Relevance. In areas where the fluoride concentration in drinking water exceeds 1.5 mg/L, fluorosis is endemic, underscoring the need to develop regional dental disease prevention programs for children and evaluate their effectiveness.

Materials and methods. A clinical study included 300 schoolchildren aged 7, 12, and 15 years who lived in an area of endemic fluorosis, where the fluoride concentration in drinking water was 2.4 mg/L. Within each age group, 50 children were included in the prevention subgroup and 50 in the comparison subgroup. Oral health status was assessed using the decayed, missing, and filled teeth (DMFT) index, the papillary-marginal-alveolar (PMA) index, the Simplified Oral Hygiene Index (OHI-S), and Dean’s fluorosis index (1942). This study reports outcomes after 3 years of program implementation.

Results. Dental fluorosis was present in 68.33% of the children, predominantly in very mild and mild forms. Its prevalence remained unchanged over the 3-year follow-up. During the same period, the prevalence of dental caries increased in all age groups. Meanwhile, the prevention subgroups showed greater improvements in oral hygiene and periodontal status than the comparison subgroups. Caries reduction was 18.2%, 66.7%, and 36% among 7-, 12-, and 15-year-olds, respectively. These findings confirm the effectiveness of the prevention program.

Conclusion. Implementation of the regional dental disease prevention program among schoolchildren living in an area of endemic fluorosis reduces the risk of dental caries and improves oral hygiene and periodontal status.

Relevance. China’s high-altitude regions are characterized by extreme climatic and geographic factors, including hypoxia, ultraviolet radiation, an arid climate, and low levels of trace elements in water. Together with traditional dietary habits, these factors may adversely affect children’s oral health. Comprehensive epidemiological data from these regions remain limited.

Materials and methods. This cross-sectional study included 128 children aged 6–12 years in Wuqia County, a high-altitude area of Xinjiang located at an elevation of >2,500 m. The prevalence of dental caries (DMFT/dmft index), gingivitis (Löe–Silness — Gingival Index [GI]) and malocclusion (Angle classification) was assessed. Parents completed a questionnaire. Data were analyzed using the χ² test, ANOVA, and logistic regression analysis.

Results. A high prevalence of caries in the primary dentition (91.5%), gingivitis (29.5%), and malocclusion (68.7%) was found. The main risk factors were frequent carbohydrate intake (OR = 2.85), irregular toothbrushing (OR = 2.41–2.93), low parental educational attainment (OR = 1.98), visible dental plaque or calculus (OR = 4.12), and deleterious oral habits (OR = 3.28).

Conclusion. Children living in the high-altitude regions of Xinjiang have an extremely high burden of oral disease, indicating the need to develop region-specific preventive programs that take behavioral, social, and environmental risk factors into account.

Relevance. The prevalence of recurrent upper respiratory tract infections (RURTIs) in children ranges from 4–18% to 27–40%, with persistently high rates reported in 6–7-year-olds. However, comprehensive assessment of oral health status in this group of children is lacking.

Objective. To investigate the prevalence of oral diseases in children with RURTIs.

Materials and methods. Oral health status was assessed in 98 children aged 6–7 years with RURTIs and 35 age-matched healthy controls who had only occasional episodes of acute respiratory infection. Caries experience was recorded using the dmft, dmfs, DMFT, and DMFS indices. Oral hygiene was assessed using the Silness–Löe and Stallard plaque indices, and gingival/periodontal status using the PMA index (%), gingival bleeding index, and Schiller–Pisarev test. The composite oral health level (OHL) score was calculated. Kendall’s tau-b correlation coefficient was used to assess associations between oral health parameters and the frequency of acute respiratory infection episodes according to the infection index (II) and resistance index (RI).

Results. Children with RURTIs had a high prevalence of caries in the primary dentition (96.9%) and high caries experience scores (dmft, 5.92 ± 0.26; dmfs, 6.26 ± 0.27; p < 0.001). Molar-incisor hypomineralization (MIH) was diagnosed in 13 children (13.2%), with a mean of 2.6 affected teeth per child. Chromogenic black stain, also known as Priestley’s black stain, was detected in 8.2% of cases. The prevalence of gingivitis was 89.8%. The PMA index was 22.9 ± 1.9% (p = 0.001), the gingival bleeding index score was 0.19 ± 0.03 (p = 0.209), and the Schiller–Pisarev test score was 1.57 ± 0.04 (p = 0.002). Oral mucosal and lip lesions were diagnosed in 40 children with RURTIs (40.8%; χ2 = 22.1, p < 0.001). Dentofacial anomalies were detected in 77.5% of cases (χ2 = 14.67, p < 0.001), and the prevalence of malocclusion was 1.9-fold higher than in controls (χ2 = 11.4, p < 0.001). The mean composite OHL score was 66.7%. Significant positive correlations were found between II and RI values and oral health parameters in children with RURTIs (p < 0.001). The OHL score showed a strong inverse correlation with II (τ = −0.685; p < 0.001).

Conclusion. Poorer oral health in children with RURTIs underlines the need for a comprehensive preventive and therapeutic oral health program.

Relevance. Malocclusion is one of the most common oral health conditions affecting children; it can make effective oral hygiene more difficult and increase the risk of dental caries and gingivitis. To date, relatively few epidemiological oral health surveys have been conducted in central and western China; most studies have focused on eastern and coastal regions. This geographical imbalance highlighted the need to survey adolescents aged 12–17 years in central and western China and examine the relationship of malocclusion with dental caries and gingivitis. Our dental survey of adolescents in this region, which included assessment using the OHI-S, PLI, GI, PMA, and DMFT indices as well as multivariable analysis, was designed to address this gap. The aim was to systematically compare oral hygiene status, caries experience, and gingival health between adolescents with malocclusion and their peers with normal occlusion, who served as the control group, using standardized assessment methods.

Materials and methods. This cross-sectional study included 75 children (60 with malocclusion and 15 with normal occlusion). Oral hygiene, caries experience, and gingivitis severity were assessed using the OHI-S, DMFT, GI, and PMA indices. Statistical analysis was performed using SPSS version 25.0.

Results. The malocclusion group had significantly poorer oral hygiene (OHI-S: 2.80 ± 0.11 vs 1.60 ± 0.13), greater caries experience (DMFT: 4.20 ± 0.27 vs 1.80 ± 0.31), and more pronounced gingival inflammation (GI: 1.80 ± 0.08 vs 1.0 ± 0.1; PMA: 25.60 ± 1.07 vs 12.40 ± 1.32); these differences remained significant after adjustment.

Conclusion. Malocclusion is an independent risk factor for dental caries and gingivitis, primarily owing to impaired oral hygiene associated with dental crowding. These findings underscore the need for early diagnosis and treatment of malocclusion, individualized oral hygiene instruction, and regular dental follow-up for affected patients.

Relevance. Disease seasonality, particularly that of infectious diseases, has been extensively studied. Associations between the timing of surgery within the calendar year and certain surgical complications have been reported; however, the potential association between the time of year when palatoplasty is performed and early postoperative complications remains insufficiently studied.

Objective. To retrospectively analyze the potential association between the calendar month in which palatoplasty was performed and the incidence of postoperative complications, particularly oronasal fistula (ONF) formation.

Materials and methods. This retrospective study evaluated early anatomical outcomes in 339 patients with cleft palate who underwent surgical treatment at a medical center in St. Petersburg over a 60-month period. Statistical analysis examined the association between postoperative complications and month of surgery.

Results. Pearson’s χ2 test showed no statistically significant association between month of surgery and the incidence of complications (χ2 = 14.52; df = 11; p = 0.205). However, logistic regression analysis with January as the reference category showed significantly higher odds of complications in May (p = 0.028) and an overall trend toward a higher complication rate in spring. No other month differed significantly from January.

Conclusion. When scheduling palatoplasty, regional seasonal variation should be considered a potential risk factor for postoperative complications.

Relevance. Despite the high prevalence of wedge-shaped non-carious cervical lesions (NCCLs), treatment outcomes frequently remain unsatisfactory, with dentin hypersensitivity, poor esthetics, chipping, and restoration loss. These limitations highlight the need to investigate bonding to the affected dental hard tissues. The available literature lacks laboratory data directly comparing the dentin interfaces formed by composite resin used with the most widely employed fifth- and seventh-generation adhesive systems and by glass ionomer cement (GIC) in wedge-shaped NCCLs. This knowledge gap prompted the present study.

Objective. To compare the thickness and structural homogeneity of the material–dentin interface formed with a fifth-generation (two-step etch-andrinse) adhesive, a seventh-generation (one-step self-etch) adhesive, and GIC in wedge-shaped NCCLs.

Materials and methods. Forty-eight extracted permanent teeth with wedge-shaped NCCLs were allocated to three groups (n = 16 per group): Group 1, restored using a fifth-generation (two-step etch-and-rinse) adhesive; Group 2, restored using a seventh-generation (one-step self-etch) adhesive; and Group 3, restored with GIC. Histological ground sections were prepared and examined by polarized light microscopy at ×200 magnification to assess interfacial thickness and morphology. Descriptive statistics included the mean, standard error of the mean (SEM), and coefficient of variation (CV); between-group differences were assessed using Student’s t test.

Results. Interfacial thickness (mean ± SEM) was 4.26 ± 0.04 µm in Group 1 (CV = 14.6%), 2.20 ± 0.01 µm in Group 2 (CV = 7.21%), and 0.730 ± 0.003 µm in Group 3 (CV = 6.29%). Intergroup differences were statistically significant (p < 0.0001). Group 1 showed poorly defined hybrid-layer boundaries and focal areas of structural heterogeneity. Group 2 showed more uniform layer thickness, with only isolated areas of poorly defined margins. No conventional hybrid layer was observed in Group 3; instead, a uniform GIC–dentin interface was present, without penetration into the dentinal tubules.

Conclusion. The fifth-generation adhesive system produced the thickest hybrid layer; however, it showed greater variation in layer thickness and less consistent interfacial morphology. The seventh-generation adhesive system produced a thinner hybrid layer with more consistent thickness and morphology. In the GIC group, no conventional hybrid layer was formed; however, GIC produced the thinnest and most morphologically uniform interface.

Relevance. Numerous approaches to correcting malocclusion in children are based on established orthodontic concepts. However, existing diagnostic principles for pediatric dentofacial anomalies have not been incorporated into a standardized algorithm, which may hinder the achievement of stable orthodontic outcomes. This highlights the need to refine diagnostic protocols and orthodontic management strategies for children with malocclusion. Accounting for the individual spatial relationship of the jaws is essential for effective orthodontic planning.

Objective. To improve diagnostic protocols and orthodontic management for Class II malocclusion in children during the mixed dentition period.

Materials and methods. The study included 90 children aged 6–9 years who were followed for 12 months. The participants were divided into four groups. Groups 1 and 2 each comprised 25 patients who received occlusal overlays followed by aligner treatment. Group 3 comprised 25 patients treated with a removable maxillary plate with an anterior inclined plane. Group 4 included 15 untreated controls. In Group 1, the mandibular position was determined using a facebow transfer and a GAMMA Dental articulator. In Group 2, the mandibular position was registered using a construction bite. The anteroposterior position of the mandibular basal region relative to the anterior cranial base was assessed using the SND angle, while craniocervical parameters were evaluated using Rocabado cephalometric analysis.

Results. At the 12-month assessment, the SND angle was within the reference range in 86.67% of patients in Group 1, 63.3% in Group 2, and 53.3% in Group 3 (p < 0.05). The craniocervical parameters assessed using Rocabado cephalometric analysis normalized in all treated patients, with the greatest improvement observed in Group 1.

Conclusion. Orthodontic assessment using a facebow and articulator allows the optimal mandibular position for appliance fabrication to be determined in children aged 6–9 years while accounting for individual maxillomandibular relationships, thereby facilitating normalization of the assessed craniofacial and craniocervical cephalometric parameters.

Relevance. Among congenital malformations, those affecting the maxillofacial region are second in frequency only to cardiovascular malformations. Congenital clefts of the lip and palate account for 88% of all congenital maxillofacial anomalies. The proportion of bilateral clefts, which represent the most severe form of this condition, has increased in recent years.

Materials and methods. A two-stage palatoplasty technique using a thin tongue flap was developed at the Department of Pediatric Maxillofacial Surgery for patients with bilateral cleft lip and palate. The technique was used in 32 patients aged 2–8 years and comprised two stages. The first stage consisted of standard veloplasty. At the second stage, a thin mucosal tongue flap was raised using the authors’ modification to close the anterior part of the hard palate cleft.

Results. No early or late postoperative complications were observed. Following orthodontic treatment, normal or edge-to-edge occlusion was achieved. Speech sound production was age-appropriate.

Conclusion. The use of a thin pedicled tongue flap enables the formation of a long, mobile soft palate while avoiding maxillary constriction and hypoplasia. The proposed technique may be considered the method of choice for palatoplasty in patients with bilateral clef t lip and palate.

Relevance. Adherence to oral health practices is among the most important factors determining a patient's general health. When considering adherence during the preschool years, it is essential to assess the child's parents or guardians because adults are primarily responsible for following clinicians' recommendations at this age. This area remains largely unexplored. In particular, no specialized questionnaire is available for assessing oral health adherence among legal representatives, including parents, guardians, and trustees, of persons under 12 years of age.

Objective. This pilot study aimed to assess the adaptation of the QAA-25 questionnaire for evaluating legal representatives' adherence to preschool children's oral health.

Materials and methods. First, the original QAA-25 D questionnaire was modified to determine the level of adherence to oral health practices. Respondents were then interviewed to refine the questionnaire wording, after which they completed the original and new questionnaires concurrently to determine the validity of the modified version. The questionnaires were compared using nonparametric statistical methods: the Wilcoxon signed-rank test and Spearman's rank correlation coefficient.

Results. The study revealed a consistent pattern. Respondents who demonstrated a high level of adherence on the study questionnaire (n = 16) also demonstrated a high level of adherence on the original questionnaire (n = 15). Respondents with a moderate level of adherence (n = 9) lik ewise demonstrated a moderate level of adherence on the original questionnaire (n = 11), while respondents with a low level of anxiety (n = 5 on the study questionnaire and n = 4 on the original questionnaire) demonstrated low adherence. In the Wilcoxon comparison, the observed T value of 163.0 deviated from the expected mean of 232.5 by 1.43σ. The z statistic was 1.429, the p value was 0.153, and Spearman's rank correlation coefficient (ρ) was 0.911.

Conclusion. The modified QAA-25 questionnaire, designated by the authors as QAA-25(III) and intended to assess legal representatives' adherence to preschool children's oral health, showed a strong correlation with the original QAA-25 D questionnaire (p = 0.153, ρ = 0.911), supporting its use as a reliable version of the existing questionnaire.

Relevance. Congenital cleft palate (CP) is among the most severe craniofacial malformations. Despite the numerous surgical techniques available, outcomes in affected children remain suboptimal. Postoperative defects may develop and require additional surgical intervention.

Objective. To evaluate and refine a combined technique incorporating palatoplasty, veloplasty, and pharyngoplasty for single-stage reconstruction of the velopharyngeal sphincter.

Materials and methods. The study was conducted at the Republican Children’s Multidisciplinary Medical Center in Nukus, Republic of Karakalpakstan, Uzbekistan. A total of 280 patients with cleft lip and palate (CLP) were evaluated, and the findings were compared with the outcomes of previously performed surgical procedures. From this cohort, a subgroup was selected comprising 120 children and 68 adults with cleft palate (CP), 34 patients with CLP, and 18 patients with bilateral cleft lip and palate (BCLP). The 120 children were divided into Group 1 (n = 35) and Group 2 (n = 85). Group 2 comprised 42 patients who had previously undergone cleft lip repair and 43 patients with previously untreated isolated cleft palate. According to the L. E. Frolova classification, 16 clefts were grade IIIa and 17 were grade IIIb. The patients were assessed in collaboration with otorhinolaryngologists to evaluate changes in the dimensions of the nasopharyngeal airway.

Results. Review of the patients’ medical histories identified the types of postoperative complications. To narrow the velopharyngeal port, we propose using a pedicled myomucosal flap raised from the lateral pharyngeal wall. The flap mechanically assists soft-palate contraction and elevation, thereby promoting velopharyngeal closure.

Conclusion. When veloplasty is performed before cleft lip repair, muscle contraction and scar tension can widen the lip cleft. Early combined cleft lip repair and veloplasty reduces pathological changes in the nasopharyngeal tissues. The proposed technique improves the effectiveness of speech therapy for articulation disorders and shortens the rehabilitation period.

Relevance. Among congenital maxillofacial malformations, cleft lip and palate (CLP) occupies a special place. The main challenges in the rehabilitation of these patients include altered anatomy, age-related progression of deformity, and scar tissue after previous surgical interventions, which adversely affect the outcomes of subsequent treatment. Failure to follow a staged rehabilitation algorithm, as well as inability to receive timely specialized care, may place many children at risk of social disadvantage.

Clinical Case Descriptiom. This article describes the comprehensive rehabilitation of a female patient with a congenital complete right-sided cleft lip, alveolar cleft, and cleft of the hard and soft palate. Treatment was provided by a multidisciplinary team including maxillofacial surgeons, an orthodontist, a prosthodontist, oral and maxillofacial radiologists, a speech therapist, and other specialists. The patient underwent staged reconstructive treatment including primary cheilorhinoplasty, palatoplasty, alveolar bone grafting of the maxilla, maxillary advancement using distraction osteogenesis devices, orthognathic surgery to restore the occlusal plane in relation to the interpupillary line, as well as long-term orthodontic treatment.

Conclusion. The rehabilitation of patients with cleft lip and palate remains an important multidisciplinary challenge because treatment begins in infancy and often continues into adulthood. Treatment planning should be individualized and based on the patient’s anatomy, medical and surgical history, and other clinical factors. A personalized, staged approach is therefore essential.

Relevance. Neurogenic tumors, most commonly neurofibromas and schwannomas, are among the disorders affecting the major salivary glands. Although these tumors are extremely rare, their nonspecific clinical presentation results in a diagnostic error rate reported by various authors to range from 7.0% to 46.0%. The report describes the successful treatment of a patient with a schwannoma of the left submandibular gland.

Clinical case presentation. A 16-year-old patient presented to the clinic with a provisional diagnosis of pleomorphic adenoma of the left submandibular gland. Additional diagnostic procedures, including magnetic resonance imaging (MRI) and ultrasonography, were performed for differential diagnosis and treatment planning. The patient underwent surgical removal of the left submandibular gland together with a mass located within the gland parenchyma. The postoperative course was uneventful, and the patient was discharged in satisfactory condition. During the subsequent 6 months, the patient reported neurological symptoms—tingling in the chin, lower lip, and tongue—which resolved spontaneously without treatment. No recurrence was detected on follow-up MRI performed 6 months after surgery.

Conclusion. The neural origin of schwannomas means that decisions regarding the extent of surgery must be made on an individual basis, taking into account the anatomical course of the nerves in the maxillofacial region.