Relevance. Aging of the body leads to the development of an imbalance in the secretory immunity of the oral mucosa, with the loss of natural teeth leading to an even more rapid decline in the host’s oral defense reactions. However, studies on salivary antimicrobial peptides in denture users and their potential role in protecting against the development of inflammation are still scarce at this time.
Purpose. To evaluate the effects of full removable acrylic dentures on the oral mucosa and analyze the content of antimicrobial peptides in the saliva of wearers of such dentures.
Materials and methods. Sixty-seven (21 men and 46 women) elderly patients (61 to 74 years old) with complete tooth loss were examined and divided into 3 study groups. In the 1st control group the patients did not use any dentures. Patients in groups 2 and 3 were made full removable acrylic dentures for the upper and lower jaws, and in group 2 from the first day of the adaptation period was used domestic denture fixation cream ASEPTA PARODONTAL. Assessment of the denture bed on the hard palate was performed visually using the Schiller – Pisarev test. Microbiological examination for Candida albicans was performed by PCR-diagnostics. The content of antimicrobial peptides in saliva was assessed using ELISA kits by Hycult Biotech.
Results. The use of the adhesive cream was found to improve the condition of the palatal mucosa by 25% on the 15th day and by 50% on the 30th day of the adaptation period. Candida albicans was detected in oral material in more than 55% of patients in all groups during their initial examination. In the group of patients using denture fixation cream, a significant decrease in Candida albicans carriage was noted, while an increase in Candida albicans detection of up to 70% was noted in those not using the cream. There was also an increase in the level of cathelicidin LL-37 in the saliva of patients without the use of the cream and with a marked increase in inflammation. One month after dentures in patients without cream use the content of alpha-defensins (HNP 1-3) was significantly lower than that of the group with cream and the control group.
Conclusion. On the basis of the carried out clinical and laboratory study, the domestic ACEPTA adhesive cream should be recommended for optimization of the adaptation period to removable acrylic dentures as well as for their permanent use.

The right choice of home hygiene products: toothbrush and toothpaste are an important aspect. The combination of different hardness of toothbrush and varying abrasiveness of tooth paste has not been fully explored.
Aim. To study the effect of a soft brush on the enamel surface according to profilometry data.
Materials and methods. For research, a special device was used to simulate the annual brushing of teeth. Abrasion was carried out on 6 extracted teeth, according to periodontal indications. Samples size was 1x1cm from 6 teeth removed for periodontal indications. Abrasion was carried out with a soft brush without the addition of paste on samples № 1,2,3 and with a soft brush in combination with a low abrasive paste with RDA 35 on samples № 4,5,6. The results of profilometry data were recorded at following time points - the initial state of the tooth, 1 week, 1 month, 6 months, 1 year.
Conclusion. Using only a soft brush without toothpaste does not change the roughness of the tooth surface while simulating an annual brushing and the combination of a soft brush with a low abrasive paste polishes the enamel surface.

After tooth extraction, it is necessary to create favorable conditions for the healing of the hole of the removed tooth. Dynamic observation of the patient by the attending physician is generally accepted to assess the condition of the postoperative wound and the patient’s implementation of recommendations for oral care. However, patients often note the presence of pain and swelling of the mucous membrane of the well of the removed tooth.
Stude – a comparative assessment of the course of the early postoperative period in patients with local application of collagen sponges Alvokon and Alvostaz.
Materials and methods. A prospective randomized study of 80 patients aged 20 to 59 years was conducted. The patients underwent a tooth extraction operation under local anesthesia. The patients were divided into 4 groups of 20 people. In patients of the first group, a collagen sponge Alvocon No. 3 was placed in the hole of the removed tooth, in patients of the second group – a collagen sponge Alvocon No. 5 in patients of the third group – a hemostatic collagen sponge «Alvostaz». Local medicines were not used in patients of the fourth group after tooth extraction. In the postoperative period, the presence of pain and the condition of the hole of the removed tooth were assessed.
Results. Wound healing proceeded by secondary tension without complications in all patients. Comparing the nature of the course of the early postoperative period, pain after tooth extraction in patients of different groups varied from 5 to 50% of cases, and the presence of edema of the wound edges – from 5 to 100% of cases.
Conclusions. Pain in the early postoperative period is expressed 2 times less when using the collagen sponge Alvokon No. 5. Edema of the marginal gum of the well of the removed tooth was 1.1 times less when using the collagen sponge Alvokon, 1.2 times when using the hemostatic collagen sponge Alvostaz in comparison with the group of patients without the use of a sponge.

Summary. The paper presents a comparative analysis of the results of ultrasound examination of the masticatory muscles proper in patients with fractures of the branch and articular process of the lower jaw at various stages of treatment using the endoscopic method and traditional osteosynthesis.
Research objective. To assess the morphological state of the masticatory muscles in patients with a fracture of the branch and articular process of the lower jaw using the endoscopic method and traditional osteosynthesis using ultrasound technologies.
Resources and Methods. The results of ultrasound examination of the masticatory muscles in 82 patients with a fracture of the branch and articular process of the lower jaw, hospitalized in N.I. Pirogov State Clinical Hospital No. 1 for 2021, were analyzed.
Research results. Based on the results of an ultrasound examination of patients aged 19 to 40 years with a mandibular fracture, it was found that the use of intraoral access using endoscopic technologies contributes to an earlier normalization of the morphological state of the masticatory muscles proper compared to traditional osteosynthesis.

The number of complications of new coronavirus infection (COVID-19) has been growing in clinics of maxillofacial surgery and otorhinolaryngology in the past two years. Among them, lesions of the jaw bones, nasal bones and paranasal sinuses are predominate. As a result of the studies, it was found that with coronavirus infection, multiple microvascular and macrovascular disorders occur, resulting in necrosis of the jaws and paranasal sinuses, often leading to life-threatening conditions, due to the anatomical proximity of brain structures. The article presents a cli-nical observation of a patient with extensive osteonecrosis of the upper jaw, which developed against the background of postcovid purulent pasinusitis, complicated by a secondary rhinogenic intracerebral abscess of the right fronto-parietal region of the brain. The provoking factors, the most characteristic symptoms, the X-ray picture at different stages of the disease, the tactics of treating such complications are considered.

The paper describes two clinical cases of treatment of patients with noma. This disease is extremely rare in the Russian Federation, and therefore its diagnosis causes difficulties, and incorrect routing of patients, due to diagnostic mistakes, leads to an increase in the time before the start of specialized care. Rapid progression of wet gangrene, in the absence of timely diagnosis and qualified treatment, leads to extensive defects of the maxillofacial region, severe intoxication, sepsis. In the first case, after surgical treatment of noma, the patient developed an extensive tissue defect of the left half of the face, which in the future will require reconstructive surgical treatment. In the second case, after surgical treatment, the patient had an extensive tissue defect in the middle zone of the face, and systemic disorders against the background of intoxication led to the death of the patient on the 7th day after hospitalization. Both clinical cases confirm the role of immunosuppression in the etiology of noma.

A feature of mathematical modeling and study of a complex three-dimensional biomechanical object is the ability to achieve unity of geometric, physical, mechanical and biological indicators with the individual characteristics of the patient. A rather urgent problem of clinical dentistry is the development of recommendations on the distribution of masticatory pressure in patients with balanced occlusal-articulation relationships of the dentition. This paper considers one of the aspects of this problem associated with modeling the stress-strain state of the functional masticatory center, which is localized in the region of the first molars and the premolar groups of the upper and lower jaws during physiological occlusion. To determine the biomechanical parameters of the functional masticatory center, an analysis of the stress-strain state of mathematical models of this fragment of the dentition was carried out using the finite element method. When developing a model of a biomechanical system, the surrounding biological tissues were considered discretely in terms of structure and physical and mechanical properties: dentin, enamel, periodontium, bone, cement. A technique for analyzing models of the functional masticatory center is proposed, which makes it possible to establish the relationship between the magnitudes and directions of functional loads, as well as internal stresses and deformations. As a result of the analysis of the stress-strain state of geometric and finite element models, the distributions of maximum strains and stresses in a given section under the action of specified loads were obtained. It has been established that under the conditions of this mathematical model, the areas of the apical periodontium of the teeth have the maximum shock-absorbing properties, and the functional masticatory center is equated to a static system. The capabilities of modern computer software make it possible to expand the understanding of areas of stress concentration with varying load parameters in the functional masticatory center in order to determine the most “critical” zones in order to predict and prevent the development of long-term complications.

Introduction. Medicine is currently considered one of the strategic and promising areas for effective implementation of artificial intelligence. Artificial intelligence in dentistry is a method of creating a second informed opinion that is based on mathematical decision making and prediction. Neural network technologies are applied in areas such as analysis of dental radiographs, prediction of oral treatment needs in children, classification of dental plaque and treatment planning for orthognathic surgery, and assisted diagnosis of caries.
The purpose of the study was to develop an optimal neural network structure to assess the risk of complications in implant treatment of partial and total tooth loss.
Material and methods. For the effective selection the optimal topology of the neural network to assess the risk of complications in the implant treatment of tooth loss a series of experimental simulations of neural network architectures by trial and error was conducted. The database was a table of 1800 patient clinical cases. A total of 1626 clinical cases were used for the simulations, which were divided into data for training and testing at a percentage of 80 to 20. Modelling was done using the high-level programming language Python 3.8.8. All the simulations were performed on a 3.00 GHz Intel(R) Core(TM) i5-8500 processor with 16 GB RAM and a 64-bit Windows 10 operating system.
Results. Because of the simulations, plots of recognition accuracy as well as error values for each of the developed neural network topologies were obtained. To improve the accuracy of the developed neural network topologies to assess the risk of complications during the implant treatment of maxillofacial pathology, a statistical study of the collected simulation database was conducted. For investigation the relationship between each patient parameter and the «implant engraftment acceptability» parameter, a parametric statistical method represented by the correlation coefficient was chosen. As a result of modeling by trial and error method it was found that using the neural network architecture № 7 without batch normalization layers (BatchNorm1d) allows achieving faster learning results with rather high recognition accuracy in a smaller number of epochs. Transforming the simulation base and reducing the input signal size significantly improved the recognition accuracy in comparison with the results of the first simulation of the different neural network systems for recognition of the implant engraftment success. The proposed topology of the neural network № 5 is the most optimal for the accuracy of recognition of the successful implant survival.

Microcirculation plays a decisive role in the metabolism processes between blood and tissue in both physiological and pathological conditions of the body. The analysis of changes in microcirculation provides a unique perspective for studying processes at the micro- and macrolevels in clinical and experimental medicine, including diseases in the maxillofacial region. Despite the critical role of microcirculation in many oral diseases, direct imaging and quantification of tissue microcirculation is currently limited. Scientific interest in microcirculatory monitoring is growing with the advent of new physical diagnostic methods. To date, there are many methods for assessing microcirculation. The purpose of this literature review is to show the positive and negative aspects of using various methods for monitoring microcirculation. The scientific literature was searched in the PubMed and Elibrary databases. As a result, the main shortcomings of various monitoring methods were emphasized, as well as what prospects for study and modification are possible today.

Dental care is one of the socially important types of medical care and is highly demanded by the population. An important factor limiting the population’s possibilities for orthopedic rehabilitation is the financial situation of low-income and retired persons. The Government of the Moscow Region has approved more than 120 different measures of social support for residents of the Moscow Region. The social support program of making and repair dentures for Moscow region residents restores chewing efficiency and the budget of the Moscow region finances the performed treatment. The program includes main types of orthopedic constructions. Sometimes clinical cases may require more complex prosthetics due to concomitant pathology. For such cases some kinds of treatment so called ‘expensive’ exist in program. The article describes a clinical case of a patient with a stomatoneurological status who received orthopedic treatment using dental implants within the framework of free dental prosthetics.

The article presents algorithms for assessing clinical certainty and risk by a dentist in the implementation of a specific medical intervention. The assessment of clinical certainty is prospective (prognostic) rather than retrospective in nature, which takes place during the examination of the quality of medical care, as well as control and surveillance activities. In this regard, a dentist, using a simple method of quantitative assessment of clinical certainty (risk), without the use of complex computational algorithms, is able to quickly navigate the level of complexity of medical intervention and personal readiness for its implementation.

The need for dental care of the adult population varies in different countries from 35 to 82%. The state healthcare system provides the same level of medical care for the entire population of Russia, but does not fully satisfy the need for full-fledged and high-quality treatment. The existing system of compulsory medical insurance in our country, which allows the majority of the population to receive a certain amount of medical services free of charge for patients, provides an alternative – a system of voluntary medical insurance. This system guarantees the protection of the interests of patients and meets modern requirements for the provision of qualified medical dental services, but needs further development and requires changes and additions to the regulatory framework. The wide development of voluntary medical insurance in the regions is hindered by a number of factors: an undeveloped infrastructure for the provision of medical services, the slow development of medical institutions, poor adaptation of doctors to better work within the framework of voluntary medical insurance, as well as low effective demand of the population.