An endo-perio lesion is one of the more common tooth-related problems. An association between the presence of apical and marginal periodontitis is known in the literature and has been observed in 5.7% of individuals aged 40–45 years old. The purpose of the present article is to present three case reports describing the successful retreatment of endo-perio lesions. In each of these cases, we used a biologically active bioceramic root canal sealer, GuttaFlow Bioseal, which is a bioactive root canal filling material composed of gutta percha, polydimethylsiloxane, platinum catalyzer, zirconium dioxide, and bioglass. All cases were followed up clinically and radiographically for a period of at least 11 months.
A number of researchers note the fact that today, in more than 5.7% of the teeth in patients over 40-45 years old with apical periodontal lesions, during a comprehensive examination, lesions of the marginal periodontium are also diagnosed.Materials and methods. The success of endodontic treatment of such teeth with the use of traditionally used polymer sealers is extremely low. Pathology develops due to a mixed apical-periodontal microflora. The use of bioceramic sealers has been reported to significantly improve the prognosis for endodontic intervention. Bioceramics inherently is the most biocompatible material and consists of aluminum oxide, zirconium dioxide, bioactive glass, glass ceramics, composite components and coatings, hydroxyapatite and resorbable calcium phosphates.Results. This article presents clinical cases of successful endodontic treatment of the main types of combined apical and marginal pathology. 9-11 months after treatment, the diagnosed signs of perio-dontal and periapical pathology are not determined.Conclusions. Based on the results obtained, the optimal method that ensures a successful treat-ment result for this pathology in one visit, often without subsequent surgical manipulations, is an ade-quate endodontic mechanical intervention with subsequent obturation of the root canals with a bioc-eramic sealer, which is confirmed by the literature data.
Background. The violation of the marginal tightness of composite restorations and the recurrence of the carious process remains relevant to this day, especially in persons with a decompensated form of caries activity. In this regard, of undoubted interest is the possibility of a wide preventive effect of individual oral hygiene products with a remineralizing effect, particularly those containing brushite crystals. Brushite crystals have unique adhesive properties and tropism to hydroxyapatite crystals on the enamel surface. The principal mechanism of action of the RemarsGel system is a chemical reaction that occurs when calcium nitrate from tube # 1 is mixed with ammonium hydrogen phosphate from tube # 2, as a result of which a brushite crystal is formed on the surface of the teeth. Material and methods. From a clinical point of view, this study compared the clinical efficacies of a standard prophylaxis program (using traditional fluoride-containing personal oral hygiene products) of carious recurrence in patients with a high degree of caries activity and a developed program for using a natural two-component complex to strengthen and remineralize RemarsGel enamel. The effectiveness of the applied technique was monitored using clinical research methods immediately after sanitation and 1, 12, and 36 months after it. Results. The high efficiency of brushite crystals was established in terms of preventing violations of the integrity of the enamelcomposite joint, which has a direct and immediate effect on the recurrence of the carious process. A statistically significant difference in the Ryge criteria was found between group Nos. 1 and 2. These results were confirmed by scanning electron microscopy and statistical processing of the research results. Conclusion. A scientifically based indication of the intended use of the system must be added to the list of main indications for use in the presence of a significant amount of adhesive restorations in the oral cavity, made using direct and indirect methods, especially with decompensate caries.
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