Abstract
The treatment of patients with chronic periodontitis is one of the important and is still not completely solved problems of modern dentistry due to its high prevalence and the number of complications, which may follow the treatment. Long-term asymptomatic course of chronic forms of periodontitis promotes the progression of destructive processes not only in periodontal tissues and alveolar bone, but also stimulates the resorption of cementum and the root dentin, which causes the formation of the acquired wide dental root apex. This prompted the search for new and more effective methods of the treatment. The aim of our study was to evaluate the effectiveness of the effect produced by calcium hydroxyapatite-based composition based on the intensity of regenerative processes in bone tissue in the experiment, analyzing the results of calcium-phosphorus metabolism, and to study the effectiveness of the treatment of patients with chronic granulating periodontitis with an acquired wide tooth root apex using the developed composition, and then to compare with the results of using the generally applied mineral trioxide aggregate (MTA) material. All animals were divided into 4 experimental groups, and the modelled destruction of their bone tissues was filled with the studied material, except for the comparison group. The test animals were killed on 14th and 90th days of the experiment. The content of calcium and phosphorus in the bone tissue homogenate was investigated. Then we divided 59 patients into two groups: the experimental group, in which the apical part of the tooth root was filled with the proposed calcium hydroxyapatite-based composition for revitalization and bioreparation of periapical tissues, and the comparison group, in which the jaw bone defects were filled with the MTA material. On the 14th day, the largest (1.8-fold) decrease in calcium and phosphorus ions was observed in the 2nd experimental group, while in the 4th group it was 1.3 time lower. On the 90th day, the content of calcium and phosphorus ions was still lower than in the control group in 1.6 and 1.5 times, respectively, and in 4th group in 1.01 and 1.1 time. Analysis of the treatment results of patients in 6 month therapy has demonstrated a decrease in the value of the SDVP index in the experimental group in 1.4 times, and in the control group in 1.1 time. In 12 months the experimental group demonstrated the 1.9-fold index decrease, while the comparison group had only 1.4-fold lowering of this value. We have demonstrated experimentally, clinically and radiologically that the proposed composition is more effective in promoting the processes of biorevitalization and regeneration of periodontal tissues compared to the generally applied MTA material.
Highlights
The viability of all microorganisms immobilized in 1% gel without additives was minimal
The addition of disaccharides of lactose, sucrose, SML medium and milk to the alginate gel increased the cryoprotective properties of the alginate gel
The highest viability of immobilized microorganisms was observed in the gel with SML medium
Summary
The viability of all microorganisms immobilized in 1% gel without additives was minimal. The addition of disaccharides of lactose, sucrose, SML medium and milk to the alginate gel increased the cryoprotective properties of the alginate gel. The highest viability of immobilized microorganisms was observed in the gel with SML medium. Immobilization in gel carriers and storage for 24 months did not affect the adhesive properties of probiotics E. coli M–17, L. acidophilus, S. cerevisiae. The viability of microorganisms immobilized in gel granules during long-term storage at different low temperatures is influenced by the species cryoresistance of microorganisms, temperature regimens and storage duration, the composition of the gel carrier. The processes of immobilization and storage at low temperatures did not change the adhesive activity of immobilized microorganisms.
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