EXPERIENCE OF USING OSTEOPLASTIC MATERIALS FOR PREVENTING BONE ATROPHY AFTER TOOTH EXTRACTION IN WOMEN

Аннотация

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:osteoplasticmaterials, toothextraction, bonetissueatrophy. INTRОDUСTIОN The modern stage of development of dentistry is characterized by rapid improvement of methodsof replacement ofdefects ofdental rows. Dental implantation has acquired aspecial 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 ofresorption and neoplasm. MАTЕRIАLSАND MЕTHОDS Bone resorption occurs under the action of osteoclasts, and new bone matrix is ​ ​ deposited byosteoblasts. The predominance ofbone resorption is possibleif thebone 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 optimaltreatment result toeliminate thealveolar bonedefect after tooth extraction surgery is apressing issue. RЕSULTSАNDDISСUSSIОN 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: 52dueto chronic periodontitisand 15dueto longitudinal root fracture. Under local anesthesia, the tooth extraction was performed atraumatically using an Implantmed drill with a physiodispenser, periotomes and microsurgical instruments. The 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 ,hcraM,5emuloV gro.srehsilbupcimedaca.www walls and bottom of the socket were examined using a periodontal probe, and the condition ofthesoft tissues was visually assessed. Accordingtotheclassification, there are 4types of toothsocket 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—2mm, thickness ofthebuccal cortical plate not 5 mm. Thin or thickgingival biotype. This classification allowed us to choose the optimal treatment plan in each individual clinical case. Usinga random sample, patients were divided into3groups after toothextraction: Group 1included 20patients inwhom healing and osteogenesis occurred from a bloodclot; 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 andcollagen. In patients of group I, in 9 cases the parameters were within + 720 H units, in 11 cases — within+745H 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 + 790Hunits,and in5 patients —610H 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 ofbonetissueatrophy aftertooth extraction. 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 ,hcraM,5emuloV gro.srehsilbupcimedaca.www During clinical examination of patients of groups I, II, III afte