IMPROVEMENT OF FRACTURE SURGERY IN SURGICAL TREATMENT OF PATIENTS WITH GENERALIZED PAR ODONTITIS BY PERIOSTEAL PENETRATION

Abstract

Among all surgical dental diseases periodontal diseases occupy one of the leading places, considering the prevalence of this pathology among the population and its negative consequences (loss of teeth and dysfunction of the dentoalveolar system). The severity of generalized periodontitis, frequent relapses and complications lead to a decrease in the quality of life of patients, significant socio-economic losses, malfunction of chewing and speech. The aim of the study – to increase the effectiveness of surgical treatment of patients with a third degree of severity by improving the individual technological stages of the Teshynsky-Vidman-Neumann operations and activating periodontal cells. Materials and Methods. We operated 46 patients with chronic generalized parodontitis (GP ) of the degree III, who were divided into two groups: group I (20 people), who underwent the traditional modified operation of Tseshinsky-Vidman-Neumann; patients of the group II (26 persons) – underwent modified operation of Tseshinsky-Widman-Neumann, with improvement by penetration of periosteum. After the treatment, it was found that the average rate of the Schiller-Pisarev sample was higher in patients of the group I (2.5±0.05 %) compared with the corresponding index of the group II (0.95±0.04 %). After treatment, the average index of bleeding index was (0.77±0.04) points in the first group and (0.32±0.04) points in the second group. Results and Discussion. In the dynamic X-ray examination of alveolar outgrowthes in patients, in 6 months after the operation, clear signs of osteo-reparative processes were revealed. The slight increasing in the height of the alveolar process by 19 % in patients of the group I and by 40 % in patients of the group ІІ have become the hallmark of this process. With the increasing of observation time in patients of the group II, the structure of the bone changed and differentiated into a mature with a characteristic trabecular pattern, and it did not differ from adjacent bone sites. Consequently, the using of peristaltic penetration in the surgical treatment of patients with a GP of the third degree has advantages over traditional treatment. Conclussions. As a result of the conducted research, the technological part of the modified Teshinsky-Vidman-Neumann operation was improved for the treatment of patients with the GP of the chronic course of the degree III by means of periosteal penetration. Clinical trials found that the number of complications in patients in the group I was 18 %, and II – 11 % of the total number of observations. Radiologically, 6 months after the operation, clear signs of active osteo-reparative processes were revealed, as evidenced bysome increase in the height of the alveolar appendix. The time of passing ultrasound on the maxillary bone decreased by 17.86 % in patients of the group I on the upper jaw and on the lower one – by 17.74 %. In patients of the second group on the upper jaw dropped by 19.3 %, and on the lower one – by 19.05 %.

Keywords

• генералізований пародонтит
• удосконалена клаптева операція
• рентгенологічні й ультразвукові дослідження.