The use of immediate implantation (directly into the extracted tooth socket) in the aesthetic zone is a rather difficult task due to the specific structural features of the bone tissue of the alveolar processes and parts of the jaw. The aim of the study was to develop and evaluate the efficacy of the new method of immediate implantation during restoration of teeth in the anterior part of the jaw with bone deficiency, which allows obtaining a high aesthetic result. Materials and Methods. The clinical study involved patients with partially edentulous anterior maxillae, chronic apical periodontitis and dental root fractures in the absence of possibility to restore these teeth with orthopedic structures. To identify the main criteria determining smile aesthetics, the detailed analysis of changes in the bone and soft tissues of the alveolar processes was made based on tooth extraction causes and dates. These criteria included gum biotype, the height of the distal and mesial interdental papillae; the width of the keratinized attached gingival area, gingival zeniths, the alveolar ridge thickness. The condition of the facial alveolar bone wall in the planned intervention area was assessed and its thickness was measured using cone-beam CT scan of the jaw. These parameters were measured during traditional immediate implantation, immediate implantation with a free connective tissue graft, implantation performed using the method developed by the authors and during delayed implantation in the anterior part. In each patient, the obtained data were compared with the results in the respective teeth area on the opposite side before the surgery, 4, 6 months and 1 year after the surgery. Results. Clinical and X-ray studies of the developed method of immediate implantation in the aesthetic zone of the jaw with bone deficiency in the facial alveolar bone wall have convincingly demonstrated its efficacy in the long term (1 year after the surgery). The proposed protocol has made it possible to reduce the length of rehabilitation time, and most importantly, to stabilize and preserve the alveolar ridge architecture. Conclusion. The proposed method showed the promising outlook for dental implant-supported restoration in difficult anatomical conditions.
Relevance. The main aim of this article is determining the possibilities of clinical application of the infrared thermometry method in order to identify, predict and correct early complications such as ischemic and necrotic process after vestibuloplasty surgery using free gingival graft.Purpose. To determine the possibility of using the infrared thermometry method to study the regeneration processes of the mucous graft after vestibuloplasty surgery using free gingival graft.Materials and methods. 34 patients with a thin biotype and a small vestibule of the oral cavity. The vestibuloplasty was indicated. Depending on the choice of the method of surgical treatment, vestibuloplasty with/ or without free gingival graft, all patients were divided into 2 groups. And the 3rd (control) group consisted of patients with similar clinical picture for control data. Particular attention was paid to the healing process in the early postoperative period on days 1, 3, 7, 14. Patients were examined using a CEM-ThermoDiagnostics infrared thermometer.Results. The study confirmed the high clinical efficacy the both surgical methods of vestibuloplasty with/ or without free gingival graft. We did not registrate negative temperature values indicating the development of ischemic process which can lead to necrosis. We have diagnosed correlation between temperature values and clinical pictures.Conclusion. Using of IR-thermometry is an effective method for examination of the healing process after vestibuloplasty using with/ or without free gingival graft. It can show processes of revascularization of free gingival graft and examine some inflammation. This is the additional method of research, but in combination with clinical picture, it can be proposed as an accurate criterion for predicting early ischemic complications.
The paper presents short and long-term results of surgical treatment of 80 patients with insufficient attached gingiva. The procedures included vestibuloplasty and gingival plasty with perfluorane and free gingival and subepithelial connective tissue grafts. Proposed surgical treatment method with perfluorane proved to reduce the local inflammatory reaction greatly thus decreasing perioperative morbidity and increasing the long term efficacy of treatment.
Is studying and control of the clinical efficacy and safety of ketoprofen lysine salt (КLS) (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in the form of sachets and solutions for application in postoperative period after dental surgeries procedures. The comparison of the analgetic effect of systemic and local forms of the "Oki" drug, depending on the type and extent of surgery procedures. Was carried out surgical treatment and patients examination in the postoperative period. Surgical procedures included: vestibulolasty, vestibulolasty with apically-displaced flap, vestibulolasty with apically-displaced flap and a free palatal mucogingival graft, removal impacted and dystopic teeth, periodontal surgery. The research was conducted in the Surgical stomatology and Maxillofacial surgery Department (stomatological policlinic of the Nizhny Novgorod State Medical Academy). Was noted rapid advanced of anesthesia when using sachets and solutions of the ketoprofen lysine salt (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in postoperative period after dental surgical procedures. Was noted a more advanced of analgetic effect in the application therapy by DCI solution when open surgical wound presented. Analgetic effect was observed after 20-30 min and was maintained in the postoperative period to an average of 8 hours. Local application sachets and solution of the ketoprofen lysine salt (KLS ), in our opinion, is the most appropriate and is highly effective when open surgical wound presented. Ketoprofen lysine salt (KLS) has a neutral pH and does not irritate the gastrointestinal tract, that determines the safety of its used.
The efficacy of perfluoran submucous administration in the postoperative period in patients with chronic parodontal diseases was studied over the dynamics of indicators of oral fluid antioxidant system and lipids peroxide oxidation. It was established that perfluoran submucous administration during postoperative period increased the efficacy of postoperative wound healing and decreased the risk of disease relapse development.