INTRODUCTION. Chronic apical periodontitis (CAP) poses significant challenges in endodontics due to microbial resistance and inadequate disinfection protocols. Polyhexanide (PHMB) is a promising irrigant due to its antimicrobial properties. However, its interactions with other commonly used endodontic irrigants require further investigation to establish effective and safe clinical protocols. AIM. To evaluate the chemical interactions of PHMB with sodium hypochlorite (NaOCl), hydrogen peroxide (H₂O₂), EDTA, and chlorhexidine and identify optimal irrigation protocols.

MATERIALS AND METHODS. The study utilized high-performance liquid chromatography (HPLC) to monitor reactions of PHMB with NaOCl, H₂O₂, EDTA, and chlorhexidine at intervals of 30 minutes, 1 hour, and 3 days. The analysis focused on detecting reaction products and assessing chemical stability.

RESULTS. PHMB formed a precipitate when combined with NaOCl, leading to its complete depletion in the solution. Reaction with H₂O₂ produced new chemical compounds, while EDTA demonstrated no significant negative reactions. Mixtures with chlorhexidine generated new products and precipitates. Sequential use of EDTA and PHMB showed compatibility and potential for effective irrigation.

CONCLUSIONS. Polyhexanide is a valuable irrigant for endodontics, particularly in combination with EDTA, as it provides smear layer removal and antimicrobial action without adverse interactions. Sodium hypochlorite and hydrogen peroxide require careful protocol adjustments to avoid chemical incompatibility. Further studies are necessary to confirm the clinical outcomes and refine protocols for safe and effective endodontic treatments.

AIM. The objective of this study is to comparatively evaluate the effectiveness of sticky bone alone, sticky bone with a PRF membrane, as well as sticky bone having a GTR membrane in healing apicomarginal defects.

MATERIALS AND METHODS. Twenty-seven patients with apicomarginal defects were randomly divided into three groups: Group I (sticky bone alone), Group II (sticky bone with GTR membrane), and Group III (sticky bone with PRF membrane). Clinical and radiographic assessments, including probing depth, bone density, and lesion size, were conducted. Statistical analyses included paired t-tests and ANOVA with a remarkable level of p < 0.05.

RESULTS. Notable improvements in all parameters were observed across groups (p < 0.05). Group III showed the most notable reductions in probing depth and lesion size and the highest increase in bone density. Group II exhibited moderate improvements, while Group I had the least favorable outcomes.

CONCLUSION. Combining sticky bone with PRF or GTR enhances bone healing in apicomarginal defects, with PRF yielding the best results.

Post-endodontic treatment pain is frequent which needs analgesics for patient’s pain relief. One of the most common reasons for post operative pain is chemical, mechanical, or microbial injuries to the periapical tissues that result in acute inflammation. Application of recently developed endodontic techniques and devices will reduce postoperative pain. Two proven methods for reducing pain associated with inflammation are low-level laser therapy (LLLT) and antimicrobial photodynamic therapy. The use of LLLT in root canal therapy procedures is supported by more and better-documented evidence.

AIM. To comprehensively analyze the information generated by earlier systematic reviews of studies on the effect of premedications on post-endodontic pain.

METHODS. The systematic reviews published in the English language until 2023 were searched in the databases PubMed, Google Scholar, and Cochrane Library using the keywords were identified. from inception to August 2023. The methodological quality of the included articles was analyzed using AMSTAR 2 tool and ROBIS tool. The corrected covered area analysis was performed using the GROOVE tool.

RESULTS. A total of n = 8 systematic reviews were identified. The included systematic reviews and meta analyses were conducted in the period 2018 to 2022. Two [25%] out of the eight included studies had meta analysis. According to the assessment of the AMSTAR 2 tool, one review had high quality, two reviews had moderate quality, two reviews had low quality, and three reviews had critically low quality. ROBIS analysis showed that all the studies had a low risk of bias. The CCA analysis performed with the GROOVE tool showed a high overlap of 11% among all the included studies.

CONCLUSION. Premedication was found to be effective as a means of reduction of post endodontic pain, especially for acute pulpitis. Corticosteroids were generally found to be more effective than NSAIDs. The use of piroxicam or prednisolone would be the premedication of choice. Oral premedication had better compliance and efficacy compared to other routes of administration, although the onset of action and sustenance of the latter was superior.

Extensive surgical interventions are accompanied by the formation of defects in the maxillofacial area, which raises serious concerns regarding the functional, cosmetic, and social rehabilitation of patients. This article, using a clinical case as an example, describes the stages of rehabilitation of a female patient with a postoperative total maxillary defect through the use of a complete removable denture with an obturator. The use of orthopedic rehabilitation methods for patients after maxillary resection enables positive results in restoring lost functions of the dentoalveolar system, facilitating better adaptation of such patients in society and allowing them to return to an active life.

Vital pulp therapy for a carious exposure in a mature permanent tooth may be a reasonable alternative to root canal therapy or extraction. Mineral Trioxide Aggregate (MTA) or Biodentine are bioactive materials which are alternatives to traditionally used calcium hydroxide. They offer advantages like easy to manipulate, shorter setting time and relatively inexpensive. Pulpotomy, a conservative treatment modality for irreversible pulpitis is a newer concept in adult dentition. In properly selected cases, may contribute to the long-term mainte nance of tooth vitality. It is a biomimetic material having  a positive effect on vital pulp cells and stimulates tertiary dentine or reparative dentine formation in direct contact with vital pulp tissue. This article presents two case reports, using Biodentine, which is a promising material having the potential to maintain pulp vitality in patients judiciously selected for vital pulp therapy.

The presence of two canals in a mandibular central incisor represents a rare and complex challenge for dentists. This case report describes the management of a patient with a mandibular central incisor exhibiting two distinct root canals. It emphasizes the importance of understanding canal anatomy to avoid endodontic failures and highlights the difficulties associated with identifying and negotiating uncommon anatomical variations. The low incidence of this anatomical variant underscores the necessity for adequate preparation and a targeted approach in managing such cases.

The introduction of rotary nickel-titanium (NiTi) instruments revolutionized endodontics, enhancing root canal treatment through greater flexibility and procedural efficiency. However, NiTi instruments carry a higher risk of fracture compared to stainless steel files. Instrument separation within the canal can complicate endodontic therapy and may adversely affect prognosis if untreated spaces remain. This case report describes the surgical retrieval of a fractured endodontic instrument extending beyond the apical foramen in a 52-year-old female patient. Under magnification and using precise techniques, the instrument was successfully removed, followed by a one-year follow-up that revealed complete healing. Advanced technologies like operating microscopes, CBCT, and regenerative materials such as platelet-rich fibrin (PRF) significantly improve outcomes by enhancing precision and supporting healing. Despite the potential challenges posed by instrument fractures, successful outcomes can be achieved with meticulous diagnosis, planning, and the use of modern techniques. This case highlights the importance of integrating advanced tools in endodontic practice to optimize treatment results.

Endodontic retreatment is a delicate procedure the success of which is associated both with the presence of factors complicating the prognosis and with the dentist’s technical capabilities. To obtain a predicable result, a clinician should not only have new technologies, but also be skilled in using them. This clinical case describes the successful implementation of classic internal root resorption treatment methods combined with new files and bioceramic materials throughout the non-surgery tooth treatment with internal perforated resorption complicated by the endo-periodontal lesion and odontogenic sinusitis.

INTRODUCTION. The study of the structure of the septa in the area of the maxillary sinus floor is important when planning implantation and sinus lifting operations. The height, number and location of the septa can affect the course of the sinus lifting operation. The aim is to study the structure of the maxillary sinus septa, their height, size, localization in order to prevent complications during surgical interventions.

MATERIAL AND METHODS. The article analyzes CBCT data from 444 patients for the presence of septa in the area of the lower wall of the maxillary sinus. The subjects were divided into two groups: with the presence of premolars and molars (288 CBCT) and with the absence of at least one chewing tooth (156 CBCT). A study of 48 passportized skulls was conducted, the anterior wall of the maxillary sinus was sawed out, the structure of the sinus floor and septa was studied in detail. The ratio of the volume of compact and spongy bone substance in the premolar and molar areas was also measured.

RESULTS. The obtained research data allowed us to obtain new information about the number of septa in the case of a complete dentition and partial tooth loss. Due to changes in the processes of sinus pneumatization, the number of septa increases with partial tooth loss. Their presence increases the risk of perforation of the Schneiderian membrane during sinus lift surgery, including the use of scaffolds based on a collagen matrix. However, when installing an implant in the base of the septum, its stability can be ensured, since the septa are some kind of buttresses of the maxillary bone. The ratio of the volume of spongy and compact bone substance in the premolar and molar area changes with age.

CONCLUSION. The study found that the presence of coronal septa can cause complications of sinus lift surgery in the form of perforation of the Schneiderian membrane. At the same time, septa, being buttresses of the maxillary bone, can serve as a basis for installing an implant. With partial loss of teeth, the number of coronal septa increases. With age, the ratio of spongy and compact bone substance changes, towards a decrease in the volume of trabecular and an increase in the volume of compact bone.

INTRODUCTION. In the treatment of peri-implantitis, it is important to significantly relieve inflammation in the peri-implant area, stop bone resorption and stimulate tissue regeneration. This is possible when using laser radiation with the effects of pigment-free laser photoablation.

AIM. Improving the effectiveness of peri-implantitis treatment using pigment-free laser photoablation.

MATERIALS AND METHODS. An experimental comparative study in 28 animals with model peri-implantitis under the influence of laser radiation with pigment-free photoablation and mechanical treatment of the periimplant area in equal groups. Treatment of 70 patients with peri-implantitis in 2 equal groups of 35 patients – using pigment-free laser photoablation and mechanical treatment. In the groups, the immediate and remote results were assessed according to clinical signs. Before and after treatment, laboratory analysis of C-reactive protein, S-IgA and cortisol was performed.

RESULTS. Morphological analysis showed that the use of pigment-free laser photoablation helps to reduce inflammation and accelerate tissue regeneration. Clinical analysis showed high efficiency of pigment-free laser photoablation by 3.2 times compared to mechanical treatment. Analysis of laboratory research showed that the use of pigment-free laser photoablation helps to reduce CRP by 7.6, stimulate S-IgA by 1.2 times, stimulate cortisol by 1.3 times compared to traditional mechanical and drug treatment of peri-implant pockets.

CONCLUSIONS. Our experimental and clinical laboratory studies confirm the need to use pigment-free laser photoablation to improve the effectiveness of peri-implantitis treatment.

RELEVANCE. Adenoid hypertrophy, mouth breathing can significantly affect the development and formation of the dental system in children. One of the most difficult to correct malocclusion pathologies is anterior open bite. The literature contains isolated, sometimes contradictory reports on the effect of adenoid hypertrophy on the development of this type of malocclusion.

AIM. To study the prevalence of adenoid hypertrophy in children aged 7 to 9 years with anterior open bite, paying special attention to the characteristics of the factors determining the development of this malocclusion.

MATERIALS AND METHODS. 60 children aged 7 to 9 years with an orthodontic diagnosis of anterior open bite were included in the study. The patients were divided into two groups (comparative and control) based on otorhinolaryngological anamnesis (adenoid hypertrophy). According to the lateral cephalometry data, the tendency to skeletal anterior open bite was estimated. The correlation between the development of malocclusion and the presence of adenoid hypertrophy was assessed using the Pearson coefficient.

RESULTS. This study included 30 children with anterior open bite and 30 without malocclusion. There was no strong correlation between the formation of an anterior open bite and the presence of hypertrophy of the pharyngeal tonsil. The skeletal growth type index according to the LC data did not differ significantly in both groups, but the average vertical ratio for children with adenoid hypertrophy and mouth breathing was significantly higher for the control group (p = 0.05).

СONCLUSIONS. The presence of adenoid hypertrophy in a child is not one of the main factors in the open anterior bite development. However, it is necessary to consider that adenoid hypertrophy and mouth breathing, especially for a long time, increases the risk of malocclusion development, effects on the growth of maxillofacial structures, which justifies the need for consultations of pediatric patients with related specialists.

AIM. Analyses the factors of prevalence and intensities of included occlusion defects chewing-oriented of localizations, complicated convergences teeth their limiting.

MATERIALS AND METHODS. In examined group entered dentistry patients with included occlusion defects of the teeth row small and average extent and convergences teeth their limiting in appoximal-medial and appoximal-distal direction. In depending of secondary deforming the position teeth, limiting defect of the teeth rows, examined patients were divided into 2 groups: in the group 1 entered the examined patients (686 persons) with small extent included of occlusion defect and convergences teeth their limiting in appoximalmedial direction; group 2 have formed the patients (287 persons) with included defect small and average extent and with convergences teeth their limiting in appoximal-distal direction.

RESULTS. The factors of prevalence included defect of the teeth row small and average extent has a reliable trend to reduction in depending of age factor. Revealed by us regularity comparatively age category of the reduction occlusion defects explained that, in the course of studies were taken into account only included defects small and average extent of chewing localization, with one positions, and were not taken into account presence ended and greater defect of the teeth row – with another.

CONCLUSION. With increase of the age patient reduction of intensities occlusion defects of chewing localization, complicated convergences teeth their limiting in the age 30–39 years forms 0.36 ± 0.10 units, in comparison with 20–29 year patient. Reduction of intensities of the abovementioned factor in following age group, in contrast with previous group, has formed accordingly 0.74 ± 0.09, 0.59 ± 0.09 and 1.19 ± 0.07 units.

AIM. Study of the frequency meets syndrome of the close-fitting position teeth and other anomaly of the correlation of the teeth rows amongst teenager and adult contingent of the population.

MATERIALS AND METHODS. Were examined 870 teenagers and adult of Dushanbe at the age from 12 before 24 years. Diagnosis of anomaly conducted by means of clinical methods of the study (questioning, checkup, study of the diagnostic models of the jaws). Results of the clinical examination registered in “Card of the checkup of oral cavity”, specially designed for purpose and problems persisting studies. Toothmaxillary anomalies diagnosed in accordance with International categorization of the diseases carry of World organization of the public health. They Were taken into account form, value, amount, position separate teeth, condition of the teeth arcs, occlusion and face signs anomaly.

RESULTS. Teethmaxillary anomalies revealed beside 527 from 870 examined that formed 60.57%. Got numeral characterizes the frequency of meets breaches of the development of the face skeleton beside inhabitants of Dushanbe. Beside 343 (39.43%) of the person exists normal (orthogenetic) bite or its border connecting forms without anomaly teeth, teeth rows and bite. Beside them beside all existed the neutral correlation first constant molars.

CONCLUSION. From 527 revealed persons with system of teethmaxillary anomaly beside 121 persons (22.96%) revealed other forms of the syndrome of the close-fitting position of teeth (vestibular, oral, mesial, tortanomaly). On sign of the localizations of anomalies most often pathology was revealed in lateral and front division of the teeth row, less – in front only, else less – only in lateral division.

AIM. Is to assess the interaction between the pathology of carious and non-carious dental hard tissues, inflammatory periodontal diseases and components of the metabolic syndrome (MS).

MATERIALS AND METHODS. A retrospective observational and comprehensive dental examination of 105 patients with MS has been performed. The complex of dental examination included analysis of complaints, anamnesis, assessment of the condition of dental hard tissues, and periodontal tissues. As a result of retrospective observational analysis, 3 clinical groups have been formed as follows: 2 main clinical groups with MS with impaired carbohydrate metabolism, and with type 2 diabetes mellitus, as well as a group with MS without impaired carbohydrate metabolism (experimental group).

RESULTS. The caries prevalence rate in patients of the 1st and 2nd main clinical groups according to WHO criteria is high, that is 92.5% and 97.3%, (р < 0.001), the average caries intensity level according to the DMF index (Decayed, Missing, Filled index) corresponds to the criterion of high and very high (< 0.001), there is a prevalence of increased abrasion in 76.3% and 51.0% (р < 0.05), hyperesthesia in 69.2% and 67.3%, wedge-shaped defects of hard tissues in 57.7% and 46.2% (р < 0.001), in 34.6% and 80.8% of cases there is a prevalence of chronic periodontitis (р < 0.001) as compared to the experimental group. In this category of patients, the median value of hygienic (SOHI / Simplified Oral Health Index) and periodontal indices of SBI, PI, periodontal pocket depth have been statistically and significantly different from the experimental group patients according to the Kruskal Wallis Test, р < 0.01.

CONCLUSIONS. Thus, in patients with metabolic syndrome with impaired carbohydrate metabolism and type 2 diabetes mellitus, the prevalence of carious and non-carious tooth hard tissue pathology and periodontal inflammatory diseases is observed among the main dental diseases. The data obtained require an interdisciplinary approach in the development and planning of early qualitative diagnostic and treatment and preventive interventions maneuvers in conjunction with a dentist, endocrinologist, and a therapist.

INTRODUCTION. In the literature there are numerous data on the issues of microcirculation in normal and periodontal diseases. Structural and functional microcirculatory changes in tissues observed in chronic generalized periodontitis cause fluid metabolism disorders, which reduces the effectiveness of therapeutic and restorative measures in periodontology. One of the methods of studying the microcirculatory bed is laser Doppler flowmetry.

AIM. To study the state of microhemocirculation of periodontal tissues in patients with cancer of extraoral localization.

MATERIAL AND METHODS. 45 women participated in the study: 15 women with a history of chronic generalized periodontitis of moderate severity against the background of cancer of extraoral localization, 15 with chronic generalized periodontitis of moderate severity and 15 practically healthy with intact periodontitis. The dental status was studied (the state of the oral mucosa and periodontal, determination of the indices of PMA, CPU, CPITN), as well as the state of microcirculation of periodontal tissues using the device “Lazma MC-1” (LLC NPP “LAZMA”).

RESULTS. Changes in standard parameters and spectral analysis parameters were recorded in patients with both chronic generalized periodontitis and in patients with chronic generalized periodontitis against the background of extraoral oncopathology.

CONCLUSION. In the course of the study, in patients with chronic generalized periodontitis, changes in the microcirculatory bed characteristic of periodontal tissue disease were revealed, and more pronounced changes were in patients with chronic generalized periodontitis against the background of an extraoral oncological disease.

INTRODUCTION. In the course of work, a complex of industrial hazards negatively affects the health of employees of chemical enterprises, among which dental morbidity occupies a significant place. To assess the risk of professional dental erosion, it is necessary to obtain more data on the dental status of employees of industrial enterprises.

AIM. To study the dental status of employees of chemical and pharmaceutical production, depending on their work experience, in order to increase the effectiveness of early diagnosis, prevention and treatment of patients with systemic lesions of hard dental tissues.

MATERIALS AND METHODS. The clinical examination involved 60 patients aged 25 to 60 years, who were divided into two groups according to work experience: Group I – work experience up to 5 years (n = 22); Group II – work experience 5–10 years (n = 38). The patients underwent: determination of the the index of the prevalence and intensity of caries, the Greene-Wermillion index, the basic erosive erasability index (BEWE – basic erosive wear examination) and pH-metry of mixed saliva.

RESULTS. In patients of Group I, in comparison with patients of Group II, there is a higher activity of the carious process and poor oral hygiene. With increasing age and length of service, there is a significant increase in the proportion of employees with dental erosion. In Group I patients, the saliva hydrogen index is lower compared to patients in Group II.

CONCLUSIONS. Among the workers of chemical enterprises, there is a great need for oral sanitation, since the influence of harmful production factors on the severity of dental pathology has been proven.