Специфіка лікування деструктивних змін у верхівковому періодонті у хворих на туберкульоз легень

Abstract

Introduction. The prevalence of a number of socially dangerous illnesses in Ukraine, including pulmonary tuberculosis, is quite high. Considerable groups of patients, in addition to anti-TB treatment, also require adequate dental care, taking into account the general somatic status.The aim of the study. To evaluate the effectiveness of the use of antibiotics in the endodontic treatment of destructive forms of apical periodontitis in patients with pulmonary forms of active tuberculosis.Materials and methods. An endodontic treatment of 23 teeth in 19 patients aged 21-39 years (30,6±5,7) with regard to destructive apical periodontitis has been performed. Therapeutic manipulations were carried out within the framework of the existing protocols. In addition to standard procedures, cotton swabs with 5% solution of kanamycin sulfate were introduced into the root canal to create the stores. In the control group aged 20 – 44 years (32,5±7,6) – 24 persons (25 teeth) with a similar dental pathology, treatment was carried out according to the standard scheme indicated in the protocol, an additional drug treatment of root canals with an antibiotic was not conducted. The control of long-term results was performed after 6 and 12 months according to clinical and radiological data.Study results and their discussion. The analysis of the immediate results confirmed the reduction in the number of complications requiring repeated endodontic interventions and other therapeutic care activities by 27% compared to the control group. According to digital dental radiography, the use of the complex of kanamycin sulfate + calcium-containing paste in endodontic treatment accelerates the processes of restoration of bone structures in the destruction zone and allows in 12 month period to restore periodontitis in 72.0% of cases.Conclusions. The inclusion of kanamycin sulfate in the protocol of endodontic treatment of destructive processes in apical periodontitis in patients with active forms of pulmonary tuberculosis improves the remote results due to the sanitation and prevention of the formation of specific infection centers in the maxillofacial area and activation of reparative processes.