Sergey Yu. Ivanov

Justification. Distal occlusion (II class according to Angle) is one of the most common dentofacial anomalies and is often combined with transverse maxillary insufficiency. In adult patients, due to completed growth, the effectiveness of classical orthodontic approaches is limited, which justifies the use of skeletal expansion methods, in particular the MARPE technology — mini-implant-associated rapid palatal expansion. Study objective — to evaluate the effect of MARPE on maxillary transverse dimensions in patients with distal occlusion by analyzing the coefficients of interpremolar and intermolar arch width compliance with Pont’s standard values, compared to traditional orthodontic therapy. Materials and methods. Sixty patients aged 18 to 35 years with a diagnosis of distal occlusion (Angle Class II) were examined. They were divided into two groups of 30 patients each. The control group received treatment using brackets only; the study group underwent preliminary maxillary expansion using MARPE followed by orthodontic correction. Diagnostic evaluation included determining the coefficients of interpremolar and intermolar arch width compliance with Pont’s standard values before and after treatment. Statistical analysis was performed using the nonparametric Wilcoxon and Mann—Whitney tests (p<0.05). Results. After completion of treatment, statistically significant increases in the interpremolar and intermolar arch width correspondence coefficients to the standard values according to the Pohn method were recorded in both groups. In the study group, the intermolar width correspondence coefficient increased from 46.80±2.02 to 70.37±11.17, and the interpremolar width correspondence coefficient increased from 59.20±9.42 to 70.00±4.99. In the control group, the intermolar width correspondence coefficient increased from 41.23±10.54 to 55.80±4.76, and the interpremolar width correspondence coefficient increased from 59.27±5.78 to 93.70±11.54. Despite higher absolute values in the control group, the expansion pattern was more variable, likely due to the predominance of the dentoalveolar component. Conclusion. The use of MARPE allows for significant and stable expansion of the maxilla through skeletal structures, ensuring a more controlled restoration of the transverse parameters of the dental arch. Analysis of the coefficients of correspondence between the interpremolar and intermolar arch widths and the standard values according to the Pont method confirms the effectiveness of this method in treating adult patients with distal occlusion and transverse insufficiency.

Modern dental implantology requires high-precision diagnostic and planning methods to achieve successful implant osseointegration. Key factors determining the long-term stability of the implant are the quality and density of the bone tissue, as well as the choice of optimal surgical technique. Despite significant advances in imaging techniques such as cone-beam computed tomography (CBCT), objective assessment of bone density and prediction of implant stability during treatment phases remain challenging. This article presents the results of a clinical study aimed at using radiopaque templates (RT) for accurate assessment of bone density according to Carl E. Misch classification (D1–D4). These templates, created on the basis of a potassium hydrogen phosphate solution with a given concentration and standardized optical density, allow precise determination of bone tissue density and selection of the optimal surgical protocol for implantation. Aim of the study: to substantiate the choice of surgical protocol for dental implant placement to achieve the required primary stability based on the assessment of jaw bone density using potassium hydrogen phosphate solution radiopaque templates. Materials and methods: the study involved 50 patients. All patients underwent preoperative radiological examination using two radiopaque templates with densities corresponding to bone tissue types D1–D2 and D3–D4 on the Carl E. Misch scale. For implantation in D1–D2 type bone tissue, IRIS LM implants (LLC «NPK Likostom», Russia) with a non-aggressive thread (diameter 4 mm, length 10 mm) and a cortical drill at the final stage of bed preparation were used. For implantation in D3–D4 type bone tissue, IRIS Evolution implants (LLC «NPK Likostom», Russia) with aggressive thread (diameter 4 mm, length 10 mm) and bone expanders were used. Primary stability was assessed by ISQ immediately after placement and at 3 months. Results. The combination of additional diagnostic methods in the form of CBCT with RT and ISQ analysis demonstrated the clinical effectiveness of the proposed surgical implant placement protocols depending on bone density.

The periosteal layer can be used effectively as a biological membrane in guided bone regeneration in horizontal atrophies of the lower jaw with or without simultaneous implant placement. The aim of the study. Evaluation of the horizontal guided bone regeneration efficacy, using bone graft material and a periosteal flap, with or without simultaneous implant placement, in patients with mandibular horizontal atrophy. Methodology. In this study were included 79 patients aged 25–65 years with horizontal atrophy of the mandible who were divided in two groups. The first group, included patients, who underwent guided bone regeneration through periosteal pocket flap with simultaneous implants placement and in the other one were included patients who underwent guided bone regeneration through periosteal flap only. In both groups, a combination of allogeneic osteoplastic material in the form of particles measuring 300–500 µm and autologous platelet-rich fibrin, obtained by centrifuging the patient’s venous blood immediately prior to surgery, was used. The sutures in both cases were removed after 7–10 days. Antibiotic therapy, antihistamines, and analgesics were prescribed as a prophylactic measure in both groups. Patients were followed up for 4 months. The width of the alveolar ridge was measured strictly on transversal sections in the projection of the implant site. Measurements were taken before operation and 4 months after. Results and conclusion. This study included 79 participants, of whom 42 underwent bone regeneration using a periosteal flap with simultaneous implant placement, while 37 underwent bone regeneration using a periosteal flap alone. The clinical and statistical results showed positive findings, with a significant increase in bone width in both groups. In the group undergoing periosteal flap surgery with simultaneous implant placement, the mean bone width increased from 3.231±0.506 mm to 7.513 ± 0.971 mm, corresponding to a mean increase of 4.281 ± 0.515 mm (95% CI: 4.121–4.442 mm; paired t-test, p < 0.001), while in the group using a periosteal flap, the mean bone width increased from 3.078 ± 0.730 mm to 5.497 ± 0.860 mm, corresponding to a mean increase of 2.419 ± 0.235 mm (95% CI: 2.341–2.497 mm; paired t-test, p < 0.001). A comparison of the treatment methods showed that the periosteal flap with simultaneous implant placemnt group achieved a significantly greater mean bone gain than the group in which only a periosteal flap was used (4.281 ± 0.515 mm versus 2.419 ± 0.235 mm). The mean difference between the groups was 1.862 mm, and Welch’s t-test confirmed that this difference was highly statistically significant (p < 0.001).

Objective: To evaluate the reported prognostic value of initial computed tomography (CT) imaging for surgical planning and postoperative outcomes in panfacial fractures, and to determine whether CT‐derived variables have been consistently linked to clinically relevant outcomes. Data Sources: PubMed, MEDLINE, Embase, Cochrane Library, CINAHL, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched from database inception to January 1, 2026. Eligible studies were restricted to publications from January 2015 onward. Methods: Studies were eligible if they included patients with panfacial fractures or separately extractable panfacial fracture subgroups, reported CT or imaging‐based assessment for diagnosis or surgical planning, and provided extractable postoperative or surgical‐management outcomes. Study characteristics, CT‐related variables, surgical‐planning data, and postoperative outcomes were extracted. Random‐effects meta‐analysis of single proportions was performed for infection, malocclusion, revision or secondary surgery, and enophthalmos. CT‐derived prognostic evidence was synthesized narratively according to whether imaging variables were directly or indirectly linked to outcomes. Results: Sixteen studies involving 1811 patients were included. Pooled postoperative complication prevalences were 11% for infection (95% CI, 0%–90%), 10% for malocclusion (95% CI, 5%–19%), 2% for revision or secondary surgery (95% CI, 2%–4%), and 5% for enophthalmos (95% CI, 1%–21%). CT, multiplanar imaging, or three‐dimensional reconstruction was frequently reported for fracture characterization and operative planning. However, standardized CT‐derived prognostic variables were inconsistently reported, and few studies directly linked initial imaging findings to postoperative outcomes. Conclusion: Initial CT imaging is essential for assessment and surgical planning in panfacial fractures. Current evidence provides pooled postoperative benchmarks but remains insufficient to establish robust CT‐based prognostic prediction. Standardized CT reporting, fracture‐severity classification, and outcome assessment are needed to clarify whether initial imaging findings can predict surgical complexity and long‐term outcomes.

Objective. To evaluate the stress-strain state of bone tissue supported by six dental implants under various types of occlusal loading by finite element analysis. Materials and methods. A three-dimensional finite element model of the mandibular segment with six implants and a fixed bridge prosthesis was developed. The properties of cortical and cancellous bone and titanium implants were modeled. The analysis was performed using the von Mises stress criterion to assess equivalent stresses in the bone, implants, and prosthesis. Results. The finite element method was used to evaluate the implant–bone system under various occlusal loads. Under a 500 N load on the incisors, the maximum von Mises stresses in the implants were 550.8 MPa (position 4.2) and 523.7 MPa (position 3.2), with displacements up to 0.109 mm. Under an 800 N load on the molars, the stresses in the implants reached 591.3 MPa (position 4.6) and 545.1 MPa (position 4.4), with displacements of 0.049 mm and 0.028 mm, respectively. In the bone tissue surrounding the implants under the 500 N load, the average stresses ranged from 8.8 MPa (position 4.2) to 18.9 MPa (position 3.2). The modeling accounted for the difference between cortical and cancellous layers through the finite element mesh. Conclusions. Thus, three-dimensional finite element analysis enabled quantitative assessment of the stress–strain state of a six-implant-supported fixed dental prosthesis, with the implants placed at different levels. The distribution of equivalent stresses and displacements was markedly non-uniform. Under each loading condition, the highest stresses were recorded in the implant placed 3 mm deeper than the adjacent implant.

This paper presents the results of an experimental study of a hydroxyapatite (HA) coating deposited on titanium by high-frequency magnetron sputtering (HFMS). During the study, cytotoxicity of the coating was investigated using cytometry, as well as analysis of the coating structure by scanning electron microscopy (SEM). The obtained results confirmed that the use of MVMN did not lead to significant changes in the surface morphology of titanium alloys. HA-coated samples obtained using HFMS did not exhibit cytotoxic properties. The investigated high-frequency magnetron sputtering method can be proposed for further clinical trials.

When planning dental implantation with immediate loading, the position of the mandible is often determined according to habitual occlusion without objective functional diagnostics, which in patients with unstable occlusion may lead to an unstable position of the mandibular condyles and an increased risk of developing symptoms of temporomandibular joint dysfunction (TMD). The aim of the study was to evaluate the effectiveness of a functionally oriented protocol for planning implantation with immediate loading in such patients. A prospective study included 70 patients randomized into two groups of 35 each. In the control group, a standard planning protocol based on clinical data and cone-beam computed tomography (CBCT) was used. In the main group, neuromuscular deprogramming, optical axiography, and digital analysis of mandibular movements were additionally performed to determine its therapeutic position, followed by digital planning and fabrication of constructions for immediate loading. Symptoms of TMD and the width of the posterior joint space according to CBCT were assessed before treatment and after 6 months. In the control group, the frequency of symptoms increased from 3 % to 12 %, whereas no new cases of dysfunction were detected in the main group. In the main group, the width of the posterior joint space increased from 1.53±0.57 to 3.22±0.36 mm on the left and from 1.55±0.52 to 3.17±0.40 mm on the right; in the control group, from 1.51±0.59 to 2.82±0.43 mm and from 1.45±0.55 to 2.91±0.46 mm, respectively (p<0.05), reflecting a more pronounced normalization of condylar position in the main group.

Purpose: to present clinical observation data and analyze the effectiveness of the orthodontic-surgical approach in the treatment of distal occlusion, taking into account the age factor. Materials and methods. The study examined 60 patients aged 18 to 45 years with distal occlusion of the dentition with narrowing of the upper jaw. The patients were stratified into control and study groups of 30 patients each, as well as into two age subgroups: the younger age group (18—25 years; n=15) and the older age group (30—45 years; n=15). In the control group, correction of distal occlusion was previously performed using a bracket system without the use of a MARPE device, whereas in the study group, treatment was performed using a bracket system in combination with a MARPE device. The control group was considered as a retrospective group. The treatment results were compared with the baseline data in the study group based on the Penn index. The main indicator of effectiveness is correction of distal occlusion, stability of achieved occlusal contacts. Results. Comparative analysis revealed that the transversal expansion of the upper jaw in patients aged 18—25 years was significantly more pronounced than in patients aged 30-45 years, both with orthodontic braces treatment and in combination with MARPE. When using only the bracket system, the increase in width was 1.2 mm in the young and 0.7 mm in the older group (p<0.001), and when using MARPE — 2.8 mm and 1.5 mm, respectively (p<0.001). The expansion was accompanied by an improvement in occlusal ratios: normalization of the position of molars and canines, reduction of the incisor gap and the formation of more uniform contacts. The achieved correction of distal occlusion remained stable during the observation period. Conclusions. The conducted research allows us to conclude that an integrated approach using the MARPE device and a bracket system provides a more pronounced transversal expansion of the upper jaw and contributes to the effective correction of distal occlusion compared with the use of a bracket system. At the same time, the patient’s age remains a significant factor influencing the outcome. The results obtained emphasize the importance of individual treatment planning, taking into account the patient’s age and morphofunctional features of his maxillofacial region in order to achieve a stable occlusal result.

The development of biocompatible implant materials remains a key priority in modern maxillofacial surgery and dental practice. This study presents an evaluation of tissue responses to subcutaneous implantation of 3D-printed constructs made from polyetheretherketone (PEEK) and polymethylmethacrylate (PMMA). A morphological and immunohistochemical analysis was performed at various time points after implantation, using markers such as CD3, CD20, VEGF, and Collagen I. The findings revealed differences in inflammatory response, angiogenesis, and fibrosis depending on the material composition. The results confirm the high biocompatibility of PEEK and highlight its potential for use in reconstructive surgery. Objective: To assess the immunohistochemical response of local tissues following subcutaneous implantation of PEEK and PMMA-based materials, and to determine their biocompatibility for clinical applications. Materials and methods. Soft tissue samples were obtained from experimental animals after subcutaneous implantation of implants made from four different polymers. Morphological and immunohistochemical analyses were conducted using antibodies to CD3, CD20, VEGF, and Collagen I. Quantitative assessment was performed within standardized microscopic fields. Results. The study revealed differences in the inflammatory response, angiogenesis, and fibrosis depending on the material composition. The findings confirm the high biocompatibility of PEEK and demonstrate its potential for use in reconstructive surgery. Mild inflammatory reaction was observed near all implant types; however, the PEEK group exhibited the most stable tissue response, with CD3+ cell density corresponding to 1—2 scores and stable VEGF levels (2—3 scores) throughout the observation period. In contrast, the PMMA group showed a more pronounced immune response, particularly on day 7, where CD3+ lymphocyte density reached 3 scores, exceeding the PEEK group by 2.8-fold (p<0.05); increased expression of VEGF and Collagen I (up to 3 scores) was also observed, followed by a decrease by day 60. Conclusion. The results demonstrate the high biocompatibility and low immunogenicity of PEEK, supporting its use as a preferred implant material. PMMA-based materials may elicit stronger tissue reactions and warrant further investigation and surface optimization.

Introduction. Osteoradionecrosis (ORN), a severe and potentially deadly bone complication arising from radiation therapy in the head and neck region, is defined by exposed, irradiated bone that fails to alleviate within three months, with no signs of remaining tumor or cancer recurrence. Research into more effective, less invasive, and safer treatments for ORN is of great importance, highlighting the need for Maxillofacial surgeons and oncologists to carefully select the most suitable treatment plan based on the disease’s advancement. Considering the central role of the RANKL-RANK system in the remodelling and resorbing processes of the bone, new therapies with denosumab and bisphosphonate have been used recently with promising results. Aim. To evaluate modern conservative and surgical methods in treatment of ORN in the maxillofacial region, based on literature review. Materials and methods. This study employed a retrospective review of articles and publications from 2018 to 2024, utilizing databases such as Google Scholar, PubMed, Springer Link, and Science Direct. A comprehensive search, utilizing the keywords such as: “jaw osteoradionecrosis”, “head and neck cancer”, “radiotherapy”, “denosumab”, “bisphosphonates”, yielded 318 articles. These articles were then meticulously screened based on their conclusions, and those deemed irrelevant to the research topic were excluded such as experiments conducted on non-human subjects, as well as treatments with unfavourable prognoses and recovery rates. Following a comprehensive analysis of the remaining publications, 47 articles were selected for inclusion in this review. Conclusion. The management of ORN is dependent on the severity and progression stage of the condition. Early stages of ORN have demonstrated responsiveness to treatments such as PENTOCLO and ozone therapy. In contrast, stages II and III of ORN require more invasive surgical approaches. The integration of surgical methods with non-invasive therapies has been associated with enhanced patient outcomes.