Inferior alveolar nerve injury after mandibularthird molar extraction

Due to anatomical location, it is possible to traumatize inferior alveolar nerve. Inferior Alveolar Nerve (IAN) injury is a serious neurological complication which can result from a number of reasons, the most common of which is by performing oral surgery procedures. These nerves can be damaged as the result of direct or indirect forces. Despite these complications, the removal of third molars associated with disease is generally justified. Extraction of impacted or erupted mandibular third molars is one of the most frequently performed dentoalveolar surgical procedures. There are well-established indications for removal of impacted mandibular third molars, and the controversies about prophylactic removal of asymptomatic mandibular third molars are based on evaluating the costs and risks of removal against the consequences of non-removal. Purpose. The purpose of this study is to identify the incidence of IAN damage following the removal of mandibular third molar teeth and to construct a predictive model to assess the risk of IAN injury. Conclusion. Our study showed that Patient’s age, radiologic relationship between the roots of the third molar and the mandibular canal, ostectomy of the bone distal to the third molar and deflection of the mandibular canal increase the risk of IAN damage. Despite technologic advances, informed consent regarding the incidence of nerve injury is very important. In spite of these drawbacks it seems clear that the skill of the operator is of great importance. Skill, coupled with anatomical, dental and patient factors will ultimately determine the potential for IAN nerve injury. Keywords: inferior alveolar nerve, impacted mandibular third molar, nerve injury

Surgical Management of Nasopalatine Duct Cyst: A Case Report

Nasopalatine duct cyst (abbreviated NPDC) is one of many pathologic processes that may occur within the jaw bones, but it is unique in that it develops in only a single location, which is the midline anterior maxilla [1,2,4]. Nasopalatine duct cysts are the most common non-odontogenic cysts of the mouth, representing up to 1% of all maxillary cysts [5]. These lesions are almost three times frequent in males than in females [6]. The maximum prevalence is between 45 and 60 years of age [7], often mistaken for an enlarged nasopalatine duct, NPDCs are of uncertain origin. The spontaneous proliferation theory appears to be the most likely explanation (a number of studies have reported cystic degeneration in the incisor duct and on the midline of the palate in human fetuses) [8]. NPDCs are normally asymptomatic, constituting casual radiological findings, though sometimes (in 17% of cases) patients report pain due to the compression of structures adjacent to the cyst, particularly when the latter becomes overinfected, or in patients who wear dentures that compress the zone. The more caudal the location of the cyst, the sooner symptoms appears [3,7,15]. In terms of histopathology the epithelium of cysts is very diverse and includes a combination of stratified, squamous, non-keratinized epithelium, false stratified columnar epithelium, stratified columnar epithelium and simple cubic epithelium [8,12]. The connective wall of cyst may contain nasopalatine vessels and nerves as well as the glandular structures [6,15]. The appropriate treatment for these cysts can be enucleation and in order to prevent damage to the nasopalatine nerve the enucleation is done from the side of the palate [4,11]. If the cyst is large and there is a risk of loss of teeth vitality or creation of a nasal fistula in the mouth and sinus, the surgeon may choose the marsupialization method [7,13]. The rate of recurrence of this lesion has been reported 2-30% and malignant changes have also rarely been reported [1, 2, 13, 14]. Here we report the case of a 28-year- old male who developed a nasopalatine duct cyst in the maxillary central incisor region. The aim of this study was to highlight the clinical presentation to describe the radiographic and pathological findings and to discuss surgical management of this entity. A 28-year-old male with a complaint of an asymptomatic, nodular swelling located on the palate between the maxillary right and left central incisors since 6 months came to the Surgical Dentistry Department of Poltava Regional Clinical Stomatological Polyclinic. The swelling was associated with a dull aching intermittent pain. Extraorally there was no detectable abnormality or lymphadenopathy. Intraoral examination revealed a well defined oval shaped bluish swelling measuring approximately 12×15 mm, located posterior to the palatine papilla in the midline. The swelling was fluctuant and non-tender

Diagnostic information of computed tomography of the upper jaw in patients required implant rehabilitation

Introduction: Dental implantation in conditions of bone deficiency in the loss of lateral group of teeth of the upper jaw is impossible without the maxillary sinus floor augmentation. Preparation for surgical intervention requires a thorough assessment of the anatomical features of the sinus, relationship between the sinus and adjacent teeth, detection of foci of chronic infection of the Schneiderian membrane. In the complex of the objective methods of investigation, computed tomography is the most informative approach to study the state of the bone and soft tissue structure of the sinus. The aim of the paper is to evaluate the state of the bone structures and maxillary sinus membrane to determine the technique for selection the optimum alternative for management of patients, who required sinus lift, based on the computed tomography. Materials and methods: Computed tomographic examination of 206 patients with bounded and free-end edentulous spaces in the lateral area of the upper jaw was carried out over a period of 2010-2017 to evaluate the appropriateness of sinus lift approach and selection of its technique. The state of the bone tissue and presence of the auxiliary septa, intranasal structures, including ostiomeatal complex, presence of edema and exudates, lesions of the mucosa, as well as the state of ostium maxillaris has been estimated. Results: In the projection of the maxillary sinus the thickness of the bone tissue ranged within 1 mm to 10,5 mm; the density of bone tissues was of the D3-D4 type. Inflammatory events were detected in 60,1%, including: thickening of the mucous membrane on the right and on the left (40,6% and 41,1%, respectively), the total edema (8,6% and 9,7%, respectively). Bilateral thickening was found in 38,8%, and bilateral total edema in 28,0% of cases. Remnants of the filling material were found in 1,4% of sinuses on the right and in 2,8% on the left. Bone septum was visualized on the right in 18,8%, and in 17,4% on the left, bilateral in the 31,8%. Cystic masses were detected on the right in 4,2% of cases and in 6,2% on the left, bilateral in 16,7%. Conclusions: Computed tomographic examination provides thorough evaluation of the parameters of the bone tissues, state of mucous membrane and peculiarities of architectonics of maxillary sinuses at the pre-implantation stage

Evaluation of clinical and radiological features of the maxillary sinus in the planning of dental implantations

Робота присвячена обґрунтуванню можливостей проведення синусліфтингу при плануванні імплантологічної реабілітації у хворих з кінцевими дефектами зубних рядів верхньої щелепи та недостанім об’ємом кісткової тканини у бокових відділах. У публікації розглядаються особливості анатомії максилярного синусу та стану слизової оболонки на основі оцінки даних комп’ютерної томографії. The article is devoted to substantiation possibilities of sinus lifting at planning implant rehabilitation in patients with distal dentition defects and bone deficiency of the upper jaw. The features of maxillaries sinus anatomy and mucosa condition was evaluated using CT scan data and described in publication

Manifestations neurostomatological diseases in maxillofacial area, the difficulty of diagnosis and treatment

У статті висвітлено актуальне питання – діагностика та лікування нейростоматологічних захворювань. Представлено групу пацієнтів з різною патологією нервової системи і проявами симптоматики захворювання у порожнині рота. Труднощі в діагностиці у практичних лікарів-стоматологів зазвичай призводять до необґрунтованого втручання – депульпування або видалення зубів. Описано результати ефективно проведеного лікування.Article is devoted to pressing question – diagnostics and treatment of neurostomatological diseases. The group of patients with a different pathology of nervous system and implication of disease symptomatology to oral cavity is present. Difficulties in diagnostics at practical dentists, as a rule, leads to an unreasonable intervention: removal of tooth pulp or tooth extraction. In the present work, results of effective treatment are present

Features of surgical treatment at patients with hard odontoma

У статті висвітлено діагностику та лікування твердих одонтом. Наведено клінічні випадки з ілюстраціями рентгенографічних знімків пацієнтів, етапів оперативних втручань та видалених одонтом. Акцентовано увагу на труднощах, які виникають на етапах діагностики та планування оперативного втручання; The problems of diagnostic and treatment of hard odontoma are presented in article. The cases history with imagines of X-ray pictures, stages of surgical operation and remote odontomas are described. Accenting of attention on the difficulties which origins during tumor diagnostic and planning of surgical removal

Level system of stomatologists training in the light of bologna declaration principles

Необхідність реформування системи підготовки лікарів-стоматологів обумовлена існу ючими соціально-економічними процесами, а саме: демократизацією суспільства, інтеграцією Украї ни у світове співтовариство; низькими показника ми стоматологічного здоров’я населення України; диспропорціями у системі підготовки та викорис тання фахівців охорони здоров’я, зокрема, низьким рівнем надання первинної стоматологічної допомо ги населенню стоматологами муніципальної систе ми охорони здоров’я; наявністю широкого кола сто матологічних закладів недержавної форми влас ності, що орієнтовані на надання спеціалізованої (вторинної) і високоспеціалізованої (третинної) сто матологічної допомоги; недостатнім рівнем уніфі кованого контролю якості підготовки фахівців галузі охорони здоров’я; недостатнім впровадженням су часних ефективних систем підготовки фахівців на додипломному та післядипломному етапах. Реформування підготовки лікарів- стоматологів в Україні передбачає приведення Про затвердження Положення про освітньо-кваліфі- вищої освіти у відповідність із державними і міжна родними стандартами та потребами охорони здо ров’я країни у якісній стоматологічній допомозі населенню. Модифікація структури, змісту, термі нів підготовки та якості потребує нового підходу до навчально-методичного забезпечення навчаль ного процесу з напряму підготовки “ Медицина” за спеціальністю “ Стоматологія”.One of pre-conditions of Ukraine’s entrance to the common European area of higher education is realization of the ideas of Bolognia declaration through the structural reform of the national system of higher education, directed on providing of mobility, employment and competitiveness of specialists in higher education. For achievement of this purpose it is necessary to coordinate the system of the stomatological personnel training with the system of their use. Preparation on the undergraduatt stage of doctors-stomatologists of wide type on the postgraduation stage is the important stage of alteration. They are able to get specialization of general practitioner-stomatologist on the postraduate state of primary (basic) specialization for the grant of primary (assured) stomatological help. The urgent question is the introduction of the clear system of postgraduate training of doctors-stomatologists by means of the secondary specialization and obligatory regular professional thematic improvement