S.G. Bezrukov ,V.R. Moroz, V.V. Moroz

Crimea state medical university named after S. I. Georgievsky, Simferopol.

 

Clinical and radiographic evaluation  of efficiency the  method of  intraoperative prophylaxis of postextractive alveolar bone atrophy  using bioresorbable membrans

 

 

         One of the  basic  problem of the  first stomatological aid provision is recovery of  integrity of the dentition , that achieved by use  the orthopedic constructions with fixation  on alveolar bone , teeth , and implants.  But,  because of  next  atrophy and deformation of alveolar bone , prosthetics  ger difficult –  is deteriorates  the quality of fixation  and aesthetic characteristics of prostheses. The applying direct tissue regeneration  by local use of bioresorbable membrans biological and synthetic  origin allow to achieve satisfactory result as optimization of conditions for processes of  bone formation in the hole tooth extraction.

          The purpose of investigation – is to prevent the developing of postextractive atrophy of alveolar bone by intraoperational use of  bioresorbable membrans based on FRP.

       Materials and methods

        The investigation included  36 patients with chronic and  aggravated chronic peridontitis od teeth of frontal group. The patients were divided by the method of closing hole tooth extraction . The patients of main group (12 people) closed the alveole  by membrabe based on FRP. The patient of first control group  the alveole of extract tooth closed by synthetic  membrane BioGide. In second control group not used  any foreign materilas – the alveole healed on its own under blood clot. Results estimated by use

 radiographic method investigation .

       Patients of main group the alveole closed by membrane, performed from platelet rich plasma.

        Results of investigation and analysis

      At the next day after opeation all patients in all groups of comparation noticed  insignificant soreness of soft tissues in surgical injure. On 3rd  day of treatment in 9 patients of second control group  observed expressive and moderate posttraumatic edema, and hyperaemia of mucosa , soreness  of soft tissues during palpation. Narrowing of local inflammatory reactions in 9( 75 % ) patients in second control group observed just on 6-7 day. In last 3 (25%)  of patients, at the background of developing alveolitis, the local inflammamtory reactions decreased   by 10 day of postoperative period.

     In first control group , where the alveole of extracted  tooth closed  by membrane Bio-Gide, on 3-5 days after operation noticed  moderate posttraumatic edema in 5 patients ( 41,7 %), not significant hyperaemia of mucosa in extracted tooth  - in 7 patients (58,3 %) . The weakly expressive soreness during the palpation of soft tissues in area of surgical injure was  oticed in all patients of this group. 

       In main group , where the postextractive  alveole closed by membrane based on FRP, on 3-5 day after tooth extraction noticed the absence of posttraumatic edema  and hyperaemia of mucosa in place of trauma.

      The estimation of indexes showed that the most formed bone determined in 3-6 month of observation.

    We can make a conclusion, that use the barrier  membrane in postextractive period optimizate rates of  bone formation by osteoinductive and osteoconductive properties  and promotes the prophylaxis of atrophic processes.

Conclusions:

1.     The dynamics of the change of local clinical symptoms in groups of observation testified by , that  the less expressive local inflammatory reactions to  surgical injure  registrated in patients of main group, where used membrane based on FRP.  The more expressive inflammatory processes in condition of use barrier membrane Bio-Gide. The most expressive and prolonged effect characterised by local inflammation in case of traditional conduct of postextractive alveole under blood clot

2.      Radiographic indexes demonstates high rates  of osteogenesis in patients of main group with use FRP-technology, with completion of processes of mineralization of regenant after 6 month after tooth extraction. The healing of alveole under blood slot accompained more slow osteogenesis. The first signs of  immature bone tissues formation  appeared by 6 month.