Optimization of postoperative protocol and diagnosis of inflammatory complications of post-extraction wounds at the stages of prosthetic rehabilitation

Abstract

Was to optimize the protocol for postoperative orthopedic management and diagnosis of wound healing zones in patients after multiple teeth extractions. At the Department of Orthopedic Dentistry and Orthodontics, Ryazan State Medical University, orthopedic treatment of 30 patients was carried out after the extraction of upper teeth. Patients were divided into 3 groups depending on the used immediate prostheses: (I) traditional, (II) having a shock-absorbing polypropylene mesh in their design, (III) having a drug reservoir made of elastic plastic and a ring made of monomer-free plastic in the region of the closing borders prosthesis. To assess the effectiveness of treatment, patients on days 5, 10, 20 underwent diagnostic supravital staining of the mucous membrane using an iodine-containing solution, planimetric control, and computerized capillaroscopy. In group I by the end of the observation period a pronounced dynamics of inflammation persisted in 30% of cases, the objective signs of which amounted to 12.5±2.06 mm2 of the area of the positive indicator of supravital staining, while in group II it was 7.2±2.09, in group III - 8.3±1.41 mm2 (p≤0.05). According to the results of supravital staining and capillaroscopy at day 20, in group II morphological and objective indicators of inflammation productivity were significantly higher than in group III: the density of the vascular network in group II was 52.5±2.17, in group III - 46.3±2.4 capillary loops/µm2, staining area 7.2±2.09 and 8.3±1.41 mm2, respectively (p≤0.05). More active wound healing in patients of group II was achieved by optimizing the design of the immediate prosthesis. An accessible and objective assessment of the severity of inflammation using vital staining allows you to accurately assess the dynamics of wound healing with a blurred or unexpressed clinical picture and timely suggest the features of inflammation to correct the course of treatment.