Many patients and doctors are wondering about the quality and availability of dental treatment in the context of sanctions that have led to the disappearance of many popular foreign materials. However, there are companies in Russia that have long been committed to import substitution of dental materials. According to experts, some of them are in no way inferior to their foreign counterparts, but others leave much to be desired.
What did we manage to replace imports with?
According to Associate Professor Zurab Khabadze, Deputy Director of the RUDN Medical Institute, Head of the Department of Therapeutic Dentistry, the field of implantation is being actively developed in Russia today. There are many native implants, methods for their processing and coating, which make it possible to maximize future osseointegration.
“The quality of the titanium used in them is also good. It is quite possible that in the near future domestic analogues will be able to compete with foreign advanced implants. There are no problems with prosthetics either: you can buy any material from dental laboratories, including high-quality zirconium dioxide,” Khabadze explained.
According to him, Russia is also in a good situation regarding injections. A study was conducted at RUDN to compare Russian fiberglass pins with foreign analogues, and the results are quite optimistic.
“The situation is the same with composite materials; Our graduate student compared the toxicity of Italian, American and domestic dental composite materials.
The results showed that ours are no worse than foreign ones and are completely safe and long-term use in the oral cavity when used correctly,” said Khabadze.
Denis Anokhin, senior researcher at the NUST MISIS Laboratory of Structural and Thermal Methods for Materials Research, also noted that there have been numerous developments in various materials for tooth straightening in Russia.
“Our laboratory has developed a biodegradable “smart” material with controlled changes in stiffness for orthodontic arches, ligatures and aligners. We propose to make the orthodontic system polymer. This will solve several problems at once. Most of the materials used in teeth straightening today are metal or metal-ceramic. The main disadvantage of the metal is its hardness, which does not change over time, so patients have to periodically come to the doctor and “tighten” the belt to correct the bite. Thanks to the polymer system, he will not have to visit the dentist so often,” explained Anokhin.
At first the arch is soft – the dentist can easily place it over the teeth, but over time it will harden and tighten, anchoring the teeth. And this rigidity can change, for example, 2-3 times in a few months.
“Secondly, our material is biocompatible and does not interact with the microflora of the oral cavity, which allows it to be used for a long time without harming the patient. It can also be used as a coating in metal orthodontic products to reduce harmful effects on the body and prevent damage to tooth enamel. In addition, since such materials are polymers, they are much cheaper than metal ones. “We also assume that bite correction in this system will be faster and with less risk of complications,” he said.
There is no similar development in Russia, and research abroad is at the prototype stage. This year, scientists plan to produce the first prototypes, which will then be tested by experts from the Volga Research Medical University. The product can be launched on the market within 3-5 years.
Maxillofacial and plastic surgeon, head of the reconstructive and plastic surgery department of the Scientific Center No. 2 of the Russian Scientific Surgery Center of the Federal State Budgetary Institution, stated that there are no problems with import substitution in the field of maxillofacial surgery. took its name. Akkadian BV Petrovsky (CDB RAS) Ilya Bozo.
“We have good metal structures and various miniplates for bone grafting; they are in no way inferior to foreign analogues and even somewhat displace them in this area. However, previously used foreign materials continue to be used. We often use local materials in our department. We also use materials that we developed jointly with the eponymous Institute of Metallurgy and Materials Science. AA Baikov RAS was established with the support of the “Artgen Biotech” holding (formerly “Institute of Human Stem Cells”). This is a gene-activated material for bone grafting,” said the expert.
According to him, it is fundamentally different from other products because it contains a pharmaceutically active ingredient that stimulates the regeneration of bone tissue. This granular material has a medicinal substance on its surface; Plasmid DNA molecules containing the vascular endothelial growth factor gene. Once implanted into a bone defect, these molecules enter the cells, allowing them to temporarily increase the production of the therapeutic protein. This leads to increased formation of blood vessels in the regeneration zone and faster and better bone restoration.
“There are currently no other products containing pharmaceutically active ingredients on the Russian market. There are foreign analogues, but they do not contain gene structures like ours. Therefore, our product was actually the first product approved for clinical use in the world,” he said.
Speaking to socialbites.ca, dentist-therapist, endodontist and consultant of the Russian Association for Pain Management and Safe Dentistry, Arthur Tumashevich, said that the production of small dental instruments has also been established in Russia.
“For example, for burs, root canals or implants, we give good tips at Chinese level or better. At the same time, I want to emphasize that Chinese manufacturers can no longer be called low quality,” Tumashevich said.
However, things are not so rosy in all areas, some materials and tools cannot be replaced by imports, while others are generally irreplaceable.
basic materials
According to Zurab Khabadze from RUDN University, the main problem to be solved is to provide the industry with high-quality anesthesia. So far domestic analogues cannot be compared with foreign ones.
“Various preservatives are added to anesthetics to keep them for a long time, and some of them can cause serious allergic reactions. The body may not react to an allergen for the first time, but when it encounters it again, it can cause a very serious reaction or even death. When using a carpule of some household anesthetics (a hermetically sealed ampoule, closed at one end with a metal cap and at the other with a rubber stopper), the effect is rather short-term, which in time cannot be compared with imported analogues, so sometimes a second or even third We have to take the carpula. This may cause toxic reactions in the patient. “For this reason, anesthesia creates great anxiety for me,” he said.
Arthur Tumashevich noted that the problem may not lie in the drug itself, but in its improper transportation and storage.
“Their composition is the same as their foreign counterparts, so they work. But I assume that temperature conditions or other requirements were not observed during their transportation or storage. As a result, they are not suitable for long-term manipulations – the anesthesia duration is very short and is only sufficient for the treatment of minor bruises. I myself use local products, for example, I sometimes resort to sewing material and measurement compositions. In general, the quality is not bad, you can work with them, but the quality is unstable. There are things that our manufacturers have problems with, and this, as a rule, has something to do with chemistry. For example, our plastics generally work well, but they are very allergenic and can cause chemical burns,” Tumashevich noted.
Another problem, according to Khabadze, is gutta-percha spots. They are used in dentistry to fill and close root canals and ensure a complete and leak-free filling by adapting to their anatomy as much as possible.
“It is extremely difficult to replace them with imports – this material is obtained from the milky liquid of gutta-percha trees, which do not grow in Russia. It is not possible to replace this material with anything else. Of course, you can use paste, but it dissolves and patients begin to experience complications in the form of chronic inflammation. The same goes for silver pins and plasticizers. Tricalcium silicate cements are also used, but they are extremely difficult to remove or fill the root canal. For me, gutta percha is still irreplaceable, here we can only hope that the supply from abroad (Korea, Vietnam) will not stop,” said Khabadze.
In addition, Russian companies cannot yet produce x-ray devices and computed tomographs at the same level as foreign companies. According to Tumashevich, today we do not have the equipment and software that would fully satisfy experts.
Orthopedist, periodontist, implant surgeon, chief physician of the German Implant Center Magomed Dakhkilgov also admits that Russia does not have the necessary X-ray equipment for any dentistry – cone beam computed tomography devices are produced in Germany, the USA, Finland and South Korea. These same countries are leaders in the creation of visiographs for targeted images. Not only image accuracy but also patient safety, namely low radiation levels, is important here.
“Actually, the picture is not very rosy, because unfortunately there is no advanced production of dental equipment in our country – this seems very strange, but it is true. Another example is high-tech silicone and polyester masses used in orthopedics to take the measurements (measurements) necessary for the manufacture of crowns, bridges and other orthopedic structures. Orthopedists place very high demands on the qualifications of these masses. So far, there is no alternative to foreign companies that have been developing and improving measurement materials in our country for decades,” said Dakhkilgov.
Today, equipment for dental laboratories necessarily includes digital technologies, both in the doctor’s office and in the work of the dental technician. For example, these are intraoral scanners, but according to Dakhkilgov, they are not planned to be produced in Russia. Today’s best models are produced by German, South Korean, Finnish and Danish companies.
“We see the same situation in bonding systems in therapy and orthopedics. (same as adhesive systems – a solution complex containing etching compound, primer and bond). You can replace some drills with Russian analogues, although they are of lower quality, but they are quite ergonomic. But high-tech tools are indispensable for channel processing,” the expert concluded.
What do Russian dentists use?
When asked what materials socialbites.ca’s interlocutors use, the majority said that they are predominantly foreign, even if there are high-quality Russian analogues.
“In our business, the authority and trust that the material manufacturer has gained over the decades means a lot, and as long as there is an opportunity to purchase them, I will use them,” he said. Khabadze.