I. I. Kartashevskiy

Background . Treatment of children with suppurative maxillofacial space infections remains an ongoing problem, which is exacerbated by the growing microbial resistance and immune response dysfunction that can prolong the recovery process. Objective . To analyze the clinical and immunological effects of using an immunomodulator based on a synthetic hexapeptide (Imunofan) in a combination therapy of suppurative maxillofacial space infections in children. Methods . A prospective nonrandomized comparative pilot trial was conducted. The study included 47 children aged 8–17 years with suppurative maxillofacial space infections, who were comparable in terms of the baseline data. The patients received either the standard treatment (surgical debridement + antibiotics; n = 27, Subgroup 1) or the standard treatment supplemented with Imunofan (45 µg/day intramuscularly for five days; n = 20, Subgroup 2). The comparison group comprised 13 relatively healthy children. The study assessed the subpopulations of lymphocytes (via flow cytometry), the levels of immunoglobulins, and the phagocytic activity of neutrophilic granulocytes. The obtained data were processed using Microsoft Excel 2019 (Microsoft, USA) and an online calculator (https://medstatistic.ru). In order to control the risk of Type I errors in the multiple comparisons of immunological parameters, the Holm-Bonferroni correction was used. After correction, the significance level was set at p < 0.05. Results . Prior to treatment, the children with suppurative maxillofacial space infections were found to have combined immune disorders: decreased relative count of T lymphocytes, helper T cells (CD3+CD4+ ), and cytotoxic lymphocytes (CD3+CD8+ ), as well as incomplete phagocytosis. The standard treatment (Subgroup 1) normalized only the leukocyte level (p < 0.05 after correction), while cellular immunity and phagocytic function remained impaired. In Subgroup 2, a clear tendency was observed toward the normalization of median T-cell parameters (T lymphocytes: 76.1% in Subgroup 2 vs. 75.73% in the comparison group; helper T cells: 46.75% vs. 46.05%) and significantly improved completeness of phagocytosis; however, after correction for multiple comparisons, no statistically significant differences were found in most immunological parameters between Subgroup 2 and the comparison group. The key clinical outcome was a statistically significant reduction in the hospital length of stay in Subgroup 2 as compared to Subgroup 1 (8.70 ± 2.49 vs. 12.89 ± 1.50 days, p = 0.02). Conclusion . The study results indicate the potential efficacy of Imunofan immunomodulator in the combination therapy of suppurative maxillofacial space infections in children, which manifests itself in the positive changes in the immunological parameters and a significant reduction in the hospital length of stay. The obtained data justify further randomized controlled effectiveness trials.

Subject. In the context of the global trend towards population aging, improving the quality of life of gerontological patients is becoming a critical task, which intensifies competition for technological leadership in the development of implants as the basis for treating oral diseases. Ceramic dental implants based on zirconium dioxide are a modern alternative to traditional titanium analogues, possessing high biocompatibility, as well as excellent aesthetic properties due to their white color and corrosion resistance. This review presents an analysis of the key factors determining the dynamics of the global ceramic implants market, as well as trends in technological leadership in various regions, including the Russian Federation. The main growth drivers, market opportunities, and existing limitations are considered. Quantitative market assessments, its segmentation and regional analysis are provided, and a list of leading leading companies is presented. Objectives. To analyze scientific publications on the global dental ceramic implants market to identify growth factors, barriers and promising areas of technological development of ceramic dental implants. Methodology. A search and analysis of publications and economic reports in scientometric databases (Scopus, PubMed, eLIBRARY) was conducted on issues dedicated to global market trends and the evolution of dental implant technologies and new materials devoid of the disadvantages of titanium. Results. The global ceramic implant market is expected to reach a value of $15.94 billion by 2029, demonstrating a compound annual growth rate (CAGR) of 6.0% in the forecast period 2022-2029. Conclusion. As a result of the analysis, it was determined that the share of ceramic dental implants in Russia will be no more than 5%, since titanium analogues prevail. In connection with the current global trends, the development of new technologies for the production of dental implants in the Russian Federation, compatible with modern hybrid information and communication technologies adapted to advanced production methods, seems relevant. The Russian Federation is developing bioactive glass-ceramic implants designed to occupy their niche in the world market.

INTRODUCTION. The study of the structure of the septa in the area of the maxillary sinus floor is important when planning implantation and sinus lifting operations. The height, number and location of the septa can affect the course of the sinus lifting operation. The aim is to study the structure of the maxillary sinus septa, their height, size, localization in order to prevent complications during surgical interventions.MATERIAL AND METHODS. The article analyzes CBCT data from 444 patients for the presence of septa in the area of the lower wall of the maxillary sinus. The subjects were divided into two groups: with the presence of premolars and molars (288 CBCT) and with the absence of at least one chewing tooth (156 CBCT). A study of 48 passportized skulls was conducted, the anterior wall of the maxillary sinus was sawed out, the structure of the sinus floor and septa was studied in detail. The ratio of the volume of compact and spongy bone substance in the premolar and molar areas was also measured.RESULTS. The obtained research data allowed us to obtain new information about the number of septa in the case of a complete dentition and partial tooth loss. Due to changes in the processes of sinus pneumatization, the number of septa increases with partial tooth loss. Their presence increases the risk of perforation of the Schneiderian membrane during sinus lift surgery, including the use of scaffolds based on a collagen matrix. However, when installing an implant in the base of the septum, its stability can be ensured, since the septa are some kind of buttresses of the maxillary bone. The ratio of the volume of spongy and compact bone substance in the premolar and molar area changes with age.CONCLUSION. The study found that the presence of coronal septa can cause complications of sinus lift surgery in the form of perforation of the Schneiderian membrane. At the same time, septa, being buttresses of the maxillary bone, can serve as a basis for installing an implant. With partial loss of teeth, the number of coronal septa increases. With age, the ratio of spongy and compact bone substance changes, towards a decrease in the volume of trabecular and an increase in the volume of compact bone.

Поверхность дентального имплантата, имеющего развитый микрорельеф и выраженную шероховатость, способствует лучшей биологической совместимости с костной тканью, уменьшает риск отторжения. Правильно подобранный микрорельеф дентального имплантата может снижать риск бактериального загрязнения и развития воспалительных процессов, способствуя тем самым профилактике периимплантита. Цель — провести сравнительный экспериментальный анализ микрорельефа и элементного состава резьбовой части дентальных имплантатов, применяемых со скаффолдом на основе коллагеновой матрицы. Использовали 6 однолетних овец (баранов) которым под рентгенологическим контролем установили 12 дентальных имплантатов. В зависимости от вида имплантатов животных поделили на 3 группы: I — 4 импланта Mis (Израиль) из титанового сплава с пониженным содержанием кислорода, азота, углерода и железа (Ti6Al4V ELI) совместно со скаффолдом на основе коллагеновой матрицы; II — Osstem (Южная Корея) с ультрагидрофильной поверхностью серии TS-III СА совместно со скаффолдом на основе коллагеновой матрицы; III (контроль) — имплантаты машинной обработки Endure (США). Через 3 месяца после операции изготавливали металлокерамические коронки, которые вводили в прикус. Через 12 и 24 месяцев имплантаты удаляли вместе с окружающими тканями и отправляли на микроскопическое и гистологическое исследование. На режущей поверхности имплантатов I и II группы выявлена высокоорганизованная костная ткань, в составе которой преобладали кислород, углерод, кальций и фосфор. В образцах контрольной группы обнаружена грубоволокнистая ткань с высоким содержанием углерода и кислорода, что более типично для несформированной костной ткани. Остеоинтеграция с костью к поверхностям дентальных имплантатов в I и во II группе (316,4 и 288,7 кН; p<0,001) оказалась более прочной, чем фиксация к титану машинной обработки (78,4±10,4 кН; p<0,002). Это подтвердилось гораздо более высоким усилием, необходимым для отделения имплантата от кости, а также бóльшим количеством ретенционных точек контактов костной ткани с поверхностью дентального имплантата. Использование дентальных имплантатов с развитым микрорельефом и модифицированной поверхностью совместно со скаффолдом на основе коллагеновой матрицы обеспечивает более полноценную остеоинтеграцию в сравнении с дентальными имплантатами машинной обработки. Это подтверждается гистологической картиной и микроэлементным составом при эксплуатации дентальных имплантатов в течение 12 и 24 месяцев. В эти же сроки в контрольной группе качественные характеристики и микроэлементный состав образцов дентальных имплантатов свидетельствовал о низком уровне минерализации. The surface of the dental implant, having a developed microrelief and pronounced roughness, contributes to better biological compatibility with the bone tissue, reduces the risk of rejection. Properly selected microrelief of the dental implant can reduce the risk of bacterial contamination and development of inflammatory processes, thus contributing to the prevention of peri-implantitis. The aim is to carry out the comparative experimental analysis of the microrelief and elemental composition of the threaded part of the dental implants used with the scaffold on the basis of the collagen matrix. . Six year-old sheep (rams) were used and 12 dental implants were placed under the radiologic control. Depending on the type of implants the animals were divided into 3 groups: I — 4 implants Mis (Israel) made of titanium alloy with reduced content of oxygen, nitrogen, carbon and iron (Ti6Al4V ELI) together with scaffold on the basis of collagen matrix; II — Osstem (South Korea) with ultrahydrophilic surface of TS-III CA series together with scaffold on the basis of collagen matrix; III (control) — machine-processed implants Endure...

Objective: To develop a detergent-enzymatic method and evaluate the quality of a decellularized pulp scaffold for regenerative endodontics.Materials and methods: Biomaterial and mesenchymal stem cells (MSCs) were derived from dental pulp that was obtained following third molar extraction indicated for orthodontic reasons in patients aged 14-18 years. The detergent-enzymatic method enabled to obtain a decellularized scaffold from pulp samples. The proliferative activity and viability of dental pulp-derived MSCs were assessed using trypan blue staining and XTT assay. To assess tissue response, Wistar rats underwent subcutaneous implantation of native and decellularized dental pulp. Explanted samples were stained with hematoxylin-eosin on days 7 and 14.Results: The detergent-enzymatic treatment of the dental pulp demonstrated the absence of nuclear material, whereas the histoarchitecture of the dental pulp was disturbed. The DNA content in the sample of the decellularized scaffold was 22.79 ± 2.1 ng/mg of tissue; the amount of DNA in the native sample was 78.5 ± 5.4 ng/mg of tissue. According to XTT assay results, no cytotoxicity of the decellularized scaffold against MSCs was found. Biopsy specimens of the rats with implanted decellularized dental pulp were characterized by no signs of inflammation.Conclusions: The study results will enable to create a biomaterial that can be the base of a tissue-engineered structure of the dental pulp and be used for the regeneration of the pulp-dentin complex.

Aim. To study the efficacy of dermal hydrogel application in the experimental treatment of superficial scarified wounds in rats.Materials and methods. The hydrogel was obtained from porcine dermis by alkaline hydrolysis. The DNA concentration was determined using the Nano Drop ND-1000 spectrophotometer. The study included 30 male Sphinx rats. Scarified wounds were created on the rat skin, then the rats were divided into two groups: group 1 – rats without treatment, or control group (n = 15), group 2 – rats with wound treatment with the dermal hydrogel for 5 days, or experimental group (n = 15). On day 3, 7, and 14 of the experiment, we explanted skin samples from the wound area and performed routine H&E staining.Results. On day 3 of the experiment, moderate inflammation, edema, and collagen fiber disorganization were revealed in the experimental group, and pronounced inflammation with purulent exudate was found in the control group. On day 7 of the experiment, inflammation and foci of stratified epithelium were detected in the control group. The histologic analysis of the skin samples from the experimental group showed pronounced plethora of the vessels, necrotic changes of the dermis, and edema. The total thickness of the epidermis and the thickness of its stratum corneum were greater than in the control group samples. On day 14, the differences between the groups were minimal and the epidermis was thickened in the experimental group animals.Conclusion. The study examined the effects of the dermal hydrogel on scarified wounds in rats. We found faster skin regeneration (by 1.5–2 days) in the experimental group compared to the controls. Besides, the rats of the experimental group were characterized by an increase in the number of fibroblasts in the dermis and thickened epidermis in the affected area.