Objective: to analyze the legal and professional protection of surgeons performing operations to treat complications after primary interventions on the extrahepatic bile ducts, using the example of treating patients with injuries and strictures.

Materials and methods. A retrospective analysis of the treatment of 123 patients who underwent reconstructive surgery between 2000 and 2024 was conducted. Statistical analysis methods, including χ² tests and Yates's correction, were used to evaluate the results. The study included an examination of surgical techniques, treatment tactics, and legal aspects of medical documentation.

Results. Injuries and strictures of the extrahepatic bile ducts most often occurred during laparoscopic cholecystectomy and gastric resection. The main complications were associated with the anatomical features of the ducts, inflammatory changes, and insufficient qualifications of surgeons. Hepaticoenterostomy with a replaceable transhepatic drain was recognized as the most effective treatment method, with a mortality rate of 9.8%. However, with external drainage, mortality reached 66–80%. Long-term results showed that the frequency of anastomotic strictures was minimal (1.37%) with transhepatic drainage.

Conclusions. The success of treating complications of the extrahepatic bile ducts depends on the level of professionalism of surgeons, the applied treatment methods, and their compliance with modern standards. To reduce legal risks, it is important to correctly describe complications in medical documentation. The authors emphasize the need for regular analysis of medical errors and improvement of the system of training surgeons.

To ensure the safety of the educational process, the world is constantly looking for new ways to fix autopsy material. The purpose of our work was to search for literature data on new preservative solutions used in modern conditions for the fixation of cadaveric biological material for educational purposes. To achieve this goal, a scientific search was conducted on the RSCI and PUBMED database over the past 5 years with additional study of article-by-article links. As a result of the literature review, it has been established that modern methods of fixation of autopsy material have been developed, including solutions both containing formaldehyde and without its use. The current trend is determined by reducing the amount of formaldehyde used in such solutions or removing it from tissues before the educational process. Modern conservation techniques have proven themselves on the good  side, allowing for the realism of biological  tissues,  but they are always more  expensive than the standard fixation technique using an aqueous formaldehyde solution due to the cost of the solution or equipment itself.

Long-term trends are classically represented by the dynamics of body length and weight. However, in order  to  solve  practical  problems associated with the development of a regulatory framework regulating the “man-machine" system, the production of clothing and personal protective equipment, including for military activities, it is necessary to create a holistic picture of the changes.

Purpose: to systematize data on long-term trends in morphofunctional indicators of practically healthy individuals in combination with data from anthropometric studies. The selection of literary sources over the past 20 years was carried out in the E-library, Pubmed and Scopus databases. The exclusion criterion was the age of subjects under 16 years. The main long-term changes are associated with an increase in body mass index due to body weight, against the background of stagnation in its length. Changes in the last two decades include developmental retardation, debrachycephalization and leptoprosopia, changes in body shape, sex inversion, decreased aerobic tolerance, decreased agility, decreased certain blood biochemical parameters, cellularity of body fluids and cognitive abilities, as well as increased activity of the sympathetic nervous system. Thus, it can be stated that a wide range of organs are involved in secular trends, which requires targeted research from the standpoint of systemic anatomy.

Background. The high prevalence of neck injuries and the complexity of their surgical treatment represent one of the key challenges in modern clinical anatomy and operative surgery. Understanding the external anatomy of the neck plays a critical  role in the diagnosis and treatment of these injuries.

Objective. To systematize and analyze data on external neck landmarks, their classification, and significance in surgical practice, with a particular emphasis on applications in operative and military field surgery.

Methods. A comprehensive analysis of historical and contemporary scientific sources on neck anatomy and surgery was conducted. Works ranging from ancient authors (Hippocrates, Vesalius, Leonardo da Vinci) to modern researchers were examined, including studies by domestic scientists (A.P. Samarin, V.N. Shevkunenko,  S.N.  Delitsyn) and foreign specialists (Monson).

Results. A classification of external neck landmarks is presented, dividing them into primary (bone and muscle structures, such as the sternocleidomastoid muscle, jugular notch of  the  sternum,  laryngeal  cartilages)  and  secondary  (superficial  vessels  and nerves). Their application in determining anatomical boundaries, localizing wound channels, and performing surgical interventions is described. The importance of knowledge of these landmarks for external examination, diagnosis, patient triage, and provision of primary and specialized medical care is emphasized.

Conclusions. Knowledge of external neck landmarks is fundamental for the effective performance of surgical manipulations and improving treatment outcomes for patients with neck injuries. This research has particular practical significance for military field surgery, where rapid and accurate diagnosis and treatment of neck wounds can be  critical for saving  patients' lives.

Practical  Significance. The results of the study can be used to improve diagnostic and treatment methods for neck injuries, as well as for training surgeons.

Studying the structure and functioning of various brain structures, as well as understanding their interaction, is a central task set for modern scientists in the field of neuromorphology. Although both hemispheres of the human brain develop simultaneously and strive for "sameness" at both the anatomical and functional levels, scientists have long established that there are certain morphofunctional differences between them.

The aim of the study was to identify the severity of asymmetry  of anatomical parameters during magnetic resonance imaging of the precentral gyrus and cerebellum.

Object and methods. The analysis of the results of MR tomography of the brain of 53 people (28 men and 25 women) of the second period of adulthood without diseases and injuries of the organs of the central and peripheral nervous system, righthanded people was carried out.

Results. When comparing the width of the precentral gyrus in both men and women, a tendency to their prevalence in the left hemisphere was revealed (p > 0.05). Similarly, an asymmetry in the cerebellum was revealed, consisting in the prevalence of indicators in its right hemisphere (p > 0.05). There is also a predominance of size in the sample of men (p > 0.05), which we explain by the larger size of the skull in comparison with the sample of women.

Conclusion. The information obtained is of important both theoretical and practical importance for specifying information about certain structures of the brain, in particular its precentral gyrus and cerebellum, when using radiation diagnostic methods, and in clinical practice it can form the basis for identifying certain anatomical patterns of the hemispheres of the brain and cerebellum.

Introduction. Soft tissue sarcomas (STS) are quite rare malignant tumors of mesenchymal origin. The incidence is up to 2% among all malignant neoplasms. In Russia, about 10,000 new cases of STS are registered annually. For a long time, the main treatment method for patients with soft tissue sarcomas of the extremities was amputation, which led to a decrease in quality of life and disability. Currently, thanks to a multidisciplinary approach, it has been possible to develop optimal tactics in the complex treatment of patients with this pathology. The modern view on the treatment of this group of patients involves drug therapy and adequate excision of the tumor, observing the ablastic principles. A necessary condition is that the distance from the palpable edge of the tumor should be 5-8 cm. Due to this indentation, the question arises of closing extensive post-resection soft tissue defects. This aspect creates certain difficulties in the treatment of patients with tumor localization, mainly in the distal parts, such as the hand and especially the foot. The purpose of this work is to analyze the experience of using revascularized flaps in the surgical treatment of patients with soft tissue sarcomas. The study was conducted at the Center of Oncology-Orthopedics of the Samara Regional Clinical Oncology Center.

Object and methods. From 2020 to 2023, our observation included a group of patients of 10 people, 6 women and 4 men, ages from 29 to 64 years. Nosological types were: spindle cell sarcoma, liposarcoma, fibrosarcoma (pT1.2a-bN0M0, GI-III, IAB, IIA-B, stage III). All patients underwent surgical interventions, which included radical removal of the soft tissue tumor and the reconstructive stage of replacing the post-resection defect using revascularized flaps on microvascular anastomoses.

Results. The main advantage of the reconstructive stage using microsurgical technology is the rapid restoration of the skin, replenishment of soft tissue deficits, including thickness, the strength of the flap to perform the supporting function, the absence of trophic disorders, the absence of joint contracture, restoration of limb function in the shortest possible time. The follow-up period was 3 years. During this time, the following were noted: relapse – 0, thrombosis of the microvascular anastomosis – 0, marginal necrosis of the flap – 1, joint contracture – 0. The relative disadvantages of using this technique include: the duration of the surgical intervention, the need for simultaneous work of several surgical teams, the constant improvement of the surgeon's manual and practical technique, the labor intensity of such operations and the mandatory availability of special optical equipment and suture material.

Conclusion. The use of revascularized flaps in the surgical treatment of patients with soft tissue sarcomas makes it possible to radically remove the tumor and fully replace the post-resection defect, which in turn reduces the risk of relapses and promotes restoration of limb function with a good cosmetic result.

Backgrоund. Distal metaphysis fractures of the humerus in children are the most common among elbow joint injuries in children, occurring in 64–70%. Aim. Generalization of literature data and presentation of modern views on epidemiology, etiology, pathogenesis, diagnostics and treatment of supracondylar humeral fractures in children.

Materials and methods. A systematic literature search was conducted using the following databases: PubMed,  PubMed  Central,  Web  of  Science,  Scopus,  MEDLINE,  eLIBRARY,  RINTS,  Google  Scholar, Cyberleninka, eLibrary, etc. The inclusion criteria were publications on fractures of the distal metaphysis of the humerus, treatment of supracondylar fractures of the humerus in children aged 1–17 years.

Results. Distal metaphysis fractures of the humerus are the most common among elbow joint fractures in children. Treatment of non-displaced fractures Gartland type I is  conservative. The preferred method of treatment for displaced fractures Gartland types (II, III and VI) is closed reduction with percutaneous pinning osteosynthesis. In case of unsuccessful attempts to perform closed reduction, or in case of development of serious neurovascularal disorders, open reduction with revision of the fracture area is used. Surgical interventions with osteosynthesis of distal humerus fractures have increased several times in recent years, but the number of corrective osteotomies in the treatment of post-traumatic deformities has significantly decreased.

Conclusions. The correct approach in the diagnostics and treatment of pediatric distal metaphyseal fractures of the humerus, a reasonable choice  of  surgical  treatment  method  and  osteosynthesis  technique  ensure positive treatment results and reduce the risk of complications throughout all stages of the treatment period.

Relevance. Despite the successes and achievements of modern traumatology, the  method  of  microsurgical autotransplantation of tissue complexes remains an urgent topic today. Unfortunately, in various situations, for various reasons, it is not possible to perform microsurgical surgery. The best results of the implantation of free autografts are achieved provided that the defect plastic is performed early, in the acute phase of the wound process, when the wound is contaminated but not yet microbially colonized. Often, the general condition of the victim does not allow for autotransplantation, since an open injury to the lower leg may be part of a multiple or combined injury. There is a contradiction between the need to close a soft tissue defect and the very possibility of performing a large reconstructive operation. The aim is to study and analyze currently existing studies on the use of reconstructive plastic surgery using perforant flaps in patients with a traumatological profile. Highlighting the main directions that can be applied in clinical practice, reviewing and delving into the technical aspects of this method of surgical treatment.

Materials and methods. The search for literary sources was carried out using the bibliographic databases of eLibrary.RU, PubMed, Google Scholar and Scopus.

Conclusion. Thanks to the review, the main directions of soft limb transplantation were identified. The search for solutions to the problem of treating soft tissue defects in the lower third of the lower leg is far from complete. An in-depth study of the possibilities of perforant skin fascial flaps will allow us to obtain a tool with which it will be possible to improve the results of surgical treatment of this group of patients.

Relevance. Inguinal hernias are one of the most common surgical diseases, often found in working age men. Despite a significant decrease in the number of relapses after tension-free hernioplasty, the severe pain syndrome, the high frequency of edematous and hemorrhagic syndromes in postoperative period are often founded. Improving the surgical treatment of inguinal hernias reduces the likelihood of the above-mentioned consequences of operations.

Goal. Improve the immediate treatment outcomes with oblique intracanal inguinal hernias by developing and modifying methods of prosthetic hernioplasty.

Material and methods. A method of inguinal hernioplasty (a method for the prevention of scarring of the spermatic cord (patent for invention No. 2655541 dated 28.005.2018) and a modification of the method of forming the Cux window (rationalization proposal No. 360 adopted by the SamSMU dated 06/29/2016) have been developed. The immediate results of the application of the developed techniques in 60 patients (the main group) were analyzed. The control group consisted of 60 patients operated according to the classical Lichtenstein technique. The pain level of syndrome on a visual analog scale, the severity of edematous syndrome, hemorrhagic complications in the area of surgery, ultrasound data on size measurements of the testicle and scrotum wall, detection of accumulations of serous fluid, and the fit of the implant were assessed and analyzed.

Results. The immediate results in the main group were better than in the control group. A decrease in the level of pain syndrome after 1 day and 3 days after surgery was noted. Reliable data were obtained on the positive effect of the proposed surgical treatment option on edematous syndromes, the decrease of hemorrhagic complications.

Conclusions. The application of the developed techniques made it possible to improve the immediate results of treatment by stitching the implant from above to the aponeurosis of the external oblique abdominal muscle, reducing the traumatization of the elements of the spermatic cord during the allocation of the hernial sac, the suction capacity of the peritoneum of the inverted section of the hernial sac.

Relevance. Acute pancreatitis occupies one of the leading places among acute surgical diseases, second in prevalence only to acute cholecystitis and appendicitis. This is one of the most difficult problems in emergency surgery. The overall mortality rate in acute pancreatitis varies from 5 to 10% depending on the proportion of its severe forms. Unfortunately, over the past 40 years, no significant results have been achieved in the treatment of this disease. Predicting fatal pancreatogenic shock in the first phase of the disease from the onset of acute pancreatitis is an important task for doctors, as it allows identifying patients at high risk of death and taking the necessary measures to stabilize the patient’s condition and improve the prognosis of his survival.

Purpose of the study. To study clinical and biochemical parameters that can be predictors of fatal pancreatogenic shock. To determine the most effective methods of diagnostics and monitoring of patients with acute pancreatitis for timely detection of the risk of developing pancreatogenic shock. To study possible risk factors that can influence the development of fatal pancreatogenic shock in patients with acute pancreatitis in the first phase of the disease before the development of purulent complications. To develop a method for predicting fatal pancreatogenic shock using known prognostic scales based on the data obtained. The aim of the study was also to examine the effectiveness of predicting the hyperergic course of acute pancreatitis using common scales for assessing the severity of patients APACHE II, SAPS, MODS and SOFA, as well as to examine the effectiveness of the new scale developed by the authors of IDAP.

Conclusions. A hyperergic reaction of the body to acute inflammation of the pancreas is likely if the degree of severity on the IDAP and APACH II scales is more than 9.0 and the ratio of severity in points to blood leukocytosis in SI units is >1.5. The applied scales for assessing the severity of acute pancreatitis adequately reflect changes in the severity of a patient with acute pancreatitis in the first phase of the disease and must be used without fail when planning treatment for patients.

Relevance. In modern traumatology, the most common methods of surgical treatment of fractures of the ulnar process are osteosynthesis with platinum and osteosynthesis with spokes and wire according to Weber, however, there are fractures in which none of these methods is optimal. In this clinical case, we consider a patient with a comminuted fracture of the ulnar process and the use of a developed metal fixator in order to improve the treatment outcomes of patients with this type of fracture.

Clinical Case Description. In the presented clinical case, we consider a 49-year-old patient with a comminuted fracture of the ulnar process resulting from a fall. After a standard X-ray examination and preparation. The patient underwent osteosynthesis of the left olecranon with an intramedullary pin with a metaphysical pad. Physical therapy was allowed on the first day after osteosynthesis. During the follow-up, for 12 months, the patient showed good and excellent results according to the clinical and instrumental control data.

Conclusion. According to the results of 12 months of follow-up, it can be stated that the proposed metal fixator performed well, the patient completely returned to everyday life and does not experience any difficulties when playing sports. Taking into account the small thickness of the metaphysical adjustment, only 2 mm, the patient does not experience discomfort when loading the area of surgery. The use of this implant expands the operational capabilities of a modern traumatologist, and also has a number of advantages compared to other implants, such as reducing the size of surgical access, early timing of the start of active development of movements in the elbow joint.

Relevance. Midfoot osteotomies are common surgical treatment option for the pes cavus in the presence of a deformity apex in the area of the Chopard joint. Most midfoot osteotomies require additional surgeries: release of the plantar fascia, tendon transfer, etc. Also, osteotomies have typical complications, such as nonunion of the osteotomy area, insufficient or excessive deformity correction. We used a new method for correcting the deformity of the pes cavus – removal of the navicular bone with wedge-shaped osteotomy of the cuboid bone.

Aim: analyze the results of a patient who underwent removal of the navicular bone with wedge osteotomy of the cuboid bone.

Object and methods. in 2020, we performed the correction of the pes cavus deformity by removing the navicular bone and wedge-shaped osteotomy of the cuboid bone. Clinical outcomes were assessed based on foot appearance, joint function, AOFAS scores, and radiographic findings. Results. Follow-up period was 36.8 months. The healing time was 6 weeks. After this surgical intervention, there was an improvement in functional results, as well as a good aesthetic result. At the last visit, the mean AOFAS score was 88/100. Meary angle, calcaneus angle and Hibb angle were close to normal and changed from 26° to 5°, from 44° to 28° and from 66° to 41°, respectively. In the other joints of the foot, no degenerative changes were  detected during  the  observation  period.  Subjectively,  the  patient  was satisfied with the results of the operation. Objective results were rated as excellent.

Conclusion. Removal of the navicular bone with cuboid wedge osteotomy is an effective surgery for pes cavus. When using this technique, the risk of developing arthrosis and stiffness of the adjacent joints is lower and there is no effect on the mobility of the ankle joint. Additional studies are required to investigate the safety of this technique, as well as to assess the long-term results of treatment.

Relevance. Differential diagnosis between the brain infectious lesions and the central nervous system (СNS) oncological diseases is an urgent task in infectology.

The aim of the study is to present and analyze a primary diffuse large-cell B-cell  lymphoma  of  the  central  nervous system clinical case.

Materials and methods. The work was carried out on the basis of the clinic and the Department of Infectious Diseases with Epidemiology of SamSMU. A clinical case of primary diffuse large-cell B-cell lymphoma of the central nervous system is presented. The patient's brain CT and MRI, cerebrospinal fluid studies were performed, general clinical, biochemical, and serological diagnostic  methods were  used.

Results. The article describes a primary diffuse large-cell B-cell lymphoma of the central nervous system clinical case in a patient admitted to an infectious hospital with a directional diagnosis of unspecified etiology acute serous meningoencephalitis.

Conclusions.  Differential  diagnosis between infectious brain lesions and CNS oncological diseases manifesting with cerebral and meningeal syndromes is a difficult task for an infectious disease specialist. A comprehensive examination allows for a diagnostic search for infectious and tumor diseases of the central nervous system, to establish a final diagnosis and to develop tactics for further patient management.

Vascular malformations are quite rare but can occur anywhere in the human body, and when affecting the female pelvis, they present a unique pattern. A thorough medical history and necessary diagnostic methods enable the correct diagnosis and the initiation of optimal treatment. Arteriovenous malformations usually require embolization. The choice between surgical intervention or medical treatment is determined within a multidisciplinary approach to patient care. A clinical case of arteriovenous malformation of the pelvis in a 32-year-old female patient is presented, including her medical history and the results of a computed tomography scan of the abdominal organs with contrast enhancement. Additionally, an overview of vascular malformations of the female pelvis, their clinical course, diagnostic studies, and treatment options is provided.

Relevance. It is known that both sarcoidosis of the respiratory organs (SRO) and COVID-19-associated pneumonia involve connective tissue structures in the lungs in pathological processes, which may have similar clinical and radiological manifestations. Computed tomography (CT) of high resolution of the chest is the main method for diagnosing various pathologies of the respiratory system with a morphological substrate.

Aim: the objective is to evaluate long-term outcomes of various CT signs of sarcoidoses and COVID‑19 pneumonia.

Materials and methods. The study was cohort-based and retrospective. 37 patients with sarcoidosis of the respiratory organs who had suffered from COVID-19associated pneumonia for more than one year prior to admission to the Central Research Institute were examined. The X-ray semiotics of patients with SRO after COVID-19 were analyzed to develop a differentiated approach and dynamic monitoring of these patients. The prevalence of lung lesions associated with COVID-19 was estimated according to 4 degrees of severity, based on the adopted methodological recommendations from the Moscow Medical Center in 2020.

Results. Signs of interstitial densification characteristic of SRS were found in 50% of cases (χ2 = 35.18, p = 0.00001), whereas for COVID-19, changes in the peripheral interstitium were more characteristic and were detected in 65% of cases (χ2 =52.46, p=0.00). The extent of the changes was limited in SRS in 46% of cases and in COVID-10 in 69% (χ²=10.8, p= 0.1). By localization, changes were subpleural in 7% of SRS cases and 81% of COVID-1 cases.The predominant topic of change in SRS was basal (77%), with caudal changes in COVID (80%).Pleural involvement was characteristic of granuloma-level SRS in 97% and COVID in 16%. Vascular involvement was 96% in SRS and 39% in COVID.

Conclusion. The CT data did not reveal a significant effect of COVID-19 on the course or change of the X-ray pattern, the stage of sarcoidosis of IHL and the lungs. Probably, granulomatous lung inflammation is a more dominant process than viral lesions associated with COVID-19. Changes in the lungs on CT scans do not always correlate with clinical manifestations of COVID-19 or SRS, so further study of their interaction is required in clinical practice.

The purpose of the work is to optimize radiation exposure in children and adolescents with respiratory tuberculosis.

Object and methods. The retrospective study included 401 patients aged 2–17 years with various clinical forms of respiratory tuberculosis. Clinical, laboratory and X-ray comparisons were carried out during the main course of chemotherapy and after its completion. The influence of CT data on patient management tactics at the stages of conservative and surgical treatment, as well as its role in the subsequent follow-up of patients, was analyzed.

Results. Indications and timing of CT scans of the chest organs in children and adolescents with respiratory tuberculosis were determined.

The purpose of the study: to clarify the possibilities of using X-ray research methods in the framework of a comprehensive diagnosis of gastrointestinal fistulas in pancreatic necrosis.

Materials and methods. The analysis of the results of X-ray examination of 23 patients with pancreatic necrosis complicated by the formation of gastrointestinal tract fistulas (GI tract) is presented. All patients underwent computed tomography (CT) of the abdominal cavity and retroperitoneal space with bolus contrast enhancement and X-ray fistulography. Contrast examination of the upper gastrointestinal tract after oral administration of a water-soluble contrast agent and CT fistulography were used as additional research methods.

Results. During the examination, 27 gastrointestinal fistulas were detected in 23 patients. In all 23 patients, CT examination revealed signs of pancreatic necrosis and parapancreatitis with the presence of fluid and necrotic accumulations that were drained. CT scan revealed indirect signs of gastrointestinal fistulas, such as: the location of the gastrointestinal tract bearing the fistula in the zone of pancreatogenic destruction (100%), thickening of the intestinal wall or stomach (100%), gas inclusions in adjacent sections of fiber (59%). Direct signs of gastrointestinal fistulas were detected by X-ray fistulography in 22 cases (81%) in the form of leakage of CA into the lumen of the intestine or stomach. In 5 patients (19%) with fistula of the duodenum, there were no direct signs of fistula during fistulography. In almost all of these observations (21 cases out of 22 95%), fistulography revealed a cavity of pancreatogenic destruction through which the fistula communicated with the intestine or stomach. At the stages of pancreatic necrosis treatment, CT monitoring was performed in all 23 patients to identify new areas of necrosis and fluid accumulations, and to assess the location of drainage tubes in relation to the intestinal wall. Dynamic X-ray fistulography (20 observations) was used to evaluate the effectiveness of treatment of fistula and the state of the destruction cavity.

Conclusion. X-ray fistulography makes it possible to diagnose gastrointestinal fistulas in patients with pancreatic necrosis with a sensitivity of 81% in general and 100% when the fistula is localized in the colon. To increase the information content in the detection of small intestinal fistulas, it is advisable to use an X-ray contrast examination of the gastrointestinal tract. At the same time, CT additionally allows you to assess the condition of the pancreatic parenchyma and parapancreatic fiber, and determine therapeutic tactics. X-ray monitoring using CT and X-ray fistulography is an integral component of the therapeutic and diagnostic algorithm in patients with gastrointestinal fistulas in pancreatic necrosis.

Digital prints are becoming increasingly popular as digital technologies can provide a faster, more convenient and cheaper workflow.

The aim is to propose the design of prosthetics with ceramic prosthetic structures made on the basis of intraoral digital casts.

Object and methods. Intraoral scanning was performed in 52 patients, whose average age was 34.62±2.74 years. The patients were trained in intraoral scanning, crown design using CAD software, and all digital workflows, including the CAM process. Сканирование полным сканером Medite i500 (Медиа-корпорация, Сеул, Корея). Statistical data processing was carried out using the Microsoft Excel 2016 program. Descriptive statistics are used.

Results. Restorations were checked for marginal and interproximal fit. All of them are fitted precisely, without any backlashes and gaps. The order of placement of restorations has been determined. To build the correct anatomical contour for all-ceramic crowns, J-shaped and knife edges are not suitable. Both shoulders and chamfers are preferred. When creating a contact point, a virtual model with a restoration proposal was viewed from an occlusal point of view; it was determined whether the buccal-palatine contour was convex; the virtual model was viewed from the buccal side and determined whether the gingival-occlusal contour was convex; it was viewed from the mesial side; the virtual model was installed at an angle of 45 ° and the area was stretched until it was The desired size was reached and the surface did not become convex; the final polishing was performed by rotating the proposed restoration and virtual model.

Conclusion. The main components of the clinical design of prosthetics with all-ceramic crowns made using intraoral digital casts are: cavity preparation/design of dental preparation; interarticular stability; ultimate integrity; occlusal stability; accuracy of the digital impression. Digital design creates the opportunity to make treatment simpler and more accurate.