


Vol 28, No 4 (2024)
- Year: 2024
- Published: 15.09.2024
- Articles: 11
- URL: https://rjdentistry.com/1728-2802/issue/view/8381
- DOI: https://doi.org/10.17816/dent.2024.28.4
Experimental and Theoretical Investigation
In vivo biodegradation rates of domestic membranes for guided tissue regeneration
Abstract
Background: Experimental research is required to provide guidelines for the use of domestic biodegradable membranes.
Aim: To assess the swelling index and biodegradation rate of barrier membranes (non-collagen and collagen) for guided tissue regeneration in vitro, as well as their biocompatibility in vivo.
Materials and Methods: The swelling index of two types of membranes was assessed after 24 h of exposure to phosphate-buffered saline (PBS) at different pH levels (6.50 and 7.37). The spontaneous degradation rate of the two types of membranes was assessed; changes in their weight following exposure to PBS at different pH levels (6.50 and 7.37) were measured at predetermined time points. Moreover, the biocompatibility of two membrane samples following subcutaneous implantation in B/D male mice was assessed.
Results: The swelling index of non-collagen membranes was higher at neutral pH compared to acidic pH: 7.7 for pH 7.37 vs 7.2 for pH 6.50. For collagen membranes, the swelling index was pH-independent. There were no differences in membrane weight loss following exposure to PBS at pH 6.5 during 8 weeks. During the first two weeks, collagen membranes had a higher resorption rate at pH 7.37 than non-collagen membranes. Following subcutaneous implantation of both membranes, histopathological specimens collected two weeks after surgery revealed the formation of foreign body granulomas with well-defined boundaries around the implants. Macrophages, monocytes, single giant cells of foreign bodies, and Pirogov–Langhans giant cells were detected, with the number gradually increasing over time.
Conclusion: Non-collagen membranes had a larger swelling index than collagen membranes, which depended on pH. At pH 7.37, collagen membranes had a higher resorption rate during the first two weeks compared to non-collagen membranes. In vitro weight loss after 8 weeks was 20–30% for both membranes, regardless of pH. Subcutaneous implantation in mice confirmed the biocompatibility of the membranes. The biodegradation rate of non-collagen membranes was higher than that of collagen membranes.



Clinical Investigation
Gender differences in periodontal pocket microflora in patients with chronic generalized periodontitis
Abstract
Background: Periodontal disease, the primary cause of tooth loss, is a critical public health concern with a considerable impact on quality of life. It is of interest to explore gender differences in the course of inflammatory periodontal diseases, as well as the prospects of their personalized treatment and prevention in males and females.
Aim: To assess the dental health and quantitative composition of periodontal pocket microflora in periodontitis patients, taking into account gender differences.
Materials and Methods: The study included 39 patients with moderate chronic generalized periodontitis aged 40–60 years. The diagnosis was made using both primary and secondary dental diagnostic tools. The study had two groups: males (41%, n=16) and females (59%, n=23). The following parameters were assessed: oral hygiene index (OHI-S), severity of gingival inflammation (PMA), and quantitative composition of periodontal pocket microflora (DENTOSCREEN, “Lytech” Co. Ltd., Russia), taking into account gender differences.
The study findings were statistically processed using Microsoft Office Excel 2016 with Data Analysis and AtteStat 12.0.5 add-ins. The Shapiro–Wilk test was used. The data are presented as median and interquartile range: Me [Q1; Q3]. The frequency of microorganisms is presented as percentage of the mean and standard error of the mean. The confidence interval was calculated using the Wald method, according to the formula for proportions and frequencies. For small values, the Wald method with Agresti–Coull correction was used. Samples were compared using the following tests: the Mann–Whitney U test was used for quantitative data and Fisher’s angular transformation (φ*emp) for frequency (nominal) attributes. Significant differences were defined as a probability >95% (p <0.05).
Results: The quantitative composition of periodontal pocket microflora in patients with moderate periodontitis revealed significant gender differences, as demonstrated by an increase in the count of Fusobacterium nucleatum and Prevotella intermedia, as well as the frequency of Porphyromonas gingivalis, in males compared to females (φ*emp=1.736; p <0.05). Dental health indices confirmed the hypothesis of significant differences between males and females in terms of plaque index (OHI-S) and РМА. In males, poor oral hygiene was reported in 93.7% cases, which was significantly higher (φ*emp=2.04; p <0.05) than in females (69.6%). Moderate gingival inflammation was more prevalent in males, while mild gingival inflammation was more prevalent in females (p <0.05).
Conclusion: The study findings emphasize the importance of oral hygiene in the prevention of chronic periodontitis and can be used to improve complex treatment algorithms for patients with periodontal diseases. This includes more frequent dental check-ups and professional oral care sessions, as well as oral hygiene training and monitoring, in males compared to females. Diagnosis by polymerase chain reaction allows for the identification and quantitative determination of DNA from periodontopathogenic bacteria at low concentrations, as well as the justification of treatment algorithms and prediction of treatment outcomes.



Hemodynamic periodontal changes in the treatment of chronic generalized periodontitis using polarized polychromatic light
Abstract
Background: Ineffective treatment of inflammatory periodontal diseases is a significant medical and social issue. Previous research have shown that improved vascular response and local immunity activation are crucial for the treatment of periodontal diseases. This can be accomplished using polarized polychromatic light. However, the effect of polarized polychromatic light on microhemocirculation in periodontal tissues is poorly understood.
Aim: To assess microhemodynamic changes in periodontal tissues in the treatment of mild chronic generalized periodontitis using polarized polychromatic light.
Materials and Methods: A complex dental examination and treatment were performed in 70 patients (32 males and 38 females) with active chronic generalized periodontitis aged 20 to 59 years. The study had two groups (35 subjects each) based on treatment approaches. Group 1 received professional oral care and a course of antimicrobial therapy using Dentamet dental gel. Group 2 received antimicrobial therapy in combination with polarized polychromatic light therapy (wavelength 480–3,400 nm, power 40 mW/cm2, flux density 2.4 J/cm2 per minute, polarization 95%). Laser Doppler flowmetry was used to assess hemodynamics before treatment, as well as 3, 6, and 12 months after treatment.
Results: Group 1 demonstrated an improvement in microcirculation parameters for up to 3 months (p=0.0027). In group 2, an improvement was observed for up to one year (p=0.0455).
Conclusion: Polarized polychromatic light therapy in mild chronic generalized periodontitis improves microhemocirculation in periodontal tissues, increasing the efficacy of drug therapy.



Assessment of dental caries severity in patients with VDR and СА12 polymorphisms
Abstract
Background: There has been insufficient research into the genetic predisposition to dental caries. Research on the effect of gene polymorphisms on the incidence of dental diseases and the use of these findings in personalized prevention strategies are of high prognostic value.
Aim: To assess the effect of VDR and СА12 polymorphisms on hard tooth tissues in young patients.
Materials and Methods: The study examined 100 individuals, of which 59 (25 males and 34 females aged 23 to 25 years) were divided into groups based on the homozygous polymorphism: group 1 — VDR (n=19); group 2 — СА12 (n=32); and group 3 — combined VDR and CA12 (n=8). The DMF index was calculated in each group by fibreoptic transillumination method. Moreover, the pH of mixed saliva and serum 25(OH)D level (ng/mL) were measured.
Results: In group 1, the DMF index was 15.11±0.15, with 25(ОН)D deficiency (17.4±0.7 ng/mL). In group 2, the DMF index was 16.99±1.43, with changes in the pH of saliva (6.80±0.01). In group 3, the DMF index was 17.92±1.37, with рН 6.30±0.11 and 25(ОН)D level of 13.7±0.4 ng/mL.
Conclusion: Patients with VDR and СА12 polymorphisms had severe dental caries, acidic pH, and a deficiency of serum vitamin В metabolite.



Factor analysis for assessing the etiopathogenesis of facial boils in military personnel
Abstract
Background: Boils are the most prevalent non-odontogenic inflammatory condition of the head and neck. The treatment of skin and subcutaneous tissue inflammations in the Russian Armed Forces (RAF) is a pressing issue. We were unable to find any data on the etiopathogenesis of facial boils in otherwise healthy RAF members, as well as the factors that contribute to the development of this condition.
Aim: To examine the causes of facial boils in military personnel, the factors that contribute to their development, and the association between them using factor analysis.
Materials and Methods: Between 2019 and 2021, 53 patients aged 18 to 25 years were examined and treated for abscess-forming face boils. Of these, 38 (72%) were conscripts and 15 (28%) were contract servicemen. At admission, clinical examinations (complaints, history taking, status localis, facial skin type and status) and laboratory tests (complete blood count, blood chemistry, immunoassay, and bacterial tests, including the composition and antibiotic sensitivity of microflora) were performed. The control group included 30 otherwise healthy individuals aged 18 to 25 years. A mathematical model for predicting maxillofacial boil development in military personnel was generated using binomial regression analysis (logistic regression). The following variables were considered: age, length of service, season of disease development, serum glucose level, lymphocyte count, white blood cell count, CD3+, CD4+, CD8+, IgA, IgG, IgM, immunosuppressive regulatory T cells (CD4+CD25brightCD45+; % of all T helper cells), skin type, and microbial composition of maxillofacial skin.
Results: The mathematical model revealed that oily skin in combination with specific blood lymphocyte (20.30±1.03%) and IgG parameters (10.15±0.70%) increases the risk of maxillofacial boils in military personnel.
Conclusion: The study revealed the cumulative effect of general and local factors on the development and progression of facial boils in military personnel, allowing for more accurate prevention and treatment strategies.



Indices for complete dentures after cleaning at home
Abstract
Background: According to experts, there are more than 350 million fully edentulous patients globally, accounting for 7% of the world population. Edentulous patients require dentures to maintain a good quality of life. Complete dentures need to be cleaned on a regular basis to prevent their microbial contamination and inflammatory complications.
Aim: To assess the efficacy of Anolit ANK Super solution for cleaning complete dentures at home.
Materials and Methods: The hygiene of complete dentures was assessed using the Ulitovsky–Leontiev index. The efficacy of cleaning complete dentures with Anolit ANK Super solution compared to 0.05% chlorhexidine bigluconate solution was assessed.
Moreover, statistical analysis methods were used: normality test; threshold value, or baseline significance level p=0.05; intragroup comparison (6 comparisons) with the Bonferroni correction (critical p=0.0083).
Results: When assessing the hygiene of dentures using the Ulitovsky–Leontiev index, the denture cleanliness index (DCI) changed from 4.65 points (poor denture hygiene) to 3.50 points (satisfactory denture hygiene) after one month of using Anolit ANK Super solution. After three months of using Anolit ANK Super solution, the DCI changed from 3.50 points (satisfactory denture hygiene) to 2.60 points (good denture hygiene). After six months of using Anolit ANK Super solution, the DCI changed from 2.60 points (good denture hygiene) to 1.55 points (very good denture hygiene).
After one month of using 0.05% chlorhexidine bigluconate solution, the DCI changed from 4.85 points (poor denture hygiene) to 4.40 points (poor denture hygiene) (p=0.0083). After three months of using 0.05% chlorhexidine bigluconate solution, the DCI changed from 4.40 points (poor denture hygiene) to 3.50 points (satisfactory denture hygiene) (p=0.0083). After six months of using 0.05% chlorhexidine bigluconate solution, the DCI changed from 3.50 points (satisfactory denture hygiene) to 2.60 points (good denture hygiene) (p=0.0083).
Conclusion: The follow-up revealed that, with similar duration of exposure to test solutions, Anolit ANK Super solution for cleaning dentures at home used for 6 months decreased the DCI threefold from baseline (p=0.000002) and improved denture hygiene from poor to good.



Case reports
Retrospective analysis and clinical features of periapical tissue regeneration
Abstract
Background: Chronic periodontitis is associated with changes in periapical tissues. Untimely diagnosis and lack of appropriate mechanical treatment increase the incidence of chronic periodontitis. Periodontitis that causes destructive changes due to long-term inflammation of periapical tissues is of particular concern. Thus, the treatment of destructive periodontal diseases is a pressing issue in modern dentistry.
Aim: To assess periapical tissue regeneration following treatment in chronic periodontitis patients.
Materials and Methods: A retrospective analysis of the destruction and regeneration of periapical tissues before and after treatment during 3–6 months was performed in 20 patients.
Results: A retrospective analysis of X-ray findings in 20 patients revealed bone destruction of varying degrees. Low-quality root canal preparation was due to various factors, primarily the anatomy and topography of root canals. Of the 20 patients who required treatment for chronic periodontitis with varying degrees of destruction, 16 came back for follow-up appointments and received endodontic treatment. Following treatment, X-ray findings were used to identify taper root canal preparation and assess the quality of obturation up to the root apex. X-ray examination was performed after 3 months in patients with clinical signs of periodontitis and after 6 months in patients without clinical signs of periodontitis. After 3 months, X-ray findings showed a reduction in bone destruction in the causative tooth area, indicating an improvement.
Conclusion: The study of periapical tissue regeneration following treatment in chronic periodontitis patients revealed that effective apical preparation, as well as appropriate irrigation and root canal filling, promote regeneration in periodontitis. Healing of periapical tissues is essential for effective root canal treatment.



Reviews
Oral pathologies in anticancer therapy: a literature review
Abstract
Anticancer therapy is associated with a wide range of systemic symptoms, including oral pathologies, such as dry mouth, mucositis, masticatory spasm, osteoradionecrosis, dental caries, opportunistic infections, dysphagia, hypogeusia, dysgeusia, and hyposalivation. Dental professionals are the most qualified experts in the diagnosis and treatment of oral pathologies, as well as their prevention and control in cancer patients receiving radiation therapy or chemotherapy. The aim of the review was to assess domestic and international literature on primary oral complications associated with anticancer therapy. The review also aimed to highlight the importance of dental care in improving the quality of life of these patients, as well as to provide practical guidelines for managing these complications. The search was performed using electronic databases PubMed, eLIBRARY.RU, and Google Scholar. The search yielded 55 literature sources, which were included in the review.
Anticancer therapy may result in significant oral pathologies, including mucositis, infections, hyposalivation, changes in taste, and pain. These symptoms can affect various functions of the oral cavity and oropharynx, causing dry mouth and difficulties chewing and swallowing, which impairs nutrition. Moreover, they can affect speech, oral hygiene, denture treatment, and appearance, all of which can be detrimental to oral health, as well as social and emotional wellbeing. These side effects may also reduce compliance with anticancer therapy, affecting treatment outcomes, overall health, and therapy costs. When examining cancer patients, a dental professional must consider the prescribed therapy, as well as potential long-term complications similar to those in patients receiving bisphosphonates. As a result, a cancer patient will continue to receive the necessary treatment, and any new problems will be identified early.



Association between narrow palate and respiratory function in children: a literature review
Abstract
Changes in the airways and dentoalveolar system are one of the most challenging aspects of modern practical and theoretical dentistry. Nasal breathing is essential for the normal development of the maxillofacial area. During a child’s growth, the respiratory tract and facial skull development are closely linked. The main stage of dentoalveolar system development occurs during preschool and elementary school years. Nasal breathing disorders are currently widespread in this age group. Dental professionals are frequently the first to detect these disorders. A dental professional can then inform parents on the potential causes and consequences of habitual mouth breathing, justify the need for treatment and prevention of this pathology, and refer a child to an ENT specialist.
The review examines the association between narrow palate and respiratory function in children. Domestic and international studies addressing the association between dentoalveolar system pathologies and respiratory patterns and functional parameters were analyzed. The studies present a variety of opinions: some authors confirm the association between narrow palate and mouth breathing, while others refute it. Moreover, changes in respiratory function parameters following rapid palatal expansion have been analyzed, emphasizing the importance of timely orthodontic treatment to improve breathing.



Oral hygiene for severe care: a literature review
Abstract
The efficacy and quality of oral hygiene are currently a major concern, especially in intensive care patients.
This literature review assessed the available data on oral hygiene in intensive care patients using various antiseptics, as well as the methods of their use.
The literature search was performed using databases Scopus, PubMed, Web of Science, eLIBRARY.RU, and Google Scholar. Original peer-reviewed research on the clinical efficacy of oral care published between 2000 and 2023 were analyzed. The studies assessed the efficacy of hydrogen peroxide (n=2, 10%), chlorhexidine (n=10, 50%), Povidone-Iodine (n=2, 10%), and herbal formulations (n=4, 20%).
According to the majority of studies, oral hygiene in intensive care patients reduces the incidence of ventilator-associated pneumonia, but has no effect on the duration of artificial ventilation or the mortality rate.
The study discovered the absence of a universal, effective protocol for oral hygiene in intensive care patients, as well as guidelines for the selection of antiseptics, their concentration, and application methods. This subject necessitates further research.



Digital Dentistry
Stress-strain state of implant-supported restorations in tooth replacement
Abstract
Background: Dental implant therapy may be associated with breakage and deformation of implant-supported restorations, necessitating an assessment of their stress-strain state when applying a load.
Aim: To compare the stress-strain state of implants with their respective fixed restorations in tooth replacement.
Materials and Methods: A 3D mathematical model of the posterior mandible with three missing teeth was used to assess the stress-strain state for the following dental restoration options: three implant-supported crowns; a two-implant-supported bridge; or a bridge supported by tooth and implant. A 150 N load was applied to the central part of a restoration in both vertical and oblique directions to compare maximum stress values and their distribution.
Results: Oblique load was found to have a negative impact on stress intensity and distribution (471.7 MPa vs 90.7 MPa with vertical load for three implants). The most heavily loaded parts of restorations were identified: the border of the crown and the implant connection zone. A homogeneous stress distribution from a bridge to the two supporting implants was observed, along with a decrease in stress when using a bridge rather than three implant-supported crowns (160.0 MPa vs 16.1 MPa). In contrast, the load on the supporting implant increased when a bridge supported by tooth and implant was used (1,053.5 MPa with oblique load).
Conclusion: Compared to three implants replacing three missing teeth, a two-implant-supported bridge decreases stress on the implants and their respective restoration. Replacing one supporting implant with a tooth increases stress on the implant to the ultimate strength of titanium alloy in the abutment.


