Forms Of Chronic Periodontitis Research Articles

RETROSPECTIVE ANALYSIS AND CLINICAL OBSERVATIONS OF REGENERATIVE FEATURES OF PERIAPICAL TISSUE

Abstract Background. Chronic forms of periodontitis are accompanied by changes in periapical tissues, untimely diagnosis and lack of full mechanical treatment increases the number of patients diagnosed with chronic periodonitis. Periodontitis, which leads to destructive changes due to a long-term inflammatory process in periapical tissues, is especially dangerous. For this reason, the problem of treating destructive forms of periodontitis is relevant in modern dentistry. The purpose of the study is to study the regeneration of periapical tissues after treatment of patients with chronic forms of periodontitis. Methods. A retrospective analysis of the destruction and restoration of periapical tissues before and after treatment in the period of 3-6 months was carried out in 20 patients. Results. According to the results of a retrospective analysis of X-ray studies, bone tissue destruction of varying degrees was revealed in 20 patients. Poor preparation of the root canals was due to a number of factors, the main one being the anatomy and topography of the root canals. Of the 20 patients requiring treatment for chronic periodontitis with varying degrees of destruction, 16 patients came to the next stage and underwent endodontic treatment. After the treatment, conical preparation of the root canals and the quality of obturation to the radiographic apex of the root were radiographically revealed. In patients with clinical signs of periodontitis, an X-ray examination was performed after 3 months, in patients without clinical manifestations - after 6 months. After 3 months, the X-ray showed a decrease in the foci of bone tissue destruction in the area of the causative tooth, and positive dynamics were determined. Conclusion The study of periapical tissue regeneration after treatment of patients with chronic forms of periodontitis showed that effective apical preparation, high-quality irrigation and root canal filling increases the degree of regeneration in the periodontium. Healing in the periapical tissues is crucial for the success of root canal treatment.

СТРУКТУРА ЗАБОЛЕВАНИЙ ПАРОДОНТА У ПАЦИЕНТОВ ПСИХИАТРИЧЕСКОГО СТАЦИОНАРА В ВОЗРАСТНОМ АСПЕКТЕ

The literature provides information on the high prevalence of periodontal diseases and hard tooth tissues in patients in a psychiatric hospital. The relationship between periodontal microbiota and psychiatric pathology and the need to maintain oral health among this group of patients is discussed. The aim of the investigation was the study of the structure of periodontal diseases in patients of a psychiatric hospital, in various age groups. Material and methods of research. In the Republican Clinical Psychiatric Hospital named after V.N. Bekhterev (Kazan) in the period from 2014 to 2018, 200 patients (95 women and 105 men) aged 35 to 65 years (average age 56,26 ± 6,74) were examined. The questionnaire recorded the patient's age, sex, diagnosis of the underlying disease, dental formula, a standard periodontal diagram was filled in. The maximum depth of the periodontal pocket was determined by sequential measurements. The results of the study. In 100% of patients in a psychiatric hospital, periodontal tissue damage was detected, of which 86.5% in the form of chronic periodontitis. The maximum number of patients with periodontitis was detected in the age group of 51–60 years. The largest number of teeth removed in patients over 70 years of age. There was a direct strong correlation between age and the number of teeth removed (rp = 0.923; p < 0.001). The maximum depth of the periodontal pocket was also in the age group of 51–60 years and amounted to 4,25 ± 1,14 mm. A direct strong correlation of the depth of the periodontal pocket with the number of teeth removed was revealed. The deeper the patient has pathological pockets, the more teeth are removed (rp = 0.892). Conclusions. The results of the study suggest the need to develop training programs for patients and psychiatric hospital staff to improve the quality of life of patients and general health.

Significance of Tissue Inhibitors of Matrix Metalloproteinases Expression in Pathogenesis and Differential Diagnosis of Periodontal Pathology

Background. The balance of metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) is crucial for the manifestation and progression of periodontal diseases and is one of the promising areas of scientific research in terms of developing methods for selective inhibition of MMPs. Aims to determine the significance of TIMP1 and TIMP2 expression parameters in gingival biopsies to identify the type of periodontitis at the stage of disease manifestation. Methods. A prospective study with parallel inclusion of patients with different forms of periodontitis in the compared groups was performed. The object of this study were patients with various forms of periodontitis. Pathological examination with morphometric analysis of TIMPs expression and subsequent statistical data analysis was performed using AperioImageScope v12.4.0.5043, Statistica 10.0, MedCalc19.6. Results. The study included 67 patients with aggressive (AgP, Grade C, n = 19), chronic simplex (CSP, Grade В, n = 10) and chronic complex (CCP, in the presence of occlusal trauma, Grade В, n = 38) periodontitis and 15 conditionally healthy patients (control group). The expression of TIMP1 and TIMP2 was detected with variable intensity both in the epithelium and in the stroma of the gingiva, and was significantly higher in periodontitis groups compared with the control group (MeTIMP1/2 = 32%/70%). Parameters of TIMP1 and TIMP2 expression had no significant differences in the groups with AgP (MeTIMP1/2 = 84%/98%) and CCP (MeTIMP1/2 = 83%/94%), except for higher parameters of the positivity of epithelial expression of TIMP2 (U = 61 372; p 0.05) and lower levels of intensity of its expression in AgP (MeAgP/CCP=180/171; U = 56 491; p 0.001). Correlation analysis revealed an inverse relationship of TIMPs expression parameters with those MMPs, including those most significant for the development of AgP MMP1 ( = 0.40), MMP8 ( = 0.34), and MMP14 ( = 0.24). ROC analysis established acceptable informativeness of all studied parameters of total expression and positivity of epithelial expression of TIMP1, as well as positivity of total expression and intensity of epithelial expression of TIMP2 to distinguish between aggressive and chronic forms of periodontitis at the stage of disease manifestation. Conclusion. Our results show an increase in the expression of TIMP1 and TIMP2 in various forms of periodontitis and an inverse relationship with the MMPs inhibited by them. This complements both the fundamental knowledge of the development and progression of periodontal pathology and may have applied significance in terms of using the studied TIMP1 and TIMP2 expression criteria to establish the aggressive course of periodontitis already at the stage of disease manifestation, which will allow to individualize treatment, prevent or slow down tooth loss in order to preserve and/or improve the quality of life of this patient group.

МОЛЕКУЛЯРНО-ГЕНЕТИЧЕСКАЯ ХАРАКТЕРИСТИКА МИКРОБИОТЫ ПАРОДОНТАЛЬНЫХ КАРМАНОВ У ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ГЕНЕРАЛИЗОВАННЫМ ПАРОДОНТИТОМ, ПЕРЕНЕСШИХ COVID-19

The aim of the study was to study the frequency of periodontal pathogens in patients with chronic forms of periodontitis who underwent COVID-19.
 Material and methods of research. Clinical and laboratory studies were conducted in a comparative aspect, depending on the presence/absence of a history of a new coronavirus infection. All patients who sought dental care for exacerbation of chronic generalized periodontitis (CGP) of mild and moderate severity were divided into 2 groups: 1 main group – 30 patients with CGP after a new coronavirus infection (after 4 months).
 Comparison group 2 – 30 patients with CGP who do not have a history of COVID-19, Patients of the compared observation groups (60 people) underwent a real-time PCR study of the contents of periodontal pockets.
 The results of the study. According to the results of molecular genetic screening, the DNA of six periodontal pathogenic bacteria was found in the contents of the periodontal pockets of the examined patients. Detection of bacteria associated with periodontitis (Porphyromonas endodontalis, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Fusobacterium nucleatum, Tannerella forsythia) showed no statistically significant differences in the prevalence of the studied bacteria in patients of the first and second groups. At the same time, the detected community of microorganisms Porphyromonas gingivalis and Porphyromonas endodontalis, characteristic of the most severe manifestations of periodontitis, was 17% more common among the examined patients who underwent COVID-19 than in patients without COVID-19.
 Thus, as a result of research, the presence of a relationship between the species composition of the microbiota of periodontal pockets and the presence of COVID-19 in the anamnesis has been shown.

Assessment of the antimicrobial efficacy of complex therapy for persistent periodontitis during endodontic retreatment

Aim. To evaluate the antimicrobial efficacy of endodontic retreatment of patients with destructive forms of persistent periodontitis using a combined approach to disinfection of the root canal system and a hyaluronic acid medication.Materials and methods. Group № 1 – endodontic retreatment with root canal disinfection by Hypochloran-3; group № 2 – the same, but for root canal disinfection, first "Hypochloran-3" was applied, and then photodynamic therapy using a 662 nm diode laser and a photosensitizer "ELOFIT®"; group № 3 – in addition to the manipulations carried out in group № 2, of the "Revident" medication was injected twice in the projection of the apical part of the causative tooth. Antibacterial efficacy was assessed according to the results of microbiological studies of biological samples taken before and 2 weeks after endodontic retreatment. The identification of microorganism colonies was carried out by mass spectrometry.Results. In patients with destructive forms of persistent periodontitis, both before and after root canals disinfection, Enterococcus faecalis ranked the first in terms of the frequency of detection in biological samples, Candida albicans the second, and Veillonella parvula the third. At the same time, before the treatment of root canals, the predominance (more than 80%) of polymicrobial associations with their participation was shown. After root canal treatment, the number of obtained microorganism isolates in groups 1-3 significantly decreased: by 60.0%, 74.3%, and 76.0%. Against this background, the share of strict anaerobes and microaerophiles in groups 1-3 decreased: by 60.6%, 81.3%, and 78.1%. The share of facultative anaerobes also significantly decreased by 59.7%, 79.7%, and 83.8%.Conclusions. Endodontic retreatment of patients with destructive forms of chronic periodontitis using combined disinfection of root canals both without and in combination with a hyaluronic acid medication is accompanied by a statistically significant reduction in species diversity, associations, and content of periodontal pathogenic microbiota.

ОСОБЕННОСТИ ЭФФЕКТОРНЫХ ПОКАЗАТЕЛЕЙ ФАГОЦИТОВ И МИКРОБИОЛОГИЧЕСКИХ ПАРАМЕТРОВ ЛОКАЛЬНОГО ОЧАГА ПЕРИАПИКАЛЬНОГО ВОСПАЛЕНИЯ ПРИ РАЗЛИЧНЫХ ФОРМАХ ХРОНИЧЕСКОГО ПЕРИОДОНТИТА

In the last decade, single-stage dental implantation has become widespread, often with immediate loading. A significant part of the implants are installed in the zone of chronic periapical inflammation, however, until now there are no data on the relationship between the form of chronic periodontitis and the processes of osseointegration in the peri-implant zone. The aim of this study was to study the effector parameters of wound neutrophils and the spectrum of pathogens of the local focus of inflammation in various forms of chronic peridontitis. 74 surveyed persons were divided into four groups, depending on the form of chronic periodontitis: group 1 was represented by patients with chronic fibrous periodontitis; Group 2 — patients with chronic granulating periodontitis; Group 3 — subjects with chronic granulomatous periodontitis; Group 4 — control group, patients with healthy teeth removed for orthopedic or orthodontic indications. We studied the quantitative composition of wound phagocytes and functional parameters of wound neutrophils of the separated socket of the extracted tooth, and also studied the biocenosis. Comparative analysis of the effector indices of neutrophils of the socket of the extracted tooth of the patients of the control group and those examined with various forms of chronic periapical inflammation made it possible to reveal in the latter: a twofold increase in the relative activity of phagocytosis and phagocytic number; multiple excess of the control value of the indicators of the intensity of the phagocytic reaction; high rates of activity and intensity of spontaneous and induced NBT-reducing function of wound phagocytes. Microbiological research made it possible to determine the differences in the composition of the microflora of the detachable sockets of the extracted teeth in patients with various forms of chronic periodontitis. Despite statistically significant differences in a number of immunological parameters and the revealed different microbial spectrum of pathogens of a chronic periapical focus, in patients with all forms of chronic periodontitis, predictors of the development of inflammatory complications were identified in the context of the planned one-stage dental implantation when implants were installed in the sockets of teeth with chronic periodontal foci.

CHARACTERISTICS OF EFFECTS PRODUCED BY OSTEOTROPIC DRUGS ON BONE REGENERATION OBTAINED FROM THE ANALYSIS OF CALCIUM-PHOSPHORUS METABOLISM IN THE EXPERIMENT AND CLINICAL FINDINGS OF RADIOLOGICAL EXAMINATIONS

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.

Comparative analysis of polymorphic variants of IL-17A and MMP-1 genes with the risk of developing chronic periodontitis in petrochemical workers

The susceptibility to the development and progression of inflammatory periodontal diseases, which depends on genetic and external factors (smoking, stress, oral hygiene), varies widely. In the development of these diseases, an important role is played not only by the presence of periodontal pathogenic microorganisms, but also by the presence of congenital or acquired immunodeficiency, immunoregulatory defects. The immune system plays a key role in the physiological and pathological processes of periodontal tissues. In this regard, IL17, produced by CD4+ Th cells, which has both Pro-inflammatory and protective activity, is of particular interest in the pathogenesis of periodontitis. The aim of study was to identify the relationship between polymorphic loci of the IL-17A (rs2275913) and MMP-1 (rs1799750) genes and clinical manifestations of chronic periodontitis in petrochemical workers. Dental examination was performed in 92 ethylene oxide production workers with chronic periodontitis and 74 patients with chronic periodontitis who did not come into contact with chemical factors (control group). Genotyping of polymorphisms rs2275913 of the IL17A gene and rs1799750 of the MMP1 gene was performed by allele-specific real-time polymerase chain reaction (PCR). Hygienic assessment of the degree of air pollution of the working area with harmful substances was carried out by gas chromatography according to the guidelines for the determination of harmful substances in the air № 5098-89, № 3119-84. When comparing the results of studies of both groups, there were no statistically significant differences in the frequency distributions of allelic variants and genotypes of the IL-17A and MMP-1 genes. The AA/AG genotypes of the IL-17A gene were associated with an increased risk of severe disease compared to the GG genotype in workers in the main group (OR=6.1; 95% CI 1.33-28.5; p=0.021) and in the control group (OR=7.26; 95% CI 1.34-39.25; p=0.016). Carriers of the A allele in the control group increased the risk of severe chronic periodontitis by 2.4 times compared to carriers of the G allele (OR=2.41; 95% CI 1.19-4.87; p=0.014). During the dental examination of employees of the ethylene oxide plant, the clinical course of periodontal diseases was more severe in comparison with the control group, and the number of patients with severe periodontitis was twice as high. It was found that the AA/AG genotypes of the IL-17A gene and the carrier of the A allele are associated with increased susceptibility to the development of severe chronic periodontitis. The association between the MMP-1 gene polymorphism and the risk of severe forms of chronic periodontitis has not been established. A risk factor for the development of inflammatory periodontal diseases in employees of the petrochemical complex is a complex of harmful production factors.

The dental status of patients with neuropsychiatric disorders who underwent dental debridement under general anaesthesia

Aim. To study the dental status of patients with neuropsychiatric disorders in dental debridement under general anaesthesia.
 Methods. A comparison of the prevalence of oral pathology among patients depending on gender, age, and nosological group was performed. It was studied the dependence of the prevalence of both acute and chronic forms of dental pathology on the type of background disease and compared the frequency of dental pathology depending on the background disease.
 Results. 50.8% of patients were male and 63.82% were female. All patients had poor oral hygiene and lack of knowledge about personal hygiene practices. Dentin caries (K01.2) was in 39 (30.5%) patients, irreversible pulpitis (K04.0) in 31 (24.2%) patients, and chronic forms of periodontitis and their exacerbation (K04.5) in 99 (77.3%) patients. In our study, most patients with neuropsychiatric disorders (35.9%) had Cerebral palsy (G80), 28.1% had mental retardation (F70F73), and 10.2% had schizophrenia (F20). Irreversible pulpitis (K04.0) was statistically significantly more common in patients diagnosed with cerebral palsy (G80) 21.7%, while in patients with mental retardation (F70F73) only in 5.6% (p=0.007). The prevalence of periodontitis was highest in patients with mental retardation (F70F73) 86.1%, medium in patients with schizophrenia (F20) 46.2% and lowest in other diseases (39.4%); the differences were statistically significant (p=0.001).
 Conclusion. We identified characteristics of the dental status, intensity and prevalence of dental diseases in patients with neuropsychiatric disorders in dental debridement under general anaesthesia.

PERIODONT TISSUES STATUS AND FEATURES OF CLINICAL COURSE OF APICAL PERIODONTITIS OF PERMANENT TEETH WITH DISORDERS OF ROOT FORMATION AS A RESULT OF INJURY

Relevance. In childhood, traumatic tooth injuries are often found. Pulp necrosis occurs in 34,2 % of injured teeth, this causes damage to the periapical tissues. The post-traumatic complications (odontogenic cysts, periodontitis) in teeth with incomplete root formation often lead to a halt in root development. Chronic nidus of infection can be the cause of the somatic pathology development. This makes the early clinical and radiological diagnosis of post-traumatic complications important.
 Objective of the work is to study the clinical features of the post-traumatic periodontitis of permanent teeth with incomplete root formation of the tooth and to assess the condition of periodontal tissues in permanent teeth with impaired root formation as a result of trauma based on data from clinical and radiological studies.
 Materials and methods. On follow-up there were 17 children 9-15 years old with post-traumatic periodontitis of permanent teeth with incomplete formation of the root of the tooth. When making the diagnosis, we relied on data from clinical and radiological studies.
 Results. Most children complained of an aesthetic defect. 9 children (52,9 %) after an acute tooth injury did not seek the help of a dentist, аfter treatment of 8 children, dynamic observation was not conducted. In 76 % (13 teeth) periodontitis is diagnosed in teeth with a crown fracture within the enamel, enamel and dentin.
 It has been established that chronic granulating periodontitis is the most common form among destructive forms of periodontitis (12 teeth – 70,6%). Exacerbation of chronic granulating periodontitis diagnosed in 5 teeth. We did not ascertain chronic granulomatous periodontitis in teeth with incomplete root formation. The prevalence of the granulating form of chronic periodontitis in children is due to the histomorphological features of periodontal disease in childhood.
 8 children, among the examined had a bite pathology – protrusion of the teeth of the front of the jaw (5 children) and a distal deep bite (3 children). In 71% of lesions, destructive forms of periodontitis were most often diagnosed in the maxillary incisors.
 Conclusion. Untimely seeking help and the lack of dynamic monitoring of injured teeth are the main reasons for the development of post-traumatic periodontitis. The clinical course of periodontitis is peculiar – chronic granulating periodontitis predominates, the inflammatory process in periodontal tissues in childhood is characterized by rapidly progressive destruction of bone tissue. Malocclusion can be a risk factor for tooth injuries.

Determination of indications for the treatment of temporary teeth in conditions of general anesthesia in preschool children by equipping the study of indicators of oxygen saturation of the brain using the method of cerebral oximetry

Annotation. A common problem at the dental appointment with different treatment methods (without general anesthesia and general anesthesia) is the risk of cognitive dysfunctions against the background of hypoxic brain damage in children: in the first case, against the background of stress, in the other, against the background of general anesthesia. The purpose of the study — to determine indications for the treatment of temporary teeth at the stages of growth and stabilization in conditions of general anesthesia in preschool children based on the study of oxygen saturation indicators of the brain using the cerebral oximetry method. Dental examination and dental procedures of varying severity were performed for 100 children under the age 3–7 years (545 teeth were treated) at the Dental Medical Center at the Bogomolets National Medical University. The method of cerebral oximetry was applied (the permissible reduction of cerebral oximetry was not more than 20%). The results of treatment of medium and deep caries showed a reliably low percentage of complications at different stages of tooth development that occur during rehabilitation of the oral cavity under general anesthesia (12.83% and 15%, respectively) than during rehabilitation of the oral cavity on an outpatient basis (23.5 % and 28.87%, respectively) (p≤0.01)). The results of the treatment of chronic fibrous pulpitis showed a reliably low percentage of complications that occur during oral rehabilitation in conditions of general anesthesia (15%) than during oral rehabilitation in outpatient settings (28.87%) (p<0.01). In the treatment of chronic forms of periodontitis at the stage of root stabilization on an outpatient basis, 59% have complications that cause tooth extraction. Of these, 38% have complications in the form of an exacerbation of the process with a violation of the cortical plate, the rudiment of permanent teeth, 62% — pathological resorption of the roots of temporary teeth. In the treatment of chronic forms of periodontitis at the stage of root resorption on an outpatient basis, 73% have complications, including local enamel hypoplasia of permanent teeth. The treatment of this diagnosis involves several visits, which is technically impossible to perform under general anesthesia. Therefore, in order to preserve the rudiments of permanent teeth, teeth with chronic granulating periodontitis at the aggravation stage were subject to lengthening, at the stage of remission, at the stage of the formed root, instrumental and drug treatment of the channels and root canal filling with iodine paste (according to indications, removal) were performed, in the remission stage at the stage of root resorption, tooth extraction was performed. Dentistry with such a diagnosis involves several visits, which is technically impossible to perform under general anesthesia. The poem, in order to preserve the rudiments of permanent teeth, teeth with chronic granulating periodontitis at the exacerbation stage were subject to extension, at the stage of remission — at the stage of the formed root, instrumental and drug treatment of the channels and root canal filling with iodoform paste (according to indications - removal) were performed, in the remission stage at the stage of root resorption, tooth extraction was performed. Thus, in children aged 3–7 years: the choice of the method of dental treatment depends on the temperament and type of phobias, which determine the nature of the behavior at the dental appointment. Dispensary supervision of children ensures their habituation to the dental chair and, as a consequence, prevents the development of cryptogenic phobias in them.

Application of the method of cooperative learning during the study of subject «pediatric therapeutic dentistry» to the IV year students of the faculty of dentistry of the Ivano-Frankivsk national medical university

Objective. To increase the efficiency of the educational process by applying one of the methods of interactive learning during the practical training to the fourth year students specialized in pediatric therapeutic dentistry of the faculty of dentistry.Мaterial and methods: Implementation into the educational process of the method of cooperative groups as an interactive form of training in order to improve the learning of educational material on the subject «Pediatric therapeutic dentistry» to the fourth year students of the faculty of dentistry, Ivano-Frankivsk National Medical University (IFNMU).Rеsults. The article highlights modern approaches to the organization of practical classes on the subject «Pediatric Therapeutic Dentistry». In order to improve material mastering and development of clinical thinking, we have proposed the method of interactive learning as a method of cooperative groups, in a practical lesson that lasts 4 academic hours. The group receives a specific task, for example, to conduct a differential diagnosis of caries and pulpitis, acute forms of pulpitis and periodontitis, chronic forms of pulpitis and periodontitis, or chronic forms of periodontitis among themselves. In addition to the report in their group, students should participate in reports from other groups — to complete, identify errors, ask questions, discuss possible alternatives to diagnostic tests, and justify their feasibility in this clinical case. The results of using the technology of interactive learning by the method of cooperative groups at the Department of Pediatric Dentistry for the study of the subject «Pediatric Therapeutic Dentistry» to the fourth year students of the Faculty of Dentistry IFNMU showed an increase in the student's motivation to repeat the study material, study it and in-depth analysis. Such a pedagogical technique enhances the level of knowledge of the material studied topics, forms the student's ability to communicate and work collectively, correctly formulate questions to colleagues or make remarks. Conclusions. Consequently, the correct organization and implementation of practical lessons in pediatric therapeutic dentistry can improve the efficiency of the educational process at the Faculty of Dentistry, and the use of various technologies of cooperative learning in the process of preparing future dentistry doctors is appropriate.

THE EFFECTIVENESS OF USAGE TRIACORTUM, CLOTRIMAZOLE AND DOXYCYCLINE FOR CHRONIC APICAL PERIODONTITIS TREATMENT


 
 
 This article represents the work for searching new and effective treatment modality for chronic forms of periodontitis with application of the antibiotic doxycycline, antifungal agent clotrimazole and glucocorticosteroid triacortum.It was made the clinical judgement of treatment of 150 patients with chronic apical periodontitis. It was indicated an improvement of microcirculation in periodontitis tissue by Lazer Doppler flowmetry method by those patients who received therapy using proposed method of treatment and set of medication.
 
 

Morphofunctional Characteristic of Bone Tissue of Alveolar Processes (Parts) in Conditions of Chronic Odontogenic Infection

Assessment of the condition of the alveolar bone is important for the choice of treatment methods for many types of pathology of the dentoalveolar system. The aim of the study was to identify morphofunctional disorders and changes in the optical density of bone tissue of the alveolar process of the maxilla and the alveolar part of the mandible arising from the effects of chronic odontogenic foci of infection. Material and methods. Histological examination of the edges of the alveoli of the removed teeth was carried out in 40 patients with chronic forms of periodontitis. Bony fragments were removed on medical reasons for the prevention of postextraction pain. Decalcification was carried out in Trilon B solution, microtome tissue sections were stained with hematoxylin-eosin. The density of bone tissue was determined on the intraoral radiovisiograms of the removed teeth and intact teeth in 80 persons of the control group. Results. It is established that with chronic forms of periodontitis under the periosteum of the alveolar processes (parts), osteoclastic resorption occurs either in the plane of the bone or with the formation of gauchepic lacunae. The channels of the osteons and the folkman channels widen, and in their circles there are also foci of resorption. Appear pycnosis of osteocytes and extensive areas with empty and dilated osseous lacunae. In the zones of osteolysis, either connective or coarse-fibrous bone tissue is formed. The optical density of bone tissue in patients is significantly less than in individuals with intact teeth. Conclusions. Toxins from chronic odontogenic foci of infection activate the processes of bone resorption of the alveolar process (part) of the jaws and inhibit reparative osteogenesis. The resulting rarefaction of bone tissue leads to a decrease in its optical density.

In Situ Anabolic Activity of Periodontal Pathogens Porphyromonas gingivalis and Filifactor alocis in Chronic Periodontitis.

Porphyromonas gingivalis and Filifactor alocis are fastidious anaerobic bacteria strongly associated with chronic forms of periodontitis. Our understanding of the growth activities of these microorganisms in situ is very limited. Previous studies have shown that copy numbers of ribosomal-RNA precursor (pre-rRNA) of specific pathogen species relative to genomic-DNA (gDNA) of the same species (P:G ratios) are greater in actively growing bacterial cells than in resting cells. The method, so-called steady-state pre-rRNA-analysis, represents a novel culture-independent approach to study bacteria. This study employed this technique to examine the in situ growth activities of oral bacteria in periodontitis before and after non-surgical periodontal therapy. Sub-gingival paper-point samples were taken at initial and re-evaluation appointments. Pre-rRNA and gDNA levels of P. gingivalis and F. alocis were quantified and compared using reverse-transcriptase qPCR. The results indicate significantly reduced growth activity of P. gingivalis, but not F. alocis, after therapy. The P:G ratios of P. gingivalis and F. alocis were compared and a low-strength, but statistically significant inter-species correlation was detected. Our study demonstrates that steady-state pre-rRNA-analysis can be a valuable culture-independent approach to studying opportunistic bacteria in periodontitis.

Обоснование выбора метода временного пломбирования каналов при лечении деструктивных форм хронического периодонтита

Обоснование выбора метода временного пломбирования каналов при лечении деструктивных форм хронического периодонтита

Обоснование выбора метода временного пломбирования каналов при лечении деструктивных форм хронического периодонтита

Обоснование выбора метода временного пломбирования каналов при лечении деструктивных форм хронического периодонтита

Сравнительная характеристика микрофлоры корневого дентина при применении различных вариантов медикаментозной обработки корневых каналов зубов

Application of ultrasonic treatment combined with conventional methods of endodontic treatment contributes to reduce the cases of relapses and the time of treatment, and causes the highest economic effect. The proposed method allows to successfully treating chronic granulating periodontitis and to save the need for prosthetics abutment teeth. The purpose of this study is to increase the effectiveness of treatment of granulating periodontitis by optimizing antiseptic treatment of root canals by means of ultrasound. In a series of studies the material of the examination and treatment of patients in the therapeutic department «Lipetsk municipal dental polyclinic №2» was examined. The basis for receiving scientific data – contingent of 127 patients from 26 to 51 years with granulating form of chronic periodontitis, of these were 83 women and 44 men. Depending on the tactics of the treatment the patients were divided into two groups: the 1st group – 43 patients who were treated by the traditional method of treatment of periodontitis; the 2nd group – 84 persons were treated by means of ultrasound. Clinical examination of patients included visual diagnostics, sensing, thermometry, percussion, determination of conductivity of the tooth pulp, radiovisiographic and x-ray study. It is established, that after use of a 3% solution of sodium hypochlorite the changes are observed not qualitative composition of the microflora, but quantitative. The methods of ultrasonic treatment of chronic granulating periodontitis are developed. The ultrasound effect on the microflora of each root channel is conducted during 30 seconds with the frequency of 30 kHz. The structure of the dentin of the root canal with the help of scanning electronic microscopy, before and after the influence of ultrasound is studied and described. After exposure to 3% of sodium hypochlorite, activated by ultrasound, on the wall of the root canal by granulating periodontitis the growth of microorganisms didn’t revealed in 94,8% of cases.

Изменения бактериального состава корневого дентина при традиционной медикаментозной обработке и с применением ультразвука

Inflammatory diseases of the dental pulp and periodontal disease are the most frequent complications of caries. Chronic inflammatory processes in the periapical tissues are the most common cause of tooth extraction. Despite, the progress made in improving the various methods of conservative therapy, the granulating form of chronic periodontitis is difficult controlled pathological state in the bones of the jaw, which often leads to the development of extensive purulent-inflammatory complications. The close relationship periapical lesions with an organism, the possibility of sensitization and toxicity require active treatment of periodontitis. Periodontitis is widespread pathology that requires additional treatment, and sometimes extraction of the affected tooth. The problem of early diagnosis and complex treatment of chronic forms of periodontitis remains relevant because of its wide availability, variety of clinical manifestations and high re-use of patients.Application of ultrasonic method of treatment combined with conventional methods of endodontic treatment contributes to reduce the number of relapses and reduction of treatment terms, it gives a high economic effect. The proposed method allows successfully to cure chronic granulating periodontitis, and consequently, to maintain all necessary for prosthetics abutment teeth.

Разработка и экспериментальное использование новых стоматологических материалов для стимулирования репаративного остеогенеза при лечении деструктивных форм хронического периодонтита

Разработка и экспериментальное использование новых стоматологических материалов для стимулирования репаративного остеогенеза при лечении деструктивных форм хронического периодонтита