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OPTIMIZATION OF SURGICAL ACCESS THE LOWER JAW MOLARS
Eshmurodova Farangiz Bakhrom kizi
2nd year clinical ordinator of the Department of Therapeutic Dentistry of the
Tashkent State Dental Institute
https://doi.org/10.5281/zenodo.14048831
Introduction.
To date, there are numerous surgical intervention
techniques that allow for the avoidance of tooth extraction in chronic
periodontal processes. However, surgical revision in the area of multi-rooted
teeth leads to bone loss in the surgical intervention zone, increases the risk of
vascular-nervous bundle damage, and prolongs the treatment duration for
patients. In this regard, the search for new methods to optimize treatment is a
pressing task.
Objective:
Improving surgical access in the mandibular molar region to
reduce surgical trauma.
Materials and methods
. Conducted examination and surgical
intervention of 21 patients with diagnoses: chronic apical periodontitis, root
cyst. Patients were divided into two groups the study groups: group 1 (n=11)
used a method with minimal trauma access, involving the formation of a bone
block using a piezo-surgical apparatus, followed by its placement on the site
.
The peculiarity of this method is convergence of the angles during bone
preparation in the direction of the removable object, which facilitates the
separation of the bone fragment and its adaptation during transplantation. The
inclusion criterion for patients in this group was the presence of a dense
compact plate of the lower jaw in the area of the molars. In the 2nd group
(n=10), access to the apical part of the roots was performed using the traditional
method. The regimen and recommendations for patients after surgery were the
same in both groups. Sutures were removed on the 7th day. Clinical assessment
of the early postoperative period was carried out according to the following
criteria: severity of pain syndrome using a visual analogue scale (VAS) on the
3rd and 7th days after surgery; the presence and degree of hyperemia of the
mucous membrane of the marginal gingiva; severity of edema; divergence of
sutures. To assess the immediate and remote results of surgical treatment,
clinical and radiological (targeted intraoral radiography on the HelioDent Plus
Sirona intraoral device with the XIOS Plus USB X-ray visiograph manufactured
by SIRONA Dental Systems GmbH, Germany, SIRONA Dental Systems GmbH,
Fabrikstrasse 31, D-64625 Bensheim, Germany) studies were conducted before
THEORETICAL ASPECTS IN THE FORMATION OF
PEDAGOGICAL SCIENCES
International scientific-online conference
25
the operation, immediately on the 1st, 3rd, 7th day after it, 6 and 12 months
after the surgical intervention. In patients of both groups, the densitometric
bone density was determined before the operation, 6 and 12 months after the
surgical intervention.
Results and discussion.
After creating access to the apical part of the lower jaw
molars using the traditional technique, a significant bone defect was noted,
indicating the longest regeneration process in the surgical intervention area. The
most intense pain was noted by patients in the control group in the first 3 days
after surgery (range 5-6 points). It was in this group that a frequent need for
painkillers was noted. The severity of edema in this group significantly prevailed
over the study group. Pain syndrome in patients of the 1st group was noted on
the day of the surgery and the next day (range 3-4 points). Analysis of targeted
intraoral radiovisiography in the control group is 108±5 units, indicating bone
restoration in the surgical area, but its reduced density. In the study group -
137±5, which proves complete vascularization of the bone block and a slight
decrease in bone density after surgery. According to the results of the study,
patients in group 1 had the most favorable postoperative period. In the early and
late postoperative period, no significant complications were observed in
patients.
Conclusion.
The introduction into clinical practice of an improved method of
surgical access to the apical part of the roots of lower jaw molars allows to
significantly reduce the risks of postoperative complications, shorten the
treatment time and intensity of postoperative pain.
