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To define the individual features of the organization of circadian rhythms, the term "chronotype" was proposed, which is becoming increasingly popular in research in the field of medicine. According to the analysis of literature data, biological rhythm affects not only the mental state, obesity but the human condition as a whole. Biological rhythms are a manifestation of the fundamental properties of the organic world, provide the ability of man to adapt and survive in the environment. In this aspect, of particular interest is the functioning of the organism, taking into account its individual characteristics in terms of the organization of biorhythmic processes. The research was conducted on the basis of the Department of Maxillofacial Surgery on the basis of CE «Poltava M. V. Sklifosovskyi Regional Clinical Hospital of the Poltava regional council». A total of 24 patients participated in the study. To study the materials, we analyzed patients who were hospitalized for routine surgery for congenital neck cysts and tumors of the head and neck. Patients were interviewed during hospitalization, as well as a questionnaire to determine the chronotype. Patients were divided into the following 2 groups, namely: group 1, which in turn comprised 2 subgroups: 1.1 - Patients with morning chronotype; 1.2 - Patients with evening chronotype. The first subgroup (1.1 - with the morning chronotype) consisted of 7 subjects who underwent surgery in the morning. The second subgroup (1.2 - with evening chronotype) consisted of 9 patients who underwent surgery at about 15:00. In each of these subgroups during surgery, intradermal administration of the drug "Cryocel" was performed. - group 2 (control). The second control group consisted of 8 patients, all patients in this group were operated on according to the classical method without the use of additional preventive measures. On the 90th day of the clinical study, we could observe a significant difference in the comparison of postoperative scars, namely in patients with morning chronotype and in patients with evening chronotype it was 42%, the difference with control was 71% and the difference between the subgroup 2 and the control group was 50%. On the 180th day of the study, we observed a significant difference between the groups, in patients of subgroups 1 and 2, as compared to the control group, clinical data in the description of postoperative scars were better by 25%. When comparing subgroups 1 and 2, no difference was observed. Thus, on the 180th day when examining patients, the clinical picture was more favorable in subgroups 1 and 2. According to the data obtained, we can say that in patients who underwent surgery in the morning and injected with placental cryoextract, wound healing and scar formation on the 90th day was faster and better than in patients who underwent surgery at lunchtime, and patients who underwent surgery according to the classical method without the use of additional preventive measures.

Today the problem of pathogenesis and rational treatment of purulent-inflammatory odontogenic diseases of the maxillofacial area is quite relevant in the field of medical and SOCIAL problems. In recent years, the number of patients with odontogenic inflammatory does not catch an illness, while the number of complications increases. In case of the development of purulent inflammation the complex of interrelated morphological, biochemical, immunological and other changes is observded. The basis in the complex treatment of phlegmon of the maxillofacial area and neck of any localization is active surgical treatment. General therapy for odontogenic inflammatory diseases of the maxillofacial area primarily provides control of infection and intoxication, aimed at normalization of the impaired functions of organs and systems. The purpose of this research was to increase the effectiveness of comprehensive treatment of patients with odontogenic phlegmon of the maxillofacial localization by the use of cryopreserved placental cells. In most cases, the cause of inflammatory processes of maxillofacial localization was untreated periodontal teeth, retained teeth and negligent behavior of patients. That is why the majority of authors believe that the "cause" tooth should be urgently removed, but the solution depends on the individual features of the patient and in some cases may be postponed until the relief of the inflammatory process [3,4]. The combination of local and general factors is necessary to avoid further development of abscesses and phlegmons of the maxillofacial area and neck. The local factors are aerobic and anaerobic infection (staphylococcus, streptococcus, enterococcus, diplococcus, intestinal, gram-positive and gram-negative rods, but less often - mycoplasmas, the simplest of the family Trichomonas, spirochetes, and fungi of the genus Candida). The concentration of causal microflora, general and local nonspecific and specific protective factors of the body, the state of various organs and systems of the body, as well as anatomical and topographic features of the tissues of the maxillofacial area play a significant role in the development and course of purulent-inflammatory processes of the head and neck. All of the above determines the nature of the inflammatory reaction: normergic, hyperergic, hypoergic, anergic. Currently, placental cryoextract preparations are widely used in various fields of medicine, in particular, in urology, gynecology and general surgery. So, maxillofacial surgeons can be interested in their use in the treatment of patients with inflammatory purulent diseases of the maxillofacial localization. That is why carrying out a detailed analysis of native and foreign literature, we have concluded that it is necessary to continue study and scientifically substantiate the issue of optimizing conservative treatment of patients with odontogenic phlegmons with the use of biologically active substances. In further studies it is planned to investigate the impact on the mechanism of purulent wound healing by cryopreserved placenta and to create a morphological and biochemical evidence base for the effectiveness of the proposed treatment.

Objective The aim: Of our study was to establish how the biological rhythm of human affects the reparative functions of the body in terms of odontogenic purulent-inflammatory diseases of the maxillofacial localization. Patients and methods Materials and methods: The research was conducted on the basis of the Department of Maxillofacial Surgery on the basis of «Poltava Regional Clinical Hospital. M.V. Sklifosovsky». A total of 40 patients with odontogenic phlegmons of maxillofacial localization. Results Results: On the first day of the study, the indicators of the clinical condition of patients did not have a significant difference in all study groups. On the 3rd day of all studied groups, the number of points probably decreased compared to the first day of the study by 22.5%, 23.1%, 23.7%, 22.7%, respectively. On day 5, we have observed a significant difference between the previous results in all groups: 1a - 26.6%, 1b - 23.8%, 2a - 23.9%, 2b - 24.0%. Conclusion Conclusions: The most effective treatment results were observed in patients of the morning chronotype who underwent surgery in the morning. Thus, the influence of the morning chronotype of the circadian rhythm on the course of reparative processes is manifested in the later stages of reparative regeneration.

OBJECTIVE The aim: Study of the influence of local oxygen deficiency on the features of the formation of keloid scars of the head and neck. PATIENTS AND METHODS Materials and methods: The research material was 17 incisional biopsy specimens of keloid scars, which were the highest age categories of patients from 19 to 63 years. RESULTS Results: It was revealed that at coloring according to Mallory's technique, sections of fibrinoid swelling of collagen fibers were noted near central homogeneous hyaline masses. The lateral areas of the dermis that adjacent to keloid scar tissue, at coloring by the Hart method, in our modification, were characterized by the separation of the hyalinosis zone from the undamaged dermis by coarse bundles of elastic fibers that are colored in dark purple. The undifferentiated dysplasia of the connective tissue has caused the replacement and obstruction of single vascular components, which has complicated the local oxygen deficiency of keloid-altered tissues. CONCLUSION Conclusions: Thus, plasmaragia and the accumulation of protein deposits in the perivascular space determine the inhibition of local hemodynamics, which explains the decrease in oxygen transport to tissues. Decreased oxygenation and increased permeability of the vascular wall causes local hemocirculatory hypoxia.

Despite the possibility of modern surgery and dermatological cosmetology, the problem of differential diagnosis of patients with keloid scars remains relevant and significant at present. As clinical practice shows, not just the presents and the size of functional or aesthetic defect in scar tissue changes are important, but also the degree of their negative influence on the process of physical, psychological and social adaptation of the patient. The aim of our study was to optimize and improve the effectiveness of treatment of facial keloid scarring by identifying the type of scarred skin of the head and neck, and using ultrasound examination. The ultrasound method of investigation was performed on 50 patients with keloid scars of the head and neck. Clinical study of the general characteristics of the scar was supplemented by an additional analysis of the structural features of the cicatricial tissues by ultrasound examination. For the purpose of comparison, intact skin was used. Analysis of ultrasonography allowed to determine the color echogenic pattern of keloid scars, which differed substantially from the dermis of intact skin. Among the echogenic signs of postoperative keloid scarring, one should point out an increase in the depth of cicatrix of the tissue in comparison with the thickness of the intact derma, an average of 8-11%, an average thickness of the epidermis is 18-26%, a clear boundary between intact skin and keloid scar is traced, which is a clear differential sign of this type of scar. Only in 7% of cases, we have visualized the border with the hypodermis in the peripheral edges of the scar, which indicates the infiltration character of the growth of the keloid and again proves its similarity with the tumor. Today, there is no universal method for differential diagnosis of various types of scars of the head and neck. Therefore, it is necessary to develop an informative and economically expedient method of diagnostics. Ultrasonography of scarring is a non-invasive survey method that can objectively, informatively and safely evaluate numerous anatomical structures, determine the type and depth of scar formation.

Objective: To determine the effect type I collagen gene polymorphism alpha-2 (COL1A2) (rs42524) on the formation of scar tissue that is localized in the head and neck areas. Material and Methods: Sixty patients with scars in different areas of the head and neck were examined. The patients were divided into four subgroups, according to the types of scarring: G I: 15 patients with normotrophic scars; G ІІ : 15 patients with atrophic scars; G ІІІ : 15 patients with hypertrophic scars; and G IV: 15 patients with keloid scars. The age of patients ranged from 17 to 54 years. The single-nucleotide polymorphic site of the COL1A2 (rs42524) gene was detected by a polymerase chain reaction and subsequent analysis of restriction fragment lengths. Pearson's chi-squared test with Yates’s correction and Fischer's exact test were used . Results: There were no significant changes between the control and basic groups (p=0.83) at analyzing the frequencies of G and C alleles. For the G allele, the calculation of odds ratio between the basic and control groups was 0.93 at 95% confidence interval (CI) (0.50-1.75), for the C allele – OR was 1.07 at 95% CI (0.57-2.01) . Conclusion: Our studies may indirectly indicate the activation of the skin’s protective reaction to physiological scarring and dosed scar formation in different areas of the head and neck.

Objective. To study the possibilities of differential diagnosis of normotrophic and atrophic postoperative cicatrices, using ultrasonographic investigation. Маterials and methods. There were examined 50 patients, suffering craniocervical cicatrices. Еchogenic peculiarities of pathological cicatrices were determined, using ultrasonographic investigation. Results. Echopicture of atrophic cicatrices was characterized by lesser depth of the cicatricial tissue bedding, than the intact skin thickness (minimal value – 0.92 mm, and maximal – 2.14 mm). Immediate zone of cicatrix have had middle degree of echogenicity with quite plain distribution of the connective tissues fibers. Conclusion. Application of ultrasonographic investigation makes possible to establish the pathological cicatrix type present to simplify the algorithm constructing for the postoperative cutaneous cicatrices treatment.

The problem of diagnosing scars of the head and neck begins important in modern society. This is due to the high incidence of different types of scar tissue, their ineffective treatment, and possible recurrences. One of the causes of pathological scars is the disruption of the collagen gene polymorphism that encodes it. However, data on the value of the polymorphic variant of the collagen type I gene in the formation of pathological conditions of the skin are rather limited. Today according to literature there are disparate data on the differential diagnosis of pathological scars, all of them are not systematized and need the optimization. Object and methods. To study the polymorphism of the COL1A2 gene (rs42524), 60 patients were examined. All patients have got cicatricial tissue localized in different areas of the head and neck and were treated at the Department of Maxillofacial Surgery of Poltava State Clinical Hospital. Additional examination of scar tissue was performed by analyzing digital images in Adobe Photoshop CC using a color system RGB. Results and Discussion. We have studied the differences in the external state of scar tissue, depending on the genotype in a group of patients with pathological scars in different topographoanatomical areas of the head and neck. The scar tissues were evaluated using features such as scar consistency, color, sensitivity, and scar area, without considering the scar tissue type by the author’s standardized system for the external evaluation of cicatricial tissue. Patients with pathological scars in different topographic and anatomical regions of the head and neck, which are carriers of the allele C (genotypes GC and CC), have more pronounced signs of low-grade chronic inflammation of the skin. The obtained data about association of the polymorphism gene COL1A2 (rs42524) with signs of low-grade chronic inflammation of the skin in patients with pathological scars in different areas of the head and neck, probably indicate a possible effect of single-nucleus replacement on the physiological functions of collagen, namely the collagen specific collaboration with different molecules and cells. Using the RGB system, it was established that using the RGB color systems in Adobe Photoshop makes it possible to differentiate the types of pathological scars of the head and neck depending on the intensity of color spectrum. It was noted the relationship between the presence of the polymorphic variant of the COL1A2 gene (rs42524) in the genotype and data of RGB examination among patients with scars in different areas of the head and neck that were separated in previous studies, by the types of scars in 4 groups according to the type of scar. At present, there is no optimized method of differential diagnosis of different types of scars of the head and neck, which is why there is a necessity to develop an informative and economically feasible method of diagnosis. Conclusions. It is possible to determine precisely the type of scar and, depending on the type, to choose the optimal method of surgery or conservative therapy by using the RGB system and determining the type of scar, taking into account the effect gene polymorphism of collagen 1 alpha-2 (COL1A2) (rs42524) on cicatricial tissue formation.