Evaluation of the Results of Repeated Endodontic Treatment of Chronic Apical Periodontitis Using Biomaterials. Clinical Observation

Abstract

Relevance. In the practice of a dentist, there are clinical situations when the chronic apical periodontitis, due to the ineffectiveness of the endodontic treatment, ends with a root apex resection, while the destruction of bone tissue in the periapical tissues remains. This paper presents cases of effective endodontic re-treatment of such teeth using biomaterials. The diagnostic value of the X-ray method was noted with an assessment of the density of the periapical tissue destruction focus using the densitometry method.
 The aim of the study is to determine the effectiveness of endodontic treatment of chronic apical periodontitis using biomaterials after root apex resection.
 Material and methods. The study included 42 patients aged 25–35 years with chronic apical periodontitis with root apex resection. All patients underwent clinical examination methods and an X-ray method with an assessment of the density of the periapical tissue destruction focus by densitometry. 
 Results and discussion. The proposed method of endodontic re-treatment included temporary obturation of the root canal system with Bioimplant with Collapan gel in a 1:1 ratio, for a period of 15 to 30 days, followed by permanent filling of the root canal system according to the generally accepted technique. After 6 months, the optical density of the periapical tissues in 27 patients was within the normal range. In 15 patients, these indicators were 82% of the norm. After 12 months, the optical density was within the normal range in 90% of cases, in 10% – the optical density parameters approached normal values and amounted to 115.0-125.0 arbitrary units. 
 Conclusions. When carrying out repeated endodontic treatment, it is recommended to temporarily obturate the root canal system using the Bioimplant biomaterial with Collapan gel, which will increase not only the density of periapical tissues to normal values, but also preserve the function of the tooth, which is important for practical health care.