Subject of our research is dental examination and identification of the features of the dental status in women with pregnancy complicated by gestosis. There is no doubt that pregnancy is a critical period for woman’s dental health. Objectives. Determine the dental status in women with pregnancy complicated by gestosis. Methods. As part of the study of the dental status of women with pregnancy complicated by gestosis, we conducted a clinical examination of the oral cavity in 127 women. The depth of the vestibule, the level of attachment of the bridles, the state of the bite, the indices of the KPU, IK, PMA, IZN were determined. Results. Our data indicate that the complication of the course of the third trimester of pregnancy with gestosis in women is accompanied by a deterioration in periodontal status, oral hygiene, and a 100% prevalence of gingivitis. Conclusions. The results of the study made it possible to obtain clinical and dental data characterizing the effect of pregnancy complicated by preeclampsia in women in the third trimester on the course of gingivitis, which is the basis for the development of methods for optimizing and increasing the effectiveness of therapeutic and prophylactic measures in this group of patients.

Subject: development of an algorithm for the rehabilitation of children with congenital cleft lip and palate in a region with petrochemical ecotoxicants. Objectives: optimization of the algorithm for the rehabilitation of children with congenital cleft lip and palate in the region with ecotoxicants. Methods. A retrospective analysis of the medical records of children with a diagnosis of congenital cleft lip and palate was conducted on the basis of the Republican Children's Clinical Hospital in Ufa in the department of maxillofacial surgery. In the period from January 1, 1985 on December 31, 2018 were surveyed 3463 children with congenital cleft lip and palate. Results. Children born and living in the region with the petrochemical industry have a high percentage of concomitant somatic diseases and deviations from the norm in blood tests. An algorithm was developed for the rehabilitation of children with congenital cleft lip and palate in the region with petrochemical ecotoxicants, optimized by including a toxicologist, anesthesiologist, immunologist, otorhinolaryngologist, gastroenterologist, and endocrinologist in the algorithm of consultation and treatment. The algorithm is aimed at improving the health of the child by increasing the effectiveness of prevention and treatment of somatic diseases in the preoperative period. Conclusions. The proposed algorithm for the rehabilitation of children with congenital cleft lip and palate has been developed taking into account the adverse effects on the body of emissions into the air of large petrochemical enterprises. Children with congenital cleft lip and palate, born and living in a region with petrochemical ecotoxicants, have a high percentage of somatic diseases and contraindications to surgical treatment according to accepted terms due to the presence of comorbidities and disorders in blood tests, and need additional treatment from a toxicologist, anesthesiologist and other specialists.

Relevance. Diabetes mellitus is one of the most complex metabolic chronic diseases. Severe forms of type I diabetes mellitus are more common in children and adolescents, and its prevalence is increasing in many countries. Type I diabetes mellitus in children and adolescents remains an essential health issue in many countries despite the achieved scientific and practical results and progress in diabetology. Therefore, its early detection in children is still relevant and is associated with the early diagnosis of endocrinolog ical pathologies.Materials and methods. The study searched the publications in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), Medline (www.elibrary.ru, www.ncbi.nlm.nih.gov/pubmed) by the specific keywords.Results. In children with diabetes mellitus, vascular changes in periodontal tissues appear earlier than in other organs. On oral examination of children with diabetes mellitus, 50% of cases reveal periodontal lesions, and the lesions are often in the areas of the lower molars. If not treated, the following perio-dontitis signs are present in diabetic children: bleeding of the gingival papillae and the bright red colour of the gingival margin. There may be bulging of granulations from pathological gingival pockets. In most patients with type I diabetes mellitus, cytology of the periodontal pockets and gingival sulci demonstrated inflammatory cytologic responses, changes in the stratified squamous epithelium, and mixed bacterial microflora with leukocytes and erythrocytes.Conclusion. The study of type I diabetes mellitus impact on pathological changes in the oral cavity of children and the development of therapeutic and preventive measures is a relevant issue in pediatric dentistry, which justifies the need to continue research in this area.

Objectives. A clinical case of surgical rehabilitation of a patient with palatopharyngeal insufficiency with congenital cleft palate after uranoplasty. Purpose. Description of the long-term result of surgical treatment of congenital cleft palate, the causes of complications and the rationale for the method of treatment of palatopharyngeal insufficiency. Methodology. The paper presents the results of a clinical observation of a patient aged 12 years with congenital cleft palate after uranoplasty and formed palatopharyngeal insufficiency. A child at the age of 2 years 8 months underwent sparing uranoplasty. Since the child lived in a remote area from the city, he did not have the opportunity to engage in logotherapy. On examination, the soft palate is moderately shortened, postoperative scars are not rough. Speech is vile. To select the most optimal method of treating this pathology, it was necessary to visualize the causes of palato-pharyngeal insufficiency. Results. When conducting an examination using nasopharyngoscopy, a sphincter type of closure of the palatopharyngeal ring was revealed. When pronouncing sounds, the soft palate rose slightly, but the lateral walls of the pharynx with the posterior palatine arches actively contracted, narrowing the palatopharyngeal ring. Taking into account the data obtained during nasopharyngoscopy, a surgical method for eliminating palatopharyngeal insufficiency proposed by M. Orticochea was chosen — “speech-improving surgery”, or sphincter pharyngoplasty, with suturing of the distal ends of the mobilized posterior palatine arches on the posterior pharyngeal wall. According to the control examination for 6 months, there was a significant improvement in speech function, there was no nasalization. Conclusions. Nasopharyngoendoscopy makes it possible to objectively assess the causes of palatopharyngeal insufficiency, which makes it possible to choose the most optimal method of surgical treatment. One of the methods of choice in the surgical treatment of palatopharyngeal insufficiency is the method of sphincter pharyngoplasty.