Abstract
Objective – improving the effectiveness of treatment of patients with retention and dystopia of the third molars of the lower jaw in their horizontal or inverse position by developing an integrated approach using photodynamic therapy and drugs that enhance osteogenesis (platelet autoplasma enriched with i-PRF fibrin and recombinant morphogenetic protein (rhBMP-2). 82 patients with difficult eruption of third molars of the lower jaw aged 19 to 37 were included in research: 40 (48.8%) men and 42 (51.2%) women. The standard approach to performing operations of atypical removal of retined third molars causes a significant number of complications (large bone defects, inflammatory contracture, post-traumatic neuritis, etc.). Treatment process was provided in two stages. During the first (preoperative) stage sanitation was done to eliminate or stabilize an acute infection which is inflammatory process in the area of impacted third molar. The second stage provides abscessed tooth extraction, wound sanitation, formed defect filling with osseo-inductive medications under the collagen membrane and complete closure. The developed surgical method for treating retention and dystopia of the lower third molars using biomaterial based on demineralized bone matrix (BCP) saturated with recombinant morphogenetic protein of bone rhBMP-2 can reduce the occurrence of postoperative inflammatory complications by 35.4%, and also reduce the time for their elimination as well.
Highlights
Effectiveness of morphogenetic protein rhBMP-2 use in atypical third mandibular molars extraction
Despite the progress in treatment modes of impaction and dystopia of the third mandibular molars, the incidence of postoperative complications connected with complex abnormal extraction remains sufficiently high [4]
Healthy patients with diagnosed according to ICD-10 third molar abnormality (K-07.35 impacted teeth with improper mandibular angle and mandibular ramus) were selected for the study. 64 (83.9%) patients were diagnosed with horizontal type of eruption with medial angulation and 8 (16.1%) patients with vertical type of eruption with mesial angulation
Summary
Effectiveness of morphogenetic protein rhBMP-2 use in atypical third mandibular molars extraction. The developed surgical method for treating retention and dystopia of the lower third molars using biomaterial based on demineralized bone matrix (BCP) saturated with recombinant morphogenetic protein of bone rhBMP-2 can reduce the occurrence of postoperative inflammatory complications by 35.4%, and reduce the time for their elimination as well. Ефективність застосування морфогенетичного білка кістки rhBMP-2 при атиповому видаленні третіх молярів нижньої щелепи. In order to prevent inflammatory complications in pre- and postoperative period different antiinfective external (antiseptic) and general (antibiotic) drugs are used Despite their broad spectrum of action, at the moment of extremely traumatizing impacted third mandibular molars extraction the number of complications varies from 14 to 55% [1]. The search for effective methods of surgical wound sanitation is relevant
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