Objectives: To assess the Candida species occurrence rate and concentration in periodontal pockets in chronic periodontitis (CP) by meta-analysis. Materials and Methods:A search was performed of articles published between January 1, 2010, and October 1, 2020, in English and in Russian, in the electronic databases MEDLINE-PubMed, Google Scholar, The Cochrane Library, ClinicalTrials.gov, Research Gate, eLIBRARY, and Cyberleninka (PROSPEROCRD42021234831). The odds ratio (OR), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated using Review Manager 5.4.1 to compare the risk of CP when Candida spp.were detected in the gingival sulcus or periodontal pocket and to compare Candida spp. density counts in patients with CP and periodontally healthy patients.Results: Twenty-six studies were included in the systematic review and 11 were included in the meta-analysis. The results showed that Candida spp. may increase the chance of CP development by 1.76 times (OR = 1.76; 95% CI = 1.04-2.99; Z = 2.10; p = .04; I 2 = 61%). More Candida spp. were found in patients with CP than in periodontally healthy patients (SMD = 1.58; 95% CI = 0.15−3.02; p = .03; I 2 = 98%).No data were found relating to the statistically significant influence of Candida glabrata, Candida krusei and Candida tropicalis on CP development. Conclusion:We found that Candida albicans insignificantly increased the risk of CP development but, due to the heterogeneity of the included studies, further research is necessary to determine the exact role of Candida spp. in the development and course of the inflammatory periodontal diseases.

The age of inflammatory periodontal disease (PD) manifestations has tended to decrease over the past decades. The study of the range of periodontal pathogens in young people and their influence on the PD manifestation contributes to the predictor identification for the early prevention of this pathology.The aim was to study the correlation between the range of periodontal pathogens in the dentoalveolar sulcus/periodontal pocket (DS/PC) contents and the clinical PD manifestations in young people.We examined 28 patients (23.1 ± 0.93 years) with dental biofilm-induced gingivitis (BG), 24 patients (30.7 ± 0.6 years) with aggressive periodontitis (AgP), and 87 clinically periodontally healthy patients (21.1 ± 0.49 years) (Control). The hygiene index and the periodontal status were determined in all patients. DNA of five periodontal pathogens was identified by PCR in the DS/PC contents. The statistical analysis was performed in Statistica 13.3. The critical significance level was p ≤ 0.05.DNA was not observed in 60.9 % of the control group samples and 7.1 % of the BG group samples. In other cases, the bacteria were found separately and as part of bacterial complexes. P.g. and T.f. were most often detected in all groups. P.g. (U = 474, р < 0.01) and A.a. (U = 209, р >< 0.05) significantly contributed to the plaque formation in the control group, T.d. – in BG and AgP groups (U = 37.5, р >< 0.05 and U = 34, р >< 0.05, respectively). In the AgP group, purulent discharge was more often recorded if T.d. was detected in the PC contents (χ2  = 5.53, р >< 0.05). T.f. + P.i. and P.g. + T.f. + P.i. complexes were exclusively associated with PD. Complexes of four bacteria were found only in the AgP group. The association of periodontal pathogens and their complexes with different PD forms was revealed.>< 0.01) and A.a. (U = 209, р <0.05) significantly contributed to the plaque formation in the control group, T.d. – in BG and AgP groups (U = 37.5, р <0.05 and U = 34, р <0.05, respectively). In the AgP group, purulent discharge was more often recorded if T.d. was detected in the PC contents (χ2  = 5.53, р <0.05). T.f. + P.i. and P.g. + T.f. + P.i. complexes were exclusively associated with PD. Complexes of four bacteria were found only in the AgP group.The association of periodontal pathogens and their complexes with different PD forms was revealed.

Relevance. The modern view of periodontitis as a dysbiotic disease that occurs as a result of changes in the microbial composition of the subgingival region is considered in a systematic review. Purpose. To study a new paradigm of development of generalized periodontitis. Materials and methods. Randomized controlled trials (RCTS) were selected for the study, including cluster RCTS, controlled (non-randomized) microbiological and clinical studies of the oral microbiome in adult patients with generalized periodontitis over the past 10 years. Results. The development of periodontal dysbiosis occurs over a period of time, which slowly turns the symbiotic association of the host and microbe into a pathogenic one. This review examines the current paradigm of periodontitis progression, which calls into question the traditional concept of a disease induced by several particular periodontal pathogens belonging to the red complex.Conclusions. As follows from modern literature periodontitis is to a certain extent caused by the transition from a harmonious symbiotic bacterial community to a dysbiotic one. Recent scientific studies have shown that not single microorganism is not able to cause disease but the microbial community as a whole leads to the development of pathology.

Relevance. The steady increase in the number of inflammatory periodontal diseases (IPD) requires the search for new methods of their diagnosis, treatment and prevention. A large number of antimicrobial peptides are expressed in the oral cavity, including β-defensins, which form the first line of defense against periodontal pathogens. A more detailed study of these proteins will help us to answer the question: why this protective barrier breaks through and may we use β-defensins as markers of IPD. The aim is to study information about the role of β-defensins in the pathogenesis of IBD and to evaluate the possibility of their use as biomarkers of these diseases.Materials and methods. Using search systems as PubMed, Google Search and eLIBRARY were found 2106 articles published between 2003 and 2020 years. According to the inclusion and non-inclusion criteria, 39 publications were selected, including in vivo, in vitro and review articles. This review presents data from the selected articles.Results. β-defensins have antimicrobial activity against periodontal pathogens, but these bacteria can change the expression of the antimicrobial peptides or can be the cause of their destruction due to virulence factors. In addition, the concentration of β-defensins may be affected by the cytokines, synthesized during inflammation in periodontal tissues. Compared with individuals without IPD the patients with chronic generalized gingivitis, aggressive and chronic generalized periodontitis most often have changes in the expression of β-defensins both up and down, which also depends on the stage of the inflammatory process.Conclusion. β-defensins play an important role in the antimicrobial protection of periodontal tissues from the introduction of periodontal pathogens and can be used as markers of IBD. However evaluating the concentration of defensins in the oral fluid, it is necessary to take into account concomitant factors: the presence of periodontal pathogens, the presence of certain cytokines, the stage of the disease, the presence of concomitant pathology and the genetic aspect.

Relevance. Investigation of the root cementum ultrastructure in chronic generalized periodontitis is still relevant as changes in structure and composition of root cementum play a significant role in successful periodontal regeneration. Am is to study changes in the root cementum ultrastructure in patients with chronic generalized periodontitis.Materials and methods. Scanning electron microscopy (SEM) was used to study the cementum surface of 9 teeth extracted due to severe chronic generalized periodontitis and 3 teeth with a clinically healthy periodontium extracted for orthodontic reasons. 3D visualization of the received SEM images was performed.Results. The cementum of periodontally healthy teeth appeared homogeneous and regular,was covered in periodontal fibers and had a pebble-like or dome-shaped surface. In chronic periodontitis patients, the cementum surface was mostly irregular with multiple defects of various depth, areas of completely destroyed cementum, exposed dentinal tubules and a complete absence of periodontal fibers.Conclusion. Loss of periodontal attachment and root cementum exposure to microbial biofilm may result in irreversible structural changes of the surface which may affect the regeneration of clinical attachment.