Subject. Postcovid necrosis of the maxillofacial region is one of the severe consequences of a new coronavirus infection, the etiology and pathogenesis of which are not fully understood. A large number of researchers emphasize the leading role of molds in the development of this complication, which they characterize as COVID-19-associated rhino-orbito-cerebral mycosis. However, there is a point of view that the inflammatory process in post-covid necrosis can also be caused by other pathogens - saprophytic microflora. The aim of the study was to evaluate the results of microbiological examination in patients with Postcovid necrosis of the maxillofacial region and in the risk group for this complication. Methodology. The main study group consisted of 19 patients with signs of osteonecrosis of the bones of the facial skeleton and inflammatory lesions of the paranasal sinuses after suffering a coronavirus infection (Postcovid necrosis of the maxillofacial region). Control group (risk group) - 32 patients with severe COVID-19 without the above manifestations. A microbiological study was performed - a smear from the mucous membrane in the region of the middle nasal passage, smear microscopy, seeding on standard and elective (Saburo) media before treatment. Data were compared using Fisher's exact test for p<0.05. Results. In the main group there were 19 people - 10 men (52.63%), 9 women (47.37%), aged 54 to 73 years, in the control group - 18 (56.25%) men, 14 (43, 75%) women, 52 to 83 years old. In the main group, Streptococcus viridans, Klebsiella pneumonia and Mucor spp. were detected significantly more often (p<0.05), and Staphylococcus aureus was found in the risk group. Mycelium of mold fungi was found only in 3 patients of the main group, in the rest the absence of fungal invasion was confirmed cytologically and pathohistologically. Conclusions. The data obtained confirm the assumption that the inflammatory process in Postcovid necrosis of the maxillofacial region can be caused by various pathogens and is an opportunistic nosocomial infection. It is required to monitor patients at risk and timely treatment if they develop specific symptoms.

Subject. The number of patients taking antiresorptive drugs (bisphosphonates and denosumab) is steadily increasing. The need of this group of patients for dental care continues to be high. In this regard, the prevalence of complications of antiresorptive therapy – drug osteonecrosis of the jaws – tends to increase. Therefore, the problem of awareness of doctors and patients on the assessment of the risk of drug osteonecrosis of the jaws and its prevention is of high relevance. The aim of the study is to develop a form of informed voluntary consent for types of dental interventions for patients receiving antiresorptive therapy. Methodology. The analysis of regulatory documents on the procedure for obtaining informed voluntary consent in the Russian Federation, as well as positional documents of the leading communities of maxillofacial surgeons on medicinal osteonecrosis of the jaws (USA, Italy, Japan, South Korea, Austria) was carried out. Results. On the basis of Appendix No. 2 of the Order of the Ministry of Health of the Russian Federation dated November 12, 2021 N 1051n, in accordance with Article 20 of Federal Law No. 323-FZ dated 11/21/2011, a form of informed voluntary consent for types of dental interventions for patients who have indicated a history of taking bisphosphonates and (or) denosumab has been developed. The form contains an explanation of the causal relationship between taking antiresorptive drugs and the onset of medicinal osteonecrosis of the jaws, a description of dental manipulations in terms of the risks of this complication, as well as ways to prevent the disease. Conclusions. The presented form of informed voluntary consent to the types of dental interventions for patients receiving antiresorptive therapy is submitted for discussion by the medical community. Openness and completeness of information, as well as cooperation and sharing of responsibility between the patient and the doctor will lead to positive changes in the problem of prevention of medicinal osteonecrosis of the jaws.