EFFECTS OF BONE AUGMENTATION MATERIALS ON PECULIARITIES OF POSTOPERATIVE PERIOD IN PATIENTS AFTER IMPACTED THIRD MOLAR EXTRACTION AND THEIR CLINICAL EFFICIENCY

Abstract

The article presents a comparative analysis of the clinical effectiveness of bone augmentation materials, in particular, compositions including multipotent mesenchymal stromal cells of adipose tissue and platelet-enriched plasma, used to fill bone defects during the operation of third molars extraction. The criteria for the effectiveness of treatment at the stage of the early postoperative period in the participants included the assessment of the pain intensity, collateral oedema and hyperaemia of the oral mucosa after the surgery. The aim of the study is to determine the clinical efficiency of osteoplastic materials and to determine the feasibility of using tissue equivalents of bone tissue based on multipotent mesenchymal stromal cells of adipose tissue for healing of bone defects in patients with impacted third molars. Methods and participants. The study was conducted on the basis of the Department of Surgical Dentistry and Maxillofacial Surgery of Bukovynian State Medical University, Chernivtsi, Ukraine. Extraction of impacted third molars surgery was performed on 72 patients. After the tooth extraction, 31.94% of them underwent bone augmentation by osteoplastic material “Colapan–L” (group A); 41.67% of patients had bone augmentation with a combination of multipotent mesenchymal stromal cells of adipose tissue+”Colapan–L”+platelet-rich plasma (group B), and in the rest, 26.39% of patients, wound healing occurred under a blood clot (group C). Postoperative pain syndrome was assessed using the Numerical Rating Scale (NRS) based on patients' subjective feeling of pain. Visual assessment of the severity of collateral oedema and hyperaemia of the oral mucosa after surgery was also performed. A scoring system was used to determine the severity of collateral oedema. To assess the state of the postoperative period in patients of all study groups, a protocol was completed daily during the hospital stay period that reflected the most important data of an objective and subjective nature.
 During the procedure of morning dressings, we analyzed patients' complaints and evaluated general and local status: presence of appetite, quality of sleep, wound pain, postoperative oedema, hematoma, and hyperaemia of the oral mucosa, presence of secretions from the wound, body temperature, and type of wound healing. The study has demonstrated that at the final stage of postoperative follow-up the 89.31% of patients who received a combination of “Colapan–L” with multipotent mesenchymal stromal cells of adipose tissue and platelet-rich plasma reported no pain that is 1.2 times p1<0.05 and 1.3 times p2<0.05 higher than in the patients of groups A and B. Collateral oedema was absent in 98.47% of the group B patients that exceeded 1.2 times p1<0.05 the number of such individuals in group A, where the bone defect was augmented with the osteoplastic material “Colapan–L”, and in 1.4 times higher, p1<0.01, p1>0.05 that the indicators of group B, where the healing of the bone defect developed without osteoplastic materials. The absence of hyperaemia of the oral mucosa was found in 92.37% of the patients in groups B, which was 1.3 and 1.4 times higher than the values obtained in groups A and B, p1<0.05, p2<0.01.