METHOD FOR SURGICAL-CONSERVATIVE TREATMENT OF CHRONIC APICAL PERIODONTITIS Russian patent published in 2024 - IPC A61C5/00 A61K31/4164 A61P1/02 

FIELD: medicine; dentistry.

SUBSTANCE: invention is intended for use in tooth-preserving treatment of teeth with chronic forms of apical periodontitis. Treatment is carried out in three sessions. At the first visit—after professional oral hygiene, its antiseptic treatment before mechanical treatment of the root canal under infiltration anesthesia, a carious cavity is prepared, creating a straight-line approach to the root canal, determining the working length of the root canal, performing its instrumental, drug-induced treatment with subsequent ultrasonic activation of the solution, root canal is dried and temporarily filled, crown part of tooth is closed with temporary filling. At the second visit, a root apex resection is performed under infiltration anesthesia, including exfoliation of mucoperiosteal flap in projection of root apex, osteotomy of cortical plate with creation of access to root apex and periradicular curettage of granulation tissue with hemostasis of bone wound followed by root apex resection at angle of 90 degrees to the longitudinal axis of the root of the tooth and retrograde preparation of the root canal to depth of 3 mm with ultrasonic tips with subsequent application of dry collagen around the root stump, and from the side of the root canal orifice a plugger is fitted for vertical condensation, freely reaching the apical part of the root stump, the root canal is dried and an apical filling is created in it in a retrograde manner, in portions, a material for retrograde obturation is introduced into the apical part of the root stump, and closing the root canal inlet from the apical part of the root stump with a flat working part of the dental instrument, preventing the obturation material from leaving the root canal beyond the root stump, and on the side of the root canal orifice, a pre-fitted plugger is placed and the introduced obturation material is compacted with it, condensing it by reciprocal movements of the plugger, thereafter, the root canal is filled orthogradely to an apical filling with a temporary material, the crown portion of the tooth is closed with a temporary filling, and the mucoperiosteal flap is repositioned and closed. At third stage—after removal of interrupted sutures, repeated instrumental and drug-induced treatment of root canal is performed from mouth part to apical filling, hardening of the apical filling material in the apical part of the root stump is instrumented, the root canal is dried and finally obturated to the apical filling; wherein all stages of treatment are carried out using a dental operating microscope and a radiovisiographic examination for its control.

EFFECT: method, by creating a dense apical filling in combination with its tight marginal fit, allows to preserve a tooth as an organ of the chewing apparatus for further functioning, while eliminating recurrences of the disease.

1 cl, 9 dwg, 1 ex