Adhesive dentistry is the foundation on the basis of which there have been global changes in the concept of adhesion of composite materials in therapeutic dentistry, protocols for fixing ceramic restorations in orthopedic dentistry. But a number of unsolved problems remained – the adhesion of composite materials to sclerosed dentin and tooth root cement, the sensitivity of the components of the adhesive systems to the wet environment of the oral cavity and spatial stability in the presence of dentinal fluid moving centrifugally in the dentinal tubules, the lack of restoration of periodontal attachment to the defect that occurs during tooth root caries. The review analyzes the results of studies on the use of self-etching adhesive systems in the treatment of root caries. The physician's ability to choose an adhesive system in a particular clinical case demonstrates his fundamental knowledge and minimizes the percentage of errors that he can make during the treatment phase.
Relevance. One of the main causes of periodontitis is oral dysbiosis, in which changes in the quantitative and qualitative composition of the microflora occur, the systems of interaction between the microorganism and the microbiota are disturbed, and immunity is reduced. Is to study the comparative anti-disbiotic efcacy of various immunobiological preparations in patients with chronic apical periodontitis against the background of oral dysbiosis.Materials and methods. The study included 66 patients who were divided into 2 groups: comparisons (n = 34) and main (n = 32). Each group was divided into three subgroups depending on the degree of dysbiosis of the oral cavity according to the method of A.P. Levitsky (2007): determination of the ratio of the relative activities of urease and saliva lysozyme. All patients underwent traditional endodontic treatment and oral hygiene with parallel correction of oral microbiocenosis through the use of a complex of immunomodulatory drugs to patients of the main group.Results. In chronic apical periodontitis, urease activity was signifcantly increased, and in those examined with grade II-III dysbiosis almost 2 times compared with patients with grade I severity of clinical manifestations. The proposed treatment reduced the activity of urease in patients in all three subgroups of both groups (main and comparison). The results indicate a signifcant decrease in the activity of lysozyme in all patients more than 2 times. Conducted traditional treatment (comparison group) increased activity, but did not lead to a recovery in the rate of healthy individuals. The use of immunomodulatory drugs allowed to increase the level of lysozyme to the indicators of the control group.Conclusions. The inclusion of immunobiological preparations in the complex therapy of chronic apical periodontitis against the background of oral dysbiosis eliminates the dysbiotic phenomena in the oral cavity and has a therapeutic effect on destructive processes in the periapical tissues that are difcult to treat and often recur.
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