Vol 26, No 2 (2022)

BACKGROUND: Peri-implantitis is mainly caused by the activity of periodontal pathogens with insufficient oral hygiene, which causes the disintegration of intraosseous dental implants against the background of chronic inflammation in peri-implant tissues. The correct techniques in the post-prosthetic stage in patients with dental implants include medical examination with regular professional oral hygiene, which is complicated by low patient compliance. In this regard, there are high requirements for the level of individual oral hygiene and for the effectiveness of local hygiene products, among which dental rinses occupy an important place. As rinses, it is possible to use pine-containing substances, particularly a complex of oil-essential fir “Solagift” of a Siberian company (Tomsk).

AIM: To conduct a microbiological study of the sensitivity of periodontopathogens and Candida albicans to the oil-essential complex of Siberian fir of different concentrations.

MATERIAL AND METHODS: A number of periodontopathogens and C. albicans were cultured in the presence of a complex of oil–essential Siberian fir in the following proportions: 1:5, 1:10, and 1:15. Incubation for up to 3 days was conducted in the Reverse Spinner RTS-1 bioreactor (BioSan, Latvia) with automatic analysis of the optical density of the culture (OD) at a wavelength of λ=850 nm. The optical density was measured in McFarland units (Mcf). The assessment of culture growth control was based on the analysis of the growth phases of periodontopathogens: adaptive (lag phase), exponential (log phase), stationary, and dying. The following clinical isolates of microorganisms were used: Streptococcus constellatus, Staphylococcus aureus, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and C. albicans.

RESULTS: Joint cultivation of periodontopathogens with the oil–ether complex of Siberian fir reduces the OD of cultures of clinical isolates when breeding coniferous substance 1:15—1:5 by 13.7–27.1% (A. actinomycetemcomitans), 18.3–62.0% (F. nucleatum), 30.0–56.4% (S. aureus), and 19.2–74.1% (S. constellatus). The studied coniferous complex suppresses the culture of C. albicans at a concentration of 1:5, reducing the OD of the culture of fungi in the microbiological experiment by 29.8%.

CONCLUSION. Joint cultivation of periodontopathogens with the oil–ether complex of Siberian fir reduces the OD of cultures of clinical isolates when breeding coniferous substance 1:15–1:5. The studied coniferous complex suppresses the culture of C. albicans at a concentration of 1:5, reducing the OD of the culture of fungi in the microbiological experiment by 29.8%. The bacteriostatic effectiveness of the Siberian fir oil-ether complex significantly exceeds the effect of the herbal preparation “Stomatophyte”.

BACKGROUND: An organized acquisition of practical skills at the military level, in the positions of dentists of a medical company (military medical organization), by cadets studying stomatology is relevant.

AIM: The purpose is to highlight the tasks solved during the military training of cadets, the methodology of their implementation and the results achieved.

MATERIAL AND METHODS: Cadets in their fifth year of the fourth pharmacy of the Faculty of Training Doctors for the Navy who were studying stomatology started their clinical practice (military internship). The departments of organization and tactics of the medical service, general and military epidemiology, general and military hygiene, military medical supplies, officials of the educational and methodological department, and representatives of the faculty took part in the preparation and conduct of the military internship. The training of cadets included the main provisions of methodological recommendations, documents worked out during the internship, and recommendations from representatives of departments focusing on certain profile issues.

RESULTS: The cadets fully completed the military internship program in the stomatology specialty, received positive feedback from the commanders of military units, and successfully defended the reports on the work done. The survey showed that the cadets who were constantly located in remote military units managed to work out the largest number of manipulations, which allowed them to determine the real conditions of their future service. They were also most satisfied with the results of their practical work. The acquired knowledge enabled the cadets to adjust their theoretical training. The vast majority of cadets requested increasing the internship period to 4 weeks. All streams completed the internship without comments due to the responsible attitude of the internship managers and the assistance of officials of the medical service of the Western Military District and the Baltic Fleet.

CONCLUSION: The military internship allowed the cadets to get acquainted with real military service, instilling a sense of pride in belonging to the Armed Forces of Russia. The experience gained allowed us to focus on planning internships in military units, whereas the number of cadets specializing in dentistry should be no more than two in one military unit. It is desirable to expand the geography of the internship. Thus, the duration of clinical practice was recommended to be at least 4 weeks. A more in-depth study of the documentation conducted in the dental office and as a part of the medical service is necessary. Publishing methodological recommendations on the organization of clinical practice (military internship) of cadets studying in the stomatology specialty is desirable.

BACKGROUND: The use of esthetic restorations (metal–ceramic and metal-free) provides for the preparation of teeth within the enamel and surface or middle layers of the dentin, which entails an increase in the reactivity of teeth. One of the promising directions for increasing the resistance of the prepared teeth in the orthopedic treatment of patients using esthetic dental restorations is the combined and consistent use of fluorides and low-intensity laser radiation.

AIM: To examine the effect of low-intensity laser radiation and sodium fluoride on the reactivity of dissected vital teeth.

MATERIAL AND METHODS: A 2% aqueous solution of sodium fluoride was administered by electrophoresis with a portable device “Desensitron-II.” For laser exposure, a dental laser device “Optodan” was used in the first (anti-inflammatory) mode of operation. The research material was the results of orthopedic treatment of 120 patients aged 20–39 years (57 men and 63 women). To assess the initial state of teeth reactivity and the effect of the therapeutic measures, the sensitivity of the teeth to temperature (thermoreactivity of the teeth), mechanical (sliding tangent test), and electrical (electrodontometry) influences was investigated.

RESULTS: In the third group, the studied indicators before fixation demonstrated the maximum improvement in indicators relative to the data obtained in other groups.

CONCLUSIONS: The combined sequential effect of low-intensity laser radiation and sodium fluoride reduces the reactivity of the prepared teeth while significantly improving the indicators of electrical excitability of the pulp and increasing the pain threshold in relation to temperature and mechanical stimuli.

BACKGROUND: The annual global oral cancer morbidity is more than 650,000 cases. Between 2007 and 2017 in the Russian Federation, the absolute number of first-ever diagnosed oral cavity malignant neoplasms is constantly increasing. According to many authors, oral squamous cell carcinoma is associated with pre-existing leukoplakia. This disease is the most common and prone to malignant precancerous oral mucosa disease. Human papillomaviruses (HPV) are crucial players in this process. However, the relationship between HPV infection in leukoplakia and oral squamous cell carcinoma remains unclear.

AIM: To establish the HPV role in the development of leukoplakia and squamous cell carcinoma of the oral mucosa.

MATERIAL AND METHODS: The study included 39 patients with verified various forms of oral leukoplakia and oral squamous cell carcinomas. The squamous cell carcinoma group included 19 patients. The oral leukoplakia group is consisted of 20 patients. The control group of healthy volunteers is represented by 22 patients with clinically healthy oral mucosa. HPV deoxyribonucleic acid (DNA) was detected and quantified in clinical materials by polymerase chain reaction with hybridization-fluorescence detection “AmpliSense® HPV HRS screen-titer-FL” for HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 and “AmpliSense® HPV 6/11-FL” for HPV types 6 and 11.

RESULTS: HPV types 6 and 11 DNA were isolated in three cases with insignificant clinical disease from 19 samples taken from patients with oral squamous cell carcinoma. In groups of leukoplakia and healthy volunteers, no high oncological risk was identified. Despite a HPV-positive expression in squamous cell carcinoma samples is detected, no significant difference was found between the squamous cell carcinoma group and control group (p=0.09).

CONCLUSION: No significant association was noted between HPV and oral squamous cell carcinoma; however, a low carcinogenic-risk HPV was detected in 15.7% of carcinoma samples. No HPV contamination was detected in patients with leukoplakia and healthy groups.

BACKGROUND: Internal disorders of the temporomandibular joint (VN TMJ) occur at orthodontic reception no less often than with other types of dental treatment. The main clinical manifestations of VN TMJ are caused by variants of anterior displacement of the articular disc, pathology of the capsular ligamentous apparatus, hypermobility of the mandibular head, and dysfunction of the masticatory muscles. The main symptom of VN TMJ is joint pain (arthralgia) and muscle pain (myalgia). VN TMJ occupies a special place in orthodontic treatment. They can be detected at the initial treatment, and their symptoms can appear at any stage of orthodontic treatment and be a complete surprise for the doctor and the patient, arise after orthodontics, and be associated with it. Since VN TMJ significantly affects the therapeutic process, its outcomes, prognoses, and treatment problems are under the close influence of orthodontists.

AIM: To examine the effectiveness of the treatment of VN TMJ and myofascial pain disorders in patients with dental anomalies.

MATERIAL AND METHODS: The study retrospectively analyzed case histories of 300 adult patients with dental anomalies in need of orthodontics who underwent examination and treatment in a multidisciplinary dental clinic between 2014 and 2016. The prevalence and structure of VN TMJ were assessed, and myofascial pain disorders (MFDB) and results of their correction were analyzed.

RESULTS: A total of 146 (71.5%) patients with myofascial pain and 58 (28.3%) with myofascial facial pain syndrome needed orthodontic treatment more often. In these patients, VN TMJ and maxillary anomalies belonging to class II according to Engle of unilateral distal occlusion, deep bite, and class I with crowding of teeth are more often detected. Internal TMJ disorders with concomitant MFDB in the form of myofascial pain were observed in 168 (82.4%) patients. Myofascial pain disorders without VN TMJ were registered in 36 (17.4%) patients. The overall effectiveness of the treatment of VN TMJ and MFBSD was 46.4% (n=78 patients). No lasting improvement was observed in 35.7% (n=60). Deterioration was registered in 17.8% (n=30). Relapses were noted in 60.7% (n=124). In the treatment of MFDB without VN TMJ, the overall effectiveness of treatment was 5.5% (n=2), stabilization in 50.0% (n=18), and deterioration in 44.4% (n=16).

CONCLUSION: Myofascial facial pain is very difficult to treat. In combination with VN, TMJ creates significant and sometimes insurmountable difficulties in adult orthodontics. All this forces specialists to look for new approaches and develop effective ways to optimize orthodontic treatment in the case of TMJ pathology and myofascial pain disorders.

BACKGROUND: The article presents a review of the chemical aspects of the reaction of light polymerization of composites in dental practice. This reaction refers to free radical polymerization reactions, with photons as activators. In dentistry, composites are classified as chemically cured, light cured, doubly cured, and thermally cured. This depends on the origin of the activation energy of free radical polymerization of methacrylates. Chemically, dental composites are usually a mixture of four main components: an organic polymer matrix, an inorganic filler, an appret compound, a binder matrix and filler, and an initiator–accelerator system. The radical polymerization process includes four main stages. The first stage is activation; in the case of light cured dental composites, it is photoactivation. In this case, a photoinitiator molecule is excited, for example, camphorquinone, which is widely used in the production of dental composite materials. If a free radical is formed, the polymerization process is similar for all composite materials based on a methacrylate organic matrix. The only difference is exactly how free radicals are formed and the rate of their formation. Under the influence of light quanta, the carbon atom of the ketone group of camphorquinone passes into an excited state, which allows the excited photoinitiator molecule to interact with two methacrylate molecules by a double bond. The double bond gives one electron to the excited camphorquinone molecule, and the second electron acts as a free radical agent; in other words, a macroradical is formed–a monomer molecule that can attach other monomer molecules to itself.

On the memory page among the Russian dentists and maxillofacial surgeons, it is impossible not to remember the outstanding figure in the world’s military medicine and practical health care, doctor of medical sciences, professor, and colonel of the medical service Vladimir Mikhailovich Uvarov. The study aimed to present scientific, clinical, pedagogical, and social activity of the outstanding dentist and maxillofacial surgeon, doctor of medicine, professor, and colonel of the medical service Vladimir Mikhailovich Uvarov, including his merits in military medicine. On the basis of the analysis of the Russian literature as well as the life, professional activity, and scientific works of Prof. V.M. Uvarov, doctor of medical sciences and colonel of medical service, we present his role in the formation and development of dentistry, maxillofacial surgery, and military medicine in Russia. There is no section of stomatology that V.M. Uvarov would not have paid attention to. He successfully defended 28 dissertations for the degree of candidate of science under his supervision. He is the author of more than 150 scientific works, including six monographs, a textbook, chapters in manuals, and textbooks. He was the author of the chapter on anesthesia and local anesthesia, written for the first textbook in the country “Surgical Dentistry” (1938). He was an honorable member of the all-union and all-Russian scientific society of dentists of the country; was a great pedagogue; generously shared his scientific, medical, and pedagogical experience with students, cadets, listeners, and lecturers; and carried out great therapeutic and consultative work. His name is among the outstanding maxillofacial surgeons of the country. He proposed the use of an extra-oral apparatus for the fixation of mandibular fractures and other innovations in the field of maxillofacial surgery and dentistry. At present, the students and followers of Vladimir Mikhailovich Uvarov keep him in their memory as a prominent organizer of military and civil health care, a clinician, a scientist, a teacher, and a model of man and humanity. He is remembered and loved.