[Kinetics of mucosal blood flow in 3D modeling of the gingival contour around dental implants after bone reconstruction of the alveolar ridge in the lateral part of the jaws]. / Kinetika krovotoka slizistoi obolochki pri 3D-modelirovanii desnevogo kontura v oblasti dental'nykh implantatov posle kostnoi rekonstruktsii al'veolyarnogo grebnya v bokovom otdele chelyusti.

OBJECTIVE: To study the kinetics of mucosal blood flow in 3D modeling of the gingival contour around dental implants after bone reconstruction of the alveolar ridge in the posterior jaw. MATERIAL AND METHODS: The work was performed at the clinical base of the Department of Surgical Dentistry and Maxillofacial Surgery of the Institute of Dentistry of the Privolzhsky Research Medical University, Nizhny Novgorod, Russia with the participation of 87 patients who were divided into two groups depending on the chosen method of treatment and a control group. The method of laser Doppler flowmetry was carried out using a multifunctional laser diagnostic complex LAKK-02. The terms of observation were 7, 14, 28, 42 days. RESULTS: On the 7th postoperative day, the decrease in microcirculation index (MI) in the groups reflected moderately pronounced hemodynamic disorders with a predominance of a decrease in MI in the center (by 35.8%). The predominance of the stagnant-ischemic type of microcirculation disorders and low intensity of neoangiogenesis was established, especially in the central zone in group 1, and in group 2 signs of neoangiogenesis were noted by the 7th day. By the 14th day, there was a decrease in venous congestion and signs of arterial inflow. In the 2nd group there was a subsidence of inflammatory phenomena and an increase in the energy of the oscillatory process in the vessels. Gradually, by the 42nd day, the indicators in groups 1 and 2 approached in value to the control group and did not differ significantly. CONCLUSION: A previously unknown mechanism of interaction between two heterogeneous grafts (xenograft and thin free gingival graft) was revealed, which determined neoangiogenesis by the traditional method (from the center to the periphery), and by the proposed method (from the periphery to the center). Understanding the wound process is necessary for the purpose of further correction of the surgical technique for the best restoration of the vascular network and an increase in the success rate of operations.

Digital Technologies in the Surgical Treatment of Post-Traumatic Zygomatico-Orbital Deformities.

The aim of the study was to determine the efficacy of using digital technologies in patients with post-traumatic deformities of the zygomatico-orbital complex (ZOC) by comparing the results with the conventional methods of surgical treatment. MATERIALS AND METHODS: The article summarizes treatment results of 231 patients with ZOC injuries who underwent surgery at the clinical facilities of Privolzhsky Research Medical University (Nizhny Novgorod) in 2011-2019. There were treated 44.2% (102/231) of patients with post-traumatic deformities of ZOC, including 38.2% (39/102) with post-traumatic defects and deformities of the orbital floor.Based on clinical and radiological planning of surgical operations, the patients were divided into two groups: group 1 included patients who underwent surgery without preoperative virtual planning (54.9% (56/102) of cases), group 2 included patients who underwent virtually planned surgical interventions (45.1% (46/102) of cases). There were 22 and 17 patients with orbital deformities in groups 1 and 2, respectively. RESULTS: The optimal restoration of ZOC anatomy was observed in 75% (42/56) of patients in group 1 and 93.5% (43/46) of patients in group 2. During reconstruction of the orbital floor in patients of group 1, successful results were achieved in 68.2% (15/22) of cases and 88.2% (15/17) in group 2, various complications were observed in the rest of cases.Based on the analysis of surgical treatment results, there was developed a personalized approach to manufacturing of zygomatic bone and orbital floor implants using computer modeling and 3D printing technologies. CONCLUSION: In contrast to the conventional methods, the use of digital technologies in the surgical treatment of post-traumatic deformities of ZOC allows avoiding the problematic issues of implant positioning and the development of complications during reconstruction, significantly reducing surgical injury and improving patient rehabilitation.

Modified Two-Stage Split Technique for Controlled Ridge Augmentation in Horizontally Atrophic Posterior Mandible: the First Stage of Research.

Various bone grafting methods are applied to eliminate horizontal atrophy of the jaws. However, problem complexity brings about ongoing research and development of new ways to achieve the predicted stable and long-term results of implantological treatment. The aim of the study was to evaluate the results of the developed method for bone grafting, a modified two-stage split technique for controlled ridge augmentation in horizontally atrophic posterior mandible, using radiological analysis data. MATERIALS AND METHODS: The study group included 18 patients with horizontally atrophic posterior mandible. According to cone beam computed tomography, 39 jaw segments were assessed before plastic surgery and after applying the two-stage split-crest technique for controlled ridge augmentation. The alveolar ridge width was estimated in the area of its top and at a distance of 1, 3, 5 mm from it using the vector of future implant position and taking into account the angle of inclination of the atrophic region of the mandible. RESULTS: When analyzing edentulous areas in the posterior mandible before treatment, there was rather a large angle of lingual inclination of the alveolar ridge. After 6 months, the average increase in bone tissue width in the region of the alveolar ridge top was 82%, it was 50.6% at a height of 1 mm from the top of the crest, 58.8% at 3 mm height, 46.7% at 5 mm (p≤0.05). Certain patterns of bone tissue growth were revealed depending on the structure of the reconstructed area. The most significant results were obtained in the molar segments of the mandible. CONCLUSION: The developed modified two-stage split technique for alveolar ridge augmentation allows achieving the required volume of bone tissue in the posterior mandible for successful implant treatment.

[Oxidation-reduction potential of tissues of the oral mucosal wound surface under the photodynamic action]. / Okislitel'no-vosstanovitel'nyi potentsial tkanei ranevoi poverkhnosti slizistoi obolochki polosti rta pri fotodinamicheskom vozdeistvii.

The purpose of the study was to examine the condition of the pro-antioxidant balance of the homogenates of tissues of the oral mucosal wound surface in vivo experiment under the photodynamic action of combined two-wave radiation to eliminate its damaging effect on the structures of cell membranes. MATERIALS AND METHODS: On the mucous membrane of the cheeks of sexually mature female autocrats of Wistar rats (n=72) experimental models of wound surfaces with a diameter of 3 mm were formed. The animals were divided into groups: control (n=36) and experimental (n=36). In the experimental group, a single photodynamic exposure was carried out for the 1st postoperative day with a sequential combined light radiation at two wavelengths (660 nm and 405 nm) with a total dose of 15 J/cm2. Wound management was carried out traditionally in the control group of animals. The observation periods were 3, 7 and 14 days. RESULTS: Macroscopic examination of the wound surface indicated complete epithelialization of the wound on the 7th day in the experimental group of animals and on the 14th day in the control group. Significant and sharp decline in free-radical oxidation processes (Imax, S, Z index) intensity was recorded in the experimental animals at earlier periods in comparison with the initial data and control results, when analyzing the results of studies of homogenates of animal tissues. A similar pattern was observed in the evaluation of lipid peroxidation products, especially in the early days of observations. The reported results were supported by the activation of antioxidant enzymes in the experimental group compared to control data and baseline data. CONCLUSION: Thus, a combined photodynamic action using two wavelengths with a combined dose of 15 J/cm2 provides safety and low invasiveness for use on the oral mucous membrane and, may be used to stimulate regeneration of the wound surface, which requires further experimental testing.

Preservation of Bone and Soft Tissue Components of the Alveolar Ridge during Immediate Implantation in the Aesthetic Zone of Jaws with Bone Deficiency.

The use of immediate implantation (directly into the extracted tooth socket) in the aesthetic zone is a rather difficult task due to the specific structural features of the bone tissue of the alveolar processes and parts of the jaw. The aim of the study was to develop and evaluate the efficacy of the new method of immediate implantation during restoration of teeth in the anterior part of the jaw with bone deficiency, which allows obtaining a high aesthetic result. MATERIALS AND METHODS: The clinical study involved patients with partially edentulous anterior maxillae, chronic apical periodontitis and dental root fractures in the absence of possibility to restore these teeth with orthopedic structures. To identify the main criteria determining smile aesthetics, the detailed analysis of changes in the bone and soft tissues of the alveolar processes was made based on tooth extraction causes and dates. These criteria included gum biotype, the height of the distal and mesial interdental papillae; the width of the keratinized attached gingival area, gingival zeniths, the alveolar ridge thickness. The condition of the facial alveolar bone wall in the planned intervention area was assessed and its thickness was measured using cone-beam CT scan of the jaw. These parameters were measured during traditional immediate implantation, immediate implantation with a free connective tissue graft, implantation performed using the method developed by the authors and during delayed implantation in the anterior part. In each patient, the obtained data were compared with the results in the respective teeth area on the opposite side before the surgery, 4, 6 months and 1 year after the surgery. RESULTS: Clinical and X-ray studies of the developed method of immediate implantation in the aesthetic zone of the jaw with bone deficiency in the facial alveolar bone wall have convincingly demonstrated its efficacy in the long term (1 year after the surgery). The proposed protocol has made it possible to reduce the length of rehabilitation time, and most importantly, to stabilize and preserve the alveolar ridge architecture. CONCLUSION: The proposed method showed the promising outlook for dental implant-supported restoration in difficult anatomical conditions.

[Modern view on the problem of oroantral fistula closure: literature review]. / Sovremennyi vzgliad na problemu ustraneniia oroantral'nykh soobshchenii: obzor literatury.

This article includes a review of Russian and foreign literature concerning the current situation in problem of oroantral fistula closure. This review considers main concepts and methods of plastic surgery directed to reconstruct tightness of mouth. Moreover, the advantages and disadvantages of presented methods among themselves and appreciated long-term results and aftermath of different ways of surgical technics.

[Experimental and clinical study of the effectiveness of polymeric membrane in surgical interventions on the oral mucosa]. / Éksperimental'no-klinicheskaia otsenka éffektivnosti ispol'zovaniia polimernoi membrany pri operativnykh vmeshatel'stvakh na slizistoi obolochke polosti rta.

In the experiment (on 15 individuals of the Shinshila rabbits) were conducted cytological research features of the healing the wound surface with the using polymeric membrane. As a result of the clinical study, 100 patients with various pathologies were operated, resulting - an open wound on the mucosa of the palatine. Two groups of patients were subsequently formed, in the first group the wound was closed with a polymeric membrane, in the second group the wound was healed by the open method. A dynamic evaluation of the course of the postoperative period in both groups was carried out. The features of the healing process were fixed on the 3rd, 5th, 7th and 10th days after the previous operation on a palatine. It was found that the processes of wound healing under the membrane occur much more actively (granulation tissue is formed more quickly), there is a decrease in complications in the postoperative period and absence of bleeding from the postoperative wound. The data received coincided with the results of the histological examination of smears-prints from the wound healing under the polymeric membrane and indicated the activation of the processes of epithelization.

[Possibilities of resonant near-field ultra-high-frequency tomography in the diagnosis of oral mucosa conditions during gingival recessions surgery]. / Vozmozhnosti metoda rezonansnoi blizhnepol'noi sverkhvysokochastotnoi tomografii v diagnostike sostoianii slizistoi obolochki polosti rta pri khirurgicheskom lechenii retsessii desny.

The clinical study involved 150 people who were divided into 5 main groups. Patients were examined using resonance near-field ultra-high-frequency sounding, which makes it possible to record the electrodynamic state of the oral mucosa. The obtained data made it possible to define the concept of the 'norm' of the dielectric characteristics of the oral mucosa of different localization, and also made it possible to conduct a survey of patients with gum recessions, assess the microcirculatory bed and the likelihood of developing ischemic disorders during the treatment stages.

[Short- and long-term results of orbital floor fractures treatment]. / Blizhaishie i otdalennye rezul'taty lecheniia patsientov s perelomami nizhnei stenki orbity.

The objective of this research was to study complications of orbital floor reconstruction by making analysis of early and late follow up treatment results of patients with orbital floor fractures. We summerized the experience in surgery of 215 victims with zygomatico-orbital complex fractures, who underwent treatment in teaching hospitals of the oral and maxillo-facial surgery department of Privolzhsky Research Medical University from 2011 to 2017. The orbital wall fractures which required reconstruction and restorative treatment were diagnosed in 78 (36.3%) patients. The amount of surgical intervention included transconjuctive approach and orbital floor reconstruction with polymeric and metal implants. In most cases we obtained good and satisfactory results during the period of early and late follow up. We made the analysis of developed early and late complications from orbital floor reconstruction. Post-operative enophthalmos and implant displacement are noted to be the most adverse events in the late follow up period and they require re-surgery. Our experience suggests that it is possible to avoid complications and receive good esthetic and functional results in case a surgeon is highly qualified and carefully plans an operation, namely calculation of anatomical and topometrical orbit parameters by CT and a right choice of operation methods and implants.

[Immediate implantation after extraction of teeth with chronic apical periodontitis].

The authors introduced an original method of intraoperative ozone and postoperative millimeter wave therapy which the short-term and long-term results of clinical, radiological, microbiological and immunological studies proved to enhance efficiency of immediate implantation in preliminary infected areas.

[The clinical estimation of ketoprofen lysine salt effect on the intensitivity of acute pain syndrome in the oral cavity during surgical procedures and postoperative period].

Is studying and control of the clinical efficacy and safety of ketoprofen lysine salt (КLS) (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in the form of sachets and solutions for application in postoperative period after dental surgeries procedures. The comparison of the analgetic effect of systemic and local forms of the "Oki" drug, depending on the type and extent of surgery procedures. Was carried out surgical treatment and patients examination in the postoperative period. Surgical procedures included: vestibulolasty, vestibulolasty with apically-displaced flap, vestibulolasty with apically-displaced flap and a free palatal mucogingival graft, removal impacted and dystopic teeth, periodontal surgery. The research was conducted in the Surgical stomatology and Maxillofacial surgery Department (stomatological policlinic of the Nizhny Novgorod State Medical Academy). Was noted rapid advanced of anesthesia when using sachets and solutions of the ketoprofen lysine salt (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in postoperative period after dental surgical procedures. Was noted a more advanced of analgetic effect in the application therapy by DCI solution when open surgical wound presented. Analgetic effect was observed after 20-30 min and was maintained in the postoperative period to an average of 8 hours. Local application sachets and solution of the ketoprofen lysine salt (KLS ), in our opinion, is the most appropriate and is highly effective when open surgical wound presented. Ketoprofen lysine salt (KLS) has a neutral pH and does not irritate the gastrointestinal tract, that determines the safety of its used.

[Specific features of thermotophographical maps of oral muscosa].

The article presents the results of infrared thermography in 256 healthy people (123 women and 133 men) aged 36 to 60 years. Thermometric and thermography values in 72 selected points of the oral mucosa were assessed in all study participants. As a result normal thermometric and thermal values of oral mucosa were identified thus completing thermal maps of middle aged men and women.

[Increasing gingivoplasty efficiency by means of free palatal grafts].

The paper presents short and long-term results of surgical treatment of 80 patients with insufficient attached gingiva. The procedures included vestibuloplasty and gingival plasty with perfluorane and free gingival and subepithelial connective tissue grafts. Proposed surgical treatment method with perfluorane proved to reduce the local inflammatory reaction greatly thus decreasing perioperative morbidity and increasing the long term efficacy of treatment.

[Surgical rehabilitation in patients with zygomatic orbital fractures and orbital floor fractures].

The study presents the results of surgical management of 65 patients with zygomatico-orbital complex and orbital floor fractures according to a self-designed technique using polymer implants Reperen. Being a method of choice the technique reduces treatment time, promotes good esthetic results, reduces complication rate, and contributes to a patient's quality life improvement.

[Clinical immunological peculiarities of complicated course of odontogenic phlegmons of maxillofacial region].

Based upon clinical immunological checkup of 76 patients with common phlegmons of maxillofacial region, their complications and analysis of general phlogogenic activity the variants of hyperergic inflammation process flow were determined, that allowed to diagnose its activity and forecast possibility of its further development and its outcome.

[Criteries of the regeneration intensity in bone jaw's tissue during treatment of inflammatory destructive processes].

Study of some biochemical parameters of oral fluid in patients with periapical jaws' inflammatory destructive processes in the process of operative treatment was conducted. It was established that dynamics of these indicators could be indirect criterion of permissive value of activity and completeness of bone tissue reparative regeneration processes. Advantage of the method is in its small invasiveness.

[Radio wave influence upon the local processes of free radicals oxidation intensity in oral cavity operational field in laboratory animals].

Experimental study of free radicals oxidation intensity processes in the tissues of oral cavity operational field in case of the use of the traditional surgical scalpel and radio wave device. The status of the primary and final products of lipid peroxidation and local antioxidation activity was assessed. Appropriate peculiarities of the studied processes in experimental animals wounds were detected. During all periods of the study there was no negative dynamics of the local antioxidation activity of the studied substrate that testified to compensation and controllability of the running processes and softer local processes flow of free radicals oxidation in operational field in experiment especially when radio wave surgery method was used.

[Experimental modeling of jaw bones for dental implantation].

As the result of morphometric study the structural correspondence of the cortical layer and cells' volume surface between jaw segments and some osseous skeletal structures was found. These pairs included zones of lower incisors and parietal bone, zones of upper incisors/lower premolars and ribbon, zones of upper premolars/lower molars and huckle-bone crest, zones of upper molars and handle and body of sternum. Received data let us use the above mentioned osseous objects as the model for experimental studies on jaw bones.

[Clinical results of perftorane use in comprehensive treatment of patients with odontogenic phlegmons].

Analysis of data collected during observation upon 76 patients with odontogenic phlegmon of maxillofacial region of different severity in complex treatment plan of whom preparation Perftorane was included according to the worked out method. Based upon received clinical, morphological, cytological and biochemical results the conclusion was derived that the application of the worked out method of perftorane use optimized traditional method of treatment of patients with odontogenic phlegmon of maxillofacial region exerting antihypoxic, desintoxicatic and antioxidant actions that led finally to speedy clearing of suppurative focus and to stimulation reparative processes in the wound.

[Evaluation of efficacy of demineralized bone transplant use in surgical treatment of patients with periapical inflammatory-destructive processes in the jaws].

The aim of the study was to raise the efficacy of surgical treatment of patients with periapical inflammatory-destructive processes in the jaws in chronic and exacerbation stages. It was established that the use of demineralized bone transplant as osteoplastic material intensified bone tissue reparative regeneration, promoted complete bone regenerate recovery in the region of remote destruction foci earlier than preparations based on calcium hydroxyapatite.