Oral Mucosal Diseases Research Articles

The psychoemotional state of patients with oral mucosal diseases and the effectiveness of its correction

Annotation. The work aims to study the psychoemotional state of patients with oral mucosal diseases and to evaluate the effectiveness of oral pathology treatment combined with psychological disorder management. Evaluation of the psychoemotional state of 48 patients with oral mucosal diseases was carried out using the Hospital Anxiety and Depression Scale (HADS). The assessment showed subclinical (mild) and clinically expressed (moderate) anxiety, as well as mild and moderate depression in pre-treatment patients. Based on the type of management, patients were divided into the main and comparison groups. The psychoemotional state of the patients of the main group was analyzed, and comprehensive treatment of oral mucosal diseases was administered, enhanced by psychological management. Patients of the comparison group underwent complex treatment of dental diseases with no psychological management. Statistical processing of the research results was carried out using generally accepted methods of variation statistics with the determination of the Student’s t-test and computer programs: “Statistica 6.1”, Microsoft® Excel 2017. Differences between the groups were considered statistically significant at p<0.05. The results of the study suggest that psychoemotional disorders lead to the development of oral mucosal diseases; at the same time, these oral diseases increase anxiety and depression. Hence, the treatment of patients suffering from oral mucosal diseases requires psychological management. After treatment, patients of the main group showed improved psychoemotional state and decreased clinical manifestations of oral mucosal diseases sooner than patients of the comparison group. Positive results of improving the psychoemotional state of patients with dental pathology invite inquiry into further study and improvement of the management strategies.

Dental diseases in patients with pathology of the gastrointestinal tract: a literature review

Annotation. The study aimed to analyze references in the scientific literature on hard dental tissue damage and periodontal and oral mucosal diseases in patients with concomitant gastrointestinal tract pathology. We used the bibliosemantic method to identify the status of the outlined issues and analysis of the scientific research data. Based on data from national and international published literature on the topic, the prevalence, severity and structurality of changes in the organs and tissues of the oral cavity associated with gastrointestinal tract diseases were evaluated. The review was carried out using data from scientific articles for the period of 2011-2022 with search words “Digestive System Diseases”, and “Diseases of the Oral Cavity” using the MESH subject headings: dental caries susceptibility, mouth diseases, gastrointestinal diseases, malabsorption syndromes, dental caries, tooth demineralization and others. The final analysis included 75 scientific articles corresponding to the purpose of the study. Data obtained from analysis of literary sources of recent years suggests that both local and general factors are involved in the process of occurrence and course of dental pathology with concomitant involvement of the gastrointestinal tract. The nature of their interaction will determine the peculiarities of the course of dental diseases. However, the lack of convincing data on the age-related features of the occurrence and development of dental diseases, as well as the inconsistency of the results regarding the significance of risk factors for the progress of comorbid conditions complicates the methods development of their treatment and prevention. The listed features of the course of dental diseases with a combined involvement of gastrointestinal disorders indicate the mandatory complexity of treatment, taking into account concomitant pathology.

A Review of Preclinical and Clinical Studies in Support of the Role of Non-Steroidal Anti-Inflammatory Drugs in Dentistry.

Patient pain is a common problem faced by dentists and oral and maxillofacial surgeons. Craniofacial pain may be caused not only by inflammation in the teeth, but also various oral, facial, and nerve-related diseases, as well as tumors. Non-steroidal anti-inflammatory drugs (NSAIDs) constitute the basis of the analgesic ladder. According to the World Health Organisation (WHO), NSAIDs are the first-line drugs in relieving pain and inflammation of oral conditions. NSAIDs have been used in almost every field of dentistry. These drugs are applied in conservative dentistry and endodontics, dental surgery, orthodontics, periodontology, and oral mucosal diseases, as well as head and neck oncology. Some of the NSAIDs exhibit additional therapeutic effects, such as inhibition of nuclear factor kappa B (NF-kappaB) and inducible nitric oxide synthase (iNOS), and reduction of oxidative stress or leukocyte passage to the site of inflammation, which further reduces inflammation in tissues. The topical use of NSAIDs in dentistry is worthy of attention and further research as it will significantly reduce the adverse effects of systemic administration. This article aims to review the preclinical and clinical studies that have supported the role of NSAIDs in dentistry.

Prevalence and risk factors of recurrent aphthous stomatitis among college students at Mangalore, India.

Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases affecting an approximate 25% of the world's population. Some common etiological factors are genetics, nutritional deficiencies, stress and immune dysfunction. There is currently no specific medication to treat the condition but RAS tends to heal by itself within a week or two. We aimed to explore about the prevalence and related risk factors of recurrent aphthous ulcers among college students aged 18-30 years who had been affected within the preceding six months prior to the study duration. A questionnaire survey was conducted among 681 students from four colleges in Mangalore, Karnataka, India after obtaining the approval for the same from the respective colleges. Consenting participants returned a survey containing various questions. The collected data was then analyzed using descriptive statistics. The study was approved by the Institutional Ethics Committee. Of the 681 participants, 322 (47.2%) were affected with RAS in the past six months which included 131 (40.6%) males and 191 (59.3%) females. Single mouth ulcers were the most common presentation seen among the study participants (74.2%). Factors showing statistically significant association were: family history of RAS (P<0.001), known diabetics (P<0.001), history of smoking (P<0.001), oral trauma (P<0.001), history of wearing braces/dentures (P<0.001) as well as those using toothpastes containing sodium lauryl sulphate (P<0.001), stress and lack of sleep (P<0.001). The most common form of medication used were topical agents (43.1%) (P<0.001). There was a statistically significant association between the occurrence of RAS and family history of RAS, diabetes, smoking, history of braces/dentures, oral trauma, sodium lauryl sulphate toothpastes, lack of sleep, stress, menstruation, consumption of particular foods and beverages. Further research is needed in this field to truly understand the prevalence and risk factors of RAS and to help in discovering a treatment modality for this condition.

Atorvastatin mucoadhesive tablets in the management of recurrent aphthous stomatitis: a randomized clinical study

BackgroundAphthous stomatitis is one of the most common oral mucosal diseases. Due to the commonness of recurrent aphthous stomatitis and considering the anti-inflammatory, analgesic, and tissue regenerative properties of atorvastatin and the lack of a study on the effect of statins on minor recurrent aphthous stomatitis, this study investigates the effect of atorvastatin mucoadhesive tablets as a topical treatment on reduction of symptoms and duration of this disease.MethodsThis study is a randomized, double-blinded clinical trial. Patients were divided into two groups, atorvastatin and, placebo; each of the patients received three mucoadhesive tablets daily in the morning, noon, and night. Finally, the patients were examined on days 0 (baseline), 3, 5, and 7 to determine the diameter of the inflammatory halo. The VAS scale was used to evaluate pain intensity for up to 7 days after each meal. The data was entered into SPSS 24 software and analyzed.ResultsThe halo diameter did not significantly differ between the two groups on baseline (P > 0.05). However, on the study’s third, fifth, and seventh days, the difference between the two groups was remarkable, so in the atorvastatin group, the size of the lesions decreased in shorter healing time (P < 0.05). In addition, the patient’s pain intensity (VAS) also showed a significant decrease in the atorvastatin group except on the first, second, and seventh days of the study (P < 0.05).ConclusionAtorvastatin mucoadhesive tablets effectively reduce the pain of patients with minor recurrent aphthous stomatitis and reduce the size and healing time of the lesions, so their application should be considered in treating minor recurrent aphthous stomatitis. The present study was approved by the Medical Ethics Committee of Mazandaran University of Medical Sciences with the ethics code IR.MAZUMS.REC.1400.8346. Also, this study received code IRCT20170430033722N4.

Deep learning algorithms for classification and detection of recurrent aphthous ulcerations using oral clinical photographic images

Background/purposeThe application of artificial intelligence diagnosis based on deep learning in the medical field has been widely accepted. We aimed to evaluate convolutional neural networks (CNNs) for automated classification and detection of recurrent aphthous ulcerations (RAU), normal oral mucosa, and other common oral mucosal diseases in clinical oral photographs. Materials and methodsThe study included 785 clinical oral photographs, which was divided into 251 images of RAU, 271 images of the normal oral mucosa, and 263 images of other common oral mucosal diseases. Four and three CNN models were used for the classification and detection tasks, respectively. 628 images were randomly selected as training data. In addition, 78 and 79 images were assigned as validating and testing data. Main outcome measures included precision, recall, F1, specificity, sensitivity and area under the receiver operating characteristics curve (AUC). ResultsIn the classification task, the Pretrained ResNet50 model had the best performance with a precision of 92.86%, a recall of 91.84%, an F1 score of 92.24%, a specificity of 96.41%, a sensitivity of 91.84% and an AUC of 98.95%. In the detection task, the Pretrained YOLOV5 model had the best performance with a precision of 98.70%, a recall of 79.51%, an F1 score of 88.07% and an AUC of Precision-Recall curve 90.89%. ConclusionThe Pretrained ResNet50 and the Pretrained YOLOV5 algorithms were shown to have superior performance and acceptable potential in the classification and detection of RAU lesions based on non-invasive oral images, which may prove useful in clinical practice.

Herpesvirus-Related Lesions of the Oral Mucosa.

The human herpesvirus (HHV) family is a group of enveloped DNA viruses containing 8 members known to produce oral mucosal lesions. Following initial exposure, which may result in symptomatic primary infection, the viruses establish latency within specific cells/tissues. After reactivation, herpesviruses can cause localized symptomatic or asymptomatic recurrent (secondary) infections or diseases. HHV may have a significant role in the cause of oral mucosal infectious diseases in immunocompromised patients. This article discusses the role of those herpesviruses that can induce oral mucosal lesions, with focus on the clinical features and treatment/management.

Promoting oral mucosal wound healing using a DCS-RuB2A2 hydrogel based on a photoreactive antibacterial and sustained release of BMSCs.

The high occurrence rate and difficulties in symptom control are listed as the major problems of oral mucosal disease by medical professionals. Following the development of oral mucosal lesions, the oral microenvironment changes, immunity declines, and continuous bacterial stimulation causes wound infection. Traditional antibacterial drugs are ineffective for oral mucosal lesions. To overcome this problem, a light-responsive antibacterial hydrogel containing sustained-release BMSCs was inspired by the trauma environment in the oral cavity, which is different from that on the body surface since it mostly remains under dark conditions. In the absence of light, the hydrogel seals the wound to form a barrier, exerts a natural bacteriostatic effect, and prevents invasion by foreign bacteria. Simultaneously, mesenchymal stem cells are presented, and the released growth factors and other substances have excellent anti-inflammatory and angiogenic effects, which result in rapid repair of the damaged site. Under light conditions, after photo-induced shedding of the hydrogel, RuB2A exerts an antibacterial effect accompanied by degradation of the hydrogel. Results in a rat oral mucosal repair model demonstrate that DCS-RuB2A2-BMSCs could rapidly repair the oral mucosa within 4 days. Sequencing data provide ideas for further analysis of the intrinsic molecular mechanisms and signaling pathways. Taken together, our results suggest that this light-responsive antibacterial hydrogel loaded with BMSCs can be used for rapid wound repair and may advance the development of therapeutic strategies for the treatment of clinical oral mucosal defects.

Proposal for clinical guidelines (guidelines) for local anesthesia in dentistry

Pain control according to sensory nerve innervation in the oral and maxillofacial area is an important part of clinical dentistry for treating diseases of teeth, periodontal tissue, oral mucosa, temporomandibular joint, and maxillofacial area. Local anesthesia has been used the basic pain control procedure in dental treatment. Dental local anesthesia is a basic procedure in the curriculum of dental schools, and is the most frequently used dental procedure by many dentists in clinical practice. As one of these procedures, we would like to review the considerations of whether clinical guidelines for these procedures are necessary.

Predicting the Activity of Oral Lichen Planus with Glycolysis-related Molecules: A Scikit-learn-based Function.

Oral lichen planus (OLP) is one of the most common oral mucosa diseases, and is mainly mediated by T lymphocytes. The metabolic reprogramming of activated T cells has been shown to transform from oxidative phosphorylation to aerobic glycolysis. The present study investigated the serum levels of glycolysis-related molecules (lactate dehydrogenase, LDH; pyruvic acid, PA; lactic acid, LAC) in OLP, and the correlation with OLP activity was assessed using the reticular, atrophic and erosive lesion (RAE) scoring system. Univariate and multivariate linear regression functions based on scikit-learn were designed to predict the RAE scores in OLP patients, and the performance of these two machine learning functions was compared. The results revealed that the serum levels of PA and LAC were upregulated in erosive OLP (EOLP) patients, when compared to healthy volunteers. Furthermore, the LDH and LAC levels were significantly higher in the EOLP group than in the nonerosive OLP (NEOLP) group. All glycolysis-related molecules were positively correlated to the RAE scores. Among these, LAC had a strong correlation. The univariate function that involved the LAC level and the multivariate function that involved all glycolysis-related molecules presented comparable prediction accuracy and stability, but the latter was more time-consuming. It can be concluded that the serum LAC level can be a user-friendly biomarker to monitor the OLP activity, based on the univariate function developed in the present study. The intervention of the glycolytic pathway may provide a potential therapeutic strategy.

"The Standard Procedure" for Investigation of Oral Neutrophils in Oral Diseases.

There is need of an objective "standard procedure" that is reliable and clinically applicable for estimating oral neutrophil content in relation to oral diseases. Forty-one patients with suspected oral candidosis (OC) and nine healthy controls with no oral mucosal disease were flushing with 10 ml mouth rinse (MR) (sterile phosphate-buffered saline) for 1 min. Aliquots were stored on different conditions to explore stability, storage, and fixation conditions for analysis by flow cytometry. The optimal storage and fixation condition for MR was by fixation 1 : 1 in 10% formalin and stored at 5°C. This procedure yielded stable results up to 7 days after collection. The ability of the optimized method to relate oral neutrophils to inflammation was demonstrated by the significantly higher number of neutrophils in patients with primary OC (p = 0.0334) compared to healthy controls. This method is rapid, reliable, and clinically applicable for establishing the content of oral neutrophils. We demonstrate increased density of oral neutrophils in the MR of patients with OC. The potential of the method is to be "the standard procedure" for investigation of the oral inflammation in patients with oral diseases as it is noninvasive and provides high stability, clinical relevance, and minimal handling.

Oral mucosa diseases in seafarers during long voyages, their treatment and prevention : prospective study

OBJECTIVE: To detect oral mucous membrane disease of the mouth, lips and tongue in seafarers on long voyage, to evaluate preventive measures and treatment effectiveness. MATERIALS AND METHODS: There was a dental examination of 169 men, aged 22-52 on long voyage, who got full treatment and preventive measures of oral rehabilitation in the pre-deployment period in a time manner. The seafarers were divided into 2 groups. The 1st group included 57 seamen, who were part of the crew. The 2nd group consisted of 112 men, who were training and had the first long voyage. The oral mucosa diagnosis was based on a clinic examination. When identifying pathology, treatment was provided and there were anti-relapse measures after its completion, which were possible given the people on board on long voyage. RESULTS: It was found that the structure of oral mucosa is quite different among people of the 1st and 2nd groups. The pathology among the crew occurred more often due to the autoimmune component of pathogenesis in 5,26% and 0,9% cases respectively, while the people in the 2nd group, being on long voyage as part of their training, experienced infectious oral mucosa pathology (12,28% and 15,32% respectively) significantly more often, and also lesions of the lips due to meteorological factors in 8,77% and 10,81% cases accordingly. DISCUSSION: The article discusses the treatment of meteorological cheilitis, the fracture of the vermilion border of the lip, Vincent disease, herpetic fever and chronic recurrent aphthous stomatitis with the use of domestic medicine for topical application. CONCLUSION: On long voyage 26,04% seafarers had cases of oral mucosa, among which most frequently diagnosed ones were infectious diseases, pathology due to meteorological factors, and also diseases with the autoimmune component of pathogenesis. In all cases domestic medicine for topical application was used to reveal pathology of oral mucosa, and further, to prevent its recurrence that allowed to achieve a good therapeutic result and to avoid recurrence of oral mucosa disease, typical for seafarers during a 9-month voyage.

Abstract 4238: Specific oral microbiome is closely associated with oral potentially malignant disorders and oral squamous cell carcinoma

Abstract Background: Bacterial and virus infection may cause pre-malignant and malignant disorder such as hepatocellular carcinoma and cervical cancer. Recent studies reported that oral bacterium is associated with gastric and colon cancer. However, it is not clear yet if the oral microbiome affects the development of pre-malignant disorder in oral cavity and oral cancer. Thus, this study aims to identify the periodontal pathogen candidates involved in the onset and progression of oral squamous cell carcinoma (OSCC). Materials and Methods: Saliva was collected from 112 patients without oral mucosal diseases (OMDs) as control, 36 patients with oral potentially malignant disorders (OPMDs), and 104 patients with OSCC, and DNA was extracted in each sample. Periodontal examinations were performed on all patients. Endpoint-PCR was performed on seven species of oral pathogens using the extracted DNA. 16S ribosomal RNA (rRNA) was utilized for analysis of oral microbiome with 20 samples in each group. 4-nitroqquinoline-1-oxide (4-NQO)-induced tongue tumor model in mice was analyzed with or without endotoxin of one of the oral bacteria, Porphyromonas gingivalis (P. gingivalis). Results: From the statistical analysis of the clinical parameters, periodontal disease tended to worsen in the OMPD and OSCC groups compared to the control group. The number of oral bacteria was significantly higher in the OSCC group than those in other groups. From PCR results, the detection rates of P. gingivalis, Aggregatibacter actinomycetemcomitans, and Treponema denticola were significantly higher in the OSCC group than those in the control group. From 16S rRNA analysis, the relative abundance of Prevotella buccae and intermedia was significantly higher in OSCC groups than in the control group. Furthermore, the relative abundance of P. gingivalis was higher in the OSCC group compared to other groups, regardless of age and the number of teeth. In mouse model, mice treated with P. gingivalis-derived endotoxin developed oral leukoplakia at earlier time points and tumors significantly higher lesions compared to control group. Conclusion: These results suggest that specific periodontal pathogens are present in the oral cavity of OPMDs and OSCC patients and those changes in the bacterial flora due to their presence may contribute to the onset and progression of OMDs. Citation Format: Mitomu Kioi, Hiroshi Isono, Shintaro Nakajima. Specific oral microbiome is closely associated with oral potentially malignant disorders and oral squamous cell carcinoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4238.

Designing and characterization of Yahom buccal mucoadhesive tablets for oral ulcer treatment

Oral ulcer is a common oral mucosal disease that affects about 5–20% of general population, particularly the elderly, and is characterized by recurrent, painful ulcerations and burning sensation. Various possible causes include local, systemic, immunologic, genetic, allergic and microorganisms. Yahom is a Thai traditional medicine that has long been used to treat nausea, vomiting, dizziness and weakness in elderly. Yahom is produced from a variety components of dried medicinal plant parts that are mostly ground into powder dosage form. Ingredients are composed of following crude drugs are common incorporated in Yahom preparations such as clove, terminalia gall, costus root and ceylon ironwood flower which practically and clearly exhibit the potent antioxidant and antimicrobial activities. Therefore, it is interesting to apply Yahom as active component for oral ulcer treatment using appropriate approach such as mucoadhesive tablet. The objective of this study is to develop buccal mucoadhesive tablet consisting of hydroxypropyl methylcellulose (HPMC) and polyvinyl pyrrolidone (PVP) as mucoadhesive polymers in formulations. The impact of various ratios of Yahom: polymer and polymer mixtures were investigated on physicochemical properties of mucoadhesive tablets were investigated including physical properties, disintegration time, water sorption/erosion behaviors and ex-vivo mucoadhesion. In addition, the antimicrobial activities of formulations against two standard microbes were also evaluated using agar cup diffusion methods. Yahom mucoadhesive tablets were successfully fabricated using direct compression tableting technique with good appearance and acceptable physical properties. Different amounts of Yahom and polymer ratios apparently influenced on water sorption, erosion behaviors and hardness of mucoadhesive tablets, resulting in alteration of disintegration time and muco-adhesion properties. In addition, these prepared tablets exhibited the efficient antimicrobial activities against Staphylococcus aureus ATCC 6538 and C. albicans ATCC 10231. Therefore, the buccal mucoadhesive tablets containing Yahom are the potential herbal delivery system for oral ulcer treatment.

Prevalence and determinants of oral potentially malignant disorders in rural areas of South India.

Oral potentially malignant disorders are associated with a risk of undergoing malignant transformation and a concomitant increase in morbidity and mortality. Moreover, epidemiological studies, especially from rural areas, are important in assessing their prevalence and the identification of determinants of these disorders so that preventive strategies can be employed in tackling them. Cross-sectional descriptive study was conducted based on guidelines of the World Health Organization's Guide Epidemiology and Diagnosis of Oral Mucosal Disease and Conditions 1995 in rural areas of south India. Prevalence of oral potentially malignant disorders (OPMDs) in the studied population was 13.28%, with oral submucous fibrosis (OSMF) accounting to 6.21% and erythroplakia at 1.3%. Regression analysis revealed, age 40-54 years (odds ratio [OR] = 3.8, confidence interval [CI] at 95%-1.5-4.0, P < 0.05), lower socioeconomic groups (OR = 2.1, CI at 95%-1.4-3.1, P < 0.05), habits (OR = 3.2, CI at 95%-1.9-3.8, P < 0.05), smoke form of tobacco-beedi (OR = 2.5, CI at 95%-1.6-2.8, P < 0.05), smokeless form of tobacco-areca nut lime and leaf and tobacco (OR = 3.1, CI at 95%-1.9-3.4, P < 0.05) to be the possible determinants for OPMDs. The overall prevalence of OPMDs in the studied population was 13.28%. The most common OPMDs were OSMF. Identified determinants were age, socioeconomic group, ethnicity, diet, body mass index, and associated harmful habits.

Effects of prolonged stimulation with heated tobacco products (Ploom TECH+ ) on gingival epithelial cells.

Heated tobacco products have recently become commercially available. These products, as well as combustible cigarettes, produce aerosols; the risk of various diseases associated with heated tobacco products may be the same or higher than that with combustible cigarettes. In this study, we examined the effect of Ploom TECH+ extract on gingival epithelial cells. Tobacco leaves from Ploom TECH+ tobacco capsules and water were mixed and heated; the supernatant subsequently collected was the heated tobacco product (HTP; control: HTP not added). Normal human gingival epithelial progenitors were cultured alternately with or without HTP for a total of 1 month. Subsequently, RNA, DNA, and proteins were isolated from these samples and comprehensively analyzed using RNA sequencing (RNA-seq), reduced representation bisulfite sequencing (RRBS), and western blotting, respectively. RNA-seq revealed that 284 genes showed a twofold increase and 145 genes showed a twofold decrease in gene expression. A heat map showed genetic differences between the control and HTP groups. A principal component analysis plot showed a clear genetic distribution between the control and HTP. Gene Ontology (GO) analysis showed that genes related to seven GO terms, including cornification and keratinization, were induced by long-term HTP stimulation. By contrast, GO pathways with a significant decrease in component expression were not detected. RRBS revealed that CpG island methylation increased more than twofold in 158 genes and decreased to less than twofold in 171 genes. Methylation of these CpG islands was not correlated with changes in gene expression levels. HTP treatment increased S100A7 expression. Long-term HTP stimulation affected epithelial differentiation and keratinization of gingival epithelial cells. Thus, habitual use of Ploom TECH+ may be a risk factor for tobacco-related oral mucosal diseases.

IMPROVEMENT OF ORTHOPEDIC CARE FOR MILITARY PERSONAL DURING WARTIME

In the current situation of Russian military aggression against Ukraine, the dental health of military personnel is a key concern. Poor dental health impacts the overall well-being of the military, which in turn affects combat tasks and quality of life. Various studies show that 90% of military personnel require dental care. The aim of our study was to analyze reasons for military personnel to seek orthopedic dental care and to carefully select construction materials for dental prostheses, taking into account clinical presentation and accompanying diseases. We conducted an examination of 92 military personnel receiving treatment in a hospital and on rotation in the Poltava region from April 2022 to January 2023. Out of this group, 52 people sought orthopedic help for the first time, while 40 people had previously undergone prosthetic treatment with fixed dental appliences that were removed due to non-compliance with clinical requirements. Chronic periodontal and oral mucosal diseases were diagnosed in 84 participants, and teeth were extracted for 37 individuals due to complications of periodontitis and periodontitis. To address these issues, we selected thermoplastic material Acron, manufactured by Roko (Poland), as the ideal material for partial removable prostheses. This material is biologically inert to the tissues of the prosthetic bed and enabled us to produce high-quality removable prostheses in two clinical visits, which is relevant for military personnel who are on rotation and receiving treatment in the hospital. In conclusion, our study provides insight into the reasons for seeking orthopedic dental care among military personnel and highlights the importance of careful selection of construction materials for dental prostheses to prevent complications and enable effective treatment in a short time.

ORAL HEALTH STATUS OF INTERNALLY DISPLACED PERSONS

Diseases of the oral cavity organs and tissues are an urgent medical problem. The urgency of the problem has been exacerbated by the extreme conditions in Ukraine in recent years: the COVID-19 pandemic and the war. These factors lead to stress, changes in living standards and living conditions, which leads to exacerbation of chronic diseases, and also impede the receipt of full, qualified medical care.&#x0D; The Ministry of Health of Ukraine presents the regulatory framework "Rights and Obligations of Internally Displaced Persons", which guarantees medical examinations and treatment. According to the MoH order, the Poltava Regional Centre of Dentistry Dental Clinical Polyclinic has created conditions to provide dental care to IDPs at present.&#x0D; Ways of implementation:&#x0D; &#x0D; provision of dental care to patients by dentists of the polyclinic;&#x0D; providing emergency dental care around the clock;&#x0D; providing consultative and medical care by teachers of dental departments and doctors-interns.&#x0D; &#x0D; The study analysed the condition of the oral cavity organs (teeth, periodontium, oral mucosa) of internally displaced persons and identified possible ways to preserve and restore dental health through preventive work, therapeutic, surgical and orthopaedic care.&#x0D; The study analysed the work of dentists and teachers of dental departments in providing assistance to internally displaced persons over the 7 months of war in Ukraine. A total of 7388 people sought help. To assess the condition of the tissues and organs of the oral cavity, examinations were carried out using clinical, radiological and laboratory methods. If necessary, patients were consulted by related specialists.&#x0D; It was found that in all examined patients, the caries prevalence rate was 100%, and the CPV index was equivalent in patients of the main group (19±1.27) and the control group (18±2.45). The number of patients with pulpitis was 2268 (37%) (acute, chronic pulpitis and exacerbation of chronic pulpitis).&#x0D; Acute and exacerbation of chronic periodontitis was treated in 1852 patients (22.7%), periostitis in 855 (14%), and odontogenic maxillary sinusitis in 196 (3.2%).&#x0D; Out of the total number of patients, 263 (4.26%) sought treatment for exacerbation of gingivitis, 482 (7.82%) for exacerbation of periodontitis, and 698 (11.4%) for diseases of the oral mucosa.&#x0D; A high degree of reliability of exacerbation of periodontal and oral mucosa diseases was found in comparison with the control group.

Complicated clinical variants of mucoperiodontal lesions: desquamative gingivitis

Objective. To study the frequency, clinical and topographic features, risk factors for development, quality of primary diagnosis and treatment of desquamative gingivitis in patients with chronic pathology of the oral mucosa.&#x0D; Materials and methods. A cohort cross-sectional clinical study with elements of sociological analysis of patients (n = 314; 99 males and 215 females aged 18 to 62 years), who visited the medical advisory center for oral mucosal diseases (OMD) was conducted. According to the results of clinical and laboratory studies, the diagnosis of the main oral mucosal disease was formulated, and patients with desquamative gingivitis were isolated into a separate group. Hygienic (OHI-S) and periodontal (PMA, BoP, PBI, CPITN) indices were evaluated, and impact of oral pathology on the patients quality of life using OHIP-49-RU index was assessed for objectification of periodontal status.&#x0D; Results. High (17.8 %) incidence of desquamative gingivitis was found in patients with chronic oral mucosal diseases of predominantly autoimmune origin (lichen planus, pemphigus vulgaris, erythema multiforme, psoriasis). Desquamative gingivitis develops significantly more often (60.7 %) in women and affects the vestibular surfaces of the anterior-upper dentogingival segment, manifests clinically apparent edema, pain, hemorrhagic and sensory-paresthetic symptoms, which limit the functionality of the patient (chewing, speech, oral hygiene, social communication and professional realization), that significantly reduces the key parameters of patients quality of life.&#x0D; Conclusions. The main reasons for chronization of desquamative gingivitis and low effectiveness of its treatment are the following: low level of polyclinic diagnostics, problems of differential diagnosis, the predominant use of irrational, pathogenetically unjustified means and methods of treatment, as well as the lack of interdisciplinary approaches to the planning of complex therapy.

Novel Double-Layer Dissolving Microneedles for Transmucosal Sequential Delivery of Multiple Drugs in the Treatment of Oral Mucosa Diseases.

The development of transmucosal drug delivery systems is a practical requirement in oral clinical practice, and controlled sequential delivery of multiple drugs is usually required. On the basis of the previous successful construction of monolayer microneedles (MNs) for transmucosal drug delivery, we designed transmucosal double-layer sequential dissolving MNs using hyaluronic acid methacryloyl (HAMA), hyaluronic acid (HA), and polyvinyl pyrrolidone (PVP). MNs have the advantages of small size, easy operation, good strength, rapid dissolution, and one-time delivery of two drugs. Morphological test results showed that the HAMA-HA-PVP MNs were small and intact in structure. The mechanical strength and mucosal insertion test results indicated the HAMA-HA-PVP MNs had appropriate strength and could penetrate the mucosal cuticle quickly to achieve transmucosal drug delivery. The in vitro and in vivo experiment results of the double-layer fluorescent dyes simulating drug release revealed that MNs had good solubility and achieved stratified release of the model drugs. The results of the in vivo and in vitro biosafety tests also indicated that the HAMA-HA-PVP MNs were biosafe materials. The therapeutic effect of drug-loaded HAMA-HA-PVP MNs in the rat oral mucosal ulcer model demonstrated that these novel HAMA-HA-PVP MNs quickly penetrated the mucosa, dissolved and effectively released the drug, and achieved sequential drug delivery. Compared to monolayer MNs, these HAMA-HA-PVP MNs can be used as double-layer drug reservoirs for controlled release, effectively releasing the drug in the MN stratification by dissolution in the presence of moisture. The need for secondary or multiple injections can be avoided, thus improving patient compliance. This drug delivery system can serve as an efficient, multipermeable, mucosal, and needle-free alternative for biomedical applications.