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Perforation of a genyantrum


Perforation  of ground area of a genyantrum can happens in the course of removal of upper teeth. Generally it will occur during removal of big, is more rare than small teeth. It happens because the anatomic structure has the features which mention roots of these teeth and a bottom of the bosom which is in an upper jaw.

At pneumatic type of formation of a bosom upper parts of roots of big and small teeth are separated from a bosom bottom by means of a bone plate. Around the first two molars having the big sizes, thickness of this plate can reach only 0,2 – 1,2 mm. Sometimes, that tops of these teeth are pressed into this bosom and can even act further its bottom. The bone which has to separate tooth roots from a genyantrum can resolve as a result of periodontitis and then the fabric which is in the pathological center merges from a mucous membrane of this bone. If to extract this tooth, then mucous bosoms it razovrtsya and forms symbiosis with an oral cavity through a hole in the extracted tooth.

Перфорация верхнечелюстной пазухи слева (отпечаток с ортопантомограммы)

Perforation of a genyantrum at the left (a print from the orthopan-tomogram)

Reasons of perforation of a genyantrum:

Perforation of a bosom can appear because of the doctor: at an unsuccessful odontectomy nippers or an elevator; at separation of roots a chisel; or during inspection of the formed hole a surgical instrument when the doctor tries to remove strenuously from a hole bottom granulyatsionny fabric. When the perforation of a genyantrum occurred, the blood containing vials of air will follow from tooth. Air will come out the formed hole with whistle. Bleeding from a nose from that party on which there is injured tooth is in certain cases possible. If process purulent – from a bosom is allocated pus.

Treatment of perforation of a genyantrum:

When the genyantrum is opened in the surgical way, it is necessary to scan it on a possibility of inflammatory process. If it does not exist, it is necessary to form in every way a clot in the turned-out hole. For protection it from external influences needs to be covered a hole with a yodoformny turunda or a sponge with gentamycin. To hold these imposings it is possible to make a kappa of quick-hardening plastic or to apply a bandage two next teeth. If in a bosom after all there is an inflammatory process, this described action will not eliminate perforation of its bottom.

If it is not possible to achieve blood solidification, it is necessary to cut partially hole walls, to smooth acute ledges, to connect edges of a gum and to sew up tightly. If thus the hole cannot be taken in, it is necessary to make closing with its block of biomaterial. From outer side of an alveolar shoot it is necessary to separate from a bone the mucous rag having the trapezoid form which should be placed on area of defect and to hem to edges of a wound and a mucous membrane of the sky. That the wound healed better and quicker it is necessary to impose on it a yodoformny gauze and a protective plate from quick-hardening plastic.

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