Modern approach to treating periodontitis in repeat endodontic treatment. Success criteria

Background. Treatment of destructive forms of chronic apical periodontitis of teeth is an urgent problem, since the elimination of inflammation in the periapical area makes it possible to eliminate the pathogenic effect of the odontogenic inflammatoryfocus on the body, as well as to maintain the full functioning of the tooth with complete healing of lysis of periapical tissues. Purpose – is to show that in periodontitis with periapical lysis of large bone (10 mm and more), with the help of modern endodontic equipment, new disposable instruments and additional devices (microscope, apex locator, endomotor), careful medical treatment and three-dimensional treatment, complete bone regeneration with subsequent full functioning of the tooth is possible. Materials and Methods. The conservative treatment of 25 patients with destructive forms of chronic apical periodontitis aged 18 to 55 years was analyzed. Results. Destructive changes in the periapical tissues of more than 1 cm were detected in 28 teeth. Root canals in the teeth were filled with resorcinol-formalin method – 21 (43%) teeth, Zinc oxide eugenol (ZOE) without gutta-percha – 3 (10.7%) teeth, ZOE with gutta-percha – 2 (7.1%) teeth, polymeric siler with gutta-percha – 2 (7.1%) teeth. At 6, 12, 24 and 36 months after treatment, the long-term results of conservative treatment were evaluated. The presence of regression of destructive changes was noted in all patients, as a result of the treatment. When evaluating radiographs, the radiological picture was compared before treatment, immediately after endodontic treatment and at long-term follow-up (2–3 years). Over 2.5 years, the positive dynamics of dental treatment was monitored: patients had no symptoms or complaints. Conclusions. When choosing a method of treatment for patients with chronic periodontitis with significant destructive changes in bone tissue, preference should be given to the use of a conservative method of treatment with the use of temporary calciumcontaining filling material.