RU2305512C1 - Method for amputating multi-root tooth root in chronic periodontitis cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves making angular or trapezoid incision. Mucoperiosteal flap is separated. Anterior or palatine alveolar wall is removed 2-3 mm downward from alveolar socket edge on mandible and upward on maxilla by means of fissure drill in projection of the root to be removed. The root is exposed and cut with cylindrical drill 2-3 mm below or above the alveolar socket edge. The root is extracted with straight elevator. Antiseptic bone cavity treatment is carried out with sponge Kolapol-KP.in particular cases after having removed granulated tissue. Laser therapy is applied at the second day after the operation with Optodan apparatus once a day during 3 min, the first apparatus channel is used within the first 3 days and the second one within the next 3 days.

EFFECT: prevented gingiva retraction; prevented bone cavity exposure.

3 cl

Description

The invention relates to medicine, namely to surgical dentistry.

A known method of treatment, which consists in the fact that amputation of the root is carried out by first separating it from the bifurcation site. A trapezoidal or angular incision is performed and a mucoperiosteal flap is separated from the vestibular or palatal surface of the alveolar part of the lower jaw or alveolar process of the upper jaw. The root is cut off with fissure boron, removed with forceps, making only rotational movements. In some cases, the anterior bone wall of the alveoli and the cut root are removed using an elevator. Moreover, cooling of the surgical field is also mandatory. After processing the alveoli, the flap is placed in place and fixed with sutures from catgut or polyamide yarn.

To fix the remaining root or roots, filling the alveoli with biomaterials is effective. ("Surgical Dentistry" / Edited by T.G. Robustova, M. "Medicine", 2003, 141 pp.).

This method has disadvantages: there is gum retraction, exposure of the bone cavity and suppuration of the postoperative wound.

The technical result of the invention is the prevention of gingival retraction, exposure of the bone cavity, suppuration of the postoperative wound, acceleration of healing of the postoperative wound and bone regeneration.

The technical result is achieved by the fact that after local anesthesia, an angular or trapezoidal incision, peeling of the mucoperiosteal flap, departing from the edge of the alveoli by 2-3 mm, lower on the lower jaw, higher on the upper jaw, with the help of the fissure boron the front or the palatine wall of the alveoli in the projection of the removed root, the root is exposed and cut off with a cylindrical boron below or above the edge of the alveoli, also 2-3 mm and the root is removed using a direct elevator. After removal of the granulation tissue, an antiseptic treatment of the bone cavity is carried out, which is performed with a sponge “Kolapol - KP”. The mucoperiosteal flap is put in place and fixed with knotted catgut sutures.

Patients are prescribed traditional preventive anti-inflammatory therapy. On the second day after the operation, root amputation is prescribed by laser therapy using the Optodan apparatus, once a day, for 3 minutes, in the first 3 days on the first channel of the device, the next 3 days on the second channel of the device.

EXAMPLE:

Patient M .. medical history No. 6919, born in 1968, was admitted to the dental clinic of the Voronezh State Medical Academy. NN Burdenko 09.21.04, with complaints of aching pain and swelling in the lower jaw on the right.

Anamnesis of the disease: The patient notes that about 2 years ago after tooth treatment in a private dental clinic in the lower jaw on the right, aching pains and slight swelling appeared a year later. The patient was referred for consultation and treatment at the Dental Clinic VGMA named after N.N. Burdenko.

Local status: On visual inspection without visible changes.

The opening of the mouth is free. 4.6 - sealed. In the area of projection of the apex of the medial root 4.6, slight puffiness is determined, hyperemia of the mucous membrane, with palpation it is slightly painful. In the gum area 4.6, a fistulous course is determined. Percussion 4.6 is painless.

Diagnosis: Chronic granulating periodontitis 4.6

Sent to R-graph 4.6

07/22/04. General condition and location unchanged. On the x-ray in the area of the apex of the medial root, the focus of rarefaction of bone tissue with fuzzy boundaries is determined. Appointed for surgery on September 30, 2004.

09/30/04, the patient did not appear.

12.10.04, General condition and local without changes. Appointed for surgery on 10/14/04

10/14/04. General condition and local without changes.

Operation: Under torus anesthesia of 2% lidocaine solution and ultracaine solution infiltration anesthesia - 3.4, a trapezoidal incision was made, the mucoperiosteal flap was peeled off, retreating 2-3 mm from the edge of the alveoli, the front wall of the alveoli was removed to expose the medial root and the distance indicated above is cut off by a cylindrical boron medial root, which is removed using a direct elevator. The curettage spoon removed granulation tissue. An antiseptic treatment of the bone cavity was carried out, which was filled with a Kolapol-KP sponge, the mucoperiosteal flap was put in place and fixed with knotted catgut sutures. Pressure bandage. Chill for 2-3 hours.

Prescribed anti-inflammatory therapy: lincomycin - 1 tablet three times a day after 8 hours, suprastin - 1 tablet at night, Trichopolum 1 tablet 2 times a day (morning and evening).

10/15/04, Complaints of pain and swelling in the region of the lower jaw on the right, t - 37.5.

Objectively: Swelling of the skin is noted in the region of the lower buccal region on the right, in the submandibular and postoperative areas.

Washing the postoperative wound with antiseptic solutions, laser therapy on the first channel of the Optodan apparatus - 3 minutes.

10.16.04. General condition and locally unchanged. Antiseptic treatment of a postoperative wound, laser therapy on the first channel of the Optodan apparatus - 3 minutes.

10/18/04, Complaints of pain in the tooth area when the "thread" from the wound.

Objectively: puffiness decreased in the lower cheek region on the right and in the postoperative region. Antiseptic treatment of a wound, laser therapy on the first channel of the Optodan apparatus - 3 minutes.

10.19.04. General condition and locally unchanged. Antiseptic treatment of a wound, laser therapy on the second channel of the Optodan apparatus - 3 minutes.

10/20/04 There are no complaints. Objectively: puffiness is not noted. Antiseptic treatment, laser therapy on the second channel of the Optodan apparatus - 3 minutes.

10.21.04. General condition and locally unchanged. Removal of the remaining catgut sutures was performed. Healing of the wound by primary intention. Antiseptic treatment of a wound, laser therapy on the second channel of the Optodan apparatus - 3 minutes.

November 14, 04, Re-examination in a month, control radiography was performed 4.6. - the complete filling of the medial root well with bone tissue is determined.

12/14/04, Re-examination after 2 months, X-ray performed 4.6. - the complete filling of the medial root well with bone tissue is determined.

The proposed method of root amputation in chronic periodontitis in the postoperative period prevents gum retraction, exposure of the bone cavity, suppuration of the postoperative wound and accelerates the healing of the postoperative wound and bone tissue regeneration.

The proposed method has novelty, significant differences, therefore, I ask you to protect the invention with a title of protection.

Claims (3)

1. The method of amputation of the root of multi-rooted teeth in chronic periodontitis, which consists in local anesthesia, an angular or trapezoidal incision, peeling of the mucosal-periosteal flap, characterized in that by retreating from the edge of the alveoli 2-3 mm lower - on the lower jaw, higher - on the upper jaw, using the fissure boron, remove the front or palatine wall of the alveoli in the projection of the removed root, expose the root and cut off with a cylindrical bore below or above the edge of the alveoli by 2-3 mm and remove the root using a straight levator. 2. The method according to claim 1, characterized in that after removal of the granulation tissue, an antiseptic treatment of the bone cavity is carried out using a sponge “Kolapol-KP”, by applying knotted catgut sutures. 3. The method according to claim 1, characterized in that on the second day after the root amputation operation, laser therapy is performed using the Optodan apparatus, once a day, for 3 minutes, on the first channel of the apparatus in the first 3 days, the following 3 days - on the second channel of the device.