Abstract
Abstract. This paper presents arguments about the possible iatrogenic eff ect during odontological or reconstructive surgical interventions on the dental- maxillary system, taking into account the morphological variability and topography of the mandibular canal(s) while maintaining the functionality of its (their) morphological structures.The aim of the study is to substantiate the necessary understanding of the peculiarities of morphological variants and laying the mandibular canal(s) in order to preserve the morphological and functional properties of its (their) structures during dental conservative and surgical interventions.Material and Methods. The screening of 1000 digital segmental records of X-ray examinations of the human lower jaw aged 25-75 years was conducted, and 58 of them were identifi ed, refl ecting the iatrogenic eff ect on its foliar morphological structures.Results and Discussion. Due to its mechanical and long-term chemical action, odontological iatrogenicity is characterized by twofold pathoetiological signs of infl uence on periapical and adjacent morphological formations. During mechanical action, the primary pathological manifestation is ischemia, in this case of the neurovascular bundle, with varying degrees of damage, which will later be refl ected in the reversible or irreversible, or conditionally reversible (anastomosing) recovery. In the case of chemical action, there are manifestations of destructive changes with a progressive degree of necrosis, depending on the origin and concentration of the etiological factor, which in most cases, becomes irreversible. Pathological processes and atrophy of the mandibular bone tissue caused by the loss of the masticatory group of teeth reduce the diagnostic diff erentiation of the anatomical and topographic features of the mandibular canal(s).Conclusions. Misunderstanding of individual anatomical variants and topography of the mandibular canal(s) during X-ray examinations to plan dental surgical interventions leads to damage to its morphological structures. Any traumatization of the neurovascular bundle laid in the mandibular canal(s) is expressed by proprioreceptive disorders in the areas of its innervation, primarily infl ammatory- resorption processes, due to a violation of their nutrition. The degree of iatrogenicity depends on the aggressiveness of the pathoetiological factor and the summation of its action over time, as well as on the morphology of the mandibular canal system, which can take on the function of «relative compensation»
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