Relevance. Under study is based on the fact that every year the number of patients with complicated forms of caries increases, in addition, the complexity of a number of treatment manipulations, often leads to various errors and complications at all stages of endodontic treatment.  

Aim. To evaluate the tightness of root canal obturation depending on the selected technique of antiseptic treatment of root canals.  

Materials and methods. 40 teeth extracted due to chronic periodontitis were studied. All extracted teeth were divided into 4 equal groups depending on the method of antiseptic treatment of root canals: traditional protocol using 3% NaOCl and 17% EDTA solution; distilled water and Er,Cr:YSGG with a wavelength of 2780 nm at 1 W; distilled water and Er,Cr:YSGG with a wavelength of 2780 nm at 1.5 W; LAI technique. All specimens were filled with continuous wave gutta-percha using the Calamus Dual instrument (DentSplay Maillefer) with AH+ epoxy sealer (DentSplay). The obturation was assessed by scanning electron microscopy.  

Results. Treatment with 1.5 W Er,Cr:YSGG laser revealed the most hermetic fit of the material to the root canal walls, which is confirmed by the absence of voids between the sealer and dentin, in contrast to the samples treated using the traditional medical protocol for root canal treatment.  

Conclusions. The inclusion of the Er,Cr:YSGG laser into the complex root canal treatment will not only increase the antiseptic treatment of the root canal, but also the success of root canal obturation, which will significantly reduce the risk of endodontic treatment complications. 

Цель. Провести сравнительный анализ протеомного профиля дентинной жидкости в норме и при болезнях пульпы с целью выявления пептидных маркеров воспаления для усовершенствования методов диагностики состояния пульпы зубов.

Материалы и методы. На клиническом этапе исследования были получены 48 образцов дентинного ликвора, забор которых проводили с помощью нитроцеллюлозной мембраны по разработанной методике, и 48 соответствующих им удаленных зубов, которые подвергались гистологическому исследованию с целью подтверждения клинического диагноза. В лабораторный этап было включено 45 проб дентинной жидкости для проведения протеомного анализа хромато-масс-спектрометрическим методом.

Результаты. При протеомном анализе выявлено 206 белковых фракций в дентинном ликворе зубов. Совпадение протеомов дентинной жидкости в норме, при начальном и остром воспалении пульпы составило 19%, или 39 белковых фракций. Определен специфичный белковый маркер начальной стадии воспаления – альфа-1- антихимотрипсин, количество которого достоверно повышается в 48 раз при начальном пульпите (p < 0,05).

Выводы. По результатам исследования были созданы протеомные карты дентинного ликвора в норме и при воспалении пульпы. Было выявлено, что белковую фракцию альфа-1-антихимотрипсин целесообразно рассматривать в качестве специфического маркера воспаления при болезнях пульпы, в частности, для диагностики начального пульпита.

Relevance. Trace elements play an important role in the life of the cell. Using a scanning electron microscope (SEM), the microelement composition of dentin and cement of the apical region of teeth previously treated for destructive chronic periodontitis in the acute stage was studied.

Aim. Using a scanning electron microscope to study the microelement composition of the apical area of hard tissues of the tooth root after the treatment of destructive periodontitis.

Materials and methods. To determine the presence of certain trace elements in the composition of solid tissues, we used spectral analysis performed on a JSM-6490LV scanning electron microscope (JEOL, Japan) and an INCA Penta FETx3 energy-dispersive spectrometer (Oxford, England).

Results. After endodontic treatment, the content and ratio of Ca and P in the hard tissues of the resorbed apex of the tooth root changes. The presence of newly formed highly mineralized cement was found. The ratio of microelements Ca/P and Na/Mg in the cement before and after the treatment of destructive periodontitis changes. Conclusions. An increased oxygen content may indicate the presence of active forms of this element in the cells. An increased content of Na in hard tissues testifies in favor of triggered regenerative processes. Perhaps the use of Cacontaining drugs helps cells form the structure of the tissue.

Conclusions. After a certain period of time, after the treatment of destructive periodontitis, calcification of the hard tissues of the apical region of the tooth root occurs. The changing ratio of trace elements indicates the predominance of regenerative processes in the tissues of the tooth.

Aim. To study and analyze the role of trace elements in pathomorphological changes occurring in teeth with destructive forms of apical periodontitis in the acute stage by means of light and electron microscopy.

Materials and methods. Pathological changes were studied on 46 teeth with destructive forms of periodontitis in the acute stage using an Olympus BX-40 light microscope. Scanning electron microscopy was used to conduct X-ray microanalysis of 10 teeth.

Results. The infiltration of the inflammatory focus is an indirect evidence of a change in the balance between the production of oxygen radicals by phagocytic cells in destructive forms of periodontitis and their elimination, which includes multifaceted interrelated factors, namely, direct damage to biomolecules, increased signaling of the nuclear factor, and cell death. The increased amount of studied chemical elements in the tissues of teeth with apical forms of periodontitis during the period of exacerbation allows us to assume that oxygen can become a source of free radicals and stimulate the process of resorption of the tooth root.

Conclusions. Cellular infiltration found in biopsy specimens of teeth with destructive forms of periodontitis in the acute stage, as well as an increased content of trace elements in dental tissues, suggests that this contributes not only to loss of bone mass in the periapical space, but also leads to the destruction of apical tissues. Trace elements are biomarkers of oxidative stress. Treatment should be aimed at accelerating the restoration of oxidative balance.

Aim. Comparative evaluation of the effectiveness of the treatment of chronic forms of periodontitis using a new technology of transcanal laser pigmentless photoablation and classical classical surgical techniques for the treatment of periapical lesions with odonto-preserving operations.  

Materials and methods. The treatment was carried out in 40 patients with chronic periodontitis on 64 teeth. All patients were divided into 2 groups – the main group and comparison of 20 in each. In the main group, treatment was carried out with the use of transchannel laser photoablation, in the comparison group, with the use of surgical odonto-preserving techniques. The immediate and long-term results of treatment were evaluated according to clinical and radiological signs.

Results. In the main group using the new technology of laser transcanal photoablation on the 3rd day, patients noted the presence of pain 3.3 times less, the presence of hyperemia 6.4 times less, the presence of edema 5.3 times less than in the comparison group with the use of traditional surgical procedures. treatment methods. X-ray 12 months after treatment in the main group, complete recovery was observed 1.46 times in more cases than in the control group.  

Conclusions. Our clinical and radiological studies confirm the expediency of using transchannel laser photoablation in the treatment of chronic periodontitis. 

Clinical complications arising from problems related to aesthetic integration can be a difficult task for the restorative dentist and dental technician. Accurate imitation of the optical appearance of dental hard tissue with indirect restorations is a relevant issue, especially when teeth have different color shades. This case report describes the approach to restoring the anterior group of teeth with porcelain veneers and the eLAB prime software. 

Relevance. Malignant neoplasms are oncological diseases that occur all over the world. Often, the diagnosis is made too late, the onco-alertness of primary care dentists plays a huge role in preventing the development of the disease. Also, timely recognition and treatment of precancerous changes in the oral mucosa is an important aspect of cancer prevention. In most cases, it is not possible to accurately predict the probability of malignancy, however, at a clinical appointment, the most important aspect is to identify both risk factors and initial signs of the development of the pathological process in the absence of complaints from the patient.  

Aim. To draw the attention of primary-level dentists to the tactics of patient management from the position of oncological alertness.  

Materials and methods. The paper presents the algorithm of the dentist's action at an outpatient appointment, demonstrates the clinical cases of patients. Which were routed according to the presented algorithm.  

Results. The prevalence of benign-malignant neoplasms makes it necessary for dentists to know various types of manifestations of pathological conditions. Modern, timely, non-invasive diagnostics, early detection of predictors, referral of patients to specialists of a related profile will prevent the development of complications, including malignancy. 

Conclusions. The primary care dentist must remember that the chronic prolonged course of the process can cause the invasion of cancer cells into the submucosal layer, into the regional lymph nodes.

Apical periodontitis is an inflammatory process of the connective tissue complex forming the periodontal ligament (periodontum), localized around the apex of the tooth, caused by microbial invasion, located in the bacterial biofilm of the root canal system (RTS), with further progressive destruction of bone tissue, manifested on the X-ray lumens of different intensity.  

The successful conservative treatment of the root canal depends on the availability of appropriate instruments, irrigation and root canal obturation. An important factor in the endodontic treatment of periodontitis is the removal of microbes, including fungi, from the complex three-dimensional root canal system. Various identification methods have revealed that fungi are more often found in secondary endodontic infections than in primary ones. Candida albicans (CA) plays an important role in endodontic treatment failure as the most significant fungus isolated from the root canal system. C. albicans is associated with root canal infections and is a potent pathogen for periapical tissue infection. Various virulence factors allow C. albicans to adhere to and penetrate the dentinal tubules. The yeast responds unfavorably to conservative root canal therapy because of the resistance of all oral Candida species to the commonly used topical medication, calcium hydroxide. Thus, the treatment of persistent cases of apical periodontitis requires alternative therapeutic methods and other drugs capable of elimination of this fungus species. Isolation with rhabberdam is important in preventing root canal contamination with saliva, in addition to prolonged contact with irrigation solutions. 

Relevance. The problem of drug addiction is medical and social, since the use of drugs causes irreparable damage to the health of drug addicts, the vast majority of whom are young people. The data of scientific publications indicate that taking drugs, in addition to affecting all systems and organs of the body, causes and exacerbates pathological processes in the oral cavity.  

Aim. To study the effect of narcotic drugs on the intensity and prevalence of dental diseases in drug addicts, according to the literature. 

Materials and methods. The authors analyzed scientific articles posted in the databases PubMed, "e-library" and "Cyberleninka", and devoted to the effects of drugs on the organs and tissues of the maxillofacial region, as well as manifestations of drug addiction in the oral cavity. The search included articles from the last 5 years.  

Results. An analysis of scientific publications on the effect of drugs on the development and progression of diseases of the oral cavity showed that in most cases drug addicted patients have poor oral hygiene, multiple caries, periodontal disease, oral mucosa, salivary glands, and destructive changes in the bone tissue of the upper and lower jaws.  

Conclusions. Drug-addicted patients present a difficult task for dentists, not only because of anxiety at outpatient appointments, but also because of the increasing and duration-dependent chronic intoxication of the body, which causes a decrease in the level of general and local immunity in the oral cavity, perverse resistance to anesthetics, an increase in the prevalence of caries, rapidly complicated by pulpitis and periodontitis, as well as inflammatory and degenerative processes in the periodontium, oral mucosa, salivary glands, bone tissue of the upper and lower jaws. 

Relevance. Today, due to the emergence of new and improvement of existing methods of laboratory diagnostics, more and more attention of researchers is directed to the study of the composition and properties of the oral fluid of a person with a history of somatic diseases.  

Aim. To study the microelement composition of the oral fluid of patients with chronic cerebral ischemia and compare the obtained data with clinical parameters.  

Materials and methods. The paper presents the results of a clinical and laboratory study of 26 patients with chronic cerebral ischemia. In the course of an objective examination, the following were carried out determination of the KPU index, Greene-Wermillion hygienic index, salivation rate and pH of the oral fluid. The concentration of microelements in the oral fluid was studied by the method of emission spectral analysis (ICP-AES), the activity of alkaline phosphatase activity was studied by the Bessie-Lowry-Brock endpoint method. Statistical processing of the results was carried out using the computer program Statistica 10.0.  

Results. According to the results of the study in the oral fluid of patients with chronic cerebral ischemia, a change in the concentration of five microelements was established. An increase for Ca (87.19 ± 2.45, p < 0.001), K (1283.73 ± 79.36, p < 0.001) and Mo (0.007 ± 0.0005, p < 0.001) and a decrease in the level of Na (672.30 ± 47.30, p < 0.05) and Fe (0.23 ± 0.07, p < 0.05) in comparison with patients of the control group. In addition, a significant increase in ALP activity in the oral fluid of patients with chronic cerebral ischemia was revealed.  

Conclusions. The obtained results of clinical and laboratory studies confirm that in patients with chronic cerebral ischemia, changes in the microelement composition of the oral fluid are noted, which leads to the development of pathological processes in the oral cavity. 

Aim. To improve the methods for assessing the state of the jaw bone tissue based on the use of ultrasonic shadow densitometry.  

Materials and methods. As a research method, there was used the latest development – velocimetric ultrasonic densitometer with an original software, ultrasonic sensors and an electronic positioner. The material of the experimental study were the macropreparations of the animal species "Domestic Pig", where the spongy and cortical substance of the bone tissue was isolated, and the speed of passage of ultrasound (SUS) through them was estimated. In the clinical part of the study, ultrasound diagnostics of bone tissue was performed in 38 people with physiological occlusion in various anatomical and functional areas.  

Results. Part of the study showed that the maximum SUS was observed through the cortical bone tissue from the oral side, and the minimum – through the spongy substance. In the clinical part of the study, the registration of SUS measurements through the bone tissue revealed statistically significant differences and showed that the highest bone density was determined in the anterior left and right parts of the mandible. The lowest bone density was determined in the lateral left and right sections of the upper jaw.  

Conclusions. Based on the conducted studies, there was developed a diagnostic map of the ultrasonic density of the periodontal bone tissue, which can complement the protocol of the patient's dental examination. The obtained results of SUS passage through the bone tissue in various anatomical and functional zones of the upper and lower jaws in examined persons with physiological occlusion can be taken as normalized indicators in assessing bone density. Ultrasound densitometry has proven to be a safe, non-invasive method that can be used to study jaw bone density in vivo. 

Trace elements contained in human saliva, despite their small amount, perform a number of biological functions and are a reflection of the processes occurring in the body. The ease of sampling, the non-invasiveness of the method determine the high interest on the part of researchers from various fields of medicine in studying the diagnostic capabilities of salivary fluid as an auxiliary method in assessing the functional state of the body, the presence of pathological processes in it, determining the prerequisites for the development of certain diseases and developing preventive measures to prevent them. This is especially true in the diagnosis of elderly patients, due to the increased risk of occurrence and development of many diseases, on the one hand, and the possibility of multiple sampling for analysis, on the other.  

The paper analyzes studies on the possibilities of using the method of microelement analysis of saliva in elderly patients in relation to such pathological conditions as the development of cardiovascular and neurodegenerative diseases, a decrease in humoral and local immunity, including the development of chronic immune inflammation as one of the geriatric syndromes of initial asthenia, and also the development of periodontitis and type 2 diabetes. The prerequisites for the use of saliva analysis as the determination of pain biomarkers and Alzheimer's disease biomarkers for the diagnosis of pain syndrome and the diagnosis of Alzheimer's disease, respectively, are noted, which seems to be especially relevant in elderly patients with dementia, suffering from cognitive impairment and unable to communicate. A number of studies have analyzed the age-related changes in the microelement composition of saliva, including changes in the microelement composition of the saliva of women with postmenopausal osteoporosis.  

According to the results of the review study, it should be noted that it is promising to study the possibilities of the microelement composition of saliva in elderly patients both as an auxiliary method for diagnosing various pathological conditions and in developing algorithms for the prevention and treatment of a number of diseases, as well as a method for evaluating the effectiveness of ongoing therapeutic procedures. 

Aim. Is the features of the microelement composition of saliva in diabetes mellitus. Objectives. To perform a systematic analysis of modern domestic and foreign literature sources to determine the main characteristics of the microelement composition of saliva, which determine the prospects for its use in the diagnosis of patients with diabetes mellitus.  

Methodology. The study was based on the search and study of original domestic and foreign articles on the study of the specifics of the microelement composition of saliva in patients with diabetes mellitus in the eLibrary, PubMed, Elsevier databases. The selection of relevant material was carried out by keywords.  

Results. Diabetes mellitus is a chronic disease of the endocrine system, related to immunological diseases, common in all countries of the world and tending to increase both morbidity and mortality. At the same time, mortality among people with diabetes mellitus can be caused not only by the disease itself, but also by a number of numerous possible complications. 

The definition of express diagnostics of the state of organs and systems in diabetes mellitus would be an effective method to prevent the development of severe stages of this serious disease and its complications. A number of studies published in periodic specialized scientific journals contain data confirming the possibility of using saliva in diagnosing the functional state of patients with diabetes mellitus. Thus, changes in the concentrations of chlorine and potassium in saliva were noted, relationships were found between the content of zinc, calcium, magnesium, phosphorus, beryllium, and boron. The obtained results are proposed to be used in the analysis of the risk of development of pathology of organs and systems in diabetes mellitus, including in the form of the development of carious lesions of the teeth, to identify disorders of carbohydrate metabolism and the implementation of metabolic control.  

Conclusions. Despite the relatively small number of studies on the possibility of using saliva trace elements as biomarkers of diabetes mellitus and its complications, an analysis of the literature on the relevance of studying the characteristics of the trace element composition of saliva in diabetes mellitus showed the prospects for performing these studies in terms of ease of analysis, rapidity of the method, its painlessness, non-invasiveness, uniqueness of the results obtained.