l Scientific novelty of the conducted research. For the first time, it has been developed a special technique for construction of an individual macropattern for a polymer membrane based on polylactic acid (priority is evidenced by invention patents of Ukraine No. 114140, No. 114143). For the first time, the worked-out modelling technique of the predicted volume and shape of the alveolar process of maxilla and part of mandible to eliminate their resorption has been applied and studied. We have carried out examination and treatment of one hundred 40 to 60-year-old patients with alveolar process resorption. All the patients were practically healthy and without any co-morbidities. In order to compare radiological data, namely bone tissue density and anthropometric parameters of the alveolar process, the archival data of spiral computed tomography of 30 patients have been analyzed and X-ray diagnostics have been performed in patients with resorption before and after surgery. Patients of groups 1 and 2 have undergone operative treatment. Thus, 50 patients of group 2 underwent osteoplasty with the use of a titanium membrane, and 50 patients of group 1 underwent directed bone regeneration using a polymer membrane and foams based on polylactic acid according to the developed technique for individual prediction of the required bone volume and the shape of the alveolar process of the jaws. The analysis of bone density indicators in patients with alveolar process resorption of the upper jaw and the alveolar part of the lower jaw has revealed difference in indices in comparison with the control group. Therefore, the most significant difference p <0.05 has been noted in the area of mandibular molars (324.25 + 12.37) HU. Analysis of bone tissue structure revealed a predominantly porous type with a more or less pronounced trabecular pattern, thus corresponding to type 4 bone density. Analysis of clinical observation data showed difference in positive results between group 1 and group 2. Thus, changes on the part of oral mucosa, namely wound dehiscence over membrane area with subsequent infection of osteoplastic material and surrounding tissues, were noted in 9 (18%) patients of group 1. The results in group 2 were worse – 20 (40%) patients with a titanium membrane. In our opinion, this fact can be attributed to a large tension of soft tissues, namely the mucous membrane flap, on the one hand, and impaired blood supply to this area in clinical group 2, on the other hand. The results of an X-ray examination of the effectiveness of the use of polymer membranes developed according to the mentioned above technique showed a fairly high efficiency within 82% of positive result, which was expressed in the formation of bone tissue with an increase in height or width of the alveolar process of the upper and lower jaw. As for patients of clinical group 2, a pronounced positive effect from plastic surgery was noted only in 60% of the cases. Our analysis of biochemical indicators in blood serum and saliva showed some difference in alkaline and acid phosphatase (AP) indicators in group 1 and group 2. Thus, in group 1, the highest indices of alkaline phosphatase (ALP), which is responsible for bone tissue synthesis, were noted on the 14th day to 6th month, the concentration of this indicator decreasing to control values later on. On the other hand, in clinical group 2, the highest concentration of alkaline phosphatase was noted on the 3rd month of the postoperative period, after which the specified indicator decreased to the control values on the 6th month and remained practically unchanged until the 12th month. On the contrary, acid phosphatase indicators in comparison with the pre-operative period decreased significantly 2 weeks after the operation with a gradual increase to normal values in group 2. However, in group 1, both blood and saliva had a somewhat greater increase in the indices of this enzyme 3.6 months after the surgical treatment. Although when compared with the control values, the mentioned above indicator in group 1 exceeded them in the oral fluid. Thus, the most pronounced changes were noted up to 3 months after the operation. It is during this period that synthesis processes prevail over resorption processes, which is indicated by reduced indicators of acid phosphatase. Instead, prolonged synthetic activity in group 1 on the 6th month after surgery is indicated by both acid and alkaline phosphatase and is associated with the accumulation of membrane hydrolysis products and increased capillary synthetic activity to remove the waste products. Key words: alveolar process resorption, osteoplastic material, bone tissue, polymer membrane, titanium membrane, osteoplasty, implantation, dental row defects, mucogingival plastic surgery, oral mucosa, dental care. Branc-Medicine.
