RECONSTRUCTIVE AND REGENERETIVE REPAIR OF THE BONE DEFECT AFTER THE IMPACTION THIRD MOLARS EXTRACTION ON THE LOWER JAW

Abstract

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.

Keywords

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