Purpose of the study. To increase the effectiveness of rehabilitation of patients with acquired bone defects of the mandible with the help of rib free non-vascularized autografts. Materials and methods. In the maxillofacial department of Municipal non-profit enterprise «City Clinical Hospital for Emergency and Medical Care, Zaporizhyzhya» Council 41 patients were treated, who underwent surgical treatment to replace the acquired bone defects of the mandible with rib free autografts on the basis of the clinic of maxillofacial surgery of the State Institution SE «Zaporizhzhya Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine» 2015–2019. Most patients were of working age: from 21 to 60 years. In general, the age composition of patients was almost identical, which allowed us to assume that all studies were conducted under the same conditions and in a standard sample. Depending on etiology, surgery – replacement of mandibular defects, performed simultaneously or across a long time period. Results. Improved technique of mandibular bone grafting by free rib autograft due to the expansion of the technical possibility to reliably fix bone fragments with titanium plates and screws, as well as tight installation of the autograft in the bone defect and create, consequently, favorable conditions for a pseudo-temporal-mandibular joint formation. The own technique of preparation and formation of a costal autograft is offered. For 15 years, no complications were detected and no rejection of freely transplanted costal autografts was observed. Conclusions. The use of reliable fixation of bone fragments ensures the formation of callus and prevents autograft rejection. The proposed method of preparation of a costal autograft with a fragment of cartilage, allows to achieve reliably forming a pseudo-temporal-mandibular joint. Keywords: bone plastic, defect of the mandible, non-vascularized rib autograft, regenerative processes.

Purpose of the study. Establishing the role of processes of proteolysis of mixed saliva in the development and course of lichen planus of the oral mucosa. Materials and methods. A comprehensive examination of 102 patients with lichen planus aged 21 to 70 years and 20 people in the control group, whose age and sex composition corresponded to that in the study group. BioRad (USA) reagent kits were used to determine the total protein content of mixed saliva. The content of protein fractions of mixed saliva was determined by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. Determination of serum proteins in mixed saliva was performed by quantitative (cross) immunoelectrophoresis. Results. In patients with lichen planus, the overall proteolytic activity of mixed saliva increases with a significant increase in the concentration of α1proteinase inhibitor, especially in exudative hyperemic and erosiveulcerative forms of the disease. Diffusion of α1proteinase inhibitor into mixed saliva increases its antiproteolytic potential and has a protective character. The content of albumin and ceruloplasmin in the mixed saliva of patients with lichen planus increases depending on the severity of the disease: typical, hyperkeratotic, exudativehyperemic, erosiveulcerative. Conclusions. Mixed saliva of patients with lichen planus in contrast to patients in the control group is characterized by the predominance of low molecular weight proteins (20–79 kDa) over high molecular weight. The level of albumin, α1proteinase inhibitor and ceruloplasmin in the mixed saliva of patients with lichen planus increases and correlates with the severity of the disease. The content of IgA in the mixed saliva of patients with lichen planus increases, depending on the form of the disease.

Aims. Improve the technique of bone plastics of the mandible with a free autogenous rib graft.Materials and methods. A retrospective analysis of 41 case histories of patients undergoing surgical treatment in connection with the replacement of the mandibular defectsacquired due to tumors, injuries, osteomyelitis at the clinic of maxillofacial surgery in 2003-2018 was carried out. The technique of osteoplasty of the mandible with free autogenous rib graft has been improved by expanding the technical possibility of reliable fixation of bone fragments with titanium plates and screws, as well as tight installation of autograft in the bone defect and creating favorable conditions for the primary osseointegration. The own method of harvesting and formation of autogenous rib graft is proposed. For 15 years, not a single complication was identified and there was no rejection of the free autogenous rib grafts.Conclusions. This technique is simple, safe, and can be effectively used to reconstruct long-span mandibular defects with minimal complications in selected patients.