Relevance. Venous malformations of the head and neck in children represent a clinically significant type of vascular anomaly that is challenging to treat due to their morphological features and high risk of recurrence. Modern approaches to sclerotherapy, particularly the use of foam formulations, provide new opportunities for minimally invasive treatment.

Objective. To compare the efficacy and safety of 3% polidocanol foam and a novel bleomycin– polidocanol mini-foam formulation in pediatric head and neck venous malformations.

Materials and methods. The study included an experimental phase involving 18 laboratory animals and a clinical phase with 82 pediatric patients. The first group underwent sclerotherapy with 3% polidocanol foam, while the second group received a bleomycin-polidocanol mini-foam formulation. Efficacy was evaluated using clinical criteria and MRI findings.

Results. The combined therapy group demonstrated a significantly higher rate of complete regression of malformations (87.8% vs. 51.2%). The mean number of procedures required to achieve a positive effect was comparable – 2.16 in the first group vs. 2.76 in the second group. Morphological analysis revealed marked endothelial damage and absence of vascular recanalization in the experimental group treated with the combined foam.

Conclusion. Bleomycin–polidocanol mini-foam sclerotherapy demonstrates high therapeutic potential and may be recommended as a first-line treatment for venous malformations of the head and neck in children.

Relevance. Orthodontic management of children with congenital osseous disorders of the temporomandibular joint (TMJ) spans the entire course of dentofacial growth and accompanies each surgical stage from early childhood through adolescence. Although a wide range of orthodontic appliances is available for this patient group, published data on their use remain limited and inconsistent. Evidence from Russian and international sources suggests that combining functional orthopedic treatment with distraction osteogenesis (DO) yields more durable, clinically stable outcomes. However, the sequence of appliance use and continuity of care remain poorly organized and insufficiently systematized, a gap compounded by the absence of a unified clinical algorithm and formal practice guidelines. Objective. To analyze existing orthodontic management methods for patients with mandibular ramus hypoplasia and/or aplasia across the stages of comprehensive rehabilitation and to synthesize the available evidence.

Materials and methods. The literature review was conducted in accordance with PRISMA guidelines for systematic reviews and meta-analyses. Searches were performed in PubMed, Medline, EMBASE, and eLibrary using the keywords “orthodontic management,” “mandibular ramus hypoplasia and aplasia,” “functional appliance,” and “stages of orthodontic treatment,” combined with the Boolean operator AND, in both English and Russian. Original publications reporting the use of removable orthodontic appliances in patients with congenital osseous TMJ disorders were analyzed. A total of 1,500 records were identified; 22 met the inclusion criteria and were included in the final review. In addition, a retrospective analysis was conducted of orthodontic outcomes in 40 patients treated at the Department of Orthodontics, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, from 2004 to 2024.

Results. Reports in the Russian-language literature describing specific functional orthodontic appliances for children with unilateral mandibular ramus hypoplasia and/or aplasia due to congenital osseous TMJ disorders are scarce. Most published cases involve the Vankevich appliance (maxilla-supported fracture splint) or a removable plate with a lingual pad (pelotte). To date, no standardized protocol for orthodontic management of these patients has been proposed.

Conclusion. In this patient population, criteria for evaluating the quality of orthodontic care across stages of dentofacial development are lacking, and the continuity of multidisciplinary collaboration within comprehensive dental rehabilitation is insufficiently characterized. A clear clinical strategy for orthodontic management has not been defined, and the biomechanical capabilities of orthodontic appliances in influencing both jaws both jaws are not fully delineated. The optimal integration of surgical and orthodontic stages into a unified, evidence-based treatment protocol also remains to be established.

Relevance. Children with autism spectrum disorder (ASD) frequently exhibit poorer oral hygiene and altered oral and gut microbiota, influenced by behavioral features, sensory hypersensitivity, and feeding difficulties. Evidence for non-invasive, home-based caries-prevention strategies in this population remains limited. The evaluation of the clinical efficacy of available preventive agents, including calcium-enriched oral foam and the oral probiotic Streptococcus salivarius K12, is considered a relevant topic of investigation in pediatric dentistry.

Materials and methods. In this prospective controlled study, 122 children with ASD aged 3–9 years received 30-day preventive regimens including a calcium-enriched oral foam (Group 1) or S. salivarius K12 (Group 2). A control group comprised 54 neurotypical children. Oral health status was assessed using the Fedorov–Volodkina Hygiene Index; the presence and severity of black stain plaque (extrinsic discoloration) were recorded clinically; caries experience was quantified as the combined dmft + DMFT score. Oral and fecal microbiota were profiled by GC–MS.

Results. At baseline, children with ASD had significantly poorer oral hygiene and higher caries prevalence than neurotypical controls. GC–MS profiling indicated pronounced dysbiosis in both oral and intestinal samples in the ASD cohort, with correlations across sites for pathogenic taxa (e.g., Streptococcus mutans, Staphylococcus aureus, Helicobacter pylori). A statistically significant decrease in oral hygiene index scores was observed in both younger and older age groups following the use of calcium-enriched oral foam and the Streptococcus salivarius K12 probiotic. After 30 days of preventive use, the proportion of children with elevated levels of S. mutans, S. aureus, and other pathogenic microorganisms decreased in oral and gut samples. No statistically significant between-regimen differences in improvement were observed across age groups. Both interventions demonstrated comparable efficacy.

Conclusion. Calcium-enriched oral foam and S. salivarius K12, used as home-based adjuncts, improved plaque-related indices and favorably modulated microbiota profiles in children with ASD. These non-invasive measures may be recommended as part of comprehensive dental care for this population.

Relevance. Nitrous oxide-oxygen sedation has been widely used in Russia since the early 2000s. It is widely regarded as an effective method for managing the behavior of uncooperative patients. However, despite generally positive assessments of its safety and efficacy, there remains a lack of research into the potential negative consequences and risks associated with its use, both for patients and healthcare personnel.

Objective. To provide structured information that will help dentists working with nitrous oxide sedation minimize its potential toxicity for all personnel involved.

Materials and methods. Publications from both international and Russian databases over the past 30 years were reviewed for key terms related to the effects of nitrous oxide on dental personnel. The initial selection process involved screening titles and abstracts, followed by a full-text review of the remaining articles. From the 145 sources identified, 33 of the most relevant studies were selected.

Results. Nitrous oxide has been used in dentistry for over 150 years, but its significant toxicity raises concerns about its safety. The primary harmful mechanism is the irreversible oxidation of vitamin B₁₂, which disrupts essential processes such as DNA synthesis, myelin formation, homocysteine metabolism, and folic acid metabolism. High-risk groups include dental personnel (due to chronic exposure), individuals with B₁₂/folate deficiency, those with congenital MTHFR gene mutations, people with chronic diseases (such as autoimmune disorders and diabetes), pregnant women, and others. Acute effects for dental personnel include dizziness, nausea, and impaired cognitive and motor functions. Chronic effects can be neurological (paresthesia, ataxia, demyelination of peripheral nerves), hematological (anemia, leukopenia), cardiovascular (thromboembolism, hypertension), reproductive (reduced fertility, pregnancy complications), and immune-related. Despite control measures such as ventilation, nitrous oxide monitoring, and respirators, the risk remains due to system leaks and insufficient awareness. Regular check-ups for personnel, twice a year, are critical are critical, including tests for homocysteine and methylmalonic acid, complete blood count, and neurological evaluations when symptoms arise. Dentists must be informed about the occupational risks of nitrous oxide.

Conclusion. Proper use of nitrous oxide sedation minimizes these risks. Dentists' proficiency in behavior management techniques, local anesthesia, and personal responsibility for following safety protocols are crucial for ensuring the safety of dental personnel.

Relevance. Leukemias and their treatment produce broad systemic effects in children and frequently involve the oral cavity, leading to qualitative and quantitative changes in saliva. Analysis of salivary facies using the wedge-shaped dehydration method is a useful morphological approach for characterizing disease-related alterations, including those associated with hematologic malignancies.

Objective. To compare the morphology of salivary facies in healthy children and in children with hematologic malignancies.

Materials and methods. The study was conducted at the Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and at the Pediatric Dentistry Department Transplantation of the Pavlov First Saint Petersburg State Medical University. Facies of the supernatant fraction of saliva were prepared by wedge-shaped dehydration, affixed to Litos System glass plates, and assessed according to the Shatokhina–Shabalin clinical crystallography method (1998). Comparison endpoints included quantitative parameters of the marginal zone, facies type, degree of amorphization, and the presence of pathologic markers.

Results. Children with hematologic malignancies showed a larger marginal-zone area (twofold, p < 0.01) and a higher marginal-zone/total facies area ratio (1.5-fold, p < 0.01) than healthy controls. Marginal-zone pigmentation was twice as common, and discontinuous spiral cracks were four times more frequent. Back-arcaded cracks, continuous spiral cracks, and partial or complete amorphization were observed only in the hematologic malignancies group (p≤0.05).

Conclusion. The morphology of salivary facies in children with hematologic malignancies differs substantially from that of healthy peers, indicating impaired salivary homeostatic function.

Relevance. Smile aesthetics influence self-esteem and social interaction in both children and adults. Do preschool and early school-age children notice dentoalveolar anomalies? Can misaligned teeth affect a child’s social life?

Objective. To evaluate the perception of smile aesthetics among preschool and early school-age children.

Materials and methods. A questionnaire survey was conducted among 155 children aged 3–10 years. The survey involved showing photographs of smiles with different tooth alignment patterns.

Results. We found that even the youngest participants distinguished attractive from unattractive smiles. Perception of smile aesthetics was associated with sex, age, and prior awareness of dental aesthetics.

Conclusion. The study identified groups of children who were more critical of smile aesthetics: girls, school-aged children, and those with greater awareness.

Relevance. The available literature confirms that classification of orofacial clefts remains a pressing issue: there is no universally accepted system and no common criteria for constructing one.

Objective. To review the evolution of orofacial cleft classification systems and propose an expanded framework.

Materials and methods. We reviewed Russian and international sources (1976–2023), retrieved via extended search capabilities across multiple bibliographic databases.

Results. The article describes the principles and approaches used to construct classifications of orofacial clefts, tracing their historical development and current concepts.

Conclusion. Classifications based on anatomical, morphological, clinical, and embryologic principles have largely been exhausted. Accordingly, etiopathogenesis-based classifications should serve as the most effective tool for understanding, prevention, and treatment of this congenital craniofacial anomaly. The authors present an etiopathogenetic classification of orofacial clefts.

Relevance. The alkaline comet assay is among the most sensitive methods for detecting genotoxic effects in diverse tissues and body fluids. It quantifies the migration of fragmented chromosomal DNA in an electric field; the extent of migration correlates with the degree of DNA damage.

Materials and methods. The study was conducted at the Republican Children’s Clinical Hospital (Ufa, Russian Federation). Five groups were compared: (1) 40 children with cleft lip and palate (CLP) living in an area without environmental toxicants; (2) 60 children with CLP living in an area with environmental toxicants; (3) 40 mothers residing in an area without environmental toxicants; (4) 60 mothers residing in an area with environmental toxicants; and (5) 40 apparently healthy children to establish reference values. Peripheral blood lymphocytes were evaluated using the alkaline comet assay. Gels were stained with SYBR Green I. Statistical analyses were performed in R (version 4.x) using the stats package.

Results. Among children with CLP residing in areas with environmental toxicants, the mean tail length measured 11.473 µm (95% CI, 11.411–11.535), % tail DNA averaged 7.816 (95% CI, 7.768–7.865), and the tail moment amounted to 0.897 (95% CI, 0.886–0.907). In mothers from the same areas, the mean tail length reached 11.403 µm (95% CI, 11.336–11.470), % tail DNA averaged 6.662 (95% CI, 6.628–6.697), and the tail moment was estimated at 0.760 (95% CI, 0.754–0.766).

Conclusion. Use of the alkaline comet assay during preconception planning in women residing in regions with environmental toxicant contamination provides significant clinical utility for risk prediction of CLP in offspring. Thresholds of tail length ≥ 11.0 µm, % tail DNA ≥ 6.5, and tail moment ≥ 0.73 are associated with a markedly increased predicted risk of cleft lip and palate in the offspring.  

Relevance. Early extraction of primary teeth in children aged 4–7 years remains relatively common, with reported rates reaching 43%. Such cases often result in dentoalveolar anomalies and arch deformation. When selecting an impression technique for the fabrication of space maintainers, the priority should be on procedural safety and patient comfort. Digital intraoral scanning offers a modern alternative to traditional impression methods.

Materials and methods. A comparative analysis of different impression-taking methods was performed in 90 children aged 4–7 years with early extraction of primary molars. The following were evaluated: fabrication time, risk of complications, and the frequency of adverse sensations during alginate impressions (Hydrocolor 5, Zhermack, Italy), condensation silicone impressions (Zetaplus, Zhermack, Italy), and digital scanning of the dental arches (Runyes IOS-11, China). Statistical analysis was conducted.

Results. Digital intraoral scanning shortened fabrication time by 11.5% relative to alginate impressions and by 59.6% relative to condensation silicone. The incidence of gag reflex during scanning was 4 times lower than with alginate impressions and 5.67 times lower than with condensation silicone. Reports of discomfort were 8.67 times less frequent than with alginate impressions and 8 times less frequent than with condensation silicone. All differences were statistically significant for both time efficiency and patient comfort.

Conclusion. A comparative analysis of impression techniques for the fabrication of band-and-loop space maintainers after premature loss of primary molars demonstrated the higher efficiency and better patient tolerance of digital intraoral scanning compared with conventional impression methods.

Relevance. DNA damage caused by exogenous factors acting on the maternal organism during preconception and early pregnancy plays a central role in the pathogenesis of congenital malformations. Many industrial toxicants released into the atmosphere possess teratogenic and mutagenic properties, among which benzo[a]pyrene and formaldehyde are of particular concern.

Objective. To conduct a randomized study to assess DNA damage by quantifying DNA strand breaks using the alkaline comet assay (single-cell gel electrophoresis) in isolated leukocytes from children with cleft lip and palate (CLP). The study compared three groups – children with CLP from regions with environmental toxicants, children with CLP from unexposed regions, and healthy controls from regions with elevated petrochemical emissions – to assess the association between DNA damage and CLP.

Materials and methods. The randomized study included 140 children aged 5–12 years divided into three groups: 60 children with CLP from regions with elevated atmospheric petrochemical emissions, 40 children with CLP from regions without petrochemical industry emissions, and 40 apparently healthy children from regions with elevated levels of atmospheric petrochemical pollutants. Peripheral venous blood was drawn after an overnight fast into EDTA tubes and transported to the Ufa Research Institute of Occupational Medicine and Human Ecology for comet assay analysis. DNA damage was assessed using the alkaline comet assay.

Results. Children with CLP living in regions with petrochemical pollutants showed markedly higher levels and prevalence of DNA damage. Comet tail length and % tail DNA differed significantly from those in healthy controls and in CLP children from unexposed regions, indicating heightened genotoxic stress associated with environmental exposure.

Conclusion. The differences in DNA damage levels among children from varying ecological conditions suggest that an unfavorable environmental background serves as a significant trigger of genotoxic stress potentially involved in the pathogenesis of cleft lip and palate.

Relevance. This study presents the results of a clinical evaluation of a whitening toothpaste and mouthwash used together to prevent dental plaque formation. The products demonstrated effective cleaning, a pronounced refreshing and whitening effect, cumulative improvement in oral hygiene, reduction of inflammation, anticaries activity, and decreased tooth sensitivity.

Objective. To evaluate, in a clinical setting, the efficacy of a whitening toothpaste and mouthwash combination.

Materials and methods. The efficacy of the toothpaste and mouthwash in preventing plaque formation was assessed using the Green–Vermillion Hygiene Index, Interdental Hygiene Index, PMA and SBI periodontal indices, enamel resistance, enamel hypersensitivity, tooth color and whitening effect, and refreshing effect measured with a visual analogue scale (VAS).

Results. Oral hygiene indices demonstrated significant advantages of the tested products, including high cleaning efficacy, a pronounced refreshing effect, and cumulative improvement in oral hygiene. The cleaning and deodorizing effects were more pronounced when the toothpaste and mouthwash were used together. The products significantly reduced oral inflammation and gingival bleeding, increased enamel acid resistance (indicating enhanced caries prevention), and decreased tooth sensitivity while producing a visible whitening effect.

Conclusion. Combined use of the toothpaste and mouthwash increased enamel acid resistance, which supports effective caries prevention. It also reduced tooth sensitivity and enhanced the whitening effect. Both products were well tolerated and caused no allergic reactions or irritation.

Relevance. Mandibular underdevelopment in adolescents without syndromic pathology is often associated with temporomandibular joint (TMJ) disorders and presents with marked facial asymmetry, malocclusion, and functional impairment. Conventional orthognathic surgery in patients with incomplete facial skeletal growth carries a high risk of relapse and considerable surgical morbidity. Mandibular distraction osteogenesis (DO) is regarded as a less invasive alternative to orthognathic surgery.

Clinical case descriptions. Three adolescents (two females, 17 years; one male, 16 years) with nonsyndromic mandibular hypoplasia secondary to TMJ degenerative changes were included in case series. All patients underwent mandibular distraction osteogenesis using intraoral curvilinear distractors (Conmet, Moscow, Russia). Preoperative planning was performed using multislice computed tomography (MSCT) and lateral cephalometric radiography. Mandibular elongation aranged from 12 to 16 mm. Treatment resulted in substantial correction of facial asymmetry, normalization of occlusion, and satisfactory regenerate quality, as confirmed on CT and ultrasonography. No complications were observed.

Conclusion. In adolescents, intraoral curvilinear distractors provide an effective, minimally invasive approach to correcting nonsyndromic mandibular hypoplasia, reducing the need for orthognathic surgery and minimizing complications.

Relevance. Ossifying fibroma is a benign fibro-osseous neoplasm most frequently diagnosed in young patients. Conventional surgical techniques such as curettage are associated with a high recurrence rate; therefore, segmental resection of the affected area with a safety margin beyond the tumor border is generally recommended. This approach, however, creates a mandibular continuity defect of variable extent, leading to loss of multiple teeth, facial asymmetry, and malocclusion. Restoring mandibular integrity and the dental arch is therefore a central treatment goal. Objective. To present a comprehensive rehabilitation protocol for a patient with juvenile ossifying fibroma (JOF) of the mandible.

Case presentation. A 10-year-old girl presented with a progressive, painless enlargement of the left mandible. Cone-beam computed tomography (CBCT) and biopsy established the diagnosis of juvenile ossifying fibroma, trabecular variant, involving the left mandibular body with an approximate length of 6 cm. The lesion was treated by en bloc (segmental) resection with immediate reconstruction using a free vascularized iliac crest bone graft with microvascular anastomosis. Postoperatively, the patient exhibited distal occlusion (Class II malocclusion), loss of the mandibular segment in the region of teeth 33–38, and reduced interalveolar height on the left. Using a digital workflow, a surgical guide fabricated from domestically produced polymer materials was used for subsequent dental implant placement. Subsequently, orthodontic treatment was performed to restore interalveolar height at the mandibular defect, followed by placement of a temporary implant-supported prosthesis.

Conclusion. A multidisciplinary approach to the rehabilitation of growing patients with JOF—including tumor removal by segmental mandibular resection with immediate reconstruction using an autogenous bone graft, placement of dental implants within the grafted area, and orthodontic management—has proven highly effective in restoring the anatomy and function of the dentoalveolar system in young patients.

Relevance. Congenital osseous disorders of the temporomandibular joint (TMJ) in children, leading to unilateral hypoplasia and/or aplasia of the mandibular ramus, play a decisive role in the development of skeletal and functional imbalance of the craniofacial complex. Such defects represent a clear indication for surgical intervention. In accordance with established protocols for comprehensive management, the initial stage involves creating a posterior mandibular support, achieved either through distraction osteogenesis (DO) or endoprosthetic replacement of the affected ramus.

Objective. To summarize current knowledge on the classification and pathogenesis of congenital osseous TMJ disorders and to evaluate the outcomes of existing surgical treatment methods in children and adolescents with this condition.

Materials and methods. The literature review was conducted in accordance with PRISMA guidelines for systematic reviews and meta-analyses. Searches were performed in PubMed, Medline, EMBASE, and eLibrary using the keywords “congenital osseous TMJ disorders,” “hemifacial microsomia (HFM),” “surgical treatment in children,” and “distraction osteogenesis (DO),” combined with the Boolean operator AND, in both English and Russian. Original publications proposing classifications of congenital osseous TMJ disorders were also reviewed. Of the 2000 scientific publications identified, 30 met the inclusion criteria and were included in the final analysis.

Results. Both published data and our own clinical observations show that surgical reconstruction of the mandibular ramus in children, while restoring its anatomical structure, does not establish long-term skeletal and functional balance of the dentofacial system due to ongoing growth and development. Consequently, multiple staged surgical procedures are required to maintain craniofacial stability. Yet, the cumulative effect of repeated operations includes progressive scar formation in the soft tissues and worsening mandibular deficiency, which together reduce the adaptive and compensatory capacity of the dentofacial system.

Conclusion. A critical evaluation of surgical outcomes and of the current state of comprehensive management for children with unilateral mandibular ramus hypoplasia or aplasia in congenital osseous TMJ disorders is essential for advancing research and expanding the potential of multidisciplinary rehabilitation for this patient population.

Relevance. Mandibular hypoplasia in adolescents poses significant functional and aesthetic challenges. Mandibular distraction osteogenesis (DO) enables gradual bone lengthening with new bone formation and remains an effective treatment modality with low relapse rates. However, the choice of surgical approach for distractor placement—intraoral versus extraoral–remains a subject of debate. Each approach entails distinct anatomical, surgical, and aesthetic considerations. The intraoral approach avoids visible scarring, which is especially important for adolescents, whereas the extraoral approach is technically straightforward in severe deformities and permits greater distraction length.

Objective. To compare intraoral and extraoral mandibular distraction in adolescents by analyzing anatomical landmarks, surgical techniques, complication rates, and aesthetic out-comes, and to develop clinical recommendations for selecting the optimal approach.

Materials and methods. A literature review was conducted using relevant sources from the PubMed, Scopus, Web of Science, and Google Scholar databases published within the past 10 years, focusing on mandibular distraction osteogenesis in children and adolescents. The following key parameters were compared: surgical approach, distraction vector and magnitude, treatment duration, complication rates, and aesthetic outcomes. Two summary tables are presented: (1) a comparative analysis of intraoral and extraoral approaches, and (2) an overview of distraction protocols and outcomes reported in various studies.

Results. Intraoral distractors are placed through an intraoral incision and typically feature curvilinear activation, allowing simultaneous vertical and horizontal mandibular lengthening with concealed hardware and no visible external scars. This approach is associated with fewer postoperative complications (~10% vs. 30–40%) and infrequent neurosensory disturbances, although it generally achieves a slightly smaller mean elongation (approximately 10–15 mm) compared to extraoral systems. Extraoral distractors require a submandibular incision and external activation units, enabling greater distraction length (~15–20 mm or more) and precise vector control. However, they are associated with higher risks of hypertrophic scarring, pin-site infections, and transient facial nerve paresis. Adolescent patients tend to tolerate intraoral distractors better due to improved comfort and aesthetics. Recent studies have shown no significant differences in treatment success or airway improvement between approaches when distraction parameters remain within device capabilities; however, intraoral systems demonstrate higher reliability (fewer mechanical failures) and a lower overall scar burden.

Conclusion. Mandibular distraction osteogenesis is a reliable treatment modality for mandibular hypoplasia in children and adolescents with incomplete facial skeletal growth. The intraoral approach is preferable for moderate deformities, providing superior aesthetic outcomes and fewer complications. The extraoral approach remains justified for severe deficiencies requiring maximal elongation or complex vector adjustment, particularly in cases with limited mouth opening. Clinical recommendations are proposed to individualize surgical access selection based on deformity severity, anatomical constraints, and aesthetic considerations.