Hard Tissue Lesions Research Articles

Gastroesophageal reflux disease as a risk factor of dental hard tissues erosions

Gastroesophageal reflux disease (GERD) is a common chronic disease leading to a spontaneous and regular retrograde flow of gastric and/or duodenal contents into the esophagus. Reflux of the gastric contents into the oral cavity refers to the extraesophageal presentation of the disease, which, in the absence of timely treatment, can result in erosion of dental hard tissue (EDHT) through repeated exposure of the dental tissue to acidic contents. EDHT are non-carious lesions of the dental hard tissues (mainly enamel, and in some cases dentin), induced by a chemical reaction involving acids, which results in demineralization processes. The incidence rates of EDHT in adult patients with GERD are 32.5–51.5%. The EDHT in GERD develops in stages. Initially, the gradual degradation of tooth pelicula happens when it gradually becomes decayed by repeated acidic attacks. The loss of the pelicula results in direct contact of hydrochloric acid refluxate with the enamel surface and initiation of its demineralization at pH < 5.5 with dissolution of hydroxyapatite crystals. Given the high prevalence of GERD in the population, it seems important to update an integrated approach to the treatment of such patients, which involves pharmacotherapy provided by the gastroenterologist, as well as prevention and minimally invasive treatment of presentations in the oral cavity by the dentist. Patients with EDHT due to GERD need to maintain individual oral hygiene (use mouth washes with a neutral pH level, avoid abrasive toothpastes), use remineralization therapy at home applying remogels (Tooth Mousse), and also be observed by a dentist as part of the follow-up care. Minimally invasive treatment by the dentist involves restorations using composite tooth filling materials and ceramic veneers. It is reasonable to empirically use proton pump inhibitors twice a day for 3 months for the direct treatment of GERD in patients with EDHT.

Structural and Functional Characteristics of the Oral Cavity Organs and Tissues in Workers of the Petrochemical Industry of the Republic of Uzbekistan.

Purpose: The aim of the study was to determine the dental status, level, and structure of dental diseases, as well as to identify some clinical and functional deviations in the organs and tissues of the oral cavity among workers in certain industrial enterprises. Methodology: A comprehensive dental examination was conducted on 1600 individuals, including 420 from the Fergana Oil Refinery Plant (FNPP - main group (MG)-1), 425 from the Almalyk Mining and Metallurgical Plant (AGMK - MG-2), and 605 from the Navoi Chemical Plant (NavCP - MG-3), as well as 150 patients as a control group (CG) who visited a dental clinic. Tooth sensitivity (TS), pain and discriminatory sensitivity (PS and DS) of the oral mucosa, taste perception threshold, and functional mobility of the taste receptors on the tongue, enamel resistance to caries, microhardness (MH) of enamel and dentin, and the condition of periodontal tissues and pH of mixed saliva were determined. The data obtained were processed using statistical methods. Findings: It was determined that the levels and relative weights of the main dental diseases among workers in the studied industries remain quite high; carious and non-carious lesions of the tooth hard tissues, deformation and defects of teeth and dental rows (18.5%), periodontal tissue diseases (74.7%), diseases of the oral mucosa - 38.7%; the need for prosthetics (58.4%) and other pathologies. Additionally, almost all clinical and functional indicators and local non-specific reactivity of the tissues of the oral cavity in workers were disrupted. Unique Contribution to Theory, Policy and Practice: The presence of the main dental diseases among those surveyed from the studied groups is quite high, with noted reductions in the excitability threshold of teeth, around tooth tissues and the oral mucosa, disruption of PS and DS of the oral mucosa, as well as deterioration of the condition of tooth hard tissues. Based on the obtained results, the authors suggest continuing in-depth scientific research with the aim of developing effective methods for the diagnosis and prevention of dental diseases among workers in these industries.

Pre-prosthetic atraumatic laser-assisted mandibular rehabilitation: Er,Cr:YSGG 2780 nm for alveoloplasty and mucocele removal. A case report

Lasers are a popular technology in many areas of dentistry due to their low invasiveness, quick tissue response, and rapid healing time. Mucoceles develop from minor salivary glands, whereas bony exostosis is a prosthodontic challenge that prevents optimal prosthetic management. Scarring, pain, and discomfort are common drawbacks of traditional surgical approaches, which are followed by prolonged postoperative healing. Laser-assisted mandibular rehabilitation is a promising approach with predictable results. The patient complained of severe pain during denture fabrication, as well as a small, painless swelling on the inner aspect of the lower lip. The patient was able to receive the planned complete dentures after undergoing atraumatic laser-assisted removal of mucocele and bone exostosis with an Er,Cr:YSGG (Erbium, chromium-doped, yttrium, scandium, gallium, and garnet) laser treatment at 2780 nm. Both procedures were completed quickly, and there were no postoperative complications to report. Blanching overlying both lesions quickly faded after healing and was replaced by a healthy pink mucosal color; both lesions were monitored until complete healing. The Er,Cr:YSGG effectively ablated and removed both soft and hard tissue lesions with minimal bleeding and pain.

Pre-prosthetic atraumatic laser-assisted mandibular rehabilitation: Er,Cr:YSGG 2780 nm for alveoloplasty and mucocele removal. A case report

Lasers are a popular technology in many areas of dentistry due to their low invasiveness, quick tissue response, and rapid healing time. Mucoceles develop from minor salivary glands, whereas bony exostosis is a prosthodontic challenge that prevents optimal prosthetic management. Scarring, pain, and discomfort are common drawbacks of traditional surgical approaches, which are followed by prolonged postoperative healing. Laser-assisted mandibular rehabilitation is a promising approach with predictable results. The patient complained of severe pain during denture fabrication, as well as a small, painless swelling on the inner aspect of the lower lip. The patient was able to receive the planned complete dentures after undergoing atraumatic laser-assisted removal of mucocele and bone exostosis with an Er,Cr:YSGG (Erbium, chromium-doped, yttrium, scandium, gallium, and garnet) laser treatment at 2780 nm. Both procedures were completed quickly, and there were no postoperative complications to report. Blanching overlying both lesions quickly faded after healing and was replaced by a healthy pink mucosal color; both lesions were monitored until complete healing. The Er,Cr:YSGG effectively ablated and removed both soft and hard tissue lesions with minimal bleeding and pain.

The use of raman-fluorescent medical technologies to assess the effect of physical and chemical factors on the mineralization of hard tooth tissues in normal and noncarious lesions

BACKGROUND: Assessment of the rapid state of mineralization of hard tooth tissues in normal and in various carious and noncarious lesions based on objective in situ methods is an unsolved and urgent issue in dental science and practice.
 AIM: To substantiate the need for the clinical application in situ of express digital raman-fluorescent technology to increase the objectivity and effectiveness of assessing the degree of mineralization of hard tooth tissues in carious (initial form) and noncarious (wedge-shaped defect, pathological erasability) lesions under the influence of various physical and chemical factors on tissues.
 MATERIALS AND METHODS: A survey of 80 patients aged 25–50 years was conducted; the patients were divided into three groups: comparison and with carious and with noncarious (wedge-shaped defect, pathological erasability) lesions of hard dental tissues. In each group, changes in hygienic conditions and mineralization parameters of hard tooth tissues were assessed by the difference in the spectral intensity of raman-fluorescent measurements before and after controlled and/or uncontrolled hygienic treatment. Previously, under experimental conditions, the effects of various physical (mechanical processing, X-ray irradiation on the LNK-268 installation) and chemical (citric acid, hydroxylapatite (GAP) dry and moistened) factors on the hard tissues of the tooth were studied. Simultaneously, “locally” in real time, the mineralization parameters of the hard tissues of the tooth were recorded before and after hygienic treatment. In this study, we used an installation of the “InSpectrM” type in our modification.
 RESULTS: Experimental studies have shown the effectiveness and objectivity of the use of raman-fluorescence diagnostics to assess the hygienic condition and mineralization of hard dental tissues. The objectivity of the assessment of mineralization in a moistened state was investigated (dry GAP, 702 rel. units; wet GAP, 1520 rel. units), and the absence of the effect of radiation on the mineralization of hard tissues of the teeth (p 0.95) was revealed.
 Clinical observations showed that in patients with a wedge-shaped defect and increased erasability of hard tooth tissues, the hygienic condition is 5–10% worse than that in patients with intact tooth tissues and initial formation of caries. The main difference in the condition of hard tissues of teeth with noncarious lesions is a statistically significantly reduced (p 0.95) mineralization of hard tissues of the tooth, requiring remineralizing therapy immediately after hygienic treatment.
 CONCLUSION: In experimental and clinical conditions, the objectivity and effectiveness of the use of express raman-fluorescent technologies to assess the mineralization of hard tooth tissues when exposed to various physical and chemical factors in normal conditions, with carious (initial form) and noncarious (wedge-shaped defect, pathological erasability) lesions, are substantiated.

The impact of laser radiation on the effectiveness of therapeutic treatment of dental patients

The paper presents an overview of modern scientific data on the study of the effect of laser radiation on biological tissues of the mouth in the therapeutic treatment of dental diseases. The use of lasers in the treatment of dental caries and its complications, non-carious lesions of hard dental tissues, as well as the use of lasers in the treatment of periodontal diseases and aesthetic restoration of teeth is considered.

A retrospective radiographic and histopathologic study of pathology associated with impacted teeth and other regions in patients at the Department of Oral and Maxillofacial Surgery: An institutional study.

To examine the prevalence and pattern of pathology related to impacted teeth and other areas in the Department of Oral and Maxillofacial Surgery of the Government Dental College in Chhatrapati Sambhajinagar. This 5-year single-center retrospective cohort study was conducted in the department of oral and maxillofacial surgery at the government dental college and hospital in Chhatrapati Sambhajinagar between 2019 and 2024. Based on age, sex, area, presence of impacted tooth, radiological and histopathological report. Statistical analysis using the Statistical Package for the Social Sciences (SPSS) software (SPSS Inc., Chicago, IL, USA). A study of 3469 patients' panoramic radiographs revealed that 1696 patients had at least one impacted tooth. The third molar was the most common impacted tooth (89.4%), with a higher prevalence among women. Among the 28,72 impacted teeth, the dentigerous cyst (193) was the most common lesion. Histopathologically, out of 546 cases, infected dental cyst (23.6%) was the most common hard tissue lesion, while traumatic fibroma (6%) was the most common soft tissue lesion according to biopsy reports. A study using panoramic radiographs found that 48.8% of 3469 patients had impacted teeth. Only 36% of patients with impacted teeth reported symptoms, and 75% had problem on just one side. Biopsies in 546 patients revealed cysts and traumatic fibromas as common findings. The study suggests that biopsies are necessary to determine the type and severity of lesions for early treatment. Key words:Radiographic analysis, Histopathological analysis, cyst, tumors, impaction.

Common soft tissue and hard tissue lesions in children and young people (Part 2).

Children and young people can present with a wide variety of symptomatic orofacial pathologies, which can often cause concern. As one presentation may masquerade in multiple pathologies, we start this chapter with a reminder of the surgical sieve used to form a differential diagnosis. An accurate history and examination are essential following which, multiple special investigations may be required. The role of the primary care clinician is recognising soft and hard tissue pathology, considering a differential diagnosis, arranging special investigations, and either initiating care for more straightforward conditions or referring for specialist input. This chapter covers common soft and hard tissue pathology, but is not an exhaustive list.This chapter aims to provide the reader with a practical guide to aid the diagnosis of orofacial pathology in the paediatric age group.

Common soft tissue and hard tissue lesions in children and young people (Part 1).

Children and young people can present with a wide variety of symptomatic orofacial pathologies, which can often cause concern. As one presentation may masquerade in multiple pathologies, we start this chapter with a reminder of the surgical sieve used to form a differential diagnosis. An accurate history and examination are essential following which, multiple special investigations may be required. The role of the primary care clinician is recognising soft and hard tissue pathology, considering a differential diagnosis, arranging special investigations, and either initiating care for more straightforward conditions or referring for specialist input. This chapter covers common soft and hard tissue pathology, but is not an exhaustive list.This chapter aims to provide the reader with a practical guide to aid the diagnosis of orofacial pathology in the paediatric age group.

Role of ferroptosis in periodontitis: An animal study in rats.

This study aimed to investigate (1) the temporal pattern of ferroptosis, an iron-dependent cell death, in ligation-induced rat periodontitis and (2) the effect of ferrostatin-1, a ferroptosis inhibitor, on the model. Ferroptosis may contribute to various diseases. However, the role of ferroptosis in periodontitis is still fully understood. In the first experiment, 25 rats with ligation-induced periodontitis were sacrificed on days 0, 1, 2, 7, and 10. Gingivae were obtained to determine tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and ferroptotic biomarkers, including solute carrier family 3 member 2 (SLC3A2) and solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (Gpx4), via immunoblotting. Using microcomputed tomography (μCT) and histology, the periodontal soft and hard tissue lesions, including dental alveolar bone crest level, bony characteristics of the surrounding alveolus, periodontal tissue inflammation, and periodontal tissue losses, were evaluated. In study two, 16 rats with induced periodontitis were grouped according to ferrostatin-1 treatment. The rats were intraperitoneally injected with solvent or ferrostatin-1 (1.5 mg/kg/day) 1 day before ligation and sacrificed on days 7 and 10. Gingival protein changes and periodontal tissue damage were also examined. In study one, SLC3A2/SLC7A11 and Gpx4 decreased since day 1; however, TNF-α/IL-1β increased on days 7 and 10. Moreover, the μCT/histology revealed resorptive bony characteristics, inflamed gingival tissue, and periodontal attachment loss. In study two, ferrostatin-1-injected rats exhibited significantly increased SLC3A2/SLC7A11 and Gpx4 but decreased TNF-α/IL-1β than vehicle rats. They also revealed lessened bone resorption, tissue inflammation, and attachment loss. This study highlights the role of ferroptosis, via the system Xc/Gpx4 pathway, in experimental periodontitis and may serve as a regulatory strategy.

Relationship between enamel resistance and physical properties of saliva in drug-addicted patients

Aim. To investigate the relationship between the physical properties of saliva and enamel resistance and caries intensity in drug-addicted patients. Materials and methods. The study involved 70 patients, who were divided into three groups: the main group (1) – 28 drug addicts diagnosed with caries, the comparison group (2) – 22 patients with caries of dental hard tissues without a history of drug addiction, and the control group (3) – 20 persons without carious lesions of dental hard tissues. We examined the rate of salivation, which was calculated by the formula: Rs = V / T, pH of oral fluid using litmus test strips (Kelilong Instruments, China), structural and functional stability of tooth enamel by the express method TER-test (V. R. Okushko, L. I. Kosareva, 1983), clinically assessed the rate of mineralization according to the Clinical Assessment of the Rate of Enamel Remineralization-test (T. L. Redinova, V. K. Leontiev and G. D. Ovrutsky, 1982), dental caries intensity using the DMF index; the International Caries Detection and Assessment System (ICDAS) was used to assess of the dental hard tissues. Results. In drug-addicted patients with caries of dental hard tissues, the slowest rate of salivation and significant changes in the oral fluid pH toward acidic were observed, namely 5.5 ± 0.09 units compared with patients of other groups. In drug addicts, the average TER-test score was 9.1 ± 0.4 points and was significantly higher than that in non-drug-addicted patients with dental caries (5.4 ± 0.2 points) and people without dental caries (1.9 ± 0.2 points). The Clinical Assessment of the Rate of Enamel Remineralization-test indicators of drug-addicted patients (6.1 ± 0.3 days) were also significantly higher than those of non-addicted and control group patients. The DMF index in drug-addicted patients was 16.4 ± 0.2 points showing a very high intensity of caries with a large proportion of deep carious lesions in the dental hard tissues. Conclusions. In drug addicts, the study results have indicated a 23 % pH shift of the oral fluid toward acidic, and a 22 % decrease in the rate of saliva secretion has also been recorded compared to the healthy individuals. These results were associated with a 79 % decrease in the tooth enamel durability and a 66 % decrease in the remineralizing capacity of the oral fluid in drug addicts as compared to the healthy individuals. The DMF index of group 1 patients differed from that of group 2 patients by 50 % and from group 3 individuals – by 98 %. Drug-addicted patients had 78 % more carious lesions in the dentin compared to non-drug-addicted patients with dental caries.

НЕКОТОРЫЕ ОСОБЕННОСТИ СОСТОЯНИЯ ТВЕРДЫХ ТКАНЕЙ ЗУБОВ И ПАРОДОНТА У ПАЦИЕНТОВ С ВОСПАЛИТЕЛЬНЫМИ ЗАБОЛЕВАНИЯМИ КИШЕЧНИКА, ПРОЖИВАЮЩИХ В РЕСПУБЛИКЕ БАШКОРТОСТАН

The work presents the results of assessing the spread of pathology of hard tissues of teeth and periodontal in patients with chronic inflammatory bowel diseases (IBD). Objective. Assessment of the intensity and spread of pathology of dental hard tissues and inflammatory periodontal diseases in patients with Crohn's disease (CD) and chronic ulcerative colitis (CUC). Materials and methods. A comprehensive clinical and dental examination of 70 patients with CD and CUC was carried out. The complex of dental examination included the analysis of complaints, anamnesis, assessment of the condition of hard tissues of teeth, periodontal tissues. Assessment of the intensity level of nociceptive pain was carried out using a visual analog scale (VAS). Results and discussion. As a result of the clinical examination, a high prevalence of caries (K02) was revealed in CD and CUC, respectively, in 97.2% and 91.4% of cases, high and very high intensity of the carious process according to the CP index ≥ 10. With CD, the symptom of hyperesthesia, increased erasure of mixed teeth and wedge-shaped defects were most often observed in 100, 77.14 and 60.0% of cases, in 68.57% chronic periodontitis prevails (K05.3), with CD, the symptom of hyperesthesia (K03.80) and increased tooth erasure (K03.0) were 1.2 times less common) (p < 0.05), chronic gingivitis prevails in 62.85% (K05.10). The level of intensity of the pain symptom for patients with CD and CUC corresponds to the VAS scale from moderate to significant (p < 0.001). Results. As a result of a comprehensive dental examination of patients with CD and CUC, a high prevalence and intensity of caries and non-carious dental hard tissue lesions, inflammatory periodontal diseases, the level of dental care in persons with CD and CUC is insufficient. Conclusion. The connection of dental status with clinical manifestations of chronic inflammatory bowel diseases is beyond doubt. The ambiguity of the etiology and pathogenesis of CD and CUC as well as the significant similarity of their clinical manifestations, dictate the need for an integrated approach to the development of methods for diagnosing pathology of hard tissues of teeth and periodontal and assessing their clinical features.

The prevalence of oral and maxillofacial pathologic lesions in pathology centers of Zanjan (Iran) over a 5-years period (2014-2020)

Background and objectives: The oral and maxillofacial region is exposed to many harmful agents and can be affected by a wide range of reactive, infectious, cystic, precancerous, and neoplastic lesions. This study aimed to determine the prevalence of oral and maxillofacial pathological lesions in pathology laboratories in Zanjan. 
 Method: This retrospective descriptive study was conducted in the period 2014 -2020 by referring to the hospitals and laboratories with pathologists in Zanjan. Information about patients with histopathological lesions of oral and maxillofacial region was extracted, and studied in terms of age, gender, location and histopathological type of lesion. Finally, the collected data were entered into SPSS software version 22 and statistically analyzed (P <0.05).
 Results: A total of 176 histopathological lesions were investigated. Of them, 120 cases (58%) were female and 74 (42%) were male. The mean age of the patients was 39.4 years. The most prevalent lesion was periapical cyst (14.8%).In terms of tissue involved, the most lesions were related to soft tissue (67%) and in terms of anatomical location, the most lesions were gingival mucosal lesions (35.2%).
 Conclusion: The prevalence of pathological lesions was higher in females than in males. Soft tissue lesions were more than hard tissue lesions. Gingival mucosal lesions were the most prevalent and lesions of the floor of the mouth and nasal vestibule lesions were the least prevalent ones. Given the histopathologic nature of lesions, periapical cyst was the most prevalent lesion.

Abfractive lesions of teeth in dogs

Introduction . The study of patterns and features of the structural state of the dentoalveolar apparatus in representatives of the Canidae family is one of the urgent problems of veterinary dentistry. Understanding the etiological factors of pathologies of the dentoalveolar system allows the veterinarian and pet owners to preserve the function of the tooth as an organ, as well as its functionality by preserving the dentition. It has long been known and confirmed that the pathology of the dentition leads to the development of chronic diseases of the gastrointestinal tract, musculoskeletal system, cardiovascular system and respiratory organs. To systematize the clinical signs of defects and lesions of hard tissues of the teeth, a brief description of these lesions, their classification and clinical signs are given, which are taken from specialized sources and the practical experience of the authors. The purpose of the study was to systematize the clinical signs of defects and lesions of hard dental tissues in dogs of dwarf, small and medium breeds. Objects and methods . A sufficient analysis of significant specialized literature data and a clinical examination of the oral cavity organs were carried out using additional research methods, adopted in dentistry, on dogs (n = 70, dwarf, small and medium breeds). Results . To eliminate the gap in information about abfractional lesions of the teeth, a brief description of these lesions, their classification and clinical signs are given. Based on the study, the following specifications of clinical signs of dental lesions should be distinguished: the presence of microcracks, slight damage to tooth enamel, the formation of a mesh pattern of enamel and the predominance of horizontal lines over vertical ones, and the absence of gum recession. Our studies allow us to identify some features of the systematization of dental lesions in dogs, which is only the initial stage in the study of this complex process. Further research will improve the treatment and prevention measures and methods for the differential diagnosis of abfraction lesions of the teeth in dogs of small and dwarf breeds.

Association of Noncarious Cervical Lesions, Gingival Recession And Cervical Dentin Hypersensitivity: A Narrative Review

Non-carious cervical lesions NCCL and gingival recession GR are two common hard and soft tissue lesions that occur in the cervical region of the teeth. They have a complex multifactorial etiology. The progression of these lesions exposes the cervical dentin resulting in cervical dentin hypersensitivity CDH. For the development of CDH the primary requisite is the exposure of the root surface to the oral environment followed by the loss of enamel and cementum exposing the dentinal tubules. The prevention and control of NCCL and GR essentially reduce CDH thereby promoting oral health. The specific roles of NCCL and GR in CDH and the reason why CDH are identified only in a few cases of NCCL and GR are not clear. Therefore this review aims to discuss NCCL GR and CDH from an etiological perspective the link between NCCL and GR and their roles in the development and prevention of CDH.

Клініко-статистична оцінка психоемоційного статусу підлітків на стоматологічному прийомі

The purpose of the study was to assess the level of personal and reactive anxiety in teenagers of the Transcarpathian region during a dental appointment and establish the correlational dependence of parameters. Materials and methods. An assessment of psycho-emotional state and dental status of 384 adolescents aged 12-18 years who were patients of the “University Dental Polyclinic” was carried out. The patient's appeal was both urgent and for the purpose of rehabilitation, planned. Depending on the level of personal anxiety, patients were divided into clinical groups to determine the prevalence, intensity and activity of caries. The first group included 244 teenagers (175 girls and 69 boys) who were diagnosed with a high level of personal anxiety. The second group consisted of 105 adolescents (48 girls and 57 boys) in whom basic anxiety was moderate, the third group consisted of 35 adolescents with low anxiety (10 girls and 25 boys). The level of reactive and personal anxiety was assessed according to the methodology of Ch. D. Spielberger (adapted by Yu. L. Khanin). Indicators of the prevalence, intensity and activity of caries (CPV index) were determined in the examined subjects according to generally accepted methods. Results and discussion. The level of reactive and personal anxiety is determined to be high in both boys and girls, and reactive anxiety caused by visiting the dentist reaches the maximum percentage indicators in both groups and has a significantly higher percentage than personal anxiety. Significant differences in caries activity indicators of the first and second groups and the first and third groups were established, in particular, significantly lower indicators of absent and compensated caries (p <0.05) and significantly higher indicators of subcompensated and decompensated caries (p <0.05). The indicators of decompensated caries differed significantly between the indicators of the second and third groups (25.8%; 14.3%; p <0.05). Conclusion. High personal anxiety is a factor in the formation and progression of carious lesions of hard tissues in adolescents, a direct relationship between the level of personal anxiety and the course of caries in adolescents has been established, with an increase in personal anxiety, the percentage of decompensated caries increases. That is, high personal anxiety is a factor in the progression of dental caries in teenagers

Bruxism: etiopathogenesis, diagnosis and its repercussions in adults. Review of the literature

Bruxism is defined as a repetitive muscular activity of the jaw, characterized by clenching, or grinding of the teeth due to dragging or thrusting of the jaw. It can manifest itself during sleep or wakefulness. The aim of this review is to establish the most important aspects of bruxism in adults, focusing on its etiology, diagnosis, and its repercussions in adults. The prevalence of sleep bruxism among adults ranges from 22% to 30% and between 1% to 15% for bruxism during wakefulness. Its etiology is associated with two groups of factors: central (psychological and pathophysiological) and peripheral (morphological). In diagnostic methods, it is found as possible (non-instrumental approach or self-report), probable (self-report and clinical examination) or definitive (self-report, clinical examination and polysomnography). The gold standard for the diagnosis of sleep bruxism is polysomnography. In terms of its repercussions, we can find different types of dental hard tissue lesions, mainly abfractions, attrition and mixed lesions. At the musculoskeletal level, the evidence is contradictory as it has been associated with muscle fatigue, sensitivity, and tension, but there is no linear cause-effect relationship. A direct and statistically significant relationship exists between sleep bruxism and morning headaches.

ANALYSIS OF THE DENTAL STATUS OF TEENAGERS IN THE TRANSCARPATIA REGION

Dental status includes an index assessment of clusters that characterize the state of hygiene, the presence of periodontal tissue diseases, and the state of the hard tissues of the teeth. The calculation of these indicators gives a clear idea of the state of the problem and dictates the ways of preventive and therapeutic tactics both in groups and individually. The level of patient anxiety, both personal and reactive, caused by a visit to the dentist, plays a significant role during the appointment with the doctor, affects the trust during communication and affects the quality of dental services in general. The second component of high-quality dental treatment is the determination of the level of dental morbidity in groups, depending on the level of anxiety as a basic factor. Dental status includes an index assessment of clusters that characterize the state of hygiene, the presence of periodontal tissue diseases, and the state of the hard tissues of the teeth. The calculation of these indicators gives a clear idea of the state of the problem and dictates the ways of preventive and therapeutic tactics both in groups and individually.
 The aim of the research. To assess the dental status of adolescents in Transcarpathian region and establish the correlational dependence of parameters.
 Materials and methods. An assessment of the dental status of 384 adolescents aged 12-18 years who were patients of LLC "University Dental Polyclinic" was carried out. The patient's appeal was both urgent and for the purpose of rehabilitation, planned.
 Indicators of the prevalence, intensity and activity of caries (CPV index) were determined in the examined subjects according to generally accepted methods. The state of hygiene in adolescents was determined according to the OHI-S index and Fedorov-Volodkina. The condition of the periodontal tissues in the examined adolescents was determined according to the PMA index. Statistical analysis of the obtained data was carried out on a personal computer using licensed programs ˝MS Excel 7˝ for the operating system˝ Windows˝ and the standard program package "STATISTICA" v. 6.0.
 Conclusions. High personal anxiety is a factor in the formation and progression of carious lesions of hard tissues in adolescents, a direct relationship between the level of personal anxiety and the course of caries in adolescents has been established, with an increase in personal anxiety, the percentage of decompensated caries increases. That is, high personal anxiety is a factor in the progression of dental caries in teenagers. Significant differences in PMA index indicators were established between clinical groups (p<0,05). In the first group of teenagers with a high level of personal anxiety, the indicators of the index corresponded to a severe degree of gingivitis, in the second and third groups, the indicators corresponded to an average degree of gingivitis.
 When assessing the state of hygiene in adolescents of clinical groups, significant differences were established between the indicators of the first and second and the first and third groups according to the OHI-S, DI-S and CI-S indicators of the I.G. index. Green, I.R.Vermillion and indicators of the Fedorov-Volodkina index (р<0.05), the indicators in the first group were significantly higher than in the second and third groups. According to the Fedorov-Volodkina index, a significantly higher index was established in patients of the first group than in the second and third.
 A direct relationship between the level of personal anxiety and the state of hygiene in adolescents has been established, with an increase in personal anxiety, the deterioration of hygiene is noted. That is, high personal anxiety is a factor in the progression of gingivitis.

Case Description of Oral Cavity Hard Tissue Disease in Banjarmasin 2017-2020

Disease that rank first from the list of ten major diseases that are often complained by Indonesian people is oral cavity diseases. The Hard Tissue of oral cavity lesions can be in the form od caries, periodontal disease, periapical abnormalities, cysts, and tumor in the oral cavity. Based on the Riset Kesehatan Dasar (Riskesdas) in 2018 the prevalence of dental and oral problem in Indonesia in South Kalimantan was 59,6%. The purpose of this study is to determine the description of oral hard tissue lesions in Banjarmasin city in 2017-2020. This research is descriptive study using a cross sectional approach. The variables on this study were oral hard tissue disease and gender, the data used were secondary data that obtained from the recording and reporting of the LB-1 form at Banjarmasin Community Health Center. The results showed that the most common type of disease on oral hard tissue case in 2017-2020 was pulp and periapical tissue disease, in 2017 it was 12,640 cases (78.37%), in 2018 it was 18,184 cases (51,45%). In 2019 it was 22,493 cases (57.07%) and in 2020 it was 3,220 cases (58.59%). In 2017, the most cases were in men with total of 7,887 cases (62.50%),while in 2018, 2019, and 2020, the most cases were in women with a total of 11,621 cases (64,29%), 14,285 cases (63.51%) and 1,892 cases (58.76%). It is necessary to prevent oral hard tissue disease, especially in pulp and periapical tissue disease.

Oral Health Status of Illicit Drug Users in a Health District in South Africa.

The prevalence of illicit drug use and its associated oral health complications have been increasing in South Africa (SA). There has been a paucity of studies to determine the oral health status among illicit drug users in SA. This study aimed to determine the oral health knowledge, practices, and status of illicit drug users at rehabilitation centers in a district in SA. This was a cross-sectional study conducted at four rehabilitation centers in Pretoria, SA. Data were collected using a validated self-administered questionnaire and an oral examination. The questionnaire consisted of three parts: demographics, oral health knowledge, and oral health practices. The oral examination was conducted by a calibrated researcher and included caries, periodontal status, dental erosion, trauma, and soft tissue lesions. The data were analyzed using the Statistical Package for Social Sciences (SPSS) software. The mean age was 25.5 (±7.49) years with 91% being male. The majority (84%) of patients were Black, and almost all (87%) had never received oral health education; 55% were not aware that illicit drugs could have an impact on the oral health status and 40% had never had a prior dental consultation. The caries prevalence was 68% with a mean decayed, missing and filled teeth (DMFT) score of 5.3 (±6.18). More than half (58%) required periodontal treatment and there were minimal soft and hard tissue lesions diagnosed. Those who perceived their teeth to be in a poor condition had a significantly higher Decayed, Missing and Filled Teeth (DMFT) score compared with those who perceived their oral health to be good. Just under half (41.9%) of the participants did not need any periodontal intervention, with the other half presenting with plaque retention or calculus and thus needed oral hygiene intervention inclusive of scaling and polishing. There was minimal evidence of pathological oral lesions with only 1.5% presenting with necrotizing periodontal disease (NPD). Overall, there was generalized poor oral hygiene CONCLUSION: Many of the participants had poor oral hygiene knowledge and practices and a relatively high prevalence of caries. It is imperative that oral health promotion and education is incorporated into the medical interventions provided at rehabilitation centers.