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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Perm Medical Journal</journal-id><journal-title-group><journal-title xml:lang="en">Perm Medical Journal</journal-title><trans-title-group xml:lang="ru"><trans-title>Пермский медицинский журнал (сетевое издание "Perm medical journal")</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0136-1449</issn><issn publication-format="electronic">2687-1408</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">709348</article-id><article-id pub-id-type="doi">10.17816/pmj434131-144</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Biology and experimental medicine</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Биология и экспериментальная медицина</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Morphofunctional remodeling of maxillary sinus tissues during subantral augmentation with bone graft materials (part 1)</article-title><trans-title-group xml:lang="ru"><trans-title>Морфофункциональная перестройка тканей верхнечелюстного синуса при субантральной аугментации с использованием костнопластических материалов (часть 1)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4924-5792</contrib-id><contrib-id contrib-id-type="spin">7498-5189</contrib-id><name-alternatives><name xml:lang="en"><surname>Sirak</surname><given-names>Sergey V.</given-names></name><name xml:lang="ru"><surname>Сирак</surname><given-names>Сергей Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>DSc in Medicine, Professor, Head of Department</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующий кафедрой</p></bio><email>sergejsirak@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0139-5094</contrib-id><contrib-id contrib-id-type="spin">2512-7267</contrib-id><name-alternatives><name xml:lang="en"><surname>Gatilo</surname><given-names>Irina A.</given-names></name><name xml:lang="ru"><surname>Гатило</surname><given-names>Ирина Анатольевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>PhD in Medicine, Associate Professor, Head, Georgy Aleksandrovich Gudzovsky Department of Hygiene</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, доцент, заведующий кафедрой гигиены имени Георгия Александровича Гудзовского</p></bio><email>chijgay@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7004-3581</contrib-id><contrib-id contrib-id-type="spin">7627-2730</contrib-id><name-alternatives><name xml:lang="en"><surname>Perikova</surname><given-names>Maria G.</given-names></name><name xml:lang="ru"><surname>Перикова</surname><given-names>Мария Григорьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>PhD in Medicine, Associate Professor, Department of Dentistry</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, доцент, доцент кафедры стоматологии</p></bio><email>masha-perikova@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1189-0136</contrib-id><contrib-id contrib-id-type="spin">1093-5853</contrib-id><name-alternatives><name xml:lang="en"><surname>Kobylkina</surname><given-names>Tatyana L.</given-names></name><name xml:lang="ru"><surname>Кобылкина</surname><given-names>Татьяна Леонидовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>DSc in Medicine, Associate Professor, Department of Dentistry</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, доцент, доцент кафедры стоматологии</p></bio><email>tatiana.kob1405@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7450-3757</contrib-id><contrib-id contrib-id-type="spin">8876-2827</contrib-id><name-alternatives><name xml:lang="en"><surname>Averyanov</surname><given-names>Sergey V.</given-names></name><name xml:lang="ru"><surname>Аверьянов</surname><given-names>Сергей Витальевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>DSc in Medicine, Professor, Head, Department of Prosthetic Dentistry</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующий кафедрой ортопедической стоматологии</p></bio><email>sergei_aver@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-1663-3377</contrib-id><contrib-id contrib-id-type="spin">6001-6960</contrib-id><name-alternatives><name xml:lang="en"><surname>Iurasov</surname><given-names>Andrey Y.</given-names></name><name xml:lang="ru"><surname>Юрасов</surname><given-names>Андрей Юрьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Assistant, Department of Prosthetic Dentistry</p></bio><bio xml:lang="ru"><p>ассистент кафедры ортопедической стоматологии</p></bio><email>andreyyr@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1152-6804</contrib-id><contrib-id contrib-id-type="spin">3438-6108</contrib-id><name-alternatives><name xml:lang="en"><surname>Dedikov</surname><given-names>Dmitry N.</given-names></name><name xml:lang="ru"><surname>Дедиков</surname><given-names>Дмитрий Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>PhD in Medicine, Oral and Maxillofacial Surgeon</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, челюстно-лицевой хирург</p></bio><email>avers_23@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Stavropol State Medical University</institution></aff><aff><institution xml:lang="ru">Ставропольский государственный медицинский университет</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Bashkir State Medical University</institution></aff><aff><institution xml:lang="ru">Башкирский государственный медицинский университет</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">AVERS Scientific and Practical Center for Maxillofacial Surgery and Dentistry</institution></aff><aff><institution xml:lang="ru">Научно-практический центр челюстно-лицевой хирургии и стоматологии «АВЕРС»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2026-09-20" publication-format="electronic"><day>20</day><month>09</month><year>2026</year></pub-date><volume>43</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>131</fpage><lpage>144</lpage><history><date date-type="received" iso-8601-date="2026-06-11"><day>11</day><month>06</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-07-31"><day>31</day><month>07</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, Эко-Вектор</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://eco-vector.com/for_authors.php#07</ali:license_ref></license></permissions><self-uri xlink:href="https://permmedjournal.ru/PMJ/article/view/709348">https://permmedjournal.ru/PMJ/article/view/709348</self-uri><abstract xml:lang="en"><p><bold>Objective.</bold><bold> </bold>To analyze morphological and functional transformations of the mucous membrane and bone structures of the maxillary sinus during subantral augmentation using β-tricalcium phosphate.<bold> </bold></p> <p><bold>Materials and methods. </bold>The experiment was conducted on 14 sheep (control and experimental groups of 7 animals each). All animals, kept under standard conditions with their usual diet, underwent subantral augmentation using an open technique according to the author's method (patent RU 2729651). In the experimental group, β-tricalcium phosphate granules were applied to the mucosa; in the control group, the defect was left to fill with a blood clot. Follow-up biopsies were performed under general anesthesia at 1, 2, and 3 months after surgery. The evaluation included a qualitative analysis of changes in the epithelium, lamina propria of the Schneiderian membrane, bone plate, and periosteum.<bold> </bold></p> <p><bold>Results. </bold>The results demonstrate a biphasic response: initial necrosis and inflammation, followed by reparative processes such as epithelial metaplasia, lamina propria fibrosis, bioresorption of the material, and the formation of reticulofibrous bone tissue. In the experimental group, ramolithic cysts (bone cysts resulting from tissue necrosis) with osteogenesis were observed, confirming the osteoinductive properties of β-tricalcium phosphate. These changes highlight the importance of monitoring tissue responses to optimize implant procedures in the maxilla.<bold> </bold></p> <p><bold>Conclusions. </bold>This study demonstrates that subantral augmentation using a bioresorbable composite material based on β-tricalcium phosphate induces a complex tissue response, including initial necrosis and inflammation of the mucosa and bone, followed by bioresorption and osseointegration.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Цель.</bold> Анализ морфологических и функциональных трансформаций слизистой оболочки и костных структур верхнечелюстного синуса в процессе субантральной аугментации с применением b-трикальцийфосфата.</p> <p><bold>Материалы и методы. </bold>Эксперимент проведен на 14 овцах (контрольная и опытная группы по семь животных). У всех животных, содержащихся в стандартных условиях с привычным питанием, выполнялась субантральная аугментация открытым способом по авторской методике (патент RU 2729651). В опытной группе на слизистую накладывались гранулы b-трикальцийфосфата, а в контрольной группе дефект формировался под кровяным сгустком. Спустя 1, 2 и 3 месяца после операции проводились повторные биопсии под общей анестезией. Оценка включала качественный анализ изменений эпителия, собственной пластинки Шнейдеровой мембраны, костной пластинки и периоста.</p> <p><bold>Результаты. </bold>Исследование<bold> </bold>демонстрирует двухфазную реакцию: начальный некроз и воспаление, сменяющиеся репаративными процессами, такими как метаплазия эпителия, фиброз собственной пластинки, биорезорбция материала и формирование ретикулофиброзной костной ткани. В опытной группе отмечены рамолиционные кисты с остеогенезом, что подтверждает остеоиндуктивные свойства b-трикальцийфосфата. Установленные изменения подчеркивают важность мониторинга тканевых реакций для оптимизации имплантологических вмешательств на верхней челюсти.</p> <p><bold>Выводы.</bold><bold> </bold>Проведенное исследование показывает, что субантральная аугментация с использованием биорезорбируемого композитного материала на основе b-трикальцийфосфата вызывает комплексную тканевую реакцию, включающую первоначальный некроз и воспаление слизистой оболочки и костной ткани, с последующей биорезорбцией и остеоинтеграцией.</p></trans-abstract><kwd-group xml:lang="en"><kwd>Subantral augmentation</kwd><kwd>maxillary sinus</kwd><kwd>bone graft materials</kwd><kwd>β-tricalcium phosphate</kwd><kwd>Schneiderian membrane</kwd><kwd>bioresorption</kwd><kwd>osseointegration</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>Субантральная аугментация</kwd><kwd>верхнечелюстной синус</kwd><kwd>костнопластические материалы</kwd><kwd>β-трикальцийфосфат</kwd><kwd>Шнейдерова мембрана</kwd><kwd>биорезорбция</kwd><kwd>остеоинтеграция</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Allevi F., Fadda G.L., Rosso C. et al. 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