МИКРОБИОТАСИСТЕМЫ КОРНЕВОГО КАНАЛА У ПАЦИЕНТОВ С ДЕСТРУКТИВНЫМИ ФОРМАМИ ХРОНИЧЕСКОГО АПИКАЛЬНОГО ПЕРИОДОНТИТА ДО И ПОСЛЕ СТАНДАРТНОГО ЭНДОДОНТИЧЕСКОГО ЛЕЧЕНИЯ И СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ВОЗДЕЙСТВИЯ НА НЕЁ

Abstract

Abstract. Introduction. Despite the modern achievements of endodontics, it is possible to obtain a positive effect in the treatment of destructive forms of chronic apical periodontitis in 80-85% of cases. In other patients, progressive pathology becomes the main cause of tooth loss with subsequent deformation of the dentition, changes in the temporomandibular joint, the development of purulent- inflammatory processes of the maxillofacial region or complicated course of somatic diseases. Aim. The aim of the study was to study the dynamics of microbiological parameters in patients with chronic apical periodontitis before and after standard endodontic treatment, as well as the possibility of exposure to blood autoplasm and hydroxyapatite gel.Material and methods. The study was conducted in 32 patients with destructive forms of chronic apical periodontitis. 82 scraping smears obtained from the apical third of the canal before its primary drug treatment were studied.Results anddiscussion.The study of the microflora of root canals in patients with destructive forms of chronic apical periodontitis after performing the main stages of the standard endodontic protocol showed that by the 10th day of treatment, small associations of microorganisms consisting of gram-positive and gram-negative coccoid, rod-shaped, convoluted forms, as well as fungal microflora, mainly Candida albicans, were found in the area of the root apex. An in vitro study of the antibacterial properties of blood autoplasm and hydroxyapatite gel showed that hydroxyapatite has a pronounced bactericidal effect on international test strains of bacteria Staphylococcus aureus ATCC 25923 and Candida albicans SSM 885, platelet-enriched blood autoplasm has a weak bactericidal effect, and the combined use of these drugs has no antibacterial effect.Conclusion. Taking into account the high osteoinductive properties of these substances, in order to achieve their positive effect on the course of inflammatory and regenerative processes, a scheme of their sequential inclusion in endodontic treatment can be used in order to optimize the existing standard protocol for destructive forms of chronic apical periodontitis, which is the subject of subsequent study.