[Assessment of microhaemodynamics and oxygenation in tissues after the vestibuloplasty with the use of a free dermal autograft in patients after the reconstructive jaw surgery with the use of the revascularized autografts]. / Otsenka sostoyaniya mikrogemodinamiki i oksigenatsii v tkanyakh posle vestibuloplastiki s ispol'zovaniem svobodnogo dermal'nogo autotransplantata u patsientov posle rekonstruktivnoi operatsii na chelyustyakh s primeneniem revaskulyarizirovannykh autotransplantatov.

Purpose of the study: to study the features of microhaemodynamics and oxygenation in soft tissues in the area of the plastically reconstructed jaw after the vestibuloplasty. MATERIALS AND METHODS: The study included 40 patients aged 20 to 65 (21 males and 19 females). The patients were divided into two groups: I group (14 patients) - patients after reconstructive surgery with the use a fibula autograft without the inclusion of a musculocutaneous «islet¼; II group (26 patients) - patients after reconstructive surgery with the use a fibula autograft with the inclusion of a musculocutaneous «islet¼. To correct the prosthetic bed soft tissues, all patients underwent vestibuloplasty with the use of a free dermal autograft. To study microcirculation in tissues, the laser Doppler flowmetry (LDF) method was used. Microcirculation status was assessed by microcirculation index characterizing the level of tissue blood flow; parameter «σ,¼ which determines the oscillability of the flow of red blood cells and by coefficient of variation, characterizing vasomotor activity of microvessels. According to the Wavelet analysis of LDF-grams the blood flow bypass was determined. An oxygenation study was carried out in the tissues of the plastically restored jaw by optical tissue oximetry, the results of which determined the oxygenation index and the specific oxygen consumption index. RESULTS: According to LDF data after vestibuloplasty, it was found that in I group, the microcirculation in soft tissues of the plastically reconstructed jaw restored in 21 days, and in II group in 2 months, which persisted at 6 months. In I group, the level of oxygenation and specific oxygen consumption normalized in 21 days, and in II group in 2 months, which persisted at 6 months. CONCLUSION: Based on the results of this functional study, it was found that before vestibuloplasty microcirculation and oxygenation indices in II group patients were lower than those in I group patients. After vestibuloplasty with the use of a free dermal autograft, microcirculation indices in II group patients restored in 2 months, while in I group patients those indices restored in 21 days.

[The use of photodynamic therapy in the complex treatment of chronic generalized moderate periodontitis]. / Primenenie fotodinamicheskoi terapii v kompleksnom lechenii khronicheskogo generalizovannogo parodontita srednei stepeni.

OBJECTIVE: Improving the effectiveness of the treatment of chronic generalized periodontitis by photodynamic therapy (PDT) due to clinical and functional validation of the effects of a photosensitizer. MATERIAL AND METHODS: A clinical and functional study and treatment of moderate chronic generalized periodontitis was carried out in 60 people (24 males and 36 females) aged 35 to 50 years without somatic pathology with orthognathic bite. The patients were divided into 2 groups depending on the type of treatment: group 1 (main) included 30 patients (17 males and 13 females, mean age of patients was 42.5±3.3 years) who received comprehensive treatment consisting of oral sanitation, removal of dental plaque and curettage of periodontal pockets followed by PDT with 1% Geleophor gel using an AFS Spektr LED emitter with a wavelength of 660 nm and a power of 2.5 W, the course consisted of 4 procedures with exposure time of 7 minutes each; group 2 (control) included 30 patients (11 males and 19 females, mean age of patients was 43.0±2.1 years) undergoing standard treatment followed by protective capping with no active therapeutic agent. The state of microcirculation in tissues was studied by the laser Doppler flowmetry (LDF) using the LAKK-M device (Lazma, Russia). RESULTS: According to LDF data in both groups, it was found that the improvement of microcirculation in periodontal tissues after complex treatment is accompanied by an increase in blood flow and its activity, at that the level of oxygenation and specific oxygen consumption increased more pronounced after PDT, the effect persisted after 6 and 12 months. CONCLUSION: The use of PDT with LED emitter has a normalizing effect on the state of microcirculation and oxygenation in periodontal tissues.

[Chronic tonsillitis and periodontal diseases]. / Khronicheskii tonzillit i zabolevaniya parodonta.

INTRODUCTION: Chronic tonsillitis is a multifactorial immunopathological process that contributes to the development of tonsillitis-associated pathology. In turn, this tonsillitis-associated pathology potentiates and aggravates the course of chronic tonsillitis. In the literature, there are data on the possible influence of oropharyngeal loci of focal chronic infection on the body as a whole. One of such foci that can aggravate the course of chronic tonsillitis and maintain sensitization of the body are periodontal pockets formed during the inflammatory process in periodontal tissues. Highly pathogenic microgranisms of periodontal pockets secrete bacterial endotoxins, stimulating the immune response of the human body. Bacteria and their waste products cause intoxication and sensitization of the whole organism. A vicious circle is formed, which is quite difficult to break. OBJECTIVE: To study the effect of chronic inflammatory process in periodontal disease on the course of chronic tonsillitis. MATERIAL AND METHODS: 70 patients with chronic tonsillitis were examined. Together with a dentist-periodontist, an assessment of the state of the dental system was carried out, according to the results of which all patients with chronic tonsillitis were divided into 2 groups: with and without periodontal diseases. RESULTS: In patients with periodontitis, highly pathogenic flora is found in periodontal pockets. When examining patients with chronic tonsillitis, it is important to assess the condition of the dental system, to calculate dental indices, the key of which are periodontal and bleeding index. It is necessary to recommend comprehensive treatment for patients with CT and periodontitis by otorhinolaryngologists and periodontists. CONCLUSION: It is necessary to recommend comprehensive treatment by otorhinolaryngologists and dentists to patients with chronic tonsillitis and periodontitis.

[Modern achievements of the functional diagnostics in dentistry]. / Sovremennye dostizheniya funktsional'noi diagnostiki v stomatologii.

The article presents the development of functional research methods in the maxillofacial region, methods of their application and the results of scientific research on the study of the neuromuscular balance of the masticatory muscles with defects and deformations in the maxillofacial region. Methods of blood circulation research (laser doppler flowmetry, ultrasound dopplerography, computer capillaroscopy) have been developed and implemented in the tissues of the maxillofacial region: periodontal, tooth pulp, in the mucous membrane of the alveolar ridge, which allowed us to study the mechanisms of disease pathogenesis and monitor the effectiveness of treatment in the maxillofacial region.

[Comparative assessment of the processes of adaptation of supporting tissues in prosthetics with the use of implants]. / Sravnitel'naya otsenka protsessov adaptatsii opornykh tkanei pri protezirovanii s primeneniem implantatov.

OBJECTIVE: The study of the adaptation processes of supporting tissues during removable prosthetics with the use of implants according to the data of microhemodynamics and oxygenation in the supporting tissues. MATERIAL AND METHODS: A clinical and functional study of the state of supporting tissues was carried out in 60 people aged 50 to 65 years with a diagnosis of complete loss of teeth in the lower jaw during orthopedic treatment based on dental implants, which were divided into 2 groups: group 1 (29 people) - with the use of removable structures with locking with a lock attachment (type locator). Group 2 (31 people) - in which orthopedic treatment was carried out with the production of removable prostheses with fixation on telescopic crowns. Implantation was performed using intraosseous implants from Astra-Tech (Sweden). Orthopedic treatment was carried out according to the generally accepted method. To study the state of microcirculation in the mucous membrane of the alveolar ridge, the method of laser Doppler flowmetry (LDF) was used using a LAKK-M device (NPP Lazma, Russia). The state of microcirculation was assessed by the index of microcirculation (M), which characterizes the level of tissue blood flow; parameter «σ¼, which determines the fluctuations in the flow of erythrocytes. According to the Wavelet analysis of LDF-grams, the shunting index (PS) of blood flow was determined. Using the multifunctional diagnostic laser complex «LAKK-M¼ in the «LDF + spectrometry¼ mode, we studied oxygenation in periodontal tissues by optical tissue oximetry (OTO), the results of which were used to determine the oxygenation index in the mucous membrane of the alveolar ridge (SpO2) and the specific consumption index oxygen (U,%). RESULTS: According to LDF data, it was established that the level of microcirculation in the mucous membrane of the alveolar ridge in response to the functional load after fixation of the removable prosthesis with fixation on locators (group 1) and on telescopic crowns (group 2), it is accompanied by an increase in the level of M and σ by 37% and 66%, and by 2.2-2.4, respectively, which indicated the development of hyperemia in the microcirculatory bed, which is associated with functional load and persists up to 3 and 6 months, respectively. Restoration of microcirculation occurs after 6 and 12 months, respectively, after prosthetics, depending on the supporting elements. After fixation of the removable prosthesis, SpO2 and U decreased, which characterized the development of hypoxia in the tissues due to functional load, which stopped after 3 and 6 months, respectively. CONCLUSIONS: The study showed that in orthopedic treatment based on implants, adaptation processes according to microhemodynamics and oxygen metabolism in supporting tissues occur 3-6 months after prosthetics, depending on the design of the supporting elements.

[Rationale for the use of bioactive cements by in vitro simulation of accidental pulp opening]. / Obosnovanie primeneniya bioaktivnykh tsementov dlya sokhraneniya zhiznesposobnosti pul'py pri ee sluchainom vskrytii.

OBJECTIVE: To study the features of reparative dentinogenesis when using biomaterials during accidental opening of the pulp in an experiment. MATERIAL AND METHODS: In an experiment on 3 dwarf pigs of the Svetlogorsk breed a traumatic opening of the tooth cavity was carried out in 18 teeth (6 molars, 6 premolars, 6 incisors), then Biodentin (9 teeth) and Aurosil (9 teeth) were applied on the opened pulp horn. After 14, 30 and 60 days, dwarf pigs were euthanized, and jaw blocks taken. Histological examination of the teeth was carried out using the method of embedding in methyl methacrylate (OsteoBead, Sigma, USA). Thin sections of 35-50 microns were made from the samples and stained using the «Heavenly Trichrome¼ method. Documentation was carried out using a Leica DM100 microscope and an EC3 digital camera in reflected and transmitted light. RESULTS: Histological examination of the thin sections of teeth stained according to the «Heavenly Trichrome¼ method revealed that 2 weeks after the pulp opening and applying of Aurosil and Biodentin, comparable processes occurred in the tooth cavity. Thus, the proliferation of odontoblasts was noted on the lateral surfaces of the chamber. New dentin layers and odontoblasts spread over the lower surface of the material with the formation of dentinal bridges by 4 weeks of observation in both groups. By week 12, there was a decrease in the proliferative activity of odontoblasts and dentin maturation in all cases. At the initial stages of the experiment, some pulp edema and moderate plethora were noted, which was no longer observed at 4 weeks. By 12 weeks, because of the proliferation of odontoblasts, the volume of the tooth cavity was reduced by a third. By the 6th month in the experiment, no significant changes in the structure of dentin and pulp were revealed. CONCLUSION: According to morphological data the studied biomaterials (Aurosil and Biodentin) contribute to dentin regeneration equally.

[The state of microhemodynamics and oxygenation in the mucous membrane of the alveolar ridge after gingival contouring during dental implantation]. / Sostoyanie mikrogemodinamiki i oksigenatsii v slizistoi obolochke al'veolyarnogo grebnya posle konturnoi plastiki desny pri dental'noi implantatsii.

The results of a comparative assessment of the state of hemomicrocirculation and oxygen metabolism in the mucous membrane of the alveolar crest after contour plastics of the gums during dental implantation using a connective tissue graft from the upper jaw, a connective tissue transplant from the palate and the collagen matrix collagen matrix are presented. During contouring with the use of connective tissue graft (CTG) from the upper jaw and collagen matrix in the mucous membrane of the alveolar mandible, the level of tissue blood flow decreases, which characterizes the development of ischemia, which is stopped after 3 weeks, when using a connective tissue graft (CTG) from the palatine, the level of tissue blood flow rises, which indicates the development of hyperemia, which is stopped for more than 3 weeks. According to oximetry data after contouring with the use of various surgical techniques, the level of oxygenation and oxygen metabolism is reduced by 8-38%, which characterizes the development of hypoxia, which is stopped after 3 weeks when using CTG from the hillock of the upper jaw and collagen matrix for more than 3 weeks when applying CTG from the palatine.

[Spectrophotometric assessment of photodynamic teeth bleaching]. / Otsenka effektivnosti fotodinamicheskogo otbelivaniya zubov.

THE AIM: Clinical analysis of the effectiveness of photodynamic tooth whitening according to the spectrophotometric method. MATERIAL AND METHODS: Photodynamic tooth whitening was performed in 35 patients aged 20-45 years, on the teeth of the frontal group. To record the optical characteristics of enamel, the spectrophotomerism method was used. RESULTS: The study reliably shows that the average change in color saturation «C¼ ranged from 0.5 to 2 units. The optical characteristic of luminosity "L" before and after photodynamic exposure remained within the limits of healthy enamel, and the optical characteristic of whiteness on the scale of whitened teeth was 2 units. CONCLUSION: The method of photodynamic therapy can be used in dental practice to conduct a teeth whitening procedure.

[Achievement of consensus and standardization of methods in dentistry on the example of studies of support reactions (posturography, stabilometry)]. / Dostizhenie konsensusa i standartizatsiia metodov v stomatologii na primere issledovanii opornykh reaktsii (posturografii, stabilometrii).

Comprehensive treatment of dental pathology involves a multidisciplinary integration of doctors, the use of general physiological control methods and correction of human conditions, such as study of support reactions (on the stabilometric platform). Participation of dentists in the public scientific-methodological initiative 'Moscow consensus on the use of stabilometry and biofeedback for the support reactions in public health practice and research' increases the efficiency of application of this method in dentistry and the development of relationships with other practical areas.

[The feasibility of combined lipofilling methods in the treatment of patients with facial hemiatrophy]. / Vozmozhnosti primeneniia kombinirovannykh metodov lipofilinga pri lechenii patsientov s gemiatrofiei miagkikh tkanei litsa.

The basis of Central Research Institute of Dentistry and Maxillofacial Surgery in the period from 2015 to 2018 years there were 30 patients with primary hemiatrophy (group 1) and patients with hemiatrophy after reconstructive operations (group 2) who were examined and treated. The elimination of deformation of soft tissues was performed by combination of micro-, nano- and classical lipofilling in two sessions with an interval of 6 months. To determine the deficit of tissue volume on the affected side before and at the treatment stages, a computer tomography was performed with the construction of the mathematical surface of the face. A study of the nature of the changes in the underlying structures in each group was carried out using ultrasound scanning and LDF studies. The use of non-invasive research methods allows us to track the dynamics of skin transformation. Based on the results of the treatment in 2 groups, a combination of micro-, nano- and classical lipofilling did not only increase the volume and eliminate deformation soft tissue, but also transform the quality of the skin. Thus, the combination of various lipofilling methods allowed to achieve a more stable result and increase the efficiency of treatment.

[Relationship between masticatory muscles activity and motor cortex activation during treatment of patients with distal malocclusion]. / Vzaimosviaz' izmeneniia aktivnosti zhevatel'nykh myshts i motornykh zon kory golovnogo mozga pri lechenii patsientov s distal'noi okkliuziei.

The processes of neuroplasticity of the motor cortex of the brain were evaluated in the treatment of 20 (12 women and 8 men) patients aged 18-35 years (22.5±1.5 years) with distal occlusion using functional magnetic resonance imaging (fMRI), as well as comparison of surface myography (EMG) data to assess the adaptive capabilities of the tooth-jaw system and the central nervous system against the background of orthodontic correction. Correction of distal occlusion was carried out using ceramic braces 'Damon' (f. 'Ormco', USA). The advancement of the lower jaw forward with bite enhancement was carried out using the Twin force device ('Ortho Orgonizers GmbH', Germany). The study was conducted in five stages: 1) before orthodontic correction; 2) before installing the Twin force device; 3) after anterior displacement of the lower jaw and bite enhancement on the Twin force device; 4) after removing the brackets; 5) 1.5 months after the treatment. FMRI proved to be a useful tool for orthodontic treatment efficacy assessment and neuromuscular adaptation of maxillofacial structures to changing functional status.

[Analysis of photosensitizer gel penetration through the teeth structure]. / Analiz glubiny proniknoveniia gelia fotosensibilizatora v strukturu tkanei zubov.

As a result of the studies carried out on 20 extracted frontal teeth it was reliably shown that after 10 minutes the concentration of the photosensitizer in enamel at full depth reached values sufficient for performing photodynamic teeth whitening. At the same time, the penetration of the photosensitizer into the deep layers of dentin was not detected which allows to carry out the photodynamic bleaching procedure only within the enamel and enamel-dentine boundary, thus not affecting the pulp of the tooth.

[The study results of the alveolar ridge mucosal microcirculation after bone augmentation using the Tunnel Technique method]. / Rezul'taty issledovaniia mikrotsirkuliatsii slizistoi obolochki al'veoliarnogo grebnia posle vypolneniia tunnel'noi tekhniki kostnoi plastiki.

It reports the results of primary basal blood flow in partially edentulous bone tissue with atrophy, as well as comparative evaluation of haemomicrocirculation level of the alveolar bone mucosa after bone augmentation via tunneling and conventional methods. The results of the initial state of microcirculation in the mucous membrane of the alveolar process in the partially edentulous area show a 45% decrease of blood flow (M), its intensity (s) by 60%. Microcirculatory shifts in blood flow levels indicators, its intensity, vasomotor activity are more evident when using the conventional method, where revascularization takes more than five months. When using the tunnel method, there is an improvement in haemodynamic mechanisms of tissue blood flow regulation. Microcirculation is restored 4 months after surgery.

[Changes of postural statusa in patients undergoing orthodontic treatment]. / Izmenenie postural'nogo statusa pri ortodonticheskom lechenii narushenii prikusa.

The study objective was to determinate variations of stato-dynamical functional markers of postural balance system in the process of malocclusion treatment. Twenty patients aged from 14 to 30 years with class II malocclusion were recruited for this prospective study. All patients underwent electromyography of mm. temporalis and mm. maseter in rest and at maximal jaws pressure. Postural balance was evaluated by stabilometry platform and body's regions relationship was assessed by computer optical topography. Orthodontic interventions included using occlusal splint, dental straps or 'TwinForce' device. There were two diagnostic sessions: before and after one month of orthodontic treatment. The majority of patients after anterior dislocation of mandible demonstrated significant increase in unilateral masticatory muscles activity (р<0.05) which correlated with iliac crest position. According to computerized topography data superior iliac crest position was registered in opposite side with regard to muscle hypertonia. According to stabilometry data forward translation of the mandible resulted in retroversion of total pressure point projection (р<0.05). Asymmetric muscle working in the process of occlusal adjustment may provoke postural imbalance in distal body regions. It dictates postural system condition monitoring during orthodontic treatment.

[Regeneration of dental pulp tissue using pulpal autologous mesenchymal stem cells and platelet-rich plasma]. / Regeneratsiia pul'py zuba s ispol'zovaniem autologichnykh mezenkhimal'nykh stvolovykh kletok pul'py i obogashchennoi trombotsitami plazmy.

Regeneration of pulp and dentin could be important in operative dentistry as a method to save teeth. Currently cell population from dental pulp of deciduous and permanent teeth of humans and laboratory animals are isolated and characterized. The paper presents a study on pulp regeneration using autologous mesenchymal stromal cells from pulp of molars in combination with fibrin clot, transplanted in pulp chamber of miniature pigs after pulp removal. The results proved that transplantation of autologous multipotent stromal cells of dental pulp in combination with autologous platelet-rich plasma in pulp chamber of miniature pigs after pulp removal leads to pulp restoration and reparative dentinogenesis with dentinal bridge formation on the 30th day. However, the completion of regeneration also results in a decrease in the pulp chamber volume due to the neodentin bedding. Tissue regeneration of dental pulp by direct pulp capping in the absence of inflammatory processes is a promising direction of the use of cellular technologies.

[Modern approaches to periodontal microcirculatory parameters assessment]. / Sovremennye podkhody k otsenke pokazatelei mikrogemodinamiki v tkanyakh parodonta.

The article presents comprehensive functional study of periodontal tissues in 62 patients aged 20-45 with periodontal disease by laser Doppler flowmetry, Doppler ultrasound and computer capillaroscopy. All patients were divided into 5 groups depending on the severity of inflammation in the periodontium (chronic gingivitis, light, moderate and severe chronic periodontal disease). The relationship between microcirculatory indexes was evaluated by Pearson Product Moment Correlation or PPMC. The study shows high correlation between blood flow velocity measurement, diameter of microvessels and oxygen saturation in periodontal tissues that establish a direct relationship between studied parameters.

[Microcirculation impairment in periodontal tissues in patients with chronic generalized periodontitis combined with metabolic syndrome].

Using the method of laser Doppler flowmetry the study of microcirculation in periodontal tissues in patients with moderate chronic generalized periodontitis and metabolic syndrome was carried out. The analysis of microcirculation values proved not only the reduction of blood flow intensity but also the decreased vasoactivity of microvessels essential to maintain normal microcirculation in periodontal tissues, as it provides active modulation of tissue blood flow and its adaptation to local metabolic needs.

[Microcirculation in periodontal tissues assessed by computer capillaroscopy in patients with periodontal disease and metabolic disorders]. / Sostoianie mikrotsirkuliatsii v tkaniakh parodonta po dannym komp'iuternoi kapilliaroskopii u patsientov s khronicheskim generalizovannym parodontitom na fone metabolicheskikh narushenii.

The method of capillaroscopy was used to study microcirculation in periodontal tissues in patients with metabolic syndrome and evaluation of vascular disorders in periodontal disease. In addition to visual assessment of the microcirculation morphometric features of microvessels were obtained: capillary diameter, capillary blood flow velocity, density of capillary network. Computer capillaroscopy thus allowed revealing the structural features of microvessels and their distribution in periodontal tissues.

[Adhesion as criterion of choice of materials for dental restorations of defects in cervical area]. / Adgeziia kak kriterii vybora materiala dlia restavratsii zubov s defektami v prisheechnoi oblasti.

The paper presents the results of comparative in vitro evaluation of classical and flow consistency restorative polymeric materials (Japan and Russia) adhesion to dentin in cervical area. The adhesive properties of these materials were compared with the experimental systems of "sandwich" type, combining layers of classic and flow consistency, glass-ionomer cement Fuji 8 (Japan) and material SMARTCEM 2 (Switzerland). The highest dentin adhesion strength showed Fuji 8, restoration materials of classical consistency proved to have advantage in adhesion properties.

[Computer capillaroscopy for periodontal microcirculation assessment in patients with early atherosclerotic lesions].

The study of gingival microvessels was carried out by means of computer capillaroscopy in patients with moderate periodontal disease and early symptoms of atherosclerosis of extracranial portions of cephalic arteries. The results proved the decreased density of the capillar network in the marginal gingiva, as well as of linear and volumetric blood flow velocities drop in the arterial and venular portions of capillaries in patients with periodontal diseases combined with early atherosclerosis.