INDICATIONS FOR REMOVAL OF IMPACTED THIRD MOLARS IN THE MANDIBLE AS POTENTIAL PREDICTORS OF ALVEOLAR OSTEITIS DEVELOPMENT

The article highlights the establishment of a relationship between the indications for surgical removal of retained third molars and the incidence of alveolar osteitis. The study standardized these variables as much as possible, which allows us to assess the significance of the results. Accordingly, the sample was divided into two main groups: cases when third molars were removed for preventive reasons and cases when third molars were removed for therapeutic reasons. Materials and methods. The extraction of 575 retained third molars was performed in the conditions of the maxillofacial department of the Poltava Regional Clinical Hospital named after M.V. Sklifosovsky. The sample consisted of 265 male patients (69.4%) and 117 female patients (30.6%). Of the sample, 58.4% underwent extraction of one third molar and 41.6% underwent extraction of two third molars; 85 patients (20.6%) underwent extraction of two lower third molars, and 20 patients (18%) underwent extraction of two upper third molars. Results. The total number of surgically retained third molars was 575. For preventive reasons, 160 (27.8%) were removed, and for therapeutic reasons 415 (72.2%). Of the 160 prophylactic extractions, 112 (70%) were performed to prevent infections, 40 (25%) were performed before prosthetics, and 8 (5%) were performed for orthodontic reasons. Out of 415 extractions for therapeutic reasons: 321 (77.3%) were for infection, 73 (17.6%) were for caries, 17 (4.1%) were for cystic lesions, and 4 (1%) were for associated pain. The total incidence of alveolar osteitis after the extraction of 575 third molars was 114 cases, 19.8% of the total number. The number of retained third molars extracted in the lower jaw was 320, and in the upper jaw 255, which is 55.7% and 44.3%, respectively, of the total number of extractions. Two retained teeth in the lower jaw were extracted in 19.4% of patients, and two retained teeth in the upper jaw were extracted in 14% of patients. There was no significant difference in the distribution of double extractions between the upper and lower jaws. Alveolar ostitis occurred in the mandible in 62 cases, which amounted to an incidence of 21.2%. On the upper jaw, 27 cases of alveolar ostitis were detected, which is an incidence of 13.3%. The incidence of alveolar osteitis increased with age, reaching a peak in the age group from 31 to 35 years. Conclusion. In this study, the authors identified risk factors for the development of alveolar osteitis after the removal of retained teeth in the upper and lower jaws for various reasons that may serve as predictors of this complication.