Relevance. In many cases, Pierre Robin sequence and congenital micrognathia lead to respiratory failure, obstructive sleep apnea, and aspiration of food due to swallowing problems. Compression-distraction osteogenesis method allowed for the effective achievement of a stable clinical result with the minimum losses for the child's body.

Purpose. The study aimed to conduct a retrospective analysis of various types of compression-distraction devices based on the Department of Maxillofacial Surgery of the Republican Children's Clinical Hospital.

Material and Methods. Since 2010, 36 children aged three months to 13 years have been operated, 20 boys and 16 girls. Four children were operated using an multi-vector external compression-distraction device. Two children with Pierre Robin sequence had surgery with a Conmet intraoral compression-distraction device, 27 children – with a KLS Martin bone-borne compression-distraction device, of which 15 had Pierre Robin sequence, and 12 had congenital lower micrognathia. Seven children had tracheostomy, which had been placed due to permanent sleep apnea.

Results. Three (8.33%) children were operated using external compression-distraction devices. From three months to one year. A patient with Pierre Robin sequence, tracheostomy, and cannula. A tracheostomy was installed at the age of 15 days due to persistent apnea. At three months of age, bilateral osteotomy of the mandible with the installation of an external compression-distraction device was performed. Compression was for three days; then, they began distraction of one mm/day for 15 days. Five months later, the child began to breathe freely through the natural respiratory tract; under mask anesthesia, the compression-distraction device was removed. Four children (11.11%) aged 8 to 12 months were operated using multi-vector external compression-distraction device. A patient aged one year with Pierre Robin sequence, tracheostomy, and cannula. The external compression-distraction device was installed at the age of eight months. The distraction period was 12 days. The consolidation period was three months. The treatment result was independent breathing through the natural respiratory tract. The tracheostomy cannula was removed. Twenty-nine children 2 (5.56%) were operated using intraoral bone-borne compressiondistraction devices. A child aged 14 months, diagnosed with Pierre Robin sequence, complained of periodic sleep apnea with signs of acrocyanosis. Moderate to severe obstructive sleep apnea was detected. A bilateral osteotomy of the mandible was performed, and a bone-borne compression-distraction device was installed. Compression was for three days, then the distraction of 0.5 mm twice a day – for 14 days. Distraction was performed at 14 mm. After five months, the bone-borne CDD was removed, and polysomnography was repeated. The apnea-hypopnea index (AHI) was <5. Respiratory function was fully restored.

Conclusion. Thus, 24 children showed successful results with the use of compression-distraction device (an orthognathic occlusion was formed, glossoptosis was eliminated, natural breathing and feeding were restored); 11 children did not have a satisfactory result (due to distraction interruption, it was not possible to achieve a physiological bite, there was postoperative wound suppuration with wound dehiscence). There was one negative result due to trauma: the child fell on his chin at home during the consolidation period, and the compression-distraction device broke, which resulted in disocclusion.

Relevance. In children, muscle hypertonia, including sustained stiffness of the chewing muscles, accompanies the spastic form of cerebral palsy. Considering hypertonia severity is necessary to develop treatment tactics and schemes. This paper proposes a reasonable criterion-based assessment of the above pathology severity based on clinical and functional examination data.
Material and methods. To develop grading of muscle hypertonia severity, we examined 30 children with spastic cerebral palsy and 30 healthy children of the same age to obtain normalized parameters. Based on the questionnaire data, the study analyzed the functions of chewing, swallowing, and speech formation, assessed the condition of the hard dental tissues by clinical examination, and obtained active and passive mouth-opening data. Electromyography calculated the average amplitude of the right and left temporal and masticatory muscles and the total biopotential.
Results. Clinical and functional evaluation data showed a direct correlation. The more complex the situation in the oral cavity was, the higher the amplitude of the chewing muscles was.
Conclusion. The correlation allowed the development of the criterion-based assessment of moderate and significant masticatory muscle hypertonia severity, which management of this patient type should consider.

Relevance. Total occlusal contact area assessment is an important tool for malocclusion diagnosing and treatment planning in children.

Purpose. The study aimed to evaluate (during six months) the effect of orthodontic treatment with plates and trainers on the change in the total occlusal contact area in children with distal occlusion compared to children with physiologic occlusion.

Material and methods. The study groups included 145 children with distal occlusion: Group I (82 patients) was treated with a plate modified by AM Schwartz, and Group II (63 patients) had silicone trainers. The control group consisted of 42 children with physiologic occlusion who had not previously had orthodontic treatment. The T-Scan III assessed the total occlusal contact area before and during six months of treatment.

Results. The analysis of total occlusal contact area changes in children with physiologic and distal occlusion revealed a statistically significant (p < 0,05) increase in the orthodontic treatment groups (plates and silicone trainers) in 3 and 6 months. Comparative analysis showed a smaller total occlusal contact area in children with distal occlusion before the treatment.

Conclusion. Patients with distal occlusion demonstrated a smaller total occlusal contact area before the treatment compared to patients with physiologic occlusion. The children with distal occlusion showed a total occlusal contact area increase during 6-month orthodontic treatment.

Relevance. The average time of orthodontic treatment in children is often several years. However, the final mineralization of erupted permanent teeth occurs during this period. The skills developed at this age rarely guarantee a high level of individual oral hygiene. Thus, modern removable appliances (aligners) in children with mixed dentition have several advantages. Remineralization therapy performed simultaneously with orthodontic treatment is one of the essential advantages of using aligners.

Purpose. The study aimed to conduct a comparative clinical assessment of changes in the enamel acid resistance and remineralization effectiveness in patients undergoing orthodontic treatment with removable appliances (aligners). Material and methods. Orthodontic follow-up observation involved 59 patients aged 8 to 14 years for six months. They made up three observation groups. The first (control) group included 17 people who visited the orthodontist for a check-up. The second (21 people) and third (21 people) groups comprised patients undergoing orthodontic treatment with aligners. Patients of the second group added ASEPTA TEENS paste to their daily oral care complex. Patients of the third group used ASEPTA remineralizing gel for children besides ASEPTA TEENS paste. The TER test assessed enamel acid resistance, and remineralization effectiveness was determined throughout the study.

Results. The comparative analysis revealed that the enamel acid resistance increased in patients of the third group who had followed our recommended scheme of oral care product use with a complex of ASEPTA TEENS paste and ASEPTA remineralizing gel for children. The group showed a remineralization effectiveness of 39.5% after six months. Patients of the second group who used ASEPTA TEENS paste without gel applications for six months also showed an increase in remineralization effectiveness of 19.5% compared to the baseline.

Conclusion. The results obtained during the study allow us to recommend ASEPTA remineralizing gel for children for oral care during orthodontic treatment with removable appliances (aligners) in patients with mixed dentition. Removable aligners allow you to combine orthodontic treatment and the preventive use of mineralizing agents for forming strong enamel and protecting it from demineralization.

Relevance. Prognosis of the dentofacial system (DS) development in children with dentofacial deformities (DD) is an urgent medical and social problem since the prognosis of the DS development will allow timely prescription and provision of adequate therapy, which will significantly reduce the risks of severe DD development in children. Machine learning methods have proven to be a reliable tool for predicting a patient's health status and evaluating the effectiveness of treatment methods. Therefore, it seems interesting to use this modern toolkit to build predictive models that allow us to assess the change in the condition of DS in children with DD after orthodontic treatment (OT) at different ages or without OT.

Purpose. The study aimed to build a set of predictive models for assessing the severity of the dentofacial system condition in 3.5-4-year-old children after and without orthodontic treatment.

Material and methods. The study used the data on the DS of children aged 3-5 years (n=50), 6-9 years (n=100), 10-12 years (n=100) and 13-17 years (n =100). The author's program was developed in Python 3.11 using the sklearn, pandas, and xgb libraries in Anaconda to build the predictive models.

Results. We developed nine models of the DS condition in children aged 3-12 years, three of which make predictions for the DS development after the OT (one - in the group of 3 – 5-year-old children, the second – in the group of 6 – 9-year-old children and the third – in the group of 10 – 12-year-olds) and six models predict the development of the DS without OT. Three out of 6 models predict DS development without OT at 3-5 years: the first makes a prediction of the DS condition for 6-9 year-olds; the second – for 10-12 year-olds; the third – for 13-17-year-olds. The accuracy of the models ranges from 82 to 86%. Two models out of 6 predict the DS development for children with DD who did not receive OT at 6-9 years old: one – at 10-12 years old, the second – at 13-17 years old. The accuracy of the models ranges from 92 to 97%. The sixth model makes predictions of the DS condition in children aged 13-17 years who did not receive OT at the age of 10-12 years. The accuracy of the model is 94%. In addition, we built three models that predict the DS condition in 3.5-4 years after the OT: the first model predicts for 3–5-year-old children; the second – for 6–9-year-olds; and the third - for children of 10–12 years old. The accuracy of the models ranges from 82 to 90%.

Conclusion. All obtained models will be used to build a web application for predicting the DS state severity in children after the orthodontic treatment and without the latter.

Relevance. Enamel hypoplasia is one of the most common defects of a child's hard dental tissue. Molar incisor hypomineralization (MIH) is one of the systemic hypoplasia forms. MIH is defined as a qualitative defect of enamel development in children and adolescents affecting at least one permanent molar with or without the involvement of the incisors. As for the causes, MIH, as a form of enamel hypoplasia, proved to be a multifactorial disease.

Material and methods. Conducted in dental clinics of St. Petersburg, an empirical study surveyed 90 respondents with the anonymous original questionnaire developed by us. The report summarized the results of descriptive statistics on measurements related to the data of the three groups on existing disorders of the hard dental tissues in children.

Results. The average age of women whose children are not diagnosed with caries and enamel hypoplasia was 35.52 years, while the average age of mothers of children with MIH was 40.17 years. The study of the number of previous pregnancies and childbirths revealed no signs of MIH and pitting enamel hypoplasia (PET) in children of the first pregnancy. The analysis of the past medical history impact in women during pregnancy on the development of enamel defects provided statistically significant results for such illnesses as URTI and VURTI, as well as chronic endocrine diseases. According to the data obtained, influenza, past respiratory diseases and antibiotic intake during the first year of a child's life led to the development of various types of enamel hypoplasia.

Relevance. Сhildren's negative behaviour may affect pulpitis treatment results. The study aimed to study the vital pulp therapy effectiveness for chronic fibrous pulpitis treatment in primary molars of children with negative behaviour.

Material and methods. The study involved 60 children aged 3-6 years with negative behaviour (according to the Frankl scale). Before the treatment, the children had non-pharmacological psychological behaviour management. One hundred and twenty primary molars were treated for pulpitis using the biological method. Follow-ups assessed the condition of the fillings and the presence/absence of clinical and radiographic signs of complications after 6, 12, 18 and 24 months. Tooth survival rate determined the effectiveness of pulpitis treatment.

Results. The after-pulpitis-treatment complication rate where tooth extraction was necessary amounted to 15.0% after six months and 1.7% after 12 months (p<0.001); there were no complications after 18 and 24 months. During the first 12 months, 4.1% of cases required retreatment of pulpitis by pulpotomy. The retreatment rate due to filling defects was 20.8% after six months, and it then significantly decreased to 1.0-3.3% (p < 0,001). The tooth survival rate after pulpitis treatment was 83.3% after 24 months. There were no statistically significant differences between the pulpitis treatment results based on the children’s age, the localization of the carious cavities, and direct or indirect pulp capping.

Conclusion. The biological method of chronic fibrous pulpitis treatment in primary molars of children aged 3-6 years with negative behaviour had high 24-month effectiveness at an outpatient dental appointment (with preliminary psychological behaviour management). Most complications developed during the first six months after the treatment, to which dental filling defects contributed.  

Relevance. Surgical treatment of patients with congenital orofacial clefts and comorbidities of other organs and systems remains a complex problem in specialized surgery, and it requires concentration of knowledge of individual characteristics and diagnosed disorders during their implementation, taking into account the sequence, volume and time of execution.

Purpose. Optimize the tactics of surgical treatment of children born with orofacial clefts combined with disorders of other organs and systems, improving rehabilitation effectiveness.

Material and methods. The work focuses on the results of a study of 2475 patients with congenital orofacial defects during the long-term follow-up period (1998-2022) in the Bonum Medical Center (Yekaterinburg). There were 823 cases of congenital orofacial clefts combined with disorders of other organs and systems. The disease combination groups were systematized and determined the tactics of surgical treatment of orofacial defects and the rehabilitation techniques for comorbid defects.

Results. To date, out of 823 patients with orofacial clefts and comorbidities of other organs and systems, 591 (71.81%) patients are known to have received comprehensive surgical rehabilitation, part of them turned 18 years and were withdrawn from the long-term follow-up care, the rest – 232 (28.19%) continued to receive specialized care in the Bonum Center system. Of the 823 patients, 370 children needed primary cheilo-rhinoplasty, 196 people (52.97%) had surgery at the traditionally accepted time (in the first six months of the child's life), 302 children (81.62%) had surgery by the age of nine months, and 329 children (88.92%) by one year. Based on the individual indications, thirty-six children (9.73%) had surgery after one year, of which eight patients (2.16%) after two years. Of the 823 patients, 770 people needed palatoplasty (cleft repair of hard and soft palates), while in the conditions of special preparation, the operation was performed in 360 children (46.75%) by 18 months, in 483 children (62.73%) by24 months, and 588 children (76.36%) by the age of 3 years. Considering the cleft palate complexity, 102 children (13.25%) needed further treatment later due to physical condition restrictions and social reasons.

Conclusion. The proposed strategy of surgical treatment of children with orofacial clefts combined with disorders of other organs and systems allows treatment of congenital orofacial malformation in the most favourable period based on the patient's physical condition.

Relevance. The prevalence of wedge-shaped defects remains high. The increased risk of the fi falling out, the development of a secondary defect around the filling, and the progression of the wedge-shaped defect development are characteristic of the operative treatment of this type of hard dental tissue non-carious lesions. Therefore, the search for new methods of diagnosis, treatment and prevention of wedge-shaped defects remains relevant in modern dentistry. Purpose. The study aimed to evaluate the prevalence of wedge-shaped dental defects and assess the effectiveness of a complex combined effect on dental tissues in non-carious lesions of hard dental tissues.

Material and methods. We examined 942 patients aged 35 to 44 years. All underwent a dental examination, according to the WHO recommendations, questionnaire and instrumental diagnosis.

Results. The dental examination detected wedge-shaped defects in 324 examined patients (34.4%). Upon presentation, patients with revealed stage I and II wedge-shaped defects complained of aesthetic dissatisfaction (11%), pain when eating (47%), and pain on brushing teeth (54%). According to the examination results before treatment, the volumetric blood flow velocity was 1.9 times lower in the group with a high degree of anxiety than in the group with a low degree of anxiety. The amplitude of the masticatory and temporal muscles at rest was 1.8 times higher in patients with a high anxiety degree than in patients with a low degree of anxiety.

Conclusion. After a one-month course of treatment with the combined method proposed by us, the indicators of systolic volumetric blood flow velocity and the average amplitude of the masticatory and temporal muscles at rest in patients with high anxiety became comparable to those of the control group.

Relevance. The incidence of oral mucosal diseases is nowadays increasing. Inflammatory periodontal diseases are common in dental practice and occupy second place worldwide among oral diseases.

Purpose. The study aimed to analyze ‘Denta Balance’, an oral synbiotic complex, and ‘Lesnoy balsam’, a mouthwash, as home care products treating inflammatory periodontal diseases and halitosis.

Material and methods. The study included 40 patients aged 18 to 28 y.o., of which 10 were males (25%) and 30 females (75%). They randomly formed two groups. The age in Group 1 was 23.0 ± 2.5 years and in Group 2 – 24.0 ± 3.2 years. In all patients, we assessed the Fedorov-Volodkina hygiene index and papilla bleeding index (PBI, Saxer & Mühlemann, 1975) before and after oral care product use. All patients formed two groups, 20 patients in each group. The fi group used a spray and powder for oral administration containing synbiotic complex; Group 2 used a natural-phytoncide mouthwash as an oral care product. Besides dental status assessment, we conducted a survey where we collected dental history. The main survey criteria were tooth sensitivity, halitosis, dry mouth, tenderness around the gums, bleeding on brushing, eating or spontaneous bleeding. We also asked the patients to assess the one-month effect of synbiotic-complex products and natural-phytoncide mouthwash.

Results. The use of products showed a positive effect in both groups, i.e., tenderness around the gums, tooth sensitivity, and halitosis disappeared; bleeding on brushing and spontaneous bleeding significantly decreased; the gum colour returned to normal. The dental status index assessment confirmed the effectiveness of the treatment: the hygiene index insignificantly improved after the treatment; periodontal indices changed for the better.

Conclusion. The study noticed a positive effect of Denta balance, a spray with a probiotic for bleeding gums, and Denta balance FRESHeffect, a probiotic for fresh breath, included in the protocol of inflammatory periodontal disease and halitosis treatment.

Relevance.  To date, painless, comfortable dental treatment of adults and children remains a priority for modern dentistry. It is of note that children specifically need adequate pain relief more than others since negative emotions received in childhood can determine the relationship between the dentist and the patient for the rest of their lives. Local anaesthetics, the preferred method of anaesthesia in pediatric dentistry, come to the aid of doctors. However, the question arises about the correct selection of a local anaesthetic and its concentration. There is a lot of research on this topic; however, not all local anaesthetics used in adult patients are safe enough and justified for use in pediatric dentistry. In addition, on the market today, there are a lot of anaesthetic drugs, various forms of presentation, types, concentrations and combinations. All of the above sets high demands on the dentist.

Purpose. To analyze and systematize scientific research on local anaesthetics in pediatric dental practice.

Material and methods. The main research method was the analysis of literature on the topic. Based on established PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, publications were searched in the Medline PubMed and E-library databases by the keywords: "pediatric dentistry", "local anaesthetics", "pain relief", and "anaesthesia".

Results. The analysis of the presented studies demonstrated a variety of used means and methods of local anaesthesia in children.

Conclusion. Pediatric dental practice dictates special rules for the treatment of patients; in each case, the doctor must take into account the data of the medical history and the level of anxiety of the child for a reasonable choice of ways and method of local anaesthesia.

Relevance. Oral mucosal cancer (OMC) is the sixteenth most common cancer worldwide. The high mortality rate is mainly due to the asymptomatic course of the disease in the early stages and late detection when the tumour process poorly responds to treatment. Determining the impact of various risk factors and establishing their relationship are necessary to prevent and diagnose malignant oral mucosal lesions in the early stages.

Purpose. Based on the modern literature, the study aimed to determine the impact value of various internal and external risk factors on malignant oral mucosal lesion development and assess the risk factors’ relationship.

Material and methods. The research material included the analysis of literature from databases – Elsevier, PubMed, Elibrary, Google Academy, Medline and Cyberleninka. The study included literature sources in Russian and English.

Results. Based on modern literature, we have determined endogenous and biological risk factors for malignant oral mucosal lesion development. The study noted the high role of microbiome changes and the presence of dysbiosis in patients with malignant neoplasms and proved the direct involvement of Candida fungi in carcinogenesis. The development of oral mucosal cancer and the presence and severity of oral yeast colonization and human papillomavirus infection showed a positive correlation. Chronic oral diseases, which are susceptible to malignant transformation or contribute to the development of carcinomas, have been identified, and their relationship has been established with biological risk factors, age, sex of the patient and duration of the disease course.

Conclusion. The studies considered in this part of the review prove the influence of endogenous and biological factors on the development of malignant neoplasms of the oral cavity and determine their relationship. However, many mechanisms remain unexplored to date. Effective primary and secondary prevention implementation needs improvement and the development of a multidisciplinary approach to research methodology, study the complex impact of all groups of risk factors on the development of malignant oral mucosal lesions.