Improving the efficiency of dental implantation of the upper jaw using the "root membrane" method

Диёра Усманова

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IMPROVING THE EFFICIENCY OF DENTAL

IMPLANTATION OF THE UPPER JAW USING THE "ROOT

MEMBRANE" METHOD

Usmanova(Isanova) Diyora Rovshanbek qizi

Second year master’s student

of surgical dentistry and dental implantology, Diyora.isanova.97@bk.ru

https://doi.org/10.5281/zenodo.6034318

ARTICLE INFO

ABSTRACT

Received: 15

th

December 2021

Accepted: 15

th

January 2022

Online: 05

th

February 2022

The article discusses the role and importance of

phraseology in the development and enrichment of speech in

primary school students. The influence and special role of
phraseology in increasing the clarity and effectiveness of speech

was also analyzed because the speech of primary school

students was norrow.

KEY WORDS

Phraseology, richness of
speech,

integrity

of

meaning,

expression,

stable connection, speech

development

One of the limiting factors for the

widespread implantation is the insufficient
volume of bone tissue for the installation of
the implant.[1] The process of dental
implantation into the frontal part of the
upper jaw, which is atrophied at a high
level or accompanied by a vertical fracture
of the teeth, requires additional bone
products and a long rehabilitation period,
the reason for this is, that the vestibular
plate of the frontal part of the upper jaw is
thin and it is characterized by a fracture
during tooth extraction.[2] Bone atrophy
after tooth extraction is one of the most
important issues of modern dentistry, since
significant atrophy of the bone tissue of the
jaws makes it impossible to perform
intraosseous implantation, and also creates
serious difficulties in the orthopedic
treatment of patients.[3]

The purpose of the study.

The study of

dental implantation using the "root
membrane" method in the upper jaw to

increase the efficiency of preservation of
the dental-alveolar segment.

Research objectives:

1. The study of dental implantation by the

“root membrane" method carried out due

to complications of caries or fracture of
teeth on the example of clinical,
radiological and laboratory parameters.

2. Comparison of the results of the

indicators of the traditional method and
the "root membrane" method, to improve
the efficiency of preserving the dental-
alveolar segment.

Materials and methods :

We treated 22

patients, aged 35 to 50 years, who came to
us for dental implantation with partial
dental adentia in the anterior part of the
upper

jaw,

with

chronic

apical

periodontitis and a tooth root fracture
when it was impossible to restore these
teeth with orthopedic structures.. There
are 12 men and 10 women among them.

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Methods

: Clinical research methods,

Radiation research methods (CBCT),
Histological research methods.

Clinical example
The patient is 45 years old. Complaints:

pain in 21 teeth; fracture in the crown of
the tooth; the remainder of 1/3 of the
crown of the tooth. Diagnosis: Chronic
periodontitis of the 21st tooth.

Treatment plan: Traditional immediate

implantation

Figure 1. Figure 2.

Figure 1. Fracture of the crown part of the

21st tooth, there are traces of filling
material, it is clear that the tooth is not
subject to endodontic treatment. After
antiseptic treatment in the oral cavity, local
infiltration anesthesia was performed.

Figure 2. With the help of the ironer tool,

the ligaments around the tooth were
detached and with the help of the luxator,
the tooth was loosened.

Figure 3. Figure 4.

Figure 3. The tooth is removed. Curettage

of the tooth well was performed. With the
help of implantalogical instruments, the
places for the implant was prepared.

Figure 4. Implant placement in the places.

Figure 5. Figure 6.

Figure 5. The upper part of the implant

was closed with a plug. Figure 6. The space
around the implant was filled with
additional synthetic bone material and free
connective tissue taken from the palate.

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Figure 7. Stitches are placed on the

wound

The "root membrane" method

This method is also known as partial

extraction

therapy,

root

membrane

method, and partial root retention. It is
aimed at preserving two-thirds of the
buccal part of the root in the nest so that
the periodontium, along with the bundle
bone and the buccal bone, remains
intact.[4] The buccal bone has a bilateral
blood supply from the gum from above and
the periodontal from below. After tooth
extraction, the buccal bone is deprived of
blood supply from the orbit, and this leads
to the loss of part of the buccal bone. The
root section preserves the periodontal
attachment apparatus, which includes the
periodontal ligament (PDL)[5], attachment
fibers, vascularization, root cement, bundle
bone and alveolar bone. The root fragment
remains vital and intact and prevents the
expected remodeling of the nest after
extraction, as well as supports the
cheek/facial tissues.

A clinical example using the root

membrane method

The patient is aged 35 years. Complaints:

pain in the 12th tooth; fracture in the
crown of the tooth; aesthetic discomfort.
Diagnosis: Chronic periodontitis of the
12th tooth (entodontic treatment is
unprofitable).

Treatment plan: Implantation by Root

membrane method.

Figure 8. Overview of the patient's oral

cavity from different angles

Figure 9. Separation of the vestibular and

oral fragment of the root of the 12th tooth.

Figure 10. Removed oral fragment of the

12th tooth.

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Figure 11. Mechanical and drug treatment

of the fragment vestibular root. The bed for

the implant has been prepared. Figure 12.

An implant is installed in the prepared

places.

Figure 13. A gum shaper is installed on the

implant. Stitches are supplied. Figure 14. X-

ray image after implant placement

Research results:

In the postoperative period, the patients
underwent antibacterial therapy for 5-7
days, if possible taking into account the
sensitivity of the seeded microflora. The
patients

complained

only

of

a

postoperative wound, moderate pain and
swelling. Soreness in the area of the
surgical wound stopped for 2-3 days. The
skin and oral mucosa in the area of the
surgical field are clean, not hyperemic.
Moderate swelling of soft tissues was
observed in the wound area for 2-3 days.
The patients were given daily irrigation of
wounds. The stitches were removed on day
7-8.
When checking patients who were treated
by the traditional method, it was

determined that 2.6 ± 1.5 months were

spent for osseointegration. the methods are

set. In addition, osteoresorption was
observed in the vestibular plate, that is,

changes from 11.14± 1.2mm were
observed before surgery and up to 6.8±

1.5mm after surgery. At the same time,
changes in the interdental papillae and the
zenith of the gingival contour, changes in
the biotype of soft tissues, fixation of the
vestibular bone wall contributed to a
decrease in aesthetic results. At the same
time, when carrying out the established
methods of checking patients treated with
the root membrane method, it was

revealed that it took 1.8 ± 0.7 months for

osseointegration. In addition, noticeable
changes

were

detected

during

osteoresobtion of the vestibular plate, i.e.
before s

urgery 9.14 ± 0.8mm and after

surgery 8.6 ± 0.2mm.

Thus, it can be said that the operation leads
to

continuous

and

predictable

osseointegration by minimizing the loss of
cheek bones caused by the remodeling of
the socket, which occurs after extraction.

Conclusion:

As the study shows, the reason is that when
a fragment of the buccal root is
intentionally left, the blood supply will be
maintained

uninterrupted,

and,

consequently, the dimensions of the
alveolar process can be preserved. Based
on these data, we can conclude that the
root membrane method is a safe treatment
method that ensures a high percentage of
implantation success. In addition, this
unique technique can ensure the stability
of the size of facial and soft tissues around
the implantation site without the use of
additional biomaterials, such as bone
grafts. The dental fibers preserved in the
root fragment enhances the aesthetics of
soft tissues when they are in the process of
aesthetic immediate implant placement.

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List Of Used Literature:

1.

О.А. Мукимов, Д.Р. Исанова // Сравнительная характеристика метода корневой
мембраны и традиционного (одномоментного) метода установки имплантата/
Молодой ученый. –

2019.

–

№ 13 (251). –

С. 8

-89. [

PubMed

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2.

Усманова Д.Р.,Муқимов О.А., Диего Лопс, Мукимова Х.О., Тургунов М.А.,

//