Оптимизация антибактериальной терапии у пациентов с эндо-пародонтальными поражениями

To improve the quality and effectiveness of medical care for patients with inflammatory periodontal diseases, it is necessary to search for new approaches in both diagnosis and treatment. The aim of our study is to determine the effect of the diode laser on the pathogenic microflora of periodontal pockets and root canals in patients with endo-periodontal lesions (EPL). We carried out a comparative assessment of the bacterial contents of the root canals and periodontal pockets by polymerase chain reaction (PCR) before and after treatment with a diode laser (Doctor Smile Simpler, wavelength 980 nm) for 54 patients with EPL. The control group consisted of 56 patients who were treated according to the generally accepted method, including professional oral hygiene, endodontic treatment, and curettage of periodontal pockets. Evaluation criteria were a qualitative assessment of the content of periodontopathogens in the root canal and periodontal pocket before and after and treatment. As a result of our study, we found a statistically significant (p<0.01) reduction in the colonization of periodontal pockets and root canals in patients with EPL after laser decontamination. The high technological effectiveness of the methods used in combination with the low risk of complications at the stages of endodontic and periodontological treatment provides an antibacterial effect and reduces the duration of inflammation. The results of treatment of patients using a diode laser give reason to recommend their use in the dental practice.Для повышения качества и эффективности оказания медицинской помощи пациентам с воспалительными заболеваниями пародонта необходим поиск новых подходов к диагностике и лечению патологии. Целью исследования было изучить влияние излучения диодного лазера на патогенную микрофлору пародонтальных карманов (ПК) и корневых каналов (КК) у пациентов с эндо-пародонтальными поражениями (ЭПП). Проведена сравнительная оценка бактериального содержимого КК и ПК методом полимеразно-цепной реакции (ПЦР) до и после лечения с применением стоматологического диодного лазера (Doctor Smile Simpler, длина волны 980 нм) у 54 пациентов с ЭПП. Группу контроля составили 56 пациентов, которым проводилось лечение по общепринятой методике, включающей профессиональную гигиену рта, эндодонтическое лечение и кюретаж ПК. Критерием оценки явилось качественное содержание пародонтопатогенов в КК и ПК до и после лечения. Выявлено статистически значимое (p<0,01) снижение обсемененности ПК и КК у пациентов с ЭПП после лазерной деконтаминации. Высокая технологичность использованных методик в сочетании с низкими рисками осложнений на этапах эндодонтического и пародонтологического лечения обеспечивает антибактериальный эффект и сокращает продолжительность воспалительных явлений. Результаты лечения пациентов с применением диодного лазера дают основание рекомендовать их использование в практике врача-стоматолога

Modern approaches in endodontic treatment of irreversible pulpitis

Relevance. Currently, there are a large number of methods and instruments for the root canal system highquality biomechanical instrumental processing and subsequent obturation. In recent years, more and more scientific works in dentistry have focused on the fact that only 10% of root canals have no branches, and the classical canal has many additional canals. In this connection, the search for endodontic treatment methods that provide high-quality both the main and lateral canals obturation remains relevant. Aim was to increase the irreversible pulpitis treatment clinical effectiveness.  Materials and methods. We have carried out a comparative assessment of the root canals instrumental treatment effectiveness by reciprocation instrument followed by obturation using the vertical condensation technique in 15 patients with irreversible pulpitis. The comparison group consisted of 12 patients with chronic pulpitis, in the treatment of which the traditional machine rotary instruments technique of root canals and obturation using the lateral condensation method of gutta percha were used.Results. Showed that the modern technologies use based on reciprocal instrument rotation with subsequent root canal obturation by the gutta percha vertical condensation method, is clinically justified, as evidenced by the comparative assessment data.Conclusions. High technological effectiveness of the methods used in combination with low complication risks at the stage of instrumental processing and obturation provides the patient with maximum comfort in the postoperative period, as evidenced by the indicators of the verbal pain assessment scale, show minimal time spent on the procedure, which is important in the ergonomic work at the present stage . The endodontic treatment results of patients with the Reciproc and BeeFill systems use give reason to recommend their application in the dental practice