Vol 28, No 1 (2024)

BACKGROUND: One of the possible ways to improve the quality of dental treatment with obliterated root canals is the use of transcanal direct current exposure.

AIM: The aim of the study was to investigate the comparative antibacterial activity of anodic dissolution of copper and silver-copper electrodes used in the endodontic treatment of teeth in the experiment.

MATERIALS AND METHODS: An experimental study was performed by implementing a technique for the automatic cultivation of microorganisms in liquid culture media. We used for the study clinical isolates of individual strains of bacteria and yeasts, namely: S. constellatus, P. intermedia, C. albicans, as well as mixed cultures: 1) S. constellatus + F. nucleatum; 2) Streptococcus sanguis + Enterococcus faecium obtained from the root canals of the teeth during treatment of chronic pulpitis.

RESULTS: The results of the study showed that anodic dissolution of both silver-copper and copper electrodes had a significant and, in general, unidirectional antibacterial effect. At the same time, it was found that, if for clinical isolate of P. intermedia the use of a silver-copper electrode was more effective, then for S. constellatus and C. Albicans strains, as well as for mixed cultures of pathogenic microorganisms S. constellatus + F. nucleatum and Streptococcus sanguis + Enterococcus faecium anodic dissolution of a copper electrode showed a more pronounced antibacterial effect.

CONCLUSION: In endodontic treatment of teeth with partially obliterated root canals, along with anodic dissolution of silver-copper electrodes, it is possible to use anodic dissolution of copper electrodes as a means capable of having a pronounced antibacterial effect.

ВACKGROUND: To extend the service life of fixed orthopedic structures of dentures, professional oral hygiene (POG) should be conducted before orthopedic treatment based on changes in the cytokine profile in the gingival fluid.

АIM: To assess the nature of changes in the cytokine profile in the gingival fluid during orthopedic treatment with the use of fixed denture structures before and after the POG.

MATERIALS AND METHODS: The patients (n=30) were divided into three groups of 10 people each: group 1, patients with intact periodontitis; group 2, patients with mild periodontitis; and group 3, patients with moderate periodontitis. The examination was conducted before the installation of fixed orthopedic structures and before and a week after POG. Six mediators of immunoregulatory processes — interleukin-6 (IL-6), interleukin 1-beta (IL-1ß), tumor necrosis factor alpha (TNF-α), chemokines (IL-8, MCP1), and vascular endothelial growth factor (VEGF) — were quantified in J samples by solid-phase enzyme immunoassay.

RESULTS: In patients with inflammatory periodontal diseases, a high IL-1ß, IL-6, IL-8, MCP1, and VEGF content was found in gingival fluid compared with the group of examined individuals without inflammatory periodontal diseases. After POG, a decrease was found in the content of the main proinflammatory cytokines/chemokines in the blood and the level of VEGF in patients with inflammatory periodontal diseases.

CONCLUSION: A decrease in proinflammatory cytokines, chemokines, and VEGF in gingival fluid after the POG procedure leads to the blockade of inflammatory and destructive processes in periodontal tissues and allows the introduction of personalized practice of preparing supporting teeth in the oral cavity for permanent prosthetics.

BACKGROUND: Among students of general education organizations of the Ministry of Defense of Russian Federation, respiratory diseases is the leading cause of general somatic morbidity and amount to 1543.5‰. When examining students, pathology of the upper respiratory tract is often diagnosed, such as partial or complete obstruction of the nasopharynx and/or oropharynx. Against this background, the formation of the oral type of breathing occurs, which affects the state of general somatic health and growth and development of the facial skeleton.

AIM: To evaluate the influence of oral breathing on the dentoalveolar and gnathic parameters of the maxillofacial region in students of educational institutions of the Ministry of Defense of Russian Federation.

MATERIALS AND METHODS: This study examined two groups of students aged 13–15 years from the St. Petersburg Cadet Military Corps named after Prince Alexander Nevsky: group 1, 30 cadets with oral breathing, and group 2 (control), 30 cadets with nasal breathing. All patients underwent an examination of the oral cavity, a photo protocol, scanning of the dentition, and cone-beam computed tomography of the skull bones and first cervical vertebrae in natural occlusion with a resolution of 17×15. The data were checked for normal distribution of features. The article presents arithmetic averages and their errors (M±m).

RESULTS: All the examined group 1 students with oral breathing were diagnosed with distal bite in combination with other dental anomalies: combined anomalies in the form of distal bite and disocclusion in the frontal region (56.7%); close position of the anterior group of teeth (93.3%); and unilateral (30.0%) and bilateral (13.3%) cross occlusion due to narrowing of the upper and lower jaws. In most cases, the group 1 students were diagnosed with a gnathic form of dentoalveolar anomaly (ANB parameter, 6.6±2.4°; Beta parameter, 24.7±3.1°) against the background of retroposition of the lower jaw (SNB parameter, 75.4±2.8°) and a decrease in the length of the lower jaw (Co–Gn parameter, 106.0±2.8 mm). All the group 2 (control) students had a neutral occlusion with a normal position of the upper jaw (SNA parameter, 81.4±2.1°) and a normal position of the lower jaw (SNB parameter, 79.8±1.6°) and the first skeletal class (ANB parameter, 2.3±1.1°; Beta parameter, 30.1±2.5°).

CONCLUSION: Oral breathing is accompanied by the development of disto-occlusion with the formation of a vertical gap in combination with cross occlusion in the lateral sections and close position of the anterior group of teeth against the background of a narrowing of the upper and lower jaws. Prompt diagnosis of upper respiratory tract pathology prevents the development of dentoalveolar and gnathic disorders of the maxillofacial area. To treat patients with oral breathing, a simultaneous approach is required with the involvement of a full-time otolaryngologist at the medical center.

BACKGROUND: Owing to the fact that, presently, at a dental appointment, it is possible to observe a wide range of consequences arising after COVID-19, among which are observed lesions of the pulp and periodontium of the tooth, additional diagnostic methods should be introduced before choosing treatment tactics. In our previous study, we analyzed the contents of root canals of teeth in patients who had COVID-19 using bacterioscopy. Coccus flora was detected in all cases and elements of Candida yeast-like fungi were recorded in 89 cases (76.1%). Based on the obtained data, it was advantageous to perform microbiological examination of the endodontium in this group of patients to further study their physical and chemical properties and correct the treatment regimen in gangrenous form of chronic pulpitis and aggravated forms of periodontitis, which determined the relevance of the present study.

AIM: To reveal the characteristics of the mycotic flora of the endodontium in patients who previously had COVID-19.

MATERIALS AND METHODS: A bacteriologic study of root canal contents in patients who had previously undergone a new coronavirus infection at different times, diagnosed as “exacerbation of chronic periodontitis”, “chronic gangrenous pulpitis”, and “acute suppurative periodontitis”, was conducted to detect fungi of the genus Candida in the tooth root canal system, which was obtained during mechanical treatment with a sterile endodontic instrument. The patients (n=49) were divided into groups according to their final diagnosis: group 1, chronic gangrenous pulpitis (27 patients); group 2, acute purulent periodontitis (9 patients); and group 3, exacerbation of chronic periodontitis (13 patients). Then, the collected material was placed in a tube with Amies transport medium and sent to the laboratory. Seeding of the material was performed in sterile Petri dishes on Sabouraud agar by rubbing with a plastic spatula. Further, Petri dishes were placed in the thermostat for 24–48 hours of incubation at 37±10 °C. Then, the study was carried out according to the generally accepted scheme: the obtained cultures were identified to species by the character of growth on dense medium.

RESULTS: The given bacteriological study of the patients’ endontic contents confirmed the data of bacterioscopy and concretized the previously obtained results. On final examination, black colonies of Candida albicans were observed in 95.92% of cases. No growth of Candida albicans colonies was observed in two cases (4.08%).

CONCLUSION: The bacteriologic study performed after bacterioscopy of diagnosis confirmed the presence of fungi of the genus Candida in the root canals of teeth in patients who previously had COVID-19. The study showed that when treating similar patients, the high risk of infection of periodontal complex tissues by Candida fungi should be considered. It is advisable to supplement the standard protocols of endodontic treatment with physical exposure, for example, laser radiation, or additional medication with antifungal drugs, such as fluconazole.

BACKGROUND: The leading role in the pathogenetic mechanism of caries development is the imbalance between the de and remineralization of hard tooth tissues. The combination of VDR alleles affects calcium-phosphate metabolism. In 65% of the human population, the structure of the VDR gene has a genetic polymorphism.

AIM: To study the effect of vitamin D and a remineralizing paste on the enamel surface structure in patients with genetic polymorphism of VDR gene receptors.

MATERIALS AND METHODS: In 18 individuals with a polymorphism index of the VDR A/A gene, a laboratory indicator of 25 (OH) vitamin D in the blood of 18.20±1.84 ng/ml, according to orthodontic indications, the retinated third molars in the lower jaw were removed. Then, the samples were lowered into three flasks of six pieces with 100 ml of artificial saliva. Containers with teeth were divided into groups: group 1, with a solution of artificial saliva only; group 2, an additional 1,000 IU of an aqueous solution of vitamin D; and group 3, tooth enamel was treated for 2 minutes with an electric toothbrush with a paste containing a remineralizing composition, immersed in artificial saliva with cholecalciferol 1,000 IU. The flasks were in the thermostat at a temperature of 37.4 C per day. In all samples, electron microscopy of the enamel contact surface at the level of the crown equator was performed using a Tescan Mira 3 LMU microscope (TESCAN, Czech Republic) with an Oxford X-MAX 5 energy dispersive X-ray detector (Oxford Instruments, United Kingdom) with analysis of local mineral composition.

RESULTS: In group 1, with electron microscopy of enamel, areas of increased mineralization alternated with areas of reduced density. The coefficient of the molar ratio Ca/P was 1.32±0.13, indicating the destruction of hydroxyapatites. In group 2 the intercrystalline pore space was filled with calcium and phosphate ions. In group 3, the enamel surface acquired a smooth homogeneous relief. An increase in the weight percentage of trace elements was observed, and the Ca/P ratio was 2.20±0.02, which indicated a phase of remineralization.

CONCLUSION: Patients with VDR gene polymorphism have a vitamin D deficiency in the blood serum. The trace element composition of the enamel surface is characterized by a phase of demineralization. Treatment with remineralizing paste and addition of cholecalciferol solution to artificial saliva changes the structure of hydroxyapatite and increases the caries-resistant properties of enamel.

BACKGROUND: Owing to the widespread prevalence of gum recession in the morbidity structure of the population, the search for optimal treatment tactics for patients with this pathology is crucial in dentistry.

AIM: To evaluate the effectiveness of treatment of patients with gum recession using the coronally displaced flap method and application of a phytoextract.

MATERIALS AND METHODS: Overall, 123 patients diagnosed with gum recession were clinically examined. During examination, all patients revealed a defect such as exposed roots in the area of the frontal group of teeth. Moreover, the size of the defect was measured, and the Miller class was determined. Then, complex treatment was performed, including conservative treatment and, if required, surgical intervention, as well as orthopedic treatment.

RESULTS: In the surgical treatment of gum recession, flap operations were performed. On postoperative day 2, to achieve the best healing and regeneration of the gums, a phytoextract was applied. Over a 3-year period after treatment of patients with gum recession, the effectiveness of treatment was monitored, and relapses of the disease were detected. The following complications were identified after treatment of patients diagnosed with gum recession: transition from class I to II to Miller, 15% of cases; class II to III according to Miller, 19.5%; temporomandibular joint diseases during recession, 16.5%; and occlusal deformation during recession, 19.8%. Stabilization in class I recession occurred in 45.0% of patients, class II in 33.4%, and class III in 8.5%.

CONCLUSION: The etiology and pathogenesis of gum recession requires long term treatment and observation and early diagnosis and an integrated approach. Therefore, new treatment methods that will be most effective and can be used in all age groups are required. One of these methods is the method developed by the authors for the treatment of gum recession using a coronally displaced flap and the application of a phytoextract, which has shown high effectiveness in the long term.

The high prevalence of chronic forms of gingivitis among young individuals is an urgent problem of modern dentistry, the solution of which requires new approaches and methods.

Thus, this study aimed to investigate the clinical and functional state of the periodontium at the initial inflammatory processes in the tissues and its correction using physical methods of treatment.

Clinical examination, index assessment, laser Doppler flowmetry, and video registration of vacuum test in a patient with chronic gingivitis revealed an increase in gingival capillary resistance and improvement of microcirculation in the periodontium at the end of vacuum therapy combined with exposure to laser radiation of red wavelength on periodontal tissues in the complex of standard treatment measures.

The results of the functional methods of research after the end of physical influence on periodontal tissues are confirmed by the decrease of bleeding and increase of oral hygiene level according to the clinical instrumental examination and by the absence of patient complaints. Thus, the clinical case demonstrates the promising application of vacuum-laser therapy in the complex treatment of chronic gingivitis.

BACKGROUND: The three-dimensional (3D) space of a virtual articulator requires precise adjustment considering individual parameters for the precision work of orthopedic dentists, orthodontists, and dental technicians. A modern solution that includes a virtual articulator is the domestic Avantis 3D software, which simplifies and speeds up functional diagnostics by creating a 3D scene of the patient.

AIM: To compare a repeatability of articulation parameters obtained when adjusting the domestic virtual articulator Avantis 3D using laboratory and intraoral scans of terminal positions of the lower jaw.

MATERIALS AND METHODS: A group of 30 volunteers aged 18–35 years participated in this study. The group consisted of 18 women and 12 men. Each participant underwent a computed tomography of the maxillofacial region, including the temporomandibular joint region in a state of habitual occlusion; one-stage A-silicone impressions were obtained, plaster models were cast, and silicone bite registers of three terminal positions were made. An intraoral scan of the upper and lower jaws was performed, and optical bite scans were obtained in the position of maximum fissure-tubercle contact and in the terminal positions of the lower jaw, fixed by previously obtained silicone registers. The same protocol was conducted for plaster models of the patient’s dentition and silicone registers of terminal positions. Using intraoral scans, optical recorders of terminal positions and computer tomograms in the Avantis 3D program and 3D scenes were created, and a virtual articulator was configured.

For each patient, the virtual articulator was adjusted in the Avantis 3D software, seven times using data from the intraoral scanner level and seven times from the laboratory level.

The reproducibility of articulatory parameters was assessed for all types of scans obtained, examining the standard and individual intercondylar distances for each patient.

RESULTS: The average values of the standard square deviation of articulatory parameters obtained when creating 3D scenes using laboratory scans at individual and standard intercondylar distances were higher than the similar values obtained using intraoral scans.

CONCLUSION: The accuracy of creating a virtual copy of a patient can be influenced by several factors: the error in combining scans, repeated scanning, the error in combining scans and computer tomograms, the error in combining jaw and bite scans, and the presence of penetrating occlusal contacts between scans of the dentition.

BACKGROUND: Providing qualified personnel to medical organizations is one of the priorities of the development of the health system. Improvement of staffing of dentists is relevant, as it enables increased availability and quality of dental care. Accessibility and quality of medical care involves the availability of the required number of medical personnel and level of their qualifications, achieved through the licensing of medical activities and certification and accreditation of medical personnel.

AIM: To analyze the staffing of dental surgeons in medical organizations subordinate to the Ministry of Health of the Krasnodar Territory.

MATERIALS AND METHODS: This study included dental surgeons of state medical organizations of the Krasnodar Territory in 2019–2021. The present study uses statistical data of reporting forms of medical organizations of Krasnodar Krai «Information about medical organization» (N 30) for the studied period. Statistical processing of the material was performed using the Microsoft Office software package applying analytical, logical, and statistical methods of research.

RESULTS: Analysis of the staffing of dental surgeons in medical organizations of the Krasnodar Territory for 2019–2021 showed an increase in established posts in general for organizations and providing medical assistance in ambulatory conditions, a decrease in established posts in the hospital and occupied posts in general by organizations, as in outpatient conditions, and in stationary.

Moreover, a decrease was noted in the number of individuals employed as primary workers in general positions in the medical organizations of the province and in outpatient and inpatient medical care and in the number of individuals employed as primary employees, having the highest category and simultaneously increasing with the first and second categories.

Further, the study found a decrease in the number of persons in the main occupations with professional certification, an increase in the number of persons with accreditation certificates, and a decrease in the number of physical persons and of employed dental surgeons in medical organizations of the Krasnodar Territory, owing to the reduction in both outpatient and inpatient conditions.

CONCLUSION: Analysis of staffing of the regional healthcare system by dental surgeons for 2019–2021 was conducted.

In Saint Petersburg, starting from 1883 and over the next 140 years, various professional dental public organizations (societies, trade unions, associations) were created and functioned, analyzing the activities of which one can find a certain similarity in the tasks they solve. Despite the specific conditions of a particular historical era, almost all of them actively performed essentially the same functions related to the organization of scientific communication of dental specialists, protection of their rights, regulation of dental practice, and development of professional education and social design in the healthcare sector.

Turning to the retrospective of the self-organization of the dental community enables establishing historical continuity between the modern association of dentists and first societies of dentists, to feel the connection of times and understand that people who devoted their lives to the dental specialty and make up this community are united today by the same values that have always united them, regardless of the change in social formations.