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Introduction: The osseointegration of dental implants in patients with systemic disorders of mineral metabolism, such as osteoporosis, osteomalacia, hypo- and hyperparathyroidism, is often disrupted, which leads to early loss of implants. The aim of the study is to develop personalized protocols for multidisciplinary management of such patients to improve the results of implantological treatment. Methods: Clinical and laboratory studies were conducted, including the assessment of bone mineral density, markers of bone metabolism (P1NP, CTX, vitamin D, parathyroid hormone), the effectiveness of various antiresorptive and osteoanabolic therapy regimens. Original protocols for personalized preoperative preparation and post-implantation management of patients with metabolic osteopathies have been developed. Results: A link was found between a decrease in bone mineral density, impaired calcium-phosphorus metabolism and an increase in the frequency of early implant loss by 35-50%. The use of personalized therapy with bisphosphonates, strontium ranelate, teriparatide, bone morphogenetic proteins under the control of markers of bone metabolism increases the 5-year survival rate of implants in osteoporosis by 25% and reduces the frequency of peri-implantitis by 40%. Discussion: The developed personalized protocols of multidisciplinary interaction between dentists, endocrinologists and rheumatologists ensure effective prevention and treatment of osteointegration disorders of dental implants in patients with systemic disorders of mineral metabolism. Further research should be aimed at studying the long-term results of the proposed approaches and their implementation in a wide clinical practice.
Keywords:dental implantation, osseointegration, osteoporosis, bone metabolism, antiresorptive therapy, personalized medicine
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