Undoubtedly, prosthetics based on implants are very popular among orthopedic doctors and among patients who have lost one or more teeth (including on completely toothless jaws). Single implant placement and immediate prosthetics are becoming increasingly recognized, the obvious advantages of which compared to the two-pronged method are a reduction in the number of visits and treatment time. Indications are clinical parameters and the general condition of the patient. In addition, in some cases, the reinforcement stage may be skipped if aesthetic correction of the jaw area of the prosthesis is not required, for example, with a "toothy smile". The combination of the All-Fit KOS implantation system and BCS implants allows not only to perform surgery and prosthetics in one visit, but also to directly use the wells of the removed teeth. This tactic becomes possible due to the design features of the proposed implants. Thus, the KOS implant is an integrated device made of high-quality titanium and equipped with a compression thread. A properly performed surgical intervention involves the use of an immediate load protocol - prosthetics for three days.KOS implants are used for bridges. If it is necessary to remove teeth, the KOS system is combined with the BCS system - BCS is an implant with screw fixation, installed in both crowns. They can be used directly after extraction with immediate loading; at least three units must be splinted per installation; BCS implants have a polished surface, the head is identical to the head of KOS implants; BCS implants have a self-tapping thread and an intraosseous anti-cranking function. A specific clinical example of an immediate loading protocol using a combination of KOS and BCS implants will be presented.
Under our supervision, there were 92 patients with included and terminal defects of the dentition, who underwent prosthetics based on dental implants of the “DIO” system at the Department of Orthopedic Direction FPK TGSI Control group (13) of the patient, “manual toothbrush” - during the entire study period, patients used only a manual toothbrush to clean the crowns on implants; The second group (30) of patients who were prescribed a “manual toothbrush + interdental brush”, corresponding to the size of the proximal space of the orthopedic construction; The third group (49) of patients who were prescribed a “manual toothbrush + interdental brush + irrigator”, in addition to a manual toothbrush, were prescribed an interdental brush and an oral irrigator, an irrigator Waterpik WP-660 (Aquarius) was prescribed for the oral cavity after brushing teeth twice per day for 3-5 minutes, the power of the water jet of the irrigator corresponded to mode 2. An index assessment of the amount of plaque in the area of a fixed structure on implants was carried out using a simplified index of oral hygiene (IGR-U) (J. R. Vermillion, 1964) The condition of the gums in the area of dental implants was assessed based on the Gingival Index (GI) - Loe & Silness, 1963. Thus, at the beginning of the study in all three groups, the HI was low and corresponded to good implant hygiene. After 3 and 6 months, the values of those indices were significantly worse, and corresponded to the unsatisfactory hygiene of the implants. In groups 2 and 3, throughout the entire study, HI indices were optimal and corresponded to good and satisfactory implant hygiene. The indicators of the 3rd group, in which the whole complex of individual and professional methods was applied, were the most positive throughout the study, in comparison with other groups. Analysis of the results of the Gingival Index study showed that the indicator increased in all observation groups. In group 2 patients using manual dental and interdental brushes for cleaning the structure, by the end of the study period the index value increased to 0.95 ± 0.05 points, which corresponded to mild gingivitis of the gums in the area of implants, i.e. there was slight hyperemia and individual punctate bleeding of the gums at the probing sites. Patients of the 3rd group, using an irrigator, had minimal index values at all periods of the study, and the index values were interpreted as “normal gums”, that is, no signs of gingivitis were recorded.
In modern abdominal surgery, one of the current areas for research continues to be the improvement of various options for plastic surgery of postoperative hernias. More than 2,100,000 operations for ventral hernia are performed annually in the world, and 42% of them are postoperative hernias. In recent years, there has been a clear trend toward the expanded use of various types of biological meshes in hernioplasty. “A pooled analysis of seven PCSTAR studies for incisional hernias using retromuscular mesh showed a hernia recurrence rate of 5.7%”[1]. The use of standard surgical interventions such as alloplasty in the onlay position does not solve the problem of early postoperative complications: seroma discharge, mesh migration, adhesive disease, high frequency of hernia recurrence, etc. At the same time, hernia repair with local tissue creates the problem of increased intra-abdominal pressure and late complications in the form of recurrent hernias. “An increase in postoperative intra-abdominal pressure leads to multiple organ failure, then abdominal compartment syndrome, and even death.” [2]. Currently, there is no consensus on the surgical approach for giant postoperative abdominal wall hernias, and therefore the need to continue to develop new technologies and improve There is no doubt about the tactics. In world practice, at present, the most relevant studies continue to be studies aimed at studying the morphological and functional aspects of recurrent postoperative ventral hernias; electron microscopy reveals ultrastructural destructive changes in skin cells, aponeurosis and muscles, which indicates morphofunctional insufficiency of abdominal wall tissues; issues of cell engineering are discussed new innovative materials, experimental studies are being carried out on animals testing the biotechnical properties, texture and elasticity of new polymers, research is being conducted on open approaches with division of the posterior component with the release of the transverse abdominis muscle and a retrograde mesh, robotic operations have begun. Modern aspects of the development of domestic healthcare include many measures aimed at improving the results of treatment of patients with postoperative ventral hernias and associated pathological conditions through the introduction of modern principles of intensive care and surgical tactics. The development strategy of New Uzbekistan for 2022-2026 in seven priority areas includes tasks to improve the quality of provision of qualified medical services to the population[3]. The implementation of these tasks, including by optimizing tactical and technical approaches to the choice of hernioplasty method, as well as the development of methods for the prevention of purulent-inflammatory complications in the field of alloplastic material, is one of the current areas of abdominal surgery and medicine in general, due to the high medical and social the significance of this pathology.
This dissertation research to a certain extent serves to fulfill the tasks approved by the Decree of the President of the Republic of Uzbekistan “On comprehensive measures to radically improve the healthcare system of the Republic of Uzbekistan” No. UP-5590 dated December 17, 2018, the Resolutions of the President of the Republic of Uzbekistan “On measures to transform the surgical service, improving the quality and expanding the scale of surgical operations in the regions" for No. PP-5254 dated October 4, 2021 and "On additional measures to ensure public health by further increasing the efficiency of medical prevention work" for No. PP-4891 dated November 12, 2020, and as well as other regulatory documents adopted in this area. Compliance of the research with the priority directions of development of science and technology of the republic. The dissertation research was carried out in accordance with the priority direction of development of science and technology of the VI Republic “Medicine and Pharmacology”. Review of foreign scientific research on the topic of the dissertation.[4] Research work aimed at improving the quality of therapeutic and preventive care for patients with ventral hernias, carried out by many leading scientific centers and higher educational institutions in the world, including the Department of Surgical and Perioperative Sciences, Umeå University, Umeå (Sweden), Department of Surgery, Kingston General Hospital, 76 Stuart Street, Kingston (Sweden). nada), Department of Surgery, Helsinki University Hospital, Helsinki ( Finland), Service de chirurgie digestive et oncologique, CHU d'Amiens (France), Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa (USA), Department of Surgery, Howard University College of Medicine, Washington (USA) , Yong Loo Lin School of Medicine, National University of Singapore (Singapore), Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA; University of Calgary, Calgary (Canada), Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia (USA), Brigham and Women's/Faulkner Hospital, Harvard Medical School, Boston (USA) , Department of Surgical Sciences, Uppsala University Hospital, Uppsala (Sweden), Department of Surgery, University of Texas Health Sciences Center at Houston, Houston (USA), Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam (Netherlands), Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka (Japan), National Medical Research Center for Surgery named after A.V. Vishnevsky" (Russia), Republican Scientific Center for Emergency Medical Care (Uzbekistan), Tashkent Medical Academy (Uzbekistan), Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov (Uzbekistan).
As a result of studies conducted around the world to increase the effectiveness of alloplasty for postoperative ventral hernias and reduce the risk of complications in the postoperative period, a number of scientific results were obtained, including: it was determined that patients who underwent reconstruction of the abdominal wall have an increased risk of postoperative respiratory failure, understanding the epidemiology of this complication can improve prevention (the Division of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health & Science University, USA); It has been proven that the larger the hernia, the higher the risk of early surgical complications, including such as respiratory decompensation, since hernias often increase in size over time, delaying surgery can lead to an increase in the size of the hernia and, therefore, a greater risk of complications (CentreforDigestiveDiseases, KarolinskaUniversityHospital, Stockholm, Sweden); it has been shown that the ratio of the hernia volume to the volume of the abdominal cavity <20% is an independent factor in tension-free closure, which justifies the interest in preoperative volumetry to adapt the tactics of surgical care (Servicedechirurgiegénérale, digestiveetendocrinienne, CHU LyonSud, HospicescivilsdeLyon, France); It has been determined that in patients undergoing elective laparoscopic hernia repair, predictors of mortality are older age and certain concomitant diseases: congestive heart failure, pulmonary circulatory disorders, coagulopathy, liver disease, metastatic cancer, neurological disorders and paralysis (Department of Surgery, College of Medicine, University of Oklahoma, Tulsa , USA); Older age, ascites, preoperative renal and pulmonary insufficiency have been found to be independent predictors of 30-day mortality, and in the presence of these risk factors, conservative treatment should be seriously considered (Department of Surgery, University of Kentucky College of Medicine, Lexington, USA); The American College of Surgeons (ACS) Universal Surgical Risk Calculator has been shown to accurately predict thirty-day outcomes, including major complications: venous thromboembolism, medical morbidity, surgical site infection, unplanned reoperation, mortality, and length of hospital stay (Department of Plastic Surgery, Brown University and Rhode Island Hospital, Providence, USA). At the present time in the world, the most relevant research in surgery continues to be the development of new methods of hernioplasty for large and giant ventral hernias, each of which has its own pros and cons depending on the complexity of implementation, the risk of postoperative complications and relapse, large randomized clinical trials are being conducted, comparing existing methods of traditional hernioplasty with laparoscopic access and robotic surgery, which has become increasingly widespread in the last 10 years, a search is being made for new synthetic and biological materials developed for the production and use of composite meshes that have the necessary strength and the ability to prevent fatal local complications in a contaminated environment. However, despite technical advances in this field, no modern hernia repair method or prosthesis meets all the requirements. One of the key problems is that existing synthetic endoprostheses do not have sufficient elasticity, resistance to infection, high mechanical strength and integrity over a long period of time. Further research into these clinical aspects will undoubtedly improve the current understanding of the capabilities of biocompatible endoprostheses and will make it possible to develop an optimal method for their placement during allohernioplasty. The degree of knowledge of the problem. The current period of development of abdominal surgery is characterized by an emphasis on the problems of the effectiveness of introducing new installation methods and techniques for attaching bioprostheses, options for various suture materials to determine the most promising directions for the development of these technologies [5]. Researchers led by BittnerR.[6] (2019) state that a giant postoperative abdominal wall hernia, the maximum diameter of which exceeds 12 cm or the ratio of the volume of the hernial sac to the abdominal cavity more than 20%, is difficult to treat, with a high recurrence rate and a large number of complications. One of the most challenging problems is that after the hernia contents return to the abdominal cavity, postoperative intra-abdominal pressure will increase, leading to multiple organ failure, then abdominal compartment syndrome (ACS), and even death. There is currently no agreement on the surgical approach for these giant incisional abdominal wall hernias. To prevent recurrences, some articles recommend placing the hernia mesh in the sublayer position and or linings (KirkpatrickAW.)[7]. According to CornetteB.[8], to prevent recurrence, it is recommended to place the hernia mesh in a sublayer or underlay position, and to achieve better mesh expansion, a component separation technique (CST) may be a suitable solution, but with a significant risk of complications and recurrence. JensenKK, et al. believe that truly successful giant hernia repair requires effective bridging or augmentation that will prevent recurrence with an acceptable risk of complications[9]. Another pressing issue in abdominal surgery is that patients with incisional hernias are extremely difficult to treat due to a number of factors including obesity, previous hernia repair, previous mesh placement, domain loss, and other variables.
The approach to patients with incisional hernias has changed significantly over the past 20 years due to both advances in mesh technology and surgical approaches. Key factors for successful outcome include modification of risk factors preoperatively, such as smoking cessation and weight loss, selection of mesh appropriate for the type of hernia and planned mesh location, and wide mesh coverage beyond the hernia defect. New techniques such as transabdominal muscle release and component separation with retrograde mesh placement and robotic approaches to abdominal wall hernia are increasingly being used in these patients[10]. Recent years have seen an increase in the number of biological meshes available for abdominal wall hernia repair. Biological meshes typically consist of materials obtained from humans, pigs, or cattle. The rationale for using biological meshes is that they can act as a scaffold for the growth of natural tissues. In addition, there are absorbable synthetic meshes that have properties similar to those of biological meshes, but with theoretically less risk because they are not derived from animal or human material. The choice of mesh for a ventral hernia depends on many factors, which include both the properties of the mesh and its location, for example, whether it should be placed intraperitoneally, preperitoneally, or retrorectus. BaierKF[11](2021) believes that the guiding principle should be to avoid placing uncoated polypropylene mesh in an intraperitoneal location where it may be in direct contact with internal organs. In addition, the type of hernia defect is another risk factor, such as whether the wound is clean or dirty, and whether the repair is performed with a bridge or abutment. Lightweight or biologic meshes to bridge the defect should be avoided due to increased recurrence rates. Holihan JL [12] (2016), Hodgkinson JD [13] (2018) believe that the principle of anatomical restoration to achieve a reliable, tension-free repair with reinforced mesh reduces the incidence of early postoperative complications and late recurrence of hernia compared with bridging mesh. The analysis of the literature concerning the theoretical aspects and clinical experience of using technologies for improving modern synthetic and biological prostheses that can provide a better plastic effect, as well as methods for preventing recurrence of ventral hernias, indicates that this is one of the priority areas in modern abdominal surgery. An unresolved issue remains the choice of the optimal endoprosthesis, which is highly effective and meets international standards for such properties as biological inertness and mechanical strength, as well as the method of positioning the mesh in relation to the layers of the abdominal wall. Considering that many of the allohernioplasty methods used today are not without drawbacks, the current direction is the development of new methods of repair for giant ventral hernias and methods for the prevention of postoperative complications in conditions of a contaminated wound, with justification of their effectiveness in a clinical experimental study. The connection between the dissertation research and the research plans of the research institution where the dissertation was completed. The dissertation research was carried out within the framework of the research work plan of the State Institution “RSNPMCH named after. acad. V. Vakhidov" under the project AL-422105574 "Development of new biocompatible mesh implants made of composite materials for reconstructive surgery of abdominal and diaphragmatic hernias" (2022-2024).
The purpose of the study is to improve the results of surgical treatment of large and giant postoperative ventral hernias by introducing new laser technologies and improving the tactical and technical aspects of surgical treatment. Objectives of the study: to study the structure of immediate complications after various types of prosthetic plastic surgery; to clarify the influence of obesity factors, primary or repeat hernioplasty on the incidence of immediate and long-term complications; to evaluate the role of the immediate complicated course of the postoperative period in the incidence of long-term complications of hernioplasty; to improve the technical aspects of alloplasty for large and giant postoperative ventral hernias (POVH); to improve the technique of photodynamic therapy (PDT) of the wound surface after prosthetic plastic surgery; to study in an experiment the effectiveness of using the proposed technique of alloplasty and PDT; evaluate the morphological features of the condition of tissues during prosthetic plastic surgery using the proposed method; in a comparative aspect, evaluate the clinical effectiveness of the proposed alloplasty options in the immediate and long-term periods. The object of the study was the results of allohernioplasty in 448 patients with extensive (large) and giant POVH, who were operated on at the surgical department of the 1st clinic of the Samarkand State Medical Institute in the period from 2012 to 2021, as well as experimental animals on which the effectiveness was assessed developed a technique for prosthetic repair of postoperative ventral hernias and applied the technique of photodynamic therapy.
The subject of the study is to analyze the effectiveness of the developed alloplasty of postoperative ventral hernias and intraoperative photodynamic therapy in abdominal surgery in experiments and in the clinic. Research methods. To achieve the goal of the study and solve the assigned problems, general clinical, instrumental, biotechnological, experimental, histomorphological, microbiological and statistical research methods were used. The scientific novelty of the study is as follows: it was established that the need for extensive tissue mobilization and, as a consequence, the intersection of lymphatic capillaries during implantation of the prosthesis in the onlay position, as well as the lack of sufficient resorption function of the hernial sac in the inlay position causes a high risk of the formation of clinically significant seromas; It was determined that with prosthetic hernioplasty, along with the volume of the defect, the type of plastic surgery and the degree of obesity, the most significant predictor of the risk of developing immediate complications is the factor of re-intervention in case of recurrent hernia with the presence of a “dormant infection” hidden in the remaining ligature granulomas or scar tissue; the structure and clinical features of the course of long-term complications of hernioplasty for giant and extensive hernias were clarified, taking into account the results of the immediate postoperative period, as well as the option of fixing the prosthesis, primary or repeated hernioplasty and the degree of obesity; the method of surgery for large hernias of the anterior abdominal wall has been improved, characterized by a combination of factors such as the formation of tension-free prosthetic repair, preservation of local resorptive function to prevent the development of fluid accumulations and reducing the risk of infection; the method of preventing the development or progression of wound infection during alloplasty of ventral hernias has been improved, aimed at enhancing the antibacterial effect and stimulating reparative activity through the photosensitizing and photodynamic effect of low-energy laser radiation; It was determined in an experimental model of prosthetic plastic surgery that the proposed method of fixing the prosthesis in combination with the use of the effect of photodynamic therapy through laser radiation helps to enhance reparative processes with a reduced risk of wound complications; It has been proven that all methods of antiseptic exposure and laser stimulation of the wound surface after prosthetic plastic surgery enhance preventive measures against the development of local infection, but are ineffective in the case of an already developed purulent-inflammatory process against the background of the use of alloplastic material. The practical results of the study are as follows: it has been determined that the implantation of synthetic materials for giant and extensive hernias is accompanied by a significant number of wound complications caused by both the surgical technique itself and the reaction of surrounding tissues to a foreign body, requiring improvement of tactical and technical approaches when performing hernioplasty; it was clarified that scar-degenerative changes in the tissues of the aponeurosis in giant and extensive hernias are a predisposing factor to the occurrence of post-prosthetic hernias, especially when implanting the prosthesis in the “inlay” position and, accordingly, require increasing the efficiency of their fixation and engraftment, as well as reducing the risk of developing local complications; it was determined based on the data of an experimental study that the proposed method of alloplasty for large ventral hernias makes it possible to achieve adequate reconstruction of the anterior abdominal wall, reduce the incidence of infection in the wound, and also use a smaller size of prosthetic material; it was determined that the proposed method of tension-free repair of large hernias of the anterior abdominal wall with strengthening of the aponeurosis with a mesh implant allows maintaining physiology, reducing the number of complications, shortening treatment time and reducing the risk of hernia recurrence; It has been determined that the proposed method for preventing the development or progression of wound infection during alloplasty of ventral hernias can reduce the frequency of suppuration, shorten the treatment time and the likelihood of relapse; It has been proven that the use of the proposed tactical and technical aspects of prosthetic repair for postoperative ventral hernias can reduce the incidence of specific complications, reduce rehabilitation time and the risk of hernia recurrence. Reliability of the research results. The reliability of the results is justified by the use of objective criteria for assessing the condition of patients, modern methods of diagnosis and treatment, the correct application of methodological approaches and sets of statistical analysis, methods for solving the problems discussed in the dissertation are based on modern scientific and practical concepts and approaches to the diagnosis and surgical treatment of patients with giant postoperative hernias. Scientific and practical significance of the research results. The results obtained make a significant contribution to the expansion of irradiation of existing ideas about the structure and clinical features of complications of hernioplasty for giant and extensive ventral hernias by identifying the morphological features of the development of a purulent-inflammatory process against the background of the use of alloplastic material, studying predictors of the risk of developing immediate complications, mechanisms for enhancing reparative processes through the use of an improved method of fixing the prosthesis in together using the effect of photodynamic therapy through laser radiation, which made it possible to enhance the antibacterial effect and improve the wound healing process. The practical significance of the study is that, based on the results obtained, the tactical and technical aspects of prosthetic hernioplasty have been optimized, the features of methods of antiseptic exposure and laser stimulation of the wound surface after prosthetic repair have been revealed, enhancing preventive measures for the development of local infection, and the method of surgery for large anterior abdominal hernias has been improved walls, characterized by a combination of factors such as the formation of tension-free prosthetic plasty, preservation of local resorptive function to prevent the development of fluid accumulations, thereby reducing the risk of developing postoperative complications, reducing the frequency of unsatisfactory results, length of hospitalization and the likelihood of relapse. Implementation of research results. According to the results of a scientific study to optimize the tactical and technical aspects of surgical treatment of large and giant postoperative ventral hernias: the “method for plastic surgery of giant hernias of the anterior abdominal wall” has been improved (invention patent No. IAP 2022 0148 dated April 18, 2022). The proposed method of tension-free repair of large hernias of the anterior abdominal wall with strengthening of the aponeurosis with a mesh implant made it possible to reduce the number of complications, shorten the treatment time and reduce the risk of hernia recurrence; the “method for preventing the progression of infection during alloplasty of infected hernias” has been improved (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022). The proposed method made it possible to reduce the frequency of wound purulent-inflammatory complications and shorten the period of rehabilitation of patients after allohernioplasty; methodological recommendations “Tactical and technical aspects of prosthetic repair for large and giant postoperative ventral hernias” have been developed (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022) . The developed recommendations made it possible to optimize the tactical and technical aspects of allohernioplasty in patients with large and giant postoperative ventral hernias; The scientific results obtained were introduced into the practical activities of healthcare, in particular, in the departments of surgery of the Khorezm and Andijan regional multidisciplinary medical centers, the clinic of the Samarkand State Medical University (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022). Improving the tactical and technical aspects of prosthetic repair for postoperative ventral hernias has made it possible to reduce the incidence of specific immediate complications from 40.9% to 15.6%, to reduce rehabilitation time from 8.6±2.7 to 7.1±1.5 days, and also reduce the likelihood of long-term complications from 11.7% to 3.1%. Approbation of research results. The results of this study were discussed at 8 scientific and practical conferences, including 5 international and 3 republican ones. Publication of research results. 26 scientific works have been published on the topic of the dissertation, including 9 journal articles, 4 of which in republican and 5 in foreign journals recommended by the Higher Attestation Commission of the Republic of Uzbekistan for publication of the main scientific results of doctoral dissertations. Structure and scope of the dissertation. The dissertation consists of an introduction, seven chapters, a conclusion, conclusions, practical recommendations and a list of cited literature. The volume of work is 200 pages.
People lose their teeth throughout their lives for various reasons: due to age, diseases (severe forms of periodontitis), and maxillofacial injuries. This condition is called adentia. Restoration of the dentition with complete or partial adentia occurs with the help of removable and non-removable dentures. Removable dentures present discomfort to many, causing the gag reflex and inconvenience. To solve this problem, implantation is used. All-on-4 technology refers to a one-stage technique with immediate loading, since a fixed prosthesis is installed immediately after implantation, until the artificial root is completely fused with the jawbone. Dental implantation and prosthetics on four implants quickly and effectively restores the aesthetics and functions of the dentoalveolar apparatus. If in classical prosthetics the patient will have to wait more than six months for all the implants to heal, then the “all on four” procedure allows the teeth to be installed on the day of treatment. In each jaw, two implants are located in the front part vertically and parallel to each other, and two implants - at an angle of up to 45 degrees in the distal region, where the molars are located.
Orthopedic treatment of partial and complete adentia is prosthetics on dental implants. The development of methods is on the way to reduce injuries, reduce costs, reduce waiting times for the end of treatment and increase the service life of structures. The purpose of this study was to analyze the effectiveness of prosthetics on implants in partial and complete adentia. The object of the study was 42 patients with partial or complete adentia. Prosthetics were performed after the method of one-stage or two-stage implantation of implants. The development of methods of prosthetics on implants is on the way to reduce injuries, reduce costs, and reduce waiting times end of treatment and increase the service life of structures.
This article deals with the results of immediate loading of 145 screw implants on the base of objective apparatus and instrumental methods of determination of their stability. From 145 implants 75 implants of Any Ridge construction and 70 implants of Any One construction were successfully integrated into maxillary bones.
The popularity of orthopedic treatment using the method of dental implantation causes the interest of researchers to study the integration of implants in bone tissue. Analysis of the literature shows that the improvement of research technology and interdisciplinary approach to the study of the phenomenon of osteointegration of dental implants has led to a change in traditional concept in recent years. This article summarizes information about the physiological processes and cellular interactions occurring on the border "implant-bone tissue" in various stages of integration. The results of studies indicate the need for revision notions of bio inertness of titanium implants and consideration of the integration process in the immunological aspect.
The article discusses the prospects for investment in free economic zones (FEZ) on the territory of the Republic of Uzbekistan. Correlation analysis of the influence of the volume of investments on the main macroeconomic indicators is made. The theoretical and practical aspects of the functioning of the SEZ are considered. The author's conclusions and proposals are made to improve the investment potential of the region and ensure the stable functioning of the FEZ.
SUMMARY
The article discusses the prospects for investment in free economic zones (FEZ) on the territory of the Republic of Uzbekistan. The correlation analysis of the impact of investment volume on the main macroeconomic indicators is made. Theoretical and practical aspects of FEZ functioning are considered. Therefore, when talking about the impact of investment on the state of Navoi's GDP, it is logical to consider the entire amount of investment, and not just the volume of foreign direct investment.
Significant impact on GDP growth. When studying the relationship between the value of Navoi's GDP and the amount of investment in Navoi FEZ, a coefficient of 0.95609 was obtained, which also reflects a strong positive relationship between the indicators — the growth of foreign investment in Navoi FEZ increases Navoi's GDP.
In other words, the correlation matrix shows that Navoi's GDP growth is directly related to two factors in the table. The criterion of correlation: -1≤r≤1.
The author's conclusions and suggestions for improving the investment potential of the region and ensuring the stable functioning of the FEZ are made.
Free economic zones operating on the territory of the Republic of Uzbekistan have a great impact on the development of our national economy. Thus, the calculations made clearly prove the significant role of investment in FEZ for the economy of Uzbekistan. The most important problem in attracting and effectively using foreign investment resources in FEZs is not just increasing their volume, but purposeful management of their structure, the ratio of direct, portfolio and other investments. In long-term regional targeted programs to attract and use foreign investment in the country, it is necessary first of all to identify priority industries and justify their equipping with foreign technologies and equipment.
At the same time, attracting foreign investment in the economy of our country means not only the implementation of new promising projects in cooperation with foreign partners, but also the introduction of new modern equipment, equipment and technologies, know-how, competitive quality of products aimed at mining.
Medical rehabilitation of patients with defects, deformities of the jaws is an urgent problem in reconstructive maxillofacial surgery. Such defects cause significant dysfunctions of the organs of the maxillofacial region, disfigurement of the soft tissues of the lower face zone. A complex problem of maxillofacial surgery is the development of methods for surgical restoration of the integrity of organs and their function. Currently, various surgical methods and materials are used to restore the defect in the jaw bone tissue [12].
Titanium is one of the most promising structural materials used for the manufacture of implants in orthopedics and dentistry. This material is characterized by low density, low modulus of elasticity, good formability, hardness close to that of tooth enamel, biocompatibility with biological tissues and corrosion resistance in biological media.
Odam organizmida mavjud bo‘lgan va dorivor moddalar tarkibiga kiruvchi elementlar ta’sir mexanizmini atom tarkibi darajasida o‘rganish hozirgi kun tibbiyotining dolzarb masalalaridan biridir. Ko‘pgina elementlar qatorida titan almashtirib bo‘lmaydigan elementlar qatoriga kirmasada, kompleks hosil qilish xususiyati ustunligi bilan tibbiyotda implantatlar va saratonga qarshi komplekslarda yengil va kuchli metall sifatida tanilgan.
Microbiological research was carried out by PCR method in 42 persons aged 25-60 years (men - 24 and women - 18), installed and Osseo integrated DIO dental implants, which were prototyped by metal-ceramic crowns, with temporary fixation on Tempo Bond NE. After 20 days, a follow-up visit was scheduled. All the examined patients were taken biological substrate of gingival fluid from the para-implant furrow using paper endodontic pins (№ 25). Exposure of two pins was made within 30 seconds with the help of tweezers between the peri-implant cuff and the crown, biological substrate of gum liquid was taken from the parai-implant furrow. The biological substrate was transported and tested according to the manufacturer's recommendations. When studying the content in patients with orthopedic constructions on dental implants by PCR method we observed high frequency of occurrence of Streptococcus sobrinus (69,3%), Streptococcus sanguis (48,6%) and Porphyromonas gingivalis (41,9). Relatively similar data on the content of these microorganisms were obtained in the molecular genetic study of Streptococcus oralis samples (22.7%). Obviously, it is the combined effect of the most frequently diagnosed pathogens and peculiarities of interaction of anaerobic agents of parasitocenosis that can determine the nature of inflammatory and destructive process in the peri-implant zone.