[Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases]. / Klinicheskaya effektivnost' konservativnogo lecheniya patsientov s khronicheskim generalizovannym parodontitom s primeneniem gelya Kholisal.

PURPOSE OF THE STUDY: To study the effectiveness of the drug Cholisal as part of the conservative treatment of chronic periodontitis. MATERIAL AND METHODS: We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute stage with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of periodontitis, patients were divided into two groups of 50 people. In the main group, Cholisal dental gel was used as part of complex conservative treatment, and in the control group, Metrogil-denta gel was used. To assess the effectiveness of treatment, a dental examination of patients was carried out with an index assessment of the condition of periodontal tissues and a biochemical analysis of the content of arachidonic acid and prostaglandin E2 in gingival blood, comparing the indicators before treatment and 14 days after the start of treatment. RESULTS: When the drug Cholisal was included in complex treatment, 14 days from the start of treatment, patients experienced a statistically significant decrease in the depth of periodontal pockets from 4.7±0.32 mm to 3.6±0.19, and the Green-Vermillion hygiene index by 60.7%, Silness-Loe plaque index by 73.1%, PMA index by 68.8%, Muhlemann-Cowell bleeding index by 68.0% (p<0.001 compared to baseline). When Metrogil-denta gel was used in complex therapy, the effectiveness of treatment was lower: the depth of periodontal pockets did not change significantly (from 4.5±0.22 mm to 4.2±0.17 mm, p>0.05), reduction in the hygiene index Green-Vermillion was 51.9%, Silness-Loe plaque index - 64.0%, PMA index - 43.7%, Muhlemann-Cowell bleeding index - 45.8% (p<0.001 compared to baseline, p<0.001 compared to the main group). A laboratory study showed that in patients of the main group, after completing a course of conservative treatment, the content of biomarkers of inflammation significantly decreased compared to the initial level (p<0.05), while in patients of the control group the content of arachidonic acid and prostaglandin E2 in the gingival blood during the study period did not change significantly (p>0.05 compared to the initial level). CONCLUSIONS: The use of the drug Cholisal in the conservative treatment of chronic periodontitis has demonstrated more pronounced positive dynamics of clinical and biochemical parameters compared to traditional therapy, which suggests its high effectiveness.

[Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases]. / Stomatologicheskii gel' Kholisal na etape konservativnogo lecheniya vospalitel'nykh zabolevanii parodonta.

PURPOSE OF THE STUDY: To study the effectiveness of using the drug Cholisal as part of the conservative treatment of chronic periodontitis. MATERIAL AND METHODS: We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute phase with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of CGP, patients were divided into two groups of 50 people. In the main group, in addition to standard treatment, the dental gel Cholisal was used, and in the control group, therapy was standard. 10 days after professional hygiene, patients in both groups were examined and underwent an index assessment of the condition of periodontal tissues and adherence to treatment. RESULTS: In patients of the control group, 10 days from the start of treatment, the depth of periodontal pockets in the control group decreased slightly from 4.7±0.28 mm to 4.2±0.21 mm (p=0.074), and the Green-Vermillion hygiene index decreased by 25.3±1.79% (p=0.041), Silnesse-Loe plaque index by 59.1±2.16% (p<0.001), PMA index by 51.5±1.92% (p<0.001) and Muhlemann-Cowell bleeding index by 42.2±1.75% (p<0.001). In the main group, the effectiveness of treatment of chronic periodontitis with conservative therapy using Cholisal was higher. There was a statistically significant decrease in the depth of periodontal pockets from 4.8±0.23 mm to 3.5±0.19 mm (p=0.043), the Green-Vermillion hygiene index decreased by 47.6±2.13% (p=0.0003), Silnesse-Loe plaque index by 78.2±3.05% (p<0.001), PMA index by 69.4±2.74% (p<0.001) and Muhlemann-Cowell bleeding index by 66.9±1.62% (p<0.001). CONCLUSIONS: The use of the drug Cholisal in the conservative treatment of chronic periodontitis has shown convincing positive dynamics in both subjective and objective assessments, which suggests its effective use.

[Mechanisms of age-related changes in the morphology of the pulp system of the first lower molars]. / Mekhanizmy vozrastnykh izmenenii morfologii sistemy pul'py pervykh nizhnikh molyarov.

OBJECTIVE: To study the coupling of age-related systemic changes in inflammation-mediated apoptosis with the features of the anatomy of the pulp system of the first mandibular molars in patients with chronic pulpitis and periodontitis. MATERIAL AND METHODS: The study included 55 patients of both sexes from 18 to 75 years of age in three age groups - young (18-44 years) (n=17), middle (45-59 years) (n=18), elderly (60-74 years) (n=20) with indications for endodontic treatment. Diagnostic measures were supplemented with New Tom 3G cone-beam tomography. The concentration of anitapoptotic protein Bcl-XL and tumor necrosis factor-a (TNF-a) was determined in the blood, and the level of the nuclear transcription factor NF-KB subunit p65 was determined in the lysates of mononuclear cells. RESULTS: As a result of the analysis of the sections, significant obliteration of the pulp was revealed throughout and an increase in the frequency of occurrence of slit-shaped channels in the distal root of the first molar of the mandible in elderly patients. CONCLUSION: The pathogenetic factors leading to a change in the morphology of the pulp system include old age and an imbalance in the system of anti-inflammatory cytokine transcription mechanisms, which contributes to increased apoptosis and the protracted nature of inflammation.

[Clinical analysis of the cleaning effectiveness of toothbrushes of various types in children aged 6-15 years after a single brushing]. / Klinicheskii analiz ochishchayushchei effektivnosti zubnykh shchetok razlichnogo tipa u detei 6­15 let posle odnokratnoi chistki zubov.

OBJECTIVE: The purpose of the study is to conduct a comparative analysis of the cleaning effectiveness of toothbrushes of various types in children aged 6-15 years after a single tooth brushing. MATERIAL AND METHODS: A parallel, randomized, open clinical trial was conducted aimed at evaluating the effectiveness of toothbrushes of various types in children aged 6-15 years. The study involved 180 children of both sexes aged 6-15 years, who were divided into 3 age categories: 6-8 years (n=60), 9-11 years (n=60) and 12-15 years (n=60). In each age category, 3 groups of 20 people were randomly formed who received toothbrushes of different types: groups I, IV and VII - a manual brush with a multi-level brush field, groups II, V and VIII - a manual brush with an even brush field, groups III, VI, IX - an electric brush with the technology of reciprocating and pulsating movements. After the dental examination, the children were taught the standard method of brushing their teeth. The cleaning efficiency of toothbrushes was evaluated using the hygiene index PI (S. Turesky, 1970) before and after a single tooth brushing. The nonparametric Wilcoxon test was used to compare the indicators of one group in dynamics, and the Mann-Whitney test was used to identify differences between groups. RESULTS: A comparative analysis showed that the efficiency of the electric brush in all age groups was significantly higher compared to manual brushes having an even brush field, and in children 12-15 years old it was higher compared to both manual brushes. In the age groups of 6-8 years and 9-11 years, a manual brush with a multi-level brush field, intersecting tufts of bristles and a power projection showed high cleaning efficiency, which did not significantly differ from the indicators of plaque reduction after using an electric brush (Mann-Whitney criterion, p>0.05). CONCLUSION: An electric toothbrush is the most effective means of oral hygiene in children. In children aged 6-8 years, a high cleansing effect was achieved with a manual brush having a multi-level brush field. In the hygienic education of children of this age, it is necessary to pay more attention to the formation of the correct technique of brushing teeth with the help of manual brushes corresponding to age characteristics.

[Clinical and radiological assessment of the anatomical and topographic structure of the root canals of teeth in patients of different age groups]. / Kliniko-rentgenologicheskaya otsenka anatomo-topograficheskogo stroeniya kornevykh kanalov zubov u patsientov raznykh vozrastnykh grupp.

THE AIM OF THE STUDY: Was to identify the features of the anatomical structure of the root canals of teeth according to CBCT data in patients in different age groups. MATERIAL AND METHODS: Patients of europeoid race, both sexes, who have indications for endodontic treatment (60 people), were divided into three groups: group 1 (young) 20 people aged 18 to 44 years, group 2 (middle age) 20 people - from 45 to 60 years, group 3 (elderly) 20 people - from 61 to 75 years old. To assess the root canal anatomy, all patients underwent x-ray examination (CT) on a Vatech computed tomography and analyzed with the Ez3D plus program before beginning endodontic treatment. The object of study was the first molars of the lower jaw (distal root canal). RESULTS: The analysis of axial, sagittal, coronal sections of the first molar of the lower jaw revealed that patients belonging to the 1st group, the distal root canal often had an oval shape all over (95%) and over a wide apical opening, in only one case out of 20 (5%) were identified at slit-like form of the distal root canal, probably due to malocclusion or as a consequence of increased abrasion of teeth. In group 2, two independent root canals were identified in the distal root of the first lower molar (in 65%), extending from the tooth cavity to the apex.in 35% of cases, the distal root canal began with a single entrance in the oral part and bifurcated into two separate channels at about the level of 2 /3 canals, then re - joined into a single apical opening, in group 3, in 75% of cases, a slit-like form of the distal root canal was observed. The obtained CLCT data (taking into account the image error) were confirmed in the clinic at the stage of endodontic treatment using optical magnification (microscope). CONCLUSION: CBCT and operation microscopy with x40 magnification data showed clear age-dependent variations of first lower molar distal root canal anatomy.

[Influence of different type of toothbrushes on gingival fluid proteolytic potential during orthodontic treatment]. / Vliyanie zubnykh shchetok razlichnogo tipa na proteoliticheskii potentsial desnevoi zhidkosti v dinamike ortodonticheskogo lecheniya.

THE AIM: To study the effect of toothbrushes of various types on the accumulation of plaque and the proteolytic potential of gingival fluid as a pathogenic factors in long-term orthodontic treatment of patients with a distal permanent bite. MATERIAL AND METHODS: We examined 63 patients of both sexes aged 11-18 years. Orthodontic treatment was carried out for the close position of the teeth with a distal permanent bite (K07.2) and cleft palate and lips (Q37.1). Patients were divided into three groups depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, «Spazzolificio Piave¼, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush ("Oral-B Pro-Expert, «Procter & Gamble¼, USA). RESULTS: The amount of soft plaque was assessed by the Silness-Loe hygiene index in the subgingival region. The activity of proteolytic enzymes - elastase, collagenase, and a α-inhibitor of proteinases was determined by the enzymatic method using a XL 200 biochemical analyzer («Erba Lachema¼, Czech Republic). The accumulation of plaque in the gingival region on both jaws during the entire period of orthodontic treatment is most pronounced when using a manual brush compared to ultrasonic and electric brushes. An increase in proteolytic activity in the gingival fluid with a simultaneous decrease in antiprotease potential with long-term orthodontic treatment of patients was observed when using a manual orthodontic brush, which can be regarded as an increase in the activity of the pathogenic factors for the development of local inflammatory and destructive changes. CONCLUSION: To prevent inflammatory and destructive changes during prolonged orthodontic treatment of patients, the use of ultrasonic and electric toothbrushes in daily oral hygiene is justified.

[Influence of different type of toothbrushes on the incidence of enamel demineralization and gingivitis in the course of orthodontic treatment]. / Vliyanie ispol'zovaniya zubnykh shchetok razlichnogo tipa na veroyatnost' razvitiya demineralizatsii emali i gingivita v khode ortodonticheskogo lecheniya.

The aim of the study was to determine the likelihood and frequency of complications, the impact of the use of various types of toothbrushes in the dynamics of orthodontic treatment with fixed appliances in patients with a distal permanent bite. The clinical study was conducted on 63 patients of both sexes, aged 11-18 years. Patients received long-term orthodontic treatment for a close tooth position with a distal permanent bite (K07.2) and cleft palate and lip (Q37.1). Three groups were conditionally distinguished depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, Spazzolificio Piave S.p.A, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush (Oral-B Pro-Expert, Procter & Gamble, USA). According to the Kaplan-Meier method, the probability of developing complications of orthodontic treatment was calculated as patients wear braces, and the impact on the effectiveness of orthodontic treatment of using toothbrushes of various types was evaluated. A frequency analysis of the complications of orthodontic treatment for the entire period of wearing fixed orthodontic structures revealed a difference only in respect to enamel demineralization. In group 1, enamel demineralization was more common (42.9%) compared with 2 (9.1%) and 3 (25%) groups (p=0.039). The likelihood of developing gingivitis was higher in group 1, the timing of the development of inflammatory processes in periodontium was also shortened in group 1 compared with groups 2 and 3. The frequency and timing of the development of gingivitis and enamel demineralization depended on the type of toothbrush used in daily oral hygiene. A marked deterioration in the oral hygiene during orthodontic treatment using a manual brush was accompanied by a more frequent development of gingivitis and enamel demineralization.

[Alveolar osteitis treatment using Holisal gel]. / Medikamentoznoe soprovozhdenie al'veolita cheliusti preparatom Kholisal.

The aim of the study was to estimate efficiency Holisal in treatment of the alveolar osteitis. 30 patients with the diagnosis of alveolar osteitis with clinics of dry socket, aged from 25 to 69 years entered a research. Patients were divided into 2 groups: in the 1st group (n=15) patients received treatment by a standard technique with the use of the iodoform gauze. In the 2nd group patients (n=15) after preliminary training used Holisal 4 times a day applying it in the socket. In both groups dynamics of clinical indicators, complaints, biochemical indicators on the 3, 5 and 10 day after the beginning of treatment were estimated. The use of Holisal for treatment of the alveolar osteitis presenting as a dry socket is effective and has advantages in comparison with a conventional technique of alveolar osteitis management.

[Influence of gender, age and metabolic factors on the course of chronic generalized periodontitis in patients with metabolic syndrome]. / Vliianie gendernykh, vozrastnykh i metabolicheskikh faktorov na techenie khronicheskogo generalizovannogo parodontita u patsientov s metabolicheskim sindromom.

In a study of 537 patients with chronic generalized periodontitis and metabolic syndrome, depending on gender, age and metabolic factors, it was found that with increasing of body mass index (BMI) symptoms of chronic generalized periodontitis is becoming more unfavorable, there is a close positive relationship between the severity of chronic generalized periodontitis and BMI. Patients' with BMI ≥40 kg/m2 in 80% of cases, periodontitis was characterized by severe course. It was found that the gender of the patient becomes relevant only with correlation of age and BMI. It was proved that for the most accurate prognosis of chronic generalized periodontitis, patient's sex, age and BMI should be taken into consideration. The developed model for predicting the course of chronic generalized periodontitis depending on the sex, age and metabolic factors of a particular patient, allows to monitor the dynamics of the disease in time.

[Diagnostic and prognostic significance of the hypoxia-dependent transcriptional mediator for the development of a carious lesion]. / Diagnosticheskaia i prognosticheskaia znachimost' gipoksiiazavisimogo transkriptsionnogo mediatora dlia razvitiia karioznogo porazheniia.

OBJECTIVE: To study diagnostic informational content of change of concentration a hypoxia-inducible factor (HIF-1α) in gingival liquid of patients for assessment of risk of development of carious process. MATERIAL AND METHODS: 75 patients with the diagnosis dentine caries entered the research: group 1 (n=30) involved patients with primary caries while group 2 (n=45) consisted of patients with caries recurrence in 12 months after treatment. RESULTS: In all patients HIF-1α was determined in gingival liquid before treatment by the IFA method. Logistic regression and the ROC analysis were used for the statistical analysis. In group 2 the level of HIF-1α was two-fold higher than in group 1 (p<0.001) and 82% higher than in healthy individuals (p<0.001). The increased initial HIF-1α level of 98 pg/ml was associated with high risk of caries recurrence in 12 months after treatment with diagnostic sensitivity of 88.4% and diagnostic specificity of 78.1% with chances of development increased by 4 times (p<0.0001). The change of HIF-1α in gingival liquid from 80 pg/ml to 170 pg/ml increased the risk of caries recurrence 12 months from 13% up to 94%. CONCLUSION: The initial content in gingival liquid a hypoxia-inducible factor-1α higher than 98 pg/ml allows triage of patients with high risk of caries recurrence requiring dental monitoring for personification of preventive measures.