Relevance. Dental fluorosis (DF) is an enamel hypomineralization caused by excessive systemic fluoride intake during critical periods of amelogenesis. It is endemic in regions with high fluoride levels in drinking water (>1.5 ppm), including the Moscow Region and the Republic of Mordovia in the Russian Federation, but may also occur in non-endemic areas because of alternative sources of fluoride exposure. Historically, teeth affected by dental fluorosis were considered resistant to dental caries; however, current evidence refutes this view and indicates an increased caries risk.

Objective: To assess whether restricting fluoride-containing oral hygiene products in patients with dental fluorosis is scientifically justified and to evaluate the benefits and risks of their use for caries prevention in this population.

Materials and methods. A literature search covering the past 30 years was performed across PubMed, EMBASE, MEDLINE, Springer, Wiley Online Library, ResearchGate, and eLIBRARY using the following search terms: dental fluorosis, dental caries, hypomineralization, fluoride, toothpaste, caries susceptibility, enamel defects, salivary buffering capacity, and dietary habits. Of the 265 identified articles, 26 relevant studies were selected for full-text analysis.

Results. Patients with dental fluorosis are at increased risk of dental caries and rapid lesion progression because of altered enamel structure, reduced mineralization, and increased enamel fragility. Caries prevalence increases with fluorosis severity regardless of fluoride concentration in drinking water. Topical fluoride use in children and adults with dental fluorosis is important for counteracting this increased caries risk. Topical fluorides do not worsen fluorosis and remain the main preventive measure for affected teeth after eruption.

Conclusion. Restricting topical fluoride use in dental fluorosis is not supported by convincing scientific evidence and may reduce protection against dental caries. Recommendations to avoid fluoride-containing toothpastes appear to stem largely from conflating the systemic pathogenesis of dental fluorosis with the topical effects of fluoride, as well as from outdated concepts.

Relevance. According to the World Health Organization, dental caries in primary teeth is the most common chronic disease in childhood, affecting 514 million children worldwide in 2022. In children aged 0–5 years, the first signs of carious lesions are typically detected in the anterior teeth, with the maxillary incisors and canines being most frequently affected. Various approaches are available for restoring primary teeth; however, in cases of extensive crown destruction, prefabricated full-coverage crowns, including zirconia crowns, are preferred. Successful treatment requires reliable bonding of crowns to primary tooth dentin using luting cements. Luting cements must meet several requirements, including adequate adhesion to hard dental tissues and indirect restorations, biocompatibility, and favorable esthetic properties. This study evaluated the bond strength of zirconia crowns to primary tooth dentin using different luting cements.

Objective. To evaluate the bond strength of zirconia crowns to primary tooth dentin using different luting cements.

Materials and methods. The bond strength of zirconia specimens to primary tooth dentin was evaluated using different luting cements. Sixty sections of primary teeth extracted for clinical indications and mechanically prepared were used as test specimens. Bond strength was assessed using shear and tensile bond strength tests.

Results. The self-adhesive resin cement Maxcem Elite demonstrated high bond strength to both zirconia and primary tooth dentin in the shear and tensile tests: 5.95 [4.33; 8.78] MPa and 13.94 [11.95; 17.88] MPa, respectively. Specimens bonded with the glass ionomer luting cement GC Fuji I also showed good results in the shear test: 5.15 [3.38; 7.70] MPa; however, tensile bond strength was low: 0.90 [0.80; 1.40] MPa. Bonding of primary tooth dentin to zirconia using the glass ionomer cement CEMION-F showed lower values in both shear and tensile tests: 1.60 [1.00; 2.45] MPa and 0.49 [0.30; 1.26] MPa, respectively.

Conclusion. The self-adhesive resin cement Maxcem Elite provided the highest bond strength between zirconia and primary tooth dentin. The glass ionomer cement Fuji I also demonstrated favorable bond strength when used to lute zirconia to primary tooth dentin. The glass ionomer cement CEMION-F showed lower bond strength.

Relevance. Fixed orthodontic appliances for the prevention and treatment of malocclusion during the early mixed dentition remain underused in clinical practice.

Materials and methods. Three groups of patients aged 7 to 9 years with maxillary underdevelopment were analyzed. All patients were treated with fixed appliances. Each group included 10 patients; the total sample comprised 15 boys and 15 girls. None of the patients had previously received orthodontic treatment or had craniofacial syndromes. All patients presented with posterior crossbite associated with maxillary deficiency. The appliances were worn for 6 to 12 months, followed by a 4-month retention period.

Results. In the first group, patients were treated with a Haas-type rapid maxillary expander and a Marco Rosa–type expander; in the second group, with 2 × 2, 2 × 4, and 2 × 6 partial fixed appliances; and in the third group, with a Hyrax-type rapid maxillary expander. The appliances used in the first and third groups were custom-fabricated in the laboratory. The expansion screw was activated at home by one-quarter turn twice daily, in the morning and evening, for 5 days, then once daily for 15 days, and thereafter by one-quarter turn every 5 days for 6 to 8 months until the desired expansion was achieved. Treatment outcomes were assessed before treatment and after expansion.

Conclusion. All appliances provided effective maxillary arch expansion. In addition to expansion, the partial fixed appliance also promoted arch lengthening and normalization of incisor position within a shorter treatment period.

Relevance. Anterior palatal fistulas are among the most common complications of primary palatoplasty in patients with cleft lip and palate (CLP) and isolated cleft palate (ICP), with reported rates ranging from 5% to 60%. These fistulas result in persistent functional impairment, including hypernasality, nasal regurgitation, and swallowing and breathing difficulties. They may also complicate orthodontic treatment and often require secondary reconstructive surgery. This study aimed to analyze the etiologic and pathogenic factors underlying the development of anterior palatal fistulas and to propose a clinical classification based on a comprehensive assessment of anatomical, surgical, and biomechanical factors.

Materials and methods. The study included 38 patients aged 6 to 18 years with anterior palatal fistulas after palatoplasty: 20 with unilateral CLP, 13 with bilateral CLP, and 5 with ICP. Clinical and radiographic examinations were performed. Anatomical factors related to cleft morphology, surgical factors, biomechanical factors associated with maxillary growth and orthodontic treatment, and postoperative risk factors were assessed.

Results. The development of anterior palatal fistulas was associated with a complex interplay of contributing factors. Cleft anatomy was the key predictor of fistula characteristics, including location, size, and timing of onset. Among the 38 patients, 18 (52.6%) had unilateral complete CLP at birth. In patients with ICP (n = 5), anterior palatal fistulas developed in all cases (100%) as a result of attempts to lengthen a congenitally short soft palate. Growth-related maxillary biomechanics was the leading cause of late-onset fistulas, and in 50% of cases the fistula developed within 3 months after surgery. A working classification was developed, identifying four types of anterior palatal fistula: combined alveolar-palatal, median, incisive foramen, and multiple.

Conclusion. Anterior palatal fistulas develop through a complex interaction of anatomical vulnerability of the anterior palate, technical shortcomings during palatoplasty, maxillary growth biomechanics, and orthodontic forces. Prevention of postoperative anterior palatal fistulas depends on careful planning of staged cleft repair with due regard for cleft type and severity, close follow-up during periods of craniofacial growth, and a multidisciplinary approach involving both the maxillofacial surgeon and the orthodontist.

Relevance. The high prevalence of oral diseases in children remains a significant challenge for pediatric dentistry and public health. Particular attention should be paid to the relationship between oral health status and gastrointestinal disorders in children, since coexisting systemic disease may contribute to the development of dental caries, non-carious lesions, and oral mucosal abnormalities.

Objective. To assess the oral health status of children with selected gastrointestinal diseases.

Materials and methods. A total of 120 children aged 7 to 17 years were examined at the clinical sites of the Children’s City Clinical Hospital, Krasnodar, Ministry of Health of the Krasnodar Krai, and at the clinic of Kuban State Medical University, Ministry of Health of the Russian Federation. Gastrointestinal diseases were diagnosed in 62 patients. The control group included 58 age-matched healthy children without gastrointestinal disease. The study assessed the prevalence and severity of dental caries, the presence of non-carious lesions of the dental hard tissues, the condition of the oral mucosa, and salivary pH.

Results. Children with gastrointestinal disorders showed greater caries experience and more pronounced inflammatory changes in the oral mucosa. Salivary pH in the study group was lower by an average of 0.5-0.8 units, and this reduction was associated with an increased risk of dental caries, particularly in children with gastroesophageal reflux disease.

Conclusion. Children with gastrointestinal diseases show marked adverse changes in oral health status, which supports the need for a comprehensive interdisciplinary approach to diagnosis, prevention, and treatment. The findings may be used to develop follow-up care programs and preventive strategies for children at increased risk.

Relevance. Oral autofluorescence examination may be a useful addition to routine orthodontic practice, as it can improve the detection and monitoring of oral mucosal changes during treatment. Patients treated with removable orthodontic appliances require particular attention because these appliances may affect the oral mucosa and therefore require regular clinical monitoring. Oral autofluorescence examination is a promising diagnostic tool for the objective assessment of pathological changes in the oral mucosa.

Materials and methods. The study included 123 children under 15 years of age who were undergoing orthodontic treatment with removable appliances. Based on the mechanism of action of the removable appliance used, participants were divided into three groups: preventive, mechanical, and functional appliances. Oral mucosa was examined using an AFS-400 LED device for oral autofluorescence examination. Statistical analysis was performed in Microsoft Excel 2010.

Results. Oral mucosal changes were detected in all study groups, supporting the use of oral autofluorescence examination during routine orthodontic follow-up visits. The most common pathological findings were acute and chronic mucosal trauma, inflammatory changes, and hyperkeratotic lesions.

Conclusion. Removable orthodontic appliances affect the tissues of the maxillofacial region, including the oral mucosa. Because they may contribute to traumatic, inflammatory, and hyperkeratotic mucosal changes, these appliances require careful monitoring during orthodontic treatment. Orthodontists therefore play an important role in the prevention, early detection, and timely management of oral mucosal lesions. Oral autofluorescence examination may support this process by helping detect early mucosal changes.

Relevance. In recent years, the number of children born with severe forms of cleft lip and palate has increased. Surgical treatment in these patients is often associated with postoperative complications, including recurrent defects of the anterior hard palate. Impaired microcirculation at the surgical site is a key factor in the pathogenesis of these complications and may result in tissue loss, delayed healing, postoperative defect formation, and the need for repeat surgery. Standard clinical assessment of flap viability based on color, turgor, and capillary refill remains subjective and lacks sufficient sensitivity for early detection of deep or central ischemia. This highlights the need for objective methods of intraoperative and postoperative monitoring. Digital vital capillaroscopy (DVC) is a promising noninvasive technique that enables objective real-time assessment of microcirculation. It allows flap monitoring, assessment of angiogenesis, detection of early signs of impaired perfusion, and prediction of the risk of flap ischemia and tissue necrosis. Understanding these processes is essential for improving tongue flap reconstruction techniques and optimizing surgical outcomes.

Materials and methods. This prospective study included 15 patients aged 12–18 years with secondary anterior hard palatal defects measuring 2–4 cm². All patients underwent two-stage defect closure using a thin split-thickness tongue flap. Microcirculation was assessed by DVC using the OKO device (Russia) before surgery in the defect area, donor site, and intact mucosa, and then daily from postoperative day 1 to day 16. Functional capillary density (capillaries/ mm2), linear erythrocyte velocity (LEV, μm/s), and volumetric erythrocyte velocity (VEV, μm³/s) were assessed.

Results. A three-phase pattern of microcirculatory changes was identified. In the early postoperative period (days 1–3), functional capillary density decreased to 5–8 capillaries/mm², LEV to 0–50 μm/s, and VEV to 0–2,000 μm³/s. During the initial regeneration phase (days 4–7), the capillary network began to recover, with LEV increasing to 250–400 μm/s and VEV to 15,000–25,000 μm³/s. During the active healing and flap integration phase (days 8–16), these parameters stabilized, with LEV reaching 550–700 μm/s and VEV 45,000–60,000 μm³/s.

Conclusion. DVC is a highly informative method for objective monitoring of microcirculation during healing after tongue flap reconstruction. Capillary blood flow parameters are early indicators of ischemic changes and prognostic markers of flap viability and successful integration. Dynamic DVC monitoring allows individualized therapy and helps determine the optimal timing of the second stage of surgery (postoperative days 14–16), thereby reducing the risk of complications.

Relevance. In children aged 6–9 years, the most common modifiable risk factors for dentofacial abnormalities were premature loss of primary molars and altered anatomical form of the primary molars, both of which contribute to the development of deep bite and Class II malocclusion. In combination with delayed attrition of the primary canines, these factors significantly influence the development and severity of dentofacial abnormalities. Timely correction of these modifiable factors through preventive interventions is essential for reducing the risk and severity of dentofacial abnormalities.

Materials and methods. A retrospective analysis was conducted of the dental records of 245 children aged 6–9 years who presented for treatment to a pediatric dentist. The study recorded the frequencies of premature loss of primary molars, altered anatomical form of primary molars, and delayed attrition of the primary canines as risk factors for dentofacial abnormalities. Interarch relationships were assessed, and the severity of dentofacial abnormalities was evaluated.

Results. Retrospective analysis of the dental records showed that, among children aged 6–9 years, altered anatomical form of the primary molars in combination with Class II malocclusion and deep bite was the most common finding, observed in 54.2% of cases.

Conclusion. Altered anatomical form of the primary molars contributes to the development of Class II malocclusion and deep bite and is associated with greater severity of dentofacial abnormalities.

Relevance. Contemporary orthodontic practice increasingly requires a biopsychosocial approach that takes into account not only anatomical and functional abnormalities but also the patient’s psychological status. Self-esteem is particularly important as an indicator of psychosocial adjustment, as it may affect motivation and clinical outcomes. However, its objective evaluation is rarely incorporated into routine orthodontic assessment.

Objective. To compare the level and structure of self-esteem in children with and without dentofacial anomalies using Harter’s Self-Perception Profile for Children (SPPC).

Materials and methods. The study included 30 children aged 8–12 years, divided into two groups: the study group (n = 15) comprised children with dentofacial anomalies, and the control group (n = 15) comprised children without clinically significant dentofacial abnormalities. All participants underwent a standard orthodontic examination and psychological assessment using the Russian-language adaptation of Harter’s SPPC, which evaluates six domains of self-esteem. Between-group comparisons were performed using Student’s t test for independent samples. Differences were considered statistically significant at p < 0.05.

Results. Significant between-group differences were identified. Children with dentofacial anomalies had lower global selfworth and lower scores for physical appearance, social acceptance, close friendship, scholastic competence, and behavioral conduct than children in the control group. The most pronounced differences were observed for physical appearance and social acceptance. No significant between-group differences were found for professional competence.

Conclusion. Dentofacial anomalies in children may be regarded as an important psychosocial risk factor associated with reduced self-esteem, a distorted physical self-image, and difficulties in social acceptance. The inclusion of validated psychological assessment tools such as the SPPC in comprehensive orthodontic assessment may support individualized treatment planning, improve treatment effectiveness, and promote a truly patient-centered approach aimed at enhancing quality of life.

Relevance. Early identification of changes in the maxillofacial region may help prevent the development of dental disorders in children. Reduced lower facial height in children is associated not only with altered facial appearance and esthetic concerns, but also with impaired oral health. However, data on oral health status in children with reduced lower facial height remain limited. The aim of this study was to assess oral health status in this patient group.

Materials and methods. A total of 84 children aged 7 to 12 years were examined. Based on the clinical examination findings, 52 patients with an interocclusal distance of 3.1 ± 0.1 mm were included in the study group. The control group comprised 32 children.

Results. Comprehensive clinical examination, supplemented by digital occlusal analysis, revealed an uneven distribution of masticatory load, poor oral hygiene, and high caries experience in children with reduced lower facial height. The Significant Caries Index (SiC) was 6.11 ± 0.29, indicating that nearly every third tooth was affected by caries or its complications.

Conclusion. The oral health characteristics of children with reduced lower facial height should be taken into account when planning treatment. A comprehensive examination is advisable for the early detection of this condition and associated dental risk factors, which may help prevent the development of further dentofacial disorders.

Relevance. Patients with unilateral temporomandibular joint (TMJ) ankylosis have marked functional and anatomical disturbances that adversely affect quality of life and social adaptation. This condition requires complex, multistage rehabilitation. After surgery on the affected side, the unaffected, non-operated joint bears the main functional load for a prolonged period. Long-standing mandibular biomechanical imbalance leads to secondary changes in the masseter and temporalis muscles, including hypertrophy or atrophy. However, the functional status of the masticatory muscles in these patients remains insufficiently studied.

Materials and methods. The study included 65 patients aged 7–18 years with unilateral TMJ ankylosis who were undergoing different stages of comprehensive rehabilitation, including removal of ankylotic masses, placement and removal of a distraction device, mandibular ramus bone grafting, and total TMJ replacement. The patients were divided into two age groups: 7–12 years (n = 25) and 13–18 years (n = 40). All patients underwent electromyographic (EMG) assessment of the temporalis and masseter muscles using a four-channel Synapsis electromyograph (Neurotech, Russia). The mean amplitude of bioelectrical activity (μV) during maximum voluntary clenching was recorded. Values on the affected side were compared with those on the contralateral side and with age-matched reference values. Statistical analysis was performed using the Mann–Whitney U test and Pearson’s chi-square test.

Results. All patients showed an imbalance in the bioelectrical activity of the masticatory muscles. In the 7–12-year age group, the amplitude of masseter muscle bioelectrical activity on the affected side was 43.5% lower than the age-matched reference value, whereas temporalis muscle activity was reduced by 23.3%. On the contralateral side, masseter and temporalis muscle activity exceeded the reference values by 25.7% and 34.4%, respectively. In the 13–18-year age group, masseter muscle activity on the affected side was reduced by 12.5%, whereas on the contralateral side it exceeded the reference value by 63%. Temporalis muscle activity exceeded the reference value by 16.7% on the affected side and by 82% on the contralateral side.

Conclusion. A statistically significant decrease in the electrical activity of the masseter and temporalis muscles was observed on the affected side. The main functional load was redistributed to the masseter and temporalis muscles on the contralateral side and, in the 13–18year age group, also to the temporalis muscle on the affected side. Increased muscle activity on the contralateral side in adolescents may indicate the development of compensatory mechanisms in response to unilateral TMJ ankylosis.