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. Despite extensive investigation of Pierre Robin sequence (PRS), significant challenges remain in the treatment and rehabilitation of infants with congenital cleft lip and palate, including alveolar and palatal clefts affecting craniofacial development across the transverse, vertical, and sagittal planes. The coexistence of cleft palate and Pierre Robin sequence substantially complicates orthodontic management at different stages of neonatal care. In PRS, cleft palate associated with glossoptosis and micrognathia frequently results in acute airway obstruction and feeding difficulties, necessitating urgent specialized orthodontic care within the first 24 hours after birth.

Materials and methods. To achieve the study objectives, a novel orthodontic appliance was developed (patent application No. 2025101519, January 25, 2025). The appliance was used as an emergency intervention in five newborns with mild to moderate Pierre Robin sequence during the first days of life. Clinical use was carried out at the Perinatal Center (Neonatal Pathology Unit) and the Dental Department of the Clinical Diagnostic Center of Republican Hospital No. 1 – National Center of Medicine named after M. E. Nikolaev (Yakutsk, Russian Federation).

Results. Newborns adapted to the appliance within the first three days, with restoration of airway patency and sucking function, allowing independent oral feeding and subsequent removal of the nasogastric tube when clinically indicated. The appliance was worn continuously and cleaned once daily using infant soap. Replacement of the appliance was planned after 1.5–2 months, based on the infant’s growth and weight gain and following endoscopic reassessment.

Conclusion. Use of an anti-glossoptosis orthodontic appliance with a contoured palatal surface and a targeted intra-cleft extension enables effective early management of acute respiratory compromise and feeding difficulties in newborns with Pierre Robin sequence during the first days of life.

Relevance. Investigation of the effects of systemic interventions on the mineralization of dental hard tissues represents a promising direction in preventive pediatric dentistry. In contrast to topical remineralizing agents, whose effectiveness has been demonstrated in numerous clinical studies, the role of systemic preventive approaches, including dietary supplementation, in reducing dental caries in children remains insufficiently studied and requires further clinical validation.

Objective. To evaluate the clinical and diagnostic effectiveness of the dietary supplement Cigapan in improving the condition of dental hard tissues and periodontal tissues in children.

Materials and methods. The study included 60 children aged 8–17 years (mean age, 12 years). Participants were stratified into two groups according to caries experience: Group 1 (n = 30), children with low to moderate caries experience (DMFT < 4.5), and Group 2 (n = 30), children with high to very high caries experience (DMFT > 4.5). Dental status assessment involved evaluation of permanent teeth using the Simplified Oral Hygiene Index (OHI-S), the DMFT index, the enamel acid resistance test (TER test), and the International Caries Detection and Assessment System (ICDAS II). The degree of demineralization of initial enamel lesions in permanent teeth was measured by laser fluorescence using the DIAGNOdent Pen 2190 (Germany). Periodontal tissue status was assessed using the Papillary–Marginal–Attached (PMA) index and the Sulcus Bleeding Index (SBI). To evaluate the comparative effectiveness of the preventive intervention incorporating Cigapan, changes in dental and periodontal tissue parameters were monitored in both groups over a three-month follow-up period.

Results. The results demonstrated a statistically significant reduction in the extent of focal enamel demineralization and in the severity of demineralization of initial enamel lesions in both study groups (p < 0.05). In children with DMFT < 4.5 (Group 1), complete resolution of initial enamel lesions classified as ICDAS II code 1 was observed. The prevalence of ICDAS II code 2 lesions decreased by 78.6%. Laser fluorescence measurements indicated a 67.6% increase in mineralization within affected enamel sites (p < 0.05), confirming the effectiveness of the intervention. In children with high caries activity (Group 2), a statistically significant reduction in ICDAS II code 1 lesions was also recorded, with a decrease of 76.9% (p < 0.05). According to DIAGNOdent Pen 2190 measurements, mineralization levels in demineralized enamel areas increased by 72.4% compared with baseline values (p < 0.05). A reduction in ICDAS II code 2 lesions was likewise observed (26%), accompanied by a 53.9% increase in enamel mineralization as assessed by laser fluorescence; all observed differences were statistically significant (p < 0.05).

Conclusion. Incorporation of the dietary supplement Cigapan as part of systemic preventive therapy within a comprehensive prevention program led to improvements in oral hygiene and gingival health in children, reduced enamel permeability, increased acid resistance of permanent teeth, a decreased prevalence of early carious lesions, and enhanced mineralization in areas of enamel demineralization.

Relevance. Congenital preauricular sinuses (PAS) account for approximately 5% of all congenital anomalies of the maxillofacial region. Previous studies have reported delayed diagnosis and postoperative recurrence following surgical treatment of preauricular sinuses.

Objective. To investigate the clinical presentation and surgical outcomes in children treated for congenital preauricular sinuses.

Materials and methods. A retrospective review was conducted of pediatric patients admitted for congenital preauricular sinuses to the Department of Oral and Maxillofacial Surgery at City Clinical Hospital No. 1 (Volgograd, Russian Federation) between 2019 and 2025.

Results. Among 149 patients hospitalized for congenital preauricular sinuses, children accounted for 12.7% of cases. In 94.7% of patients, a unilateral sinus tract opening was observed near the superior pole of the helix. In some cases, atypical anatomical variants were identified, including atypical location, the presence of two sinus tract openings, or bilateral preauricular sinuses located at the typical anatomical site. Most children (73.7%) presented with inflammatory changes, whereas 26.3% were admitted for elective surgical treatment. Preoperative ultrasonography combined with intraoperative dye injection significantly improved visualization of the sinus tract.

Conclusion. Children with congenital preauricular sinuses typically seek medical care only after the development of inflammatory complications. During clinical assessment, possible atypical location of the sinus tract should be considered, as this may result in technical difficulties during surgical treatment.

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. 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. The duration of palliative care in children is determined by the underlying medical condition and often extends over many years. Therefore, timely diagnosis, prevention, and treatment of dental diseases are of critical importance, as the severity of the primary condition can significantly complicate dental interventions. Despite notable advances in this field, investigation of the oral microbiota composition in children with disabilities as an additional noninvasive approach for the early identification of caries risk factors still requires a unified understanding of the mechanisms underlying dental plaque formation and the pathogenesis of dental hard tissue diseases in this patient population. The rationale for using dental plaque as the study material is based on its complex physiological role in the development of dental hard tissue diseases, as well as the accessibility of diagnostic sample collection.

Materials and methods. To analyze the dental plaque microbiota, a comprehensive clinical oral examination was performed in 15 children aged 6 years. Microbiological assessment included determination of the total microbial count and identification of bacterial and fungal strains, along with evaluation of their basic microbiological characteristics. Biofilms of the isolated strains were formed in flat-bottom microtiter plates and subsequently treated with herbal infusions, furacilin solution, and chlorhexidine. Biofilm thickness was assessed using crystal violet staining followed by ethanol extraction.

Results. Bacteriological examination of 15 dental plaque samples enabled the isolation and identification of 45 bacterial and fungal strains. The microbial community was dominated by representatives of the genus Staphylococcus — 16 strains (35.6%) isolated from 13 samples (86.7%). The majority of the isolated strains demonstrated a high capacity for biofilm formation. Conventional antiseptic agents (chlorhexidine and furacilin) showed little or no effect on mature biofilms. Infusions of all tested medicinal herbs effectively reduced the biofilm thickness of coagulase-positive staphylococci but had no significant effect on coagulase-negative species. Chamomile and nettle infusions demonstrated antibiofilm activity against Neisseria spp.; calendula and nettle infusions were effective against enterobacteria; and calendula and chamomile infusions reduced Candida biofilms.

Conclusion. Bacteriological analysis of dental plaque in children receiving palliative care revealed a diverse microbial composition, with predominance of enterobacteria and staphylococci. Conventional antiseptic agents (chlorhexidine and furacilin) showed minimal effects on the biofilm thickness of clinical strains. In contrast, the herbal infusions evaluated in this study exhibited pronounced antibiofilm activity.

Relevance. Improving the detection of early enamel demineralization remains an important challenge not only in dentistry but also in medicine overall. This is largely attributable to the high prevalence of dental caries worldwide and the ongoing difficulties associated with its timely diagnosis, management, and prevention. Dental caries and its complications may serve as a chronic focus of oral infection and, through systemic sensitization, contribute to the development of focal infection–related conditions.

Materials and methods. A total of 1,061 schoolchildren aged 7–18 years were examined. Early detection of enamel demineralization was performed using a newly developed diagnostic method (Patent No. 2846572, September 9, 2025). White spot lesions were identified using a diagnostic dye applied with a dental microbrush. The stained areas were subsequently evaluated to assess demineralization-related changes in dental hard tissues, allowing for the early detection of initial caries lesions across different age groups of schoolchildren.

Results. The proposed dye may be used as an alternative diagnostic agent for the early detection of dental caries and for vital enamel staining, demonstrating performance comparable to conventional methods employing a 2% aqueous methylene blue solution, the Omega caries indicator solution (Russia), Color Test No. 2 (Vladmiva, Russia), and the Sherb caries indicator (China). The diagnostic effectiveness for identifying early enamel demineralization remained consistently high.

Conclusion. The proposed method for preclinical diagnosis of dental caries at the white spot stage is distinguished by its simplicity, versatility, ease of use, and ability to provide comprehensive assessment of multiple tooth surfaces across the dental arches.

Relevance. While the prevalence of temporomandibular joint dysfunction among adults is high, ranging from 25% to 83%, prevalence estimates in children range from 4% to 77%, with reported rates of 25% to 44.8% among prepubertal schoolchildren. While the majority of studies focus on the diagnosis and treatment of TMD in adults, an increasing number of publications address this condition in children.

Objective. To assess the relevance and significance of temporomandibular joint dysfunction as a clinical problem among primary school–aged children based on available research evidence.

Materials and methods. A systematic search and analysis of the available literature published over the past 15 years were conducted using the electronic databases PubMed, Google Scholar, and eLibrary.ru. A total of 2,127 publications were initially identified. After duplicate removal, 476 studies remained eligible for screening. Following the selection process, 24 publications met the inclusion criteria and were included in the systematic review.

Results. Analysis of the reviewed literature indicates that temporomandibular joint dysfunction in children is a clinically relevant and increasingly recognized condition, with growing research interest in recent years. Considerable attention has been devoted to diagnostic approaches and etiological factors, whereas relatively few studies focus on therapeutic interventions for TMD among children.

Conclusion. Greater attention to temporomandibular joint dysfunction in children is required. Further research is needed to develop and evaluate management approaches for children presenting with clinical manifestations of TMD.

Relevance. Periodontitis and dental caries are highly prevalent oral diseases that frequently coexist in the context of chronic inflammation. Periodontitis is associated with increased production of inflammatory mediators (IL-1β, IL-6, TNF-α, PGE2, among others), resulting in destruction of periodontal tissues and enhanced enamel demineralization. In this context, the inclusion of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of periodontitis has attracted attention as a means of modulating the immune response. NSAIDs effectively inhibit prostaglandin synthesis and thereby reduce inflammation; however, their effects on clinical periodontal parameters and caries risk require systematic evaluation.

Objective: To evaluate the efficacy and safety of systemic and topical administration of five NSAIDs (acetylsalicylic acid, ibuprofen, diclofenac, ketoprofen, and tenoxicam) as adjunctive therapy for chronic periodontitis in adults.

Materials and methods. A systematic review of randomized controlled trials and controlled clinical studies published up to March 2024 was conducted in accordance with PRISMA guidelines. The review protocol was registered in PROSPERO (CRD42024518732). Electronic searches were performed in PubMed, the Cochrane Library, Embase, Scopus, and Web of Science. Eligible studies included adult patients diagnosed with chronic periodontitis, compared systemic or topical NSAIDs with placebo or standard non-surgical periodontal therapy, with a minimum follow-up of 4 weeks, and reported clinical outcomes such as probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), and related periodontal parameters (Table 2). Risk of bias was assessed using RoB 2 and ROBINS-I tools. Where appropriate, meta-analysis was performed using random-effects models.

Results. The literature search identified 876 records, of which 72 articles were assessed in full text; five studies comprising a total of 150 patients met the inclusion criteria, including four randomized controlled trials (RCT) and one controlled nonrandomized study. Adjunctive administration of low-dose acetylsalicylic acid (75–150 mg/day) in combination with non-surgical periodontal therapy over 3–6 months resulted in statistically significant reductions in mean PPD (approximately 0.6 mm) and gains in CAL (approximately 0.5 mm) compared with placebo (p < 0.05). Meta-analysis of three aspirin-based randomized controlled trials demonstrated a significant reduction in PPD (mean difference −0.62 mm; 95% CI −0.78 to −0.45; I2 = 21%) with a moderate level of evidence. Systemic diclofenac provided postoperative analgesia comparable to that of a non-NSAID local analgesic; however, due to the short observation period (3 days), its effects on periodontal parameters were not assessed. Postoperative ibuprofen administration did not improve periodontal healing compared with control treatment and was associated with gastrointestinal complaints in 15% of patients. A 10-day course of tenoxicam (20 mg/day) showed no advantage over placebo with respect to PPD or CAL. No data were identified on systemic ketoprofen use in periodontitis. In contrast, topical NSAID formulations demonstrated beneficial effects: rinsing with a 2% ibuprofen solution three times daily for 12 weeks resulted in an additional reduction in PPD of approximately 0.6 mm and a CAL gain of approximately 0.5 mm without adverse effects; application of a 1.5% ketoprofen gel twice daily for 3 months led to a further reduction in PPD of approximately 0.8 mm (p < 0.05) and a CAL gain of approximately 0.6 mm compared with scaling alone. Application of a 1% diclofenac gel after scaling was associated with a significant clinical attachment gain (+0.4 mm at 3 months). No serious adverse events or ulcerative gastrointestinal bleeding were reported. Topical formulations were well tolerated, with no mucosal irritation observed.

Conclusion. Nonsteroidal anti-inflammatory drugs may be effectively used as adjuncts in comprehensive periodontal therapy as modulators of the inflammatory response. Prolonged administration of low-dose aspirin yields moderate but reproducible improvements in key periodontal parameters. Topical NSAID formulations (ibuprofen, ketoprofen, and diclofenac mouthrinses or gels) provide additional periodontal benefits without systemic adverse effects, which is particularly relevant for patients at increased risk of NSAID-associated gastropathy. Incorporation of NSAIDs into treatment protocols for patients with pronounced periodontal inflammation and high caries risk may contribute to suppression of inflammatory tissue destruction and indirectly enhance resistance of dental hard tissues to demineralization. Further high-quality studies are required to determine optimal dosing regimens, treatment duration, and long-term outcomes, including effects on caries activity, before NSAIDs can be recommended for routine inclusion in periodontal treatment standards.

Relevance. The prevalence of crossbite in children and adults across different populations ranges from 4% to 23%. During the primary and mixed dentition periods, unilateral posterior crossbite accompanied by a functional mandibular shift is most frequently observed. This condition may result in altered neuromuscular equilibrium and asymmetric mandibular growth. Conventional orthodontic management is primarily focused on maxillary expansion, whereas insufficient attention is often paid to correction of mandibular position. 
Case presentation. This article presents a clinical case of orthodontic treatment in a patient with unilateral posterior crossbite associated with a functional mandibular shift. The proposed author-developed treatment approach involves simultaneous maxillary expansion and mandibular repositioning, enabling functional correction at an early stage of occlusal development. 
Conclusion. Application of this orthodontic treatment method allows rapid establishment of normal occlusal relationships. The approach promotes symmetrical mandibular growth and contributes to the prevention of dentofacial asymmetry.

Relevance. Fractures of the mandibular condylar process represent a clinically significant type of mandibular injury and are commonly associated with trauma to the temporomandibular joint (TMJ). Conventional management usually involves mandibular immobilization using splints, followed by orthodontic treatment with different orthodontic appliances. Even when treatment outcomes are favorable, patients aged over 13 years frequently develop condylar hypoplasia and mandibular ramus hypoplasia on the affected side. These changes lead to mandibular asymmetry and the development of dentofacial anomalies, often requiring combined treatment involving orthodontic therapy and orthognathic surgery. Consequently, dental rehabilitation of patients with post-traumatic condylar hypoplasia remains a clinically relevant issue warranting further study.

Description of a clinical case. A clinical case of orthodontic treatment of a 17-year-old patient with unilateral post-traumatic hypoplasia of the condylar process with the orthodontic device “activator for verticalization of the lower jaw” developed by us is presented. A clinical case of orthodontic treatment in a 17-year-old patient with unilateral post-traumatic hypoplasia of the mandibular condylar process is presented. Treatment was carried out using a custom-designed orthodontic appliance – a unilateral mandibular verticalization activator developed by the authors.

Conclusion. Application of the unilateral mandibular verticalization activator in a 17-year-old patient with unilateral post-traumatic condylar hypoplasia resulted in stimulation of condylar growth and remodeling, with improvement in mandibular form and articulation. The findings suggest that the use of a custom-designed orthodontic activator appears to promote adaptive remodeling with enhanced bone formation as part of an adaptive biological response. The morphological and functional changes of the maxillofacial region observed in this clinical case indicate the need for further refinement of current principles and approaches to orthodontic management in this patient population.