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EXPERIENCE OF USING OSTEOPLASTIC MATERIALS FOR PREVENTING
BONE ATROPHY AFTER TOOTH EXTRACTION IN WOMEN
Gafurova Dilshodakhon Alisherovna
2nd year master of the Andijan Medical Institute
Abstract:
This article is devoted to the use of osteoplastic materials for the prevention of
bone tissue atrophy after tooth extraction surgery and the assessment of their effectiveness,
as well as the determination of optimal conditions for their use. The study showed that the
use of these materials allows preventing physiological bone tissue resorption under optimal
conditions.
Kеywоrds:
osteoplastic materials, tooth extraction, bone tissue atrophy.
INTRОDUСTIОN
The modern stage of development of dentistry is characterized by rapid improvement of
methods of replacement of defects of dental rows. Dental implantation has acquired a special
role in clinical practice over the last decades [1], in connection with which dentists have
faced complex tasks of preservation of surrounding soft tissues and prevention of bone
tissue atrophy after tooth extraction. It is known that under functional load in the alveolar
bone the process of remodeling constantly occurs: the bone is constantly renewed as a result
of resorption and neoplasm.
MАTЕRIАLS АND MЕTHОDS
Bone resorption occurs under the action of osteoclasts, and new bone matrix is
deposited by osteoblasts. The predominance of bone resorption is possible if the bone is
subjected to a load that exceeds physiological values in strength and duration. However,
the absence of a load on the alveolar bone in the area of a tooth defect after its
extraction also leads to bone tissue atrophy. The literature discusses various methods for the
prevention of bone tissue atrophy, such as the “root immersion” technique, direct
implantation using osteoplastic materials, and orthodontic extrusion [2]. Some authors
discuss this issue about the choice of osteoplastic material - auto- or allo-bone, xeno- or
alloplastic material, and directed tissue regeneration [3]. Predictable achievement of the
optimal treatment result to eliminate the alveolar bone defect after tooth extraction surgery is
a pressing issue.
RЕSULTS АND DISСUSSIОN
The patients were aged from 19 to 55 years. Of these, 23 were men and 39 were women. All
patients were relatively healthy at the time of tooth extraction. A total of 67 teeth were
extracted: 52 due to chronic periodontitis and 15 due to longitudinal root fracture.
Under local anesthesia, the tooth extraction was performed atraumatically using an
Implantmed drill with a physiodispenser, periotomes and microsurgical instruments. The
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walls and bottom of the socket were examined using a periodontal probe, and the condition
of the soft tissues was visually assessed.
According to the classification, there are 4 types of tooth socket defects.
Type 1 - a clean socket of a single-root tooth with intact walls, wall thickness> 1 mm. Thick
gingival biotype.
Type 2 — socket of a single-root or multi-root tooth with minor destruction of the walls,
partition — 2 mm, thickness of the buccal cortical plate not < 1 mm. Thin gingival biotype.
Type 3 — destruction of one or two socket walls from 3 to 5 mm. Thin or thick gingival
biotype.
Type 4 — characterized by the presence of destruction of the socket walls> 5 mm. Thin or
thick gingival biotype.
This classification allowed us to choose the optimal treatment plan in each individual
clinical case.
Using a random sample, patients were divided into 3 groups after tooth extraction:
Group 1 included 20 patients in whom healing and osteogenesis occurred from a blood clot;
Group II included 21 patients who had their tooth socket defect filled with Bio-Gen Putty
bone paste immediately after extraction without separating the mucoperiosteal flap. A cross-
shaped suture was applied to the edges of the socket. This xenomaterial is obtained on the
basis of horse bone and type I collagen with deantigenization, i.e. with the removal of
antigens of animal origin. Group III — 19 patients who had colapol KP-3 inserted into the
tooth socket defect immediately after extraction without separating the mucoperiosteal flap.
Colapol KP-3 belongs to the group of alloplastic materials based on calcium hydroxyapatite
and collagen.
In patients of group I, in 9 cases the parameters were within + 720 H units, in 11 cases —
within + 745 H units.
In patients of group II, complete biodegradation of the material in the area of the socket
defect was visualized in 19 cases, the bone density was within + 950 H units, and in 2 cases
the material biodegradation did not occur completely, the bone density was within + 660 H
units.
Results of CT of group III: in 14 patients — the bone density in the area of socket
defects was + 790 H units, and in 5 patients — 610 H units.
Analyzing the obtained data from the clinical examination of patients and CT, it was
possible to evaluate the effectiveness of the use of osteoplastic materials for the prevention
of bone tissue atrophy after tooth extraction.
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During clinical examination of patients of groups I, II, III after 2 months, complete
epithelialization of soft tissues in the area of the sockets of extracted teeth and painless
palpation were noted. The results of computed tomography (CT) were assessed in patients of
groups I, II, III after 6 months. The Hounsfield scale was used to determine the bone density
at the site of the socket defect.
СОNСLUSIОN
The use of osteoplastic material in a fresh tooth socket is possible only in the absence of an
acute or chronic process in the exacerbation stage of the causative tooth and with atraumatic
performance of surgical intervention.
One of the optimal conditions for achieving successful results of surgical treatment of
patients with a thin biotype is the use of osteoplastic materials to preserve soft and bone
tissues in the area of \u200b\u200bextracted teeth.
The use of osteoplastic materials to replace socket defects after tooth extraction allows
preventing physiological resorption of bone tissue.
RЕFЕRЕNСЕS
1. Ivanov S. Yu., Kuznetsov G. V., Chailakhyan R. K., Panasyuk A. F., Larionov E. V.,
Panin A. M. Clinical implantology and dentistry. SPb; 2011; 3-4 (17-18): 37-40.
2. Kirilova I. A., Sadovoy M. A., Podorozhnaya V. T. Comparative characteristics of
materials for bone grafting. Composition and properties // Spine surgery.–3, 2012.— P. 72-
83.
3. Amler MH. The time sequence of tissue regeneration in human extraction wounds. Oral
Surg Oral Med Oral Pathol 2014; 27 (3): 309-18.
4. Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extractions. An
experimental study in the dog. J Clin Periodontol 2015; 32: 212-8.
