Военно-медицинская академия им. С. м. кирова, Санкт-петербург, Россия 2 Ставропольский государственный медицинский университет, Россия 3 Северо-Западный государственный медицинский университет им. И. И. мечникова, Санкт-петербург, Россия 4 Федеральное бюро медико-социальной экспертизы, москва, Россия muscle acTiViTY in paTienTs WiTh dYsfuncTion of The TismaTmouralmaliTY: The role of unifferenTiaTed connecTiVe Tissue diplasion Blinov m. s. 1 , Borodulina i. i. 1 , grebnev g. a. 1 , sirak s. V. 2 , ivanov a. s. 1 , fadeev r. a. 3 , Kozlov s. i. 4 , Kovalevsky a. m. 1 1 s. m. Kirov military medical academy, saint petersburg, russia 2 stavropol state medical university, russia 3 i. i. mechnikov north-Western state medical university, saint petersburg, russia 4 federal Bureau of medical and social expertise, moscow, russia

Legal, economic and clinical aspects of treatment of military personnel, retired military personnel, as well as the attached contingent in the conditions of hospitals of the Ministry of defense are presented. The study is based on the results of studying the number of dental implants installed in patients from 2014 to 2019 based on the medical records and outpatient records of a dental patient in two specialized departments of multidisciplinary hospitals of the Ministry of defense of the Russian Federation. Primary medical records were studied, data on the sex and age of patients, the presence (absence) of opportunistic diseases used implant system, the installation of dental implants and their amount and frequency of soft tissue and osteoplastic operations (to increase the volume of the bone and soft tissues of the alveolar bone (part) jaws) and the Protocol of the temporary and permanent prosthesis. Based on the analysis, we describe the current possibilities of medical and diagnostic work and present various types of orthopedic structures on dental implants for the dental rehabilitation of the above-mentioned contingents with complete adentia of the jaws (including in cases where absolute indications require the removal of all teeth due to foci of chronic odontogenic infection or periodontitis). The methods of treatment of patients in cases of combination of adentia with varying degrees of atrophy of the alveolar processes (parts) of the jaws are analyzed in detail. Clinical examples of dental rehabilitation are shown both with and without the use of methods for increasing the volume of jaw bone tissue, using various modern protocols for fixing orthopedic structures on zygomatic and root dental implants, and the frequency of their use in military medical organizations of the Ministry of defense of the Russian Federation during the reporting period. Based on the presented results, it is shown that the military medical organizations of the Ministry of defense of the Russian Federation have a full range of opportunities to provide comprehensive dental care to patients with complete secondary adentia, even in the presence of extreme bone atrophy of the jaws.

Odontogenic maxillary sinusitis is a problem that is at the junction of two specialities: otorhinolaryngology and dentistry. According to domestic and foreign authors in the structure of dental diseases, odontogenic maxillary sinusitis is6-24%. According to doctors-otorhinolaryngologists among all types of sinusitis about 40% is odontogenic maxillary sinusitis. Currently, there is a gradual increase in the number of odontogenic maxillary sinusitis. This is due to the improved diagnosis of this pathology. The use of dental computed tomography usually allows establishing reliably the cause of odontogenic maxillary sinusitis. Unsatisfactory results of treatment of some dental diseases, the increase in the number of odontogenic maxillary sinusitis determines the relevance of the study. The problem of odontogenic maxillary sinusitis is considered, modern views on the aetiology, pathogenesis, clinic, diagnosis and treatment according to domestic and foreign authors, as well as some issues of the relationship of pathology of intraosseous structures and the course of odontogenic maxillary sinusitis, the principles of an interdisciplinary approach in the treatment of odontogenic maxillary sinusitis are presented. The search for new methods of treatment of odontogenic maxillary sinusitis is dictated by some differences in clinical manifestations of odontogenic sinusitis from rhinogenic. The approach based on the joint primary examination and treatment of patients with suspected odontogenic maxillary sinusitis by an otorhinolaryngologist and maxillofacial surgeon, as well as the development of further tactics for the management of this category of patients, is, in our opinion, promising. The use of modern methods of functional endoscopic surgery is an effective means of prevention and treatment of odontogenic maxillary sinusitis, as it is a minimally invasive technique that allows you to create conditions for further rational prosthetics of the oral cavity.

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BACKGROUND: Modern methods of restorative and reconstructive surgery have made it possible to improve the results of treatment of patients with defects in the zygomatic-orbital complex; however, achieving good long-term treatment results continues remains difficult. The study presented a description of the methods of surgical treatment of defects and deformities of the zygomatic-orbital complex. The study made it possible to identify the advantages and disadvantages of the previously proposed methods and to assess the volume and characteristics of complications associated with specific methods. The surgical method of treatment was defined as the treatment of diseases by separating and connecting tissues during a surgical operation. AIM: This study aimed to identify the main methods of surgical treatment of defects and deformities of the zygomatic-orbital complex, describe the most common of them, and determine the frequency and type of complications associated with each method. MATERIAL AND METHODS: The study was based on the results of a retrospective analysis of 9605 case histories of patients treated at the Clinic of Maxillofacial Surgery and Surgical Dentistry of the Military Medical Academy named after S.M. Kirov from 2014 to 2020. Of these patients, 715 had facial injuries 335 had midface injuries, and 189 had injuries of the zygomatic-orbital complex. RESULTS: The study interviewed 10 oral and maxillofacial surgeons who scored (15, most uncomfortable to see no improvement) the seven most popular materials in the clinic based on nine characteristics. Of the 189 patients who received treatment, late (not earlier than 6 months) complications were detected in 31 (16.4%) patients, which were divided into three groups: (A) fractures of the zygomatic-orbital complex with slight displacement of fragments, (B) subtotal fractures with the formation of defects and deformations, and (C) total defects and deformations. CONCLUSION: There is no consensus as to how many fixation points are needed in the treatment of MJ fractures. Generally, the number of unstable fragments determines the number of fixation points in direct proportion. A recent meta-analysis showed that a 3-point fixation had greater fracture stability up to 3 months postoperatively compared with a 2-point fixation, but the level of evidence was low.