The prevalence of periodontal diseases is increasing, tends to increase with age and is considered as one of the main causes of tooth loss. To assess the effectiveness of new methods of treatment of periodontal diseases, studies on laboratory animals can be promising. The aim of the study: to develop a new method of accelerated modeling of experimental periodontitis on laboratory animals. Material and methods. The study was carried out on 22 female rats. A wire ligature was applied to the cervical area of the incisors of the animals in an eight-shaped manner. Plaque obtained from a patient with periodontitis was placed under the wire, and nicotine and ethyl alcohol solutions were injected under the gingival mucosa. A complex index has been proposed to assess inflammation. At the end of the experiment the animals were euthanized, their jaws were dissected into dentoalveolar blocks and further descriptive histologic analysis was performed. Results. On the second day the gingiva of the rats acquired a cyanotic-pink color, on the fourth day the consistency of the gingiva became friable, mobility appeared in the lower incisors. Complex index of inflammation in animals of the main group: before the study—9, on the 7th day—195. Gingival preparations showed signs of exudative inflammation. In alveolar processes—irreversible resorption of bone structures. The difference of indicators in animals before and after the experiment was statistically significant (p < 0.05). Conclusion. The new experimental model of periodontitis is reproduced in a short period of time, provides intensive development of inflammation, leads to disruption of the integrity of epithelial and connective tissue attachment, destruction of alveolar bone.

Relevance. The growing prevalence of combined endo-perio lesions (EPL) attracts the interest of researchers. Insufficiently covered in the scientific literature, issues of the anatomical and functional relationship between periodontal tissues and dental pulp, the lack of an algorithm for diagnosis and treatment of EPL determine the need for their research. The study aimed to arrange the available data on the morpho-functional aspects of the relationship between dental pulp and periodontal tissues and their features that determine the p athogenesis of EPL.Materials and methods. The study found 2875 publications, presented in the international electronic scientific databases PubMed, Google Search, Embase, Web of Science, ScienceDirect, SciELO and eLibrary. Following the inclusion and non-inclusion criteria, we selected 52 publications, which included the results on studying the structure and function of periodontal tissues, roots and pulp of teeth in the aspect of EPL development. The methodology of this study meets the criteria for systematic reviews and meta-analyses (PRISMA).Results. In EPL lesions, inflammation is maintained by an infection, which persists in the additional root canals and dentinal tubules and the periodontal pocket. Prevention of the formation and elimination of infection foci in the root canal system of the tooth, periapical tissues and periodontal pockets is the basis for EPL prevention and treatment. At the same time, there are no diagnostic and therapeutic algorithms, which allow timely detection of EPL and adequate treatment, depending on the primary lesion of pulpal and periodontal tissues and individual characteristics of the patient. The structure specifics of roots, pulp, cementum, periodontium and alveolar bone are described. The characteristic features of blood supply and innervation of the pulpal and periodontal tissues are presented. Promising areas of scientific research in EPL prevention and treatment are identified.Conclusion. Tooth pulp and periodontal tissues are closely related morphologically and functionally. They are principally connected through the apical foramina and additional canals. Bacterial infection can also penetrate the pulp and periodontal tissues from the infected root canal system of the tooth through the dentinal tubules of the tooth root.

Backgroud: The aim of this study was to create an accessible, simple and reliable method for assessing the relative density of bone tissue in dentistry based on the analysis of digital panoramic radiographs. Methods: Measurement of average gray values on orthopantomograms was carried out using ImageJ Version 1.54i software. To estimate the relative bone density, functions for selecting regions of interest (ROI), calculating the area of selection, and statistics of the selected area were used. Statistical characteristics of samples and testing of hypotheses using statistical criteria were performed using Microsoft Excel. Results: we found that when manually selecting the reference and comparison areas for areas without signs of pathological changes in bone tissue, the average standard deviation was 0.058, and the coefficient of variation was 0.055 ± 0.011%, which makes the choice of the jaw angle as a reference more preferable. The average relative bone density of the assessed defective areas to the jaw angle was 0.64 ± 0.11, and the average relative bone density of the areas without pathology to the jaw angle was 1.052 ± 0.058. Conclusions: a research protocol was developed and justified using the ImageJ software package, which establishes a strict procedure for quantitative assessment of relative bone density based on the results of digital panoramic radiography. The proposed protocol can be used to monitor the condition of bone tissue after all types of dental treatment over time.

Эндопародонтальные поражения (ЭПП) — клинические состояния с вовлечением в патологический процесс как пульпы зуба, так и тканей пародонта. Недостаточно данных об эффективности применения разных протоколов лечения и профилактики ЭПП, отсутствуют диагностические алгоритмы, позволяющие врачу правильно поставить диагноз. Прогноз играет ключевую роль при планировании лечения. Цель исследования — обобщить имеющиеся данные о современных методах лечения и профилактики, прогнозировании течения и исходах ЭПП. Проведен систематический обзор данных литературы в PubMed, Google Search, Ebsco, Embase, Web of Science, ScienceDirect, SciELO и eLibrary с 2000 по 2023 г. Найдено 1721 публикация, отобрано 54 публикации, которые включали результаты изучения диагностики, лечения и профилактики, прогнозирования и исходов ЭПП. Методология соответствует требованиям для систематических обзоров и метаанализов PRISMA. Описаны традиционные протоколы, а также современные подходы к лечению и профилактике ЭПП. Отдельное внимание уделено прогнозированию развития и исходам ЭПП; выделены прогностические критерии и факторы, ухудшающие исход лечения ЭПП. Представленный детальный систематический анализ показал, что проблемы лечения и профилактики, прогнозирования и исходов ЭПП изучены недостаточно и представляют собой сложную задачу для клиницистов. Данные полученные в ходе исследования помогут практикующим врачам-стоматологам в определении прогноза ЭПП и разработке комплексных лечебно-профилактических мероприятий. Endo-periodontal lesions (EPL) are clinical conditions involving both the tooth pulp and periodontal tissues in the pathological process. There is insufficient data on the effectiveness of the use of different protocols for the treatment and prevention of EPL, there are no diagnostic algorithms that allow the doctor to correctly diagnose. Prognosis plays a key role in treatment planning. The purpose of the study: to summarize the available data on modern methods of treatment and prevention, prognosis of the course and outcomes of EPL. . A systematic review of the literature data was carried out, 1721 publications were found, presented in international electronic databases: PubMed, Google Search, Ebsco, Embase, Web of Science, ScienceDirect, SciELO and eLibrary from 2000 to 2023. Based on the selection criteria, 54 publications were selected, which included the results of studying the diagnosis, treatment and prevention, prediction and outcomes of EPL. The methodology of this study meets the requirements for systematic reviews and meta-analyses of «PRISMA». . Traditional protocols are described, as well as modern approaches to the treatment and prevention of EPL. Special attention is paid to the prediction of the development and outcomes of EPL; prognostic criteria and factors that worsen the outcome of EPL treatment are highlighted. . The presented detailed systematic analysis showed that the problems of treatment and prevention, prediction and outcomes of EPL are insufficiently studied and represent a difficult task for clinicians. The data obtained during the study can help practicing dentists in determining the prognosis of EPL and the development of comprehensive therapeutic and preventive measures.

The main ways of interrelation of pulp and periodontal tissues are normally the apical openings of the roots of the teeth and additional root canals. In addition, it is important to remember that the bulk of the tooth is dentin, permeated with the smallest dentine tubules, which can also serve as a road in the «endodont-periodontal» system. A doctor who is faced with endo-periodontal lesion (EPL) faces a difficult task, which consists in competent planning of complex treatment and predicting the patient's condition. And one of the main questions that a clinician needs to answer when planning effective prevention and treatment of EPL is «What is primary? ». This systematic review is devoted to the problem of the primacy of infection in EPL, as the most complex and poorly studied.Aim. To summarize the available data on the features of the etiology, pathogenesis, diagnosis and clinical course of EPL.Materials and methods. 3587 publications were found, presented in international lectronic databases: PubMed, Google Search, Ebsco, Embase, Web of Science, ScienceDirect, SciELO and eLibrary from 2000 to 2023. Based on the selection criteria, 65 publications were selected, which included the results of studying the structure of periodontal tissues and tooth pulp, etiology, pathogenesis, as well as the diagnosis and clinical course of EPL. The methodology of this study meets the requirements for systematic reviews and meta-analyses of «PRISMA».Results. The features of pulpo-periodontal relationships are described, data on the prevalence and classification of EPL are presented. Special attention is paid to the etiology of EPL and possible infectious agents involved in the pathogenesis of EPL. The clinical and diagnostic features of the course of EPL and the main approaches to treatment, depending on the primary infection of tissues, are described.Conclusions. The presented detailed systematic analysis showed that the problem of EPL, which has high relevance and significance, has not been studied enough, which does not allow to effectively diagnose, treat, prevent and predict this pathology.

Быстропрогрессирующий пародонтит как форма агрессивного течения пародонтита характеризуется выраженной потерей клинического прикрепления и деструкцией альвеолярной кости с ранней манифестацией у системно здоровых людей. Эффективность лечения такого заболевания невысокая, связана в том числе с уровнем приверженности пациента лечению, со сроками начала терапии и особенностью иммунной системы больного. Цель исследования — повысить эффективность лечения быстропрогрессирующего пародонтита путем включения в комплексную терапию новой методики интрапериопокетного гальванофореза c гидроксидом меди—кальция. Был оценен стоматологический (включая пародонтальный) статус, определены индекс зубной бляшки по Силнесс—Лоу, индекс кровоточивости десны при зондировании (BoP), папиллярно-маргинально-альвеолярный индекс (PMA), проведена периотестометрия с помощью прибора Periotest S. Состояние твердых тканей зубов и пульпы определяли с помощью вертикальной перкуссии, зондирования и электроодонтодиагностики (ЭОД) с помощью прибора ПульпЭст L (Геософт, Россия—Израиль). Методику интрапериопо´кетного гальванофореза проводили с препаратом гидроксида меди—кальция Купрал (HumanChemie, Германия) и полоской алюминиевой фольги, которую фиксировали медицинским клеем «Сульфакрилат» (НТО «Медицинские Инновации», Россия). Для обтурации отверстий дентинных канальцев и реминерализации дентина использовали Дентин-герметизирующий ликвид (HumanChemie, Германия). На 14-е сутки от начала лечения фиксировали купирование воспалительного процесса в тканях пародонта и уменьшение количества зубного налета по всем оцениваемым показателям. Динамика показателей ЭОД: в области зубочелюстных сегментов основной группы значения показателей увеличились через 6 месяцев после лечения в 1,7—3,5 раза. В области зубочелюстных сегментов группы сравнения значения ЭОД через 6 месяцев как увеличивались, так и уменьшались, от 1,3 до 2 раз по сравнению с исходными значениями. Проведенная терапия быстропрогрессирующего пародонтита с применением новой методики интрапериопо´кетного гальванофореза гидроксидом меди—кальция и глубоким фторированием дентина корней зубов в представленном клиническом случае показала свое преимущество перед традиционным лечением, является перспективной и может повысить эффективность лечения и свести к минимуму частоту рецидивов быстропрогрессирующего пародонтита. Rapidly progressive periodontitis, as a form of aggressive periodontitis, is characterized by a pronounced loss of clinical attachment and destruction of the alveolar bone with early manifestation in systemically healthy people. The effectiveness of treatment of such a disease is low, it is associated, among other things, with the level of patient’s adherence to treatment, with the timing of the start of therapy and the peculiarity of the patient’s immune system. The aim of the study was to increase the effectiveness of the treatment of rapidly progressive periodontitis by including in complex therapy a new technique of intraperiopoket galvanophoresis with copper—calcium hydroxide. . The dental (including periodontal) status was assessed, the Silness—Low dental plaque index, the gingival bleeding index during probing (BoP), the papillary-marginal-alveolar index (PMA) were determined, and periotestometry was performed using the Periodest S device. The condition of the hard tissues of teeth and pulp was determined using vertical percussion, probing and electro-dental diagnostics (EDI) using the Pulpest L device (Geosoft, Russia—Israel). The intraperiopocket galvanophoresis procedure was performed with Cupral copper—calcium hydroxide preparation (HumanChemie, Germany) and a strip of aluminum foil, which was fixed with Sulfacrylate medical glue (NTO “Medical Innovations”, Russia). Dentin-sealing liquid (HumanChemie, Germany) was used to obstruct the openings of the dentine tubules and ensure the remineralization of dentin. . On the 14th day from the beginning of treatment, the relief of...