A Comparative Analysis of the Clinical Efficiency of the Treatment of Chronic Granulomatous Periodontitis Using Different Protocols of Drug Treatment of the Root Canals

Abstract

Background. Infectious and inflammatory processes in periapical tissues are the most common diseases of the dentition. In the structure of the provision of dental care in treatment of chronic periodontitis amounted to 30% of the total number of visits to medical institutions of the healthcare system. Promising is the further development and clinical and radiological justification for the use of new effective means for drug treatment of root canals which affect the pathogenic microflora of the infected canal and have a prolonged antibacterial and antiinflammatory effects and contribute to the processes of reparative regeneration of bone tissue in the area of the focus of inflammation. Objective. Based on a comparative analysis of the results of clinical and radiological research / treatment of chronic granulomatous periodontitis to determine the effectiveness of new drug compositions based on tetracycline and 2% chlorhexidine in the protocol for drug treatment of the root canal system. Materials and methods. There have been conducted the clinical and radiological study of the effectiveness of treatment of 31 patients with chronic granulomatous periodontitis who were divided into two groups: the main and control group. Patients of the main group in the treatment protocol at the stage of instrumental treatment used the drug composition with tetracycline and at the stage of temporary obstruction-a composition with 2 % chlorhexidine in the form of a gel for 3 days under a light-polymerized dressing. After instrumental and drug treatment of the root canal the control group patients underwent temporary obstruction with calcium hydroxide for 7 days under an airtight light-polymerized dressing. The effectiveness of the treatment was evaluated on the basis of clinical and radiological data before treatment, after treatment, and after 6 and 12 months. Results. According to the results of a comparative clinical and radiological study the high efficiency of the use of medicinal compositions based on tetracycline and based on 2 % chlorhexidine for patients with chronic granulomatous periodontitis (p <0.001) was proved. The high clinical efficiency of the proposed treatment method is due to the sensitivity of the pathogenic microflora of the infected root canal to tetracycline and the prolonged antibacterial effect of chlorhexidine on the system of the root canals reducing inflammatory processes in the periapical tissues, which positively contributes to the process of reparative regeneration of bone tissue in the area of the root apex. According to the results of the X-ray examination a reduction in the focus of the infectious and inflammatory process in the periapical tissues, a probable decrease in the destruction area in the periapical region in the main group, where the medicinal compositions based on tetracycline and 2 % chlorhexidine in gel form: from 3.29±0.11 mm 2 to 0.03 ± 0.03 mm 2 12 months after treatment, that is, 99.12 %, which is 18, 28% better, compared to the control group, where 12.8 months after treatment the...