КЛИНИКО-РЕНТГЕНОЛОГИЧЕСКИЕ ПОКАЗАТЕЛИ ПОРАЖЕНИЯ ПАРОДОНТА И ПЕРИАПИКАЛЬНЫХ ТКАНЕЙ ЭНДОДОНТИЧЕСКИ ЛЕЧЕННОГО ЗУБА У ПАЦИЕНТОВ С ЭНДОДОНТО-ПАРОДОНТАЛЬНЫМИ ОСЛОЖНЕНИЯМИ

Abstract

Objective: Explore the clinical and X-ray indicators of periodontal and periapical tissue lesions in patients with combined endodontic-periodontal pathology. Methods: The results of endocanal treatment of 65 teeth with 82 foci of periapical destruction in the form of bone resorption, periodontal slit expansion, and inflammation of marginal-alveolar gum are presented in 78 patients with combined endodontic-periodontal pathology between the ages of 20 and 50 years and older. Depending on the diameter of the periapical resorption and the severity of the inflammatory process in periodontal tissues, the patients were divided into three groups: the group I – 45 patients who were found to be foci of periapical destruction with a diameter of 1 to 3 mm, and diagnosed a mild course of endodontic-periodontal pathology of a combined nature; II group – 19 patients with bone hotspots resorptions of periapical arrangement with a diameter of 3 to 5 mm and the presence of combined endodontic-periodontal pathology of moderate severity. Patients of group I and II received a combination of complete endodontic treatment with antioxidants, calcium containing and antimicrobial drugs as well as professional oral hygiene. 14 patients with foci of periapical destruction with a diameter of 1 to 5 mm and the presence of periodontal pathology of different severity of stages included into group III. These patients received complete endodontic treatment only. Results: A reliable decrease in the size of the foci near the upper grade of resorption in patients of the first group occurred 12 months after endodontic treatment. With full endodontic treatment, the area of the focal point of destruction in the periapical tissues decreased by 4.8 times, and the restoration of bone tissue in the form of a reduction in the area of resorption 60.0±3.5% of cases. Periodontological index was significantly reduced, which indicates a decrease in inflammatory phenomena in periodontal tissues. Conclusion: After high-quality endodontic treatment, a reliable decrease in the diameter of the resorption focus and an increase in the rate of periapical reparative processes were found. During the 12 months of observation, the complete restoration of bone tissue in the periapical area with focal points of destruction from 1 to 2 mm was noted in 67.3% of cases, in the diameter of the foci 3-4 mm – in 37.6% of observations, and in the case of 5 mm – in 25.3% of cases. Keywords: Endodontic, periodontic, resorption, periapical focus, endodontic-periodontal pathology, endodontic treatment.