CHOICE THE METHOD OF SURGICAL EXTRACTION OF LOWER WISDOM TEETH DEPENDING ON THEIR POSITION TO PREVENTION OF POSTOPERATIVE SENSORY DISTURBANCES

Gogol A. M., Pankevych A. I., Kolisnyk I. A.

DENTISTRY

Scentific article

The data of clinical researches of correlation between the position anomalies of impacted wisdom lower teeth and sensory disturbances by choice of surgical tooth extraction method. Overall, 567 surgical extractions was conducted during the time of clinical researches of impacted wisdom lower teeth. A clinical examinations of patients was conducted by using standard technique of X-ray evaluations (radiography angle and body of the mandible in lateral projection, orthopantomography (OPTG) or cone-beam computed tomography (CBCT). The choice of surgical extraction method depends from several factors. Take into account the depth position of tooth, degree of root formation, tooth ratio of the mandibular canal of jaw, which was reflected in the existing classifications. The most common international classification by G. Winter (1926) and G. Pell, B. Gregory (1933) for presentation of impacted lower third molars was used in clinical researches. The complexity and invasiveness of surgical tooth extraction is correlated with a high probability of complications during surgery and postoperative period. Because, the development and practical implementation of the surgical tactics in practice according wisdom tooth position are important. The researches of archival material are detected that in 53.95% cases of impacted lower third molars the lack of sufficient space for tooth eruption was turned what confirming the theory of involution of masticatory system. In 92.4% cases the crown of tooth was covered mucous membrane or partly bone tissue. In 18.1% of cases the crown was completely covered bone tissue. The more difficulty of surgical extraction is C2-C3 typical characteristic of the teeth per classification. The origin of sensory disturbances after surgical extraction impacted wisdom lower teeth most observed in the C2-C3 position by G. Pell, B. Gregory (1933) classification and in media angular and horizontal position by G. Winter (1926) classification. The relative position of the lower wisdom tooth and channel of mandible is crucial for choice a method of surgical tooth extraction to prevent sensory disturbances iof nferior alveolar nerve. Using of coronectomy is indicated in this case. Cone-beam computed tomography is the most informative method of X-ray examination for detected individual variability of anatomical structures. Clinical monitoring of patients after surgical extraction are needed for establishment the effectiveness of the operations and to optimize the patient treatment.

lower wisdom teeth, surgical extraction, sensory disturbances

• 1. Огоновський Р.З. Лікування запальних ускладнень після операції атипового видалення третіх нижніх молярів: огляд літератури (частина 1) / Р.З. Огоновський, Н.М. Хомич, Н.Б. Кузняк // Вісник проблем біології і медицини. – 2014. – № 1. – С. 17-22.
• 2. Carvalho R.W. Assessment of factors associated with surgical difficulty during removal of impacted lower third molars / R.W. Carvalho, B.C. do Egito Vasconcelos // J. Oral Maxillofac. Surg. – 2011. – № 69 (11). – Р. 2714-2721.
• 3. Goto S. Clinical and dental computed tomographic evaluation 1 year after coronectomy / S. Goto, K. Kurita, Y. Kuroiwa [et al.] // J. Oral Maxillofac. Surg. – 2012. – № 70 (5). – Р. 1023-1029.
• 4. Kim J.W. Which risk factors are associated with neurosensory deficits of inferior alveolar nerve after mandibular third molar extraction? / J.W. Kim, I.H. Cha, S.J. Kim, M.R. Kim // J. Oral Maxillofac. Surg. – 2012. – № 70 (11). – Р. 2508-2514.
• 5. Leung Y.Y. Coronectomy of the lower third molar is safe within the first 3 years / Y.Y. Leung, L.K. Cheung // J. Oral Maxillofac. Surg. – 2012. – № 70 (7). – Р. 1515-1522.
• 6. Suomalainen A. Availability of CBCT and iatrogenic alveolar nerve injuries / А. Suomalainen, S. Apajalahti, T. Vehmas, I. Ventä // Acta Odontol. Scand. – 2013. № 71 (1). – P. 151-156.

«Bulletin of problems biology and medicine» Issue 2 part 1 (128), 2016 year, 179-183 pages, index UDK 616.314.7-089.87.-084