SAĞLAMLIQ

POSTEKSTRAKSION DIŞ AĞIRLAŞMALARININ KOMPLEKS MÜALICƏSINDƏ YENI YANAŞMA

19-11-2018

Introduction. Tooth extraction is the complex and the most often traumatic procedure carried out in the dental clinic, which can lead to a number of undesirable complications, such as alveolitis, which today remains one of the most actual  dental problems, the prevalence of which among all complications is about 24.4-40% [5,7].

The major etiological factors in causing of alveolitis are periapical infection in dental tissues, lack of blood clot, its both infection and decomposition leading to disruption of healing process in the surgical wound [1,9].

Immediately after extraction, the tooth socket is filled with blood, then a blood clot is formed in the socket,and acts as a biological barrier. 7-10 days after the tooth is extracted, its socket is covered with epithelium and the blood clot is failed. Disruption of the integrity of the blood clot, as well as its complete absence, leads to a significant slowdown or even termination of the healing process after tooth extraction [1].

There are many different methods of alveolitis' treatment, but their effectiveness does not always remain high, which lengthens the treatment' terms of patients.The most popular and effective used medications are Hexicon, Corsodil, Stomatidin, Chlorhexidine, “Alveojil”paste, which has antiseptic ,analgesic and hemostatic properties, as well as flagella ,impregnated in the above mentioned paste [11].For the treatment of alveolitis, hydrocortisone, hydroxylapatite, as well as Russian-made “Alvostas”, which has hemostatic and antiseptic properties, are used [2,10].However, the most of the listed medications have a local irritant and biotoxic effect. Considering their toxicity, as well as the high risk of allergic reactions to their use, psychological reactions to the complication itself, as well as the need for subsequent implantation, the searching for new methods of treatment of alveolitis is still actual [3,4,8].Physiotherapeutic methods are the safest, like the use of reflex therapy and helium - neon laser for the treatment of alveolitis [6].

A relatively new trend in the treatment of inflammation is the use of DENAS – therapy with use of the DiaDENS - T device.

The principle of the device is based on one of the most effective methods in modern physiotherapy - dynamic electroneurostimulation (DENAS-therapy).This method  includes  the action of microcurrents on the receptors of the skin of the affected area, causing  the responses in organs and tissues.

DENAS –therapy method is registered in Russia in the Federal Service for Supervision of Health and Social Development and is an officially recognized medical technology [12]. The device DiaDENS - T is effective in the treatment of various diseases.

The aim of the work is the studying of the device DiaDens - T application effectiveness, which has a reduced local irritant and biotoxic effect on the affected area, as well as expanding the range of methods used to  the treatment of alveolitis.

Methodology. In the process of alveolitis 'treatment, the method of DENAS-therapy was used in patients.

Results. The high spreading of alveolitis after tooth extraction is associated with traumatic extraction and inadequate care of the dental socket. Monitoring for the state of the dental socket in the postoperative period,is rarely carried out and this indicates the absence of prevention.

Conclusions.Timely treatment of alveolitis allows to correct the disturbance and to ensure the normal healing of the dental socket. Therefore, the role of early prevention and treatment of alveolitis is extremely important.

Introduction In 2014-2016 years, alveolitis was treated in patients after tooth extraction according to indications. The analysis revealed a high prevalence of postextraction complications.As a result, it was found that 97% of patients who extracted their teeth according to the indications had one or another form of inflammation.

The identified indicators are very alarming and make one to pay close attention to the reasons of a such dental status formation in order to further form an optimal strategy for the prevention and treatment of this complication.

Material and methods: 20 patients were included into  the study with a diagnosis of post-extraction alveolitis.In all patients the dental sockets had previously been inspected and treated with antiseptics.

For a comparative estimation of treatment' effectiveness, depending on the nature of the carrying method out, the patients were divided into 2 groups with 10 patients in each one. For the treatment the patients of the main group, the device DiaDENS-T was used.Patients with alveolitis who were in group 1 (10 patients) were anesthetized, the dental socket was rinsed with a warm antiseptic solution of furasiline, and after curettage ,the dental socket was filled with alveojil.

Then, through the effect on the skin of the affected area, the DiaDENS-T device was used in a therapeutic mode.

In 98% of  the patients in this group, after using the device, on the second day the symptoms of alveolitis, such as pain, swelling, contracture, bad breath have drastically decreased, only a small redness around the dental socket remained, and on the 3-4th day all the symptoms disappeared completely, there was no pain when touching to the dental socket.

For comparison, 10 patients with alveolitis after extraction of teeth, according to indications, also were included into the second group.

The treatment of these patients' group was also carried out according to the generally accepted method, but the device was no longer used.

Even after a week, in 85% of patients in the second group, after revision of the socket and antiseptic mouth rinses, the symptoms was not disappeared completely and the patients complained of pain and bad breath.

Thus, a comparison of the results of alveolitis' treatment in 2 groups showed ,that the use of the DiaDENS-T device can significantly improve the treatment results of the patients with alveolitis.

This technique, along with the elimination of inflammation, also does not change the height of the alveolar process, which is of great importance for further prosthetics and implantation [3,8].

Discussion of the got databases.State dental care in Azerbaijan is currently going through difficult times.And this has especially affected to ambulatory surgery. Recently, due attention has hardly been paid to the care of a postoperative wound.

Of course, at  the present time , surgical treatment is a rather expensive procedure, but early detection of alveolitis, its treatment and prevention of the development of more serious complications such as osteomyelitis of the jaws, that occur after alveolitis,would be very important for improving the dental health of the population. Especially if these activities were carried out at the state level and would be free of charge, which means that they are accessible to the majority of the population, because qualified surgical assistance has a significant influence on the quality of life and health of the patient.

Conclusion.With an increasing of dental caries and its complications, the probability of tooth extraction and the development of alveolitis increases. The results of the obtained data indicate that serous inflammation of the dental socket is the most common (95%).

Purulent inflammation has a low incidence. The use of this device has shown its high efficacy in the treatment of alveolitis and its ability to activate the regenerative healing processes, and also allows to recommend its possible use both in dental clinics and in domestic conditions.

 

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