An integrated approach to dental implantation in patients who underwent Cavid-19

Аннотация

The feasibility and effectiveness of complex treatment in patients with secondary adentia and past Covid-19 was assessed. The planning of dental implantation in patients who have undergone Cavid-19 should be carried out with the most complete use of diagnostic procedures, including clinical, laboratory and functional examination of the patient. A systematic analysis of the studies conducted at all stages of dental treatment allows us to conclude that there are relative contraindications to dental implantation in patients with underlying pathology and who have undergone Cavid-19. Keywords: coronavirus pathology Covid-19, dental implantation, hemostasis. . Relevance of the problem. Currently, scientists around the world are paying increased attention to the problem of the Covid-19 pandemic, the entire population living on planet Earth was exposed to a mild and moderate coronavirus infection, 58% of the earth's population suffered this infection in a severe form, 27% with a fatal outcome. On March 11, 2020, the World Health Organization declared COVID-19 a pandemic. As of 08/03/2021, there were 199,622,425 cases of confirmed morbidity worldwide (including 131,978 in Uzbekistan), 4,250,338 deaths (including 886 in Uzbekistan) [1]. The infectious disease COVID-19 is caused by the SARS-CoV-2 virus, which belongs to the large family of coronaviruses. The virus consists of a single-stranded RNA, an envelope and a lipid layer. The novel SARS-CoV-2 coronavirus, severe acute respiratory syndrome coronavirus (SARS- CoV), belongs to the same genus of betacoronaviruses [10,11]. Ways of transmission of Covid-19 from person to person: airborne - when sneezing or coughing, contact - directly from an infected person, through infected surfaces. The entrance gates for the virus to enter the body are the mucous membranes of the nose, mouth and eyes. The results of the research, consisting in the fact that the ACE2 enzyme is expressed in the mucous membrane of the oral cavity, and to be more precise, in the epithelium of the tongue. In this regard, the main mechanism has been elucidated, according to which the oral cavity represents a potentially high risk of infectious susceptibility to 2019-nCoV [8]. Excessive activation of systemic immunity after infection with SARS-CoV-2 causes the so- called "cytokine storm", in which released cytokines - tumor necrosis factors (TNF), interleukin-6 中华劳动卫生职业病杂志2022年13月第40卷第13期Chin J Ind Hyg Occup Dis， 2022，687-697 688 (IL-6) and interleukin-1β (IL-1β) - damage body cells. This can lead to increased vascular permeability, and subsequent damage to organs such as the kidneys and heart, leading to multiple organ failure and death [10,12,13]. In case of circulatory disorders caused by the development of an infectious and inflammatory process, the most vulnerable elements of the microvascular system are primarily affected: arterioles, precapillary arterioles, blood capillaries, postcapillary venules and venules. In the pathogenesis, clinical manifestations and course of many diseases of the oral cavity, disorders at the microhemocirculatory level are the leading link. To date, dental implantology is a fundamentally sound approach to the treatment of adentia, which contributes to an increase in the clinical effectiveness of this complex of minimally invasive methods and their widespread introduction into the practice of modern dentistry [Losev F.F., 2010; Mirgazizov M.Z., 1999; Nikitin A.A., 2010; Olesova V.N., 2009, 2010; Robustova T.G., 2003]. However, to date, in domestic dentistry, there are practically no reports on the results of complex clinical and experimental studies in patients with a history of coronavirus infection and devoted to a comparative assessment of the clinical and economic efficiency of using microsurgical methods during dental implantation in patients with partial and complete secondary adentia. The implantation procedure in patients with somatic pathology, especially infectious-viral etiology, can itself provoke an exacerbation of those diseases that the patient suffers from. From the point of view of an implantologist, it is important that with prolonged arterial hypertension, reduced immunity due to Covid-19, and regular use of antihypertensive, anticoagulant drugs, the phenomenon of "rarefaction" or "discharge" occurs, which is expressed in a reduction in the total surface of the exchange vessels [Jablonski D, 2004]. The presence of concomitant somatic pathology in patients with a coronavirus infection of viral etiology who need dental implantation indicates the relevance of this problem, on the one hand, and its practical significance, on the other hand. Purpose of research: Improve treatment through an integrated approach in the use of dental implantation in patients who have had a coronavirus infection in preparation for prosthetics. Materials and methods of research. 49 patients were under observation when applying for treatment for the purpose of implantation and fu