Vol 28, No 1 (2024): DENTISTRY

Relevance. Dental caries, according to World Health Organization, is one of the most common diseases in children throughout the world. In the absence of timely diagnosis and treatment, the carious process can affect not only the efficiency of chewing function, but also speech, smile and, as a consequence, psychosocial adaptation, as well as the quality of life of the child and family. Despite the fact that the etiological factors have been well known for many years, reducing the number of teeth affected by caries in children still remains an urgent task. This article is a review of information sources about the prevalence, etiology and integrated approach to the diagnosis, treatment and prevention of dental caries in children. The authors analyzed scientific data in the search engines PubMed, Google Scholar and eLibrary. Conclusion . Based on the literature review, a number of modern trends were identified that define a series of key hypotheses that summarize the accumulated material and confirm the prospects and relevance of the problem. The goal is to help clinicians recognize common patterns of caries in children and make appropriate decisions regarding the diagnosis, treatment and prevention of carious lesions, taking into account available methods, materials, knowledge, age and patient history. It is also important to create a comfortable and safe environment during the appointment, as unfamiliarity with a new physical interaction can provoke anxiety as a standard response to uncertainty, which often results in childhood dental phobia, contributing to behavioral resistance to return visits. In general, based on the analysis, we can conclude that the use of an integrated approach to diagnosis and treatment has great potential for achieving better results in working with dental patients of early and preschool age, the development and improvement of which should remain a priority to ensure more complete and effective treatment of children and maintaining their health in the long term.

Relevance. The psychological adaptation of a child to a dental appointment is of particular relevance today. This study analyzes the literature on the role of child behavior management in pediatric dentistry. The causes of dental fear, its manifestations and consequences are considered. Also, various methods of adaptation of the child and the results of studies evaluating the effectiveness of such methods are analyzed. The goal is to find out which ways of managing a child’s behavior are able to form positive associations with dentists as well as overcome anxiety and fear of treatment. Conclusion. The results of the literature analysis show that even the simplest methods of interaction with children are effective in reducing anxiety and fear before visiting a dentist. In addition, working with parents and using various forms of interactive communication helps to create a positive atmosphere in the dental clinic and form a positive experience for children. In general, based on the analysis, it can be concluded that the control of the child’s behavior has great potential to achieve better results in the work of a dentist. The development and improvement of methods of controlling the behavior of children in dentistry should remain a priority to ensure more complete and effective treatment, as well as maintaining their health in the long term.

Relevance. Many patients suffer from anxiety when planning a surgical procedure, which leads them to either postpone it or go through it with all those negative feelings that may affect the course of the surgical work or even its outcomes. Modern medicine aims to find non-pharmaceutical ways, such as music, to put these emotions under control so that the patient feels a sense of calm and tranquility throughout the surgical operation and comes out with less negative feelings and good memories, which prevents the formation of any psychological trauma. Our investigation aims to study the effect of three types of music, on the psychological state of the patient during surgery, by evaluating the data of systolic and diastolic pressure, pulse, and oxygen level in the blood. Materials and Methods . 36 patients who visited the Medical Center of the RUDN University on a daily basis for dental implants and wisdom tooth extractions were randomly selected to undergo the experiment. They were divided into four groups, the first was the control group which was not exposed to music, the second was exposed to classical music, the third was exposed to Buddhism music, and the fourth was exposed to music generated by Artificial Intelligence. Pressure, pulse, and oxygen level were recorded in three phases and changes assessed using Student’s t-test and Mann-Whitney U analyses. Results and Discussion. The final results obtained did not show any significant changes in the values of pressure, pulse, and blood oxygenation during the period of exposure to music when compared with control group. Conclusion. Exposing to music didn’t show any positive effect on stress levels during dental implantation and extraction.

Relevance. Until now, disputes among scientists about its etiology, pathogenesis, nomenclature and risk factors for the development of vulvar lichen sclerosis have not subsided, which actualizes the need for scientific research aimed at solving these problems. The aim of the study - to establish statistically significant clinical and anamnestic risk factors for vulvar lichen sclerosis. Materials and Methods. An electronic database was formed with data from 344 patients with lichen sclerosus of the vulva and 60 women without vulvar diseases aged 20-70 years on hereditary, obstetric-­gynecological, somatic and infectious history. A statistical comparative correlation analysis of the obtained data was carried out using the Spearman correlation coefficient (R > 0.15), nonparametric Mann - Whitney U test and Student t test (p < 0.05), Chi-square tests, Phi and Cramer statistics. Results and Discussion. Statistically significant (p < 0.05) risk factors for the development of vulvar lichen sclerosus (R, in descending order) were established: the presence of fibrocystic mastopathy (-0.29); late menarche (15 years and older) (-0.28); onset of menopause (-0.25); recurrent vulvo-­vaginal infections (-0.18); recurrent bacterial vaginosis (-0.18); autoimmune thyroiditis (-0.16) and stage II obesity (-0.16). Also, the average number of abortions and births (1.23 and 1.49, respectively) in the group of patients with lichen sclerosis of the vulva is statistically significantly greater (p < 0.05) than the average value (0.27 and 1.13, respectively) in control group. Conclusion. The data obtained on the impact of obesity and autoimmune thyroiditis on the risk of developing vulvar sclerotic lichen are consistent with the results of global studies and confirm the association of the disease with autoimmune and metabolic disorders. Recurrent vulvo-­vaginal infections and dysbiotic processes in the vagina can be both a cause and a consequence of vulvar lichen. The relationship between fibrocystic mastopathy and vulvar lichen sclerosus remains debatable and requires further research. Late menarche, the onset of menopause, a large number of abortions and childbirth can also be considered triggers for vulvar lichen sclerosus in patients with a genetic predisposition to the disease.

Relevance. Magnesium deficiency in the blood (hypomagnesemia) is due to many reasons, among which loop diuretics (furosemide) occupy a certain place. The role of the spleen in this process has not been determined. The aim of the work was to elucidate the effect of furosemide-­induced hypomagnesemia on the immune structures of the white pulp of rat spleen. Materials and Methods. Furosemide (Lasix® Aventis Pharma Ltd, India) was injected daily intraperitoneally at a dose of 30 mg/kg to the experimental group of white outbred rats for 6 days, animals of the control group received an injection of 0.9% NaCl. Investigated: blood serum for the content of magnesium, calcium, sodium and iron; serial sections of the white pulp of the spleen after staining with hematoxylin and eosin to assess the structure and azure-­II-eosin to assess the cellular composition. With a microscope magnification of 280 times, the ratio (in %) of primary (PLNS) and secondary lymphoid nodules of the spleen (SLNS) was calculated, the following were measured (µm): the diameter of the germinal center (GC), the width of the mantle and marginal zone, the diameter of the periarteriolar lymphoid sheath (PALS). In GC, the peripheral zone of lymphoid nodules, PALS at a magnification of 1500 times per field of view (100 μm2) was counted and presented as a percentage of the number of lymphocytes; macrophages; cells, mitotic and apoptotic elements. Morphometric analysis was carried out using Image ProPlus 6.0 software (Media Cybernetics, USA). Statistical processing was carried out using the Statistica 10.0 software package with the determination of the arithmetic mean (M) and its error (m). Results and Discussion. The administration of furosemide led to a decrease in magnesium in the blood serum by 1.6 times (p < 0.05). In the white pulp of the spleen of animals of the experimental group, the proportion of SLNS decreased by 18.14%, the number of SLNS increased by 42.5% (p < 0.05). The diameter of SLNS increased insignificantly, the diameter of GC and the width of the marginal zone significantly increased by 27.1 and 24.8%, respectively. The proportion of macrophages increased by 20.6% in GC SLNS, and by 17.0% in PALS. The highest increase in the proportion of cells with signs of apoptosis was found in the periarteriolar lymphoid sheath of experimental animals - 34.6% (p < 0.05). Conclusion. Furosemide loading causes the development of dyselementosis, with the most significant loss of magnesium (hypomagnesemia) and has a pronounced effect on the immune parameters of the spleen, represented by white pulp structures. Therefore, correction of the elemental status and monitoring of the state of the spleen in hypomagnesemia caused by the use of loop diuretics is a necessary element in the prevention of complications associated with the use of diuretic drugs.