Increasing the Efficiency of the Treatment of Endoparodontal Lesions

Abstract

Chronic inflammation in the periodontium, pulp and periodontium, through the pocket of which the infection can spread towards the root apex and cause a retrograde development of the inflammatory process in the pulp and periapical tissues, is considered as an odontogenic focus.
 Aim: to study the state of periodontal tissues, periodontitis in the presence of a periapical focus of infection and the dynamics of its change in complex treatment.
 Material and methods. 150 medical records of a dental patient were studied, among them a randomized controlled study of 100 patients with combined endodontic and periodontal lesions and 50 individuals not burdened by this pathology was also conducted. At the next stage a study of 41 patients with EPL was conducted. The patients were divided into two groups depending on the treatment algorithm: I – with a diagnosis of EPL20 patients of the main group, who, along with standard treatment, received additional therapy with decontamination of CC and laser curettage with a dental diode laser (Picasso Life); II with a diagnosis of EPL 21 patients in the control group with traditional treatment. Evaluation of the effectiveness of traditional and proposed methods of treatment of endoperiodontal lesions was carried out by assessing the degree of gingival bleeding (SBI index (Muhlemann H.R. modified by Cowell I., 1975)) and probing depth (PD).
 Results. The age indicators for patients of two groups most often varied within 40-49 years. The second most frequent was the age of the subjects, which amounted to 50-59 years. When studying the influence degree of industrial environment factors with irritating and general toxic properties on the frequency of occurrence of EPl, it was found that in the main group 14.0% of patients with this pathology have been working in such conditions for a long time. In addition, in the control group, the number of persons professionally burdened with inflammatory periodontal diseases without signs of apical periodontitis was 16.0%. In the course of further analysis of the obtained anamnestic data, it was revealed that alcohol abuse occurred in the main group in 36.0% of cases, in the control group in 24.0%. Abuse of tobacco products, against the background of which there is inflammation of the gums in the form of hyperemia, edema, bleeding, was noted by half of the patients in the control group and almost the same number of patients in the main group 48.0%, in whom pathological changes in the periapical region were detected in parallel.
 Conclusion. At certain periods of observation, statistically significant distinguishing intergroup signs were clearly expressed 6 months after the completion of therapeutic and preventive measures, and this trend in a sharp and significant decrease in gum bleeding and periodontal pocket depth continued by the end of observations in the main group when using a laser.