Relevance. Remineralization therapy and fluoridation are well-established methods for preventing hard tissue diseases of the teeth across various age groups. Given the unique composition and structure of teeth in the elderly, there is a need for specialized remineralization and fluoridation agents tailored to this demographic.

Materials and methods. A new remineralizing gel, formulated from a mixture of tetra- and dimethylglycerolates of silicon, was developed specifically for the prevention and treatment of hard tissue diseases in elderly patients. The clinical efficacy of this gel was assessed using enamel resistance test (ERT) values and electroodontodiagnostics (EOD) both before and after treatment. Laboratory analyses included the evaluation of phosphorus, calcium, and the Ca/P ratio in saliva using Mindray reagents. An experimental study on tooth sections treated with various remineralizing agents was conducted using a Tescan MIRA LMS scanning electron microscope, equipped with an Oxford Instruments EDS X-max80 attachment, to determine the chemical composition and surface characteristics.

Results. The clinical application of the new gel resulted in significant reductions in ERT and EOD values, indicating its effectiveness. An increase in the calcium-phosphorus ratio in saliva further demonstrated the gel’s remineralizing properties. The experimental study revealed the highest fluoride uptake in tooth sections treated with the new gel, confirming its penetration into the hard tissues of the teeth.

Conclusion. The new gel, based on a silicon glycerolate mixture, demonstrated superior efficacy in elderly patients compared to other remineralizing agents, which is attributed to the high conductive properties of its base.

Relevance. The documentation processes in medical organizations across the DPR are being restructured, particularly in relation to providing therapeutic and rehabilitative care for children with congenital maxillofacial anomalies. Significant changes have been made to both the requirements for medical documentation and the speed at which it is processed, thanks to advancements in information technology and the introduction of individual electronic medical records. In this era of medical digitalization, it is crucial to simplify data collection and improve the forecasting of the effectiveness of therapeutic and rehabilitative measures conducted at the Pediatric Maxillofacial Surgery Center in Donetsk.

Materials and methods. To evaluate the effectiveness of forecasting therapeutic and rehabilitative measures using the "Outpatient Monitoring" software, a previously developed model for predicting treatment outcomes was used. This model is based on an analysis of factors and indicators that reflect different aspects of the treatment and rehabilitation process for children with cleft lip and/or palate.

Results. The study led to the implementation of a methodology for forecasting the effectiveness of therapeutic and rehabilitative measures at the Pediatric Maxillofacial Surgery Center in Donetsk, utilizing the "Outpatient Monitoring" computer-based accounting and analytical software, which facilitates both practical and scientific tasks related to the monitoring, treatment, and rehabilitation of children with cleft lip and/or palate.

Conclusion. The developed forecasting model will greatly simplify the work of specialists at the Pediatric Maxillofacial Surgery Center.

Relevance. Assessing the influence of risk factors during the primary dentition period on the development of dental arch abnormalities is essential for planning preventive and therapeutic interventions, as well as encouraging compliance with these measures. The first part of this article focused on identifying predictors of malocclusion, while this second part aims to determine the predictors of dental arch abnormalities.

Purpose. To identify prognostic factors (predictors) of dental arch abnormalities in children during the primary dentition period.

Materials and methods. This study presents the results of a retrospective analysis of the oral health status of 123 children (55 boys and 68 girls). The initial examination took place when the children were between 4.0 and 5.5 years old (mean age 5.1 ± 0.6 years), with follow-up examinations conducted between the ages of 6.0 and 10.5 years (mean age 8.7 ± 1.3 years). The relationship between risk factors in primary dentition and the development of dental arch abnormalities in early mixed dentition was evaluated using Pearson's chi-squared test (χ²) and Welch's t-test (V). For each pair of "primary dentition risk factor – dental arch abnormality in early mixed dentition," the odds ratio with a 95% confidence interval was calculated.

Results. Differentiating predisposing factors and analyzing the effects of their various combinations allowed the identification of predictor clusters in primary dentition, where the probability of developing dental arch abnormalities in mixed dentition exceeds 95%. For upper arch abnormalities, the cluster includes infantile swallowing and early extraction of deciduous molars in the lower jaw (χ² = 19.67, V = 0.50); for lower arch abnormalities, the cluster consists of infantile swallowing, "lazy" chewing, sucking habits, and a deep bite in the anterior region (χ² = 16.58, V = 0.67); For lower incisor crowding, the cluster includes "lazy" chewing, infantile swallowing, and a deep bite in the anterior region (χ² = 17.54, V = 0.63); for diastema in the upper arch, the cluster includes an abnormal labial frenum and interdental tongue position (χ² = 19.16, V = 0.49); for maxillary anterior spacing, early extraction of deciduous canines in the upper jaw is the primary factor (χ² = 16.23, V = 0.46).

Conclusion. Identifying and addressing predictors of dental arch abnormalities in children during the primary dentition period can significantly reduce the risk of developing pathological conditions during the mixed dentition period.

Relevance. This article presents the findings from studies evaluating the effectiveness of toothpastes containing 1000 ppm fluoride in clinical settings. The data demonstrates the cumulative benefits of these toothpastes on oral hygiene, the reduction of inflammatory oral manifestations, and their anticaries effects.

Purpose. To assess the effectiveness of fluoride-containing toothpastes through laboratory tests and clinical trials.

Materials and methods. The study evaluated the effectiveness of toothpastes containing 1000 ppm fluoride using the following parameters: Greene-Vermillion hygiene index, periodontal indices (PMA and SBI), enamel mineralization and resistance, presence and number of carious lesions at the white spot stage, enamel hypersensitivity, and antimicrobial activity against Streptococcus spp.

Results. The analysis of hygiene indices demonstrated that the tested toothpastes were highly effective in cleaning, with a positive cumulative effect on participants' oral hygiene. The use of these toothpastes significantly reduced inflammatory manifestations, decreased gum bleeding, and improved periodontal tissue health. A reduction in the number of participants with early-stage carious lesions, as well as a decrease in the overall number of lesions, was observed. The toothpastes also enhanced enamel resistance to acid exposure, contributing to their anticaries benefits. Enamel hypersensitivity was reduced, and a dose-dependent antibacterial effect against Streptococcus mutans, Streptococcus gordonii, and Streptococcus sobrinus was observed.

Conclusion. Toothpastes containing 1000 ppm fluoride demonstrated strong cleaning and refreshing effects, along with a positive cumulative impact on oral hygiene and a significant reduction in inflammation. Their anticaries benefits were confirmed, and they also reduced enamel hypersensitivity. The tested toothpastes were well-tolerated, with no reports of allergic reactions or irritation.

Relevance. Understanding the impact of oral health problems on the quality of life in children with rare metabolic disorders that affect mineral metabolism is critically important.

Materials and methods. An oral health assessment was conducted on 59 children aged 6 to 17 years with rare diseases affecting mineral metabolism, each with a genetically confirmed diagnosis. The children were divided into two study groups: the first group (24 children) comprised those with bone mineralization disorders (hypophosphatemic rickets, hypophosphatasia), while the second group (35 children) included those with disorders of bone and cartilage formation (osteogenesis imperfecta, Marfan syndrome, achondroplasia, etc.). The clinical condition of the children's dental tissues was assessed by evaluating oral hygiene levels and caries intensity in permanent teeth, using the OHI-S and DMFT indices, respectively. The pufa/PUFA index was used to document complications arising from dental caries. To assess the perception of oral health problems, a survey was administered to parents and legal guardians using the Oral Health-Related Quality of Life (OHRQoL) questionnaire.

Results. The average DMFT and OHI-S index values did not show statistically significant differences, with values of 4.26 ± 0.28 and 1.96 ± 0.15 in the first group, and 3.76 ± 0.40 and 1.75 ± 0.10 in the second group, respectively. However, the mean pufa/PUFA index values were significantly higher in children with bone and cartilage formation disorders (p = 0.003), being three times greater than those in the group with bone mineralization disorders, with values of 1.03 ± 0.18 and 0.30 ± 0.11, respectively. This increase was associated with higher correlation coefficients between the DMFT and PUFA indices and the modules for physical discomfort, oral functional status, and emotional well-being, with values of 0.38 and 0.41, and 0.49 and 0.27, compared to 0.07 and 0.02, and 0.29 and -0.21 in the first group. These differences were statistically significant at p < 0.05 and p < 0.005.

Conclusion. The study revealed that existing oral health conditions have the greatest impact on the quality of life in children with rare diseases affecting bone and cartilage formation.

Relevance. There is currently significant interest in studying the prevalence of diseases affecting the oral mucosa and lip vermilion border in adolescents. A promising approach in this field is the use of modern non-invasive optical technologies, which not only offer additional insights into the patient's oral health status but also enhance their compliance.

Materials and methods. A total of 71 adolescents (9^th to 11^th grade students) aged 15 to 17 years (mean age — 16.2 ± 0.8 years) were examined. The oral mucosa and lip vermilion border were assessed for abnormalities under natural light and through endogenous fluorescence using autofluorescent stomatoscopy. Various optical filters were applied, and clinical images were compared with autofluorescent images. A visual analog scale was used to assess the clarity of the diagnostic test results for the participant. Recommendations were provided, and treatment was prescribed according to the established diagnoses.

Results. Oral mucosal lesions and lesions of the lip vermilion border were observed in 45% of cases, all of benign origin, without visible changes to the naked eye or pain. The most frequently diagnosed lesions were morsicatio buccarum and chapped lips. Distinct autofluorescent characteristics of the identified lesions were observed and documented. Participant-reported feedback was positive in 100% of cases during autofluorescent stomatoscopy. The mean score for the clarity of diagnostic results, assessed using the visual analog scale, was 9.3±0.12, indicating a high level of diagnostic visibility.

Conclusion. Implementing a qualified clinical approach focused on preventing oral diseases in adolescent patients is recommended with the use of autofluorescent stomatoscopy. This technique not only offers real-time insights into the patient’s oral health status but also actively engages young patients, increasing their motivation to maintain good oral health. 

Relevance. Malocclusions accounts for 37% to 89% of all maxillofacial conditions in children aged 3 to 18 across various regions of Russia. These malocclusions can present as isolated issues in a single plane or as combined anomalies across multiple planes. Jaw narrowing or underdevelopment is influenced by various endogenous and exogenous factors. The choice of treatment depends on the severity of the malocclusion. While literature indicates several effective methods for treating transverse malocclusions, some aspects remain insufficiently explored.

Materials and methods. A statistical analysis was conducted on 271 patient records of individuals with transverse malocclusions who received treatment in the Department of Pediatric Maxillofacial Surgery at A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, between 2013 and 2023.

Results. There was an almost equal distribution of patients by gender, with a noticeable increase in medical consultations from 2013 to 2023. The majority of surgically treated patients were between 15 and 17 years old. Isolated transverse malocclusions were significantly less common than cases combined with other pathologies, with mesial occlusion being the most frequent comorbidity.

Conclusion. The findings demonstrate a significant need for surgical treatment in pediatric patients with transverse malocclusions through distraction osteogenesis. This underscores the importance of continually improving treatment methods for children, including enhancing diagnostics, refining treatment indications, optimizing distraction protocols, and adjusting treatment courses. These efforts aim to improve the quality of rehabilitation for children, ensuring better outcomes into adulthood and facilitating their social adaptation.

Relevance. Research into the effects of nickel-titanium alloys and heavy metal ions on the development of inflammatory oral diseases is becoming increasingly significant in orthodontics. The relationship between toxic elements and inflammatory responses remains under-researched and controversial. Data on the connection between heavy metals and inflammatory reactions could influence the choice of orthodontic appliance materials and guide the subsequent management and monitoring of patients with braces. The question of the safe use of nickel-titanium alloy braces continues to be a relevant concern.

Purpose. To assess the levels of heavy metals in the oral fluid of young patients with braces, both in those who developed plaque-induced gingivitis and those who did not.

Materials and Methods. The study involved 50 clinically healthy patients (Groups I and II health categories) with intact teeth, including patients with compensated dental caries (isolated carious lesions – Grade I) and no periodontal diseases (PMA index <20), presenting with dental crowding and malocclusion (K07.2, K07.3). The average age of the patients was 22.1 ± 2.7 years, all of whom were undergoing treatment with metal braces. Oral fluid samples were analyzed for 12 heavy metal elements using inductively coupled plasma mass spectrometry (ICP-MS) in a laboratory setting. Additionally, lysozyme activity and oral fluid pH were measured before appliance placement and six months into orthodontic treatment.

Results. Adaptation to braces in young patients is frequently complicated by the development of gingivitis and periodontitis due to impaired oral hygiene and the mechanical pressure exerted on teeth and gums, leading to elemental imbalances. Patients with gingivitis during orthodontic treatment are particularly at risk of developing such imbalances and therefore require timely correction of their mineral metabolism.

Relevance. Acute purulent-inflammatory diseases of the maxillofacial region (APID-MFR) are the leading cause of pediatric referrals to the maxillofacial surgery department. The prevalence of APID-MFR requiring hospitalization among children in Krasnodar and Krasnodar Krai averaged 42.9% from 2017 to 2021.

Objective. To investigate the nature and structure of odontogenic and non-odontogenic inflammatory processes in patients treated at the maxillofacial surgery department of the State Healthcare Institution "Children’s Regional Clinical Hospital" (CRCH), Krasnodar.

Materials and methods. Medical records of patients with inflammatory diseases of the maxillofacial region, treated in the maxillofacial surgery department at CRCH, Krasnodar, from 2017 to 2021, were analyzed. The study focused on examining the structure and characteristics of the pathology in patients receiving inpatient care.

Results. The most common pathology identified in children was periostitis (30.9%), which significantly differed (p = 0.007) from the second most prevalent condition, exacerbation of chronic periodontitis (26.1%). The third place was shared by lymphadenitis (13.6%) and inflammatory skin and subcutaneous tissue diseases, including boils and carbuncles (13.5%), both of which significantly differed from the top two conditions (p < 0.001) but not from each other (p > 0.05). In fourth, fifth, and sixth places were other inflammatory skin and subcutaneous tissue diseases: abscess (10.1%), phlegmon (4.8%), and adenophlegmon (1.0%), which also significantly differed from one another.

Conclusion. The high prevalence of odontogenic APID-MFR in children highlights the insufficient prevention of caries-related complications and emphasizes the need for enhanced pediatric dental care. Early diagnosis and prevention of APID-MFR complications are crucial to improving outcomes in affected children.

Relevance. With the advent of advanced methods for functional diagnostics, dentists have gained new opportunities for detecting carious lesions. However, the diagnostic sensitivity of these methods requires further investigation

Purpose. To evaluate the condition of intact and demineralized dentin in children's permanent teeth using both ultrasonic and mechanical methods.

Materials and methods. Divided cross-section" models were created from premolars extracted from children for orthodontic purposes. After a 20-day exposure to a demineralizing buffer solution with a pH of 4.5, both the intact and demineralized dentin cross-sections were tested using ultrasonic and mechanical methods.

Results. Statistically significant differences were observed in the mean ultrasonic signal speed C between two independent sample groups: intact dentin (Group 1) and demineralized dentin (Group 2), based on Mann-Whitney U-test calculations (p = 0.01). In Group 2, the mean value of C was 27% lower compared to Group 1. Additionally, significant differences were found in the mean ultimate strength σ between two independent groups: intact dentin (Group 3) and demineralized dentin (Group 4), with Group 4 showing a 29.5% reduction in the mean σ value, according to Mann-Whitney U-test calculations (p = 0.01).

Conclusion. Demineralization leads to significant changes in both the ultrasonic and mechanical properties of dentin. Statistical analysis of the laboratory test results using the "divided cross-section" model supports the effectiveness and diagnostic sensitivity of the methods applied for evaluating the extent of dentin demineralization. 

Relevance. Class II malocclusion (distal occlusion) is a common pathology of the maxillofacial region in the sagittal plane and is one of the most prevalent malocclusions. Studies confirm that Class II malocclusion in adolescents exhibits significant variability, prompting the development of various treatment approaches using both removable and fixed orthodontic appliances. The challenges of adolescence include concurrent physiological and psychological changes, which can complicate the treatment process.

Purpose. To enhance the effectiveness of orthodontic treatment for patients with the dentoalveolar form of Class II malocclusion by utilizing the Rotation-Torque Index (RTI).

Material and methods. A study was conducted on 49 residents of St. Petersburg with physiological occlusion types, who were included in the control group. The main group comprised 95 adolescents (aged 12-18) with the dentoalveolar form of Class II malocclusion classified into three levels of severity, based on the proposed working prognostic classification.

Results. A new method was developed to calculate a coefficient that describes the relationship between the position of the upper and lower jaws and the torque of the central incisors. This coefficient helps predict treatment outcomes and guides the selection of the optimal treatment strategy. The Rotation-Torque Index (RTI) was introduced to quantify the relationship between the position of the jaws in the skull (SNA, SNB) and the inclination of the central incisors of the upper jaw relative to the nasal line (NL) and those of the lower jaw relative to the mandibular line (ML).

Conclusions. Based on the Rotation-Torque Index (RTI), a working prognostic classification and treatment strategies for patients with the dentoalveolar form of Class II malocclusion were proposed.