Method for treating dystopic half-retained and retained wisdom teeth on the mandible

FIELD: medicine.

SUBSTANCE: method involves making local anesthesia. Angular or trapezoid incision is done. Mucoperiosteal flap is separated. Projecting spongious bone tissue is withdrawn above the tooth crown, between the crown, roots and cortical plate from external and lingual surface with the exception of inferior surface. The tooth is extracted. The bone cavity is filled with Colapola KP sponge and 1-2 Alvostasa sponges. 1-2 apposition catgut sutures are placed. Laser radiation therapy is administered at the second day after the operation once a day for 3 min using Optodan apparatus. The first apparatus channel is used during the first 3 days, and the second one during the following 3 days.

EFFECT: enhanced effectiveness of treatment; accelerated healing process.

 

The invention relates to medicine, namely to dental surgery.

The known method of treatment, namely, that after the local anesthesia and incision (angular or trapezoidal) and exfoliation of the mucoperiosteal flap, remove overhanging the bone over the crown of the wisdom tooth, saw the crown fully or divide it into 2-3 pieces and remove them. Then proceed to the separation of the roots with cutters, burs and direct Elevator removed individually with mezhkornevoy root partition. Postoperative wound (well) wash solution with antibiotics and tightly sewn nylon thread ("fundamentals of operative dentistry", Kiev, 1970, 1983-1984, p.142, Wiernosci).

This method has drawbacks: traumatic surgery, frequent complications, sometimes fatal.

The technical result of the invention is to reduce the morbidity, reduced operative time, acceleration of healing of surgical wounds and regeneration of bone tissue.

The technical result is achieved by the fact that after local anesthesia, incision (angular or trapezoidal), exfoliation of mucoperiosteal flap and removal of bone over the tooth, exposing the crown of the wisdom tooth and using boron remove bone (spongy) mezhdunarodnoi, the roots of the wisdom teeth and the cortical outer and lingual surfaces, i.e. almost completely released from the bone of the lower jaw, except for the bottom surface. Then, using a direct Elevator and plane forceps to extract the wisdom tooth from the hole. After hemostasis, the hole is filled sponge "kolapola KP and 1-2 sponges "Alvostaza." The mucosa superimposed 1-2 guiding catgut suture. Patients assigned to conventional prophylactic anti-inflammatory therapy: lincomycin - 1 capsule three times a day, 8 hours, suprastin 1 tablet at night, calcium gluconate 2 tablets 3-4 times a day. On the second day after surgery, removal of wisdom teeth and for 3 days appointed by laser using, for example, the unit "Optodan" on the first channel for 3 minutes and the next 3 days on the second channel, also within 3 minutes.

EXAMPLE:

The patient, the medical history, number C-501, born in 1982 he entered stomatologica ugma them. NEC 27.11.03, with complaints about the presence of aching pain in the area deportivareglas wisdom tooth on the lower jaw on the left side, radiating in the region 3.7.

Medical history: the Patient said that about a year ago there was swelling and severe pain in the left lower jaw, limited mouth opening, painful swallowing. On the Les independent of anti-inflammatory treatment of a pathological process was stopped, but there were nagging pains that radiate to the area of the second molar. Turned to the dental clinic, ugma them. NEC for consultation and treatment.

Local status: external examination without visible changes. Palpation in the left submandibular region are defined slightly enlarged and slightly painful lymph nodes.

Opening of the mouth free. 3.7 sealed, percussion is painless, in the projection of 3.8 mucosa hyperemic, edematous, palpation painless.

The x-ray exposure (intraoral) is determined by the localization 3.8 in bone tissue in a horizontal position, the crown of which is directed towards the roots 3.7.

Diagnosis: Dystopic impacted 3.8.

The patient is scheduled for surgery on 28.11.03,

28.11.03, Total state and local unchanged.

Operation: Under toryalai anesthesia with 2% lidocaine solution is 6.0 and infiltration anesthesia - ultracain - 1,8 produced an angular cut in the projection of 3.8, debonded mucoperiosteal flap, using boron removed bone tissue covering 3.8 and removed spongy bone between the crown and roots 3.8 and the cortical outer and lingual surfaces. Hemostasis wells, the last full sponge "kolapola KP and sponge "Alvostaza." The mucosa imposed nawaday kathodavid seam. Compressive bandage until the morning chill for 2-3 hours. Assigned to traditional preventive anti-inflammatory therapy: lincomycin - 1 capsule three times a day, 8 hours, suprastin 1 tablet at night, calcium gluconate, 2 tablets 3 times a day.

29.11.03, Complaints about the presence of pain and swelling in the lower jaw on the left lower part of the left cheek, limited mouth opening, T - 38,0°C.

About-but: there is swelling of the soft tissue in the angle of the mandible, the lower part of the left cheek.

Limited mouth opening - lockjaw II degree. Swelling and redness of the mucous membrane, as well as tenderness to palpation in the recovery area. Postoperative lavage of antiseptic solutions, laser therapy on the first channel for three minutes, for example, the unit "Optodan" 1 times a day.

1.12.03, Total state and local unchanged. T - 37,5°C. Washing n/wound with antiseptic solutions, laser therapy for 3 minutes.

2.12.03, Complaints about the presence of weak pain and swelling in the left lower jaw. T - 37,0°C.

About-but: Swelling of the angle, the lower part of the left cheek fell, but held. The mouth opening is more limited - lockjaw first degree. A slight swelling of the mucous membrane in the recovery area.

Washing n/wound with antiseptic solutions, aerotherapy 3 minutes.

3.12.03, no Complaints. T - normal. Laser on the second channel for 3 minutes.

4.12.03, Total state and local unchanged. T - normal. Laser therapy for 3 minutes.

5.12.03, no Complaints. T - normal.

About-but: healing n/wound with initial tension, laser therapy for 3 minutes.

29.12.03, Re-examination, made control x-ray

- is determined by a uniform filling holes bone.

29.01.04, Re-examination, made control x-ray

- determined the complete filling of the holes bone.

The proposed method is less traumatic, reduces operative time, accelerates wound healing and regeneration of bone tissue, contributes to the prevention of complications, both local and General.

The method of treatment and dystopic poluretenirovannyh impacted wisdom teeth in the lower jaw, which in the local anesthesia, angular or trapezoidal section, exfoliation of mucoperiosteal flap and removal of bone hanging fabric over the crown of the tooth and physiotherapy, characterized in that the removed bone spongy tissue between the crown, roots and cortical plate of the outer and lingual surfaces, except for the bottom surface, then removed the tooth with subsequent C the complement of the bone cavity one sponge "kolapola KP and one or two jaws "Alvostaza" and the imposition of 1-2 leading kathodavid seams, by appointment on the second day after surgery wisdom tooth extraction therapy using the apparatus "Optodan", once a day, for 3 min in the first 3 days on the first channel of the device, the next 3 days on the second channel of the device.



 

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