Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector64089910.17816/KMJ640899ReviewsОбзорыReview ArticleMorphological assessment of dental implantation outcomesМорфологическая оценка результатов дентальной имплантацииhttps://orcid.org/0000-0002-8182-50848626-5394MaiborodinIgor V.МайбородинИгорь Валентинович
Russian Federation

MD, Dr. Sci. (Med.), Professor, Chief Researcher, Laboratory of Invasive Medical Technologies

д-р мед. наук, проф., главный научный сотрудник лаборатории инвазивных медицинских технологий

imai@mail.ruhttps://orcid.org/0009-0004-1986-4172SarkisiantsBoris K.СаркисянцБорис Каренович
Russian Federation

postgrad. Stud., Prosthodontist of Prosthodontist Depart.

аспирант, врач — стоматолог-ортопед ортопедического отделения

genus87@mail.ruhttps://orcid.org/0009-0008-4140-35319905-4138SheplevBoris V.ШеплевБорис Валентинович
Russian Federation

MD, Dr. Sci. (Med.), Rector

д-р мед. наук, ректор

shepa@icloud.comhttps://orcid.org/0000-0002-5169-63738492-6291MaiborodinaVitalina I.МайбородинаВиталина Игоревна
Russian Federation

MD, Dr. Sci. (Med.), Leading Researcher, Lab. of Invasive Medical Technologies

д-р мед. наук, ведущий научный сотрудник лаб. инвазивных медицинских технологий

mai_@mail.ruhttps://orcid.org/0000-0001-9235-93847715-7009ShevelaAleksandr A.ШевелаАлександр Андреевич
Russian Federation

MD, Dr. Sci. (Med.), Head of Oral Surgical Depart.

д-р мед. наук, заведующий хирургическим отделением

mdshevela@gmail.comInstitute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of SciencesИнститут химической биологии и фундаментальной медицины Сибирского отделения Российской академии наукInternational Center of Implantology iDentМеждународный Центр имплантологии iDentNovosibirsk Medical and Dental Institute DentmasterНовосибирский медико-стоматологический институт Дентмастер070320252004202510622772860311202411122024Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://kazanmedjournal.ru/kazanmedj/article/view/640899

Numerous publications have addressed gingival and bone augmentation involving both the alveolar processes of the jaws and the floor of the maxillary sinuses. In some cases, patients require not only dental restoration but also complex reconstruction of facial skeletal regions damaged by trauma, radiation exposure, cancer surgery, and other factors. Dental implantation is an essential component in the correction of extensive defects not only of the jaws but also of the paranasal sinuses. Additionally, various techniques have been described for covering the outer part of dental implants immediately after insertion to enhance integration. At the same time, certain disagreements remain regarding gingival manipulation during dental implantation and preparatory procedures. Some sources recommend covering implants with a flap of autologous soft tissue, whereas others support flapless approaches. Reports also differ on the source of soft tissue used for coverage: ranging from autologous grafts to allogeneic transplants, such as porcine-derived monolayer collagen matrices. There is no consensus on the optimal bone augmentation method for implant placement. Morphological data on the processes of lysis, replacement, or consolidation of autologous bone fragments that are placed into or left within tissues damaged during preparation and implantation are clearly insufficient, and existing publications lack detailed descriptions of these processes. All of this indicates that none of the challenges in dental implantation have been definitively resolved, including the need for a step-by-step understanding of the pathomorphological processes involved in bone graft consolidation or resorption.

Имеется множество публикаций об аугментации (пластике) десны и костных тканей как альвеолярных отростков челюстей, так и дна верхнечелюстных пазух. В некоторых случаях пациенты нуждаются не только в восстановлении зубных рядов. Существует проблема комплексной реконструкции отдельных частей лицевого скелета, повреждённых при травмах, лучевых воздействиях, операциях при онкопатологии и т. п. Дентальная имплантация является необходимым компонентом при коррекции значительных дефектов не только челюстей, но и придаточных пазух. Кроме того, есть описание различных способов закрытия наружной части дентальных имплантатов для улучшения интеграции непосредственно после их внедрения в кость. Вместе с этим имеются определённые разногласия относительно манипуляций с десной при дентальной имплантации и подготовительных процедурах. Приводятся как рекомендации закрывать внедрённые изделия лоскутом собственных мягких тканей, так и мнение, что имплантация может быть осуществлена без лоскута. Также разнородны сообщения об источнике мягких тканей для закрытия имплантата: от аутологичных тканей до аллогенной трансплантации, например, использование монослойного коллагенового матрикса свиньи. Нет единого мнения о самом оптимальном методе наращивания костных тканей для установки имплантатов. Явно недостаточны морфологические сведения о процессах лизиса, замещения или консолидации фрагментов аутогенной кости при помещении их или оставлении в тканях, повреждённых при подготовке и в ходе самой процедуры имплантации, статьи не содержат подробного описания этого процесса. Всё вышеизложенное свидетельствует, что ни одна проблема дентальной имплантации окончательно не решена, в том числе нет пошагового представления патоморфологических процессов консолидации или лизиса костных трансплантатов.

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