olesov E.E., Radzishevsky B.M., Movsesyan V.G., Olesova V.N.


BACKGROUND: At the orthodontist’s clinic, patients with pain in the maxillofacial region and internal disorders of the temporomandibular joint (TMJ) are not uncommon. These pathological conditions are characterized by the complexity of interdisciplinary therapy and frequent recurrence.

AIM: To analyze the detectability and effectiveness of treatment of myofascial pain disorders and internal disorders of the TMJ in adult patients with dental anomalies.

MATERIAL AND METHODS: Case histories of 300 adult patients with dental anomalies who underwent examination and treatment in a multidisciplinary dental clinic were retrospectively analyzed. The study included patients who received orthodontic treatment for at least 5 years. The prevalence and structure of internal disorders of the TMJ and myofascial pain disorders were assessed, and their correlation was analyzed.

RESULTS: Orthodontic treatment was more often needed by patients with myofascial pain (71.5%), followed by those with myofascial facial pain syndrome (28.3%). In these patients, internal TMJ disorders and maxillary anomalies of class II according to Engl with unilateral distal occlusion, deep bite, and class I with crowding of teeth were more often detected. Internal TMJ disorders with concomitant myofascial pain disorders in the form of myofascial pain were observed in 82.4% of the patients. Myofascial pain disorders without internal TMJ disorders were registered in 17.4% of the patients. The overall effectiveness of the treatment of internal TMJ disorders and myofascial pain disorders was 46.4%, no lasting improvement was observed in 35.7%, deterioration was recorded in 17.8%, and relapses were noted in 60.7%. In the treatment of myofascial pain disorders without internal TMJ disorders, the overall effectiveness of treatment was 5.5%; stabilization, 50.0%; and deterioration, 44.4%.

CONCLUSION: Myofascial facial pain is very difficult to treat. The combination with internal TMJ disorders creates significant and sometimes insurmountable difficulties in the orthodontic treatment of adults. All these forces specialists to look for new approaches to optimizing orthodontic treatment of TMJ pathology and myofascial pain disorders.

Russian Journal of Dentistry. 2022;26(5):397-405
pages 397-405 views

Study of the duration of the retention period in patients with the combined pathology of occlusion of the dentition

Vodolatsky V.M., Makatov R.S.


BACKGROUND: One of the most severe categories of pediatric patients is those with concomitant dental occlusion. Owing to the increase in the quality and effectiveness of orthodontic care nowadays and the reduction in the duration of the treatment stage in pediatric patients with orthodontic problems with concomitant dental occlusion, the duration of the retention period and retention devices used should be analyzed, which is the aim of this study.

AIM: To analyze the duration of the retention period in patients with concomitant dental occlusion.

MATERIAL AND METHODS: The study enrolled 26 children aged 6–18 years with dental occlusion in the second and third planes who were taken for orthodontic treatment. The patients were divided into two groups. Group 1 included 14 children aged 6–16 years with dental occlusion in two planes (53.85%). All patients underwent orthodontic treatment using removable and non-removable orthodontic devices. Group 2 included 12 children aged 7–18 years with dental occlusion in three planes (46.15%).

RESULTS: After orthodontic treatment, the duration of the retention period was analyzed in children with concomitant dental occlusion.

CONCLUSIONS: Retention of the achieved result after correction of concomitant dental dentition is an important stage of the rehabilitation process. During the retention period, which lasted for 16–24 months in group 1 and 19–32 months in group 2, all patients had inactivated removable and non-removable retention devices, specially made for this purpose.

Russian Journal of Dentistry. 2022;26(5):407-413
pages 407-413 views


Combined use of antimicrobial medication and physical therapeutic factors in periodontitis

Kodzaeva Z.S., Daurova F.Y., Tomaeva D.I., Volkov A.G., Dikopova N.Z., Budina T.V.


Metronidazole-based preparations are widespread in periodontal practice among those with antibacterial action. However, recently, reports are increasing about the resistance of pathogenic microorganisms to metronidazole. The treatment of this problem is facilitated by the combined effect of metronidazole and physical therapeutic factors, which can ensure the delivery of the antimicrobial agent to periodontal tissues and its deposition. The efficacy of Metrogil Dent gel ultraphonophoresis with low-frequency ultrasound and Metrogil electrophoresis in the treatment of periodontitis has been proven. However, no information is available in the literature about the comparative effectiveness of ultraphonophoresis and electrophoresis of metronidazole-based preparations in the complex treatment of periodontitis, which is of scientific and practical interest.

Russian Journal of Dentistry. 2022;26(5):415-420
pages 415-420 views

Digital Dentistry

Digital educational environment: Effectiveness of adaptive testing of medical students

Meshcheryakova M.A., Gvetadze R.S., Kharakh Y.N., Karpova V.M., Timoshchenko M.V., Galstyan M.S., Arutyunov S.D.


BACKGROUND: The computer-adaptive approach in testing is becoming more widespread, and research and optimization of algorithms for its work are underway, especially in the pedagogical sphere. According to literature data, adaptive testing has several advantages over traditional linear testing of knowledge, which determined the purpose and objectives of the study.

AIM: To assess the feasibility of using an adaptive approach in digital test control of the knowledge of students majoring in Dentistry, through a comparative analysis of their psycho-emotional state, success of the test task completion, and time spent.

MATERIAL AND METHODS: In this study, we considered the simplest mechanism of the algorithm (pyramid strategy) to ensure the adaptive operation of a computer test. The study included 446 first-year students of the Moscow State Medical University named after A.I. Evdokimov, who were majoring in dentistry (average age 18.76±2.26 years), divided into two groups: control group (n=200), in which linear testing was conducted, and experimental group (n=246), in which adaptive testing was conducted. The testing process is implemented through publicly available electronic resources and platforms.

RESULTS: As the result of the study the absence of statistically significant differences in all parameters (p >0.05), except for time costs (p <0.05), was determined.

CONCLUSIONS: The results of the study emphasized the feasibility of an adaptive approach in digital test control of the knowledge of students majoring in Dentistry.

Russian Journal of Dentistry. 2022;26(5):421-429
pages 421-429 views

Memory pages

Contribution of military dentists to the development of modern salivalogy

Iordanishvili A.K.


Salivary gland diseases remain one of the most common pathologies of the masticatory apparatus, presenting challenges for the diagnosis and treatment of individuals in practical healthcare settings.

AIM: This study aimed to present the contribution of military dentists to modern salivalogy and illuminate their professional journey in maxillofacial surgery and dentistry. The main scientific publications about the life and professional activity of military dentists A.V. Klementov and V.V. Lobeiko were analyzed. Lobeiko devoted to modern salivalogy, and other related aspects of modern stomatology and maxillofacial surgery have been analyzed. We present previously unknown information from the lives of A.V. Klementov and V.V. Lobeiko, military dentists well-known in our country. Lobeiko made a considerable contribution to the study of salivary glands pathology and thus developed a new direction of stomatology and maxillofacial surgery –salivalogy. The main directions of their scientific activity in the development and improvement of methods of treatment of diseases, injuries, and tumors of the salivary glands as well as rehabilitation of patients after combined treatment of oncostomatological diseases are considered. A.V. Klementov proposed the classification of inflammation, systemic diseases, and salivary gland tumors, which is used up to now by dentists and maxillofacial surgeons in the Russian Federation and neighboring countries. He improved many diagnostic methods and conservative and surgical treatment of this pathology and suggested treatment methods for salivary gland injuries and their outcomes. For the first time, Lobeiko proposed index methods of the evaluation of the severity of inflammatory, reactive, and dystrophic diseases of the salivary glands, radiation- and drug-induced sialoadenopathies, and evaluation system of the effectiveness of the treatment of the aforementioned diseases in adults, which allowed standardization on the severity of pathologies and objectification of the positive results of complex treatment. He was one of the first who used the endoscopic technique to remove salivary glands. Military dentists were credited for the study of psychophysiological status of adults suffering from different salivary diseases and determination of age-related immunological indices of saliva in adults. Familiarity with the life history of military dentists A.V. Klementov and V.V. Lobeiko, as well as their scientific research in the field of salivalogy, is useful for dentists and maxillofacial surgeons dealing with salivary gland pathology.

Russian Journal of Dentistry. 2022;26(5):431-439
pages 431-439 views

Military doctor V.V. Fialkovsky: life path and contribution to the development of military maxillofacial surgery and dentistry

Iordanishvili A.K.


On the page of memory among domestic dentists and maxillofacial surgeons, it is impossible not to recall a prominent figure in domestic maxillofacial surgery and military dentistry, Vladimir Vasilyevich Fialkovsky. The purpose of the study was to highlight the scientific, clinical, pedagogical, and social activities of a prominent maxillofacial surgeon, candidate of medical sciences, associate professor, and colonel of the medical service V.V. Fialkovsky, as well as his services to military medicine. Based on the analysis of Russian literature and the life, professional activity, scientific works of the candidate of medical sciences, associate professor, colonel of the medical service V.V. Fialkovsky, this paper presents his role in the formation and development of military dentistry, maxillofacial surgery, and military medicine in Russia. The paper also presents the life transformation of Vladimir Vasilyevich Fialkovsky as a military doctor, researcher, and teacher which began during the battle in Lake Khasan and Khalkhin-Gol River, Soviet–Finnish (Winter) War, and the Great Patriotic War. The main directions of his scientific activity touched upon the development and improvement of methods for the treatment of gunshot wounds and inflammatory diseases of the maxillofacial region and injuries and pathology of the masticatory apparatus in radiation sickness. V.V. Fialkovsky clarified the function of the maxillary sinuses and the physiological significance of its walls and described the age and functional restructuring of the bone tissue of the upper jaw under the maxillary sinuses and its significance for direct prosthetics. Vladimir Vasilyevich studied in detail the possibility of bone grafting of gunshot defects of the lower jaw in acute radiation sickness, plasticizing soft tissue defects by free skin and mucous membrane grafting, and flaps on the feeding leg. He also described the manifestations of chronic radiation sickness in the oral cavity, their treatment, and prevention and revised some erroneous attitudes in the principles of surgical treatment of wounds in those exposed to radiation. The study also described the personal qualities of V.V. Fialkovsky, attitude of the leader of the Kirov Military Medical Academy, and the staff of the Department of Maxillofacial Surgery and Dentistry to him. V.V. Fialkovsky was one of the pioneers of Russian military dentistry.

Russian Journal of Dentistry. 2022;26(5):441-446
pages 441-446 views

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