[The possibility for the early diagnosis of suppurative-inflammatory wound complications of the maxillofacial area and neck by using an acoustic skin analyzer]. / Vozmozhnost' rannei diagnostiki gnoino-vospalitel'nykh oslozhnenii ran cheliustno-litsevoi oblasti i shei s pomoshch'iu akusticheskogo kozhnogo analizatora.

The acoustic method was used for early diagnosis of pyo-inflammatory complications of wounds of the maxillofacial area and neck. Acoustic skin analyzer was used. The velocities of acoustic wave propagation (Vx, Vy) were notably increased in the pyo-inflammatory focus in comparison with perifocal tissues and with the symmetrical contralateral side. The difference in the absolute values of velocities was about 45-65 m/s. No acoustic anisotropy was observed in the focus of inflammation. Hence, the acoustic method can be used as a method for early diagnosis of pyo-inflammatory complications and for monitoring the wound status in the course of wound process.

[The surgical treatment of jaw cysts using hydroxyapatite with an ultrahigh degree of dispersity]. / Operativnoe lechenie kist cheliustei s ispol'zovaniem gidroksiapatita ul'travysokoi dispernosti.

Ultrahighly dispersed hydroxyapatite, a biochemically active form of hydroxyapatite, stimulates the repair osteogenesis at the early stages. Drugs with ultrahighly dispersed hydroxyapatite: 33% OSTIM-100 paste and its composition with lincomycin Lincogap, which ensures a prolonged release of the antibiotic at the site of implantation, were used for filling the bone cavity formed after cystectomy in 49 patients. In controls (n = 43) the postoperative cavity was filled with blood clot. The results of clinical, x-ray, and radiovisiographic studies indicate that use of the above preparations decreased the incidence of postoperative complications and created the optimal conditions for bone repair at the site of defects of different size. The therapeutic efficacy was the highest when the intervention was preceded by inflammatory symptoms at the site of the cyst.

[The pharmacokinetics of lincomycin when used as a component of a drug combination with ultrahighly dispersed hydroxyapatite]. / Farmakokinetika linkomitsina pri ispol'zovanii v kachestve komponenta lekarstvennoi kompozitsii s gidroksiapatitom ul'travysokoi dispersnosti.

A drug composition LINCOGAP is assessed, consisting of lincomycin hydrochloride (33%), ultrahighly dispersed hydroxyapatite (HA) (33%), gelatin (7%), and water (27%). Distribution of tritium-labeled lincomycin in organs and tissues of experimental animals was studied by the radiometric method after implantation of the composition into a standard rat mandibular defect. Lincomycin concentration surpassing by orders of magnitude the minimal inhibitory concentration for the main lincomycin-sensitive microorganisms persisted at the site of implantation of the composition for at least 7 days, while the concentration in internal organs and tissues was the minimum. Microbiological findings indicate active diffusion of lincomycin from the site of injection into the adjacent bone. Thus, LINCOGAP exerts an antibacterial effect in the pathological focus while its general toxic effect is low and, therefore, side effects are minimized. Combination of the antibiotic with ultrahighly dispersed HA helps regulate the process of bone repair, stimulating the proliferative and functional activity of osteoblasts. Hence, combined drug LINCOGAP is a promising agent for the treatment of inflammatory destructive diseases of osseous tissue.

[The comparative characteristics of stimulators of reparative osteogenesis in the treatment of periodontal diseases]. / Sravnitel'naia kharakteristika stimuliatorov reparativnogo osteogeneza v lechenii zabolevanii parodonta.

The authors compare the efficacy of ultra highly dispersed hydroxyapatite (brand OSTIM-100) and demineralized bone matrix implanted to 395 patients for repair of bone defects. OSTIM-100 was found not inferior to bone transplant, but devoid of its shortcomings. Complications occurred in 1.5% cases and never involved the site of osteoplasty, whereas in the group transplanted bone matrix 3.6% patients developed complications, which were frequently associated with the graft rejection. OSTIM-100 was particularly effective in the treatment of periodontitis at the stage of abscesses. It is convenient and recommended, in combination with membranes of directed regeneration of tissues (GORE-TEX), for surgical treatment of patients with periodontal diseases.

[The use of hydroxyapatite with ultrahigh dispersity in the combined treatment of patients with mandibular fractures]. / Primenenie gidroksiapatita ul'travysokoi dispersnosti v kompleksnom lechenii bol'nykh s perelomami nizhnei cheliusti.

Altogether 125 patients with mandibular fractures of different localization were treated. Implantation of ultrahigh dispersed hydroxyapatite was included in the treatment schemes, both surgical and conservative, of 65 of these patients. Such implantations were found easy to perform, well tolerated by the patients, and causing no side effects. The incidence of complications in this group was by 6.78% lower than in controls treated by the traditional methods alone and by 7.16% lower than in all patients with mandibular fractures treated over a year. The mean disability period was reduced by 4.8 days when this preparation was used.

[The treatment of periodontal diseases with the preparation Linco-HAP]. / Lechenie zabolevanii parodonta preparatom Linko-GAP.

Hydroxyapatite paste with lincomycin (linco-HAP) was for the time used for the treatment of such a prevalent disease as periodontitis. A follow-up of 380 patients demonstrated a positive therapeutic effect of this complex expressed in reduction of the depth of periodontal pouches and inflammation arrest, thus appreciably shortening the treatment duration.

[The effect of plasmosorption on the healing dynamics of postoperative wounds in patients with suppurative-inflammatory processes of the maxillofacial area and diabetes mellitus]. / Vliianie plazmosorbtsii na dinamiku zazhivleniia posleoperatsionnykh ran u bol'nykh s gnoino-vospolitel'nymi protsessami cheliustno-litsevoi oblasti i sakharnym diabetom.

Pyoinflammatory processes run an uncommonly malignant course in diabetics. Healing of postoperative wounds in diabetics is caused by impairement of all types of metabolism and by development of endogenous intoxication which depresses the protein-generating function of the liver. The plasma sorption technique used at the clinic of Department of Maxillofacial Surgery and Dentistry, Russian State Medical University, helps more effectively control endogenous intoxication, this, in its turn, promoting activation of cleansing and healing of postoperative wounds. Basing on the clinical and laboratory findings, the authors demonstrated that plasma sorption used in multiple-modality treatment of diabetics with pyoinflammatory processes accelerates healing of purulent wounds by 5-6 days.

[The immunoadjuvant properties of hydroxyapatite with ultrahigh dispersity]. / Issledovaniue immunoad''iuvantnykh svoistv gidroksiapatita ul'travysokoi dispersnosti.

Chemically pure hydroxyapatite (HA) with particles less than 140 microns, less than 60 microns, and 0.01 to 0.03 microns was studied. The immunoadjuvant properties were assessed from the count of IgM-secreting cells and titer of IgG antibodies. Mice were immunized with Salmonella Vi antigen, using mixtures of the antigen with HA with different size of particles. Preparations with particles less than 60 microns and 0.01 to 0.03 micron had a reliable immunoadjuvant effect, whereas HA with particles of up to 140 microns in size did not show such an effect; these data are in line with those published elsewhere about HA as a surfactant. At the same time, our findings give grounds to speak about new prospects of HA use as a carrier of immunocorrective properties.

[The role of plasmosorption in correcting the microcirculatory disorders in patients with suppurative-inflammatory processes of the maxillofacial area and diabetes mellitus]. / Rol' plazmosorbtsii v korrektsii mikrotsirkuliatornykh narushenii u bol'nykh s gnoino-vospalitel'nymi protsessami cheliustno-litsevoi oblasti i sakharnym diabetom.

A positive clinical effect of plasma sorption added to multiple-modality treatment of patients with pyoinflammatory maxillofacial diseases and diabetes mellitus was revealed. Plasma sorption is conducive to normalization of lipid metabolism, improves blood rheology, activates microcirculation, this promoting sooner healing of postoperative wounds and reducing hospitalization periods.

[Plasmosorption in the combined treatment of patients with phlegmons of the maxillofacial area in diabetes mellitus]. / Plazmosorbtsiia v kompleksnom lechenii bol'nykh s flegmonami cheliustno-litsevoi oblasti na fone sakharnogo diabeta.

Diabetes mellitus and surgical infection coursing intermittently aggravate each other, and therefore search for methods of treatment permitting a simultaneous impact on the pyoinflammatory process and on diabetes mellitus is a priority. Plasmasorption method used at present at Chair for maxillofacial surgery and dentistry of the Russian State Medical University meets these requirements to a great measure. Clinical and laboratory studies showed that plasmasorption used in multiple-modality treatment helps effectively control a purulent process, reduces intoxication of the body, corrects the development of insulin resistance in patients with maxillofacial phlegmons coursing in the presence of diabetes mellitus. In patients with grave and medium-severe diabetes the same insulin doses injected after plasmasorption reduce blood sugar levels by 1.5-1.7 times on an average, and in slight forms of the condition even normalize them. Secondary healing of postoperative wounds is accelerated in diabetics with maxillofacial phlegmons, and hospital stay of such patients is reduced by 9.5-10 days, on an average.

[The immunotropic and allergenic activity of hydroxyapatite with an ultrahigh degree of dispersion]. / Izuchenie immunotropnoi i allergennoi aktivnosti gidroksiapatita ul'travysokoi dispersnosti.

Hydroxyapatite is a well-known biologic material intended for intraosseous implantation which is widely used in practical dentistry. The agent causes no inflammatory reaction at the site of administration and is not characterized by acute or chronic toxicity. The possibility of development of specific contraindications against hydroxyapatite has not yet been studied; such contraindications might be connected with its possible immunotropism and allergenic activity which are to this or that measure present in all materials used for implantation into the bone. Since hydroxyapatite is known as surfactant, we used in our studies its modification characterized by the highest specific surface known at present, and therefore the most biochemically active. "Cold", that is, not exposed to high-temperature treatment ceramics was used in order to prevent reduction of hydroxyapatite reaction capacity. Complex of animal experiments showed that hydroxyapatite cannot possess immunotropic or allergenic characteristics.

[A dynamic study of the intensity of mitogenesis in an osteoblast culture in the presence of ultrasonically dispersed hydroxyapatite]. / Dinamicheskoe issledovanie intensivnosti mitogeneza kul'tury osteoblastov v prisutstvii gidroksiapatita ul'trazvukovoi dispersnosti.

Ceramic hydroxyapatite is frequently used in clinical practice nowadays; it is applied in surgical interventions on facial skull bones. This biological material is used as bone substitute and bone connector, but many authors claim that it is devoid of osteoinductor properties. Research is in progress on the effects of a "cold", that is, biochemically active form of ceramic hydroxyapatite on proliferative activity of a number of cell populations. No mitogenesis stimulation was observed during incubation of hydroxyapatite with osteoblast culture; on the contrary, a reduction of proliferative processes intensity was observed. Remembering that hydroxyapatite is a surfactant we repeated this experiment under similar conditions but used a hydroxyapatite molbfication with specific activity increased by two orders in comparison with its close analogs. Mitogenesis intensity was assessed by radiometric method from 3H-thymidine incorporation. The data indicated stimulation of proliferative processes in osteoblast culture.

[The clinical effect and dynamics of hormonal homeostasis with the inclusion of plasmosorption in the combined therapy of patients with maxillofacial phlegmons against a background of diabetes mellitus]. / Klinicheskii éffekt i dinamika gormonal'nogo gomeostaza pri vkliuchenii plazmosorbtsii v kompleksnuiu terapiiu bol'nykh s flegmonami cheliustno-litsevoi oblasti na fone sakharnogo diabeta.

A positive clinical effect of plasma sorption included in multiple-modality treatment of patients with maxillofacial phlegmons and diabetes mellitus was observed. This treatment modality was conducive to normalization of hormonal homeostasis, it had a correcting impact on development of resistance to sugar-reducing drugs, favorably influenced the course of pyoinflammatory process, thus helping cut down hospitalization period.

[The role of the genotype in the development of suppurative inflammatory complications in trauma to the facial bones]. / Rol' genotipa v razvitii gnoino-vospalitel'nykh oslozhnenii pri travme litsevykh kostei.

The distribution of the genetic markers of leukocytes (HLA I and II), serum proteins (allotypes Gm, transferrin, haptoglobin, group-specific component), red cell enzymes (acid phosphatase--AP, phosphoglucomutase--PGM, esterase D, adenosine deaminase) was found to be universal in patients suffering from various pyoinflammatory diseases. The incidence of HLA A10, Cw4, DR5 antigens, IgG allotype G1m (2) and phenotype G1m (+1+2) and AP (aa) and PGM (2-2) phenotypes was found increased in patients with maxillofacial suppuration and pyoinflammatory complications of maxillofacial injuries as against normal subjects and patients with maxillofacial injuries without such complications. Traumatic osteomyelitis much more often develops in the carriers of the before genetic markers than in those in whom these markers are absent (61.6 and 20.4%, respectively).

[Immunocorrection in the combined treatment of patients with osteomyelitis developing following combined injuries to the maxillofacial and craniocerebral areas]. / Immunokorrektsiia v kompleksnom lechenii bol'nykh s osteomielitom, razvivshimsia posle sochetannykh povrezhdenii cheliustno-litsevoi i cherepno-mozgovoi oblastei.

Twenty-one of the forty-two patients with osteomyelitis developing after a combined maxillofacial and craniocerebral injury were administered thymogen, an immunocorrective drug, as a component of combined therapy; immunologic indications for the prescription of such an agent were present in all these patients. Depressed T-cellular immunity was the principal disorder of the immunologic reactivity of this patient population; they also developed elevated counts of NK cells and increased interleukin synthesis by the macrophages, this reflecting a high activity of inflammation. Thymogen therapy was conducive to normalization of the immunologic and nonspecific reactivity and enhanced the treatment efficacy on the whole.

[T- and B-lymphocytes, interleukins and natural killers in patients with osteomyelitis developing after combined injuries to the maxillofacial and craniocerebral areas]. / T- i B-limfotsity, interleikiny i estestvennye killery u bol'nykh s osteomielitom, razvivshimsia posle sochetannykh povrezhdenii cheliustno-litsevoi i cherepno-mozgovoi oblastei.

Forty-three patients with traumatic osteomyelitis developing after combined maxillofacial and craniocerebral injuries and thirty normal subjects were examined. Immunologic findings permit distinguishing two groups of patients: those with marked disorders of the T cellular immunity (reduced T helper and Tx counts, interleukin-2 synthesis, and Tx/T suppressor coefficient) and without such shifts. The therapy of patients without manifest immunity shifts was generally effective whereas in those with marked immunity disorders the therapy efficacy was inadequate and the immunity disorders persisted.

[The combined use of ultraviolet blood irradiation and Essentiale therapy as an element in preventing suppurative-inflammatory complications in patients with combined maxillofacial and craniocerebral trauma]. / Kompleksnoe primenenie ul'trafioletovogo oblucheniia krovi i éssentsiale-terapii kak élement profilaktiki gnoino-vospalitel'nykh oslozhnenii u bol'nykh s sochetannoi cheliustno-litsevoi i cherepno-mozgovoi travmoi.

Studies of a relationship between the severity of the developing secondary tissue hypoxia and reduction of the neutrophil phagocytic activity in patients with combined maxillofacial and craniocerebral injuries of varying severity have prompted the authors to include ultraviolet irradiation of the blood and essential therapy in the complex of therapeutic measures aimed at prevention of pyoinflammatory complications with due consideration for the severity of secondary tissue hypoxia detected in the patients on admission to hospital.