Cherednyk D. Correction of bone remodeling processes during dental implantation in patients with generalized periodontitis against the background of type 2 diabetes

The dissertation delves into a comprehensive exploration of the effectiveness of implantological treatment in patients with type 2 diabetes who are afflicted by generalized periodontitis. The significance of this research arises from the fact that dental implantation in patients with systemic medical conditions, coupled with bone tissue alterations, poses a notable risk for complications. Of specific concern in this context is systemic metabolic osteopathy in type 2 diabetes, which can extend its impact to the jaw bones. The study's objective is to enhance implant osseointegration effectiveness during dental implantation in patients with various forms of generalized periodontitis complicated by diabetic osteopathy through the refinement of diagnostic methods for detecting varying bone mineral density and rectifying bone metabolism disorders. Modern clinical, biochemical, and statistical research methodologies were employed throughout this work. Clinical investigations adhered to generally accepted protocols for periodontal tissue examination. To identify osteoporosis in periodontal bone structures, cone-beam computed tomography was utilized. Biochemical markers of bone formation, such as alkaline phosphatase (BAP) and osteocalcin (BGLAP), were analyzed in blood samples to assess osteoblast activity. To evaluate bone tissue resorption activity, levels of tartrate-resistant acid phosphatase (TRACP) and C-terminal telopeptide of collagen I type (β-Cross Laps or β-Cl) were measured. Scientific novelty in this study lies in the expanded understanding of the pathogenetic mechanisms contributing to adverse outcomes of dental implantation in patients with different forms of generalized periodontitis associated with type 2 diabetes and osteopathology. The research highlights that one of the primary factors affecting implant osseointegration and long-term function is the disturbance in bone mineral density and bone metabolism. The diagnostic and prognostic value of bone density and bone metabolism indicators has been established, providing additional insights into patients' readiness for dental implantation, the speed and direction of osseointegration processes, and the subsequent performance of implants. This is crucial for determining the suitability of dental implantation as a restorative treatment method, selecting appropriate corrective therapy, and monitoring its effectiveness. The study highlights the significant role of correcting bone metabolism disorders in the pre- or post-operative stages of dental implantation, allowing for the optimization of patient management strategies for those with generalized periodontitis and type 2 diabetes. The research underscores the use of a complex containing calcium carbonate and the ossein-hydroxyapatite complex osteogenon as a pathogenetically justified method for increasing bone tissue mineral density and enhancing bone metabolism in patients with type 2 diabetes. Furthermore, it was observed that the dynamics of mineral density in bone tissue, as indicated by bone markers, provides an objective means to assess various outcomes of dental implantation in patients with type 2 diabetes and concurrent osteopathology. In practical terms, this research has led to the development, substantiation, and implementation of a drug therapy approach for dental implantation in patients with type 2 diabetes suffering from generalized periodontitis. This approach involves the use of the morphogenetic protein rhBMP-2 and the ossein-hydroxyapatite complex osteogenon. The drug treatment and prevention schemes applied in clinical practice have proven effective in increasing the success rate of dental implantation and reducing post-implantation complications, particularly in groups with complex combined somatic pathology