METHOD FOR THE TREATMENT OF DESTRUCTIVE FORMS OF CHRONIC APICAL PERIODONTITIS Russian patent published in 2023 - IPC A61C5/00 A61K31/4164 A61P1/02 

FIELD: medicine; surgical dentistry.

SUBSTANCE: invention is intended for use in the treatment of a destructive form of chronic apical periodontitis. Oral hygiene, anesthesia, cutting out and tilting the mucoperiosteal flap in the area of the root apex are carried out. Trepanation of the cortical plate is carried out in the projection of the root apex, pathologically altered periapical tissues are removed, with the apex of the tooth root exposed, a cavity is formed in the root of the tooth and its retrograde filling. The flap is repositioned and the wound is sutured. After cutting out the mucoperiosteal flap and performing trepanation of the cortical plate, the tooth root apex is resected by 3–5 mm at an angle of 90 degrees to the longitudinal axis of the tooth root, followed by removal of granulation tissue in the periapical region. Hemostasis of the bone wound, retrograde endodontic preparation are performed using ultrasonic tips, with simultaneous irrigation with saline, to a depth of 3–5 mm along the axis of the channel. After that, drug treatment of the prepared cavity with a 2% solution of chlorhexedine bigluconate, drying and its retrograde closure is carried out. Moreover, retrograde filling of the prepared part of the canal is carried out 2 mm deeper from the cut of the root stump with a liquid bioceramic sealer in a volume sufficient to fill the retrograde cavity, evenly distributing it, followed by the introduction of mixed portland cement in the volume necessary to completely close the created cavity, condensing it for sealing marginal adaptation. The whole treatment is carried out using a dental operating microscope and a radiovisiographic study to control retrograde obturation.

EFFECT: method, due to the sequential introduction of liquid bioceramic sealer and then mixed portland cement, and the complex action of both the antibacterial effect of the materials used and the osteogenesis-stimulating effect of obturation materials for retrograde filling, allows for a short time to achieve complete restoration of the bone defect in the area of the apex of the tooth root and save the tooth as an organ of the chewing apparatus for further functioning.

1 cl, 7 dwg, 1 ex