— The choice of donor material poses a problem for surgeons handling reconstruction of large combined bone defects or limited maxillofacial bone defects. Restoration methods, applicable in reconstructive microsurgery are based on materials of non-biological origin and musculoskeletal autogenous transplants which have complications and may inhibit the processes of osseointegration. Our study aimed to improve the efficiency of surgical treatment and rehabilitation of patients with mandibular defects using vascularized autograft in combination with macroporous titanium fiber material. The reconstruction of the defective mandible caused by chronic osteomyelitis, trauma, benign tumors was performed in 107 patients either by means of conventional methods (titanium plates, free and vascularized bone autografts), or by a novel engineered bone substitute. Our novel vascularized bone autotransplant combines a macroporous fiber titanium material and spiral bone autochips. For its fabrication we applied digital 3D technologies and methods of rapid prototyping, whereas its vascularization was harvested in iliac crest. Unlike the standard methods of reconstruction, the use of the engineered vascularized implant showed a significant reduction in stages, volume and invasiveness of surgical procedures and an improvement of esthetic and functional outcomes in patients with mandibular defects.
Аннотация В статье пред ставлен метод статистического моделирования формы, примененный для реконструкции анатомических структур с деформациями. Данный метод является перспективным для моделирования деформированных объектов, имеющих некоторую анатомическую форму. Метод статистического моделирования формы позволяет восстановить деформированный объект на основе информации об его анатомической форме и недеформированной части формы экземпляра, при этом учитывая особенности данного экземпляра и его вариативность относительно средней формы. Ключевые слова: статистическое моделирование, модель формы, совмещение облаков точек.
The guide will allow doctors of surgical profile to get information about the meaning of eponymous terms that they face in practice and in the study of special medical literature. The book contains 2008 eponymous symptoms, symptomocomplexes, syndromes and diseases related to the main sections of surgery. The book consists of two parts, the first part of which refers to the semiotics of surgical diseases and presents their symptoms and signs. The second part of the manual includes nosological units, which are divided into 8 chapters – sections of clinical surgery – and systematized in alphabetical order. Their explanation, the historical reference, data on epidemiology of diseases, their etiology and pathogenesis and a clinical picture are given. From the standpoint of modern evidence-based medicine provides information on the diagnosis, treatment and prevention of major surgical diseases. At the end of the book is a subject index, referring to which the reader can easily find the term of interest. The guide is addressed to a wide range of doctors of surgical profile. It will be useful to researchers, teachers of higher medical school.
The problem of complications arising after dental implantation is still relevant. The aim of the work was to investigate the effect of various types of removable appliances and dental implants on the oral microbiocenosis during orthopedic treatment of 64 people: 12 patients of the first index group, 40 patients of the second index group and 12 people of the control group. 6 months after the implants were installed, as a result of a microbiological study of the oral cavity, the differences were found in the qualitative composition of the microflora of the mucous membrane around the neck of the dental implant. In the first index group representatives of normal microflora prevailed. In 100% of cases Streptococcus vestibularis was isolated, from more than half patients S. oralis, S. mitis, Rothia mucilaginosa were isolated, S. gordonii was isolated from one patient. In the second index group, a significant diversity of microbial species was observed, including enterobacteria, which were isolated from 22.5% of the examined patients. In the control group, in addition to representatives of the normal microflora of the oral mucosa S. vestibularis (75.5%), S. oralis (50.0%), Neisseria subflava (66.7%) and Haemophylus parainfluenzae (50.0%) were found. From all patients of the control groups S. gordonii was isolated, as well as the other potentially pathogenic streptococci species, S. anginosus and S. constellatus by 66.7%. The type of removable appliances and dental implants used affects the microflora composition of the oral cavity, and, consequently, the further prognosis and the risk of complications. Collapsible dental implant supported removable prosthetic appliances with a metal frame and fixing elements, telescopic crowns and clasps less than other types of prosthetic appliances change the qualitative composition of the microflora of the oral mucosa around the neck of the dental implant.
Проблема осложнений, возникающих после проведения дентальной имплантации, остается актуальной. Целью работы было исследовать влияние различных видов съемных конструкций и дентальных имплантатов на микробиоценоз полости рта при ортопедическом лечении 64 человек: 12 пациентов 1-й основной группы, 40 пациентов 2-й основной группы и 12 человек группы контроля. Через 6 месяцев после установки имплантатов в результате микробиологического исследования полости рта были выявлены различия в качественном составе микрофлоры слизистой оболочки вокруг шейки дентального имплантата. В основной группе 1 преобладали представители нормальной микрофлоры. В 100% случаев выделен Streptococcus vestibularis, более чем у половины пациентов выделены S. oralis, S. mitis, Rothia mucilaginosa, S. gordonii выделен у одного пациента. В основной группе 2 отмечено значительное разнообразие видов микроорганизмов, включая энтеробактерии, которые были выделены у 22,5% обследованных. В контрольной группе помимо представителей нормальной микрофлоры слизистой оболочки полости рта обнаружены S. vestibularis (75,5%), S. oralis (50,0%), Neisseria subflava (66,7%) и Haemophylus parainfluenzae (50,0%). У всех пациентов контрольной группы были выделены S. gordonii, а также другие виды потенциально патогенных стрептококков — S. anginosus и S. constellatus по 66,7%. Вид используемых съемных конструкций и дентальных имплантатов влияет на состав микрофлоры полости рта, а, следовательно, на дальнейший прогноз и риск развития осложнений. Съемные ортопедические конструкции с металлическим каркасом и фиксирующими элементами, телескопическими коронками и замковыми креплениями с опорой на разборные дентальные имплантаты менее других видов конструкций изменяют качественный состав микрофлоры слизистой оболочки полости рта вокруг шейки дентального имплантата.
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