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In periodontal surgery, advanced technologies such as the use of platelet-enriched plasma, the technique of directed tissue regeneration, applying various osteoplastic materials are widely spread. Despite the undoubted achievements, there is a risk of postoperative complications. The aim of the work was to study the intensity and duration of the wound healing phases after surgical treatment of spontaneous periodontitis accompanied by normo-, hyper- or hyporeactivity of the body by bone morphometry. Materials and methods. Wistar rats were selected for the study ‒ 90 nonlinear white adult male rats weighing 270 ± 58 grams, aged 11–12 months with spontaneous periodontitis. The animals were divided into three equal groups depending on the condition of their organism reactivity. All the animals underwent surgery on the periodontium: one half of the animals in each of the three groups underwent flap operations, the other – flap operations with osteoplasty (Kolapan-L, Hypro-sorb F). The specific weight of microhemocirculatory bed, connective tissue and bone granulation tissue, bone trabeculae, bone marrow cavities, polymorphonuclear leukocytes, lymphocytes, macrophages, plasma cells was studied by a morphometric method. Results. Morphometric study of bone wound preparations from animals with spontaneous periodontitis accompanied by normoreactivity of the body has allowed to identify the following phases of healing during the wound process: degenerative-inflammatory changes (the 10th day), an increase in reparative processes (the 20th day) and active regeneration (the 30th day). In cases of hyper- and hyporeactivity, the intensity and duration of the wound healing phases differed. In case of hyperreaction, the granulocyte-macrophage reaction was more expressed and lasted longer until the 20th day, therefore later, only on the 30th day, the signs of regeneration could be observed. In case of hyporeaction, the granulocyte reaction appeared later (only on the 20th day) and lasted longer, signs of active regeneration were noticed later, on the 30th day. The identified patterns occurred regardless of the absence or presence of osteoplastic material in a wound. Conclusions. In case of normoreactivity, the intensity and timing of the wound process phases were optimal. In case of impaired (hyper- and hypo-) reactions, altered intensity of the cellular phase (increased or decreased) and terms (accelerated or slowed down) resulted in delayed bone wound healing, that is, a complicated course was observed. It justifies the feasibility and necessity of developing methods of targeted drug correction for transforming the wound process phases with impaired body reactivity into those that are typical of normoreaction.

Development of the modern dental implantology as a science is rapidly advancing, making impressive gains. Despite the undoubted achievements, an important issue of the dental implantation is the risk of inflammatory post-surgical complications. Aim of the study. To assess the effectiveness of the proposed differential medicamentous therapy after dental implant surgery based on the results of clinical picture dynamic monitoring in the early postoperative period (up to 3 months). Materials and methods. 124 somatically healthy people (54 men and 70 women) aged from 18 to 34 years were examined, among them: 25 patients with intact periodontium, 35 patients with chronic catarrhal gingivitis (CCG), 30 patients with generalized periodontitis (GP) of the initial, initial-І degrees of severity, 34 patients with GP of the І and ІІІ degree of severity. Patients were divided into 2 equal study groups: the proposed differential therapy was used for the experimental group (62 patients) in the early post-surgical period depending on the determined initial oral hygienic status; the traditional medicamentous treatment was applied for the control group (62 patients). Since the special medicamentous therapy was not advisable for the patients with healthy periodontium (25 patients) after the implant surgery, they made up the comparison group. Immunomodulating monotherapy (6 “Imudon” lozenges per day for 2 weeks) was prescribed to patients with CCG in the postoperative period. Immunomodulating therapy (“Imudon” by the same scheme) combined with a universal broad-spectrum antimicrobial drug “Miramistin” was prescribed to patients with GP of the initial, initial-I, І and І–ІІ degrees of severity for 2 weeks. Control examinations were performed one week after removing the stitches, then weekly for 3 months before the second stage of surgery. Results. One week after removing the stitches a significantly better oral hygienic status was observed in the main group of patients with CCG compared to the control (P < 0.05). When assessing the mucosa state above the intraosseous element in CCG patients, cases of peri-implantitis were detected neither in the main nor in the control group in the postoperative period. In the main group of patients with GP of the initial, initial-I degrees of severity the oral cavity hygienic status was significantly better in all periods of observation, starting from the first week after removing the stitches and after 3 months compared with the control (P < 0.05). When assessing the mucosa state above the intraosseous element in patients with GP of the initial, initial-I degree of severity in the postoperative period, one case of peri-implantitis was revealed in the control group. It manifested as hyperemia and edema of the mucosa above the intraosseous element during the 1st week after removing the stitches and granulation tissue growth during the 2nd week. The main group of patients with GP of the I, I–II degrees of severity were characterized by significantly better oral hygienic status – 1.90 times on average (P < 0.05), compared with the control, from the 1st week after removing the stitches and over the follow-up period up to 3 months. When assessing the mucosa state above the intraosseous element in patients with GP of the I, I–II degrees of severity in the postoperative period, one case of peri-implantitis was revealed in the control, similarly to patients with GP of the initial, initial-I degrees of severity. Conclusions. Analysis of the clinical parameters dynamics in the patients after dental implant surgery suggests the effectiveness of the proposed methods in addition to the traditional maintenance therapy in the early period of 1 week after removing the stitches to 3 months. The obtained results allow to recommend the proposed methods of differential medicamentous therapy in the early postoperative period following the dental implant surgery for a wide application in dental practice.