Olga Nikolaevna Risovannaya

Aim. To systematically evaluate the efficacy of diode lasers (810, 940, and 980 nm) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Material and methods. A systematic search was conducted in PubMed/MEDLINE, PMC, Cochrane Library, CyberLeninka, and eLibrary.ru databases for the period 2008—2024 following PRISMA guidelines. Only randomized controlled trials (RCTs) comparing SRP combined with diode laser therapy vs. SRP alone in adult patients with chronic periodontitis were included. Results. Ten RCTs (n=287 patients total) met the inclusion criteria. Adjunctive diode laser therapy resulted in statistically significant additional reduction in probing pocket depth (PPD) of 0.32 mm (95% CI: 0.15—0.45) and clinical attachment level (CAL) gain of 0.18—0.35 mm (95% CI: 0.12—0.52) compared to SRP alone. The most pronounced effect was observed with 810 nm and 980 nm lasers. No serious adverse events were reported. Conclusion. Adjunctive diode laser application is safe and provides statistically significant improvements in periodontal clinical parameters. The clinical magnitude of the benefit is modest and most pronounced in moderate-depth pockets (4—6 mm).

Objective. To synthesize evidence from randomized controlled trials (2020—2025) on dental laser applications in surgical dentistry and to summarize benefits and limitations compared with conventional approaches. Materials and methods. A systematic search of PubMed, Embase, and the Cochrane Library was conducted (search date: 15 Aug 2025). We included human RCTs (N≥50) evaluating lasers during surgical dental procedures (tooth extraction, soft-tissue surgery, implant surgery, periodontal interventions) or perioperative photobiomodulation (PBM/LLLT) after surgery. Studies focused on restorative/therapeutic dentistry (endodontics, caries removal, dentin hypersensitivity), non-controlled designs, sample size <50, and/or non-clinical outcomes were excluded. Risk of bias was assessed using RoB 2.0. Results. Of 612 records, 9 RCTs were included in the qualitative synthesis. Most trials investigated perioperative PBM /LLLT after mandibular third-molar extraction and laser-assisted hard-tissue procedures (Er:YAG). For soft-tissue surgery (frenectomy), diode lasers were associated with less pain and faster healing than scalpel surgery. In implant dentistry, PBM /LLLT showed variable results: one RCT found no differences versus sham, whereas another reported improved soft-tissue healing; evidence on marginal bone changes was limited by short follow-up. Laser-assisted periodontal therapy showed modest additional improvements over SRP. Conclusion. Laser technologies may reduce postoperative symptoms and support healing in surgical dentistry, but the evidence is heterogeneous and laser parameters vary substantially. Standardized, adequately powered multicenter RCTs with longer follow-up are needed.

Horizontal atrophy of the alveolar ridge represents a significant challenge in contemporary dental practice, substantially limiting the possibilities for successful osseointegration of dental implants and requiring the application of various bone grafting methods. Traditional approaches to guided bone regeneration often require the use of additional barrier membranes and fixation elements, and may be associated with increased surgical trauma. This paper presents a clinical case of a modified guided bone regeneration technique using a periosteal flap as a natural barrier membrane, which allows for maximum utilization of the regenerative potential of the patient's own tissues with minimal procedural invasiveness. A 28-year-old patient presented with complaints of missing teeth 3.5 and 3.6 in the left mandibular region. Cone-beam computed tomography revealed significant horizontal bone deficiency with an alveolar ridge width of 2.72 mm in the area of tooth 3.5 and 4.66 mm in the area of tooth 3.6. A guided bone regeneration procedure was performed with periosteal flap formation through split-thickness mucoperiosteal flap technique, creation of multiple cortical perforations, and filling of the subperiosteal space with allogenic material Lioplast. Three months post-intervention, follow-up computed tomography demonstrated an increase in alveolar ridge width of 1.50 mm (55%) in the area of tooth 3.5 and 0.54 mm (12%) in the area of tooth 3.6. Histological examination confirmed the formation of mature bone tissue with active vascularization, presence of lamellar structure in the cortical plate, and cancellous bone with high cellular density of reticular tissue. The presented clinical case demonstrates the high effectiveness of using a periosteal flap as a natural barrier membrane in guided bone regeneration, providing sufficient bone tissue augmentation for subsequent dental implantation with minimal trauma and without the need for additional fixation elements. This approach can be considered as a promising alternative to traditional bone grafting techniques for horizontal atrophy of the mandibular alveolar ridge.

Single-stage dental implantation requires strict adherence to protocols aimed at preserving bone tissue and ensuring implant stability. One of the promising directions in this field is the use of extracellular matrix biomimetics (ECMB), which mimic natural regenerative mechanisms. Objective. To evaluate the effectiveness of an ECMB-based preparation Spherogel Long and Light in one-stage implantation in the anterior maxillary region. Material and methods. 37 patients diagnosed with K04.5 Chronic apical periodontitis, K02.2 Caries of cementum were examined and operated on. After clinical and radiologic examination, extraction of the causative tooth with one-stage dental implantation was performed. The study and control groups were formed depending on the applied treatment methods. In the study group (n=18) the preparation of ECMB Spherogel (Estetis Pharm, Russia) was used: at the stage of dental implant placement the preparation Spherogel Long was injected into the bone bed, as well as Spherogel Light locally in the form of injection. In the control group (n=19) surgical interventions were performed according to the standard technique: extraction of the causative tooth with one-stage dental implantation and the use of bone-plastic material. The evaluation criteria were the frequency resonance analysis of the dental implant before prosthetics (6 months after surgery), the degree of bone loss in the alveolus. Results. The results showed that the use of ECMB significantly improves implant osseointegration (ISQ 76.5±1.3 vs. 50.8±2.6; p<0.0001) and contributes to better preservation of the vestibular bone height (Cohen’s d=1.083). These findings confirm the clinical effectiveness and high biocompatibility of the Spherogel preparation in one-stage dental implantation. Conclusion. The Spherogel preparation based on extracellular matrix biomimetics demonstrated high clinical effectiveness in one-stage implantation, providing improved implant stability and a significant reduction in bone resorption. These findings support the rationale for its use to enhance the success of implantation in aesthetically important areas.

The symmetry of masticatory muscle tension in tooth loss undergoes various changes due to the reorganization of the chewing process itself. Electromyography (EMG) of the masticatory muscle’s measures muscle tone over time, for example, during the chewing cycle or during clenching. Thus, EMG can provide an assessment of muscle tone during the chewing sequence. Since bite force and chewing efficiency are important parameters, the use of EMG in patients with tooth loss can be an effective tool for diagnosing various pathological processes. Purpose: to identify a correlation between the restoration of chewing function in patients with tooth loss and the symmetry of masticatory and temporal muscle tension. Materials and methods. 20 patients with tooth loss (K08.1) underwent dental implant placement in the upper and lower jaws followed by prosthetic rehabilitation. Before surgery and one month after permanent prosthetic rehabilitation, electromyography (EMG) was used to measure the activity of the masseter and temporal muscles (total amplitude during teeth clenching) and calculate the symmetry index of muscle tension on the right and left sides. Results. Preoperative measurements showed average muscle tension levels of 27.00±9.78 mV in the right temporal muscle and 28.15±9.60 mV in the left temporal muscle. For masseter muscles, the total clenching amplitude was 24.30±5.56 mV on the left side and 20.60±8.88 mV on the right. After one month of prosthetic rehabilitation, significant correlations emerged between masticatory function recovery and muscle activity patterns: analysis revealed an inverse ipsilateral relationship between masseter and temporal muscles (r=−0.87 right, r=−0.74 left, p<0.001), bilateral synchronization of masseter muscles (r=0.72, p<0.001), and cross-muscle regulatory patterns (Md/Ts: r=−0.45, p=0.046; Ms/Td: r=−0.63, p=0.003) demonstrating asymmetric masticatory control mechanisms, while demonstrating improved symmetry following prosthetic rehabilitation. Conclusion. Overall, this work shows that the activity of the masticatory muscles in patients with tooth loss improves after orthopedic rehabilitation on dental implants. This improvement is manifested in a more symmetrical tone of the masticatory muscles.

The aim is to study the effect of photodynamic therapy as an additional method of treatment of inflammatory periodontal diseases on a clinical example. Research objectives. To develop and apply a protocol for the treatment of periodontal patients using photodynamic therapy in combination with traditional methods of treatment in a clinical study. Evaluate the results of the treatment, compare the results with the literature data. Materials and methods. The study involved 50 patients diagnosed with K05.1 Chronic gingivitis of moderate severity. The patients were divided into 2 groups: the study group and the control group. The study group, unlike the control group, received photodynamic therapy in addition to the standard treatment of chronic gingivitis. The evaluation of treatment results was carried out using the papillary-marginal-alveolar index (PMA) modified by C. Parma (1960). The results obtained during the study were statistically analyzed. Descriptive statistics methods were used, the Student’s t-test was calculated, as well as the nonparametric Mann—Whitney test for independent groups. Results and discussion. During the comparison of the groups before the start of periodontal treatment, there was no statistically significant difference between the groups: the study and control groups did not differ from each other before the treatment. However, after periodontal treatment, the values of statistical criteria showed a statistically significant difference: in the study group, after therapeutic measures, a greater degree of reduction in the average papillary-marginal-alveolar index was revealed than in the control group. Conclusion. The developed protocol of photodynamic therapy demonstrates high efficiency in reducing the level of inflammation (reduction of the PMA index by 36.84% in the group using photodynamic therapy (p<0.05)) in periodontal tissues due to the elimination of pathogenic microflora. Treatment using photodynamic therapy contributes to a more significant reduction in the average PMA index than in the control group by 10.88% (p<0.05). The use of photodynamic therapy opens up new horizons in the treatment of periodontal patients. The results of the study are consistent with the data obtained by a number of authors. In all the presented works, there was a significant decrease in the PMA index (p<0.05, p<0.05, p=0.0001) in groups of patients undergoing combined treatment, including traditional treatment of inflammatory periodontal diseases and photodynamic therapy, which also emphasizes the effectiveness of photodynamic therapy in the treatment of inflammatory periodontal diseases.

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.

Relevance. Tooth extractions are one of the most common surgical procedures in dentistry. Tissue regeneration at the extraction site plays a vital role in restoring the affected area. Various methods are available to accelerate and improve the quality of tissue regeneration in dental practice. Extracellular matrix (ECM)-derived biomaterials provide a wide range of therapeutic and regenerative benefits due to their unique biological properties. This study aimed to evaluate the effectiveness of an ECM-derived biomaterial in promoting post-operative tissue regeneration after tooth extraction.Materials and methods. The study included two groups of patients: an experimental group (N = 46) and a control group (N = 46), all of whom underwent tooth extractions. The groups were compared based on two key parameters: the time required for complete wound surface healing and the time to achieve complete radiographic wound healing. Statistical analysis was conducted using the non-parametric Mann-Whitney U test for independent samples. The incidence of complications between the groups was analyzed using Fisher's exact test.Results. The analysis of wound surface healing times between the groups revealed statistically significant differences (p < 0.05). Post-operative tissue repair occurred at a significantly faster rate in the group treated with the extracellular matrix (ECM)-derived biomaterial compared to the control group.Conclusion. Tissue regeneration at the surgical site after tooth extraction is a manageable process. Advances in modern biomaterials have facilitated accelerated tissue healing and functional recovery, leading to improved quality of life for patients.

   Introduction. The operation of resection of the tip of the tooth root is one of the main dental–preserving surgical methods of dental treatment with destructive changes in periapical tissues. Despite the high efficiency and other positive aspects, there are some disadvantages of this method of treatment, among which one can single out a long period of healing of periapical tissues, which necessitates the search for remedies that contribute to solving this problem.   The aim is to study the possibility of using a drug based on extracellular matrix biomimetics as a means of regenerative therapy during resection of the tip of the tooth root, to evaluate its effect on the healing time of periapical tissues and the occurrence of complications.   Materials and methods. The study involved 42 patients with indications for resection of the tip of the tooth root. The patients were randomly divided into two equal groups (n = 21): the control group, which underwent a traditional operation of resection of the tip of the tooth root, and the study group, which additionally used a drug based on extracellular matrix biomimetics. The timing of complete healing of periapical tissues and the presence of complications (in the form of lack of healing) were assessed using targeted intraoral contact radiography and percussion 6 months after the operation. The collected data were statistically analyzed. The indicators of descriptive statistics included the number of objects, the average value, the mean square deviation (SKO), 95 % confidence interval (CI95 %), median, lower (Q1) and upper (Q3) quartiles, minimum and maximum values. The comparison of the healing time in the study and control groups was carried out using the nonparametric Mann – Whitney criterion for independent groups. The comparison of the groups by the number of complications was carried out using the exact Fisher criterion.   Results. In the study group, healing occurred on average after 129.9 days. (COE = 8.6 days), DI95 % 126.0–133.8 days, minimum healing period – 117.0 days, maximum – 151.0 days, median – 128.0 days, lower and upper quartiles 124.0 days and 133.0 days accordingly. In the control group, the average healing time was 181.5 days. (COE = 9.0 days), DI95 % 177.4–185.6 days, minimum healing period – 167.0 days, maximum – 199.0 days, median – 181.0 days, lower quartile – 175.0, upper quartile – 188.0 days. A comparison of the groups by healing time using the nonparametric Mann – Whitney criterion for independent samples showed a statistically significant difference (p = 0.00000003). In the study group, healing was faster (on average 129.9 days) than in the control group (on average 181.5 days). A comparison of the groups by the proportion (%) of complications using the exact Fisher criterion showed that there was no statistically significant difference between the groups (p = 0.49). In the study group, healing was in 21 (100 %) patients, in the control group – in 19 (90.5 %), complications were in 2 (9.5 %) patients.   Conclusion. The results obtained during the study indicate the effectiveness of using the drug based on extracellular matrix biomimetics after resection of the tip of the tooth root: its effect reduces the time for complete healing of periapical tissues and completely prevents the occurrence of complications in the form of lack of healing.

Photodynamic therapy (PDT) consists of three elements: a photosensitizer, light and oxygen. The photosensitizer has the property of selective accumulation in target tissues without harming healthy cells. This innovative therapeutic method has already been successfully adapted in many areas of medicine, such as dermatology, gynecology, urology and oncology. PDT is also beginning to be introduced in dentistry. The antibacterial and fungicidal properties of the photosensitizer are used to achieve better results in the medical and surgical treatment of patients. Objective. To analyze current scientifi   data on the application of photodynamic therapy (PDT) in various fi   of dentistry, evaluate its effectiveness, and assess prospects for development. Materials and methods. A review of recent scientifi literature was conducted, including original studies, systematic reviews, and meta-analyses focused on PDT application in dentistry. Data on mechanisms of action, clinical efficacy, and new developments in PDT were analyzed. Results. High effi of PDT was established in the treatment of periodontal diseases, peri-implantitis, endodontic infections, and oral oncological diseases. Advantages of combined application of PDT with other treatment methods were noted. Promising directions for PDT development were identifi     including the creation of new photosensitizers and technological innovations in equipment. Conclusions. PDT is a promising treatment method in dentistry, demonstrating high efficacyand safety. Further research is aimed at optimizing treatment protocols, developing personalized approaches, and integrating PDT with other modern technologies.