No abstract

No abstract

Effectiveness of morphogenetic protein rhBMP-2 use in atypical third mandibular molars extraction. Gudaryan O.O., Іdashkіna N.G., Nekhanevich Zh.M.Objective -improving the effectiveness of treatment of patients with retention and dystopia of the third molars of the lower jaw in their horizontal or inverse position by developing an integrated approach using photodynamic therapy and drugs that enhance osteogenesis (platelet autoplasma enriched with i-PRF fibrin and recombinant morphogenetic protein (rhBMP-2). 82 patients with difficult eruption of third molars of the lower jaw aged 19 to 37 were included in research: 40 (48.8%) men and 42 (51.2%) women. The standard approach to performing operations of atypical removal of retined third molars causes a significant number of complications (large bone defects, inflammatory contracture, post-traumatic neuritis, etc.). Treatment process was provided in two stages. During the first (preoperative) stage sanitation was done to eliminate or stabilize an acute infection which is inflammatory process in the area of impacted third molar. The second stage provides abscessed tooth extraction, wound sanitation, formed defect filling with osseo-inductive medications under the collagen membrane and complete closure. The developed surgical method for treating retention and dystopia of the lower third molars using biomaterial based on demineralized bone matrix (BCP) saturated with recombinant morphogenetic protein of bone rhBMP-2 can reduce the occurrence of postoperative inflammatory complications by 35.4%, and also reduce the time for their elimination as well.

The purpose of the work is improvement of the effectiveness of the mandibular fractures treatment in patients with partial or complete adentia by developing and experimentally testing transalveolar osteosynthesis technique. An experimental study was carried out by 3D computer simulation modeling by the final element analysis to assess the efficiency of mandibular fractures fixation at partial or complete adentia using the Ш-shaped plate, which we developed for the transalveolar osteosynthesis method. Calculations of the immobilized fractures for static (own weight) and dynamic (functional) loads were performed according to the author's method, taking into account pronounced resorptive processes in the bone from the beginning of the reparative reaction to assess the rigidity of fragments fixation during the entire period of the fractures healing. Under the conditions of the same three-dimensional model of the mandible, calculations were performed when the fracture was fixed with ordinary linear titanium osseous plates. It is proved that at functional load the new plate provides a compression effect in the fractures region, as evidenced by the negative displacements in the final elements of the mental region according to the results of design load combination 2- 3. The maximum efforts in the screws of the calculation model with a conventional bone plate were 136.955 N, which is almost ten times more than on the model with a Ш-shaped titanium retainer (12.656 N).

Background: The treatment and rehabilitation of military servicemen with mandibular fractures at the hospital stage is an important medical, social and economic problem. Methods: A clinical study was conducted in 63 military servicemen with mandibular fractures, which injured during warfare in eastern Ukraine in the 2014-2019. The analysis of the potential use for the fragments intermaxillary fixation standard band splint vs the titanium pins and elastic traction for the treatment of mandibular fractures in military personnel has been carried out. Results: On the results of seven-year findings of administration in military servicemen injured during the hybrid war on the East of Ukraine, the advantages of using maxillomandibular fixation with screws for the treatment of mandibular fractures were illustrated.Conclusion: The operative treatment of mandibular fractures in military personnel preference should be given to method of maxillomandibular fixation with intermaxillary fixation screws, which provides with the high quality reposition and fixation. Trial registration: The work is a fragment of the research project of the Oral Surgery, Implantology and Periodontology Department of Dnipro State Medical University: «Development of methods for the prevention of complications in the treatment of inflammatory state and traumatic injuries in the maxillofacial area», state registration № 0113U005253 and applied research carried out in 2020-23 at the expense of the government funding "The prognosis, prevention and treatment of delayed union of bone tissue in patients with fractures of the jaws" № 0121U109420.