КОРРЕКЦИЯ АНОМАЛЬНОГО ПОЛОЖЕНИЯ НИЖНИХ ТРЕТЬИХ МОЛЯРОВ ПРИ ИХ ЗАТРУДНЕННОМ ПРОРЕЗЫВАНИИ

Abstract

Retention of the third lower molars is quite common. Surgery for this pathology is one of the most complicated in ambulatory surgical dentistry and is often accompanied by inflammatory complications. The antiinflammatory drug therapy is used to stop the inflammatory process in the retromolar area, in combination with the pocket rinsing under the operculum with solutions of antiseptics, antibacterial drugs and physiotherapy, as well as the sorbent SUMS-1. The authors proposed an effective method of correction of vestibular and lingual tilt of the lower third molars, allowing them to be preserved. A three-part incision is made on the side of the third molar dystopia under local anesthesia on the background of premedication After acute inflammatory phenomena in the area of an erupting tooth subside,. Then the mucosal-periosteal flap is peeled off from the vestibular and lingual sides of the jaw and the compact plate is perforated with a round bur in a staggered pattern, without penetrating into the cancellous bone substance. The compact plate is perforated only in the area of the root apex of the dystopian tooth on the inclined side; the perforations are made in the projection of the tooth root along its entire length on the opposite side of the inclined tooth. The number of holes depends on the degree of inclination of the tooth and the direction of movement. The operating wound is washed with a suspension of the sorbent SUMC-1 in physiological solution of sodium chloride in a ratio of 1:2 after the weakening of the bone tissue. The mucosal-periosteal flap is put on the place and the wound is sutured. After 1-2 days, orthodontic correction of the wisdom tooth position is started. The patient undergoes a selective cusps grinding of the upper and lower eighth teeth and further prescribes mechanotherapy, which consists in pressing on the tooth with the tip of the tongue or finger pressure on the tooth depending on the direction of the inclination. The original method developed for the correction of the abnormal position of the lower wisdom teeth expands the possibilities of preservation and reduces the incidence of inflammatory complications during their difficult eruption.