Abstracts of the 6th National Ukrainian Dental Congress “Innovative technologies in dentistry” (October 22–23, 2021, Kyiv, Ukraine)

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State programs for the primary prevention of major oral diseases in Belarus

Background. The purpose of the study was to analyze the results of the implementation of state programs for the prevention of major dental diseases, dental caries and periodontal diseases, in the Republic of Belarus. Materials and methods. Generalization of studies on the epidemiology of dental caries and periodontal diseases among children and adults in Belarus. Results. The first state program for the primary prevention of dental diseases in children, developed by professor E.M. Melnichenko in 1986, together with the updated version of 1998, was effective in reducing the prevalence of dental caries in the key age group of 12-year-old children by 20 % from the baseline level; the national prevention program made it possible to achieve the decayed, missing and filled teeth index of 2.4. Conclusions. The experience of practical implementation of the state program for the prevention of dental diseases in the Republic of Belarus was positive due to the use of evidence-based methods recommended by the World Health Organization.

Unresolved issues of classification of periodontal diseases (discussion)

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Address of the editor-in-chief prof. I.P. Mazur

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Vitamin D in periodontology

Generalized periodontitis is one of the most common dental diseases that can lead to tooth mobility and tooth loss. Plaque is main etiological factor, but periodontitis is a multifactorial disease. There are data on the effect of vitamin D levels on generalized periodontitis. Vitamin D has a pleiotropic effect by affecting various links in the pathogenesis of generalized periodontitis. Stimulating the secretion of antimicrobial peptides, vitamin D increases local immunity and adversely affects periodontal pathogens; modulating the immune system, it affects inflammation in periodontal tissues and the immune response; increasing the absorption of calcium and reducing the release of parathyroid hormone, vitamin D stimulates bone mineralization. The high prevalence of vitamin D deficiency and insufficiency worldwide indicates the relevance of studying its effects on the human body in general and the oral cavity in particular.

Analysis of the main indicators of dental care in Ukraine for 2020

The article presents an analysis of the results of state and sectoral statistical reports of dental healthcare institutions, which were submitted to the State Institution “Center for Medical Statistics of the Ministry of Health of Ukraine” in 2020. As of January 1, 2021, 22,180 general dental practitioners and 766 dentists provided dental care to the population of Ukraine in 6,443 institutions of various forms of ownership. The article pre-sents the structure, staffing level and dentistry personnel density in Ukraine; also, a comparative analysis for the last 5 years was conducted in terms of staffing level of dentists working in healthcare institutions of different forms of ownership. The main indicators of the system of providing dental care in both public and private healthcare facilities are presented. A comparative analysis with the main indicators of dental care for 2019 was carried out. The number of routine examinations of the oral cavity decreases and the number of malignant neoplasms, especially advanced ones, increases.

Polypharmacy: definition, risks, management

A search was performed in the Scopus, Web of Science, MedLine, The Cochrane Library databases. The term “polypharmacy”, in contrast to the term “polypragmasia”, does not always has a negative meaning and is often used to describe the simultaneous use of five or more drugs, and polypharmacy is considered intensive, when the patient takes 10 or more drugs at the same time. One of the main causes of polypharmacy is polymorbidity. Severe condition of the patient, self-medication and inappropriate recommendations can also cause polypharmacy, as well as some demographic factors (age, gender, level of education) and the level of the health care system development. Polypharmacy can be appropriate when the prescription of a large number of drugs is justified, and inappropriate (problematic) when the number of prescribed drugs is incorrect and/or unbalanced. Problematic polypharmacy is a manifestation of polypragmasia, with several drugs prescribed improperly that does not allow realizing the expected advantage of these drugs. The risk of harm from treatment outweighs the benefits due to drug interactions, adverse reactions, increasing economic burden of treatment. Problematic polypharmacy is especially dangerous for critically ill patients. The management of problematic polypharmacy should be based on its transition into an appropriate form. The combination of drugs is substantiated, which allows treating the patient effectively, safely and economically expediently through the prevention of drug interaction and adverse effects. Deprescribing of certain drugs can be used as a therapeutic intervention, it should be performed in each individual patient through the assessment of benefits and risks. Beers criteria, ARMOR, STOPP-START criteria are offered for prevention and correction of problematic polypharmacy in the elderly.

Organization of the state dental service in Ukraine: historiographical analysis

Background. The historical chronology of the creation of the state system of dental care organization in Ukraine reveals the first steps of formation and further development of dentistry as an integral part of scientific and clinical medicine. In 1920, a fundamentally new organizational and economic model of dental care with state funding was introduced in Ukraine, which provided for the coverage of the entire population of the country. The long history is the best basis for the analysis of the passed evolutionary way of dental care development in Ukraine. Objective: to study the historiography of dentistry formation as an independent discipline of scientific and clinical medicine, organization of the state dental service in Ukraine based on the results of research of archival materials of normative-legal documents. Materials and methods. Materials of the main archival documents of the Central State Historical Archives of Ukraine in Kyiv for 1919–1920 were studied and analyzed. The materials of the study were the main normative-legal documents regulating dental care: Order of the People’s Commissariat of Health of the Ukrainian SSR No. 3 dated April 5, 1920 “On the organization of dental sections at the provincial health departments”; Order of the People’s Commissariat of Health of the Ukrainian SSR No. 4 dated April 10, 1920 “On the organization of state dental care”; instructions to paragraph 2 of the Order of the People’s Commissariat of Health of the Ukrainian SSR No. 4 dated April 10, 1920 “On state dental care”; instruction “On the issues of the decision of dentistry in state outpatient clinics” approved by the People’s Commissariat of Health of the Ukrainian SSR on April 13, 1920; “Plan for the organization of dental care provision to the population of Ukraine” approved by the People’s Commissariat of Health of the Ukrainian SSR on June 26, 1920. The research methods were the historical one, which involves the study of the creation, formation and development of objects in chronological order; and historical-critical one, which involves the extraction of reliable information from historical sources, the reconstruction of historical facts in order to study the history of events. Results. On the basis of archival materials of normative-legal documents of the Central State Historical Archives of Ukraine in Kyiv, a historical-critical analysis of the creation of the state system of dental service organization in Ukraine for 1919–1920 was conducted. The orders, directives and instructions approved by People’s Commissariat of Health of the Ukraine reveal the first steps in building and implementing a new organizational and economic model of dental care. The created healthcare system was based on the provision of social medical dental care by the state to every citizen of Ukraine. Conclusions. Historiographical analysis of normative-legal documents reveals the formation of dentistry as an integral part of highly qualified medical care. The introduced new organizational and economic model of providing social dental care to the population of Ukraine was based on the principles of gratuitousness, availability, proficiency, integration and prevention of dental diseases. Dental care for the population of Ukraine included the construction of a network system of state outpatient clinics, dental departments as a part of multidisciplinary clinics, dental departments and offices in hospitals, which were subordinated to the provincial odontological subdepartments and the People’s Commissariat of Health of the Ukrainian SSR. The new model of state regulation was grounded on the planning and control of the provision of social dental care on the basis of state funding. The main tasks of the created healthcare system were the introduction of organizational measures aimed at mass coverage of free dental care for the citizens of Ukraine. An important area of dental care was the creation of school offices for the prevention of dental di-seases of the oral cavity in organized children’s groups.

Prospects and ways of development of accessible stomatology in Ukraine

The article presents the basic principles of functioning of the system of providing medical dental care to the population for 1991, the changes that have taken place in recent years. The state of providing medical dental care to children, rural and privileged categories of the population, prevention of major dental diseases and work on preventive dental programs are analyzed. The vision of further development of affordable dentistry in Ukraine is presented.

Effectiveness and safety of oral care products

The article presents the classification of the main antiseptic chemotherapeutic active substances used in personal oral care products. The efficiency and safety of active ingredients of toothpastes and rinses was analyzed. The review of literature sour-ces on the clinical effectiveness of the combination of amine fluoride with tin fluoride in the prevention of plaque formation and inflammatory processes of the oral cavity is presented.