Treatment Of Periodontitis Research Articles

A state-of-the-art review of the recent advances in drug delivery systems for different therapeutic agents in periodontitis.

Periodontitis (PD) is a chronic gum illness that may be hard to cure for a number of reasons, including the fact that no one knows what causes it, the side effects of anti-microbial treatment, and how various kinds of bacteria interact with one another. As a result, novel therapeutic approaches for PD treatment must be developed. Additionally, supplementary antibacterial regimens, including local and systemic medication administration of chemical agents, are necessary for deep pockets to assist with mechanical debridement of tooth surfaces. As our knowledge of periodontal disease and drug delivery systems (DDSs) grows, new targeted delivery systems like extracellular vesicles, lipid-based nanoparticles (NPs), metallic NPs, and polymer NPs have been developed. These systems aim to improve the targeting and precision of PD treatments while reducing the systemic side effects of antibiotics. Nanozymes, photodermal therapy, antibacterial metallic NPs, and traditional PD therapies have all been reviewed in this research. Medicinal herbs, antibiotics, photothermal therapy, nanozymes, antibacterial metallic NPs, and conventional therapies for PD have all been examined in this research. After that, we reviewed the key features of many innovative DDSs and how they worked for PD therapy. Finally, we have discussed the advantages and disadvantages of these DDSs.

Best practices for disinfection in dental settings: insights from Italian and European regulations.

Disinfection practices in dental settings are fundamental to clinical safety, playing a pivotal role in preventing cross-infections and protecting the health of patients and healthcare professionals. This article examines the key components of effective disinfection, based on evidence-based protocols developed by international organizations such as the WHO and the U.S. CDC, alongside European and Italian regulatory standards. Dental instruments require stringent sterilization by autoclave or chemical methods, while high-level disinfection is essential for non-sterilizable items. Clinical surfaces require routine biocidal treatment tailored to microbial hazards and material compatibility. The European Biocidal Products Regulation and the Medical Devices Regulation provide critical oversight, ensuring product safety and effectiveness while preventing resistance. Antiseptics also play a vital role in oral care, with applications ranging from infection prevention to the treatment of periodontal disease, and are governed by strict regulatory frameworks. Disinfection effectiveness is significantly affected by factors such as microbial load, presence of biofilm, pH, temperature and biocide exposure time. Preventing bacterial resistance requires appropriate germicide selection, adherence to manufacturer protocols, robust sterilization and cleaning procedures. In addition, the increased use of disinfection during public health emergencies highlights the need for adaptability to mitigate evolving risks. Regular audits, biological tests, and training for healthcare personnel ensure the consistent application of these rigorous protocols. By integrating international and national standards, dental facilities achieve a uniform approach to hygiene and safety, advancing public trust and compliance. This article highlights the imperative for ongoing research and dissemination of best practices to enhance infection control in dental care environments.

Antimicrobial activity of Ruta angustifolia L. Pers against periodontal pathogen: Porphyromonas gingivalis

Background Porphyromonas gingivalis is widely recognised as a periodontal pathogen. In recent years, there has been growing interest in the use of medicinal plant extracts as alternative treatments for periodontitis to combat the emergence of antibiotic-resistant bacteria. Ruta angustifolia L. Pers has been traditionally used to treat various ailments, including oral bacterial infections. However, the antimicrobial potential of R. angustifolia extracts against the periodontal pathogen P. gingivalis remains unexplored. Hence, the aim of this study was to investigate the antimicrobial activity of R. angustifolia extracts against P. gingivalis. Methods The antimicrobial activity of R. angustifolia extracts (crude methanol, hexane and chloroform fractionated extracts) against P. gingivalis was evaluated using the well diffusion method. Additionally, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined. Biofilm biomass assessment and live/dead cell viability assays were performed to analyse the effect of R. angustifolia extracts. Ultrastructural morphological changes in P. gingivalis cells were determined using field emission scanning electron microscopy (FE-SEM). Results It was found that P. gingivalis was susceptible to R. angustifolia extracts, with the chloroform fractionated extract exhibiting the highest inhibition zones. The MIC and MBC of chloroform fractionated extract were determined to be 6.25 mg/mL which substantially reduced P. gingivalis biofilm biomass. Live/dead cell viability assays showed the highest percentage of dead P. gingivalis cells after 48 h of incubation. FE-SEM confirmed that the chloroform fractionated extract effectively damaged the bacterial cell wall and altered the ultrastructural morphology of P. gingivalis. Conclusion The results indicated that extracts of R. angustifolia has the potential to be used as an alternative treatment in addition to conventional periodontal therapies.

A review on in situ gels as polymer drug carriers in the treatment of periodontitis

A review on in situ gels as polymer drug carriers in the treatment of periodontitis

Self-Driven Janus Ga/Mg Micromotors for Reducing Deep Bacterial Infection in the Treatment of Periodontitis.

A self-propulsion Janus gallium (Ga)/magnesium (Mg) bimetallic micromotor is designed with favorable biocompatibility and antimicrobial properties as a therapeutic strategy for periodontitis. The Janus Ga/Mg micromotors are fabricated by microcontact printing technique to asymmetrically modify liquid metallic gallium onto magnesium microspheres. Hydrogen bubbles produced by the magnesium-water reaction can provide the driving performance of up to 31.03 µms-1 (pH 6.8), prompting the micromotor to actively breakthrough the biological barrier of saliva and gingival crevice fluid (GCF) into the bottom of periodontal pockets. In addition, the Janus Ga/Mg micromotors are effectively converted by degradation into the built-in antimicrobial ion Ga(III) to eliminate deep-seated Porphyromonas gingivalis (P.gingivalis), with bactericidal efficiencies of over 99.8%. The developed Janus Ga/Mg micromotors have demonstrated potent antimicrobial and anti-inflammatory activity both in vitro and in vivo studies. Crucially, it reduces alveolar bone resorption, demonstrating the superior efficacy of liquid metal gallium in treating periodontitis. Therefore, Ga/Mg bimetallic micromotors hold great promise to be an innovative and translational drug delivery system to treat periodontitis or other inflammation-related diseases in the near future.

H2S-Scavenging Hydrogel Alleviating Mitochondria Damage to Control Periodontitis.

H2S, as a typical metabolite of periodontal pathogens, exhibits a clear positive correlation with the occurrence and development of periodontitis. H2S at physiological concentrations can regulate many biological processes. However, excess H2S in the periodontal pocket can trigger secretion of proinflammatory cytokines, cause oxidative stress, and result in mitochondrial damage and cell death in human gingival fibroblasts, exacerbating periodontitis development and periodontal tissue destruction. Worse, H2S facilitates bacteria survival and proliferation by maintaining bacterial redox balance and enhancing antibiotic resistance. Unfortunately, scavenging H2S during periodontitis treatment is usually ignored. Herein, a kind of hyaluronic acid methacryloyl/ZnO (HMZ) composite hydrogel with an H2S-scavenging ability was prepared to enhance periodontitis treatment. The HMZ hydrogel possessed good injectability and cytocompatibility and was able to remove H2S by a reaction with ZnO. As a result, the HMZ hydrogel was able to increase cell viability from 13% to 120% for human gingival fibroblasts and 22% to 94% for human periodontal ligament fibroblasts at 48 h, restore mitochondrial homeostasis, and alleviate cGAS-STING signaling pathway-mediated inflammation. Meanwhile, the HMZ hydrogel showed satisfactory antibacterial properties and efficiency of plaque biofilm removal. The in vivo results further confirmed that HMZ hydrogel decreased the concentration of H2S within the periodontal pocket from 0.7 to 0.8 mM to the normal level (0.3 to 0.4 mM), killed the bacteria in the periodontal tissues, inhibited osteoclast activity, relieved excess inflammation, and decreased the vertical distance between the cementoenamel junction and the alveolar bone crest from 1,175 µm to 798 µm on the 7th day and from 1,075 µm to 693 µm on the 14th day, achieving efficient periodontal bone regeneration. In brief, an H2S scavenging-based promising strategy was developed to enhance the therapeutic efficiency of periodontitis.

Management of Persistently Symptomatic Teeth in Primary Root Canal Treatment: Advice on Maximizing Successful Outcomes

The aim of root canal treatment is chemo-mechanical debridement of the root canal system to promote healing. Root canal treatment is a predictable modality in the treatment of apical periodontitis; however, there are situations during primary root canal treatment where signs and symptoms persist despite repeated chemo-mechanical disinfection. This article highlights such situations and offers practical solutions on how to minimize them. CPD/Clinical Relevance: Understanding the possible causes of a persistently symptomatic tooth during treatment may allow for appropriate management.

FOXA1 knockdown alleviates inflammation and enhances osteogenic differentiation of periodontal ligament stem cells via STAT3 pathway

BackgroundEvidence has confirmed that forkhead box protein A1 (FOXA1) inhibits the osteogenic differentiation of bone marrow mesenchymal stem cells. However, whether FOXA1 regulates the osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) to participate in periodontitis process is unclear.MethodsLipopolysaccharide (LPS) was used to treat hPDLSCs to mimic inflammation environments. FOXA1 expression was examined by quantitative real-time PCR and western blot. The levels of IL-6 and TNF-α were evaluated by quantitative real-time PCR, ELISA and immunohistochemistry staining. hPDLSCs osteogenic differentiation was assessed by measuring alkaline phosphatase activity, alizarin red S intensity and the levels of osteogenic differentiation-related markers. Besides, the expression of signal transducer and activator of transcription 3 (STAT3) pathway-related markers were examined by western blot and immunofluorescence staining.ResultsFOXA1 was upregulated in the periodontal ligament tissues of periodontitis patients, and its knockdown enhanced osteogenic differentiation of hPDLSCs. Besides, downregulation of FOXA1 suppressed inflammation levels in LPS-induced hPDLSCs. Also, FOXA1 silencing promoted the osteogenic differentiation of LPS-induced hPDLSCs by the inactivation of STAT3 pathway.ConclusionOur data confirmed that knockdown of FOXA1 attenuated inflammation and enhanced osteogenic differentiation of LPS-induced hPDLSCs by regulating STAT3 pathway, indicating that FOXA1 might be a target for periodontitis treatment.

The Association between High-density Lipoproteins and Periodontitis.

Periodontitis is one of the most typical chronic dental diseases. This inflammatory disease can change various functions of immune cells and impair lipid metabolism through proinflammatory cytokines. High-Density Lipoprotein (HDL) is considered protective of the cardiovascular system. It has anti-thrombotic and anti-inflammatory effects. In this article, we have reviewed the association between periodontitis and HDL. Various studies have demonstrated a reverse relationship between inflammatory cytokines and HDL. HDL contains antioxidative enzymes and proteins, whereas periopathogens impair HDL's antioxidant function. The presence of periodontal bacteria is associated with a low HDL level in patients with periodontitis. Genetic variants in the interleukin- 6 (IL)-6 gene and cytochrome (CYP)1A1 rs1048943 gene polymorphism are associated with HDL levels and periodontal status. Studies showed that HDL levels improve after treatment for periodontitis. On the one hand, periodontal pathogenic bacteria and their metabolites and pro-inflammatory cytokines from periodontal infection can result in various disorders of lipid metabolism and lipid peroxidation. On the other hand, hyperlipidemia and lipid peroxidation stimulate proinflammatory cytokines, resulting in oxidative stress and delayed wound healing, making individuals susceptible to periodontitis.

Formulation and Development of Clove and Coriander Combination Herbal Dental Anticaries Gel and Evaluation of its Antimicrobial Activity

Background:: Dental caries is one of the Periodontal diseases that has been recognized as a major public health problem for decades throughout the world. It occurs in all groups, ethnicities, races, and genders at all socioeconomic levels. Natural remedies are more acceptable in the belief that they are safer with fewer side effects than synthetic ones. Clove and coriander oil are established herbal drugs for periodontal diseases. Objective:: This research work was intended to formulate a dental gel containing clove and Coriander as the major constituents and evaluate it for dental caries treatment. Both of the herbal oils have a vast range of antimicrobial activity against a great number of periodontal pathogens; therefore, they are used for periodontitis treatment. Methods:: The combination gel was prepared using carbopol 934 as a gelling agent, clove oil and coriander oil as therapeutic constituents, polyethylene glycol as a co-solvent, methyl paraben and propyl paraben as a preservative and a required quantity of distilled water as vehicle. Results:: The gel was analyzed for various properties like antimicrobial activity, pH, spreadability, extrudability, drug content etc., and it was shown that the combination gel is a satisfactory dosage form that is used in periodontitis treatment. The combination gel revealed the ZI (zone of inhibition) of about 22.05±0.04 mm. Conclusion:: The present study concluded that the combination gel preparations of clove oil and coriander oil reported satisfactory physicochemical properties along with good drug content compared to the single gel preparation.

The Study of Chemical Constituents and Metabolite Profiles of Chitong Xiaoyanling Granules in Normal and Periodontitis Model Rats Based on Ultra-High-Performance Liquid Chromatography-Quadrupole Time-of-Flight-Tandem Mass Spectrometry Analysis.

Periodontitis is a chronic inflammation of the periodontal support tissues. The typical symptoms of periodontitis are inflammation and alveolar bone resorption. Chitong Xiaoyanling Granules (CXG) is composed of 10 Chinese herbs, which have the efficacy of dispersing wind, clearing heat, cooling blood, and relieving pain. CXG is clinically used for the treatment of periodontitis and other diseases, with remarkable efficacy and broad application prospects. However, due to the lack of systematic research on its chemical constituents and metabolites, it is of great significance to characterize the various chemical components and metabolites of CXG. In this study, ultra-high-performance liquid chromatography-quadrupole time-of-flight-tandem mass spectrometry analysis was used to identify the chemical constituents and metabolites of CXG, and the differences in metabolite profiles between normal and model rats were compared. A total of 147 compounds were identified in CXG, including 53 flavonoids, 28 terpenoids, seven chromones, eight coumarins, eight organic acids, 12 phenols, 10 alcohols, nine sugars, and 12 others. In normal and model rats, 191 and 179 CXG-related xenobiotics were detected respectively. In conclusion, a rapid and accurate identification method was used to identify the chemical components and metabolites of CXG, which laid a foundation for the study of the quality control and pharmacological mechanisms of CXG.

Evaluation of the Effect of Topically Applied Resveratrol Gel as Adjunctive Treatment for Periodontitis

Evaluation of the Effect of Topically Applied Resveratrol Gel as Adjunctive Treatment for Periodontitis

The use of non-steroidal anti-inflammatory drugs (NSAIDs) in clinical practice for the treatment of periodontitis: a narrative review

Abstract After dental caries, the most common multifactorial oral disease is periodontal disease. Periodontitis can result in biofilm and host dysbiosis, ultimately causing inflammation and destruction of periodontal tissues. This narrative review aimed to summarise and discuss the mechanism of action, categories and use of non-steroidal anti-inflammatory drugs (NSAIDs) in clinical practice in the treatment of periodontitis because of their analgesic, anti-inflammatory and reducing effects on platelet aggregation and thus bleeding. Also, this review illustrates the importance of studies demonstrating synergism between specialty drugs and their derivatives as valuable active substances. The eleven clinical trials conducted in small groups of adult volunteers (14-50) treated with various NSAIDs, e.g. aspirin, ibuprofen, diclofenac, ketoprofen and tenoxicam are discussed. The results of clinical trials have shown that the use of NSAIDs together with surgical intervention in the treatment of periodontal diseases produces beneficial effects as an adjunctive treatment. It is worth noting that these studies were conducted on small cohorts of adult volunteers, with variations in the duration of treatment and doses of administered drugs. Further research on the impact of NSAIDs administration on periodontal disease may provide in-depth knowledge of patient groups with different demographics, including age, gender and comorbidities. Additional research is necessary to explore the use of NSAIDs in combination with periodontitis treatment for different patient groups.

Amylopectin from maize-derived carbonized polymer dots as a novel high-efficiency antioxidant for periodontitis treatment

Periodontitis is a common chronic inflammatory disease and the local accumulation of excessive reactive oxygen species (ROS) could cause oxidative damage to periodontal tissues. Thus, antioxidative therapy is considered to be the promising strategy for treating periodontitis. However, highly efficient antioxidant activity of biomaterials with low cost, ease of synthesis, and good biocompatibility are still highly desired. Here amylopectin from maize (AFM)-derived carbonized polymer dots (AFM-CPDs-240) with excellent antioxidant activity, good water solubility and biosafty is parepared. Detailed characterizations identify that the antioxidant properties and formation mechanism of AFM-CPDs, and antioxidant activity of AFM-CPDs-240 is much higher than Trolox (a hydrophilic derivative of vitamin E) due to the large contents of conjugated C=C and C=O. Besides, in vitro and in vivo experiments suggest AFM-CPDs-240 could effectively alleviate inflammatory response, inhibit alveolar bone resorption and promote bone formation, showing excellent therapeutic effects on periodontitis. Moreover, the label-free proteomics and western blot results demonstrate AFM-CPDs-240 could accelerate the recovery of periodontitis by blocking TLR4/NF-κB (Toll-like receptor 4/ nuclear factor-kappa B) signaling pathway. This study will develop a simple approach to design highly efficient antioxidant carbon dots with good biocompatibility, and also provide a new promising nanoplatform for treating diseases associated with ROS.

THE CRITICAL CONNECTION BETWEEN ORAL HEALTH AND CARDIOVASCULAR WELL-BEING

The relationship between oral health and cardiovascular health has gained significant attention, particularly regarding the prevention of periodontal diseases to mitigate cardiovascular complications, especially in hypertensive patients. Periodontal diseases, including gingivitis and periodontitis, are chronic infections affecting the gums and supporting structures of teeth, potentially leading to systemic inflammation and the release of inflammatory mediators into the bloodstream. This chronic inflammation is associated with cardiovascular diseases, as it can contribute to plaque formation in arteries, increasing the risk of adverse cardiac events. Hypertension is a notable risk factor for cardiovascular diseases, and studies suggest that individuals with periodontal diseases are more likely to develop hypertension and related conditions. Therefore, proper prevention and treatment of periodontal diseases play a crucial role in the cardiovascular health of hypertensive patients. Early detection and intervention through periodontal screening programs can help reduce systemic inflammation and healthcare costs related to cardiovascular complications. Various studies support the positive effects of periodontal therapy on cardiovascular risk factors, indicating significant reductions in blood pressure and inflammatory markers following periodontal treatment. Furthermore, the alarming prevalence of hypertension, affecting approximately 45% of the global population, necessitates increased awareness of its links to periodontal health. Collaborative approaches between dentists and primary care physicians are essential to improve early detection and management of both periodontal and systemic health issues. Investing in preventive dental care not only enhances oral health but can also lead to substantial savings in healthcare costs by alleviating the financial burden associated with treating cardiovascular diseases. Ultimately, integrating oral health into broader health strategies is vital for promoting overall health and preventing chronic diseases.

Flowable Oxygen-Release Hydrogel Inhibits Bacteria and Treats Periodontitis.

Periodontitis, the chronic inflammation of the periodontal tissues caused by bacteria in plaque, is the leading cause of tooth loss in adults in the world. Currently, periodontitis is effectively treated with mechanical cleaning and the use of antibiotics. However, these treatments only temporarily remove plaque, which can rapidly proliferate and multiply in periodontal pockets over time. Although antibiotics have positive antimicrobial effects, their long-term use increases the risk of the emergence of drug-resistant strains. The emergence of resistant strains reduces the effectiveness of periodontitis treatment and makes the disease more difficult to control. Herein, this paper reports the development of an injectable self-oxygenating composite hydrogel for periodontal therapy, which was produced by loading CaO2 nanoparticles and ascorbic acid into an injectable alginate hydrogel. CaO2 can improve the periodontal pocket microenvironment by reacting with water to generate oxygen, calcium ions can be used as a bone regeneration material, and ascorbic acid protects cells. The authors further showed that the composite hydrogel inhibited growth and colonization of anaerobic bacteria, reduced the degree of inflammation, and promoted alveolar bone regeneration. In conclusion, these findings suggest that the composite hydrogel can be used as a biocompatible, convenient, and effective method for periodontitis treatment.

Beneficial effects of non-invasive physical plasma on human periodontal ligament cells in vitro.

Periodontitis is a chronic inflammatory disease of the periodontium that can lead to the loss of affected teeth if left untreated. It is induced by a multifactorial process centered on microbial pathogens such as Fusobacterium nucleatum (F.n.). Non-invasive physical plasma (NIPP), a highly reactive gas, has become a focus of research, not only for its hemostatic, proliferation-enhancing and apoptotic properties, but also for its antimicrobial potential. The objective of this study was to examine the impact of NIPP on human periodontal ligament (PDL) cells that had been induced into a state of periodontal infection in vitro. Initially, the solitary effect of NIPP was evaluated by measuring temperature and pH and analyzing reactive oxygen species (ROS). Additionally, DAPI and phalloidin staining were employed to investigate possible cytotoxic effects. The cells were pre-incubated with F.n. and treated with NIPP after 24 hours. Interleukin (IL)-6 and IL-8 were analyzed at mRNA and protein levels, respectively, by real-time PCR and ELISA. NIPP alone had no significant effect on PDL cells. However, the F.n.-induced upregulation of IL-6 and IL-8 was counteracted by NIPP. Thus, the utilization of NIPP may be regarded as a promising therapeutic strategy for the treatment of periodontal diseases.

Can Epimedii herba treat periodontitis? A prediction based on network pharmacology, molecular docking, and dynamics analysis

Epimedii herba (EH) showed numerous activities and has the potential to treat periodontitis. However, the pharmacological mechanism has not been exhaustively elucidated. This study predicted the specific targets and mechanisms of EH to prevent and treat periodontitis. A traditional Chinese medicine system pharmacology database and analysis platform was used to screen key compounds of EH and their corresponding targets. Therapeutic Target Database and Comparative Toxicogenomics Database were used to identify targets related to periodontitis. Intersection targets were observed using a Venn diagram. The key components and corresponding protein targets of EH were searched. The intersection targets were obtained and then they were imported into the STRING database to construct a PPI network. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed. Molecular docking between the screened chemical components of EH and key targets was performed using Discovery Studio 2019. The binding stability between components and target proteins was confirmed using molecular dynamics simulations. The binding stability between components and target proteins was confirmed using molecular dynamics simulations. Through network pharmacological analysis, 23 active compounds of EH were identified, including kaempferol and icariin. Based on GeneCards, GEO, and other databases, 3291 periodontitis-related genes were obtained. Venn diagram analysis revealed 137 intersection targets of EH and periodontitis, and Protein kinase B (AKT1) and Tumor necrosis factor (TNF) were identified as the key targets of EH for periodontitis treatment. GO and KEGG analyses revealed that the primary pathways mediating the therapeutic effects of EH were related to cancer, lipid, and atherosclerosis. Molecular docking showed that 8-isopentenyl-kaempferol had the best binding ability to ESR1, which was confirmed by dynamics simulations. This study demonstrated that EH can be used for periodontitis treatment, and the corresponding targets and potential mechanisms were investigated based on network pharmacology, molecular docking, and dynamics simulation analysis. Notably, 8-isopentenyl-kaempferol exhibited good binding affinity and stability to ESR1, which may partially explain the molecular mechanisms of EH for treating periodontitis. Hence, EH can be a novel choice for the clinical treatment of periodontitis in the future.

Hemodynamic periodontal changes in the treatment of chronic generalized periodontitis using polarized polychromatic light

Background: Ineffective treatment of inflammatory periodontal diseases is a significant medical and social issue. Previous research have shown that improved vascular response and local immunity activation are crucial for the treatment of periodontal diseases. This can be accomplished using polarized polychromatic light. However, the effect of polarized polychromatic light on microhemocirculation in periodontal tissues is poorly understood. Aim: To assess microhemodynamic changes in periodontal tissues in the treatment of mild chronic generalized periodontitis using polarized polychromatic light. Materials and Methods: A complex dental examination and treatment were performed in 70 patients (32 males and 38 females) with active chronic generalized periodontitis aged 20 to 59 years. The study had two groups (35 subjects each) based on treatment approaches. Group 1 received professional oral care and a course of antimicrobial therapy using Dentamet dental gel. Group 2 received antimicrobial therapy in combination with polarized polychromatic light therapy (wavelength 480–3,400 nm, power 40 mW/cm2, flux density 2.4 J/cm2 per minute, polarization 95%). Laser Doppler flowmetry was used to assess hemodynamics before treatment, as well as 3, 6, and 12 months after treatment. Results: Group 1 demonstrated an improvement in microcirculation parameters for up to 3 months (p=0.0027). In group 2, an improvement was observed for up to one year (p=0.0455). Conclusion: Polarized polychromatic light therapy in mild chronic generalized periodontitis improves microhemocirculation in periodontal tissues, increasing the efficacy of drug therapy.

Retrospective analysis and clinical features of periapical tissue regeneration

Background: Chronic periodontitis is associated with changes in periapical tissues. Untimely diagnosis and lack of appropriate mechanical treatment increase the incidence of chronic periodontitis. Periodontitis that causes destructive changes due to long-term inflammation of periapical tissues is of particular concern. Thus, the treatment of destructive periodontal diseases is a pressing issue in modern dentistry. Aim: To assess periapical tissue regeneration following treatment in chronic periodontitis patients. Materials and Methods: A retrospective analysis of the destruction and regeneration of periapical tissues before and after treatment during 3–6 months was performed in 20 patients. Results: A retrospective analysis of X-ray findings in 20 patients revealed bone destruction of varying degrees. Low-quality root canal preparation was due to various factors, primarily the anatomy and topography of root canals. Of the 20 patients who required treatment for chronic periodontitis with varying degrees of destruction, 16 came back for follow-up appointments and received endodontic treatment. Following treatment, X-ray findings were used to identify taper root canal preparation and assess the quality of obturation up to the root apex. X-ray examination was performed after 3 months in patients with clinical signs of periodontitis and after 6 months in patients without clinical signs of periodontitis. After 3 months, X-ray findings showed a reduction in bone destruction in the causative tooth area, indicating an improvement. Conclusion: The study of periapical tissue regeneration following treatment in chronic periodontitis patients revealed that effective apical preparation, as well as appropriate irrigation and root canal filling, promote regeneration in periodontitis. Healing of periapical tissues is essential for effective root canal treatment.