ANTIBACTERIAL AND REPARATIVE ACTIVITY OF DIODE LASER IN ENDODONTIC TREATMENT OF TEETH WITH PERIAPICAL LESION ANALYZED WITH OPTICAL DENSITY AND RT-PCR

Objectives: Modern methods of endodontic treatment of periodontitis include a set of measures to achieve sterilization of the root canal system. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure. Relatively new approaches for disinfecting and cleaning the root canals include lasers. However, the acceptance of laser technology by clinicians still remains limited. The aim of the study was to evaluate the antibacterial and reparative activity of a diode laser in the endodontic treatment of teeth with a periapical lesion. Material And Methods: Endodontic treatment in the experimental group included the use of calcium hydroxide three times with an interval of 7-14 days, followed by a long-term temporary obturation with calcium hydroxide with iodoform, ultrasonic activation of sodium hypochlorite, hydrodynamic irrigation, and a diode laser with the following permanent root canal obturation. In the control group the same treatment was applied without the use of a diode laser. The study of the content of microorganisms in the root canal was carried out by Real-Time PCR. Optical density (OD) in the periapical area was performed using the Measure Density Profile program (Sidexis, Sirona). Results: Under our supervision, there were 62 human permanent teeth with a periapical lesion from 1.8 mm to 5.9 mm in size, divided into two groups (experimental and control), 31 in each. Endodontic treatment performed in both groups ascertained dif ferent antimicrobial activity. Complete inhibition of microorganisms was determined in patients of the experimental group. The treatment performed in the control group, which did not include the use of a diode laser, was less active antimicrobiologically. According to optical density in the experimental group, a change in bone density in the periapical area from 35.7 ± 1.76% to 50.6 ± 1.51% (p ˂ 0.001) was determined. The improvement in bone density during the treatment period was 14.9 ± 1.38%. In the control group, where antibacterial activity was less pronounced, a change in bone density occurred from 36.0 ± 1.87% to 48.7 ± 1.62% (p˂0.001). Indicators of improvement in bone density were significantly lower - 12.7 ± 1.28%. (p˂0.05). Conclusion: Both treatment regimens tested in groups determined dif ferent antimicrobial activity. Complete inhibition of microorganisms was determined in patients of the experimental group. The treatment regimen tested in the control group, which did not include the use of a diode laser, was less active antimicrobiologically. The use of a diode laser in endodontic treatment of the teeth with a periapical lesion enhances the antibacterial activity and promotes more active repair in the bone.