The aim of the work was a comprehensive assessment of the cytokine system and peripheral blood osteocalcin with the establishment of features of their interconnections in children with congenital cleft lip and palate (CCLP) in comparison with corresponding controls at different age periods. Levels of IL17, IL4, IL6, IL1b, IFNc and osteocalcin were analyzed by enzyme immunoassay in the peripheral blood of 80 children (0-12 months, 1-3 years, 4-9 years, 10-15 years) with CCLP and age-appropriate control of healthy individuals (40 people). An analysis of the obtained data shows that in children with CCLP we revealed significant differences between pro-inflammatory (IL1b, IL6, IL17), regulatory (IFNc), anti-inflammatory (IL4) cytokines and osteocalcin compared with controls. Differences were found in the content of IL17, IFNc, IL4 and osteocalcin in healthy children and in children with CCLP in postnatal ontogenesis. Cytokine deregulation of immunosteogenesis in CCLP, leading to a significant deficit of osteocalcin in the first year of life due to imbalance of the cytokine profile: discordant IL17, IFNc and IL4 were detected. Obtained data are undoubtedly important in the future for developing new strategies for targeted therapy aimed at normalizing osteocalcin levels at different age periods in children with CCLP.

Aim.This study was designed to evaluate the immediate and long-term results of the Protocol of complex rehabilitation of 15 Kubanskij nauchnyj medicinskij vestnik 2018; 25 (5) children with bilateral through-cleft lip and palate (BTCLP) developed by the Department of pediatric dentistry, orthodontics and maxillofacial surgery of KSMU.Materials and methods. There was conducted the evaluation of the immediate and long-term results of the complex treatment of 25 patients with BTCLP aged 0 to 18 years according to the Protocol developed by the Department of pediatric dentistry, orthodontics and maxillofacial surgery of KSMU.Results. There was carried out a detailed analysis of the results of the application of the function-forming plate (FFP) in patients with BTCLP aged 0 to 1 year. The results of the models measurement in dynamics showed a significant growth and development of the upper jaw, the approximation of the shape and size of the upper alveolar arc to the norm, reducing the distance between its fragments to the minimum. There was established that long-term gradual orthodontic treatment provides conditions for physiological growth and development of the facial skeleton and for the formation of physiological occlusion in children with BTCLP. The usage of gentle methods of uranoplasty reduces the risk of dentoalveolar anomalies in children with BTCLP. The complex of therapeutic measures and terms of surgical intervention should be planned individually. The elimination of the defects of the alveolar process of the upper jaw by the method of autoosteoplasty is a necessary step in the complex rehabilitation of children with BTCLP during the periods of changing and forming permanent dentition. The planning of the stage of prosthetics of patients with BTCLP is individual and involves the creation of conditions for fullfledged functions of chewing, swallowing and speech, and it is recommended to carry it out with the help of modern aesthetic constructions that ensure the preservation of the results of the complex, including orthodontic, treatment.Conclusion.The analysis of the photographs of the face, TRG, CT and jaws diagnostic models obtained during the treatment of children and adolescents with congenital cleft lip and palate confirms the high morphofunctional and aesthetic result of the application of the developed at the Department of pediatric dentistry, orthodontics and maxillofacial surgery of KSMU Protocol of comprehensive rehabilitation of children with BTCLP.

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Congenital malformations of the maxillofacial area - congenital cleft lip and palate (CCLP) due to their frequency, the severity of anatomical and functional disorders, the difficulty of social adaptation of patients, economic aspects are one of the most important problems of medicine. It is established that for timely stage surgical treatment of children with IAPC the emphasis is on the somatic status of the child, anti-infective resistance, the ability to safely tolerate surgery, which is important for the restoration of anatomical defects, communication functions and psychosomatic health. Children with CCLP are at risk for increased occurrence of postoperative complications, since upper respiratory tract infection and exacerbation of chronic respiratory tract diseases and ENT organs is a contraindication to surgical intervention. The study of immune status revealed deep violations of antiviral and antibacterial immunity in children with CCPC aged from 6 to 12 years. A program of combine interferon- and immunotherapy has been created. Positive clinical and immunological efficacy of combine interferon-(gel Viferon - recombinant IFNα2b in combination with antioxidant) and immunotherapy in the rehabilitation of children with CCPC aged 6 to 12 years was demonstrated.