Relevance. Squamous cell carcinoma of the head and neck, including oral and oropharyngeal cancer, ranks as the seventh most common cancer worldwide, contributing to over 660,000 new cases and 325,000 deaths annually. Understanding the interplay of adverse factors, their association with disease development, and the creation of mathematical risk prediction models can play a crucial role in enhancing screening efforts and advancing primary prevention of malignant neoplasms. Objective. This study aimed to identify significant risk factors for oral mucosa cancer in the Altai Krai population and to develop a mathematical model for disease risk assessment. Material and methods. The study included 184 patients diagnosed with oral mucosa cancer, along with a control group of 416 healthy volunteers with no history or current diagnosis of oncological diseases. A total of 39 potential risk factors were analyzed across all participants. Statistical analyses were conducted to identify region-specific risk factors for Altai Krai. Binary logistic regression and ROC analysis were used to construct the risk prediction model. Results. Comparative analysis between the patient group and the control group revealed differences in 19 of the 39 evaluated factors. However, the final risk prediction model identified five key factors significantly influencing disease development. Advanced age, smoking status, the number of cigarettes smoked, and alcohol consumption were found to substantially increase the risk of oral mucosa cancer, while engagement in intellectual work-related activities was associated with a reduced risk. The resulting formula demonstrated high predictive accuracy, with an Area Under the ROC Curve (AUC) of 0.91, a standard error of 0.024, and a 95% confidence interval of 0.856–0.955 (z-statistic: 17.50; significance level: P (area = 0.5) < 0.001). Both the sensitivity and specificity of the model were high. Conclusion. The developed risk assessment model shows great promise for helping screen and diagnose oral cancer in the Altai Krai population. This tool could give dentists and healthcare providers a simple, practical way to identify individuals at risk early by using well-established risk factors.

Relevance. Cancer stands as a prominent cause of untimely mortality in young and middle-aged individuals (aged 20-64 years). The inquiry into the extent of influence exerted by external risk factors on the emergence of oral mucosal oncopathology remains pertinent. Equally crucial is understanding the intricate interplay among different groups of factors and their effects.Research objective. To determine the extent of influence exerted by various endogenous and exogenous risk factors on the development of malignant oral mucosal lesions, based on contemporary literature data, and to assess their interrelationships.Materials and methods. The research material was the analysis of literary data from bibliographic sources – Elsevier, PubMed, Elibrary, Google Academy, Medline, Cyberleninka. The study included literature sources in Russian and English. The second part of the review combines studies devoted to the study of the influence of exogenous controlled factors on the risk of developing malignant neoplasms of the oral mucosa.Results. Through contemporary literature analysis, the potential and scale of influence attributed to controllable exogenous risk factors in the development of malignant oral mucosal lesions have been established. Notably, significant impact has been associated with smoking and alcohol consumption. Additionally, adverse socio-economic conditions, environmental factors, and dietary habits have been identified as contributors to an elevated cancer risk. Throughout this investigation, it became evident that literature sources frequently highlight the influence of individual factors without adequately considering potential synergies, antagonistic effects, or interactions with endogenous factors. Moreover, certain factors pivotal to the carcinogenesis of oral cavity tumors remain inadequately researched.Conclusion. To facilitate efficient primary and secondary prevention measures, it is imperative to advance and refine a multidisciplinary research methodology. This approach should aim to comprehensively identify the collective impact of diverse groups of risk factors on the progression of malignant oral mucosal lesions.

Relevance. This article presents the findings from studies evaluating the effectiveness of toothpastes containing 1000 ppm fluoride in clinical settings. The data demonstrates the cumulative benefits of these toothpastes on oral hygiene, the reduction of inflammatory oral manifestations, and their anticaries effects.Purpose. To assess the effectiveness of fluoride-containing toothpastes through laboratory tests and clinical trials.Materials and methods. The study evaluated the effectiveness of toothpastes containing 1000 ppm fluoride using the following parameters: Greene-Vermillion hygiene index, periodontal indices (PMA and SBI), enamel mineralization and resistance, presence and number of carious lesions at the white spot stage, enamel hypersensitivity, and antimicrobial activity against Streptococcus spp.Results. The analysis of hygiene indices demonstrated that the tested toothpastes were highly effective in cleaning, with a positive cumulative effect on participants' oral hygiene. The use of these toothpastes significantly reduced inflammatory manifestations, decreased gum bleeding, and improved periodontal tissue health. A reduction in the number of participants with early-stage carious lesions, as well as a decrease in the overall number of lesions, was observed. The toothpastes also enhanced enamel resistance to acid exposure, contributing to their anticaries benefits. Enamel hypersensitivity was reduced, and a dose-dependent antibacterial effect against Streptococcus mutans, Streptococcus gordonii, and Streptococcus sobrinus was observed.Conclusion. Toothpastes containing 1000 ppm fluoride demonstrated strong cleaning and refreshing effects, along with a positive cumulative impact on oral hygiene and a significant reduction in inflammation. Their anticaries benefits were confirmed, and they also reduced enamel hypersensitivity. The tested toothpastes were well-tolerated, with no reports of allergic reactions or irritation.

The article presents the results of a survey of young people from 18 to 30 years who have undergone COVID-19. The study conducted a quantitative and qualitative analysis of lesions of the oral mucosa in medical university students during the period of COVID-19 disease and after recovery and identified the most common lesions of the oral mucosa associated with coronavirus infection. Pathological changes in the oral cavity have been identified, including with a mild course of coronavirus infection, reducing the quality of life, health and without timely treatment, leading to serious consequences. The obtained results of the study and the high percentage of manifestations characterizing postcovid syndrome justify the need for dental examination of these patients after their clinical recovery. The relationship between the course of the underlying disease COVID-19 and the severity of the lesion of the oral mucosa was revealed. It is determined that the more complex the form of the underlying disease, the longer and more severe the duration of dental symptoms. The role of a dentist in the timely diagnosis of dental manifestations in patients who have had a coronavirus infection and the selection of the most adapted treatment regimen depending on the clinical manifestations in the oral cavity in order to prevent the development of complications and the severe course of the identified pathology is shown.

OBJECTIVE:The aim of the study is to increase the effectiveness of diagnostics of microhemocirculatory changes in periodontal tissues in anatomical and functional disorders of the mucogingival complex, based on the use of the method of discriminant analysis of ultrasound opplerography. MATERIAL AND METHODS:187 patients aged 18-44 years (young age according to WHO) were examined without concomitant somatic pathology with various variants of anatomical structures of the mucous-gingival complex, which included an assessment of blood flow in periodontal tissues by ultrasound dopplerography at rest and during a functional test of the tension of the soft tissues of the upper and lower lip, cheeks using an opt-out. After qualitative and quantitative analysis of dopplerograms, an automated assessment of the microhemocirculation of the studied structures was performed, identifying differences between groups using step-by-step discriminant analysis with the study of several variables. RESULTS:Depending on the type of reaction to the sample, a model of the distribution of patients into separate groups based on the application of the discriminant analysis method is proposed. It was found that patients of all groups were classified statistically significantly (p<0.05) and the possibility of distributing patients according to the described criteria (the ratio of the maximum systolic blood flow rate along the mean velocity curve, Vas) to a specific class corresponding to the highest value of the function was proved. CONCLUSION:The proposed method for assessing the functional state of periodontal tissue vessels allows classifying patients with high accuracy and a minimum of the probability of false results, reliably assess the degree of existing functional disorders, determine the prognosis and further tactics of therapeutic and preventive measures and can be recommended for use in clinical practice.

УДК 378.14 РОЛЬ ФОРМИРОВАНИЯ ОБЩЕКУЛЬТУРНЫХ КОМПЕТЕНЦИЙ У ИНОСТРАННЫХ СТУДЕНТОВ МЕДИЦИНСКОГО ВУЗА В ПОВЫШЕНИИ АДАПТАЦИИ К ОБУЧЕНИЮ В РОССИИ Токмакова С.И. 1

ПРИМЕНЕНИЕ НАГЛЯДНЫХ ПОСОБИЙ В ОБРАЗОВАТЕЛЬНОМ ПРОЦЕССЕ НА КАФЕДРЕ ТЕРАПЕВТИЧЕСКОЙ СТОМАТОЛОГИИЛуницына Ю.В., Токмакова С

Relevance. Oral mucosal cancer (OMC) is the sixteenth most common cancer worldwide. The high mortality rate is mainly due to the asymptomatic course of the disease in the early stages and late detection when the tumour process poorly responds to treatment. Determining the impact of various risk factors and establishing their relationship are necessary to prevent and diagnose malignant oral mucosal lesions in the early stages. Purpose. Based on the modern literature, the study aimed to determine the impact value of various internal and external risk factors on malignant oral mucosal lesion development and assess the risk factors’ relationship. Material and methods. The research material included the analysis of literature from databases – Elsevier, PubMed, Elibrary, Google Academy, Medline and Cyberleninka. The study included literature sources in Russian and English. Results . Based on modern literature, we have determined endogenous and biological risk factors for malignant oral mucosal lesion development. The study noted the high role of microbiome changes and the presence of dysbiosis in patients with malignant neoplasms and proved the direct involvement of Candida fungi in carcinogenesis. The development of oral mucosal cancer and the presence and severity of oral yeast colonization and human papillomavirus infection showed a positive correlation. Chronic oral diseases, which are susceptible to malignant transformation or contribute to the development of carcinomas, have been identified, and their relationship has been established with biological risk factors, age, sex of the patient and duration of the disease course. Conclusion . The studies considered in this part of the review prove the influence of endogenous and biological factors on the development of malignant neoplasms of the oral cavity and determine their relationship. However, many mechanisms remain unexplored to date. Effective primary and secondary prevention implementation needs improvement and the development of a multidisciplinary approach to research methodology, study the complex impact of all groups of risk factors on the development of malignant oral mucosal lesions.

Relevance. Mouthwashes occupy a special place among the oral hygiene products range for their wide prevalence and high effectiveness. At the same time, their unreasonable use can lead to an oral microbial imbalance for the pronounced antimicrobial activity of the mouthwashes. Aim. To evaluate the effect of mouthwashes with various preservative systems on the normal oral microbiota quantity and to assess the possible risk of dysbiotic changes if used regularly for prevention purposes. Material and methods. The study examined the antimicrobial properties of nine experimental samples of mouth-washes developed for home oral care. The study included 110 healthy volunteers and collected 2 ml of unstimulated saliva from the subjects before toothbrushing and 5, 30, 60 and 180 minutes after rinsing with a test product for 1.5-2 minutes. The microbiological laboratory plated saliva samples and counted the number of colony-forming units. The results were statistically processed. Results. The analysis of the average microbiota levels for all the products at various time points revealed that the number of viable bacteria in the oral cavity decreased by no more than 1.5 orders of magnitude, except for 0.2% chlorhexidine mouthwash. This decrease is short-term, and for most mouthwashes, there were no statistically significant differences in the number of colony-forming units in 60-180 minutes compared to the baseline. Conclusion. All the tested samples of mouthwashes do not significantly affect the microbiota and, consequently, can be recommended for daily home oral care practice.

Relevance. Numerous studies confirm the increase in malignant neoplasm number in the incidence pattern worldwide. The proportion of oral mucosa diseases, including precancerous lesions and cancer, is also quite high in dental diseases. Cancer alertness is a paramount professional competence for a dentist, and its implementation should be a priority in daily practical work. Studies conducted by a number of authors in various regions of our country prove the fact of low cancer alertness in clinicians.The study aimed to assess the level of cancer alertness in dentists of the Altai Territory.Material and methods. To achieve the goal, the study surveyed 1,150 dentists of the Altai Territory with various specializations and work experience in institutions of various forms of ownership.Results. The mistakes made by dentists proved to be often caused by non-compliance with the patient examination protocol, insufficient knowledge of cancer alertness principles and existing screening methods. In addition, the study found routing errors in patients with a diagnosed malignant neoplasm of the oral cavity and little knowledge of the main regional documents concerning the provision of care to patients with cancer.Conclusion. Thus, analyzing the survey results, we revealed the imperfection of early diagnosis of oncological diseases at a dental appointment in the Territory. Insufficient knowledge of screening tests and patient routing schemes by dentists, the principles of cancer alertness, and lack of examination represent a serious problem that prevents early diagnosis of a disease.

Неудовлетворительное гигиеническое состояние ротовой полости является определяющим фактором в развитии основных стоматологических заболеваний. В стоматологии все большее значение приобретают информированность и мотивация пациента к выполнению профилактических мероприятий. С целью выявления знаний в вопросах стоматологического здоровья проведено анкетирование взрослого населения Барнаула, посещающего стоматологические клиники. В результате получены сведения о гигиенических знаниях и навыках, владение которыми способствует снижению интенсивности и частоты наиболее распространенных стоматологических заболеваний. Результаты проведенного исследования свидетельствуют о недостаточном уровне гигиенического воспитания населения, что требует корректировки комплекса санитарно-просветительных мероприятий в стоматологических лечебно-профилактических учреждениях.

СИМУЛЯЦИОННОЕ ОБУЧЕНИЕ В ПОДГОТОВКЕ К ПРАКТИЧЕСКОЙ ДЕЯТЕЛЬНОСТИ И АККРЕДИТАЦИИ ВЫПУСКНИКОВ ПО СПЕЦИАЛЬНОСТИ «СТОМАТОЛОГИЯ» В УСЛОВИЯХ САМОИЗОЛЯЦИИ В ПЕРИОД ПАНДЕМИИ КОРОНАВИРУСНОЙ ИНФЕКЦИИ COVID-19Токмакова С.И. 1 , Жукова Е.С. 1 , Шилова Ю.Н. 1 , Бондаренко О.В. 1 , Луницына Ю

1ФГБОУ ВО «Алтайский государственный медицинский университет Минздрава России», Барнаул, e-mail: bonda76@mail.ru В статье описан опыт использования дистанционного обучения в медицинском высшем учебном заведении на примере стоматологического факультета в период пандемии COVID-9. Охарактеризованы положительные и отрицательные стороны данной формы обучения. Проведено анонимное анкетирование 449 студентов 1-5 курсов стоматологического факультета. Вопросы анкеты касались пандемии COVID-19, организации дистанционного обучения в условиях самоизоляции и уровня владения персональным компьютером и навыков работы в сети Интернет. В ходе анализа ответов выявлено, что современные студенты обладают хорошими навыками по работе с современной техникой, программным обеспечением и работой в сети Интернет, и это способствует быстрой адаптации к новой форме обучения; абсолютное большинство студентов владеют актуальной информацией, касающейся путей распространения и методов профилактики распространения новой коронавирусной инфекции, получаемой в основном из официальных источников; большинство студентов удовлетворены процессом обучения в дистанционном режиме, высоко оценивают содержание учебной информации и ее подачу преподавателями университета; проблемы и трудности, возникающие в ходе освоения образовательных программ в новой форме, в основном связаны с техническими проблемами из-за высокой нагрузки на сервер вуза. Сделан вывод о возможности использования данной формы образования в качестве взвешенной альтернативы очной форме в условиях пандемии и при отсутствии возможности классической формы обучения. Подчеркнута важность отработки практических навыков в условиях симуляционного центра и поликлиники как одного из самых значимых недостатков медицинского образования в новых условиях. Ключевые слова: дистанционное обучение, высшее медицинское образование, стоматология, Moodle, пандемия COVID-19.

ОПЫТ ДИСТАНЦИОННОГО ОБУЧЕНИЯ СТУДЕНТОВ СТОМАТОЛОГИЧЕСКОГО ФАКУЛЬТЕТА В УСЛОВИЯХ ПАНДЕМИИ COVID-19Токмакова С.И. 1 , Бондаренко О.В. 1 , Луницына Ю

Objective : Assessment of the quality of root canal obstruction by the method of cold high-flowing gutta-percha in comparison with standard methods of filling. Methods : In vitro experiment on 60 extracted teeth with one root canal. In 20 teeth, the canals were obturated by lateral condensation of gutta-percha, in 20 – by a central conical pin, and in another 20 – fluid cold gutta-percha with a gutta-percha pin. Visiography was performed, then after polymerization of the sealer, the root was sawn in the transverse direction and the quality of the filling was evaluated using digital microscopy. Results : In the first two groups, satisfactory results were obtained with a homogeneous filling of the lumen of the root canal. In the third group, unsatisfactory results were obtained in 65 % of cases: lack of sealer in the middle and apical parts of the canal, filling defects. Conclusions : The technique of lateral condensation of gutta-percha and the method of filling with a conical central pin with a polymer endo sealer significantly exceed the quality of filling cold high-flowing gutta-percha.

Relevance . Periodontal diseases rank the first in the world among dental diseases, in this regard, their early diagnosis, treatment and prevention is relevant. The problem is actual for both urban and rural areas. In addition, there was an increase in the percentage of patients with age. Certain risk factors that are of great importance in the occurrence and development of periodontal diseases are identified, at the same time their combined influence is not always taken into account. Purpose. Evaluation of epidemiological indicators and etiopathogenetic factors of periodontal inflammatory diseases in a large agro-industrial region. Materials and methods. There was an examination of 600 people. For each of them, a periodontal online card was filled out on the website perio-tools.com, which included the main criteria for the state of periodontal tissues. The relationship between the severity of periodontal risk factors and the severity of periodontal diseases was being determined. Results. Among the examined adult population, the structure of inflammatory periodontal diseases at urban and rural residents was dominated by pathology corresponding to an average degree of periodontal risk. In the elderly group, a high degree of periodontal risk prevails among rural residents (Talmenka village 16.00 ± 0.03%, Shipunovo village 14.00 ± 0.02%), which is two times more than among residents of the capital Altai Territory (7.00 ± 0.06%). Correlation analysis showed a direct relationship between risk factors and the severity of periodontal disease, as well as the statistical significance of individual factors in the population of the Altai Territory when compared. Conclusion. The most significant factors and their totality in the occurrence and development of periodontal diseases depending on age and region of residence are identified, which is important in the organization of early prevention.