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Background/Objectives: Chronic kidney disease (CKD) influences different organs including the temporomandibular joint (TMJ). This study aims to identify structural and functional TMJ changes in children with CKD using ultrasound as the least invasive and most accessible method. Methods: TMJ changes were examined using ultrasound screening in 40 children. The first group (control, n = 10) included children with normal occlusion without TMJ complaints. The second group (n = 10) included children with CKD stage 1 and 2. The third group (n = 10) included patients on hemodialysis after renal transplantation. The forth group (n = 10) included patients at least 6 months after renal transplantation. Results: The size of the anterior section of the right TMJ gap in the third group was the largest among all the groups studied (1.085 mm) and statistically significantly different from the first group (0.570 mm; p = 0.001) and the second one (0.665 mm, p = 0.001). The width of the middle section was also greatest in the third group and statistically significantly different when compared to the first and second groups (0.390 mm; p = 0.023 and 0.340 mm; p < 0.001, respectively). A posterior articular gap width differences between the individual patient groups under study were not statistically significant in a posteriori comparison with Bonferroni correction. Statistical significance of differences between all groups when comparing the gap width was found in all sections of the left TMJ. The frequency of anterior disc displacement between groups ranged from 50 to 100% in all groups studied and was not statistically different when comparing right and left TMJs between groups (p = 0.084 and p = 0.662, respectively). Conclusions: CKD children have different TMJ changes, so TMJ ultrasound could screen joint pathology at early stages, and dental specialists can start timely rehabilitation.

Children with cerebral palsy suffer from dental diseases almost three times more often than healthy children. Risk factors that cause the development of dental diseases in children with CP include low rates of unstimulated salivation rate, acidity, increased saliva osmolarity and total protein concentration, which indicates a violation of hydration. The above factors contribute to the formation of acquired pellicles and biofilms due to increased bacterial agglutination. Ultimately, this contributes to the accelerated formation of plaque. There is a tendency to increase the concentration of hemoglobin and reduce the degree of oxygenation of oxyhemoglobin and, as a result, to increase the active forms of oxygen and nitrogen, which, in turn, have a toxic effect and lead to cell death. Photodynamic therapy (PDT) using photosensitizers (FS) improves blood filling and the degree of oxygenation in periodontal tissues, and also allows the elimination of bacterial biofilm. At the same time, opto-spectral diagnostics painlessly in the monitoring mode allows to identify and fix tissue areas with low hemoglobin oxygenation rates for precision photodynamic effects. PDT is a method used as a therapy for oral diseases of various origins, such as cancer, precancerous diseases, caries, periodontitis and gingivitis. Initially, methylene blue was the first dye used in medicine as an antiseptic, as well as the first tested and approved photosensitizer for antimicrobial photodynamic therapy. The use of photodynamic therapy with methylene blue as a photosensitizer can allow to deactivate inflammation and completely destroy bacteria in the biofilm, which will contribute to the functional normalization of gum tissue and restore oxygenation in the microcirculatory bed. The advantages of this method are antibacterial, anti-inflammatory and wound healing effects. The article presents the literature data on photodynamic therapy with the use of methylene blue in children, on the methodology and results of the use of this treatment technique in practice.

Background/Objectives: End-stage chronic kidney disease (ESKD) represents a complex condition that also impacts oral health. This pilot study evaluates and compares some approaches to oral health assessment and aims to define the specific oral features common in adolescents with ESKD. Methods: A total of 50 children aged 12 to 17 years were examined, including 30 adolescents with ESKD (Group 1) and 20 adolescents without urinary pathology (Group 2). The decayed, missing, filled teeth (DMFT) index, oral hygiene index-simplified, papillary marginal attached index, and periodontal index were used for dental and periodontal assessment. The Milwaukee PH56 device was used to determine salivary pH. Oral microbiota was analyzed by chromatography–mass spectrometry and polymerase chain reaction detection of periodontopathogenic bacteria. Salivary and gingival crevicular fluid (GCF) biomarkers (IL-1β, TNF-α, IL-8, VEGF, sIgA) and total antioxidant capacity (TAC) were determined using an enzyme-linked immunosorbent assay. Results: DMFT did not differ between the groups. Periodontal indices in Group 1 were increased compared to Group 2 (p < 0.0001). Salivary pH in Group 1 was slightly alkaline; in Group 2, it was slightly acidic (p < 0.0001). Oral dysbiosis and periodontopathogenic bacteria were found in ESKD adolescents. Salivary IL-1β, TNF-α, VEGF, and IL-1β in GCF were elevated in Group 1 compared to Group 2 (p < 0.05). TNF-α, IL-8, and VEGF in GCF and TAC in both fluids were lower in Group 1 compared to Group 2 (p < 0.0001). Salivary IL-8 and sIgA in both saliva and GCF did not differ between the groups. Conclusions: ESKD adolescents had poor oral hygiene and significant oral dysbiosis including periodontopathogenic bacteria. Evaluation of biomarkers in saliva and GCF allowed us to vindicate inflammation, dysbiosis severity, and periodontal diseases.

Objective. To study bone turnover markers in biological fluids (urine, blood serum, oral fluid (OF) and gingival crevicular fluid (GCF)) at the stage of planning an orthodontic strategy in children with end-stage chronic kidney disease (ESKD).Materials and methods. Pilot, cross-sectional, multicenter study was conducted. A total of 48 children aged 7 to 17 years were examined and divided into three groups: 14 children with ESCKD, 14 children with renal transplant dysfunction (RTD), 20 almost healthy children. Bone turnover markers were assessed by changes in osteocalcin (OC) in the OF, GCF and blood serum, urinary deoxypyridinoline (DPD), levels of total, ionized calcium and phosphorus in blood and pH of OF. Bone tissue mineral density was assessed by cone-beam computerized tomography according to the C. Mish classification.Results. All groups of children were comparable by gender and age. All patients had no significant mineral and bone disorders. Total and ionized calcium did not demonstrate statistically significant differences between the study groups. Serum phosphorus level was higher in ESCKD children compared to RTD children and control group. Urinary DPD, OC in GCF and OF pH were higher in children with CKD compared to healthy children. However, there were no statistically significant changes between the ESCKD group and the RTD group. In the posterior maxilla, the Hounsfield index was higher in the group with RTD compared to the ESCKD group (p < 0.01), and similar to the control group. In the anterior maxilla, as well as in the anterior and posterior mandibular regions, the Hounsfield index was higher in the control group than in the ESCKD and RTD groups.Conclusion. The most prominent changes of bone turnover markers were found in children with ESCKD. Urinary DPD and OC in GCF were associated with the decrease in kidney function and jawbone mineral density.

Aim: to evaluate the level of knowledge about dental trauma injury and first aid skills among teachers of educational institutions by means of a survey in Moscow, Russia. Materials and methods: A questionnaire, consisting of 4 parts and including 20 questions, including questions from the category of own experience in working with this problem, awareness of the problem of complete dislocation of the tooth, first aid skills and motivation for training. Several questions have multiple answers. The survey accepted 56 people from 1 educational institution. Results: the study indicated the knowledge level of teachers to be quite low. Early help reduces the risk of complications. The priority treatment provided within the educational institution will seriously affect the increase in the number of positive outcomes. Timely assistance, which can be provided by teachers from among the teachers of educational institutions, significantly reduces the risk of developing complications that can negatively affect the psychoemotional health of the child in adolescence. Early diagnosis, prophylaxis or treatment of dentate abnormalities at an early age help to avoid further progression of pathologies, save material means and time. Conclusions: the authors identified a lack of first aid skills in working with children who received an acute tooth injury, as a result of this, the need was revealed to train teachers of school educational institutions in theoretical and practical foundations for this group of pathologies, to conduct further clinical studies that will improve the epidemic situation around the world and in Russia in particular.