EXPLORING CYTOLOGICAL ASPECTS OF SOCKET HEALING OPTIMIZATION AFTER ATYPICALREMOVAL OF THE THIRD LOWER MOLAR

Abstract

This study aims to investigate the cytological characteristics of socket healing after atypical removal of the lower third molar, utilizing osteoplastic synthetic material in conjunction with platelet-rich gel and plasma enriched with thrombocyte factors, to enhance local osteogenesis. Materials and Methods For this comparative clinical study, smears of alveolar content were collected following atypical extraction of the lower third molar. Cell elements were quantified for cytological analysis. Data collection utilized a template developed in Microsoft Excel version 16.34. Statistical processing was performed using RStudio 2023.03.1 Build 446 (Posit Software, PBC). Smears were air-dried, fixed in a 1:1 mixture of alcohol and acetone for 5 minutes, stained first with May-Grünwald’s methylene blue (15 minutes), followed by Romanowsky-Giemsa’s azure-eosin stain (30 minutes). Smear images were captured with the Leica morpho densitometric complex: DM 1000 microscope, DFC-320 camera, images were obtained in jpg format at 400x magnification. Results The study encompassed 30 patients divided into control and experimental groups. Cytological analysis was conducted on the 2nd, 5th, and 10th days of post- operation. In both groups, on the 2nd day, alveolar smears showed the presence of erythrocytes (n = 6) and neutrophils (n = 2). On the 5th day, the experimental group exhibited neutrophils (n = 3) and abundant cocci microflora (n = 6). On the 10th day, epitheliocytes (n = 8) primarily indicated proliferation. Conclusions The obtained results underscore the effectiveness of employing osteoplastic synthetic material in combination with plateletrich gel and plasma enriched with thrombocyte factors for enhancing local osteogenesis following atypical removal of the third molar. This approach demonstrates significant elevation in epithelialization activity, fibroblastic activity, and other markers of the reparative process in comparison to the control group.