Современные представления о качестве эндодонтического лечения

Abstract

The aim of the study is to analyze the factors that prevent the improvement of endodontic treatment. Materials and methods: we considered possible prospects for long-term endodontic treatment and prediction of results. Results of the study: these literature data show that intra- and extracorporeal factors influence the prediction of endodon treatment. Incomplete purification of pulp space after preparation, stability, ability of microflora to maintain apical inflammatory process, synthesis of intra- and extraradiclar biofilm, inactivation of medicines in root canal requires search of alternative irrigation agents and disinfection modes. In addition to the conventional preparation, the use of iodine preparations and physical factors in both primary and repeated endodontic treatment is promising. At the modern stage of endodontia, the size of the periapical lesion is not the main factor in deciding on conservative endodontic treatment or surgical treatment of the lesion. Due to the availability of tools, equipment and treatment techniques, endodontic intervention should ideally end successfully. But in the analysis of treatment results, a number of publications note that an unfavourable outcome is even in the case of «well-treated channels». Intracorneal factors include the complexity of endodontic anatomy, infection, diversity of microflora in the root canal system, its resistance and ability to organize into biofilm. Extracorporeal reasons include extradicular infection, «true» cysts, the presence of endo-periodontal lesions, root resorption, the reaction of periapical tissues to the foreign body (endogenous or exogenous origin) and yatrogenic factors (arising during preparation, irrigation of the root canal), toxic and irritating properties of the used drugs. Several of these etiological factors often lead to the development of the inflammatory process in the periodontal. Each can influence the outcome of endodontic treatment. The failure of conservative treatment is still recommended to be considered as the development of an infectious process.