Osteoplastic Material Research Articles

RECONSTRUCTION OF POSTOPERATIVE DEFECTS OF THE JAW WITH OSTEOPLASTIC MATERIAL BIO OST

The study of the processes of reparative osteogenesis in the area of postoperative defects of the jaws was carried out. It is shown that osteogenesis is most active in the wall mounted region of the defect. The high efficiency of the osteoplastic material Bio Ost (local origin) in the surgical treatment of the peri-apical cysts of the jaws was indicated.

TO A QUESTION OF THE DIFFERENTIATED APPLICATION OF OSTEOPLASTIC MATERIAL S AT FILLING OF A DENTAL SOCKET

This article discusses osteoplastic materials of various origin for differentiated use, as well as the results of their usage at filling of the dental socket under histological control.

ИЗМЕНЕНИЯ ГЕМАТОЛОГИЧЕСКИХ ПОКАЗАТЕЛЕЙ ПРИ ИСПОЛЬЗОВАНИИ ОСТЕОПЛАСТИЧЕСКОГО БИОКОМПОЗИЦИОННОГО МАТЕРИАЛА ДЛЯ ВОССТАНОВЛЕНИЯ КОСТНОЙ ТКАНИ У ЖИВОТНЫХ

Damage, injuries and fractures of locomotor apparatus, agricultural, small unproductive, wild animals, are diagnosed in at least 30% of cases of the total number of non-infectious pathologies. In veterinary and humane medicine, complications associated with violation of the integrity of tubular bones have not been eliminated to date. Today, taking into account the various methods of osteosynthesis, where a variety of metal structures, spokes, pins, devices are used, it is definitely important to add biocomposites to the area of intramedullary space at the level of the fracture zone, to accelerate the consolidation process and prevent bacterial contamination. The article presents the hematological parameters of experimental animals (rabbits) using the developed biocompositional osteoplastic material injected into the intramedullary canal, with a simulated fracture followed by osteosynthesis. Samples of general and biochemical analysis of animal blood (n=60) served as the material for research. The purpose of this experiment and research was to evaluate hematological parameters using the developed biocomposite, with confirmation of the absence of undesirable complications of delayed and immediate type on the part of experimental animals. The authors determined, based on a clinical blood test, the absence of hematopoiesis inhibition and inflammatory reactions to a biocomposite consisting of sodium alginate, hydroxyappatite, distilled water, amoxicillin and methyluracil. Thanks to the study of biochemical blood analysis, the absence of intoxication activity of the biocomposite on the hepatobiliary and renal systems of experimental animals was determined. This osteoplastic biocomposite, from the point of view of a group of authors, accelerates the consolidation activity of bone fragments due to antibacterial, osteoconductive and osteoinductive effects.

USE OF OSTEOPLASTIC MATERIALS TO RESTORE BONE DEFECTS FOLLOWING THE SURGICAL TREATMENT

In recent years, the number of dental surgical operations has been growing rapidly worldwide, and clinicians are facing pressing issue to select and apply osteoplastic materials, which would promote rapid repair of jaw bone defects and relieve symptoms during the post-operative period. With the advancements in the field of dentoalveolar reconstruction, it is of great importance to develop the material for bone restoration, which by its properties would be identical to autologous bone. The aim of this study is to analyze the effectiveness of osteoplastic materials used for the augmentation following sinus lift, tooth socket preservation, osteosynthesis of mandibular fractures and extraction of impacted third molars. 280 people aged from 18 to 55 with partial or complete adentia and atrophy of the alveolar arch of the jaws, with chronic periapical infection, chronic generalized periodontitis, fractures and impacted third molars were examined at the Department of Surgical Dentistry and Maxillofacial Surgery of the Chernivtsi Regional Clinical Hospital. All patients were planned to undergo prosthodontic treatment assisted by dental implants. The study has demonstrated that the patients of subgroups B of all groups of the study, where the augmentation of bone defects was performed using a combination of osteoplastic material «Colapan-L» containing multipotent mesenchymal stem cells of adipose tissue and platelet-rich plasma presented alleviating clinical symptoms including pain, collateral oedema, hyperaemia of the oral mucosa and better bone regeneration at the site of surgery, compared with subgroups A, where the augmentation was performed with osteoplastic material «Colapan-L», and sub-groups B, whose healing followed by blood clot forming. The use of osteoplastic materials containing multipotent mesenchymal stem cells of adipose tissue during dental operations improves the regenerative and reparative properties of bone tissue, facilitates the postoperative period and reduces the duration of inpatient treatment period.

Development of Substance Technology for the Production of Osteoinductive Materials

A technology has been developed for obtaining an osteoplastic material consisting of a powder of natural bone tissue, the preparation contains hydroxyapatite and tricalcium phosphate compounds, as well as a complex of minerals. One of the most urgent problems of traumatology and orthopedics, surgical dentistry and maxillofacial surgery is the problem of treating patients with large bone defects. A distinctive feature of such defects is the insufficient severity of the natural regenerative processes of bone tissue. Thus, the development of a technology for obtaining bone blocks for further use as a fully bioinert and biocompatible osteoinductive material on the world market that is fully bioinert and biocompatible with body tissues for plastic compensation of bone defects of the jaw bones is relevant. The resulting material was a complex structured system consisting of specially treated bone tissue obtained from slaughter animals (bulls up to 12-18 months of age), containing bioavailable silicon and a number of biologically active compounds that stimulate reparative processes in bone tissue. An optimal technological scheme for obtaining an osteinductive material has been developed. The composition and main stages of the developed technology have been optimized. Bone material accumulated using the developed technology was used in further research on the development of complex dosage forms that have an osteoinductive effect.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Relevance. The effect of a tissue engineering construct based on synthetic octacalcium phosphate activated with plasmid DNA with vascular endothelial growth factor gene on bone morphogenesis at the jaw defect sites of patients was studied. It is shown that the studied osteoplastic material stimulates osteosynthesis pathways already at early stages, and xenogenic hydroxyapatite, triggers osteogenesis processes with considerable delay and does not have time to form a full-fledged bone structure by 6 months.Aim. Evaluate the dynamics of reparative osteogenesis based on the results of histomorphometric diagnostics in patients with defects in the jaw bones of various configurations and lengths with an implanted bone matrix based on synthetic octacalcium phosphate activated with plasmid deoxyribonucleic acid with genes of vascular endothelial growth factor.Materials and methods. Histomorphological examination of bone tissue biopsy of jaws was carried out in 50 patients of both genders, who needed additional volume of bone tissue to install dental implantation. Patients were divided into 2 groups by type of grafted material. 6 months after the surgery, bone biopsies were taken from the bone sites at the stage of implant placement. Histomorphological patterns and histomycrophotograms were studied in bone biopcies.Results. In bone tissue biopsies of patients implanted with a tissue engineering construct based on synthetic octacalcium phosphate activated with plasmid DNA with vascular endothelial growth factor gene, it was revealed that after 6 months there was prevaluation of mature bone tissue (42,71%), with the proportion of differentiated plate bone tissue being < 90%.Conclusions. Histomorphometric analysis showed that in patients implanted with a tissue engineering construct based on synthetic octacalcium phosphate activated with plasmid DNA with vascular endothelial growth factor gene, after 6 months, early rearrangement of bone tissue into a mechanically dense and highly mineralized structure was detected.

Alloplastic and Implant Materials for Bone Grafting: a Literature Review

Bone reconstruction aft er trauma, infection, tumour or congenital genetic disorder is an important subject of modern medicine usually relying on bone graft ing materials. Autologous bone or autograft is still considered the “gold standard” most eff ective in bone defect reconstruction and osseous regeneration. Having the advantages of autograft ing, a series of issues remain related to a limited donor material, painful graft taking and the risk of putative complications (nonunions, graft rejection, infection, iatrogenic fractures, post-microsurgery arteriovenous shunt thrombosis, etc.). Th erefore, improved biomaterials are demanded to adequately meet the autograft criteria. Choosing optimal graft materials becomes relevant, aside to the rationale of selecting new surgical techniques. Th e osteoconductive and osteoinductive property evaluation in modern osteoplastic materials comprises a research avenue into optimal graft development for osseous correction in maxillofacial surgery, neurosurgery, traumatology and orthopaedics. Such biomaterials can be combined with alloplastic graft s to attain the required properties of osteoconduction, osteoinduction and osteogenesis. Th is analytic literature review focuses on current state-of-the-art in alloplastic graft ing that, in our opinion, grounds the progress of auto- and allograft innovative development.

MINIMAL INVASIVE SURGICAL METHODS FOR TREATMENT OF CHRONIC PERFORATED SINUSITIS

MINIMAL INVASIVE SURGICAL METHODS FOR TREATMENT OF CHRONIC PERFORATED SINUSITIS

Evaluation of in vitro biocompatibility of scaffolds for the repair of bone defects

The use of bone scaffolds in traumatology and orthopedics is an extremely important issue. The growing number of cases of significant bone defects, in particular after revision arthroplasty, combat trauma and due to the introduction of new methods of reconstructive surgery of bones and joints, requires more detailed studies of the using different osteoplastic materials. Materials and methods. As scaffolds used 4 types of materials that are most often used in the clinic for the correction of bone defects - ceramic hydroxylapatite, beta-tricalcium phosphate, allogeneic bone matrix treated with gamma irradiation, allogeneic bone matrix scaffold. The effect of matrices on the viability of normal human fibroblasts (M19 cell line) in cell culture in vitro was studied. The viability of cells after their co-cultivation with scaffolds was determined by colorimetric method by staining with crystal violet. To obtain an osteoinductive effect used platelet-rich plasma (PRP), standardized by the method of Araki with some modifications. The proliferative activity of fibroblasts was assessed by the level of expression of the proliferation marker Ki-67 by immunocytochemical analysis. Results. It was found that the least pronounced antiproliferative effect is shown by allogeneic bone matrix treated with gamma irradiation. Data on the complex effect of co-cultivation of fibroblasts with scaffolds in the presence of PRP on cell viability and proliferative activity were obtained. It was found that PRP improves the survival of fibroblasts by 15-30 % and increases their proliferative activity by 35-75 %. Delipidization of scaffold from allogeneic bone matrix, heat-treated by local bone bank technology, increased its biocompatibility with human fibroblasts. Conclusions. According to the results of a comparative analysis of the impact of different scaffolds on the viability of normal human fibroblasts, it was found that scaffolds from allogeneic bone matrix have the least pronounced antiproliferative effect. Platelet-rich plasma has been shown to improve fibroblast survival and increase their proliferative activity. Treatment with 70 % ethyl alcohol scaffold from allogeneic bone matrix, heat-treated by local bone bank technology, increased its biocompatibility with human fibroblasts.

OPTIMIZATION OF SURGICAL INTERVENTION METHODS IN THE TREATMENT OF ODONTOGENIC CYSTS OF THE UPPER JAW

Abstract: The therapy of odontogenic cysts of the upper and lower jaws, both conservative and operative, is of a complex nature – the frequency of this disease, according to the data, does not decrease. A number of researchers believe that the risk of inflammatory complications in odontogenic cysts is very high. The result of the injection of an odontogenic cyst of the upper jaw can be the occurrence of acute osteomyelitis with the development of a fistula and the outflow of purulent discharge into the maxillary sinus, which can later lead to the development of chronic odontogenic sinusitis. Studies of pus and granulations and analysis of the results obtained in most cases indicate a mixed microflora (staphylococcus, streptococcus, proteus, etc.). Also, when analyzing the literature, it was noted that the surgical treatment of odontogenic cysts localized on the upper jaw, as well as the use of osteoplastic materials for filling bone defects is very ambiguous and contradictory. The authors justify this fact by the fact that there is a high risk of relapses, in particular, after cystectomy, the probability of relapse is at least 17.8%. The usual scenario for conducting such nosologies is radical excision of odontogenic cysts of the jaws, after which a long time is needed to restore the bone defect, as well as adequate subsequent prosthetics. Based on these data, modern authors develop low-traumatic, sparing methods of surgical treatment of odontogenic cysts, especially of the upper jaw, including using endoscopic techniques. Based on the above, an urgent task for dental surgeons is to optimize the methods of surgical treatment of odontogenic cysts of the upper jaw, in particular with a decrease in the volume of the operating field.

Development of Osteoplastic Material Impregnated with Plasmid Encoding Bone Morphogenetic Protein-2

Development of Osteoplastic Material Impregnated with Plasmid Encoding Bone Morphogenetic Protein-2

Osteoinductive Moldable and Curable Bone Substitutes Based on Collagen, BMP-2 and Highly Porous Polylactide Granules, or a Mix of HAP/β-TCP.

In dentistry, maxillofacial surgery, traumatology, and orthopedics, there is a need to use osteoplastic materials that have not only osteoinductive and osteoconductive properties but are also convenient for use. In the study, compositions based on collagen hydrogel were developed. Polylactide granules (PLA) or a traditional bone graft, a mixture of hydroxyapatite and β-tricalcium phosphate (HAP/β-TCP), were used for gel filling to improve mechanical osteoconductive properties of compositions. The mechanical tests showed that collagen hydrogels filled with 12 wt% highly porous PLA granules (elastic modulus 373 ± 55 kPa) or 35 wt% HAP/β-TCP granules (elastic modulus 451 ± 32 kPa) had optimal manipulative properties. All composite components were cytocompatible. The cell’s viability was above 90%, and the components’ structure facilitated the cell’s surface adhesion. The bone morphogenetic protein-2 (BMP-2) provided osteoinductive composition properties. It was impregnated directly into the collagen hydrogel with the addition of fibronectin or inside porous PLA granules. The implantation of a collagen hydrogel with BMP-2 and PLA granules into a critical-size calvarial defect in rats led to the formation of the most significant volume of bone tissue: 61 ± 15%. It was almost 2.5 times more than in the groups where a collagen-fibronectin hydrogel with a mixture of HAP/β-TCP (25 ± 7%) or a fibronectin-free composition with porous PLA granules impregnated with BMP-2 (23 ± 8%) were used. Subcutaneous implantation of the compositions also showed their high biocompatibility and osteogenic potential in the absence of a bone environment. Thus, the collagen-fibronectin hydrogel with BMP-2 and PLA granules has optimal biocompatibility, osteogenic, and manipulative properties.

Morphological Characteristics of Reparative Osteogenesis in Mandibular Repair with Different Osteoplastic Materials

Morphological Characteristics of Reparative Osteogenesis in Mandibular Repair with Different Osteoplastic Materials

EFFECTS OF BONE AUGMENTATION MATERIALS ON PECULIARITIES OF POSTOPERATIVE PERIOD IN PATIENTS AFTER IMPACTED THIRD MOLAR EXTRACTION AND THEIR CLINICAL EFFICIENCY

The article presents a comparative analysis of the clinical effectiveness of bone augmentation materials, in particular, compositions including multipotent mesenchymal stromal cells of adipose tissue and platelet-enriched plasma, used to fill bone defects during the operation of third molars extraction. The criteria for the effectiveness of treatment at the stage of the early postoperative period in the participants included the assessment of the pain intensity, collateral oedema and hyperaemia of the oral mucosa after the surgery. The aim of the study is to determine the clinical efficiency of osteoplastic materials and to determine the feasibility of using tissue equivalents of bone tissue based on multipotent mesenchymal stromal cells of adipose tissue for healing of bone defects in patients with impacted third molars. Methods and participants. The study was conducted on the basis of the Department of Surgical Dentistry and Maxillofacial Surgery of Bukovynian State Medical University, Chernivtsi, Ukraine. Extraction of impacted third molars surgery was performed on 72 patients. After the tooth extraction, 31.94% of them underwent bone augmentation by osteoplastic material “Colapan–L” (group A); 41.67% of patients had bone augmentation with a combination of multipotent mesenchymal stromal cells of adipose tissue+”Colapan–L”+platelet-rich plasma (group B), and in the rest, 26.39% of patients, wound healing occurred under a blood clot (group C). Postoperative pain syndrome was assessed using the Numerical Rating Scale (NRS) based on patients' subjective feeling of pain. Visual assessment of the severity of collateral oedema and hyperaemia of the oral mucosa after surgery was also performed. A scoring system was used to determine the severity of collateral oedema. To assess the state of the postoperative period in patients of all study groups, a protocol was completed daily during the hospital stay period that reflected the most important data of an objective and subjective nature.
 During the procedure of morning dressings, we analyzed patients' complaints and evaluated general and local status: presence of appetite, quality of sleep, wound pain, postoperative oedema, hematoma, and hyperaemia of the oral mucosa, presence of secretions from the wound, body temperature, and type of wound healing. The study has demonstrated that at the final stage of postoperative follow-up the 89.31% of patients who received a combination of “Colapan–L” with multipotent mesenchymal stromal cells of adipose tissue and platelet-rich plasma reported no pain that is 1.2 times p1<0.05 and 1.3 times p2<0.05 higher than in the patients of groups A and B. Collateral oedema was absent in 98.47% of the group B patients that exceeded 1.2 times p1<0.05 the number of such individuals in group A, where the bone defect was augmented with the osteoplastic material “Colapan–L”, and in 1.4 times higher, p1<0.01, p1>0.05 that the indicators of group B, where the healing of the bone defect developed without osteoplastic materials. The absence of hyperaemia of the oral mucosa was found in 92.37% of the patients in groups B, which was 1.3 and 1.4 times higher than the values obtained in groups A and B, p1<0.05, p2<0.01.

Materials based o tricalcium phosphate as bone defects substitute (literature review)

The objective of the study is to determine the current tendencies in the use of osteoplastic materials based on tricalcium phosphate (TCP) in orthopedics and traumatology. Methods. The search of the scientific information for the analysis was carried out in the PubMed, Google Scholar, World Digital Library, ScienceDirect. Results. The development of biomaterials for reconstructive surgery on the skeleton remains an urgent issue of biomaterial engineering, biology and current traumatology and orthopedics. Calcium-phosphate ceramics have the excellent properties of biocompatibility, affinity with bone tissue, biodegradability as well as perfect osteoconductive and osteointegrative properties. They are used in orthopaedics and traumatology as a coating for endoprosthesis components in order to achieve a strong bond with the bone as well as a filling material for bone defects in the form of blocks, granules or powder. The optimal structure of ceramic materials in order to achieve the necessary hardness and control of the dissolution rate is still undetermined. The interest of researchers in the creation of osteoplastic materials containing TCP is explained by the advanced osteoinductive properties and the ability to quickly degrade with the formation of bone tissue. Due to different configurations and sizes of the bone defects, the creation of a material with osteoinductive and osteoconductive properties that could be inserted into the cavity in a liquid state and which would quickly harden and acquire the properties similar to those of the bone has been of great current interest. The material should be biodegradable while having sufficient time for bone formation at the implantation site. In view of the above, the creation of cements based on calcium phosphates has become more attractive. Unfortunately, this material is limited in use due to its brittleness and insufficient hardness. Certain reinforcing additives are expected to significantly improve the mechanical properties of the cement. It is desirable that these particles should have bioactive properties analogous to those of cement. A slight modification of the material can significantly change its properties, which makes it imperative to investigate experimentally the biological properties of the investigated material.

Development of a new osteoplastic material based on bioactive ceramics and recombinant biologically active factors

Development of a new osteoplastic material based on bioactive ceramics and recombinant biologically active factors

Evaluation of Vertical Guided Bone Regeneration Using a Particulate Form of Experimental Bioactive Glass in a Rabbit: A Case Report with Literature Review

Background: There are a large number of different types of bone-grafting materials that are used for the regeneration of atrophied alveolar ridges in order to make dental implantation possible. However, available surgical techniques and materials for bone augmentation do not contribute to the achievement of the desired reliable results and require a search for new solutions to an existing problem. A group of synthetic osteoplastic materials based on bioactive glass (BAG) may become a matter of choice in bone tissue regeneration because of special osteogenic properties. The aim of this study was to visually and histologically evaluate the behavior of an experimental BAG in rabbit tibia bone samples, which were collected from the animal 6 weeks after filling the bone defects. Methods and Results: The observation was carried out on one outbred rabbit whose tibia bone defects were filled with an experimental osteoplastic material based on the BAG. The chemical composition of the experimental osteoplastic material included SiO2 (41%), Na2O (21%), CaO (28.5%), P2O5 (6%), CaF2 (1.5%), MgO (1%), Al2O3 (1%). For histological analysis, H&E staining of paraffin-embedded tissues was performed according to the standard technique. Light microscopy of tissue samples was performed using a Leitz HM-LUX microscope (Germany). Six weeks after filling the bone defects, a strong bond between the augmented hard tissue and rabbit tibia was recognized. Also, a dense fusion of adjacent soft tissues with a newly formed bone without signs of chronic inflammation or graft particles in granular tissue was noted. Microscopic examination of the stained sections showed the presence of mature viable BT with a uniform distribution of osteocytes. Also, residual fragments of the degraded biomaterial surrounded by the fibers of a woven bone were revealed in several slices. Conclusion: In accordance with the results of this experiment, it can be concluded that the usage of BAG related to the system SiO2(41%)-Na2O(21%)-CaO(28.5%)-P2O5(6%)-CaF2(1.5%)-MgO(1%)-Al2O3(1%) may increase the volume of bone without application of barrier membrane. However, further research involving more animals needs to be done to estimate the scientific significance of the obtained data and to evaluate the mechanical properties of augmented bone.

Reparative histogenesis of bone tissue in femoral fractures in rats using biocomposite material along with immunocorrection

The paper studies the effect of the RVI biocomposite material belonging to the group of osteoplastic biocomposite materials, the RV-2 immunomodulator – a synthetic dipeptide inducing an immunocorrective effect, and combinations of these drugs on the reparative histogenesis of bone tissue in femoral fractures in rats. It was found that the remodeling of the primary bone callus into the secondary one in the fracture of the studied animals was of a diverse nature. This process was the most pronounced in the group where the components were used in complex, i.e. the bone defect was filled with RVI during the surgery, as well as RV-2 was injected intramuscularly to rats at a dose of 10 mcg per 1 kg of live weight for five days, starting immediately after the surgery. Well-formed coarse-fibrous connective tissue callus was recorded in animals of this group. The connective tissue was stained more intensely which indicates a denser arrangement of fibers in the callus. Focal cartilage tissue spanning bone fragments was observed within the callus. At the periphery of the site the cartilaginous callus was subjected to endochondral ossification with replacement by coarse-fibrous trabeculae with elements of lamellar bone tissue having haversian canals in the center. The inter-girdle spaces were filled with elements of the myeloid bone marrow in the forming bone tissue. Markedly proliferated osteoblasts were visible in the cambial layer of the periosteum. The bone tissue ratio increased up to (60.21 ± 2.62)%, which significantly exceeded the same indicator in the control group and in all experimental groups. The low content of connective tissue and the high ratio of bone tissue indicated more active osteogenesis processes and reparative regeneration in comparison with other groups.

CLINICAL PECULIARITIES OF WOUND HEALING IN THE POSTOPERATIVE PERIOD OF SURGICAL TREATMENT OF ALVEOLAR PROCESS ATROPHY OF THE UPPER JAW AND PART OF THE LOWER JAW IN POSTMENOPAUSAL WOMEN

Introduction. Atrophy of the alveolar process of the upper jaw and part of the lower jaw is often observed after the tooth extraction. It is known that the atrophy of bone tissue is most likely observed in the first 12 months after the tooth extraction. According to the Koln classification, atrophy of the bone tissue of the jaws can be vertical, horizontal and combined. The aim of surgical treatment of jaw bone tissue atrophy is to increase the size in the area of alveolar process of the upper jaw and part of the lower jaw to further restoration of masticatory function, in particular with the use of dental implants.
 The aim of the study: to study the dynamics of wound healing in postmenopausal women with osteopenia after surgical treatment of jaw bone tissue atrophy using osteoplastic material and ossein-hydroxyapatite compound.
 Materials and methods of the study. There were observed 63 postmenopausal women with osteopenia, aged from 50 to 59 years, with atrophy of the maxillary and mandibular alveolar process, who were performed surgical treatment. During surgery, patients were divided into 3 groups: Group I – 23 patients with atrophy of the alveolar process of the upper jaw and part of the lower jaw with osteopenia, with the reduced bone tissue density, who were treated surgically for bone tissue atrophy using the method worked out by us. Group II – 23 patients with atrophy of the alveolar process of the upper jaw and part of the lower jaw with osteopenia, with the reduced bone density who were performed surgical treatment of atrophy of the jaw bone tissue using osteoplastic material of animal origin. Group III – 23 patients with atrophy of the alveolar process of the upper jaw and part of the lower jaw with the indices of bone tissue density within normal limits, who were performed surgical treatment of atrophy of the jaw bone tissue using osteoplastic material of animal origin.
 The results of the study. A total of 69 edentulous areas on the upper and lower jaws were examined after surgery for the treatment of jaw bone tissue atrophy. Examination of the postoperative wound was performed during the 3rd, 9th, and 14th day in the absence of complaints from patients during this period, as well as in the presence of signs of complications.
 Discussion of the results. According to the offered by us method of decortication of the bone tissue of the jaws, which was used to treat patients of group I, the blood supply to the postoperative area and infiltration of bone material with blood due to provoked by decortication of bone tissue bleeding, are improved. Impregnation of bone material with blood promotes angiogenesis in the postoperative area, increasing cellular activity during wound healing. It is known that due to the absence of sufficient blood supply, tissue necrosis occurs [8,9]. In patients of groups II and III the complete healing of the postoperative wound with primary tension took longer than in patients of group I. Also, in 3 patients of group II and in 1 patient of group III the wound dehiscence in the postoperative area was observed.
 Conclusions. As a result of the performed observations of wound healing after surgical treatment of jaw bone tissue atrophy in patients of groups I, II and III, the least complications were observed in patients of group I in the early postoperative period.

RESULTS OF X-RAY AND DENSITOMETRIC INVESTIGATION IN PATIENTS WITH DESTRUCTIVE FORMS OF APICAL PERIODONTITIS IN EARLY FOLLOW UP PERIOD

This article presents a comparative analysis of the effectiveness of various treatment approaches, including bone mixture “mp3, Osteobiol, and platelet-enriched plasma, in the therapy of destructive forms of apical periodontitis in the early follow-up. The aim of this work is to investigate the dynamic changes in radiological and densitometric parameters depending on the treatment methods for patients with destructive forms of apical periodontitis in the early follow up period. The study involved 185 patients with destructive forms of apical periodontitis, who were examined and receive the treatment. The subjects were divided into 4 groups. Measurements of the size of the lesion in the bone tissue (for lesions of round shape) were performed by the formula: S = πr2. The area of lesions of elliptical shape was measured by the formula S = π ab, where π = 3.14; r = the radius of the circle; a = the value of the major half-axis of the ellipse; b = the length of the small half-axis of the ellipse. After 3 months of the follow up, the patients of group IV, who received the composition of platelet-rich plasma and osteoplastic material mp3 OsteoBiol, demonstrated an increase in the number of the lesions of the periapical zone sized 1.6-10 mm2 in 1.7 times, while the number of the subjects with foci of bone destruction sized 11–20 mm2 and 21–30 mm2 lowered in 2.8 times and 2.0 times, respectively. In 3 months of the follow up period, the patients of group IV showed the values of Rtg scoring of bone tissues destruction in the apical area with a lesion area of 1.6-20 mm that averaged 2.13±0.10 scores and indicated a reduction of the periapical process by 1/3.
 The average Rtg score in the patients of group IV (0.92 ± 0.10 points) was significantly higher than in the individuals in groups I and II, p, p 1 <0.01, and was equal to the findings obtained in the individuals of the group III, p2 > 0.05. The relative indicator of bone tissue repair in this follow up was characterized by the minimum values in the individuals of groups I and II: 0.49 ± 0.05 and 0.57 ± 0.06, p <0.05, respectively. In the groups III and IV, the value of the relative indicators of bone tissue repair were significantly higher and scored 4.82 ± 0.54, p, p1 <0.01, and 6.94 ± 0.77, p, p1 <0.01, p2 < 0.05, respectively.
 At the same time, the average Rtg scoring in patients of group IV was significantly higher than in the participants of groups I and II, and was identical to the values in the subjects of group III. This study has demonstrated the successful outcomes of the treatment of dystrophic forms of apical periodontitis in the early follow up period when applying the composition based on platelet-rich plasma and osteoplastic material "mp3 OsteoBiol".