Subject. Lichen planus is a chronic inflammatory disease of the skin and mucous membranes, less commonly affecting nails and hair, the typical elements of which are papules. In the structure of diseases localized on the oral mucosa, chronic lichen planus is up to 35―40 %. A number of authors indicate the nature of the development of lichen planus in the oral cavity caused by herpes, in particular type 4 herpes virus (Epstein―Barr). The goal is to increase the efficiency of diagnosis and treatment of patients with lichen planus associated with the Epstein―Barr virus. Methodology. This article illustrates the experience of managing a patient with exudative-hyperemic form of lichen planus associated with Epstein―Barr virus and the inclusion of antiviral drugs in the treatment regimen. The paper used clinical and laboratory methods for diagnosing the conditions under study. Results. In the course of the observation, a positive clinical and laboratory dynamics of the conditions under study was revealed when applying the modernized treatment plan for lichen planus. The appointment of systemic and local antiviral therapy can reduce the treatment time for lichen planus on the mucous membrane of the oral cavity and not resort to the appointment of local hormone therapy. Conclusions. In order to increase the effectiveness of the therapy for lichen planus, it is necessary to conduct a study to identify specific DNA not only for Epstein―Barr virus, but also for all herpes viruses due to immunotropy and persistence mainly in the cells of the oral mucosa. The use of a systemic antiviral component reduces the treatment time for dental manifestations of lichen planus and eliminates the need for corticosteroid therapy, which improves the quality of life of patients.

The problem of complications arising after dental implantation is still relevant. The aim of the work was to investigate the effect of various types of removable appliances and dental implants on the oral microbiocenosis during orthopedic treatment of 64 people: 12 patients of the first index group, 40 patients of the second index group and 12 people of the control group. 6 months after the implants were installed, as a result of a microbiological study of the oral cavity, the differences were found in the qualitative composition of the microflora of the mucous membrane around the neck of the dental implant. In the first index group representatives of normal microflora prevailed. In 100% of cases Streptococcus vestibularis was isolated, from more than half patients S. oralis, S. mitis, Rothia mucilaginosa were isolated, S. gordonii was isolated from one patient. In the second index group, a significant diversity of microbial species was observed, including enterobacteria, which were isolated from 22.5% of the examined patients. In the control group, in addition to representatives of the normal microflora of the oral mucosa S. vestibularis (75.5%), S. oralis (50.0%), Neisseria subflava (66.7%) and Haemophylus parainfluenzae (50.0%) were found. From all patients of the control groups S. gordonii was isolated, as well as the other potentially pathogenic streptococci species, S. anginosus and S. constellatus by 66.7%. The type of removable appliances and dental implants used affects the microflora composition of the oral cavity, and, consequently, the further prognosis and the risk of complications. Collapsible dental implant supported removable prosthetic appliances with a metal frame and fixing elements, telescopic crowns and clasps less than other types of prosthetic appliances change the qualitative composition of the microflora of the oral mucosa around the neck of the dental implant.

Background. Contemporary dental diagnosis should supplement clinical examination with instrumental diagnostic techniques. Raman spectroscopy has become widely adopted due to high spatial resolution, non-invasiveness, the lack of strict requirements and ease of sample preparation.Objectives. A qualitative assessment of enamel mineral and organic composition dynamics using Raman spectroscopy.Methods. Raman spectroscopy was used as primary research method. The trial bench consisted of a Shamrocksr-303i high-resolution digital spectrometer with built-in DV420A-OE cooled optical detector (spectral range 200–1200 nm), RPB-785 optic fibre scattering probe integrated with LuxxMaster LML-785.0RB-04 laser source with wavelength 785 nm.Software spectrum processing was performed with Wolfram Mathematica 9. Spectra were denoised with a median filter (5 points), the approximating line (fifth order polynomial) of autofluorescent component was determined in 700–2200 cm-1 range using an iterative algorithm and then subtracted to receive isolated Raman spectra.Linear discriminant analysis (LDA) of data was performed with the IBM SPSS Statistics package. Results. The assay included 28 teeth, with 14 extracted for orthodontic indications and 14 — for chronic periodontitis. Spectral dental enamel dynamics has been established in periodontal disease and after the in-office bleaching procedure. The evidence obtained can be applicable in dental practice to verify patients at risk of periodontal disease by interpreting the tooth enamel spectral properties, as well as prior to in-office bleaching.Conclusion. We demonstrate high efficiency of Raman spectroscopy for qualitative assessment of the mineral and organic enamel composition dynamics in various settings. Raman spectroscopy is confirmed effective and versatile in various aetiologies. It was successfully applied to diagnose periodontitis by changes in the organic and mineral enamel composition and evaluate enamel after in-office bleaching.

Трунин Д. А., Садыков М. И., Нестеров А. М., Постников М. А., Нестеров Г. М., Сагиров М. Р. ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России, г. Самара, Россия АннотацияВ статье представлен научный обзор литературы по актуальной проблеме восстановительной стоматологии: подготовка атрофированных малоподатливых тканей протезного ложа перед протезированием пациентов с полным отсутствием зубов на нижней челюсти. Несмотря на значительный прогресс в ортопедической стоматологии, проблема протезиро-вания пациентов с полным отсутствием зубов на нижней челюсти не теряет своей актуальности. От 15 до 46 % паци-ентов в возрасте 45-70 лет нуждаются в изготовлении полных пластиночных съемных протезов. Одним из факторов, непосредственно влияющих на фиксацию полного съемного пластиночного протеза на нижней челюсти, является состояние слизистой оболочки протезного ложа. Наиболее неблагоприятным для протезирования полными съемными пластиночными протезами считается 2 класс слизистой оболочки по классификации Суппле, который характеризуется истонченной, натянутой и сухой слизистой оболочкой протезного ложа, объем и податливость которого необходимо восстановить для достижения успеха в ортопедическом лечении таких пациентов. Проведено изучение хирургиче-ской, ортопедической и физиотерапевтической подготовки тканей беззубого протезного ложа нижней челюсти, а также их комбинации. Из известных методов заслуживают внимания способы пластики альвеолярной части нижней челюсти и увеличение объема мягких тканей беззубого протезного ложа методом Plasmolifting, а также комбинация введения аутоплазмы, богатой тромбоцитами, с изготовлением временных иммедиат -протезов на эластичной подкладке. Описаны преимущества и недостатки предложенных методов. Несмотря на множество различных способов подготовки протез-ного ложа перед протезированием, данная проблема остается до конца не решенной и требует дальнейшего изучения.Ключевые слова: беззубая нижняя челюсть, подготовка протезного ложа. MethOds Of preparatiOn Of prOsthetic Samara state medical university summaryThe article presents a scientific overview of the literature on the actual problem restorative dentistry: preparation lowsupple atrophied tissue prosthetic bed before the prosthesis patients with complete absence of teeth in the lower jaw. Despite significant progress in prosthetic dentistry, the problem of prosthesis patients with complete absence of teeth on the lower jaw does not lose its relevance. From 15 to 46 % of patients aged 45-70 years, need to manufacture complete dentures. One of the factors that directly affect the fixation of complete removable lamellar denture for the lower jaw is a condition of the mucous membrane of prosthetic bed. The most unfavorable for prosthetics full removable laminar dentures is considered as grade 2 3-9Литературные обзоры Reviews 3-9

An objective assessment of the morphofunctional characteristics of the state of soft tissues and bone structures adjacent to the dental implant allows to control the dynamics of the processes of osseointegration in the jaw-dental implant system. The aim of the work was to investigate the level of the β-CrossLaps, С-reactive protein (CRP), osteocalcin markers after orthopedic treatment of patients using dental implant supported advanced dental restoration technologies, to perform a biochemical analysis of the oral fluid of patients after restoration using dental implants and new two-part dental implants. In patients of the index group (52 people), the removable prostheses with metal frame and fixing elements or the commercially available dental implant supported removable prostheses were installed. For the patients of the control group (12 people), the commercially available dental implant supported removable prostheses of acrylic plastics were constructed. For all the patients after 6 months the level of β-CrossLaps, CRP, osteocalcin markers in the oral fluid was analysed. In patients of the index group, the average content of β-CrossLaps was 0.0126 ± 0.002 ng/ml, in the control group it was 0.0147 ± 0.002 ng/ml. The average content of the CRP in patients of the index group was 0.358 ± 0.019 mg/l, in patients of the control group it was 0.78 ± 0.01 mg/l. In patients of the index group, the average content of osteocalcin was 1.46 ± 0.25 ng/ml, in the control group it was 1.98 ± 0.31 ng/ml. It has been shown that biochemical markers of the oral fluid can be used to predict complications after the dental implants installation. Restoration with two-part dental implants of modern design is associated with fewer complications.