Relevance. The high prevalence of dysplastic disorders involving connective tissue, and its negative effect
on the development of dentoalveolar anomalies, carious and non-carious lesions of the teeth, periodontopathy, temporomandibular joint issues in the child population, lay the basis for improving diagnostics algorithms. Enhancing the already available standards is of greatest importance for children at the initial stages of diagnostics when evaluating the external signs of dysplastic disorders.

Purpose – improving diagnostics algorithms for connective tissue dysplasia (CTD) in children in primary dental care facilities based on the evaluation of external phenotype signs and maxillofacial morphological features.

Materials and methods. Depending on the external phenotype manifestations severity, as well as on laboratory, clinical and instrumental signs, the 92 children with CTD were divided into groups with mild, moderate and severe degrees of undifferentiated dysplasia. Gnathometric and biometric examinations of the maxillofacial area were performed through traditional methods, whereas the diagnosis was set following the generally accepted classifications. The diagnosis confirmation implied evaluation through cone beam computed imaging.

Results. The nature and the intensity of morphofunctional disorders in the craniofacial structures (“small” stigmas) depend on the severity of connective tissue dysplastic disorders.

Conclusions. The change direction vector in the facial and brain parts of cranium in children with CTD is aimed at increasing hypoplastic tendencies and dolichocephalia, proof to that being the following constitutional and morphological features: the prevalence of the vertical type of face skeleton growth over the horizontal and neutral ones; a convex face profile with a disproportionate general heights of the face skeleton; reduction of latitudinal with an increase in altitude facial parameters; a narrow short branch of the lower jaw; the upper jaw displaced downwards and forward; a decrease in the size of the apical basis of the lower dentition, the lower jaw body, as well as the height and width of the lower jaw branches. 

Relevance. According to the World Health Organization, it was found that cleft lip and palate cases ranges from 0.6 to 1.6 cases per 1000 newborns. According to the severity of the lesion, bilateral cleft lip and palate takes the first place, however, it occurs much less common – 15-25%.

Purpose – to analyze methods of treatment in children with bilateral cleft lip and palate during the period of the mixed dentition.

Materials and methods. An analysis of 51 sources Russian and foreign articles for the period from 1951 to 2019 was carried out. The features of the development of occlusion in children with bilateral cleft lip and palate during the period of a changeable occlusion, as well as methods of treating this pathology, are considered.

Results. It was found that the main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during the period of a changeable bite are -narrowing of the upper and lower jaws, the presence of soft tissue scars. The main methods of treatment for such children are reconstructive surgery, including the closure of a hard palate defect using a mucoperiosteal flap cut out in the lateral part of the hard palate, as well as orthodontic treatment methods, the main purpose of which is to expand and extend the dentition using single jaw removable plate apparatuses, fixed plate apparatuses.

Conclusions. Taking everything into account, surgical reconstructive operations, as well as complex orthodontic treatment, the main purpose of which is to expand and extend the upper and lower jaws, are the integral methods of treating such children. Orthodontic treatment should be aimed at eliminating myofunctional disorders with the helpof orthodontic trainers and elastopositioners. Conducting a comprehensive surgical and orthodontic treatment can reduce the rehabilitation time of children with bilateral cleft lip and palate.

Relevance. Skeletal malocclusion stands at the head of all oral diseases and is encountered in 32-35% of children and adolescents in Russia [7;12;15]. The number of malocclusions has increase due to various reasons, one of which is early extraction of deciduous carious teeth resulting in impaired vertical dimension and occlusion of teeth [1;14]. Diagnosis with due regard to caries resistance degree and planning of respective operative and orthodontic treatment are indispensable in children with skeletal malocclusion. 

Purpose – to increase effectiveness of functional treatment of malocclusion in children with various degree of caries resistance.

Materials and methods. There were examined 108 patients aged between 6 and 16 with Class I malocclusion according to Angle, abnormal arch-to-arch relationship and tooth position and various degree of caries resistance. 4 groups were formed: high, sufficient mean, decreased mean and low caries resistance of dental enamel. Intensity of carious process was detected in all patients before and after orthodontic treatment. The effectiveness of reminerlization administered by removable orthodontic appliances was evaluated by electrometrical testing of hard dental tissue. Surface EMG was used to assess normalization of tone of maxillofacial muscles in children by average amplitude of biopotentials of superficial masseter and temporalis muscles.

Results. Сhanges in caries intensity in children after treatment with removable orthodontic aligners indicate the necessity for remineralization of hard dental tissues during orthodontic treatment and it is confirmed by decrease of electroconductivity of enamel in children with sufficient mean, decreased mean and low degree of dental enamel caries resistance. Increase of biopotential mean amplitude during «total mastication» for masseter and temporal muscles confirms effectiveness of preformed elastic positioner along with myodynamic exercises.

Conclusions. The conducted study proves the necessity of comprehensive approach with procedures  increasing the degree of caries resistance of hard dental tissues during orthodontic treatment of skeletal malocclusion in children. 

Relevance. The narrowing of the maxilla is one of the most common pathologies in orthodontics. Recent studies show that the narrowing is always asymmetric which is connected to the rotation of the maxilla. To choose the treatment correctly one need a calculation that reveals the asymmetry, which is impossible with using standard indexes.

Purpose – to compare efficiency of indexes of Pont and Korkhause with the Kernott's method in patients with narrowing of the maxilla.

Materials and methods. The study involved 35 children aged from 8 to 12 years old undergoing dental treatment in the University Children's Clinical Hospital of the First Moscow State Medical University with no comorbidities. For every patient a gypsum model was prepared and after that to carry out the biometrical calculation. In this study two indexes were used: Pont's index and Korkhause's; using this standard analysis the narrowing of the maxilla was revealed. After using Pont's Index and Korkhaus analysis all the models were calculated by the method of Kernott with Kernott's dynamic pentagon.

Results. As a result of the analysis of the control diagnostic models a narrowing of the maxilla in 69% of cases (n = 24) was revealed in all cases, the deviation of the size of the dentition was asymmetric. Thus, 65% of the surveyed models showed a narrowing on the right. This narrowing was of a different severity and averaged 15 control models.

Conclusions. This shows that for the biometrics of diagnostic models it is necessary to use methods that allow to estimate the width of the dentition rows on the left and on the right separately. To correct the asymmetric narrowing of the dentition, it is preferable to use non-classical expanding devices that act equally on the left and right sides separetly.

Relevance. Underestimating the importance of economic analysis is the barrier to the implementation of caries
prevention programs.

The aim is to study with use of mathematic modeling method the clinical and economic effectiveness of dental caries prevention programs provided for schoolchildren.

Materials and methods. The method of mathematic modeling was used to evaluate the clinical and economic efficiency of the caries prevention programs (educational, fissure sealing, fluoride varnish). The cost of prevention program implementation and the expenses for caries treatment without prevention were calculated according to the rate of Volgograd territorial mandatory medical insurance Fund for 2018 year. The differences between the caries prevention program’s cost and the expenses needed for the treatment of “prevented caries” were considered as saving.

Results. It was revealed that the Educational Dental Program for the first grade schoolchildren has short duration (2 years) of clinical-economic efficiency. The Continuous Educational Dental Program applied for 6 years by dental hygienists or dentists led to saving (per 100 children) of 99.5-115.0 or 84.0-99.6 thousand roubles respectively. The economic effect of The First Permanent Molar Fissure Sealing Program was revealed after 2 years only when The Program was implemented by dental hygienists. After 6 years of working with this Program the saving were 181.3 or 146.2 thousand roubles per 100 children depending on who implemented the Program, dental hygienists or dentists. The cost of Fluoride Varnish Program implementation was higher than the treatment of “prevented caries”. However, the number of “prevented caries” after fluoride varnish application is higher than after the implementation of the Educational Dental Programs. Moreover, fluoride varnish, in contrast to fissure sealing, prevents caries of smooth surfaces of permanent teeth.

Conclusions. The method of mathematic modeling can be used for the development of the caries prevention programs in various regions considering the availability of personnel and financial resources, and for evaluation of the clinical and economic effectiveness of preventive programs implementation.

Relevance. Prevention of caries of the first permanent molars is one of the most relevant problems in pediatric
dentistry.

Purpose – to develop an algorithm for prevention of first permanent molars caries in children with different
levels of caries risk.

Materials and methods. The article presents the results of the implementation of the algorithm for prevention of first permanent molars caries in children with different levels of caries risk. This algorithm includes a comprehensive assessment of the values of indices dmft, DMFT, OHI-S, and the patient's health group is also taken into account. The study involved 253 children aged 6-7 years divided into 4 groups: 3 groups of children depending on the health group and the control group. 3 subgroups were identified in each group – with a low, medium, and high caries risk. We developed preventive measures schemes were for children of each group including training in oral hygiene; controlled and home toothbrushing using fluoride-containing toothpastes; applications of varnishes containing fluoride, calcium, phosphates from 2 to 3 times a year; fissure sealing of the first permanent molars. We carried out these activities were for 24 months, and then evaluated theirs effectiveness. Children in the control group were trained in oral hygiene. The clinical effectiveness of medical prophylaxis was evaluated by changes in the above clinical indicators.

Results. In group of children with medium caries risk the increase in caries was 0.09, and the reduction in caries was 89.65%. In children with a low and high caries risk no increase in caries was observed; the reduction in the intensity of caries was 100%. A significant decrease in OHI-S oral hygiene index values was noted in all groups (p < 0.05). We noted high preventive efficacy of fissures sealing in the first permanent molars. No occlusal surface caries developed in sealed fissures.

Conclusions. The application of the proposed preventive schemes in patients demonstrates high efficacy of fluoride and calcium-containing varnishes and sealing the fissures of the first permanent molars. 

Relevance. In adolescence, focal demineralization after orthodontic treatment is highly prevalent. This, in turn, leads to symptomatic hypersensitivity in the absence of other predisposing factors (recessions, exposure of cervical dentin, increased abrasion, etc.). Reviewed the mechanism for reducing hypersensitivity and remineralizing of calcium-sodium phosphosilicate, also the effectiveness of using a prophylactic toothpaste with this component in adolescents.

Materials and methods. A single-center, non-comparative open study was conducted to evaluate the  effectiveness of the Sensodyne Restoration and Protection toothpaste at the Department of Pediatric Dentistry and Orthodontics, USMU for 4 weeks. 22 adolescents aged 14-16 years with focal demineralization of enamel in the stain stage after completion of orthodontic treatment participated in the study.

Results. The use of toothpaste with calcium-sodium phosphosilicate after a month of use leads to a decrease in the hygiene index by 23.38%, a decrease in hypersensitivity according to the results of the Schiff air index by  56.94% (p ≤ 0.05), and a tendency to an increase in the level of mineralization and a decrease in areas of white  spot lesions.

Conclusions. Toothpaste with calcium-sodium phosphosilicate has a cleansing effect and reduces sensitivity and can be recommended for adolescents with focal demineralization against the background of orthodontic  treatment.

Relevance. Characteristics of eruption of secondary teeth is of diagnostic and prognostic interest, is the basis for implementation of targeted therapeutic and preventive measures among children. No research has ever been carried out in Uzbekistan to study an age and gender regional features of secondary teeth eruption. The aim is to determine the timing and symmetry of secondary teeth eruption in children of the city of Tashkent of the Republic of Uzbekistan and comparative assessment with the children of different cities of Russia.

Materials and methods. 3,834 children between 3 and 17 years were conducted dental examination. A comparative analysis was made of the initial, intermediate and final periods of eruption of secondary teeth for children of Uzbekistan (Tashkent city) and Russia (Saratov, Izhevsk and Sergach).

Results. In Tashkent children of both gender, in most cases, lower teeth were erupted before than their antagonists. In girls, teeth were erupted earlier than their male counterparts. At the initial stage of eruption, asymmetry was more pronounced in boys than in girls, while in the middle and final stages it was more pronounced in the opposite direction. Observed asymmetry of antimere’s teeth were indicated left-handed permanent dentition in boys and right-handed in girls. Children of Tashkent city were observed permanent dentition in one group of teeth 1-16 months earlier, and in others – 1-24 months later than their peers in Russian cities. Revealed differences were more pronounced among boys than among girls. Children in Tashkent differed more from their peers in Sergach and less from those in Izhevsk.

Conclusions. Regional peculiarities of permanent dentition in children of Tashkent city and revealed expressed differences with indicators of Russian children are the basis for development of separate age and  gender normative assessment permanent dentition tables for children of Uzbekistan. 

Relevance. At present the question of finding and applying effective methods and approaches for diagnosing early manifestations of dental caries in the form of foci of demineralization during eruption of  permanent teeth in children remains an important and relevant issue. Timely diagnosis at the age of 6-7 years prevents the transition of the initial forms of caries into carious defects and further excludes the use of invasive methods of surgical recovery treatment. The aim is improving the approach of caries diagnostics approach by identifying foci of demineralization and hidden carious cavities in children during teething of permanent teeth.

Materials and methods. An epidemiological examination of 380 children in Moscow aged 6-7 years was carried out. Of the total number of children examined by the method of randomization 150 people were selected, which are divided into 3 groups depending on the intensity of caries. Children of each group were diagnosed with caries using various diagnostic methods – visual inspection, vital staining, hardware method (Estus-LED-Alladin Multicolor (Geosoft, Russia).

Results. In children 6-7 years of age in Moscow, the average prevalence and intensity of caries was established. However, the epidemiological examination does not take into account the number of foci of demineralization and hidden carious cavities, which can subsequently be transformed into destructive forms and cause an increase in caries. This indicates the need to improve the diagnostic approach using different methods for identifying early forms of caries. When using the hardware method, a greater number of foci of demineralization and hidden carious cavities were revealed on all surfaces of permanent teeth. There was a tendency to an increase in the number of foci of demineralization and hidden carious cavities depending on the intensity of caries.

Conclusions. The effectiveness of the hardware method in the group of children DMF = 0 was 40,9% in comparison with the visual method and 36,4% in comparison with vital staining; with DMF = 1-2 – 35,4% in comparison with other methods, with DMF ≥ 3 – 43.3% in comparison with the visual and 40% in comparison with the vital. Diagnosis of early forms of caries made it possible to prescribe treatment and preventive measures in a timely manner and further reduce the growth of caries. 

Relevance. To study the incidence of different types of resorption of multirooted primary teeth, to specify indications for deciduous molar extraction to prevent eruption abnormalities of permanent posterior teeth in mixed dentition.

Materials and methods. Root resorption of 375 multirooted primary teeth (166 first primary molars and 209 second primary molars) was studied on panoramic X-rays of 60 children (30 girls and 30 boys) aged between 7 and 15. Illustrated classification by T.F. Vinogradova (1967) improved by authors was used to determine type and degree of root resorption of multi-rooted primary teeth. Received data were described with absolute values of number of cases and percentage. Chi-square was used to detect differences in sign incidence rate between groups, p<0.05 was considered statistically significant.

Results. There were no statistically significant gender differences (p>0,05) in type and degree of root resorption of multirooted primary teeth. Type A resorption prevailed and constituted 53.3% of all primary molars. Disturbances in root resorption of multirooted primary teeth in mixed dentition were related to health condition of primary teeth. Transition of even resorption to unven was considered a risk factor of delayed eruption and aberrant position of permanent teeth, and indication for extraction of a primary molar in question. 

Conclusions. 1) Even root resorption (type A) was detected in 53.3% of primary molars in mixed dentition by orthopantomography. 2) Transition from even resorption of primary molar roots to uneven resorption was associated with eruption deviations and delayed premolar eruption. 3) Timely extraction of primary molars with uneven root resorption facilitated correct eruption of premolars and increased effectiveness of secondary prevention of malocclusion in children.

Relevance. The relevance of the literature review presented by the authors is due to the diversity and complexity of the differential diagnosis of tumors of the orofacial zone in children and adolescents. Against the background of the absolute predominance of benign neoplasms, about 10-20% falls on the share of malignant neoplasms in this area. In this regard, polyclinic specialists often do not show sufficient oncological alertness, which leads to an unjustified lengthening of the diagnostic period and late diagnosis of malignant neoplasms.

The purpose of the literature review is to discuss the results of studies on the epidemiological, clinical and therapeutic features of the tumor process in the orofacial zone in children and adolescents.

Materials and methods. The searching of publications on the subject of the review were performed in the databases: https://www.ncbi.nlm.nih.gov/, https://elibrary.ru/cit_title_items.asp, https://www.researchgate.net/, https://elibrary.ru/. The authors describe the clinical manifestations of tumors depending on the location of the lesion and histological affiliation. The initial symptoms of both malignant and benign neoplasms are often nonspecific. Prevailing benign neoplasms can only be treated by surgery. Much less often in children and adolescents, malignant neoplasms are also found: squamous cell carcinoma of the oral cavity, Langerhans cell histiocytosis and others, which are treated in accordance with the principles of complex / combined anticancer therapy, including courses to minimize the amount of rehabilitation.

Results. Timely diagnosis and prevention of the development of neoplasms in the orofacial area can reduce the severity of morphological and functional disorders in children and adolescents. Despite the use of effective methods of surgical or combination therapy, many need rehabilitation measures.

Conclusions. The optimal position of a pediatrician, therapist, dentist, or surgeon at the stage of tumor diagnosis should be the implementation of oncological alertness, which implies an active approach without long-term "dynamic observation" of patients. Oncological alertness, especially among dentists, will improve the results of antitumor therapy in patients with Orofacial tumors.

Relevance. In clinical practice, dentists often encounter diseases of the salivary glands, and their hypofunction adversely affects the self-cleaning and hygiene of the oral cavity, contributing to the development and progression of the inflammatory pathology of periodontal and oral mucosa. The goal is to present a contribution to the modern dentistry of the candidate of medical sciences Valery Valerievich Lobeyko, in connection with his death on April 14, 2020.

Materials and methods. Based on the analysis of life, military and professional activities, as well as scientific works of V.V. Lobeiko highlight research on salivalogy and other aspects of modern dentistry.

Results. The scientific, clinical and pedagogical work of the dentist and maxillofacial surgeon Valery Valerievich Lobeyko, his contribution to the study of the morphological and functional characteristics of the parotid gland is normal, under the influence of factors of aircraft flight, against the background of pharmacological correction, as well as to the solution of the difficult problem of dentistry in the treatment of salivary diseases glands in the elderly. Particular attention is paid to the results of his research in salivalogy, as well as to little-known areas of his scientific work in the field of military dentistry and gerontostomatology.

Conclusions. Scientific works of V.V. Lobeiko entered the domestic military medicine and dentistry, and their results will be used by dentists for a long time to come.