Сучасні аспекти внутрішньоканальної дезінфекції при лікуванні ускладнених форм карієсу

Abstract

The widespread prevalence of pulp and periodontal diseases indicates the need for continuous improvement of the method of endodontic treatment and determines the relevance of the development of new methods of complex therapy. The primary etiologic agents of apical periodontitis are microorganisms and their by-products that have invaded the pulpal space and established multispecies biofilm communities in the root canal system. Biofilms are involved in all stages of root canal infection and can be found on root canal walls, in dentinal tubules, and on extraradicular surfaces. The success of endodontic dental treatment is determined by careful mechanical processing using modern instruments, drug treatment and subsequent three-dimensional hermetic obturation of the root canal. Only a high-quality and optimal solution to the three problems allows you to achieve high-quality long-term results of treatment. Instrumentation disrupts biofilms which colonize infected soft and hard tissues and provides access for irrigation and exposure to antimicrobial solutions for disinfection of the root canal system. Disinfection is achieved by the use of both antimicrobial agents and the mechanical flushing action of irrigation, with the goal being the disruption, displacement and removal of pulpal remnants, microorganisms, metabolic byproducts, debris and the smear layer created during instrumentation. The multistage, duration and laboriousness of drug treatment of root canals makes it not always effective, which can subsequently cause unsuccessful endodontic treatment. A practicing dentist should be able to rationally and efficiently utilize standard disinfection protocols in the irrigation and medication of root canal spaces.