[Features of medical care provision in the profile «Maxillofacial surgery¼ in the Southern Federal District of the Russian Federation]. / Osobennosti okazaniya meditsinskoi pomoshchi po profilyu «chelyustno-litsevaya khirurgiya¼ v Yuzhnom federal'nom okruge Rossiiskoi Federatsii.

OBJECTIVE: To study the actual state of the organization of medical care for patients with the profile of «maxillofacial surgery¼ in the Southern Federal District of the Russian Federation in order to develop proposals for its optimization within the framework of a three-level system of medical care. MATERIAL AND METHODS: We analyzed accounting and reporting materials characterizing the organization of medical care in the field of «Oral and maxillofacial surgery¼ to the population in the Southern Federal District of the Russian Federation. RESULTS: The population of the Southern Federal District of the Russian Federation is currently provided with accessible round-the-clock medical care in the field of maxillofacial surgery. The forces and means at the disposal of the district government allow this to be implemented. However, the article describes a number of obstacles to the provision of high-quality medical care in the field of maxillofacial surgery and suggests ways to eliminate them. CONCLUSION: Preparation of an Order defining the functioning of a three-level system of medical care for adults and children with maxillofacial pathology in the Southern Federal District of the Russian Federation, as well as more effective use of telemedicine consultations will significantly improve the availability and quality of medical care.

[Classification of lower impacted third molars position and their interrelationship with mandibular canal]. / Klassifikatsii vidov retentsii nizhnikh tret'ikh molyarov i ikh anatomicheskogo vzaimoraspolozheniya s nizhnechelyustnym kanalom.

Classification of lower Impacted third molars position and their interrelationship with mandibular canal have a great scientific, theoretical and practical importance. An attempt to systematize and classify all anatomical impacted third molars position has been made by many authors. Based on our scientific literature search, we found: 8 impacted third molars classifications, 7 third molars and mandibular canal interposition classifications, as well as 5 classifications of mandibular canal anatomical branching variants. Most classifications are proposed by the author to predict third molar eruption perspective, determine level of operation complexity and prevent mandibular canal damage. New clinical classification development of impacted third molars interrelationship with mandibular canal, which combined the radiological PR, CBCT criteria, neurovascular bundle trauma prognosis, and operative technic choice can be actual.

[Microanatomy features in third molars roots adjacent to mandibular canal]. / Osobennosti anatomii kornei tret'ikh molyarov i nizhnechelyustnogo kanala pri ikh tesnom prileganii.

THE PURPOSE: Of the study is to reduce the risk of postoperative neuropathy of the inferior alveolar nerve by improving diagnostic methods, assessment of individual topographic and anatomical features and extraction technique of impacted teeth adjacent to the mandibular canal. MATERIALS AND METHODS: According to the CBCT examination, orthopantomography and macroscopic examination of removed third molars roots (n=140) the relative position of the mandibular canal and the roots of the third molars were studied. RESULTS: Three variants of close mandibular canal and third molars position have been identified. In the lateral and apical nerve position, the root surface depressions were detected. With inter-radicular position fit, the mandibular canal and the nerve bundle form a «bed¼ in between impacted tooth roots. CONCLUSION: The injury of neurovascular bundle prognosis during extraction with an interadicular mandibular position depends on roots anatomy and their convergence degree. If the interradicular distance is less than the diameter of the mandibular canal, nerve injury during tooth extraction is inevitable, in such cases coronectomy is indicated.

[Comparative analysis of the groin and SCIP flap in reconstructive microsurgery of soft tissues of the maxillofacial area and oral cavity]. / Sravnitel'nyi analiz pakhovogo i SCIP-loskuta v rekonstruktivnoi mikrokhirurgii myagkikh tkanei chelyustno-litsevoi oblasti i polosti rta.

Most of the articles on the groin flap were published in the period from 1975 to 2010, from 2015 to 2022, the SCIP flap surpassed the groin flap in the number of publications. According to the results of a literature search in PubMed and RINC, 30 articles were found and selected, including 288 flaps from the iliac region. The length of the vascular pedicle, the diameter of the vessels, the complications, the prevalence of the flap in the reconstruction of the head and neck, the thickness and the size of the flap were evaluated. Both of these flaps have the same nutrition, but different levels of dissection. In comparison with the groin flap, the SCIP flap has a longer vascular pedicle, which can be enlarged due to new techniques, which also allows it to be used as an ultra-thin flap, and it reduces the need for secondary procedures for defatting and reduces the risks of the complications in the donor area. The thickness of the SCIP flap is less than the groin one, which, according to the author, increases the aesthetic level of operations in the facial area in the case of the texture and color of the flap. Vascular anatomy of the SCIP flap is variable, therefore, the use of preoperative planning is necessary. Despite this, complications in the donor or recipient area during reconstruction with a SCIP flap are minimal. It has been proved that the SCIP flap is versatile and safe in all aspects of reconstruction. It can be concluded that the SCIP flap should be considered as a «workhorse¼ in reconstructive microsurgery of soft tissues of the throat and oral cavity.

Morphological and Molecular-Biological Features of Inflammatory and Regeneratory Processes in Peridont Tissues with Periimplantitis and Periodontitis.

A morphological and immunohistochemical study of periodontal tissues was performed in patients with chronic generalized periodontitis who underwent dental implantation. We studied 44 biopsy specimens from 21 patients (13 women and 8 men) aged 35-60 years with a diagnosis of periimplantation mucositis (7 patients), periimplantitis (8 patients), and severe chronic generalized periodontitis (6 patients). It was established that periimplantitis differs from periimplantation mucositis by a more pronounced inflammatory reaction with a clear predominance of plasma cells in the infiltrate, which captures the fibrous capsule around the implant, destroys it and further spreads to the bone tissue. Based on the immunohistochemical differences in SMA, VEGF, and Ki-67, it is concluded that periimplantation mucositis and periimplantitis are successive stages of progression of the same process. When comparing chronic generalized periodontitis and periimplantitis, the latter shows much more pronounced inflammatory and destructive processes in the area of the implant, due to the addition of immune inflammation, impaired regeneration processes, and destruction of bone tissue.

Immunohistochemical and Morphological Study of Periodontal Tissues in Predicting the Results of Dental Implantation in Patients with Chronic Periodontitis.

Morphological and immunohistochemical examination was made on 24 gum biopsies obtained from 35- to 60-year-old patients with diagnosis of partial secondary adentia, chronic generalized moderate to severe periodontitis (19 patients), as well as on the biopsy samples from five patients without pathological periodontal changes who underwent dental implantation. Serial paraffin sections were treated with antibodies against Ki-67, VEGF, and SMA. In patients with severe chronic periodontitis, a high proliferative activity of epithelium indicative of hyperplastic changes was observed, as well as a reduced number of the SMA-positive cells and actual absence of the SMA-positive cell couplings associated with the "growth zones" in tissues, which testifies indirectly to a lower tissue regenerative capacity. Hence, before dental implantation, additional anti-inflammatory and pro-regenerative treatment is required.