The review presents the possibilities and experience of using diode lasers for treatment of oral inflammatory diseases. Earlier, low-intensity laser was used in dentistry only as a physiotherapeutic device. The laser applications range has expanded significantly with the advent of new technologies. Diode laser has a high level of safety, so it can be used in periodontics and endodontics without fear of tooth tissue structure damaging. In surgical dentistry, high-intensity laser radiation is used as an alternative to cutting and rotational instruments. Features of diode laser for surgical interventions are sterile conditions during the intervention and avoidance of bleeding during and after surgery, predicted depth of injury, high incision accuracy. Accumulated experience of using a diode laser shows good hemostatic effect, which leads to minimal recession of gingival margin. Many authors emphasize that postoperative scars are absent or are more tender and elastic, not constricting tissues. In comparison with traditional methods, use of laser scalpel can reduce epithelialization time of a wound by half. Also, a number of authors claim that the diode laser stimulates immune system, reduces pathogenicity of microflora, increases its sensitivity to antibiotics, positively regulates the function of dental cement in vitro. Use of laser technology improves the quality and effectiveness of ongoing treatment, reduces repeated paient visits, shortens treatment time, avoids relapses and complications. Due to this, the question of expanding the indications for diode lasers use in dentistry and improving the methods remains of current interest.

Aim. To determine the dynamics of clinical changes and indicators of local immunity in integrating the diode laser into the treatment of the endo-periodontal lesion. Methods. We performed a prospective study of 110 patients of both sexes aged 2555 years with endo-periodontal lesions. The patients were randomized into two groups the main group (n=54), whose received root canal treatment and periodontal pockets with a diode laser in addition to standard therapy, which included endodontic and periodontal treatment, and control group (n=56), whose patients received only standard treatment. The GreenVermillion oral hygiene index and Russells periodontal index, as well as the levels of immunoglobulin (Ig) A, tumor necrosis factor-alpha (TNF-alpha) and cytokine interleukin-10 (IL-10) in the mixed saliva of patients, were determined during the study. Quantitative data were described using median, lower and upper quartiles. These data were visualized using boxplots. The MannWhitney U test was used to compare differences between an independent set of quantitative data. Differences were considered significant at a confidence level of p 0.05. Results. The median oral hygiene index decreased from 2.9 to 1.0 (p 0.001) in the main group and from 2.9 to 1.6 (p 0.001) in the control group. The median Russell's periodontal index decreased from 3.38 to 1.3 (p 0.001) in the main group and from 3.95 to 2.0 (p 0.001) in the control group. The median immunoglobulin A content decreased from 5.25 to 3.13 mg/L (p 0.001) in the main group and from 5.23 to 4.21 mg/L (p 0.001) in the control group. The tumor necrosis factor-alpha level decreased from 16.65 pg/ml in the main group and 18.28 pg/ml in the control group to 3.96 and 8.44 pg/ml (p 0.001), respectively. The median cytokine interleukin-10 levels increased from 0.83 to 2.94 pg/ml (p 0.001) in the main group and from 1.29 to 2.13 pg/ml (p 0.001) in the control group. Conclusion. The use of a diode laser in the treatment of endo-periodontal lesions has a positive effect on the dynamics of clinical and immunological parameters, as evidenced by a statistically significant decrease in clinical indices, as well as the normalization of the immunoglobulin A and cytokine levels in mixed saliva.

Aim. To study the prevalence and structure of periodontal disease in in-patients with coronary heart disease preparing for coronary artery bypass surgery.Methods. The study included 144 male in-patients with coronary heart disease who were prepared for coronary artery bypass surgery in the department of cardiac surgery. The diagnosis of periodontal disease was set according to the World Health Organization recommendations based on the comprehensive dental examination. Exclusion criteria were: diabetes mellitus, survived blood transfusions and all teeth missing. A prognostic model based on binary logistic regression method was created for estimation of risk factors on periodontal disease risk.Results.The prevalence of chronic generalized periodontitis in patients with coronary heart disease preparing for coronary artery bypass surgery reaches 73.6%. Mild (51.9%) and moderately severe (48.1%) chronic generalized periodontitis were the most common. Among the risk factors for periodontal disease patients, we have identified older age, smoking, hypertension and survived acute ischemic episodes. For the created model, χ2 value was assessed as 42.7, meaning statistical significance of pConclusion. In in-patients with coronary heart disease, prophylaxis for periodontal disease should be performed to decrease the risk for exacerbations. Using the created prognostic tool in clinical practice may be used for outlining patients with higher risk for periodontal disease.