Bone grafting is considered from the theoretical perspective of biotechnology. Modern bone injuries including high-energy trauma can require special osteoplastic treatment and combination with modern approaches, namely gene activation of bone regeneration. The authors present treatment of patients with maxillofacial bone damage and diaphyseal pseudarthrosis of a long tubular bone accompanied by osteogenic deficiency. Gene-activated bone plastic material is octacalcium phosphate granules with attached superficial plasmid DNA molecules and vascular endothelial growth factor gene (vegf165). This material together with high-quality surgery ensures a full-fledged wealthy bone regenerate via induction of local vascular growth and improvement of local oxygenation. The purpose of this report was to demonstrate clinical cases from the practice of maxillofacial surgery, traumatology and orthopedics, where biotechnological approach was effective for bone reconstruction.

BACKGROUND: According to clinical and statistical observations, there is the high prevalence of gingival recession in children and adults. Currently, the methods of treating gingival recession are considered as corrective surgical measures. However, all modern corrective techniques are traumatic and force the patient to refuse surgical treatment in the presence of a shallow recession with a depth of no more than 2 mm. The depth of gingival recession in the absence of treatment progresses, which causes clinicians to search for alternative minimally invasive therapy for such patients. AIM: The aim of our study is to determine the effectiveness of prevention and non-surgical treatment of gum recession using a Radiesse filler (Merz North America, USА). MATERIAL AND METHODS: 36 patients (men and women) of the young age between 1844 with thin and intermediate biotype of gums and bones and patients with initial signs of gum recession (not more than 2 mm) have been examined. The state of periodontal tissues and changes in them have been assessed by clinical examination methods; laser Doppler flowmetry and a morphological analysis of tissues have been performed. RESULTS: Two injections of a Radiess filler have been found to improve the condition of the patients with gum recession compared with the initial values. CONCLUSIONS: Gingival recession after two injections of a Radiesse filler steadily decreases compared to its initial values. In the absence of treatment, a statistically significant (p 0.05) increase in the depth of gingival recession has been noted after 12 months from the start of observation. When using a Radiesse dermal filler to support the keratinized zone of the gums, a decrease in microcirculation in the injection zone is observed in the first month, however, after 6 and 12 months, its value significantly increases compared to the initial value and the data of the control group.

Background: Tooth extraction is often accompanied by bone tissue loss. This systematic review aims to compare osteoplastic materials for socket preservation. Methods: This systematic review was carried out with the PRISMA statement. To identify relevant studies, a thorough literature search was executed in several databases, such as Medline, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. The inclusion criteria were restricted to randomized controlled trials, and their methodological quality was evaluated with the Cochrane Risk of Bias tool (ROB 2). Results: Based on the predefined inclusion and exclusion criteria, nine randomized clinical trials published before 2024 were selected for analysis, all of them investigating the application of osteoplastic materials. Six studies performed xenogenic bone augmentation; one of them compared alloplastic and xenogenic materials; two studies described synthetic osteoplastic materials; and one described autogenic bone material. Conclusion: Socket augmentation with osteoplastic materials demonstrates effectiveness in preserving alveolar ridge dimensions and creating favorable conditions for further implant placement, though differences in clinical performance highlight the need for careful material selection.

BACKGROUND: About a half a century ago, the concept of physiological regeneration of bone tissue was introduced, which is based on the functioning of basic multicellular units (BMUs). Later, such an approach can also be used to understand the regularities of reparative regeneration. Bone grafting using gene-activated synthetic replacement materials introduces additional features into the reparative process because the material becomes an active participant in the process. Bone grafts sequentially undergo resorption and metabolism and become a matrix on the basis of which the BMUs implement regenerative osteogenesis. AIM: To reveal the function of BMUs in a human bone wound during implantation of a gene-activated osteoplastic material from octacalcium phosphate. MATERIALS AND METHODS: Microfocal computed tomography, histological and immunohistochemical studies, histomorphometry were analyzed and processed statistically. RESULTS: When using an ordinary product and a gene-activated material based on octacalcium phosphate, the bone regenerate was represented by a multi-tissue structure formed by bone beams surrounding non-resorbed fragments of bone replacement products. In the histomorphometric analysis of gene-activated material, the median area of the unresorbed granules was 0.039 [0.013; 0.079] mm2, and the median area of the osteoclasts was 67 [22; 235] cells/mm2. In the group using an ordinary product, the values were 0.029 [0.009; 0.068] mm2 and 15 [0; 79] cells/mm2, respectively. CONCLUSION: BMUs that are in various phases of functional activity (resorption, reversion, formation, and rest) can be detected at the gene-activated material–bone interface. The last phase appears only in cases when the components of the material do not induce osteogenesis.

Objective: to evaluate the long-term clinical results of the gene-activated bone substitute based on octacalcium phosphate and plasmid DNA encoding vascular endothelial growth factor in bone grafting for dental implantation. Materials and methods. This clinical study analyzed the long-term treatment results of 100 patients with alveolar ridge atrophy and acquired bone defects of the jaws who underwent bone grafting with gene-activated bone substitute, starting with registration clinical trials initiated in 2017. All patients enrolled in the study underwent bone grafting of the upper or lower jaws using the gene-activated bone substitute in standard surgeries (sinus lifting, guided bone augmentation, cystectomy, etc.). The results of delayed clinical observation were assessed at different time points from 6 months to 7 years after bone grafting using clinical methods and computed tomography (CT), as well as histological analysis of trephine biopsy specimens. Results. Newly formed tissues of bone density were detected in the bone grafting area in all patients within 6 months after surgery. The density remained at a high level during 7 years of follow-up. The volume of the newly formed tissues was maintained with minimal resorption: the decrease in volume was 12±5.9%. Histologically, newly-formed bone tissue with partially resorbed bone substitute fragments were indentified in trephine biopsy specimens. Conclusion. Thus, the gene-activated bone substitute has proven its safety and long-term effectiveness in jaw bone grafting for up to 7 years, and it can be used to treat patients requiring dental implantation.

Background: Dysferlinopathy has a high prevalence in relatively isolated ethnic groups where consanguineous marriages are characteristic and/or the founder effect exists. However, the frequency of endemic mutations in most isolates has not been investigated.Methods: The prevalence of the pathological DYSF gene variant (NM_003494.4); c.200_201delinsAT, p. Val67Asp (rs121908957) was investigated in an isolated Avar population in the Republic of Dagestan. Genetic screenings were conducted in a remote mountainous region characterized by a high level of consanguinity among its inhabitants. In total, 746 individuals were included in the screenings.Results: This pathological DYSF gene variant causes two primary phenotypes of dysferlinopathy: limb‐girdle muscular dystrophy (LGMD) type R2 and Miyoshi muscular dystrophy type 1. Results indicated a high prevalence of the allele at 14% (95% confidence interval [CI]: 12–17; 138 out of 1518 alleles), while the allele in the homozygous state was detected in 29 cases—3.8% (CI: 2.6–5.4). The population load for dysferlinopathy was 832.3 ± 153.9 per 100,000 with an average prevalence of limb‐girdle muscular dystrophies ranging from 0.38 ± 0.38 to 5.93 ± 1.44 per 100,000.Conclusion: A significant burden of the allele was due to inbreeding, as evidenced by a deficiency of heterozygotes and the Wright fixation index equal to 0.14 (CI 0.06–0.23).