L. L. Borozdkin

Despite the abundance of dental implant surface modification methods, a gap exists between their laboratory efficacy and the level of evidence-based clinical data, complicating the selection of the optimal technology for specific clinical scenarios. Aim: to conduct a comparative analysis of modern surface modification methods (chemical etching, anodization, plasma spraying, laser treatment, nanotechnology) by evaluating their clinical advantages, limitations, and application prospects based on a systematic literature review. Materials and methods. An analysis of publications from 2015—2025 was conducted using the PubMed, Scopus, Web of Science, eLibrary, and RSCI databases. Inclusion/exclusion criteria were applied to select peer-reviewed articles, including original research, reviews, meta-analyses, and clinical trials. Results. It was established that each method creates a surface with unique parameters (micro- and nanotopography, chemical composition, bioactivity), which determines the differences in their clinical efficacy. Chemical etching and anodization demonstrate high osseointegration and are supported by long-term studies. Plasma spraying of hydroxyapatite is effective in complex cases but carries risks of coating degradation. Laser treatment and nanotechnology offer the highest precision and multifunctionality but require further long-term clinical studies. Conclusions. The choice of a surface modification method should be based on considering its evidence-based advantages and limitations for specific clinical conditions. Future development prospects are associated with the combination of technologies and the creation of intelligent surfaces with controllable properties. The integration of advanced methods into practice requires the development of standards and long-term randomized studies.

Tunnel soft tissue augmentation using a free connective tissue graft in the area of dental implants is a popular technique in modern clinical dentistry. This technique is aimed at preventing soft tissue loss in the postoperative period, especially in clinical settings complicated by severe localized periodontitis. Given the high risk of inflammatory and recurrent processes in severe forms of periodontitis, the rationale for using this technique is particularly clinically significant. Materials and methods. Forty patients with chronic, severe localized periodontitis in the area of the central teeth of the maxilla were examined and operated on. In Group I, 20 patients underwent extraction and simultaneous dental implantation, as well as tunnel soft tissue augmentation using a free connective tissue graft (FCT). Patients in the control group II (n=20) underwent tooth extraction and immediate dental implantation without soft tissue grafting. Soft tissue loss in the implant area was assessed after 12 months. Results. In Group I, the average soft tissue loss was 1.0 mm, which was significantly less than 2.1 mm in the control group (p<0.01). Conclusion. Tunnel soft tissue grafting using FCT during extraction and immediate dental implantation in the anterior region of the maxillary dentition contributes to a favorable prognosis and prevents postoperative soft tissue loss around dental implants.

Inflammation of the submandibular region occurs quite often in dental practice. The ethology and clinical manifestations of this pathology are diverse and despite the great possibilities of conservative therapy, in some cases it is necessary to perform surgical intervention. The causes of inflammation in the submandibular region are odontogenic diseases, lymphadenopathies, sialorrhea, neoplasms of submandibular salivary glands and sialolithiases. The odontogenic abscesses (88.9 % of cases) and phlegmon (2.7–3.4 % of cases) of the maxillofacial region account for 88.9 % of oral infections. Odontogenic diseases are accompanied by impaired colonization resistance of the oral cavity and are of a big problem. Lifadenopathies in the submandibular region occur in 70 % of cases, while surgical treatment is required for 4 % of patients with this pathology, intensive postoperative medical therapy – 1.7 %, lethality occurs in 0.12 % of cases. Sialorrhea often develops in patients with mental retardation, cerebral palsy, autism, and neuromuscular or sensory dysfunctions. with low efficacy of anticholinergic drugs or botulinum toxin arministration, the main treatment is submandibular resection. Benign neoplasms of the submandibular salivary glands occur in 13 % of cases and are malignancies more often than tumors of the parotid gland. Neoplastic diseases of the submandibular glands of the maxillofacial region account for 34 to 54 %. The most common pathology of these glands is salivary stone disease which occurs in 80–90 % of cases.Aim. To analyze the main causes of inflammation in the submandibular region, requiring surgical intervention

The symmetry of masticatory muscle tension in tooth loss undergoes various changes due to the reorganization of the chewing process itself. Electromyography (EMG) of the masticatory muscle’s measures muscle tone over time, for example, during the chewing cycle or during clenching. Thus, EMG can provide an assessment of muscle tone during the chewing sequence. Since bite force and chewing efficiency are important parameters, the use of EMG in patients with tooth loss can be an effective tool for diagnosing various pathological processes. Purpose: to identify a correlation between the restoration of chewing function in patients with tooth loss and the symmetry of masticatory and temporal muscle tension. Materials and methods. 20 patients with tooth loss (K08.1) underwent dental implant placement in the upper and lower jaws followed by prosthetic rehabilitation. Before surgery and one month after permanent prosthetic rehabilitation, electromyography (EMG) was used to measure the activity of the masseter and temporal muscles (total amplitude during teeth clenching) and calculate the symmetry index of muscle tension on the right and left sides. Results. Preoperative measurements showed average muscle tension levels of 27.00±9.78 mV in the right temporal muscle and 28.15±9.60 mV in the left temporal muscle. For masseter muscles, the total clenching amplitude was 24.30±5.56 mV on the left side and 20.60±8.88 mV on the right. After one month of prosthetic rehabilitation, significant correlations emerged between masticatory function recovery and muscle activity patterns: analysis revealed an inverse ipsilateral relationship between masseter and temporal muscles (r=−0.87 right, r=−0.74 left, p<0.001), bilateral synchronization of masseter muscles (r=0.72, p<0.001), and cross-muscle regulatory patterns (Md/Ts: r=−0.45, p=0.046; Ms/Td: r=−0.63, p=0.003) demonstrating asymmetric masticatory control mechanisms, while demonstrating improved symmetry following prosthetic rehabilitation. Conclusion. Overall, this work shows that the activity of the masticatory muscles in patients with tooth loss improves after orthopedic rehabilitation on dental implants. This improvement is manifested in a more symmetrical tone of the masticatory muscles.

The purpose of the work is to analyze the available software for planning operations in maxillofacial surgery and surgical dentistry, with an assessment of the capabilities and prospects of domestic programs in the conditions of international sanctions. Materials and methods. The study analyzed the functionality of programs for planning operations based on domestic and foreign software products. Systems such as Materialize, Dolphin, 3D Systems, Brainlab, Planmeca, as well as Russian developments Avantis3D, Endoprint, Bonabyte, Medgital Vision and Autoplan were considered. A comparative description of their functionality, advantages and limitations has been made. The possibility of replacing foreign programs with domestic analogues under sanctions was assessed. Results. The study showed that the Russian programs Avantis3D, Endoprint and Bonabyte have functionality comparable to their foreign counterparts, which makes them a full-fledged alternative for use in maxillofacial surgery and dentistry. However, bioprinting remains one of the areas where domestic developments are still lagging behind. Conclusion. Russian developments can fully replace foreign programs in most clinical cases, which is especially important under sanctions. Further research and development is needed in the field of bioprinting and robotics.

Ортопедическая реабилитация пациентов на дентальных имплантатах при тяжелых случаях хронического пародонтита затруднительна в силу большого риска осложнений в виде вторичного инфицирования раны, а также нестабильности маргинальной периимплантной зоны. Цель — оценить клиническую эффективность применения универсальных flat-абатментов при реабилитации пациентов с хроническим генерализованным пародонтитом тяжелой степени. У пациента (44 года) с хроническим генерализованным пародонтитом тяжелой степени на КЛКТ обнаружена генерализованная убыль межзубной костной перегородки от 1/3 до 2/3 высоты корней зубов верхней и нижней челюстей. Проведены удаление зубов на нижней челюсти, редукция альвеолярного гребня, установка 6 дентальных имплантатов, фиксация универсальных абатментов (3.4, 3.2, 4.2, 4.4) и стандартных прямых мультиюнитов (3.6, 4.6) с дальнейшим внутриротовым сканированием и немедленной ортопедической нагрузкой. Через 12 месяцев после протезирования убыль костной ткани в области имплантата 3.6 составила 0,2 мм, в области 3.4 — 0,1 мм, в области 3.2 — 0,1 мм, в области 4.2 — 0,3 мм, в области 4.4 — 0,1 мм, в области 4.6 — 0,3 мм. Применение flat-абатментов в комбинации со сферическими абатментами позволило добиться благоприятного клинического результата в виде отсутствия послеоперационных проявлений (отека, боли, дискомфорта), высоких показателей эстетики, а также минимальной убыли маргинальной кости у пациента с хроническим генерализованным пародонтитом тяжелой степени. Orthopedic rehabilitation of patients with severe chronic periodontitis on dental implants is difficult due to the high risk of complications in the form of secondary wound infection, as well as instability of the marginal peri-implant zone. Objective — to evaluate the clinical efficacy of universal flat abutments in the rehabilitation of patients with severe chronic generalized periodontitis. . A 44-year-old patient with severe chronic generalized periodontitis showed generalized loss of the interdental bone septum from 1/3 to 2/3 of the root height of the teeth of the upper and lower jaws on CBCT. The following procedures were performed: extraction of teeth on the lower jaw, reduction of the alveolar ridge, installation of 6 dental implants, fixation of universal abutments (3.4, 3.2, 4.2, 4.4) and standard straight multi-units (3.6, 4.6) with subsequent intraoral scanning and immediate orthopedic loading. . After 12 months of prosthetics, bone loss in the area of implant 3.6 was 0.2 mm, in the area of 3.4 — 0.1 mm, in the area of 3.2 — 0.1 mm, in the area of 4.2 — 0.3 mm, in the area of 4.4 — 0.1 mm, in the area of 4.6 — 0.3 mm. . The use of flat abutments in combination with spherical abutments allowed to achieve a favorable clinical result in the form of the absence of postoperative swelling, pain, discomfort, high aesthetics, as well as minimal loss of marginal bone in a patient with severe chronic generalized periodontitis.

Цель исследования — повысить эффективность лечения пациентов с переломом мыщелкового отростка нижней челюсти. В исследовании приняли участие 24 пациента от 18 до 65 лет с переломом мыщелкового отростка нижней челюсти на уровне головки и шейки с медиальным смещением (S02.62). Пациенты были разделены на 2 группы: в I группе 14 пациентам выполняли классическую открытую репозицию костных отломков с последующим металлоостеосинтезом, 10 пациентам II группы проводили эндопротезирование височно-нижнечелюстного сустава (ВНЧС) по собственной методике. В обеих группах осуществлялся комбинированный хирургический доступ — внутриротовой и транстрагальный. В течение первого месяца после операции у пациентов II группы отмечалось стойкое нарастание величины открывания рта по сравнению с пациентами I группы — 35,4±0,7 и 23,4±2,6 мм соответственно. Выраженность болевого синдрома по ВАШ снизилась до 1,1±0,7 балла в I группе и до 0,5±0,5 балла во II группе. Девиация нижней челюсти сохранялась у 70% пациентов I группы и совсем отсутствовала у пациентов II группы. Неврологический дефицит со стороны ветвей лицевого нерва, преходящий парез, наблюдали в 38% случаев: у 43% пациентов I группы и у 30% пациентов II группы. При переломах мыщелкового отростка нижней челюсти методом выбора хирургического лечения можно считать тотальное эндопротезирование ВНЧС индивидуальными конструкциями на основании предварительного трехмерного планирования и прототипирования. Такой подход способствует снижению рисков послеоперационных осложнений как в раннем, так и в позднем послеоперационном периоде. The aim of the study was to improve the effectiveness of treatment of patients with fracture of the mandibular condyle. . The study involved 24 patients from 18 to 65 years old with a fracture of the mandibular condyle at the level of the head and neck with medial displacement (S02.62). The patients were divided into 2 groups: in group I 14 patients underwent classical open repositioning of bone fragments with subsequent metal osteosynthesis, 10 patients of group II underwent endoprosthesis of temporomandibular joint (TMJ) according to our own method. In both groups a combined surgical access — intraoral and transtragal access — was performed. . During the first month after the operation the patients of group II had a steady increase of the mouth opening value in comparison with the patients of group I — 35.4±0.7 and 23.4±2.6 mm, respectively. The intensity of pain syndrome according to VAS decreased to 1.1±0.7 points in group I and to 0.5±0.5 points in group II. The deviation of the mandible was preserved in 70% of patients in group I and was absent in group II. Neurological deficit of the facial nerve branches, transient paresis, was observed in 38% of cases: in 43% of group I patients and in 30% of group II patients. . In mandibular condyle fractures the method of choice for surgical treatment can be considered total TMJ endoprosthesis with individual constructions on the basis of preliminary three-dimensional planning and prototyping. This approach helps to reduce the risks of postoperative complications both in the early and late postoperative period.

Цель исследования — клиническая оценка эффективности применения витамина D при лечении хронического апикального периодонтита у пациентов с остеопенией. Проведено лечение хронического апикального периодонтита у 128 пациентов, выполнены измерение концентрации витамина 25(OH)D в сыворотке крови, денситометрия для определения плотности костной ткани, измерение объема очагов деструкции на всем этапе лечения. Изучали скорость восстановления костной ткани при лечении хронического апикального периодонтита у пациентов с остеопенией и без нее. Из 128 пациентов у 48 обнаружена остеопения. У пациентов с остеопенией через 18 месяцев не происходит полного ремоделирования костной ткани, в отличие от группы пациентов, не имеющих остеопению. Восстановление периапикальных тканей у пациентов с остеопенией происходит на 12 месяцев дольше, чем у пациентов без остеопении. При сравнении периода ремоделирования костной ткани у пациентов с остеопенией и дефицитом витамина D и его коррекцией и у пациентов с остеопенией, низким уровнем витамина 25(OH)D и без его коррекции во времени лечения определена разница в 20 месяцев (p<0,001). На эффективность лечения хронического апикального периодонтита значимое влияние оказывают наличие системной остеопении, дефицит уровня витамина D и его коррекция. При лечении персистирующего хронического апикального периодонтита целесообразно проведение таких дополнительных методов обследования, как определение содержания 25(OH)D в сыворотке крови и денситометрия, по показаниям должна проводиться коррекция этих показателей у эндокринолога. The aim of the study was to conduct a clinical evaluation of the efficacy of vitamin D administration in the treatment of chronic apical periodontitis in patients with osteopenia. . Treatment of chronic apical periodontitis in 128 patients was carried out; vitamin 25(OH)D concentration in blood serum was measured, densitometry to determine bone tissue density, and the volume of destruction foci was measured at the whole stage of treatment. We studied the rate of bone tissue regeneration during the treatment of chronic apical periodontitis in patients with and without osteopenia. . Of 128 patients, 48 had osteopenia exposed. Patients with osteopenia do not have complete bone remodeling after 18 months, in contrast to the group of patients without osteopenia. Periapical tissue remodeling in patients with osteopenia takes 12 months longer than in patients without osteopenia. When comparing the period of bone tissue remodeling in patients with osteopenia with vitamin D deficiency and its correction and in patients with osteopenia, low vitamin 25(OH)D level and without its correction in the time of treatment, a difference of 20 months (p<0.001) was determined. . The efficacy of treatment of chronic apical periodontitis is significantly influenced by the presence of systemic osteopenia, deficiency of vitamin D level and the presence of its correction. In the treatment of persistent chronic apical periodontitis it is advisable to carry out such additional methods of examination as determination of 25(OH)D content in blood serum and densitometry, if indicated, correction of indices should be carried out by an endocrinologist.