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Документ Circumstance For Removal of Impacted Mandibular Second and Molars Teeth(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2016) Masoud, K.; Pankevych, A. I.; Lokes, K. P.; Skikevich, M. G.; Масуд, Кіані; Панькевич, Артур Іванович; Локес, Катерина Петрівна; Скікевич, Маргарита Георгіївна; Масуд, Киани; Панькевич, Артур Иванович; Локес, Екатерина Петровна; Скикевич, Маргарита ГеоргиевнаImpaction is defined as failure of tooth eruption caused by a physical obstacle in the eruption path or the abnormal position of the tooth. The most commonly affected are third molars followed by maxillary canines and mandibular second premolars. Impaction of a second permanent molar is rare and usually occurs in the mandibular arch with an incidence of 0.06-0.3%. Surgery for removal of impacted mandibular second and third molars may be associated with several postoperative complications. They may include infection, dry socket, bleeding, nerve injury, delayed healing and periodontal pocketing Impacted mandibular wisdom tooth are wisdom tooth which do not fully erupt into the mouth because of blockage from other teeth. If the third molar tooth do not have an open connection to the mouth, pain can develop with the onset of inflammation or infection to the adjacent teeth. Mandibular third molars teeth likely become impacted because of a mismatch between the size of the teeth and the size of the jaw and horizontal impaction that can damage the second molar roots and cause possible periodontal disease. Problems associated with impacted second molars are caries, periodontitis, resorption of adjacent teeth, cyst formation, malocclusion and pain. Treatment options for an impacted molar include extraction, orthodontic uprighting, surgical uprighting, transplantation, surgical-orthodontic approach, and dental implant replacement. Generally, the impaction of mandibular second molars is a rare complication in tooth eruption. The presence of deeply horizontally impacted lower second and third molars is even more unusual. The arrested eruption of the lower second and third molars can determine disturbances of mastication and aesthetics. Moreover, an increased risk of caries in the distal side of the first lower molar is possible. This study about a 20-year-old male with impacted mandibular second and third molars. A panoramic radiograph showed that the left mandibular second molar was deeply impacted horizontally, with the mesial cusps below the first molar’s root apexes. The left mandibular third molar laid above and parallel to the second molar. The panoramic radiograph also showed the presence of unerupted teeth numbers 18, 25, 27, 28 and 38. CT scans of the mandible revealed the relationship of the inferior alveolar canal with the second molar. According to the classification by Andreasen and Kurol, the absence of eruption of the second molar could be caused by three events: impaction, primary retention and secondary retention. Impaction of the second molar is usually determined by a physical obstacle because of lack of space, odontomas, supernumerary teeth, odontogenic tumors, giant cell fibromatosis in the eruption line, and collision between the follicles of the second and third molars. However, the third molar cannot be considered as a cause of lower second molar impaction. Indeed, it is not involved in either the time or in the path of the eruption of the lower second molar. Simply extracting it does not lead to the proper eruption of an impacted second molar. An ectopic eruption pathway could also be considered as a cause of the impaction of the second molar. The eruption of the second molar arrested before the rupture of the gum is called primary retention. It is usually due to unknown causes. In some cases, it is observed in patients affected by syndromes with a compromised osteoclastic activity. Finally, secondary retention is the cessation of the eruption after gingival rupture, without the presence of a physical obstacle. This event is more common than primary retention, and it is determined by ankylosis, especially in the interradicular zone. The arrested eruption of the mandibular second and third molars teeth is an extremely rare condition. Different therapeutic options should be considered. In this case, we decided to perform the surgical removal of the second and third molars because of the age of the patient, the deep impaction of the second molar and the lack of supporting bone. It is important to diagnose arrested eruption of the permanent lower second and third molars as early as possible because orthodontic treatment at a late stage could be complicated and present difficult clinical problems; Як правило, ретенція другого моляра нижньої щелепи є рідкісним ускладненням прорізування зубів. Горизонтальне положення другого і третього молярів зустрічаються ще рідше. У даній роботі представлений клінічний випадок 20-річного пацієнта з ретенцією другого і третього молярів нижньої щелепи. На панорамній рентгенограмі має місце горизонтальне положення другого моляра, мезіальні горби якого розташовуються нижче рівня апексів першого моляра. Лівий третій моляр розташовується вище і паралельно другому моляру. Панорамна рентгенограма також показала наявність непрорізавшихся зубів 18, 25, 27, 28 і 38. КТ щелепи показала взаємозв’язок нижньощелепного каналу з другим моляром. За класифікацією Andreasen і Kurol, відсутність прорізування другого моляра може бути викликана трьома факторами: власне ретенцією, первинною та вторинною ретенцією. Затримка прорізування другого моляра зазвичай визначається фізичною перешкодою через нестачу місця, наявністю одонтом, понадкомплектних зубів, одонтогенних пухлин, гігантоклітинного фіброматозу в області прорізування зубів і фолікулів другого і третього молярів. Затримка прорізування другого і третього молярів нижньої щелепи є надзвичайно рідкісним захворюванням. Різні варіанти лікування повинні бути розглянуті. У цьому випадку було виконано хірургічне видалення другого і третього моляра в зв’язку з віком пацієнта, глибоким положенням другого моляра і відсутністю опорної кістки; Как правило, ретенция второго моляра нижней челюсти является редким осложнением прорезывания зубов. Горизонтальное положение второго и третьего моляров встречаются еще более редко. В данной работе представлен клинический случай 20-летнего пациента с ретенцией второго и третьего моляров нижней челюсти. На панорамной рентгенограмме имеет место горизонтальное положение второго моляра, мезиальные бугры которого располагаются ниже уровня апексов первого моляра. Левый третий моляр располагается выше и параллельно второму моляру. Панорамная рентгенограмма также показала наличие непрорезавшихся зубов 18, 25, 27, 28 и 38. КТ челюсти показала взаимосвязь нижнечелюстного канала со вторым моляром. По классификации Andreasen и Kurol, отсутствие прорезывания второго моляра может быть вызвано тремя факторами: собственно ретенцией, первичной и вторичной ретенцией. Задержка прорезывания второго коренного зуба обычно определяется физическим препятствием из-за недостатка места, наличием одонтом, сверхкомплектных зубов, одонтогенных опухолей, гигантоклеточного фиброматоза в области прорезывания зубов и фолликулами второго и третьего моляров. Задержка прорезывания второго и третьего моляров нижней челюсти является чрезвычайно редким заболеванием. Различные варианты лечения должны быть рассмотрены. В этом случае было выполнено хирургическое удаление второго и третьего моляра в связи с возрастом пациента, глубоким положением второго моляра и отсутствием опорной кости.Документ Inferior alveolar nerve injury after mandibularthird molar extraction(«Паринские чтения 2016». – Минск, 2016) Masoud, K.; Pankevych, A. I.; Панькевич, Артур ІвановичDue 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.Документ Surgical Management of Nasopalatine Duct Cyst: A Case Report(2017) Masoud, K.; Pankevych, A. I.; Hohol, A. M.; Kolisnyk, I. A.; Панькевич, Артур Іванович; Гоголь, Андрій Михайлович; Колісник, Інна АнатоліївнаNasopalatine 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.