INFLUENCE OF BIOCERAMIC SEALANTS ON THE REGENERATION OF DESTRUCTIVE PROCESSES OF PERIAPICAL TISSUES AFTER TREATMENT OF CHRONIC PERIODONTITIS. CLINICAL CASE

Abstract

The chronic periodontitis remains one of the main causes of tooth loss today. The effectiveness of conservative treatment of periodontitis is on average 75%, but this indicator varies. Therefore, the search for new technologies that would have a positive therapeutic effect during and after treatment, and in dynamics stimulate the regeneration of periapical tissue destruction, is relevant. Among the requirements for endodontic filling materials, there are requirements for the quality of sealing, antiseptic action and biocompatibility. Such properties are combined by materials belonging to the group of MTA derivatives – bioceramic sealers. The use of ceramic materials significantly expands the possibilities of effective treatment of most diseases and injuries of bone tissue, in particular chronic periodontitis, which is accompanied by significant periapical changes, including the formation of cysts. The aim of the study – to analyze the effectiveness of the treatment of chronic periodontitis with extensive destructive changes in periapical tissues using bioceramic materials in dynamics using a clinical case example. Materials and methods. The clinical examination of patient L., 18 years old, with a massive odontogenic cyst of tooth 12, was performed. For clinical assessment, subjective and objective examinations were performed, and electroodontodiagnostics was performed using the Denjoy apparatus on the teeth of the upper jaw on the right. The assessment of the condition of the roots of the teeth, periapical tissues, and bone structure of the upper jaw was performed using computed tomography. Results. The patient L., 18 years old, after subjective, objective examinations and additional methods (EOD, CT), was diagnosed with exacerbation of chronic periodontitis of the 12th tooth, odontogenic cyst of the upper jaw. At the first visit, the causative tooth was opened. After mechanical treatment and thorough rinsing, it was decided to seal the root canal with a temporary calcium-containing preparation under a hermetic bandage. The treatment of the tooth lasted 4 weeks, during which the calcium-containing temporary paste was used three times. On the fourth visit, it was decided to obturate the root canal by the method of cold lateral condensation of gutta-percha using a bioceramic sealer. After 4 months, the patient appeared for a repeat examination. On the repeated computed tomography, all signs of bone healing are observed. The defect has visually decreased in diameter due to bone regeneration along the periphery. On the palatal side, complete restoration of the cortical plate is noted. Conclusions. The based on the results of our treatment, we can conclude that the use of bioceramic sealers is highly effective in the work of an endodontist.