Relevance. The COVID-19 pandemic caused by the SARS-CoV-2 virus has demonstrated the critical importance of understanding the mechanisms of transmission and finding effective methods of prevention. Particular attention has been paid to the role of oral hygiene, as the oral cavity serves as a major route of transmission. Studies show that the composition of the oral microbiota can influence the course and outcome of COVID-19 disease. Therefore, there is a need to study the effects of oral antiseptics on the microbiome, which may offer new opportunities for the prevention and treatment of this disease.

Objective. The aim of this study is to evaluate the effectiveness of the oral cleansing foam «Parodontol PROF» in reducing the pathogenic microflora of the oral cavity in patients with COVID-19 and to assess its effect on the risk of secondary infections.

Materials and methods. The study was conducted on the basis of the Clinical Medical Centre «Kuskovo» of Russian University of Medicine. It included 450 patients with a confirmed diagnosis of COVID-19. The participants were divided into two groups: the test group used oral cleansing foam, while the control group used no additional oral hygiene. Comparative analyses of the taxonomic composition of the oropharyngeal microbiota and dental plaque before and after the use of the cleansing foam were performed.

Results. The study showed that patients who regularly used the cleansing foam «Parodontol PROF» had a significant decrease in the representation of pathogens, including Mycoplasma, and an increase in the number of beneficial commensals such as Lactococcus and Lactobacillus. These changes indicate the potential efficacy of this product to improve oral hygiene and reduce the risk of secondary infections.

Conclusion. The study supports the hypothesis that improving oral hygiene with specialised antiseptic agents, such as a cleansing foam, may help to reduce pathogenic microflora in the oral cavity in patients with COVID-19. This, in turn, may reduce the risk of pathogen migration into the lower respiratory tract and the development of secondary infections. The findings emphasise the importance of further research in this area and the development of comprehensive approaches to oral hygiene management in the context of infectious diseases.

This article describes an experimental study with animal training, which examines the osseointegration of dental implants installed during the reconstruction of the alveolar part of the mandible by the method of reversible bone block. The protocols of surgical intervention, sampling of material for microtomography analysis, as well as the results of the study are presented.

This article describes an experimental study involving animals, which examines the osseointegration of dental implants installed during the reconstruction of the alveolar part of the mandible by the method of reversible bone block. The protocols of surgical intervention, sampling of material for morphohistological analysis, preparation of biopsy samples for examination, as well as the results of the study are presented.

Relevance. Fractures of the mandibular fracture are a stressor on the body and lead to changes in the functioning of the autonomic nervous system. At the same time, patients with mandibular fractures often experience local changes in the nervous system associated with the anatomical and physiological features of the location of the third branch of the trigeminal nerve and its damage. These changes affect the course of the post-traumatic period and may increase the likelihood of complications of mandibular fractures.

Purpose: to determine the significance of disturbances in the functioning of the nervous system during the post-traumatic period of fractures of the mandibular fracture.

Materials and methods. When examining 130 patients with fractures of the mandibular fracture, the state of the autonomic nervous system and local neurological changes were studied.

Results. In patients with mandibular fractures, dysfunction of the autonomic (autonomic) nervous system and local neurological changes were revealed.The severity of these changes is reflected in the development of complications of fractures. When studying the autonomic nervous system in patients with mandibular fractures, there was an increase in the activity of the sympathetic nervous system, which increased the likelihood of developing complications of mandibular fractures. A high incidence of injury to the inferior alveolar nerve was also found. The most pronounced deviations in autonomic balance indicators – pathological increased excitability of the autonomic nervous system – were diagnosed in patients with complicated fractures of the mandibular fractures. In most patients with complicated mandibular fractures, damage to the trigeminal nerve was detected, confirming the role of neurotrophic disorders in the development of complications.

Conclusion. With fractures of the mandible, there is an increase in the activity of the sympathetic nervous system, which increases the likelihood of complications. The most pronounced deviations in autonomic balance indicators were diagnosed in patients with complicated fractures of the mandible. In addition, in patients with mandibular fractures, a high incidence of damage to the inferior alveolar nerve was revealed; in complicated fractures, neuropathy is severe, which confirms the role of neurotrophic disorders in the development of complications. Thus, methods for preventing purulent-inflammatory complications in jaw fractures should include correction of neurological disorders.

To date, the use of a temporary skeletal anchorage in orthodontic treatment in almost every clinical case. Despite this, there are only two variants of this surgical instrument: mini-screws and mini-plates. Both variants of the skeletal anchorage have their positive and negative qualities, which, to one degree or another, affect the result and timing of treatment. The purpose of this literature review is to describe the main methods of using temporary skeletal anchorage, in which clinical cases their use is possible and contraindicated, as well as what positive and negative aspects can be observed during and after the treatment of orthodontic patients. The search for scientific data was carried out in the PubMed database using such keywords as: orthodontic skeletal anchorage, temporary anchorage, orthodontic mini-screw, orthodontic mini-plate. A literature search revealed that temporary skeletal anchorage allows the surgeon and orthodontist to predictably make changes to the jaw bones that were previously only possible with orthognathic surgery. Before installing a mini-screw or mini-plate, careful planning in the form of an examination and x-ray examination should be carried out. Ultimately, informed consent should be obtained explaining to the patient that orthognathia may still be necessary if the skeletal anchorage method fails. Although this is still a relatively new technique, some issues need to be considered and further clinical research is needed.

Introduction. Materials based on extracted teeth in various studies have been radiographically and histologically proven to be effective in osteoplastic operations. These materials can be used in the form of crushed dentin matrix, a fragment of the tooth’s root and an autogenous dentin block. The purpose of this clinical case was to evaluate the effectiveness of using an autogenous dentin block to increase the alveolar process of the jaws in the preimplantation period.

Description of a clinical case. Patient F., 30 years old, applied to the clinic of the Clinical Center of Maxillofacial, Plastic Surgery and Dentistry Russian University of Medicine with a complaint of a missing tooth in the frontal region of the lower jaw. At the time of treatment, the patient was already undergoing orthodontic treatment in another medical institution in Moscow. The patient underwent a clinical and radiological examination together with a prosthodontst. A diagnosis of «partial secondary adentia», «atrophy of the alveolar ridge in the frontal part of the lower jaw» and «dystopia of teeth 1.8, 2.8, 3.8, 4.8» was established. A comprehensive treatment plan has been drawn up. At the first stage, the patient underwent extraction of teeth 1.8, 2.8, 3.8, 4.8 for orthodontic indications with simultaneous bone grafting of the alveolar ridge in the area of the missing tooth 3.1. At the second stage, the patient underwent a trephine biopsy in the area of augmentation and installation of a dental implant in the area of missing tooth 3.1. The third stage was rational prosthodontic treatment on a dental implant in the department of prosthodontics.

Results. The present study showed that autogenous dentinal block can serve as an alternative material for alveolar ridge augmentation.

Introduction. To date, according to WHO, the number of people with a complete absence of teeth is greater than 8% of all the people worldwide. Loss of teeth due to complications of caries treatment, chronic periodontitis and trauma leads to atrophy of the alveolar ridge and that of soft tissues in this area, which in turn complicates the rehabilitation of the patients. According to the literature, in the first year after tooth extraction, the volume of the bone tissue of the alveolar ridge decreases by 40–60%, which greatly complicates the subsequent orthopedic rehabilitation of the patients. Currently, the «gold standard» for increasing the volume of the bone tissue of the alveolar ridge of the upper jaw in the distal section is the sinus lift operation. However, according to the literature, when sinus lift operation is performed, Schneider’s membrane perforation occurs in 7–23% of cases, which in terms, leads to the inability to complete the operation and complications in cases with total perforations of membrane.

Purpose of the study. To evaluate the complex rehabilitation of patients with partial secondary absence of teeth and severe atrophy in the lateral sections of upper jaw using the «envelope technique» during open sinus lifting.

Materials and methods. In 2020–2022, during a clinical study at the clinic of the Department of maxillofacial and plastic surgery of the Moscow State Medical University named after A.I. Evdokimov, 54 patients who had a history of PPI interventions in the ENT department were treated. All patients underwent bilateral open sinus lifting using enamel matrix proteins or the «envelope technique» for perforation of the Schneider membrane. After 9–12 months, a comprehensive rehabilitation of patients based on dental implants was carried out.

Results. The number of extensive (total) perforations of the Schneider membrane in the study group of patients was 50%. As a result of the use of the patented «envelope technique» with the use of enamel matrix proteins, no postoperative complications were observed in patients with total perforation of the Schneider membrane. Taking into account the planned orthopedic design, 292 dental implants were installed in all patients.

Conclusion. The method is effective and safe, allowing to rehabilitate patients with missing teeth and severe atrophy in the lateral part of the upper jaw, in case of intraoperative total perforation of the Schneiderian membrane.

The article presents the results of the outcomes analysis of osteoplasty in the rehabilitation of patients using dental implants, examines its various types and biological factors affecting the success of these operations. An attempt has been made to find possible solutions to the problem of bone insufficiency in the treatment of patients with missing teeth.

The aim of the study is to study the results of various bone grafting techniques in patients in preparation for dental implantation and the success factors of this surgery.

Materials and methods: the results of 281 osteoplasties were evaluated. The patients were divided into 4 groups according to the surgery technique performed: guided bone regeneration (GBR); bone block transplantation (BBT); open sinus-lifting (OSL); local bone modifying (LBM). Complications and results of these surgeries were evaluated.

Results: significant and critical complications were more common in the operations of GBR (61.7% and 21.28%, respectively) and BBT (28.57%). After evaluating the outcomes of osteoplastic surgery, it was found that the acceptable result of OSL was 93.27%, LBM 88.43%; while we noted an unacceptable result during GBR in 76.59%, and BBT 57.14%. Complications in the form of non-critical reversible ones were more common during OSL (42.3%), however, significant and critical complications were detected after operations of GBR (61.7%) and BBT (28.57%). The results of the analysis of the outcomes of bone plastic surgery in the oral surgery indicate a significant percentage of unsuccessful outcomes of the GBR (76.59%) and BBT (57.14%).

Conclusion: the study demonstrates the clinical value and effectiveness of various osteoplasties’ methods. In our opinion, outcomes and complications is associated, among other things, with a different factors, the main of which are the number of existing bone walls of the defect (atrophy), the volume of replacement, age and localization, which must be taken into account when predicting the results of this surgery.

One of the most pressing problems of maxillofacial surgery (MFS) is the provision of specialized medical care to the wounded and injured in combat conditions. Even more complex tasks are reconstructive surgical treatment at the stages of evacuation and the most complete rehabilitation of patients with the consequences of combat injuries to the maxillofacial area (MFA). Gunshot combat wounds of the MFA are characterized by severe anatomical and functional disorders, they can manifest themselves as significant defects and severe deformations, which in turn leads to an increase in sanitary losses of army personnel, disability of young and middle (working) age patients, a decrease in the quality of their life, long-term and expensive treatment that requires special knowledge and manual skills from specialists. All this determines not only the medical, but also the socio-economic significance of the topic of this study.

Objective. Present an analysis of the quality of surgical care provided to patients with consequences of gunshot combat wounds of the MFA.

Methods. The study was carried out by specialists from the State Budgetary Healthcare Institution «Maxillofacial Hospital for War Veterans» of the Moscow Department of Health, under the guidance of the chief, PhD, professor, main specialist in MFS – V.A. Belchenko, for the period from October 2022 to July 2023. Diagnosis, planning and surgical treatment of adult patients with the consequences of gunshot combat wounds of the MFA were carried out at the stages of treatment and evacuation measures. A sample of medical documentation was made, the data obtained was processed by the generally accepted statistical method. The results were analyzed and compared with data from similar studies.

Results. The study group included 55 males, aged from 23 to 56 years, the average age of the patients was 36.16±7.79 years. We divided the studied patients into subgroups according to the conditional zones of damage to the MFA: 1st – upper zone of the face (n=3, 5.45%), 2nd – middle zone of the face (n=28; 50.91%), 3rd – lower zone of the face ( n=32; 58.18%). The number of patients with isolated injuries is 18.18% (n=10); with multiple – 81.81% (n=45); with combined – 72.72% (n=40). The article presents the characteristics of patients with the pathology under study, discusses some features of diagnosis and planning, discusses tactics and problems associated with the surgical stage of treatment, as well as further rehabilitation measures.

Conclusion. Despite the emergence of new medical equipment, equipment for diagnostics, planning and solving complex problems of surgical intervention, there is a clear need for training specialists, developing and improving the applied medical recommendations, with a clear indication of the method of choosing tactics and methods of surgical treatment. Medical care for adult patients with the consequences of gunshot combat wounds of the MFA must be comprehensive and carried out on the basis of specialized centers, and must include both surgical and orthopedic components, which will minimize the number of errors and complications, increase the effectiveness of treatment and, as a result, make rehabilitation as complete as possible.

In the last few years, postcovoid osteonecrosis has become increasingly common among the causes of defects in the upper jaw, as a complication after a coronavirus infection.

Purpose. To increase the effectiveness of orthopedic treatment of defects of the upper jaw formed as a result of postcovoid osteonecrosis of the maxillofacial region by applying a material for soft relocation GC COE-Soft Professional Package to the obturator of a compound jaw prosthesis made according to the method of Y.M. Zbarzh.

Materials and methods. Over the past three years nine patients with postcovoid osteonecrosis of the upper jaw have had complex-jaw prostheses made according to the method of Y.M. Zbarzha with the application of GC COE-Soft Professional Package soft relocation material to the obturating part of the prosthesis to accelerate patient adaptation.

Results. A postresection prosthesis made according to the method of Y.M. Zbarzha, which restores the defect of the upper jaw, turns out to be hollow, which greatly facilitates the design and improves the fixation of the prosthesis in the oral cavity. The use of Remanium button clamps from Dentaurum has confirmed its effectiveness. Due to the application of acrylic material for soft relocation GC COE-Soft Professional Package to the obturating part of the prosthesis, the patient’s adaptation is accelerated, the number of visits for correction is reduced.

Introduction. In the practice of an orthodontist, diseases of the temporomandibular joint (TMJ) are an urgent problem due to their widespread, diverse clinical manifestations.

Goal. To study the relationship between the identified anatomical and functional disorders of the TMJ, as risk factors for complications during orthodontic treatment, and the presence of characteristic complaints in the structure of pathological changes in the TMJ.

Materials and methods. According to the type of organization and the ratio of data collection time, the scientific study belonged to a longitudinal retrospective study, according to the type of observation: case-control. A retrospective analysis of 102 outpatient medical records of patients who sought medical help from an orthodontist at a dental clinic was carried out. The criterion for inclusion in the study was the presence of a newly diagnosed disease of the temporomandibular joint, mandatory radiological diagnostic methods. Magnetic resonance imaging (MRI) of the TMJ in the patient who sought medical help was used as a radiation diagnosis. As part of the scientific study, the structure of pathological changes in the TMJ was analyzed, the relationship between the presence of complaints and the revealed pathology was studied.

Results. The analysis of the data showed that the MR examination of the TMJ reveals pathological changes in patients who sought orthodontic care, both with complaints and with an asymptomatic course of diseases. Data analysis did not show a statistically significant relationship between the presence of complaints and the revealed pathology in the case of degenerative (χ² = 0.123; p > 0.05), inflammatory changes in the TMJ (χ² = 0.123; p > 0.05) and pathological disorders of the masticatory muscles (F = 0.704; p > 0.05). The relationship is statistically significant, but weak for ventral dislocation without reposition (p < 0.05; φ = 0.107) and the dorsal arrangement of the disc (p < 0.05; φ = 0.101). In the case of ventral dislocation of the articular disc with the reposition, the relationship is statistically significant, of medium strength (p < 0.05; φ = 0.284).

Conclusions. The results of a retrospective analysis of medical documentation confirm the need for instrumental research methods for all patients, regardless of whether they have any complaints at the stage of determining the optimal tactics of orthodontic intervention to obtain diagnostic information on the state of the TMJ in order to prevent the risks of complications during orthodontic treatment.

Introduction. Removal of wisdom teeth is always accompanied by the appearance of collateral edema of varying severity, pain, neurological dysfunction and inflammatory contracture of the masticatory muscles.

Purpose. To evaluate the use of local apparatus hypothermia and the method of three-dimensional facial scanning for the treatment of patients after extraction of mandibular third molars.

Materials and methods. 60 patients had their wisdom teeth removed. Depending on the group, local apparatus hypothermia (LAH) (study group of 30 patients) and local ice hypothermia (LIH) (control group of 30 patients) were performed after surgery. Evaluation criterion: three-dimensional scanning of the face on days 3, 5, 7.

Results. In the control group, on the 3rd day the size of the edema was 6.31 mm (SD 0.81), on the 5^th day – 4.88 mm (SD 0.73), on the 7^th day – 3.44 mm (SD 0.88). In the study group, on the 3^rd day the size of the edema was 5.09 mm (SD 0.80), on the 5^th day – 2.73 mm (SD 0.71), on the 7^th day – 1.28 mm (SD 0,62). In the control group, the size of edema on the 5^th day changed by 22.67% compared to the 3rd day, on the 7^th day by 30.12% compared to the 5^th day and by 45.94% compared to 3^rd day. In the study group, the size of edema on the 5^th day changed by 46.42% compared to the 3^rd day, on the 7^th day by 53.16% compared to the 5^th day and by 75.32% compared 3^rd day. Comparison of groups 3, 5 and 7 in terms of absolute values of edema size and percentage change showed a statistically significant difference (p<0.001).

Conclusion. The use of local apparatus hypothermia in the postoperative period can reduce the severity of collateral edema in a shorter period compared to standard methods of local hypothermia.

Background. An increase in the number of patients with chronic apical periodontitis is becoming a global trend, which is mediated by several factors: the formation of foci of chronic infection, an increase in the number of various odontogenic complications leading to the loss of a causal tooth, a decrease in general resistance and the development of persistent sensitization of the body.

The aim of the study was to evaluate the effectiveness of diagnostic measures based on a complex of microbiological and joulemetric methods in patients with chronic apical periodontitis.

Materials and methods. 25 patients with the established diagnosis of «chronic apical periodontitis» were examined. Microbiological and joulemetric analyses of the root canal system were performed before and at the stages of treatment using the delayed obturation method, which provides for intra-channel administration of a preparation of highly dispersed calcium hydroxide.

Results. The comprehensive analysis of the results of bacteriological and joulemetric studies of the contents of the root canal system in the examined patients at the diagnostic and treatment stages fully corresponded to the clinical picture of the course of this nosological form and reflected the dynamics (negative and positive) of the inflammatory process in the studied periapical region.

Conclusions. The combined use of microbiological and joulemetric techniques increases the effectiveness of therapeutic and diagnostic measures in patients with chronic apical periodontitis, which in turn reduces the risk of possible complications and improves the effectiveness of immediate and long-term therapy results.

Background. Recently, the interest of dentists and physiologists has been focused on the development of a set of informative computerized techniques for an objective analysis of the functional state of the dentofacial apparatus. Achieving certain successes in conducting functional diagnostic examinations contributes to the development of algorithms for complex treatment of patients with generalized periodontitis and premature occlusal contacts.

Goal. Study of the functional state of the dentofacial apparatus according to the parameters of bioelectrical activity of muscles in patients with chronic generalized periodontitis and occlusal disorders in static and dynamic conditions of the lower jaw.

Materials and methods. The study involved 37 people with clinically healthy periodontium, physiological occlusion, and absence of occlusal disorders (Group 1) and 45 patients with physiological types of occlusion, generalized chronic periodontitis and premature occlusal contacts (Group 2). Functional methods included electronic registration of occlusal relationships with the T-Scan® III computer occlusion analysis system and study of the bioelectrical activity of the masticatory muscles using the Bio-EMG® III electromyography using standard functional tests.

Results. In patients of group 2, in comparison with patients of group 1, neuromuscular discoordination of the functional activity of the masticatory muscles was diagnosed. This condition is confirmed by the asymmetry and lack of muscle synergy when performing the “Maximum volitional compression” test, an improvement in the symmetry of the work of the muscles of the same name on the right and left sides and the synergy of the work of the muscles of the right and left masticatory groups, as well as a statistically significant increase in the values of biopotentials m. temporalis and m. masseter during the “Maximum volitional compression on rollers” test.

Conclusions. Disturbances in the coordinated work of the muscles of the craniofacial region in patients with chronic generalized periodontitis and premature occlusal contacts are realized in a statistically significant increase in the biopotentials of the masticatory muscle group at rest, a decrease in biopotentials during functional loading, as well as a reduction in the values of symmetry and synergy in relation to similar values patients of group 1.

A review of modern Russian and foreign, mainly English, literature on the topic of contact allergy to toothpaste ingredients is carried out. During the systematic review, literature data on the composition of toothpastes are analyzed, the most common allergens are identified, and the clinical picture of contact allergy to toothpaste ingredients is described. It is shown that the most common allergens in toothpastes are fragrances. In addition, potential allergens are cocamidopropyl betaine, propylene glycol, essential oils, parabens and propolis.

Relevance. The article is devoted to the issue of diagnosing the condition of the jaw bone tissue in children with mixed dentition. The relevance of the study is related to the increased consumption of chewing gum by children.

The purpose of this study was to evaluate the echodensity of the jaw bone tissue in patients with mixed dentition using chewing gum with varying intensity.

Materials and methods. We examined 31 children, the average age was 8.5±1.2 years. It is at this age that the active formation of facial morphology and anatomy takes place, which is directly related to the condition of the jaw bones. For diagnosis, an ultrasound technique was chosen – osteometry. This method is based on assessing the speed of propagation of ultrasound waves along the surface of the bone. In addition, in comparison with radiation, ultrasound methods for studying bone tissue have significant advantages, expressed in the reliability of the results obtained, low cost of procedures, ease of use, absence of radiation for personnel and patients, and minimal research time. From a practical point of view, this method is the most accessible in a dental office. Echoosteometry was carried out using the Echoosteometer EOM-01TS apparatus.

Results. Based on the study, it was revealed that there was an imbalance in bone density in children who actively used chewing gum.