Order No. 984 of August 20, 2020 of the Ministry of Science and Higher Education of the Russian Federation approved the Federal State Educational Standard of Higher Education – a specialty in the specialty 31.05.03 «Dentistry», programs are developed and approved by the organization independently with the formation of requirements for the results of its development in the form of universal, general professional and professional competencies of graduates. At the Department of Pain Management in Dentistry of Moscow State Medical University named after. A. I. Evdokimov developed the program «Features of providing dental care to patients with concomitant diseases» and an educational and methodological complex consisting of a textbook (monograph), a course of video lectures, an educational and methodological manual (workbook) for self-preparation of students for classes. In order to control the acquired knowledge, a bank of test tasks and situational tasks was created. An analysis of the performance of 1,306 students of the Faculty of Dentistry, who studied in the 9th semester, demonstrated the high efficiency of the developed program and educational and methodological complex.

Objective. Improving the assessment of the state of the bone tissue of the alveolar process of the toothless upper jaw, by calculating the level of its atrophy according to the diagnostic model of the jaw. Material and methods. The study of patients was carried out: anamnesis of the disease, examination of the oral cavity, analysis of diagnostic plaster models of the upper jaw according to the method we proposed. In accordance with the classification of the Shreder, groups were formed: the first is the 1st type of Shreder (n=24); the second is the 2nd type of Shreder (n=23); the third is the 3rd type of Shreder (n=19). Results. In some areas of the alveolar process of the toothless upper jaw, atrophy reaches vertical values at points A1-D: 0.71±0.20 mm (group 1), 0.57±0.19 mm (group 2), 0.19±0.26 mm (group 3), sagitally A1-A2: 4.72±0.28 mm (group 1), 4.48± 0.30 mm (group 2), 3.85±0.32 mm (group 3); transversal – K1-K2: 3.22±0.29 mm (group 1), 3.67±0.32 mm (group 2), 3.37±0.47 mm (group 3) and more intensive in the first year of operation the prosthesis. Conclusion. Thus, the proposed diagnostic method makes it possible to determine the uneven level of bone loss in various areas of the alveolar process of the upper jaw. The data obtained are taken into account to minimize the negative consequences of the transfer of masticatory pressure from the basis of the prosthesis when planning orthopedic treatment of patients with this pathology.

The purpose of our study was to study the effectiveness of the drug «Sextafag» as a therapeutic and prophylactic agent after the removal of impacted lower third molars.

Recently, there has been a large number of patients with antibiotic resistance, so it is to find an alternative to traditional antibiotic therapy. This article examines the qualitative and quantitative composition of the oral microbiota after removal of impacted lower wisdom teeth. We studied the dynamics of changes in microflora during antibacterial treatment and phage therapy. The data obtained confirm the clinical and bacteriological effectiveness of oral phage therapy for inflammatory diseases in dental practice and can serve as the basis for the development of a new algorithm for the use of bacteriophages in the treatment of purulent-inflammatory diseases of the oral cavity.

Relevance. In clinical observations, a combination of somatic pathology with various forms of periodontal tissue diseases has long been established. Hormonal status is of particular interest in this direction, since hormonal failure causes disturbances in the hormonal background of a person.

Goal. The aim is to increase the effectiveness of treatment of women with chronic generalized periodontitis on the background of hormonal imbalance by correcting the receptor status of the gingival epithelium.

Materials and methods of research. The research methodology provided for the integration of clinical, laboratory, histological and immunohistochemical methods. To realize the purpose of the study, a systematic approach was used, which was based on the analysis of the content of interrelated sources of primary information. The object of the study were women aged 18 to 59 years, who were assessed for periodontal status against the background of gynecological pathology and hormonal imbalance with the use of substitution therapy.

Conclusions. The inclusion in the complex treatment of periodontal tissue diseases of drugs with receptor-modulating and anti-inflammatory effect normalizes the work of the receptor apparatus of the gingival epithelium, which increases the effectiveness of the treatment of periodontal pathology.

The relevance of the study of the prevalence and intensity of caries in children of different age groups increases due to the fact that the tasks of modern pediatric dentistry include improving the level of care and prevention of caries and its complications.

Aim. The purpose of this study is to assess the prevalence and intensity of caries of temporary and permanent teeth in children and adolescents of different age groups (3–5 years, 6–8 years, 9–11 years and 12–16 years) living in the Solntsevo district of Moscow.

Material and methods. The study included 1,725 children of four age groups who underwent a routine dental examination in dental departments of hospitals, preschool and school institutions of the Solntsevo district with registration of the presence of carious cavities, fillings and removed teeth.

Results. The prevalence of caries in children of different age groups varies depending on the factors affecting the development of caries. The prevalence and intensity increase during the period of milk bite, then drop sharply by the beginning of the period of tooth change, then gradually increasing by the time the formation of a permanent bite is completed. Most of the children are not sanitized at the time of examination.

Conclusion. Preventive measures in preschool and school institutions, the level and nature of dental care for children in the Solntsevo district of Moscow are insufficient, since the increase in caries in children of different age groups of the district exceeds acceptable indicators, as a result of which many of the examined have carious cavities.

Today, in clinical practice, the loss of marginal bone mass around dental implants in the early stages after the installation and opening of the implant is increasingly common. Early clinical publications suggested that this bone loss occurred during the first year of prosthetics. Thus, numerous attempts have been made to minimize or eliminate such bone loss. However, the timing and cause of bone loss are not always obvious. The purpose of this review was to analyze data on marginal bone loss around dental implants in terms of biological implications to help understand changes in marginal bone around dental implants. One hypothesis for bone loss around dental implants has been related with infected interface between the implant and abutment. This review article shows that bone loss of 1.5 to 2.0 mm occurred around implant-abutment junctions at the bone level. The bone loss level was correlated with implant-abatement interface size. Recent publications indicate that such dental implant systems with large prosthetic-implant gaps may cause peri-implantitis with further implant loss.

Background. The study of microcirculation disorders, as one of the key factors in the pathogenesis of periodontal diseases, is relevant in clinical dentistry. Premature contacts, acting as provoking factors for occlusal disorders, cause overload of individual teeth and aggravate the severity of inflammatory periodontal pathology. Objective registration of capillary blood flow and associated changes in the microvessels of the arteriolar and venular units in patients with periodontopathies and occlusal dis-orders will allow us to assess the degree and nature of tissue blood flow disorders in the gum tissue.

Goal. Increasing the efficiency of diagnosing microcirculatory disorders in periodontal tissues in patients with chronic generalized mild periodontitis and disorders of the occlusal relationships of the dentition.

Materials and methods. Using laser Doppler flowmetry (LDF), the state of mi-crocirculation in the periodontium was studied in 78 people aged 21–35 years with intact dentition and physiological occlusion, of which 33 people (group 1) had clinically healthy periodontium and the absence of occlusal disorders (group 1), with generalized chronic pulmonary periodontitis degree and premature occlusal contacts – 45 people (group 2). The microcirculation index (M), standard deviation (σ), and coefficient of variation (КV) were assessed. To obtain objective diagnostic data, amplitude-frequency analysis of the harmonic rhythms of LDF-grams was used with spectral decomposition into harmonic components of physiological oscillations of tissue blood flow (wavelet analysis).

Results. In patients of group 2, in comparison with patients of group 1, a decrease in the level of periodontal blood perfusion, a reduction in the fluctuation of erythro-cyte flow and vasomotor activity of microvessels is determined, while a decrease in “active” and an increase in «passive» modulation of tissue blood flow contributes to an increase in the volume of circulating blood at arteriovenular anastomoses when the intensity of blood flow through the vessels of the capillary bed decreases.

Conclusions. Patients of group 1 were diagnosed with a normoemic type of LDF-gram, which provides a relatively high degree of intensity of tissue blood flow, balance of regulatory mechanisms, and optimal trophism of periodontal tissues. In patients of group 2 with a spastic type of LDF-gram, characterized by a reduced level of perfusion, flux, vasomotor activity of microvessels, indicators of tissue blood flow and trophic function are significantly reduced.

Relevance. The retention period is the most important stage during which the structural and functional state of the organs and tissues of the mouth must be fully restored after long-term orthodontic treatment. An increase in the time spent by orthodontic equipment in the oral cavity associated with the use of retention devices also increases the risk of developing complications from the hard tissues of teeth and periodontal tissue, while the problem of preventing these complications is not fully addressed.

Purpose. Based on a multi-level study of the condition of the organs and tissues of the mouth, to evaluate the effectiveness of the use of modern domestic means of intraoral hygiene in the retention period of orthodontic treatment.

Materials and methods. 84 patients aged 18 to 45 years during the retention period of orthodontic treatment were examined. The control group consisted of 32 people using usual hygiene products. Patients of the second group (28 people) were prescribed anti-inflammatory hygiene products for the first 7 days after removal of the equipment; then using a combination of anti-inflammatory and remineralizing intraoral agents based on hydroxyapatite. In the third group (24 people), a rinse aid based on benzydamine (0.15%) and chlorhexidine (0.05%) was prescribed for the first 7 days after removal of the equipment; then use your usual hygiene products and any means to remineralize the enamel at night. The condition of periodontal tissues was assessed using the PMA index and the CPITN index. Enamel caries resistance was determined using the TER test. The desensitivity effect was studied using the dental sensitivity index of L.Yu. Orekhova - S.B. Ulitovsky. Examinations of patients were carried out on the day of removal of fixed orthodontic equipment, after 7 days, after a month and after 3 months from the start of the study.

Results. The dynamics of changes in the CPITN index in the second group were 9.1% after 7 days of use, 35.6% after a month of study and 46.2% after 3 months from the start of observation. The dynamics of changes in the PMA index were 13.6% after 7 days of use, 39.7% after a month of study and 47.7% after 3 months from the start of observation. Remineralizing efficiency in the second group improved by 13.1% after 7 days, after a month of use to 36.1%, and after 3 months it increased to 57.4%. In patients of the second group, the desensitizing effectiveness was 27%, after 1 month -47%, after three months -56%.

Conclusions. The data obtained allow us to recommend proven oral care products during the retention period of orthodontic treatment for the purpose of primary and secondary prevention of diseases of the hard tissues of teeth and periodontal tissue after removal of fixed orthodontic equipment (brackets).

This article describes a method of directed bone regeneration (DBR) of alveolar bone using 3D printed individual titanium framework membranes (ITFMs). Using computer modelling and additive technologies, we have designed and manufactured ITFMs for directed bone regeneration. The use of such membranes made it possible to reduce the duration of operations and obtain a larger volume of bone regenerate. Barrier membranes made of cross-linked collagen with a long resorption time were used as a comparison group.

Results. The use of ICTM for alveolar bone reconstruction allowed us to achieve a maximum bone regenerate height of 6.28 mm, while using Lamina collagen membrane – 2.75 mm. The median difference of bone height before and after surgery with ICTM was 3.605 mm, for Lamina – 1.33 mm. The obtained results allowed us to recommend the use of Lamina membrane for restoration of alveolar bone width and/or height within 3 mm. In case of combined defects of alveolar bone width and height of more than 3 mm, we recommend the use of customized 3D printed titanium frame membranes.

To date, thyroid diseases are one of the most common pathologies of the endocrine system and are an urgent medical and social problem. In order to treat and diagnose differentiated thyroid cancer, thyrotoxic goiter, and diffuse toxic goiter, radioiodine therapy is used in combination with other methods (surgery, hormone therapy). Lesions of the salivary glands that occur after radiotherapy are associated with the ability of large salivary glands to concentrate iodine in ductal cells. The accumulation of radioactive iodine I131 has an adverse radiation effect on the salivary glands, which leads to damage to the tissues of the glands of varying degrees of intensity.

Background. Despite the large number of publications devoted to this problem, the clinical and laboratory characteristics of radioiodosialadenitis remain incomplete and often contradictory. In this regard, the study of this topic does not lose its relevance.

Materials and methods. As a result of the examination of 45 patients after radiooderpia, with a clinical-radiological examination, a group of patients (n = 12), with a lack of a secret during visual examination and contrast of one or more salivary glands, is probably associated with irreversible changes in the salivary glands, was identified and described in this article.

Results. Different combinations of damage to one or more salivary glands have been identified, reducing the level of quality of life of patients in this group of patients. When examining the salivary glands and conducting differential diagnostics, various combinations of examination methods must be used.

Conclusions. The side effect of the effects of radioid therapy on the salivary glands is characterized by a wide spectrum of the involvement of the salivary glands up to a decrease in the functional activity and atrophy of the salivary glands, however, adverse consequences are not always dose-dependent. The results of the methods obtained do not exclude, but complement each other, which allows you to fully evaluate structural and functional changes in salivary glands. The negative effects of radionuclide therapy on the salivary glands affects the quality of life of patients.

Attempts to restore continuity of the dentition date back to ancient times, as evidenced by the numerous archaeological and written records found throughout the world. They served as material evidence of the existence of implantology in ancient civilizations and helped to restore the chronology of its development. For example, in about 2500 BC the Egyptians tried to strengthen teeth with diseased periodontium with gold ligature wire, and in 2000 BC in ancient China lost teeth were replaced with bamboo pegs. In different time intervals, different materials were used to make artificial teeth: sea shells, rose quartz, animal teeth and bones, porcelain, etc., teeth were tried to be replanted, transplanted from living and dead people. High percentage of postoperative infection, limited knowledge, religious prohibitions, skepticism of scientific elites acted as inhibiting factors at different stages of formation of implantology as an important field of dentistry. This article is devoted to the development of dental implantology and to the doctors and scientists who played a key role in the formation and development of this field of dentistry.

Surface modifications of dental implants to provide optimal conditions for osseointegration remains an urgent task in modern dental implantology. A few publications demonstrate that the surface of the dental implants modified by plasma electrolytic oxidation (PEO) possess a combination of several important features that promote osteointegration: optimal micro roughness within 1-7 microns, high chemical purity, and mechanical strength [8,20].

The aim. To evaluate the clinical efficacy of IRIS implants with a new surface modified by the PEO method (hereinafter referred to as IRIS PEO).

Materials and methods. Based on the Patrice Lumumba RUDN Medical Center and the Center of Medical Care for Dental Diseases, FGBU «Central Clinical Hospital with Polyclinic» of the Presidential Affairs Department of the Russian Federation, 60 patients aged 27 to 52 years with partial tooth loss were examined and treated. The patients received 1 IRIS-PEO implant each on the upper or lower jaw. All implants were placed with the force from 35 to 50 N/cm², with gingiva shapers. Prosthetics were performed after 2 months on the lower jaw and after 4 months on the upper jaw. Before taking impressions, the stability of implants was measured using the Penguin RFA (Integration Diagnostic Sweden AB, Sweden). One year after prosthetics, the neck resorption of the implants was evaluated.

Results. Because of the treatment, all prosthetic constructions met the functional and aesthetic requirements. The stability indices of implants in ISQ units on the upper jaw averaged 75±3.4, on the lower jaw 79±2.4. Bone resorption in the implants’ neck area 1 year after the end of the treatment was not observed. The pilot clinical study of the IRIS-PEO implants allowed to optimize the terms of rehabilitation and to obtain high functional and esthetic result in the treatment of patients with tooth loss.

Conclusions. Pilot clinical implementation of the implants of the IRIS system with the surface modified by plasma electrolytic oxidation demonstrated the possibility of open management of the implants with the gingiva shaper, to carry out prosthetics in 2 months on the lower jaw and 4 months on the upper jaw. No neck resorption was observed one year after prosthetics.

This article deals with the creation of a three-dimensional model of the cancellous bone-cortical bone-implant-abutment-screw system. This model allows predicting the mechanical stress of the implantation system elements under conditions close to the real one. Such visualisation helps to determine the stress coefficients and to determine the places of presumed mechanical loading of the future implantation bed.

Lichen planus (lichen ruber planus), according to most Russian and foreign scientists, is one of the most common diseases of the oral mucosa in the system, but the available data on the frequency of the lesion are quite contradictory and range from 17 to 79%. Rare clinical forms of the disease present certain difficulties for diagnosis, which in approximately 35–40% of cases leads to an incorrect diagnosis. In recent years, the frequency of relapses of the disease has increased, and there has been an increase in the number of patients in whom lichen planus manifests itself atypically. Scientific reviews contain information about the primary manifestation of the disease after a coronavirus infection. Not only the decrease, but also the temporary loss of ability to work of patients with this nosology is of significant socio-economic importance. Existing theories of the occurrence of the disease – viral, neurogenic, hereditary, immunological, toxic-allergic and others – only partially explain the features of the pathology. The purpose of our work was to review scientific articles, dissertations and systematic reviews of domestic and foreign authors on numerous etiological concepts of lichen planus of the oral mucosa and red border of the lips. A review of the available Russian and foreign scientific literature over the past 10 years has been carried out, which allows us to more fully evaluate the etiological theories of the occurrence of lichen planus in the oral cavity proposed by many authors for the further prescription of adequate therapy, as well as the prevention of this disease.

Denture stomatitis is a common inflammation of the mucous membrane covered by the denture, which is caused by yeast-like fungi of the genus Candida. Candida albicans is considered the most common cause of denture stomatitis. It occurs under removable dentures due to several causative and contributing factors. If left untreated, this disease can lead to fatal systemic candidal infections. Denture-associated candidal stomatitis, clinically described in the literature, is a localized or generalized inflammation of the oral mucosa in association with a removable denture. During this inflammatory process, Candida biofilms and the patient’s immune response play a significant role. Among the microorganisms in this mixed biofilm, Candida species easily multiply and transform from a saprophyte into an opportunistic pathogen. In this situation, the presence of a prosthesis plays an important role. In particular, Candida albicans is capable of interfering with the body’s innate immune system to cause infection. Additionally, edentulous older adults wearing dentures may experience an imbalance and decreased diversity of the oral microflora. The present narrative review focuses on the presentation of denture stomatitis in patients who wear dentures and, in particular, on the involvement of Candida albicans sp. associated with this pathology.