Aim. To analyse the effi ciency of osteoplastic material application in order to reduce the resorption level after tooth extraction in the preimplantation period according to the data of cone beam computed tomography.Materials and methods. The study involved 80 patients who were divided into 4 equal groups depending on the preservation material used. The fi rst group was treated with Cerabone (Botiss, Germany) xenomaterial based on natural bovine bone. Plasma enriched with PRGF growth factors obtained by the BTI Endoret (Spain) technology was used for the patients of the second group. The third group consisted of patients who underwent a socket preservation of the extracted tooth with a powdered autologous dentin matrix (ADM) obtained from their own tooth. In the fourth group, bone-plastic material based on hydroxyapatite with Collapan-L lincomycin hydrochloride (Intermedapatit, Russia) was used to prevent socket resorption. All patients had a cone beam computed tomography of the maxillofacial region before the extraction and 3 months after the preservation in order to evaluate the level of bone resorption. After the installation of dental implants, a comparative assessment of the bone resorption level in the vertical and horizontal directions before tooth extraction and in the preimplantation period was carried out.Results. The smallest level of vertical bone resorption after socket preservation was observed in group 1 (Cerabone) and group 3 (ADM). The median value of the socket resorption level in group 1 was 0.7 mm (8.54 %) in the vertical direction and 0.5 mm (9.45 %) in horizontal measurement as compared to the level of bone tissue before tooth extraction. Similar indicators were observed in the group using an autologous dentin matrix. The vertical decrease in the socket bone tissue was 0.61 mm (7.75 %), horizontal — 0.51 mm (6.2 %). The level of bone resorption was signifi cantly higher using two other materials.Conclusions. The use of three-dimensional radiation research methods allows a comprehensive assessment of the bone tissue volume to be carried out, which in turn determines the choice of the dental implant size, the need for further bone-plastic surgery to increase the width/height of the alveolar ridge. The use of cone beam computed tomography showed that the most optimal results can be obtained by introducing Cerabone material into the socket of the extracted tooth, as well as using the innovative method of preservation with the patient’s own powdered tooth (ADM).
In the process of evaluating X-ray diagnostic images of the jaw bones of dental patients, foci of altered bone structure and atypical intraosseous inclusions of increased density are often found. The identified inclusions have different etiology, but at the same time a similar and in some cases implicit scialogical picture, which may cause an incorrect radiological conclusion. When analyzing the available literature, limited information was found about the typical radiosemiotic signs of dense intraosseous inclusions of the jaw bones found in everyday medical practice.
BACKGROUND: According to various data, orofacial diseases occur in the population in 20%85% of cases. The most common cause of maxillofacial pain unrelated to the dental system is temporomandibular joint (TMJ) dysfunction, which is defined as a disruption of the anatomical relationship during natural movements. Magnetic resonance imaging (MRI) is the method of choice for diagnosing joint pathology.
AIM: MRI with static, pseudodynamic, and dynamic protocols were optimized for targeted diagnosis of TMJ dysfunction.
METHODS: Classical examination of the TMJ is performed in a closed and open mouth position. However, the images obtained do not reflect the location of the intra-articular disc at all stages of mandibular motion.
RESULTS: After a static examination in two oral positions, pseudodynamic sagittal T1 weighted imaging (WI) scans were obtained. The patient was asked to divide the movements from full closure to full mouth opening into five steps. The examination was conducted with the MRI operator and the patient acting together. The scans assessed the position and shape of the meniscus at five stages of mandibular movements. The performed program is leading in the assessment of the disc shape changes at each stage of the mouth opening. Wide coverage of the studied area allows to visualize both articular relations of internal structures and surrounding soft tissues, including contraction of the lateral wing muscle and superficial and deep parts of the masseter muscle. The final stage was a dynamic T2 WI scan performed by the patient individually. The obtained series of images represents sequential movements of the condyle, maximally approximating the natural mouth opening. The pulse sequence helps to assess the amplitude of motion of the mandibular condyle and hypermobility, which can be difficult when performing static images with standard mouth expanders.
CONCLUSIONS: An optimized dynamic and pseudodynamic TMJ study protocol is an essential part of the precise diagnosis of TMJ dysfunction and allows for differential diagnosis between muscle spasm and intra-articular disc adhesion and reliable visualization of intra-articular relationships during mouth opening.
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