COMPARATIVE ANALYSIS OF THE RESULTS OF SURGICAL APPROACHES IN PROSTHETICS ON DENTAL IMPLANTS IN PATIENTS WITH COMPLETE EDENTULISM AGAINST THE BACKGROUND OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objective. To evaluate the results of dental implantation using a traditional incision and a minimally invasive approach in completely edentulous patients with chronic obstructive pulmonary disease (COPD). Materials and Methods. A prospective study of 56 patients aged 54–79 years with COPD and complete edentulism included six implants in the maxilla (AOS) or four implants in the mandible (AOF). The groups were traditional incision (n = 28) and minimally invasive approach (n = 28). The following outcomes were assessed: early healing (EHS, 0–10 days), stability (ISQ, 0, 3, 6 months), hygiene, bone loss (CBCT), quality of life (OHIP-14, before, 3, 6, 12 months, 5 years), and respiratory function (FEV1, FEV1/FVC, GOLD, 1 and 5 years). Statistics: Mann-Whitney, Spearman correlation (p < 0.05). Results. In the AOS group, no differences in ISQ were found between surgical approaches, whereas in the AOF group, the traditional incision was associated with a statistically significant decrease in ISQ compared to the minimally invasive protocol (71.52 ±4.13 vs. 73.91 ±4.16; p ≈ 0.0075). Incisionless AiF demonstrated maintenance of high ISQ values at 3/6 months. The EHS was better with the minimally invasive approach (1.29 ±0.46 vs. 2.00 ±0.76; p≈3.4 x 10-¹³). Bone loss was less in the no-incision group (0.36 ±0.18 mm vs. 0.73 ±0.33 mm; p ≈ 7.5 x 10-¹³). Total OHIP-14 was lower in the no-incision group at all follow-up times (overall analysis: 13.57 vs. 17.72; p ≈ 2.6 x 10-4). FEV1 and FEV1/FVC, as well as the GOLD stage, did not differ significantly between the groups after 1 and 5 years. Conclusions. In patients with COPD, a minimally invasive approach provides higher primary stability of AOF implants, better early healing, less bone loss, and more favorable quality of life dynamics compared to a traditional incision, without a negative impact on external respiratory function.