PREVENTIVE PLASTIC OF BUCCAL FRENUM IN СOMPLEX TREATMENT OF PATIENTS WITH ACQUIRED MAXILLOMANDIBULAR ANOMALIES.

Aim - improving the effectiveness of complex treatment of patients with maxillomandibular anomalies and disorders of the architectonics of the vestibule of the mouth. We conducted clinical, X-ray methods and cytomorphometric, rheographic examination of the oral mucosa of 30 patients 15-17-years old with acquired maxillomandibular anomalies and disorders of the architectonics of the vestibule of the mouth (buccal frenum) and 15 relatively healthy children - norm group. The patients of I group had surgical correction of buccal frenum, where the surgical wound was healing by secondary tension. The patients of II group had proposed surgical correction of buccal frenum, where the surgical wound was healing by primary tension Patients were prescribed chlorhexidine-denta and a preparation based on hyaluronic acid (Gengigel, Italy) in the postoperative period. Statistical processing of the results was performed using a personal computer using the software package Statistica 12.0. Data distribution was assessed using the Kolmogorov-Smirnov test of normality. Mean values and standard errors were calculated for continuous variables. Correlation between parameters was analyzed using Spearman's correlation coefficient and tested for significance. Significance was set at p<0.05. Clinical studies have shown that all patients have anomalies of buccal frenum fixationin the area of the canines and premolars. The results of cytomorphometric and rheographic studies indicated a deficiency of blood supply in these areas. The results of clinical and laboratory examination showed the advantage of the proposed treatment plan. Long-term results indicate the formation of a normorthophic scar, the absence of recurrences and recessions of the gums in the area of projections of the buccal frenum, the normalization of clinical and laboratory parameters. The obtained data in ІІ group significantly differ from those in І group (p <0.05). Surgical correction of disorders of the architectonics of the vestibule of the mouth is an important and necessary stage of complex treatment of patients with maxillomandibular anomalies and disorders of the architectonics of the vestibule of the mouth. We can achieve the desired therapeutic effect in the treatment of such patients and prevent relapses only by eliminating the etiological factor. The use of preparations based on hyaluronic acid in the postoperative period stimulates reparative processes in the operated area and contributes to the formation of a normotrophic scar. Plastic of buccal frenulum is a prevention of abnormal position of premolars and gum recession in the area of canines and premolars. It is important for preventive dentistry.

STUDY OF BONE RESORPTION AS A RISK FACTOR IN DENTAL IMPLANTATION IN PATIENTS WITH GENERALIZED PERIODONTITIS.

The method of dental implantation in patients with generalized periodontitis is one of the priority areas requiring in-depth study. The aim of the study was to increase the efficiency of dental implantation by developing methods for eliminating bone resorption in patients with generalized periodontitis. There were examined 240 patients with generalized periodontitis of I, II, III degree of development with partial adentia of the upper and lower jaws, who later underwent comprehensive periodontal treatment using dental implantation methods. There were used radiological, densitometric and clinical research methods. The lowest rates of bone resorption in patients with 24 months development with reduced bone mineral density, which was carried out in stages periodontal treatment, followed by dental implantation and one-staged periodontal treatment and dental implantation - (0.69±0.006) mm, (0.74±0.006) mm, respectively. The highest level of resorption was observed in patients with generalized periodontitis of III degree of development with reduced bone mineral density, who underwent one-staged periodontal treatment and dental implantation - (4.27±0.06) mm compared with patients with generalized periodontitis of I, II degree of development. - (0.74±0.006) mm, (2.41±0.006) mm, (p<0.05).

THE EXISTENCE OF A FUNCTIONAL MATRIX IN THE DEVELOPMENT OF THE FACIAL SKELETON IN CHILDREN.

Aim - identifying the relationship between the presence of oral habits and the violation of the formation of the facial skeleton in children. Improving the effectiveness of comprehensive treatment of patients with pathological occlusion and existing oral habits through orthodontic treatment and elimination of oral habits. We conducted clinical, radiological methods of examination of 60 patients 12-15 years old with acquired maxillomandibular anomalies and oral habits, 15 persons aged 12-15 years without maxillomandibular anomalies and acquired deformities (norm group). We studied the data of computer tomograms, performed stereotopometric analysis (three-dimensional cephalometry), determination of the thickness of the masticatory muscles in symmetrical areas of the face. Statistical processing of the results was performed using a personal computer using the software package Statistica 12.0. Data distribution was assessed using the Kolmogorov-Smirnov test of normality. Mean values and standard errors were calculated for continuous variables. Correlation between parameters was analyzed using Spearman's correlation coefficient and tested for significance. Significance was set at p < 0.05. Clinical examination showed that oral habits were manifested in 98.3% of patients. The results of clinical and radiological examination, analysis of cephalometric parameters and data on the thickness of the masticatory muscles on symmetrical areas of the face confirm the relationship between chronic oral habits and formation of acquired maxillomandibular anomalies; confirm the presence of acquired rather than congenital deformity of the facial skeleton, which is associated with changes in the thickness of the masticatory muscles on the part of the deformation та compensatory muscle hypertrophy on the opposite side. After 12 months, the patients' cephalometric parameters differed significantly from the indicators before active orthodontic treatment and elimination of the oral habit, an increase in muscle thickness was observed in the areas where there was a chronic injury (p≤0.05). An increase in the thickness of the bone structure of the facial skull and an increase in the thickness of the masticatory muscles on the side where the oral habit was eliminated were observed. Oral habits progress regardless of the patient's age, they appear in 96.6% of patients in this group of patients. The results of clinical and X-ray research, analysis of cephalometric indicators and level of the thickness of the masticatory muscles confirm the relationship between a chronic oral habit and the development of the bone and muscle system. The obtained results indicate the ability of bone tissue to change its thickness and contours after eliminating a bad habit and confirm the presence of a functional matrix of bone structure development.

DIAGNOSTIC VALUE OF BIOCHEMICAL MARKERS OF BONE REMODELING FOR PREDICTING THE RESULTS OF DENTAL IMPLANTATION IN PATIENTS WITH GENERALIZED PERIODONTITIS.

The method of dental implantation in patients with generalized periodontitis requires in-depth study of markers of bone remodeling, which will reveal the features of bone mineral density (BMD) and allow to predict the results of implantation in the above category of patients. The aim of the study was to evaluate the role of indicators of resorption and bone formation markers in predicting the results of dental implantation in patients with generalized periodontitis. We examined 240 patients with generalized periodontitis with partial adentia of the upper and lower jaws, who subsequently underwent comprehensive periodontal treatment using dental implantation methods. In the study of bone metabolism, it was found that 128 (53,4%) patients have normal BMD, and these patients are not at risk of osteoporosis in the cell bone, which caused the least number of complications (3,2%) of these patients. In 98 (40,8%) patients whose BMD corresponded to osteopenia, for 2 years of dispensary observations the number of periimplants and implant disintegration increased slightly, and the number of complications was 5,7%. In 14 (5,8%) patients whose BMD corresponded to osteoporosis, was observed the high activity of the resorptive process around the implants and their disintegration in 9,28% of cases.

EFFICIENCY OF DENTAL IMPLANTATION IN PROSTHETIC REHABILITATION OF PATIENTS WITH GENERALIZED PERIODONTITIS.

The method of dental implantation in patients with generalized periodontitis is one of the priority areas requiring in-depth study. The aim of the study was to increase the efficiency of dental implantation in prosthetic rehabilitation of patients with generalized periodontitis. A study of 240 patients with chronic generalized periodontitis and partial edentulous upper and lower jaw was carried out, who subsequently underwent complex periodontal treatment and dental implantation. The patients were divided into groups depending on the severity of generalized periodontitis (I, II, III) and the method of treatment. Evaluation of the results of the effectiveness of the proposed method of surgical treatment of patients with generalized periodontitis of the first stage of development with one-stage and staged dental implantation and targeted osteotropic therapy showed that after 12 months all implants (100%) were preserved. In patients with grade II generalized periodontitis, who underwent periodontal treatment and dental implantation in stages, the safety of implants was 92.1%, and in patients who underwent one-stage dental implantation with surgical treatment of periodontal disease, the safety of implants was 89,4%. In patients with stage III generalized periodontitis who underwent staged periodontal treatment and dental implantation, the safety of implants was 80,2%, and in patients who underwent one-stage dental implantation and periodontal treatment - 51,7%.