Nekhanevych Zh. M.

DENTISTRY

Scentific article

The issue of restoration of bone defects after atypical removal of third molars on the lower jaw is relevant today for the practicing dentist-dentist. The main goal of this work is to optimize reparative osteogenesis in the area of postoperative bone defects formed after atypical removal of retinal third molars of the mandible. The study included males and females aged 19 to 38 years without general somatic pathology with significant bone defects resulting from atypical and severe extraction of 38 and 48 teeth, and / or loss of integrity of the interdental alveolar membrane in the adjacent tooth after retinal tooth extraction, and gave written consent to participate in the study. All patients (58 people) were divided into three groups. The I group included 18 patients (31,0%), a bone defect was filled by an own blood clot after removing of impaction third molar, in ІІ group 20 patients in that (34,5%) the bone wound was filled by an own blood clot with automembrans of а-PRF, in the ІІІ group was 20patients (34,5%) the bone defect filled by calcium phosphate biomaterial (BCP), saturated by the recombinant morphogenic protein of bone (rhBMP-2) in correlation of mass part 3:1. The patients where the complex with а-PRF, і-PRF applied, postoperative complications was decrease, however there was a loss of volume of bone after time and was caused of the recession of gingiva and exposure of distal root of seventh tooth. In cases with the use of calcium phosphate biomaterial (BCP), saturated by the recombinant morphogenic protein of bone (rhBMP-2) in correlation of mass part 3:1 such effect was not. The dynamics of bone density in the area of bone defect after 3 months after surgery in patients of group III was statistically significantly higher, after 12 months this difference between groups significantly decreased and approached the density of healthy bone in all groups. The average bone density in the area of the defect in patients of group I (the defect was filled with its own blood clot) after 3 months was on the Hounsfield scale (computed tomography) 209.0±40.2 ED, after 6 months 330.0±40 , 5 ED, and after 12 months – 618.0±7.8 ED, which is 2.3; 1.7; 1.3 times less than in patients of group III.

postoperative complications, bone defect, third molars on the lower jaw.

1. Toledano-Serrabona J, Ruiz-Romero V, Camps-Font O, Gay-Escoda C, Sánchez-Garcés M-Á. A systematic review and meta-analysis on the effectiveness of xenograft to prevent periodontal defects after mandibular third molar extraction. Medicina Oral, Patologia Oral, Cirugia Bucal 2021;26(4):414-421.
2.  Vares YaE, Kyiak SV. Struktura ta osoblyvosti perebihu retentsii nyzhnikh tretikh moliariv. Visnyk problem biolohii i medytsyny. 2015;3:355- 357. [in Ukrainian].
3. Vranckx M, Fieuws S, Jacobs R, Politis C. Surgical experience and patient morbidity after third molar removal. Journal of Stomatology, Oral and Maxillofacial Surgery. 2021;11:2468-7855.
4. Khomych NM, Ohonovskyi RZ. Interleikiny yak markery zapalnoho protsesu u pisliaoperatsiinomu periodi atypovoho vydalennia nyzhnikh tretikh moliariv. Bukovynskyi medychnyi visnyk. 2016;20(1):173-175. [in Ukrainian].
5. Daware SN, Balakrishna, Deogade SC, Ingole YS, Patil SM, Naitam DM. Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar. Journal of Family Medicine and Primary Care. 2021;10(4):1712-1717.
6. Trybek G, Aniko-Włodarczyk M, Preuss O, Jaroń A. Assessment of Electrosensitivity of the Pulp of the Mandibular Second Molar after Surgical Removal of an Impacted Mandibular Third Molar. Journal of Clinical Medicine. 2021;10(16):3614.
7. Beleva I, Kissov C. Creating a distal limited defect by surgical exposure of an impacted third molar. Prognosis and treatment. Halytskyi likarskyi visnyk. 2015;22(3):23-27.
8. Trybek G, Rydlińska J, Aniko-Włodarczyk M, Jaroń A. Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars. International Journal of Environmental Research and Public Health. 2021;4;(16):8249.
9. Vares YaE, Slipyi VZ. Zastosuvannia zbahachenoho trombotsytamy fibrynu v khirurhichnii stomatolohii. chastyna ii. zamishchennia vnutrishnokistkovykh defektiv shchelep. Visnyk problem biolohii i medytsyny. 2016;4(1):21-24. [in Ukrainian].
10. Barylo OS, Kanishyna TM. Doslidzhennia vplyvu fibrynu, zbahachenoho trombotsytamy (platelet rich fibrin, PRF ), na reheneratsiiu tkanyn parodontav eksperymenti. Ukrainskyi stomatolohichnyi almanakh. 2017;2:5-8. [in Ukrainian].
11. Gudarjan AA, Idashkina NG, Nekhanevych ZhM. Prymenenye razlychnykh fraktsyi autoplazmy krovy (PRF, a-PRF, i-PRF) pry khyrurhycheskom lechenyy retynyrovanыkh tretykh moliarov nyzhnei cheliusty. Visnyk problem biolohii i medytsyny. 2016;4(1):21-24. [in Ukrainian].
12. Boda SK, Almoshari Y, Wang H, Wang X, Reinhardt RA. Mineralized nanofiber segments coupled with calcium-binding BMP-2 peptides for alveolar bone regeneration. Acta Biomaterialia. 2019;85:282-293.
13. Carlisle P, Guda T, Silliman DT, Burdette AJ, Talley AD. Localized low-dose rhBMP-2 is effective at promoting bone regeneration in mandibular segmental defects. Journal of Biomedical Materials Research. 2019;107(5):1491-1503.
14. Gomes-Ferreira PH, Okamoto R, Ferreira S, De Oliveira D, Momesso GA, Faverani LP. Scientific evidence on the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in oral and maxillofacial surgery. Oral and Maxillofacial Surgery. 2016;20(3):223-232.
15. Gudaryan OO, Іdashkіna NG, Nekhanevych ZhM. Effectiveness of morphogenetic protein rhBMP-2 use in atypical third mandibular molars extraction. Medicni perspektivi. 2020;2:137-144.
16. Hudarian AA, Idashkina NH, Nekhanevych ZhM. Zastosuvannia riznykh fraktsii autoplazmy krovi (PRF, а-PRF, i-PRF) pry khirurhichnomu likuvanni retynovanykh tretikh moliariv nyzhnoi shchelepy. Visnyk problem biolohii i medytsyny. 2017;1:352-355. [in Ukrainian].
17. Khalafian AA. STATISTICA 6.1. Statystycheskyi analyz dannikh. Moskva: «Bynom-Press»; 2007. 512 s. [in Russian].

«Bulletin of problems biology and medicine» Issue 1 (163), 2022 year, 230-234 pages, index UDK 616.314.7 – 007: 616.716.4 – 089: 616.153

10.29254/2077-4214-2022-1-163-230-234