Results of X-Ray and Densitometric Investigation in Patients With Destructive Forms of Apical Periodontitis in Early Follow Up Period

Abstract

This article presents a comparative analysis of the effectiveness of various treatment approaches, including bone mixture “mp3, Osteobiol, and platelet-enriched plasma, in the therapy of destructive forms of apical periodontitis in the early follow-up. The aim of this work is to investigate the dynamic changes in radiological and densitometric parameters depending on the treatment methods for patients with destructive forms of apical periodontitis in the early follow up period. The study involved 185 patients with destructive forms of apical periodontitis, who were examined and receive the treatment. The subjects were divided into 4 groups. Measurements of the size of the lesion in the bone tissue (for lesions of round shape) were performed by the formula: S = πr2. The area of lesions of elliptical shape was measured by the formula S = π ab, where π = 3.14; r = the radius of the circle; a = the value of the major half-axis of the ellipse; b = the length of the small half-axis of the ellipse. After 3 months of the follow up, the patients of group IV, who received the composition of platelet-rich plasma and osteoplastic material mp3 OsteoBiol, demonstrated an increase in the number of the lesions of the periapical zone sized 1.6-10 mm2 in 1.7 times, while the number of the subjects with foci of bone destruction sized 11–20 mm2 and 21–30 mm2 lowered in 2.8 times and 2.0 times, respectively. In 3 months of the follow up period, the patients of group IV showed the values of Rtg scoring of bone tissues destruction in the apical area with a lesion area of 1.6-20 mm that averaged 2.13±0.10 scores and indicated a reduction of the periapical process by 1/3.
 The average Rtg score in the patients of group IV (0.92 ± 0.10 points) was significantly higher than in the individuals in groups I and II, p, p 1 <0.01, and was equal to the findings obtained in the individuals of the group III, p2 > 0.05. The relative indicator of bone tissue repair in this follow up was characterized by the minimum values in the individuals of groups I and II: 0.49 ± 0.05 and 0.57 ± 0.06, p <0.05, respectively. In the groups III and IV, the value of the relative indicators of bone tissue repair were significantly higher and scored 4.82 ± 0.54, p, p1 <0.01, and 6.94 ± 0.77, p, p1 <0.01, p2 < 0.05, respectively.
 At the same time, the average Rtg scoring in patients of group IV was significantly higher than in the participants of groups I and II, and was identical to the values in the subjects of group III. This study has demonstrated the successful outcomes of the treatment of dystrophic forms of apical periodontitis in the early follow up period when applying the composition based on platelet-rich plasma and osteoplastic material "mp3 OsteoBiol".