Vol 28, No 3 (2024)

BACKGROUND: Recurrent herpetic stomatitis, also known as oral herpes, is one of the most common viral diseases of the oral cavity. Currently, saliva is widely used in innovative diagnostic methods. However, there are only limited data supporting the diagnostic value of salivary biomarkers in herpes infections.

AIM: To establish the informative value of using the wedge-shaped dehydration method and the express method for determining salivary amylase activity in patients with recurrent herpetic stomatitis.

MATERIALS AND METHODS: Diagnosis of recurrent herpes stomatitis was carried out based on the results of a clinical examination and confirmed using molecular genetic (PCR with real-time detection) and serological studies (ELISA — VectoHSV-IgG test system). For non-invasive diagnosis of recurrent herpetic stomatitis, we used crystallography methods — wedge-shaped dehydration of oral fluid and an express method for determining salivary amylase activity. The study included 26 patients with HHS in the acute stage (frequency of exacerbations of 4 or more per year) and 14 patients in the control group with no history of episodes of herpetic stomatitis.

RESULTS: The results of crystallography of mixed saliva and determination of salivary amylase activity in patients diagnosed with recurrent herpes before and after treatment are presented. Specific changes in facies in the protein zone were established during wedge-shaped dehydration during the exacerbation period and an increase in salivary amylase activity in patients with recurrent herpetic stomatitis in the acute stage.

CONCLUSION: To confirm the diagnosis of recurrent herpetic stomatitis at a dental appointment, a non-invasive method of wedge-shaped dehydration using samples of mixed saliva is recommended, and to determine the effectiveness of treatment, along with clinical indicators, the most informative is a rapid test based on a study of the level of amylase in mixed saliva.

BACKGROUND: To eliminate white spots in dental fluorosis, methods of remineralizing therapy, microabrasion, and infiltration are currently used, which have special features in this pathology because of the deep location of the hypomineralization zone.

AIM: To study the adhesive strength of a fluid composite filling material to the infiltrate ICON and tooth enamel in fluorosis and evaluate the results of the combined use of resin infiltration and composite material in the clinic.

MATERIALS AND METHODS: Adhesive tear strength tests of various materials were performed on 60 extracted teeth with fluorosis, such as lesions in the form of white spots. By random sampling, teeth with fluorosis were divided into four groups of 15 teeth each. To induce a defect that allowed for the study of adhesive strength using a sandblaster (Rondoflex, CAVO, Germany), an aluminum oxide powder with a particle size of 27 microns at a distance of 1 cm was treated in the center of the vestibular surface for 3 s.

RESULTS: The best indicators of adhesive tear strength were obtained using a universal adhesive system and a low-modulus composite material and combining an infiltrant and a low-modulus composite material containing a 10-methacryloyloxydecyl dihydrogen phosphate (MDP) monomer. The results of the experimental study indicated that the combination of an infiltrate and a low-modulus composite material based on MDP monomer can be a promising option in the minimally invasive treatment of dental fluorosis in the clinic. After the treatment following the previously described scheme, the examination after 1 month did not reveal disruption of the marginal fit and staining of the border and secondary caries; however, one case of sensitivity was noted. Upon examination after 1 year, no cases of violation of the marginal fit, development of caries along the boundaries of the treatment, and sensitivity were observed.

CONCLUSION: The results of the experimental clinical study indicated the high effectiveness of minimally invasive dental fluorosis treatment using a combination of infiltration and low-modulus composite material based on MDP monomer.

BACKGROUND: The effect of Helicobacter pylori (HP) on the course of sialadenosis (sialosis) of parotid salivary glands in patients with HP-associated gastrointestinal pathologies remains a relevant issue.

AIM: To improve the effectiveness of diagnosis in patients with parotid salivary gland sialadenosis and acid-dependent diseases associated with HP.

MATERIALS AND METHODS: The study included 40 patients aged 47.03±6.33 years with sialadenosis of parotid salivary glands and HP-associated gastrointestinal diseases diagnosed by immunochromatographic antigenic test using fecal samples and enzyme immunoassay of blood serum for anti-H. pylori IgG before eradication treatment. All patients underwent a comprehensive examination including basic tests (collection of complaints, anamnesis data, external examination and palpation of the regional lymph nodes and salivary glands, oral cavity examination), sialometry, express test (Helicobacter test), polymerase chain reaction diagnostics of parotid salivary gland secretion for HP, and measurement of proinflammatory cytokine levels (interleukin-1β and interleukin-6, and tumor necrosis factor-α in pg/mL). Patients with sialadenosis of the parotid salivary glands depending on HP detection in parotid secretions were divided into groups I (n=7, aged 45.14±8.51 years, negative) and II (n=33, aged 47.42±5.85 years, positive). The control group included 20 practically healthy people aged 45.40±6.54 years.

RESULTS: In group I (HP not detected in the parotid secretion), a reactive–dystrophic process of parotid salivary glands was found, which resulted from an increase in the concentration of proinflammatory interleukins. In group II (HP detected in the parotid saliva), severe sialosis of the parotid salivary glands was observed, which was caused by local inflammation and changes in cytokine status.

CONCLUSION: The comprehensive plan of the examination of people with parotid salivary gland sialadenosis and HP-associated gastrointestinal tract diseases should also include Helicobacter test, and the levels of proinflammatory cytokines in parotid secretions must be measured.

Dental implantation is widely used to achieve functional results of dentoalveolar region rehabilitation. Moreover, an increase in the volume of supporting tissues of approximately 43–77% is needed. In addition, current approaches for the augmentation of tissue structures do not always show the expected results. Problems with the growth of new supporting tissues are commonly caused by the reduced activity of inducing factors of local and systemic levels in the human body. A critical deficiency of the support structures significantly affects the result of ridge augmentation interventions. In this regard, a regenerative approach using biomaterials with inducing properties is relevant for modeling early processes of neovascularization and osteohistogenesis in the area of interest and achieves functional outcomes.

To review modern achievements of intraoral reconstruction of supporting tissue defects, including bioengineering for the regeneration of the alveolar ridge and covering structures.

An electronic search of literature sources was performed in PubMed using the keywords mentioned in PubMed and MeSH headings. The formats “review”, “systematic review”, and “clinical trial” were requested. The search depth was 20 years.

Of the 378 articles found, 44 met the inclusion criteria set for this review. The prerequisites for the reconstruction of the alveolar ridge focusing on early vascularization of de novo tissues were outlined, and the advantages and disadvantages of bone and soft tissue grafts using osteosubstituting biomaterials for bone augmentation and integumentary tissues were characterized. The results of research efforts in the framework of the use of mesenchymal stem cells, which play a crucial role in the regeneration of the alveolar bone and gum, were presented. The evolution of tissue engineering structures for intraoral integumentary tissues — from thin layers of epithelial cells to three-dimensional structures, which are the epithelized equivalents of the oral mucosa, was presented.

The rapidly increasing number of studies of the biomaterial properties of various chemisms, growth factors, and stem cells and the active development of tissue engineering currently indicate the prospects of scientific thought for the development of next-generation biomaterials, which can work effectively owing to their tissue regeneration activity and unique architecture.

BACKGROUND: High-quality dental rehabilitation of patients suffering from bronchial asthma is one of the priority tasks of an integrated approach to the treatment of a general somatic pathology. To date, changes in the oral cavity are polyetiological and can be associated with xerostomia, nutrition, nature of treatment, and poor hygiene. Thus, the microbial factor may play an important role in the development of pathological changes in the oral cavity.

AIM: Through a literature review, this study aimed to examine typical and atypical types of microbial colonies developing in the oral cavity of patients with bronchial asthma and study ways to correct the pathogenic microflora of the oral cavity.

MATERIALS AND METHODS: An analysis was made of information sources in the international databases of Google Scholar, PubMed, and eLIBRARY.RU from 2000 to 2023. The keywords of the query were “oral cavity”, “bronchial asthma”, “microbes”, “antimicrobial therapy”.

RESULTS: The literature search extracted 118 sources, of which 34 were relevant. Patients diagnosed with bronchial asthma were found to have dental problems associated with conditions associated with bacterial flora, such as caries, periodontal diseases, and candidiasis. Inflammatory and autoimmune processes were activated by the action of pathogenic microflora.

CONCLUSION: Changes in the microbial balance have affected the development of oral cavity pathologies. Correct hygiene and use of antibacterial and antifungal agents, intake of low-dose drugs, or avoidance of drugs that stimulate the increase in pathogenic microbes, contribute to a decrease in the microbial pathological potential in the oral cavity.

BACKGROUND: Patients with facial defects require urgent rehabilitation. In addition to the annual increase in the number of patients with cancer of the maxillofacial region, in recent years, the number of people with shrapnel and gunshot wounds to the face has increased as a result of local wars and conflicts.

Traditional methods of orthopedic rehabilitation of patients and the manufacture of facial epitheses are quite complex and lengthy. Postoperatively, the quality of life of these patients sharply decreases, basic body functions necessary for vital activity are impaired, and patients have poor social adaptation.

Direct application of facial prosthetics in the postoperative period is impossible owing to the lack of appropriate digital modeling technologies and structural materials for additive or subtractive production methods. Thus, the production of immediate facial epitheses using digital technologies is an urgent task to improve the social and functional living conditions of patients.

AIM: To develop three-dimensional (3D) modeling technology for additive manufacturing of immediate facial prostheses.

METHODS: The first task was to develop specialized 3D software for modeling defects in the facial area. The functionality of the program should allow virtual simulation of the missing parts of the face (ear, eye, nose, and orbit). Together with IT specialists, a digital platform was created using the following programming languages: C++ (for writing the software core and UI/UX interaction modules and interacting with the Windows operating system), C# (a complex assembly of the entire project), Python (for the automated assembly of virtual library modules), OpenGL HSLS (a shader language for graphical visualization of objects), and C ( creation of functions for interacting with shaders that require high speed).

RESULTS: A specialized computer program was developed for the 3D modeling of prostheses for patients with midface defects using combined facial scanning and computed tomography data (Computer program. Apresyan SV, Stepanov AG. A program for 3D modeling of facial epitheses. Registration number (certificate) 2023663490, Registration date: 07/04/2023).

Instead of obtaining analog impressions with plaster or silicone material, the developed technology uses a special 3D facial scanner, which greatly eases the suffering of patients. A virtual 3D database of ears, noses, orbits, and zygomatic bones of patients of various ages and sexes was integrated into the developed program. This allowed the specialist to select the most adaptive part of the face to make up for the defect. Built-in modeling tools allowed for the personalization of a 3D model of a part of the face based on the structural features of the maxillofacial region of a person. The finished 3D model of a part of the face can be exported in various formats.

CONCLUSION: The developed 3D program for modeling defects helps avoid invasive prosthetics approaches to coordinate the shape of future structures with the patient. The built-in library of structures with a database provides remote manufacturing of the prosthesis without the presence of the patient if replacement is needed. Among the undeniable advantages of the technology, prostheses can be made directly on the day of surgery for the removed part of the face, completely restoring lost functions and providing rapid social adaptation.

Today, not many healthcare organizers, scientists, doctors, and heads of large medical organizations, being in a high position, retain the best qualities of a person: respect for others, a sense of camaraderie and participation, and many others.

This study aimed to share personal impressions about the prominent organizer of military and practical healthcare, former Minister of Health of the Russian Federation Professor Y.L. Shevchenko, and his attitude and contribution to dentistry and maxillofacial surgery.

Personal memories from communication with the Academician of the Russian Academy of Sciences Professor Y.L. Shevchenko were included in this article.

Many publications have written the professional and social activities of the Academician of the Russian Academy of Sciences, Honored Scientist of the Russian Federation, Laureate of the State Prize of Russia, Professor, Colonel-General of the medical service, retired Yuri Leonidovich Shevchenko. Y.L. Shevchenko made a major contribution to the creation of a territorial health system (practical and military), focusing on economics and health management, formation of the national health insurance system, etc. This article highlights the personal qualities of this respected scientist, clinician, organizer of military and practical healthcare, and public figure and emphasizes his humanity, respect for teachers and subordinates, dedication to his work, his understanding, and importance of tasks facing dentistry and maxillofacial surgery. Y.L. Shevchenko has notable contributions to dentistry, and the perpetuation of the memory of outstanding military maxillofacial surgeons and dentists is presented.

Personal communication with the Academician of the Russian Academy of Sciences Professor Y.L. Shevchenko has always been pleasant and productive. Such teachers as Professor Y.L. Shevchenko can be considered the standard of man and humanity.