Stanislav Yu. Maksyukov

The article discusses the current problem of low patient motivation for complete oral cavity sanitization. The author analyzes the influence of modern objective visualization tools (intraoral cameras, digital macro photography, computer modeling systems) on the process of building trust between the doctor and the patient. In the course of the study, a comparison was made between the effectiveness of the standard consulting protocol and the protocol using visual means of objectifying the diagnosis. It has been found that visual contact of the patient with pathological changes in their own oral cavity significantly increases the motivation index, improves individual hygiene indicators and promotes the adoption of complex treatment plans, including orthodontic and orthopedic stages. A list of the clinic’s equipment required for implementing the method is provided. The study results confirm that the method’s implementation can be a step toward the qualitative transformation of dental care.

INTRODUCTION. The leading problem of modern dentistry is the treatment of caries and its complications: diseases of the pulp and periapical tissues, and as a result, these pathologies in the adult population make up the basis of therapeutic procedures in the daily dental appointment of a practicing doctor. Currently, in order to provide an effective treatment method during conservative therapy with a diagnosis of pulp hyperemia, a dentist should clearly interpret the algorithm of therapeutic procedures and the means used. AIM. To improve the effectiveness of treating pulp hyperemia. MATERIALS AND METHODS. The study was conducted on the basis of the Kuban State Medical University Dental Polyclinic of the Russian Ministry of Health. This study was conducted with the approval of the Kuban State Medical University Ethical Committee, Protocol No. 125 dated September 12, 2023. A total of 127 patients with a diagnosis of pulp hyperemia (K04.0) and a chewing group of I-class teeth according to Black were observed. The patients were divided into 3 groups and 6 subgroups for the study. RESULTS. Among the patients examined, on the 30th day of the study, the Biodentine+Trigexylon method demonstrated a statistically significant advantage over the other two methods in terms of the frequency and intensity of complaints, especially in the subgroup of patients with tooth cavity opening. On the 180th day of observation, the Biodentine+Trigexylon method ensured complete absence of complaints in all patients, while in Groups 2 and 3, single complaints persisted in a small number of patients. By the end of the first year from the start of treatment, the Biodentine+Trigexylon method provided complete and stable relief of symptoms in all patients, regardless of whether the tooth pulp was exposed, while in Groups 2 and 3, there were occasional complaints related primarily to the subgroup with exposed pulp. CONCLUSION. The obtained data confirm that in the long-term period, all three methods provide a comparable objective result. This is consistent with scientific evidence on the choice of material for the treatment of deep caries and direct pulp coverage. However, the subjective outcome (absence of complaints) is achieved most reliably when using the combination Trigexylon+Biodentine.

BACKGROUND: One of the most difficult tasks in clear aligner treatment is maintaining anchorage during molar distalization. Traditional anchorage methods often lead to unwanted side effects in the anterior segment. AIM: To analyze the effectiveness of maxillary molar distalization using clear aligners and to optimize this treatment protocol based on a comparative analysis of clinical results obtained with the standard protocol versus a protocol using micro-implants. METHODS: A total of 40 patients with Class II malocclusion were examined and treated. The patients were divided into two groups: the study group (aligners + micro-implants) and the control group (aligners + Class II elastics). Results were evaluated based on cone-beam computed tomography data and superposition of 3D jaw models. RESULTS: In the study group, bodily molar movement of 3.2 ± 0.4 mm was achieved without loss of anchorage. In the control group, incisor protrusion (average 2.3°) and distal crown tipping (tipping) of the molars were observed. CONCLUSION: The integration of micro-implants into the aligner treatment protocol provides predictable results and minimizes dependence on patient compliance. Skeletal anchorage provides absolute anchorage, preventing undesirable incisor protrusion and ensuring bodily control of molar movement. The use of this technique increases the predictability of digital planning and reduces the dependence of treatment outcomes on patient compliance with elastic wear.

BACKGROUND: Citric acid, commonly encountered through the consumption of fruits and juices, is a frequent factor affecting teeth in daily life. It contributes to enamel dissolution, exposing the underlying dentin in the crown region and potentially leading to significant tooth surface loss. On the other hand, acid etching is widely used in restorative dentistry to enhance the adhesion of restorative materials to tooth surfaces. This process partially dissolves and demineralizes the enamel’s inorganic matrix, creating micropores and microgrooves that increase surface roughness. Pre-etching of enamel improves the bond strength of resin-based adhesives compared to non-etched enamel. Orthodontists also employ acid etching to create retention surfaces, which enhances bracket adhesion but simultaneously weakens adjacent enamel prisms, increases permeability, promotes biofilm adhesion, and reduces enamel’s protective properties. AIM: To evaluate the effect of citric acid exposure time and etching duration on the surface properties of dental hard tissues, including enamel and dentin. MATERIALS AND METHODS: Three enamel samples were obtained from a maxillary molar extracted from a 21-year-old male patient. The tooth was embedded in epoxy resin for easier sectioning. Sectioning parameters on the IsoMet 4000 (Buehler, Switzerland) were set to a disk rotation speed of 2500 rpm and a feed rate of 10 mm/min. Three distinct areas were selected for analysis. Each sample was embedded in epoxy resin again for subsequent grinding and polishing, which was performed simultaneously for all three samples using the MetaServ 250 (Buehler, Switzerland). The prepared enamel surfaces were examined using an optical microscope (Stemi 305; Carl Zeiss, Germany) equipped with a color video camera (Axiocam 105; Carl Zeiss, Germany) under reflected light. The samples were etched as follows: Sample 1 with 0.5 wt.% citric acid (pH = 2.3), Sample 2 with 3 wt.% citric acid (pH = 1.86), and Sample 3 with 5 wt.% citric acid (pH = 1.71). The pH was measured using Cobra4 Mobile-Link (PHYWE, Germany). Atomic force microscopy of enamel surface topography before and after etching was performed using the NANOEDUCATOR microscope (NT-MDT, Russia) with a tungsten probe operating in non-contact mode. Surface roughness (Ra) was measured at each etching stage for each sample using the Gwyddion software (Czech Metrology Institute, Czech Republic). RESULTS: Optical microscopy provided images of enamel, dentin, and the dentinoenamel junction, confirming the healthy condition of the examined samples. The findings suggest that 5 wt.% citric acid is more suitable for controlled etching than 37% phosphoric acid, as prolonged exposure to phosphoric acid can cause severe enamel damage. AFM analysis demonstrated the surface characteristics of each sample before and after etching at different time intervals. A linear increase in surface roughness was observed in all samples after 45 s of etching. CONCLUSION: For achieving significant surface roughness and visualizing enamel prisms within a reasonable timeframe, etching with 5 wt.% citric acid is recommended. However, further studies on the adhesive properties of enamel post-etching with citric acid are necessary for clinical implementation.

The aim of the article was to improve the results of reconstructive treatment of patients with toxic osteomyelitis of the upper jaw through the use of developed prostheses with valve obturators with additional fixation by a dental implant system. The results of surgical treatment in the hospital of 21 drug-dependent patients with toxic osteomyelitis of the upper jaw were evaluated. The developed methods of reconstructive treatment allow to achieve the best clinical results. The reliable clinical effectiveness of the proposed methods in comparison with traditional ones has been identified and substantiated.

In the present research, nanoindentation, atomic-force microscopy and optical microscopy were used to study the mechanical and microgeometrical parameters of tooth tissues. A nanoindentation test unit equipped with Berkovich indenter was used to determine the values of the reduced Young’s modulus and indentation hardness and both nanoindentation and atomic force microscopy using a diamond probe on a silicon cantilever were used to study microgeometrical parameters of human tooth root cementum. Three areas of cementum were studied: the cervical region near the dentine–enamel junction, the second third of the tooth root, and the apex of the tooth root. The interpretation of the results was carried out using the Oliver–Pharr method. It was established, that the mechanical properties of cementum increase from the cervical region to the central part of the root, then decrease again towards the apex of the tooth root. On the contrary, the microgeometrical characteristics of cementum practically do not demonstrate any change in the same direction. A decrease in the roughness parameters in the direction from cellular cementum to dentine was observed. Additionally, a decrease in the reduced Young’s modulus and indentation hardness of dentine in the cervical area compared to dentine in the crown part of the tooth was found using nanoindentation. The investigation of the dentine–cementum junction with high resolution revealed the interspaced collagen fiber bridges and epithelial rests of Malassez, whose sizes were studied. The parameters of the topographic features of the cementum in the vicinity of the lacunae of cementocytes were also established.

Introduction. The complex of transcriptional proteins of NF-kB (Nuclear Factor kappa-light-chain-enhancer of activated B cells) family deservedly attracts attention as a factor capable of determining the course of malignant disease. Its promising study in combination with the expression of proinflammatory gene IL6 in patients with parotid cancer (PSG) is associated with the development of modulation of malignant disease treatment and risk assessment of the disease course. Aims — to determine the effect of the expression activity of the proinflammatory interleukin-6 gene and the NFKB1 transcriptional gene on the survival rate of patients with parotid cancer. Materials and methods. A cohort retrospective study was conducted in two groups. The epidemiological group of patients included 140 people from the cancer registry of Rostov region. The clinical part of the work was carried out on 25 patients with PSG cancer of both sexes aged 50 to 80 years. Followup period of the patients after radical surgery was 18 years. Expression activity of NFKB1 and IL6 genes was estimated by real-time PCR in tumor and conditionally healthy tissue. Patient survival rate was analyzed using Kaplan-Meier method. Results. According to the results of the survival analysis in the epidemiological group, the probability that an PSG cancer patient would survive the first year after diagnosis was 95.7%, three years — 82.4%, five years — 70.9% and 10 years — 31.2%. A comparative study of gene expression levels in tumor tissue samples compared to conditionally healthy tissue revealed an increase (pDiscussion. Analysis of our data showed the possibility of using the complex evaluation of NFKB1 and IL6 gene expression in the cells of tumor samples of PSG cancer tissue obtained during surgery to predict the long-term survival of patients after surgical treatment. Conclusions. The expression profile of NFKB1 gene in tumor tissue was a proven prognostic factor determining the course of the disease in patients with PSG cancer, which should be taken into account when forming the prognosis of the disease. The expression of IL6 gene expression in tumor cells had no independent effect on the survival rate of PSG cancer patients, but contributed to the functional activation of NFKB1 transcription gene.

BACKGROUND: Among the anomalies of the dentoalveolar system, narrowing of the upper dental arches in a permanent bite occurs in 57% of the cases examined. Aligners are a preferable method for correcting the position of the teeth and expanding dental arches. Planning and modeling treatment outcomes when using clear aligners are essential parts, since it is the quantitative assessment of treatment outcomes that improves clinical practice. The ClinCheck software allows making an almost fully automated design and manufacturing of Invisalign. AIM: This study aimed to assess the accuracy of predicting the expansion of the upper arch using the ClinCheck software. MATERIAL AND METHODS: A prospective clinical study included 19 patients with dentoalveolar anomalies whose dental arch parameters were measured before and after treatment with Invisalign Full and Invisalign Teen. Evaluation of the accuracy of predicted expansion using ClinCheck was carried out by comparing the simulated parameters and actual outcomes. To assess the achieved results, individual tooth from the original ClinCheck model was superimposed on the digital model from the post-treatment scan. For the studied parameters, the arithmetic mean was calculated, and significant differences were established at a significance level of p 0.05. RESULTS: As regards treatment result, patients showed a significant expansion of the upper dental arch in the premolar and molar region as well as protrusion of the incisors. Data showed a high accuracy of prediction using ClinCheck, since no significant differences were found between the mean values obtained as a result of treatment and those predicted using ClinCheck. CONCLUSIONS: 1) Invisalign technology is effective in widening the upper arch. Following treatment, patients showed significant differences in the width for the first premolars at 4.030.24 mm, for the second premolars at 3.610.25 mm, for the first molars at 2.110.31 (p 0.05), as well as clinically significant incisor protrusion of 6.531.41 (p 0.05). 2) Differences between the mean values obtained following treatment and simulated in the ClinCheck program were as follows: expansion along the canines, 0.050.11 mm (p 0.05); expansion along the first premolars, 0.040.23 mm (p 0.05); expansion along the second premolars, 0.0030.14 mm (p 0.05); expansion along the first molars, 0.0020.13 mm (p 0.05), and incisor protrusion, 0.120.92 (p 0.05).

BACKGROUND: Among the anomalies of the dentoalveolar system, narrowing of the upper dental arches in a permanent bite occurs in 57% of the cases examined. Aligners are a preferable method for correcting the position of the teeth and expanding dental arches. Planning and modeling treatment outcomes when using clear aligners are essential parts, since it is the quantitative assessment of treatment outcomes that improves clinical practice. The ClinCheck software allows making an almost fully automated design and manufacturing of Invisalign. AIM: This study aimed to assess the accuracy of predicting the expansion of the upper arch using the ClinCheck software. MATERIAL AND METHODS: A prospective clinical study included 19 patients with dentoalveolar anomalies whose dental arch parameters were measured before and after treatment with Invisalign Full and Invisalign Teen. Evaluation of the accuracy of predicted expansion using ClinCheck was carried out by comparing the simulated parameters and actual outcomes. To assess the achieved results, individual tooth from the original ClinCheck model was superimposed on the digital model from the post-treatment scan. For the studied parameters, the arithmetic mean was calculated, and significant differences were established at a significance level of p 0.05. RESULTS: As regards treatment result, patients showed a significant expansion of the upper dental arch in the premolar and molar region as well as protrusion of the incisors. Data showed a high accuracy of prediction using ClinCheck, since no significant differences were found between the mean values obtained as a result of treatment and those predicted using ClinCheck. CONCLUSIONS: 1) Invisalign technology is effective in widening the upper arch. Following treatment, patients showed significant differences in the width for the first premolars at 4.030.24 mm, for the second premolars at 3.610.25 mm, for the first molars at 2.110.31 (p 0.05), as well as clinically significant incisor protrusion of 6.531.41 (p 0.05). 2) Differences between the mean values obtained following treatment and simulated in the ClinCheck program were as follows: expansion along the canines, 0.050.11 mm (p 0.05); expansion along the first premolars, 0.040.23 mm (p 0.05); expansion along the second premolars, 0.0030.14 mm (p 0.05); expansion along the first molars, 0.0020.13 mm (p 0.05), and incisor protrusion, 0.120.92 (p 0.05).

BACKGROUND: The practice of prosthetics on implants shows a fairly high percentage of removed implants over the specified period. The reasons can be both insufficient hygiene of the tissues around the implants and their overload. Regardless of the cause, bone resorption occurs from the apex of the alveolar ridge (part) of the jaw deep into contact with the implant in combination with chronic inflammation of the periimplant soft tissues. Removal of the implant in such cases is indicated for bone resorption at half the length of the implant. Microstructural analysis of the surface of implants is rarely reflected in publications, since high-resolution microscopy is only possible for removed implants. AIM: Microscopy and spectrometry of the surface of implants removed for periimplantitis. MATERIALS AND METHODS: The surface analysis of the five implants removed due to periimplantitis was carried out by scanning electron microscopy in high vacuum mode with electron probe microprobe analysis of the elemental composition. A FEI Teneo VolumeScope single-beam scanning electron microscope with a detector was used to perform XFlash 6/30 energy dispersive analysis. The research was carried out in the Skolkovo Technopark. RESULTS: The performed microscopic and spectrometric analysis, accompanied by micrographs and spectrograms of the cervical part of the implant in the area of bone tissue conservation, the presence of connective tissue and in the area of the exposed surface of the implant, demonstrate the process of disintegration of the implant due to periimplantitis, which consists in demineralization and resorption of bone tissue (in places up to the surface of the implant, in places with through defects to the surface of the implant) and its replacement with connective tissue. CONCLUSIONS: Disintegration of the implant due to periimplantitis is accompanied by the process of demineralization and resorption of bone tissue (in places up to the surface of the implant, in places with through defects to the surface of the implant) and its replacement with connective tissue.