S. V. Tkachyk’s research while affiliated with Bukovinian State Medical University and other places

Due to a signifi cant increase in the frequency and complexity of maxillofacial injuries, one of the priorities in the development of modern surgical dentistry is the search for new eff ective methods of treating facial bone fractures. In recent decades, the attention of clinicians has been focused on biological treatment methods aimed at restoring bone defects using cell technologies and biological transplants.The aim of the study was to determine the eff ect of using osteoplastic materials based on multipotent adipose- derived mesenchymal stromal cells in dental patients in the surgical treatment of mandibular fractures.Materials and methods. The clinical material included 56 patients, 13 of whom underwent mandibular osteosynthesis with hydroxyapatite bone graft substitute (subgroup 1I), 25 of whom underwent surgery with a combination of multipotent adipose tissue mesenchymal stromal cells, hydroxyapatite bone graft substitute and platelet-rich plasma (subgroup 1B), and 18 of whom underwent spontaneous healing of the fracture line (subgroup 1C). Patients were clinically evaluated on a daily basis. Clinical parameters were assessed on days 1, 3, 5, 7, 10, 14 and 28 after surgery. The postoperative pain syndrome was assessed using the Numerical Rating Scale (NRS), considering the subjective signs of pain in the operated patients.The statistical processing of the study results was performed using the statistical analysis software for biomedical research ‘Microsoft Excel 21’ and ‘Statistica’ (licence number STA862D175437Q). In the statistical processing of the results, we used the variational analysis of series – calculation of the arithmetic mean and its standard error (Mim) – and assessed the signifi cance of diff erences in the results obtained in the comparison groups using the Student’s t-test method. p<0.05 was considered a signifi cant diff erence. [17]. The study was conducted in accordance with the basic provisions of the «Rules of Ethical Principles for Scientifi c Medical Research Involving Human Subjects» approved by the Declaration of Helsinki (1964-2013), ICH GCP (1996), EEC Directive 609 (24.11.1986), Orders of the Ministry of Health of Ukraine ¹ 690 of 23.09.2009, ¹ 944 of 14.12.2009, ¹ 616 of 03.08.2012. The Commission on Biomedical Ethics of the Bukovinian State Medical University found no violations of ethical and moral standards in the conduct of the research (ProtocolNo. 6, 16.03.2023). Patients signed informed consent to participate in this study and all measures were taken to ensure their anonymity.The results. The comparative analysis of the clinical eff ectiveness of the use of various osteoplastic materials in the performance of osteosynthesis surgery of the lower law confi rmed the advantages of the use of bone tissue substitute based on hydroxyapatite and its combination with multipotent adipose tissue mesenchymal stromal cells before spontaneous augmentation. It is confi rmed by the data of subjective and objective symptoms of patients during the postoperative period.Conclusions. Our data show that osteoplastic material based on multipotent mesenchymal stromal cells of adipose tissue, bone substitute based on hydroxyapatite and platelet-rich blood plasma is a promising biological material. Its application improves the regenerative and reparative properties of bone tissue, facilitates the postoperative period and shortens the duration of hospitalization, promotes the development of innovative ways of reconstructive osteogenesis in modern maxillofacial surgery.

Maxillofacial bone defects may result from various pathological conditions, such as traumatic tooth extraction, aggressive periodontitis, jaw osteomyelitis, neoplasms, cysts, congenital malformations, and gunshot injuries. These circumstances can pose difficulties in addressing both (primary and secondary) dental adentia, especially when considering dental implantation. One of the current challenges in dentistry is to give more attention to the advancement of innovative osteoplastic materials. The purpose of this study was to assess the effectiveness of a therapeutic composition that includes stem cells in enhancing the alveolar ridge, as suggested by bone remodeling markers in oral fluid. The research revealed that all study groups showed favorable changes in oral fluid markers of bone metabolism during the extended follow-up period (6-12 months), with statistically significant differences (p2<0.01, 0.05). However, in group A, acid phosphatase activity decreased by 12.98% (p>0.05) and 32.49% (p<0.01, p1<0.05), while alkaline phosphatase increased by 8.73% (p>0.05) and 15.16% (p>0.05), respectively, after one year of observation compared to groups B and C. Thus, it can be inferred that a reduction in acid phosphatase activity, along with a rise in alkaline phosphatase levels in oral fluid, suggests enhanced regenerative processes and the initiation of bone remodeling in the patients belonging to the study group. However, it seems that the procedures were particularly effective in patients belonging to group A, where we used the combination of “Bio-Oss”+MSCs-AT+PRP to fill bone defects. This suggests the best effectiveness of the composition we developed for alveolar ridge augmentation.

Objective: The aim: To analyze the results of inflammatory and immunological parameters of the oral cavity after cystectomy with different methods of connecting the edges of the operated area. Patients and methods: Materials and methods: The research was conducted in 87 patients who sought surgical treatment of odontogenic cysts of the jaws. Patients were divided into groups depending on the method of wound closure after surgery. We analyzed the results of laboratory tests (leukocytes, ESR, IL-1β, IL-6, TNF-α, IL-8, NO synthase, MMP-9). Results: Results: The analysis of the effectiveness of using different methods of approximation of the oral mucosa wound on inflammatory and immunological pa¬rameters showed that when using welding of the edges of the operated area using the EKVZ-300 "Patonmed" apparatus, we get positive results of laboratory indicators of inflammatory markers faster (leukocyte counts are normal on day 30, ESR, IL-1β - on the 14th day, TNF-α - on the 7th day, IL-6, IL-8, NO synthase, MMP-9 - on the 30th day), that is, healing in such patients is faster than in patients with wound closure with classic suture material or laser. Conclusion: Conclusions: When comparing the methods of approximation of postoperative oral mucosa wounds by different methods, based on the results of these inflammatory and immunological parameters, the best results were obtained when using electric welding of tissues. Further research and use of the proposed method will facilitate and shorten the rehabilitation period of patients after surgery.

The article presents a comparative analysis of the clinical effectiveness of osteoplastic materials, in particular a preparation based on multipotent mesenchymal stromal cells of adipose tissue and platelet-enriched plasma used to fill bone defects during the socket augmentation after the tooth extraction. The criteria to assess the therapy effectiveness at the stage of the early postoperative period included the intensity of pain and the amount of collateral oedema after surgery. The aim of this study is to evaluate the clinical effectiveness of osteoplastic materials to augment the volume of the alveolar bone during the operation of socket augmentation after the tooth extraction. Setting of this study: Bukovynian State Medical University, Chernivtsi, Ukraine. The study included 85 patients. The procedure of socket augmentation was performed by using "Kolapan - L" (28.57% of individuals, subgroup A), by combinations of MMSK AT + "Kolapan - L" + PRP (46.43% of individuals, subgroup B); the subgroup C included individuals (25.0%) whose wounds after tooth extraction healed by the formation a blood clot. The assessment of postoperative pain was performed by applying the digital rating scale (Numerical Rating Scale, NRS), taking into account the subjective pain in the patients. The subjects underwent visual assessment of the severity of collateral oedema after the tooth extraction surgery. To determine the dynamics of the severity of oedema we used a scoring system. The study demonstrated the patients of the subgroup B, who received the socket augmentation with "Kolapan - L" + MMSC-AT + PRP, experienced no pain at the final stage of postoperative observation (89.31% of cases) that was 1.2 times higher (p1 <0.05) than in the patients of subgroup A (p> 0, 05). At the final postoperative stages, no collateral oedema was seen in 98.47% of the participants of the subgroups B that exceed the number of cases in the subgroup A where the bone defect was augmented by "Kolapan - L", in 1.2 times (p1 <0.05). A comparative analysis of the clinical effectiveness of osteoplastic materials to increase the volume of the alveolar bone in the jaws during the socket augmentation after the extracted tooth convincingly proved the advantage of using the combination of "Kolapan - L" + MMSС - AT + PRP that was also confirmed by signs and symptoms in the postoperative period.

Лікування гнійно-запальних захворювань є однією з найбільш актуальних проблем хірургічної стоматології і забезпечується застосуванням різноманітних лікарських засобів, серед яких провідне місце займають антисептики, антибіотики, детоксикуючі засоби, препарати з сорбційним механізмом дії, серед яких «Гелевин», «Регенкур». Мета дослідження – враховуючи сучасний підхід до місцевого лікування гнійно-некротичних ран, доцільно застосовувати лікарський засіб, який би виявляв одночасно сорбційну, детоксикуючу та пролонговану протеолітичну дії. Матеріали і методи. В роботі використано композицію, яка містить білокфіксуючий сорбент полісорб (не менше 96 %), кристалічний трипсин та антисептик етоній, який, крім того, виконує функцію стабілізатора протеолітичної активності. Для оцінки ефективності застосування композиції використовували клінічні дані та показник лейкоцитозу. Результати досліджень обробляли статистично. Результати досліджень та їх обговорення. Результати спостережень на 48 хворих з аденофлегмонами щелепно-лицевої ділянки показали, що застовування композиції «Лізетокс», яка містить полісорб, трипсин та етоній, підвищує ефективність лікування: на 2 доби раніше зникає біль та інфільтрація тканин навколо рани, на добу швидше проходить запальна контрактура нижньої щелепи та гіперемія шкіри. Нормалізація кількості лейкоцитів периферійної крові та повне очищення рани відбувається на 2 доби швидше. Висновки. Включення композиції «Лізетокс» у комплекс лікування пришвидшує очищення та детоксикацію гнійної рани.

Objective: Іntroduction: Main functions of the inner nose in humans are respiration and olfaction. Therefore, human needs a large surface of inhalable and exhalable air contact, warming and moistening. Importance of these organs in animals in phylogenesis before and after the secondary palate development can explain their anatomic and functional designation. The aim is to find out the functional significance of some anatomic formations of the inner nose and their development peculiarities in phylo-and ontogenesis. Patients and methods: Materials and methods: We used a comparative anatomy method where we compared well-known facts of different animals' development before and after secondary palate formation in phylo- and ontogenesis. Results: Review: Olfactory organ in lower vertebrates develops as canal with two openings through which as a result of water penetration the olfactory ability increases. Sinuses formation in animals happens after secondary palate formation. Secondary palate in embryo develops by second month of development, and sinuses' development begins on the 3-4 month. As a result, upper jaws and facial skull became stronger. Importance of mucous and lacrimal glands of the nose cavity and mucous glands of mouth received new functions of animal and vegetable food digestion. Conclusion: Conclusions: development of the secondary palate in warm-blooded vertebrates changed (limited) functional applicability of the lacrimal gland and nasolacrimal canal, mucous glands of nose and vegetative innervation. Groups of lacrimal, mucous glands of nose and mouth are unified system of primary, neurosecretory reaction to environment.