Aim. To evaluate the environmental change of root canal biofilm during primary endodontic treatment under the influence of paste containing calcium hydroxide.
Materials and methods. Twenty-nine patients with 68 root canals diagnosed with Chronic Apical Periodontitis were included in the study. Treatment was carried out according to clinical recommendations (treatment regimen) for the diagnosis: "Diseases of periapical tissues", approved by Resolution No. 18 of the Council of the Association of Public Association "Stomatological Association of Russia" of September 30, 2014, updated on August 02, 2018. Biological material of the root canal contents was taken before and after injection of calcium hydroxide paste into the root canal for 14 days. The following methods were used: clinical, microbiological – plate count, gram-positive and gram-negative microorganisms, fungi were determined, and polymerase chain reaction (PCR) was performed at the same time. Statistical analysis of data included description of accounting features, assessment of statistical significance of changes in the studied indicators. The critical level of statistical significance of differences (p) was chosen with a value of p < 0.05.
Results. According to the conducted studies, statistical analysis showed statistically significant negative dynamics for all studied microbiological indicators.
Conclusions. The obtained data allow us to conclude that preparations containing calcium hydroxide can be used in the treatment of patients diagnosed with chronic apical periodontitis as an intracanalicular drug, because it has a bactericidal effect on a limited area.

Aim. The aim of this study was to compare the effectiveness of diode laser and low-level laser therapy (LLLT) in primary pulpotomy treatments with deep dentinal caries.
Materials and methods. The study comprised 90 patients (42 females and 48 males) aged 6–9 years with deep dentin caries in the lower second molar. The patients were assigned to the following treatment groups: the diode laser group (n^S= 45) or the LLLT group (n^S= 45). The appointments were scheduled 3, 6, and 12 months after the treatment, and both clinical and radiographic follow-ups were performed.
Results. The diode laser group had a clinical success rate of 95.6% and a radiological success rate of 93.3% at 12 months, while the LLLT group had a clinical success rate of 97.7% and a radiological success rate of 90.9%. There were no statistically significant differences in the success rates of the two groups.
Conclusions. LLLT+CH may be a good treatment alternative for pulpotomy instead of devital diode laser pulpotomy.

Aim. To evaluate the advantages of working with the Endoactivator device on the example of a series of clinical cases concerning the treatment of chronic apical periodontitis.
Materials and methods. The series of clinical cases included five patients (two men and three women) who were treated for chronic apical periodontitis (diagnosis according to ICD-10 K04.5). The patients underwent endodontic treatment in two visits, namely, mechanical treatment with rotating nickel-titanium instruments, drug treatment using an Endoactivator device for sound activation of irrigation solutions and the introduction of calcium hydroxide between visits. Postoperative sensitivity was assessed according to the criteria: absent, low, medium and high. The patients informed the research doctors via messengers about the intensity of postoperative soreness.
Results. Next results of postoperative sensitivity have been revealed: none of the patients noted high postoperative soreness, average soreness was noted by one patient, low soreness was noted by two patients and absence of soreness was noted by two patients.
Conclusions: on the example of this series of clinical cases, convenient manipulation characteristics of the EndoActivator device were revealed. There were no cases of high postoperative sensitivity after operation of these devices in the presented series of cases. In all clinical cases, radiological methods confirm the positive dynamics of healing of periapical foci.

Aim. To study the antibacterial efficacy of the antiseptic drug Miramistin, activated by ultrasound of different frequencies, against pathogenic microorganisms of periodontal pockets, in an experiment.
Materials and methods. As an antiseptic drug, the drug Miramistin 0.01% was used, which was activated using ultrasound of different frequencies: high-frequency (880 kHz) in continuous mode for 4 minutes, low-frequency (26.5 kHz) in continuous mode for 2 minutes. To conduct the study, clinical strains of microorganisms obtained from periodontal pockets with moderate periodontitis were used: S. sanguis, S. pyogenes, P. intermedia, C. albicans. The study was carried out using automatic programmable cultivation, using the RTS-8 system. The studied samples of the antiseptic drug were previously diluted in a nutrient broth in a ratio of 2:200.
Results. In the course of the study, it was found that with respect to pathogenic microorganisms obtained from periodontal pockets with moderate periodontitis, Miramistin in a dilution of 2:200, activated by low-frequency ultrasound, showed more pronounced antibacterial effect compared to Miramistin activated by high-frequency ultrasound.
Conclusions. In the treatment of periodontitis, to suppress the vital activity of pathogenic microorganisms, preference should be given to the combined effects of low-frequency ultrasound and the antiseptic drug Miramistin.

Aim. To assess compliance with clinical guidelines for periapical tissue diseases by dentists.
Materials and methods. Evaluation of medical records in non-state medical organizations for compliance with the completeness of simple medical services was performed. In the process of evaluating the completeness of clinical guidelines, the sections of the requirements for outpatient diagnosis and treatment of periapical tissue diseases in complicated clinical cases were analyzed. A total of 9 cases of patients with periapical tissue pathology were analyzed.
Results. Out of 22 simple therapeutic and diagnostic medical services (SMS) that should be performed for each patient with periapical tissue diseases, most of the mandatory PMU related to professional oral hygiene were not performed, or were performed in an insignificant number of cases. Recommendations for the selection of items and hygiene products integral to oral care education were given only to those patients (22.2%) who had a root apex resection surgery as part of the package of measures. In 100.0% of cases, dentists perform and record the following PMU: collection of anamnesis and complaints for oral pathology, visual examination for oral pathology, diagnosis of the state of the dentoalveolar system using methods and means of radiological imaging, description and interpretation of radiological images, instrumental and medicamentous treatment of root canal, root canal filling. Considering the requirements of clinical guidelines for outpatient diagnostics in periapical tissue diseases it must be noted that the following obligatory PMU are performed insufficiently: palpation of oral organs (33,3%), targeted intraoral contact radiography (33,3%), thermodiagnostics of tooth (11,1%).
Conclusions. The conducted research has shown that there are considerable deviations from requirements of acting clinical recommendations in diagnostics and treatment of periapical tissue diseases which may be connected both with continuation of the steady treatment and diagnostic approaches existing for many decades and with lack of careful attitude of dentists to the new normative legal acts regulating their labor functions.

Aim. Based on the results of the study of the frequency and structure of complete loss of teeth in the upper and lower jaws, to determine the need of elderly and senile people in prosthetics with complete removable orthopedic structures.
Materials and methods. A dental examination was carried out in 5,791 people aged 60 to 93 years. At the same time, on the recommendation of WHO, a key age group of 65-74 years was formed. The study took into account the topography of the absence of teeth, gender, age, the presence and evaluation of previously manufactured complete removable dentures and the need for prosthetics.
Results. A high prevalence of complete loss of teeth on the upper and lower jaws was found in the examined age groups of elderly and senile age. The largest proportion of complete loss of teeth of the upper and lower jaws was revealed in the age group of 75-84 years. At the same time, in elderly people, complete adentia is detected mainly in women, since men occupy a quarter of the gender ratio. Meanwhile, taking into account the indications for reprosthetics and the absence of prostheses with complete loss of teeth, the need for the manufacture of orthopedic structures in the form of complete removable prostheses in the surveyed population is determined.
Conclusions. The obtained results dictate the need to improve orthopedic rehabilitation of patients with complete loss of teeth in the upper and lower jaws, taking into account the data obtained on the structure and frequency of complete loss of teeth in elderly and senile people.

Aim. To describe the radiological signs of a "missed" root canal when using CBCT based on verified clinical cases.
Materials and methods. The study is based on the analysis of cases of endodontic treatment, which are associated with the detection of a "missed" root canal detected intraoperatively at the stage of primary endodontic treatment or at the stage of endodontic revision (repeated endodontic intervention). Clinical cases were verified by detecting the root canal during endodontic treatment using a microscope.
Results. During the endodontic treatment of 2149 teeth, 506 "missed" canals were identified and verified using a microscope. Based on the comparison of cone-beam computed tomography data and clinical data obtained during the examination of teeth under a microscope, 7 signs of the presence of a "missed" root canal are described. General recommendations are given to improve the quality of root canal system diagnostics.
Conclusions. The presented information contributes to improving the accuracy of diagnosis, proper planning and improving the effectiveness of endodontic treatment not only in endodontic revision (repeated root canal treatment), but also in primary endodontic treatment.

Aim. To analyze different methods of socket preservation. This procedure plays important role in the placement of implants, since due to this procedure, the bone that was left after the tooth extraction is going to be preserved. Also this procedure promote bone formation that is very significant for the reliable placement of implants.
Materials and methods. Was produced the study of the publications from PubMed, Cyberleninka , Google Scholar during the systematic review of the literature.Selected and included articles, the content of which concerns different methods of the socket preservation and their role on the bone tissue.
Results: 78 publications were reviewed. After analyzing the literature for inclusion criteria, the total number of publications has become 50.
Conclusions. According to the analyzed data, there are different methods of the socket preservation that lead to a successful result. However there are some methods that lead to a deterioration result for some patients. Therefore, at this moment investigating different methods of the socket preservation is not ended.

Diagnosis and treatment of pulp disease is one of the leading and widespread problems in dentistry. Clinicians are often faced with a dilemma when treating vital teeth with deep carious lesions and the development of reversible inflammation in the pulp tissue: whether to perform minimally invasive treatment to maintain pulp viability or to perform vital extirpation to prevent pulp necrosis, its further infection and prevention of apical periodontitis. To date, researchers and clinicians report that clinical recovery of the pulp with viable new bioactive materials is observed in 90% of cases provided that the inflammatory process in the pulp is diagnosed in the stage of reversibility. This article presents a clinical case of initial pulpitis treatment of teeth 1.5, 1.6 with the pulp-preserving method: direct pulp capping with bioactive cement Biodentine (Septodont). In the dynamics of observation after 1, 6, 12, 18 months teeth were asymptomatic and a favorable prognosis of the therapy was observed.

Aim. To estimate the size of the areas of the skull holes along the course of the trigeminal nerve in dental patients with prosopalgia according to computed tomography.
Materials and methods. Twenty seven dental patients were examined. Clinical methods of examination, palpation, assessment of the intensity pain manifestations using a visual analog scale of pain, clinical index Helkimo. Instrumental methods: gnathodynamometry, spiral computed tomography.
Results. The article describes data on the condition of bone canals and skull holes of dental patients with facial pain. 27 dental patients with complaints of pain in the facial area were examined using a visual analog scale of pain, the clinical Helkimo index and spiral computed tomography. The method of measuring the bone channels and holes of the skull is described. Criteria for assessing the degree of asymmetry of bone structures are proposed.
Conclusions. The factors of predisposition to prosopalgia of dental patients in the presence of narrowing and pronounced asymmetry of the size of the bone canals of the skull were revealed.

Aim. To conduct a comparative evaluation of methods for measuring the width of the upper jaw in growing patients in order to determine the difference between these standard values and improve diagnostics.
Materials and methods. The study was conducted in 20 patients aged 6, 8, 10 and 12 years. Measurement of the transversal dimensions of the jaws was carried out on frontal cephalograms using the Ricketts cephalometric analysis, and on CBCT scans using the analysis of the University of Pennsylvania.
Results. The results of measurements by frontal cephalograms and CBCT scans have almost the same indicators, the data of both methods differ insignificantly.
Conclusions. As a result of the study, both methods confirmed their reliability, however, the analysis of cone-beam computed tomography has a number of advantages. Accordingly, it is possible to simplify the carrying out of diagnostic measures to determine the width of the upper jaw, limiting ourselves to one research method – cone-beam computed tomography without prescribing additional teleroentgenography.

Aim. To study the effectiveness of remineralization and hygienic measures in the prevention of demineralization of hard tissues of teeth when using a fixed orthodontic structure in children and teenagers with dentoalveolar anomalies.
Materials and methods. We examined 150 children and adolescents with anomalies of the dentition at the age of 12 to 16 years with fixed orthodontic structures. When starting orthodontic treatment of anomalies of the dentoalveolar system in children, we proceeded from the fact that the treatment and prophylactic methods of education consisted of two stages: 1st stage – general, where they explained in detail how to carry out an individual hygienic procedure in the oral cavity with controlled brushing of the teeth; Stage 2 – specialized, which includes the features of oral care in children with orthodontic appliances in these specific conditions, in accordance with the new dental clinical situation of the oral cavity.
Results. The data obtained necessitate the conditions for successful prevention of orthodontic complications during corrective therapy of dentoalveolar anomalies are remineralizing therapy, the correct choice of methods and means of individual oral hygiene.

Aim. To evaluate the effectiveness of the method of corticotomy with bone grafting with narrowing of the upper jaw for its expansion.
Materials and methods. A clinical case of a 35-year-old patient with a narrowing of the upper jaw is presented. The transversal size of the jaw was measured using a CT scan using the analysis of the University of Pennsylvania. The patient also underwent an analysis of the inclination of the molars and an assessment of the thickness of bone tissue before and after corticotomy.
Results. The results showed that after corticotomy with bone grafting, skeletal expansion of the upper jaw occurred in patient V.
Conclusions. As a result of the conducted research, this method has confirmed its effectiveness and has several advantages. Accordingly, in certain clinical cases, you can limit yourself to this method, excluding surgical expansion of the upper jaw with the installation of a distraction device.