Periodontitis is a disease that progresses with age and contributes to the biological aging of the dentition. One of the reasons for this phenomenon is the aging of human gum fibroblasts. Low-intensity laser therapy stimulates the release of growth factors from fibroblasts and their division. The aim of the study was to determine the number, proliferative activity and apoptosis of gingival fibroblasts in people without signs of periodontal inflammation, with chronic periodontitis and after laser therapy. We used biopsy material obtained for periodontal, surgical, orthopedic and orthodontic indications under infiltration anesthesia in two age groups of patients aged 20–40 and 41–60 years. Cell markers Ki-67 and p53 were detected by immunohistochemical methods, the total number of gingival fibroblasts was estimated by staining with hematoxylin and eosin. The results of the conducted studies showed that the number of fibroblasts in the connective tissue lamina of the gums has age-related features. In young people from 20 to 40 years, the number of fibroblasts in gum preparations is 1,12 times higher than in people aged 41–60 years. Among the reasons for the decrease in the number of gingival fibroblasts is a decrease in their proliferative activity and activation of the proapoptotic p53 protein with age. Chronic periodontal inflammation leads to a significant increase in the number of fibroblasts, regardless of the age of the subjects. Fibroblast proliferation and p53 protein expression were more sensitive to microbial inflammation in patients aged 41 to 60 years compared to younger patients. Three-fold laser exposure had a differentiated modulating effect on the state of the gingival fibroblast population, depending on the age of the patients, the number of gingival fibroblasts was restored to the levels characteristic of healthy people, and this was observed only in the group of young patients. Thus, the number of fibroblasts in the human gingival connective tissue lamina changes with age, under conditions of inflammation and under the influence of a diode laser, which must be taken into account in dental practice.

Hygienic care of lingua plicata is of particular relevance, since the degree of microbial contamination of the tongue folds is a key factor in initiation and progression of non-specific glottitises. The aim of the work was to study the effectiveness of hygienic modes of tongue care using "Albadent" balm-rinse in patients having a fissured tongue. Three subgroups of patients were included in the study; patients of the 1st subgroup had their tongues treated with a toothbrush pad, patients of the 2nd subgroup rinsed it with Albadent balm twice, and patients of the 3rd subgroup treated their tongues twice with an irrigator with Albadent balm solution. A comparative assessment of care regimens showed that in patients of the 1st subgroup the hygienic condition of the tongue improved by 2.7 times, and the prevalence of Candida albicans decreased twice. The patients reported unpleasant «scratching» sensations in the tongue after its mechanical treatment. In patients of the 2nd subgroup, the depth of the folds decreased, and hyperemia in the bottom of the folds decreased in half of the observed patients. The hygienic condition of the tongue improved by 2.2 times, and the prevalence of Candida albicans decreased by 2.5 times. Patients reported a pleasant freshness sensation in the tongue after treatment, continuing after spitting for 60-90 minutes. In patients of the 3rd subgroup, the depth of the folds changed insignificantly in the direction of decrease, and hyperemia of the bottom was not detected. The hygienic condition of the tongue improved twice, and the prevalence of Candida albicans decreased by 2 times. Patients reported a pleasant freshness sensation in the tongue after rinsing, continuing after spitting for 40–60 minutes.

The article presents the experience of complex managing a patient with gum recession in the area of the maxillary premolars. Periodontal treatment of gum recession consisted of initial therapy, including supra- and subgingival scaling, root planing, pharmacotherapeutic support (broad-spectrum antiseptics, drugs that stimulate regeneration), surgical combined method based on the use of enamel matrix protein to stimulate regenerative processes. The clinical material Emdogaine is a combination of an enamel matrix derivative and propylene glycol alginate, which performs the function of a carrier. Biora company has been producing it for more than 20 years (Emdogain, BIORA): now the rights to this material belong to Straumann). This preparation was developed to stimulate regeneration of periodontal tissues. Amelogenin is a specific enamel protein capable of stimulating regeneration of lost periodontal tissues by influencing cell differentiation. Dental cement is an osteoid connective tissue that covers the roots of teeth and serves to attach periodontal fibers. Application of an enamel matrix derivative to the sanitized root surface leads to regeneration of non-cellular cement and to the formation of periodontal tissues, which was observed in our study. Transplantation of free connective tissue grafts to eliminate gum recessions makes it possible to effectively eliminate gum recession in most clinical cases (complete root coverage, an increase in the level of clinical attachment from the keratinized attached gum area). In our clinical case, free grafts were obtained in the donor area of the maxillary tuberosity. Transplantation of free connective tissue grafts provides an aesthetic result and is currently considered a standard technique for eliminating gum recession. According to the clinical study, a combined use of connective tissue grafts and the enamel matrix derivative, an additional use of enamel matrix derivative enabled to obtain a satisfactory result and to improve the appearance of the dentition. Such combined surgeries are indicated in an aesthetically significant area. The described materials, methods and stages of patient's follow up can serve as the basis for the protocol of managing patients with gum recession.