Goncharenko Y. Pathogenetic substantiation of prevention of dental implant complications at stage of primary implant fixation.

The thesis is devoted to pathogenetic justification of preventing of inflammatory complications of dental implantation in primary fixation of the implant by developing a complex method of diagnosis, planning, and control of effectiveness at the implantation stage, including radiological and functional methods. Pathophysiological research methods were used to assess the accuracy of linear measurements using digital orthopantomography compared to the cone-beam computer tomography (CBCT). The experimental model was a cadaveric lower jaw with fixed on it radiopaque markers. The experiment demonstrated that orthopantomogram may be distorted in displaying of linear dimensions, which may cause errors in the planning phase, which may lead to an increase in the number of implantation complications. This study included 46 patients with secondary partially edentulous mandible, to which installation of the implant in the lateral section was shown. The implantation was performed using two-staged delayed procedure. All patients underwent ultrasound bone densitometry which was performed before planning of implantation. The study included only patients with no systemic osteoporosis, where the value of Z-ratio was 90% or more (but not more than 110%). In the control group implant planning was performed using conventional techniques of digital orthopantomography. Immediately after surgery and before the second stage digital orthopantomography patients was also performed. To control the primary mechanical stability of the implant the resonant frequency analysis method for determining the rate of implant stability quotinent (ISQ) intraoperatively was used. This analysis was repeated by opening the implant at the stage of prosthetics. CBCT was performd to the patients of the main group in addition to the described research before surgery and after it. Diagnosis and planning procedures were performed according to CBCT. The stability of the implant according to the postoperative frequency resonance imaging was significantly higher in patients of the main group, which is due to more accurate planning of the optimum direction for the insertion of the implant according to CBCT. Etiopathogenetically grounded comprehensive planning of intraosseous dental implantation method makes it possible to get the maximum amount of information about the state of the bone tissue that allows for surgical intervention with a high degree of efficiency, and reduce the likelihood of the development of inflammatory complications. The proposed method for evaluating the state of the implant can improve treatment results control accuracy, which is the basis for reducing the likelihood of inflammatory complications in primary implant fixation stage.