ALGORITHM FOR CHOOSING A TREATMENT METHOD FOR PATIENTS WITH MANDIBULAR FRACTURES IN CHRONIC GENERALIZED PERIODONTITIS.

The course of the post-traumatic period in mandibular fractures is influenced by various factors, including periodontal diseases, the prevalence of which continues to increase. According to World Health Organization (WHO) experts, more than 80% of the world's population showed signs of periodontitis in 1990. Severe periodontitis occurs in 15–20% of middle-aged individuals. The pathogenetic role of inflammatory periodontal diseases in the development of purulent-infectious complications of mandibular fractures has been proven (Erokina N.L., 2009). Both conservative and surgical methods are used for the therapeutic immobilization of jaw fragments. Among conservative methods, tooth-borne bimaxillary splints are currently the most widely used (Robustova T.G., Starodubtsev V.S., 1993, 2003; Timofeev A.A., 2004). Dental splints are readily available and easy to fabricate; however, they have significant disadvantages: they complicate oral hygiene procedures and make patient nutrition more difficult. These factors contribute to the progression of inflammatory processes in patients with periodontitis. Dental splints are fixed in the cervical region of the teeth using ligature wire. As a result, unavoidable trauma to the marginal periodontal tissues occurs both during splint placement and throughout the entire period the splints remain in the oral cavity. A significant deterioration in oral hygiene and the traumatic effects of fixation devices can lead to pathological changes in the marginal periodontium or aggravate existing conditions (Avetikyan V.G., 2010; Puzin M.N. et al., 2010). At the same time, there is evidence supporting the use of dental splints for mandibular fracture immobilization in patients with chronic generalized periodontitis when combined with comprehensive treatment (Erokina N.L., 2009).