Aim. To analyse the effi ciency of osteoplastic material application in order to reduce the resorption level after tooth extraction in the preimplantation period according to the data of cone beam computed tomography.Materials and methods. The study involved 80 patients who were divided into 4 equal groups depending on the preservation material used. The fi rst group was treated with Cerabone (Botiss, Germany) xenomaterial based on natural bovine bone. Plasma enriched with PRGF growth factors obtained by the BTI Endoret (Spain) technology was used for the patients of the second group. The third group consisted of patients who underwent a socket preservation of the extracted tooth with a powdered autologous dentin matrix (ADM) obtained from their own tooth. In the fourth group, bone-plastic material based on hydroxyapatite with Collapan-L lincomycin hydrochloride (Intermedapatit, Russia) was used to prevent socket resorption. All patients had a cone beam computed tomography of the maxillofacial region before the extraction and 3 months after the preservation in order to evaluate the level of bone resorption. After the installation of dental implants, a comparative assessment of the bone resorption level in the vertical and horizontal directions before tooth extraction and in the preimplantation period was carried out.Results. The smallest level of vertical bone resorption after socket preservation was observed in group 1 (Cerabone) and group 3 (ADM). The median value of the socket resorption level in group 1 was 0.7 mm (8.54 %) in the vertical direction and 0.5 mm (9.45 %) in horizontal measurement as compared to the level of bone tissue before tooth extraction. Similar indicators were observed in the group using an autologous dentin matrix. The vertical decrease in the socket bone tissue was 0.61 mm (7.75 %), horizontal — 0.51 mm (6.2 %). The level of bone resorption was signifi cantly higher using two other materials.Conclusions. The use of three-dimensional radiation research methods allows a comprehensive assessment of the bone tissue volume to be carried out, which in turn determines the choice of the dental implant size, the need for further bone-plastic surgery to increase the width/height of the alveolar ridge. The use of cone beam computed tomography showed that the most optimal results can be obtained by introducing Cerabone material into the socket of the extracted tooth, as well as using the innovative method of preservation with the patient’s own powdered tooth (ADM).

ОБОСНОВАНИЕ Обезболивание нижнего альвеолярного нерва является наиболее востребованной методикой местного обезболивания в стоматологии при лечении зубов нижней челюсти, которую стоматологи используют в своей повседневной практике. Однако частота неудач (технические ошибки, инфекционные осложнения и т.д.) местной анестезии нижнего альвеолярного нерва по разным данным достигает 25%. В связи с этим актуальным является анализ анатомических ориентиров для обезболивания нижнего альвеолярного нерва по данным компьютерной томографии (КТ). ЦЕЛЬ ИССЛЕДОВАНИЯ Рентгенанатомическим путем определить оптимальную траекторию проведения проводникового обезболивания на нижней челюсти. МАТЕРИАЛ И МЕТОДЫ В исследовании приняли участие 57 пациентов в возрасте 53,37±1,83 года, из них 35 мужчин и 22 женщины. При обезболивании нижнего альвеолярного нерва по данным КТ делали замеры по челюстям. Сравнение и анализ результатов исследования проводили в программе Statistical Package for Social Sience (IBM SPSS Statistics 23). Эффективность методики, проводимой по найденным точкам, оценивали с помощью электроодонтодиагностикой. Использовался критерий t Стьюдента для оценки статистической значимости различий между выборками, а также коэффициент корреляции Пирсона. Статистически значимыми считали различия при p<0,05. РЕЗУЛЬТАТЫ Исследование показало, что крылонижнечелюстное пространство сложно обнаружить на КТ с шагом более 3 мм. Было определено, что угол между задней поверхностью ветви нижней, образованный плоскостью инъекции с сагиттальной плоскостью, проходящей через задний край ветви нижней челюсти, значительно варьирует и зависит от многих параметров: пола, возраста, формы зубных дуг, ориентации нижнечелюстных ветвей. В большинстве случаев корреляция с возрастом была слабая или очень слабая. Только некоторые параметры имели статистически значимую корреляцию с возрастом, а именно поперечный черепной индекс (r= –0,282; p=0,033) и расстояние от точки входа нерва до внутреннего края нижней челюсти слева (r= –0,266; p=0,045). Из сравнительных данных электроодонтодиагностики следует, что самым рациональным вариантом анестезии является комбинированный, которой дает наиболее глубокую и продолжительную анестезию (200 МкА) и глубокую — выше 170 МкА в течение 150 мин. ЗАКЛЮЧЕНИЕ Установлено, что расстояние от клыка до точки вкола на противоположной стороне имело среднюю положительную корреляцию с полом, расстоянием от мезиобуккальной поверхности первого моляра нижней челюсти и точке контакта первого и второго моляров верхней челюсти (p<0,05).

An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone’s volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue.

Objective. To identify the anatomical variants of nasal bones and pyriform apertures in view of normal configuration of external nose and different types of aesthetic nasal deformities, to estimate its possible relations.Material and methods. We performed a retrospective analysis of multi-slice computed tomography (MSCT) data of 2737 patients with the image processing (multiplanar and 3D-volume rendering). The sample comprised 121 patients with aesthetic nasal deformities (rhinokyphosis – nasal hump, long nose, combined deformity like a hidden hump, short nose, wide nose) and 37 individuals with normal European nasal configuration.Results. The most frequent variants of pyriform apertures are drop, heart and pear types. The most common variants of nasal bones in all groups were II, V, VI types according to Lang and Baumeister. Every kind of deformities was described with their characteristic features of pyriform apertures and nasal bones.Conclusion. Statistically proved correlation between the facts of deformities and variants of pyriform apertures and nasal bones was obtained. The preoperative study of variable anatomy must be always performed for improving functional and aesthetic results of rhinoplasty.

At the present stage of the development of maxillofacial surgery, the treatment of patients with defects in the auricles is one of the most difficult. Defects of the auricles, characterized by its absence, are divided according to the etiological factor into two main groups: congenital (microtia) and acquired (as a result of injuries of various origins). Microtia (including anotia the complete absence of the auricle) is a malformation of the auricle and the external auditory canal caused by anomalies of the first and second zygomatic arch and the first sulcus.Congenital malformations of the auricle occur in 1 out of 700–15 000 newborns and more often have a right-sided localization. In 15 % of cases, they are hereditary, and in 85 % they are sporadic, in boys they are detected on average 2–2,5 times more often than in girls.Currently, much attention is paid to the prosthetic reconstruction of the auricle with fixation by means of cranial intraosseous implants. At the same time precise diagnostics of the state of the temporal bones in the area of the proposed implantation and the correct positioning of the intraosseous supports are the basis of an effective fixation system. Among the methods of radiological diagnostics used for planning ectoprosthetics of the auricles, radiography has long been preferred. However, the introduction of computed tomography into clinical practice has provided a high-quality assessment of the temporal bones state, which has increased the efficiency of surgical intervention planning and treatment.