The paper considers the possibilities, prospects, and drawbacks of the mixed reality (MR) technology application using mixed reality smartglasses Microsoft HoloLens 2. The main challenge was to find and develop an approach that would allow surgeons to conduct operations using mixed reality on a large scale, reducing the preparation time required for the procedure and without having to create custom solutions for each patient. Research was conducted in three clinical cases: two median neck and one branchial cyst excisions. In each case, we applied a unique approach of hologram positioning in space based on mixed reality markers. As a result, we listed a series of positive and negative aspects related to MR surgery, along with proposed solutions for using MR in surgery on a daily basis.

The facial allotransplantation technique was first introduced to the general public in 2005. The definition of the face as a complex system of organs that perform social functions made possible the adaptation of this operation into clinical practice. The year 2010 was the starting point for initial research in the Russian Federation. Based on previous achievements and existing world experience in this field, facial allotransplantation was used for the first time in 2015 in St. Petersburg. The goal of this operation was to reconstruct a soldier’s central facial area after an electric burn; he was injured in the military line of duty. This article describes complications faced regarding the preparation for this operation, the issues encountered for facial tissue removal, as well as donor selection criteria. Each stage of the composite facial allotransplantation, complications that can occur during operation, milestone results, as well as the subsequent rehabilitation and immunosuppressive therapy during the 4-year patient observation period following surgery, including the description of a single episode of cell-humoral rejection of transplanted tissue, are described in detail. The experience gained from the first facial allotransplantation performed in Russia shows the possibility of using a new composite allograft to correct deformities in the central area of the face with the achievement of a successfully functioning and aesthetically pleasing result after the operation. After 4 years of dynamic observation and individual rehabilitation programs, the main goal of the facial transplantation, that is, social re-adaptation of the patient, was achieved.

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Background: Ridge reconstruction with extraoral bone grafts is a reliable method in patients with severe alveolar atrophy prior to implant placement. Iliac crest is the most frequently used harvesting site providing abundant bone, associated with high resorption rate and possible painful walking postoperatively. The lateral border of scapula is an alternative grafting area, provided large amounts of cortical and cancellous bone, that showed less resorption rate and postoperative morbidity. Aim/Hypothesis: The aim of this clinical study was to compare treatment protocol, complication rate and early functional outcomes in patients with severe ridge atrophy reconstructed with lateral border of scapula and iliac crest grafts. Materials and Methods: A total of 40 partially or fully edentulous patients with severe ridge atrophy were reconstructed with autogenous iliac crest grafts in 20 cases and lateral border of scapula block in 20 patients. Twenty-eight patients had simultaneous sinus-lifting and onlay bone grafting, in twelve cases onlay grafting was performed. Complication rate, post-operative morbidity and ambulation-time were analyzed. Five to 6 months after augmentation, patients underwent cone beam computed tomography and receive dental implants. All blocks were checked for the Barone success criteria of bone grafting. Three months later, healing abutments were placed and prosthetic rehabilitation was performed. Results: An average graft dimensions were for iliac crest 5.8 ± 3.3 cm in length, 3.9 ± 1.1 cm in height and 1.4 ± 0.7 cm width, for lateral bored of scapula block-length 6.3 ± 2.3 cm, height 2.3 ± 0.7 cm, and width 1.2 ± 0.5 cm. Mean grafting stage time was 40.3 ± 15.6 min for iliac crest and 66.4 ± 19.9 min scapula. At the recipient site postoperative complications occurred equally in both groups. Two weeks after iliac crest harvesting 4 patients had painful walking and in 1 case sensory disturbance was detected. After lateral border of scapula grafting no skin sensory disturbance occurred, but 1 patient had discomfort during arm movements 2 weeks postoperatively. At the time of implant placement, the dimensions of lateral border of scapula reconstructed ridge was 12.3 ± 2.0 mm and 6.9 ± 1.6 mm in height and width, respectively. Alveolar height after iliac crest grafting was 11.5 ± 0.4 mm and width 6.5 ± 0.4 mm and grafts from iliac crest showed higher resorption. Implant survival rate was similar in both groups. Conclusions and Clinical Implications: In patients with severe ridge atrophy both lateral border of scapula and iliac crest bone-grafting approaches are reliable and successful techniques prior to implant placement. Lateral border of scapular showed less postoperative morbidity and significantly lower resorption rate during early healing phase compare to iliac crest. But, the surgical approach of iliac crest harvesting is easier; therefore, it is more commonly used.

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