Background: The question of reconstruction of human tissues and organs with the use of medical materials is still open, because of the accurate requirements for their biological and physical features. The aim of this study was to prove the efficiency of titanium nickelide constructors in treatment of isolated orbital floor fractures or combination with zygomatico-orbital complex fractures. Methods: Patients with a fracture of zygomatico-orbital complex and/or low orbital floor (n = 44) carried out different treatments: in the first group, osteosynthesis and endoprosthesis with titanium nickelide structures; in the second group, titan mini-plates osteosynthesis; in the third group (‘blow-out’), endoprosthesis with a titanium nickelide mesh; and in the fourth group (‘blow-out’), conservative treatment and monitoring (archive data) (p > 0.05). The paraesthesia, diplopia, enophthalmos and exophthalmos degree were measured in points. Results: In one year, the first and second groups had no differences in level of paraesthesia (p > 0.05). The absence of exophthalmos and differences between first and second groups, and between the third and the fourth groups with positive dynamics inside the groups were proved (p < 0.05). In the first and third groups, enophthalmos was absent, and it increased in the second and fourth groups (p < 0.01, p < 0.11). Diplopia in the first and third groups was absent, and it increased in the second and fourth groups (p < 0.05, p < 0.01). Conclusion: The elasticity and biocompatibility of titanium nickelide make the implant insertion and restoration of the lower orbital wall anatomy easier, with good postoperative clinical results.
Background.Due to the prevalence of Vitamin D deficiency as well as the frequency of reconstructive surgical interventions followed by dental implantation, the issue arises concerning the effect of Vitamin D on reparative regeneration of bone and osseointegration of dental implants.The purpose using literature data we are conducting an impact assessment of vitamin D on reparative regeneration of bone tissue, in particular, after oral reconstruction surgeries and dental implantation.Methods.Retrieval, systematization and analysis of scientific data on application of vitamin D supplementation and its effect on reparative regeneration of jaw bone tissue.The conclusions.For the most part, the positive effect exerted on reparative regeneration of jaw bone tissue and osseointegration of dental implants is due to the role of vitamin D in physiological processes evolving in bone tissue, namely maintenance of calcium and phosphate exchange through intestinal absorption and TNF, RANKL (Receptor activator of nuclear factor kappa-B ligand) and consequently differentiation of precursors to osteoclasts into osteoclasts through VDR stimulation (VitaminD Receptor) receptors for further osteogenesis. Also, according to literature data, FGF23 (Fibroblast Growth Factor) protein is a marker of osteoblasts differentiation into osteocytes, it is also known that FGF23 and 1,25(ОН)2D3 are genetically related. FGF23 is the main regulator of both phosphate exchange in bones and metabolism of vitamin D and its metabolites. Besides, indirect anti-inflammatory effect has been observed thanks to inhibition of pro-inflammatory cytokine secretion. Taking into account the abovementioned data, of particular relevance is the definition of serum concentration 25(ОН)D and development of schemes of vitamin D level pre-surgery correction in patients, who have to undergo oral reconstruction surgeries and dental implantation. Mass spectrometry is a promising diagnostic method for determining the level of vitamin D in a body, as it allows to identify the actual amount of vitamin D free from admixture of other steroid hormones. The introduction of this method into clinical practice will allow to monitor the level of vitamin D in patients, receiving reconstructive and rehabilitative treatment.
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