[Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases]. / Klinicheskaya effektivnost' konservativnogo lecheniya patsientov s khronicheskim generalizovannym parodontitom s primeneniem gelya Kholisal.

PURPOSE OF THE STUDY: To study the effectiveness of the drug Cholisal as part of the conservative treatment of chronic periodontitis. MATERIAL AND METHODS: We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute stage with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of periodontitis, patients were divided into two groups of 50 people. In the main group, Cholisal dental gel was used as part of complex conservative treatment, and in the control group, Metrogil-denta gel was used. To assess the effectiveness of treatment, a dental examination of patients was carried out with an index assessment of the condition of periodontal tissues and a biochemical analysis of the content of arachidonic acid and prostaglandin E2 in gingival blood, comparing the indicators before treatment and 14 days after the start of treatment. RESULTS: When the drug Cholisal was included in complex treatment, 14 days from the start of treatment, patients experienced a statistically significant decrease in the depth of periodontal pockets from 4.7±0.32 mm to 3.6±0.19, and the Green-Vermillion hygiene index by 60.7%, Silness-Loe plaque index by 73.1%, PMA index by 68.8%, Muhlemann-Cowell bleeding index by 68.0% (p<0.001 compared to baseline). When Metrogil-denta gel was used in complex therapy, the effectiveness of treatment was lower: the depth of periodontal pockets did not change significantly (from 4.5±0.22 mm to 4.2±0.17 mm, p>0.05), reduction in the hygiene index Green-Vermillion was 51.9%, Silness-Loe plaque index - 64.0%, PMA index - 43.7%, Muhlemann-Cowell bleeding index - 45.8% (p<0.001 compared to baseline, p<0.001 compared to the main group). A laboratory study showed that in patients of the main group, after completing a course of conservative treatment, the content of biomarkers of inflammation significantly decreased compared to the initial level (p<0.05), while in patients of the control group the content of arachidonic acid and prostaglandin E2 in the gingival blood during the study period did not change significantly (p>0.05 compared to the initial level). CONCLUSIONS: The use of the drug Cholisal in the conservative treatment of chronic periodontitis has demonstrated more pronounced positive dynamics of clinical and biochemical parameters compared to traditional therapy, which suggests its high effectiveness.

[Clinical analysis of the cleaning effectiveness of toothbrushes of various types in children aged 6-15 years after a single brushing]. / Klinicheskii analiz ochishchayushchei effektivnosti zubnykh shchetok razlichnogo tipa u detei 6­15 let posle odnokratnoi chistki zubov.

OBJECTIVE: The purpose of the study is to conduct a comparative analysis of the cleaning effectiveness of toothbrushes of various types in children aged 6-15 years after a single tooth brushing. MATERIAL AND METHODS: A parallel, randomized, open clinical trial was conducted aimed at evaluating the effectiveness of toothbrushes of various types in children aged 6-15 years. The study involved 180 children of both sexes aged 6-15 years, who were divided into 3 age categories: 6-8 years (n=60), 9-11 years (n=60) and 12-15 years (n=60). In each age category, 3 groups of 20 people were randomly formed who received toothbrushes of different types: groups I, IV and VII - a manual brush with a multi-level brush field, groups II, V and VIII - a manual brush with an even brush field, groups III, VI, IX - an electric brush with the technology of reciprocating and pulsating movements. After the dental examination, the children were taught the standard method of brushing their teeth. The cleaning efficiency of toothbrushes was evaluated using the hygiene index PI (S. Turesky, 1970) before and after a single tooth brushing. The nonparametric Wilcoxon test was used to compare the indicators of one group in dynamics, and the Mann-Whitney test was used to identify differences between groups. RESULTS: A comparative analysis showed that the efficiency of the electric brush in all age groups was significantly higher compared to manual brushes having an even brush field, and in children 12-15 years old it was higher compared to both manual brushes. In the age groups of 6-8 years and 9-11 years, a manual brush with a multi-level brush field, intersecting tufts of bristles and a power projection showed high cleaning efficiency, which did not significantly differ from the indicators of plaque reduction after using an electric brush (Mann-Whitney criterion, p>0.05). CONCLUSION: An electric toothbrush is the most effective means of oral hygiene in children. In children aged 6-8 years, a high cleansing effect was achieved with a manual brush having a multi-level brush field. In the hygienic education of children of this age, it is necessary to pay more attention to the formation of the correct technique of brushing teeth with the help of manual brushes corresponding to age characteristics.

[Diagnostic value of biomarkers of bone metabolism in the gingival fluid in inflammatory-destructive and tumor oral pathology]. / Informativnost' otsenki biomarkerov kostnogo metabolizma v desnevoi zhidkosti pri vospalitel'no-destruktivnoi i opukholevoi patologii v polosti rta.

OBJECTIVE: The aim of the work was to determine the informativeness of the assessment of biochemical markers in the gingival fluid with destructive bone changes in the peri-implantation area, primary tumor lesion of the alveolar processes of the jaws and metastatic destruction of the jaw bone tissue in cancer of the large salivary glands. The study included 51 patients aged 30 to 75 years of both sexes. Depending on the genesis of destruction of the bone tissue of the lower jaw, three groups of patients were identified. Group 1 - 20 patients with peri-implantitis. Group 2 - 22 patients diagnosed with cancer of the oral floor mucosa (ICD C04) with erosion of the cortical bone or dental socket by a primary tumor. Group 3 - 9 patients with adenocarcinoma of the large salivary glands with metastatic lesions of the lower jaw. 15 people were practically healthy persons without periodontal pathology. The test material was gingival fluid or exudate from peri-implantation pockets. The content of cathepsin K, tartrate-resistant acid phosphatase (TAP) was determined by the enzyme immunoassay, and the bone fraction of alkaline phosphatase (BAP) was determined by the kinetic method. RESULTS: As a result, it was found that in group 1 in the exudate of the peri-implantation sulcus, the content of cathepsin K increased in comparison with the control by 2.5 times (p<0.05), TAP by 1.6 times (p<0.05). in groups 1 and 2, there was a moderate increase in the production of activated osteoblasts of KAP. In cancer of the mucous membrane of the floor of the mouth, a tenfold increase in the concentration of cathepsin K and TAP in the gingival fluid was observed. With metastatic lesions of the jaw in patients with adenocarcinoma of the large salivary glands, along with a multiple increase in the concentration of cathepsin K and TAP in the gingival fluid, there was a twenty-fold increase in the bone formation marker BAP, which indicated a mixed type of metastases and was a differential diagnostic criterion for metastatic lesion of bone tissue in comparison with the primary metastatic lesion of bone tissue. CONCLUSION: Thus, biochemical markers are sensitive indicators of remodeling of bone tissue both in local inflammatory and destructive processes in peri-implantitis and in primary and metastatic tumor lesions of the jaws.

[Diagnostic possibilities of laboratory assessment of cathepsin K activity in gingival and peri-implant fluid under normal conditions and periimplantitis]. / Diagnosticheskie vozmozhnosti laboratornoi otsenki aktivnosti katepsina K v desnevoi i periimplantatsionnoi zhidkosti v norme i pri periimplantite.

OBJECTIVE: The aim of the work was to develop a non-invasive laboratory method for local control of the severity of osteo-destructive processes in the bone tissue of the jaws after dental implantation. MATERIALS AND METHODS: The study comprised 75 individuals aged 18 to 65. The main group included 40 patients with a diagnosis of dental periimplantitis (ICD K 10.2). A comparison group (n=20) included patients after dental implantation without postoperative complications. The control group (n=25) consisted of individuals without dental pathology. Cathepsin K (CTSK) (Human) ELISA Kit (Cloud-Clone Corp., USA) was used to determine the concentration of cathepsin K by the enzyme immunoassay in the gingival or peri-implant fluid. RESULTS: The concentration of cathepsin K in the gingival fluid in the patients of the control group was 1.7±0.3 pmol/l, in the comparison group the concentration of the studied biomarker corresponded to 2.3±0.4 pmol/l. In the main group, the concentration of cathepsin K in the exudate of peri-implantation pockets increased 2.8 times (p<0.05) and corresponded to 4.9±0.5 pmol/l. The concentration of cathepsin K in the gingival fluid normally did not depend on age and gender, which increased the independence of the osteomarker for characterizing the osteoresorbent process in the peri-implantation area. After dental implantation, an excess of cathepsin K concentration above the level of 2.7 pmol/l with a diagnostic sensitivity of 82.5% and a specificity of 83.7% suggests a high risk of developing peri-implantitis. CONCLUSION: The concentration of cathepsin K may be seen as valuable marker for local inflammatory and destructive processes in the contents of the peri-implantation area.

[Clinical and radiological assessment of the anatomical and topographic structure of the root canals of teeth in patients of different age groups]. / Kliniko-rentgenologicheskaya otsenka anatomo-topograficheskogo stroeniya kornevykh kanalov zubov u patsientov raznykh vozrastnykh grupp.

THE AIM OF THE STUDY: Was to identify the features of the anatomical structure of the root canals of teeth according to CBCT data in patients in different age groups. MATERIAL AND METHODS: Patients of europeoid race, both sexes, who have indications for endodontic treatment (60 people), were divided into three groups: group 1 (young) 20 people aged 18 to 44 years, group 2 (middle age) 20 people - from 45 to 60 years, group 3 (elderly) 20 people - from 61 to 75 years old. To assess the root canal anatomy, all patients underwent x-ray examination (CT) on a Vatech computed tomography and analyzed with the Ez3D plus program before beginning endodontic treatment. The object of study was the first molars of the lower jaw (distal root canal). RESULTS: The analysis of axial, sagittal, coronal sections of the first molar of the lower jaw revealed that patients belonging to the 1st group, the distal root canal often had an oval shape all over (95%) and over a wide apical opening, in only one case out of 20 (5%) were identified at slit-like form of the distal root canal, probably due to malocclusion or as a consequence of increased abrasion of teeth. In group 2, two independent root canals were identified in the distal root of the first lower molar (in 65%), extending from the tooth cavity to the apex.in 35% of cases, the distal root canal began with a single entrance in the oral part and bifurcated into two separate channels at about the level of 2 /3 canals, then re - joined into a single apical opening, in group 3, in 75% of cases, a slit-like form of the distal root canal was observed. The obtained CLCT data (taking into account the image error) were confirmed in the clinic at the stage of endodontic treatment using optical magnification (microscope). CONCLUSION: CBCT and operation microscopy with x40 magnification data showed clear age-dependent variations of first lower molar distal root canal anatomy.

[Influence of different type of toothbrushes on gingival fluid proteolytic potential during orthodontic treatment]. / Vliyanie zubnykh shchetok razlichnogo tipa na proteoliticheskii potentsial desnevoi zhidkosti v dinamike ortodonticheskogo lecheniya.

THE AIM: To study the effect of toothbrushes of various types on the accumulation of plaque and the proteolytic potential of gingival fluid as a pathogenic factors in long-term orthodontic treatment of patients with a distal permanent bite. MATERIAL AND METHODS: We examined 63 patients of both sexes aged 11-18 years. Orthodontic treatment was carried out for the close position of the teeth with a distal permanent bite (K07.2) and cleft palate and lips (Q37.1). Patients were divided into three groups depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, «Spazzolificio Piave¼, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush ("Oral-B Pro-Expert, «Procter & Gamble¼, USA). RESULTS: The amount of soft plaque was assessed by the Silness-Loe hygiene index in the subgingival region. The activity of proteolytic enzymes - elastase, collagenase, and a α-inhibitor of proteinases was determined by the enzymatic method using a XL 200 biochemical analyzer («Erba Lachema¼, Czech Republic). The accumulation of plaque in the gingival region on both jaws during the entire period of orthodontic treatment is most pronounced when using a manual brush compared to ultrasonic and electric brushes. An increase in proteolytic activity in the gingival fluid with a simultaneous decrease in antiprotease potential with long-term orthodontic treatment of patients was observed when using a manual orthodontic brush, which can be regarded as an increase in the activity of the pathogenic factors for the development of local inflammatory and destructive changes. CONCLUSION: To prevent inflammatory and destructive changes during prolonged orthodontic treatment of patients, the use of ultrasonic and electric toothbrushes in daily oral hygiene is justified.

[Influence of different type of toothbrushes on the incidence of enamel demineralization and gingivitis in the course of orthodontic treatment]. / Vliyanie ispol'zovaniya zubnykh shchetok razlichnogo tipa na veroyatnost' razvitiya demineralizatsii emali i gingivita v khode ortodonticheskogo lecheniya.

The aim of the study was to determine the likelihood and frequency of complications, the impact of the use of various types of toothbrushes in the dynamics of orthodontic treatment with fixed appliances in patients with a distal permanent bite. The clinical study was conducted on 63 patients of both sexes, aged 11-18 years. Patients received long-term orthodontic treatment for a close tooth position with a distal permanent bite (K07.2) and cleft palate and lip (Q37.1). Three groups were conditionally distinguished depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, Spazzolificio Piave S.p.A, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush (Oral-B Pro-Expert, Procter & Gamble, USA). According to the Kaplan-Meier method, the probability of developing complications of orthodontic treatment was calculated as patients wear braces, and the impact on the effectiveness of orthodontic treatment of using toothbrushes of various types was evaluated. A frequency analysis of the complications of orthodontic treatment for the entire period of wearing fixed orthodontic structures revealed a difference only in respect to enamel demineralization. In group 1, enamel demineralization was more common (42.9%) compared with 2 (9.1%) and 3 (25%) groups (p=0.039). The likelihood of developing gingivitis was higher in group 1, the timing of the development of inflammatory processes in periodontium was also shortened in group 1 compared with groups 2 and 3. The frequency and timing of the development of gingivitis and enamel demineralization depended on the type of toothbrush used in daily oral hygiene. A marked deterioration in the oral hygiene during orthodontic treatment using a manual brush was accompanied by a more frequent development of gingivitis and enamel demineralization.

[Hypoxia-dependent control of the activity of innate antimicrobial immunity in patients with dentin caries]. / Gipoksiia-zavisimyi kontrol' aktivnosti vrozhdennogo antimikrobnogo immuniteta u patsientov s kariesom dentina.

OBJECTIVE: To study interrelation of maintenance of α-defensins 1-3 and a hypoxia-inducible factor 1-alpha (HIF-1α) in gingival liquid of patients with caries. MATERIAL AND METHODS: 75 patients with the diagnosis dentine caries were enrolled in the study and divided into two groups: in group 1 (n=30) caries was diagnosed in earlier untreated tooth, the 2nd group (n=45) included patients with the recurrence of carious process (in earlier treated tooth). Controls involved 25 caries-free individuals. The level of α-defensins 1-3 was studied in gingival fluid by ELISA method. RESULTS: The level of α-defensins 1-3 and antimicrobic peptide in gingival liquid in group 2 was 28 and 36% higher than in the 1st group, correspondingly (p<0.001). Concentration of HIF-1α in gingival liquid in the 2nd group was almost twice higher (p<0.001) than in group 1 and 82% higher than in controls (p<0.001), while in group 1 it decreased by 11% when compared to controls (p<0.001). All controls showed a close correlation between the level of α-defensins 1-3 and HIF-1α in gingival fluid (R=0.78, p<0.001), not observed in group 1 (R=0.32, p>0.05) but statistically significant in group 2 (R=0.78, p<0.001). Thus, the recurrence of carious process in caries-associated tooth is associated with the hypoxia-dependent activation of a congenital antimicrobial immunity by means of accumulation of HIF-1α and pronounced increase of α-defensins 1-3 in gingival fluid.

[Clinical and laboratory evaluation of the Elgydium Protection caries toothpaste effectiveness in patients with high intensity of dental caries]. / Kliniko-laboratornaia otsenka éffektivnosti primeneniia zubnoi pasty Él'gidium zashchita ot kariesa u patsientov s vysokoi intensivnost'iu kariesa.

The aim of the work was to evaluate the effectiveness of rehabilitation after the complete elimination of carious cavities in patients with dentin caries according to clinical and laboratory indicators when using the ELGYDIUM Protection caries toothpaste for cleaning teeth for 6 months. 29 patients with high intensity of dental caries were examined and received treatment. Depending on the organization of daily hygienic measures after treatment the patients were divided into two groups. The main group included 14 patients who used Elgydium Protection caries paste ('Pierre Fabre Medicament', France) for brushing their teeth twice a day for 6 months. The control group included 15 patients who used toothpastes with fluoride of the first generation. All patients underwent clinical dental examination with the determination of the DMFT index and the amount of soft dental plaque according to the Silness-Lohe index, as well as in the gingival fluid bacteriological examination of cariogenic microbiota, determination of the proinflammatory cytokine tumor necrosis factor alpha (TNF-α) and an immunoassay for anti-inflammatory peptides α-defensins 1-3. Effective change in the concentration of antimicrobial peptides α-defensins 1-3 and TNF-α after treatment along with successful eradication of cariogenic bacteria from carious cavities, the absence of recurrent dental caries in the main group compared with the control group proved the successful anti-caries action of long-term use of fluorenol capable of forming a uniform film on the surface of the tooth in the presence of silyglycol. The protective film helps to increase the resistance of the tooth to demineralization and prevents plaque formation. Thus, the study results proved the effectiveness of ELGYDIUM Protection caries toothpaste used for 6 months for the reduction of caries.

[Dynamics of bone metabolism markers in oral fluid after surgical treatment of chronic periodontal disease with various osteoplastic materials]. / Dinamika kostnogo metabolizma posle khirurgicheskogo lecheniia khronicheskogo generalizovannogo parodontita s podsadkoi razlichnykh kostno-plasticheskikh materialov po pokazateliam rotovoi zhidkosti.

The aim of the work was to assess the balance between osteosynthetic and osteodestructive processes in the oral cavity in patients with chronic generalized periodontitis (CGP) of moderate and severe severity in the dynamics of a remote period of patchwork using various bone-plastic materials (BPM) based on xenogeneic hydroxyapatite (HA), ß-tricalcium phosphate (TCP). 123 patients with CGP were examined. Depending on the type of BPM, two groups were distinguished by composition in the course of patchwork operations. Patients of group 1 (n=61) received BPM on the basis of xenogeneic HA, 2 groups (n=62) on the basis of ß-TCP. Initially and after surgery at 8 and 12 months in the oral fluid, the concentration of osteoprotegerin (OPG), the ligand of the soluble activator of the kappa B nucleation factor (sRANKL), the bone isoenzyme of alkaline phosphatase (BAP), was determined by an immunoenzyme method. As a result of the study, it was found that in patients with moderate-bodied CGP after surgical treatment, restriction of osteoclast activity with a decrease in sRANKL due to an increase in OPG in the oral fluid, an increase in osteoblast activity with BAP secretion is most pronounced when using ß-TCP-based BPM at 8 months. After surgery with an average severity of the disease. Less pronounced changes in bone metabolism in the oral cavity are detected with the use of BPM on the basis of HA. In severe CGP, changes in bone homeostasis in the oral cavity after scrappy operations with BPM insertion based on TCP or HA are not expressed and are observed only after 12 months. Thus, the most effective changes in bone metabolism develop with the use of TCP as BPM.

[Alveolar osteitis treatment using Holisal gel]. / Medikamentoznoe soprovozhdenie al'veolita cheliusti preparatom Kholisal.

The aim of the study was to estimate efficiency Holisal in treatment of the alveolar osteitis. 30 patients with the diagnosis of alveolar osteitis with clinics of dry socket, aged from 25 to 69 years entered a research. Patients were divided into 2 groups: in the 1st group (n=15) patients received treatment by a standard technique with the use of the iodoform gauze. In the 2nd group patients (n=15) after preliminary training used Holisal 4 times a day applying it in the socket. In both groups dynamics of clinical indicators, complaints, biochemical indicators on the 3, 5 and 10 day after the beginning of treatment were estimated. The use of Holisal for treatment of the alveolar osteitis presenting as a dry socket is effective and has advantages in comparison with a conventional technique of alveolar osteitis management.

[Correlation of gene polymorphism and risk of aggressive periodontal disease].

The study included 179 patients aged 18-45 years (56 with aggressive periodontal disease and 123 with no clinical signs of periodontitis). Gene polymorphism was analyzed by means of real-time PCR and kissing probes in order to reveal marker panel for aggressive periodontal disease predisposition. Significant difference was found for gene MMP9 in rs17576 position for A allele (55.2% in aggressive periodontal disease patients and 69.5% in control group) and in rs3918242 position for C allele (67.7 and 81.7%, respectively).

[The mean timing of periodontic care rendering].

The time-studies demonstrated that the periodontologist spend 30.3 +/- 2.6 minutes on the primary ambulatory visit of patient and 16.4 +/- 0.9 minutes on the revisit of patient (non-registering time spending on preventive and curative activities). Time spending on curative preventive activities in each group of patients with periodontal diseases depended on both the severity of inflammatory destructive processes in periodontium and therapy stage.

[PCR "real time" to analyze the quantitative and qualitative relations microbiota of periodontal pockets].

The introduction of a broad medical practice PCR "real time" is just beginning and dentistry is no exception. Modern molecular genetic methods provide numerous opportunities for diagnosis, assessment and prediction in patients with inflammatory periodontal diseases. Early and accurate diagnosis can allow in the future reduce the incidence of periodontitis and the progression of its course.

Relationship between the Pathogenic Representatives of Periodontal Pockets Microbiocenosis in Patients with Periodontitis with Varying Degrees of Severity.

Periodontitis is a common disease that is considered to be a manifestation of the distortion of the ratio between the normal and conditionally pathogenic microflora of periodontal pockets. In this study, the ratio between the six most important periodontal pathogens and the total microflora of the periodontal pocket in healthy individuals and patients with varying severity of periodontitis was ascertained by quantitative real-time PCR. It was ascertained that the relative content ofPorphyromonas gingivalis,Prevotella intermedia, andTannerella forsythensis(Bacteroides forsythus) persistently develops in the total microflora of the periodontal pocket upon progressing periodontitis; this value is higher than that in the control group by more than two orders of magnitude upon a severe degree of chronic generalized periodontitis.