Effectiveness of morphogenetic protein rhBMP-2 use in atypical third mandibular molars extraction.

Authors

DOI:

https://doi.org/10.26641/2307-0404.2020.2.206789

Keywords:

retention, pericoronaritis, third molars, inflammatory complications

Abstract

Objective – improving the effectiveness of treatment of patients with retention and dystopia of the third molars of the lower jaw in their horizontal or inverse position by developing an integrated approach using photodynamic therapy and drugs that enhance osteogenesis (platelet autoplasma enriched with i-PRF fibrin and recombinant morphogenetic protein (rhBMP-2). 82 patients with difficult eruption of third molars of the lower jaw aged 19 to 37 were included in research: 40 (48.8%) men and 42 (51.2%) women. The standard approach to performing operations of atypical removal of retined third molars causes a significant number of complications (large bone defects, inflammatory contracture, post-traumatic neuritis, etc.). Treatment process was provided in two stages. During the first (preoperative) stage sanitation was done to eliminate or stabilize an acute infection which is inflammatory process in the area of impacted third molar. The second stage provides abscessed tooth extraction, wound sanitation, formed defect filling with osseo-inductive medications under the collagen membrane and complete closure. The developed surgical method for treating retention and dystopia of the lower third molars using biomaterial based on demineralized bone matrix (BCP) saturated with recombinant morphogenetic protein of bone rhBMP-2 can reduce the occurrence of postoperative inflammatory complications by 35.4%, and also reduce the time for their elimination as well.

Author Biographies

O. O. Gudaryan

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of surgical dentistry, implantology and periodontology
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

N. G. Іdashkіna

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of surgical dentistry, implantology and periodontology
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

Zh. M. Nekhanevich

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of surgical dentistry, implantology and periodontology
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

References

Gudaryan OO, Іdashkіna NG, Nekhanevich ZhM. [Features of treatment of patients with complicated retention of the third molars at the inpatient stage]. Мedichni perspektivi. 2016;16(3):47-50. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2016.3.82020

Jordanishvili AK, Korovin NV, Serikov AA, Kevlova EV. [Аnatomo-topometric jaws characteristics at crossing and retention of wisdom toothes]. The problems of dentistry. 2017;3:53-56. Russian. doi: https://doi.org/10.18481/2077-7566-2017-13-3-53-56

Khalafyan AA. [STATISTICA 6. Statistical Data Analysis . Moskva: OOO «Binom-Press»]. 2007;512s. ISBN: 978-5-9518-0215-6. Russian.

Candotto V, Oberti L, Gabrione F, Scarano A, Rossi D, Romano M. Complication in third molar ex­tractions. J Biol Regul Homeost Agents. 2019;33(3 Suppl. 1):169-72. PMID:31538464.

Jeyaraj PE, Chakranarayan A. Soft tissue healing and bony regeneration of impacted mandibular third molar extraction sockets, following postoperative incor­poration of platelet-rich fibrin. Ann Maxillofac Surg.2018;8(1):10-18. doi: https://doi.org/10.4103/ams.ams_185_17

Boda SK, Almoshari Y, Wang H, Wang X, Rein­hardt RA, Duan B, Wang D, Xie J. Mineralized nanofiber segments coupled with calcium-binding BMP-2 peptides for alveolar bone regeneration. ActaBiomater. 2019;85:282-293. doi: https://doi.org/10.1016/j.actbio.2018.12.051

Kim YJ, Lee JY, Kim JE, Park JC, Shin SW, Cho KS. Ridge preservation using demineralized bone matrix gel with recombinant human bone morphogenetic protein-2 after tooth extraction: a randomized controlled clinical trial. J Oral Maxillofac Surg. 2014;72(7):1281-90. doi: https://doi.org/10.1016/j.joms.2014.01.022

Gomes-Ferreira PH, Okamoto R, Ferreira S, De Oliveira D, Momesso GA, Faverani LP. Scientific evi­dence on the use of recombinant human bone morpho­genetic protein-2 (rhBMP-2) in oral and maxillofacial surgery. Oral Maxillofac Surg. 2016;20(3):223-32. doi: https://doi.org/10.1007/s10006-016-0563-4

Steed MB. The indications for third-molar ex­tractions. J Am Dent Assoc. 2014;145(6):570-3. doi: https://doi.org/10.14219/jada.2014.18

Graziani F, D'Aiuto F, Gennai S, Petrini M, Nisi M, Cirigliano N, Landini L, Bruno RM, Taddei S, Ghiadoni L. Systemic inflammation after third molar removal: A Case-Control Study. J Dent Res. 2017;96(13):1505-12. doi: https://doi.org/10.1177/0022034517722775

Meimandi M, Talebi Ardakani R, Esmaeil Nejad A, Yousefnejad P, Saebi K, Tayeed MH. The effect of photo­dynamic therapy in the treatment of chronic perio­dontitis: A Review of Literature. J Lasers Med Sci. 2017;8(Suppl 1):S7-S11. doi: https://doi.org/10.15171/jlms.2017.s2

Schorn L, Sproll C, Ommerborn M, Naujoks C, Kübler NR, Depprich R. Vertical bone regeneration using rhBMP-2 and VEGF. Head Face Med. 2017;13(1):11. doi: https://doi.org/10.1186/s13005-017-0146-0

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1.
Gudaryan OO, Іdashkіna NG, Nekhanevich ZM. Effectiveness of morphogenetic protein rhBMP-2 use in atypical third mandibular molars extraction. Med. perspekt. [Internet]. 2020Jul.1 [cited 2024Dec.23];25(2):137-44. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/206789

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CLINICAL MEDICINE