The aim: To study the effectiveness of chronic apical periodontitis treatment by the combined use of ultrasonic treatment of root canals and multicomponent antimicrobial gel according to the results of clinical and microbiological researches. Materials and methods: 64 patients with chronic apical periodontitis at the age of 18-56 years were treated. Patients were divided into two groups: the main and control. In the main group the root canals of 36 teeth were sonicated in combination with multicomponent antimicrobial gel, in the control – 35 teeth were treated by a standard method. The content of the root canals for microbiological studies was obtained before endodontic treatment and before permanent obturation. Frequency of content and number of bacteria in the samples were evaluated. Results: All samples before treatment were positive for the presence of variable bacterial flora, among which Staphylococcus epidermidis (43.9%), Enterococcus faecalis (37.9%), Streptococcus spp. (24.8%), Candida albicans (24.4%), Fusibacterium (9.4%) were the most dominant, their number was 7.4-4.8 lg CFU/ml. Repeated research after the proposed and standard method of root canal decontamination has shown a significant decrease in microflora. According to the data of clinical and microbiological examination, the method which was developed by us revealed a positive result in 86% of cases compared with 63% when treated by the standard method. Conclusions: The effectiveness of a complex treatment method with combined use of the ultrasonic irrigation and multicomponent antimicrobial gel for root canals decontamination in chronic apical periodontitis is demonstrated. Significant reduction of microflora growth and destruction of microbial associations, good penetration of multicomponent antimicrobial gel into endodontic structures due to ultrasound compared with a standard method were achieved.
Aim: To evaluate the therapeutic effectiveness of the use of photodynamic therapy in chronic traumatic lesions of oral mucosa. Materials and methods: Clinical examination and treatment of 67 patients aged 18-65 years with erosive-ulcerative lesions of oral mucosa were carried out. Treatment of patients in the main group was performed using photodynamic therapy. Treatment of patients of the control group was carried out according to the standard method. The results of treatment were evaluated by clinical and cytological parameters. Results: In all patients of the main group with chronic traumatic erythema, already on the second day of treatment, complaints of pain when talking and eating completely disappeared, and on the third day in 100% of patients the affected mucosa had no pathological changes. In patients with erosive-ulcerative lesions, complete clinical recovery in the main group was observed on the 3-4th day of treatment, in the control group – on the 7-10th day. The results of cytological examination, namely the absence of young epithelial cells of stages 1 and 2 of differentiation, a significant decrease of intermediate maturity cells (stages 3 and 4) and a similar increase of mature cells (stages 5 and 6), indicated the acceleration of mucosal regeneration in patients of the main group compared to the control group. Conclusions: The use of photodynamic therapy in the treatment of traumatic oral mucosa lesions contributed to the acceleration of elimination of clinical manifestations of chronic mechanical injuries and the normalization of parameters of cytological characteristics of epithelial cells in patients of the main group compared to the group of standard treatment.
The introduction of laser systems into the dental practice takes an important place in the development of methods for accelerated and effective treatment of viral diseases. As a matter of fact, laser radiation blocks the inflammatory process, suppresses the pathogenicity of the virus, improves the processes of microcirculation. The use of tea tree oil-based preparations promotes regeneration and restoration of the tunica mucosa of mouth. The aim of this study is to assess the therapeutic efficacy of combined use of laser radiation with “Tebodont” gel based on tea tree oil in the treatment of recurrent Herpes simplex Labialis. Clinical observation of 44 patients was conducted on the basis of Pyrohov Memorial Vinnytsia National Medical University at the age from 17 to 22 years old. Among them there were 26 women and 18 men with a prolonged history of the disease within 6 years or more: light severity. Diagnosis of the disease was performed on the basis of complaints of patients, results of objective examination and molecular-biological method of polymerase chain reaction (PCR). To assess the treatment efficiency, patients were divided into three levels according to the number of group: I, II and control. All patients were prescribed a commonly agreed treatment regimen, which included the local application of antiviral “Herpevir” ointment for the first 3 days, anaesthetic gel “Kamistad”, and keratoplastic agents to stimulate the epithelization. Patients of I group, with the exception of “Herpevir” ointment, during the first 3 days of the disease received a daily two-time application of “Tebodont” gel on the affected lip area until the final epithelization. Patients of II main group underwent laser contactless irradiation of the affected lip area with diode laser Picasso made by the company “AMD Lasers” (USA) in a continuous mode with the power range of 0.5 Watt using non-activated fibre and “Program 4”. Exposition – 2 minutes on the area, number – 5 procedures and daily two-time application of “Tebodont” gel on the affected lip area until the final epithelization. The efficiency was being assessed within two weeks from the starting date of treatment based on subjective data and clinical examination results. Patients of I main group began to recover on 3-4 days of examination. Full epithelization of the affected area occurred on the 5-6 days of treatment. All patients of II main group showed an improvement in the clinical picture already on the second day after the treatment. They noted a decrease in pain, edema, and hyperaemia. Complete epithelization of erosive defects in patients was observed on the 3-4 days of the examination. Patients of the control group noted an improvement in the clinical picture of the disease – decrease of discomfort, pain, only on the fifth day of treatment. Initial manifestations of epithelization of the affected area were observed in the patients of this group only on the 7-8 days. High efficiency of treatment in the main groups was observed already on the 5th day of treatment and constituted 100% in II and 79% in the I group. In the control group, complete healing occurred only on the 10-12 days of treatment. Obtained results of the study certify that the use of laser radiation in combination with tea tree oil-based “Tebodont” gel in the treatment of recurrent Herpes simplex Labialis, in terms of therapeutic efficiency, exceeds conventional medical treatment. The prospect of further research is to develop and introduce modern methods for the treatment of diseases of the tunica mucosa of mouth into the dental practice with the usage of laser radiation and preparations based on tea tree oil.
Aim: To evaluate the effectiveness of injectable platelet-rich fibrin (i-PRF) in the complex treatment and rehabilitation of patients with peri-implant mucositis. Materials and Methods: Clinical examination and treatment of 23 patients with peri-implant mucositis were carried out. Patients of the main group (n=11) were injected with liquid platelets-rich fibrin. In patients of the control group (n=12) the treatment protocol involved local antibacterial and anti-inflammatory therapy. The assessment of peri-implant tissues condition was performed on the basis of visual inspection, generally accepted instrumental and X-ray examination and was based on the data of periodontal tests and indexes. Results: In 72.7% of patients after i-PRF usage, reduction of inflammation was observed on the 3rd day of treatment; on the 7th day the clinical status corresponded to the norm. At the same time, in the control group a decrease of inflammation signs was revealed only in 33.3% of patients on the 3rd day and in 66.7% on the 7th day; complete elimination of inflammation in all patients was registered on the 14th day of observation. In 12-month follow-up examination the positive dynamic of peri-implant mucositis treatment was maintained in 81.8% of patients of the main group and in 50.0% of patients of the control group. Conclusions: The use of i-PRF in the complex treatment of peri-implant mucositis contributes to the rapid elimination of inflammation signs and bleeding of the gums surround the implants, accelerates the soft tissues regeneration, shortens treatment times and provides long lasting stabilization of the process.
The aim: To compare the quality of root canal system preparation with the use of manual K-files, machine Protaper Universal and Silk files by in vitro studies. Materials and methods: Root canals preparation in 45 extracted premolars was performed in three groups with 15 teeth in each with K-files, Protaper Universal and Silk files. Transverse sections of the dental root were prepared. Histologically were assessed: amount of sawdust and predentin remaining, the purity degree of root canal walls. Results: When calculating the sawdust amount at the distance of 3 mm from an apex, a high degree of contamination was observed in the manual K-file group: 53.3% versus 33.3% in the Protaper Universal group and against 20.0% in the Silk file group. The amount of predentin after root canal treatment with manual files reached 25-30%. At the distance of 5 mm from the apex the root canals with high and medium purity degree were detected in 86.7% with Silk files and 80.0% with Protaper Universal files used. All predentin was removed when working with Protaper Universal and Silk files. Conclusions: In the histological sections of the root canals treated with K-files, the larger amount of dentine particles and predentin has been revealed than when using machine tools. The largest amount of predentin and dentine were removed with Protaper Universal files. Silk endodontic system is better for treatment of the root canals dentine surface in the apical area compared to Protaper Universal and K-files.
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