METHOD FOR OBTURATION OF ROOT CANALS OF TEETH BURDENED BY ABSENCE OF APICAL CONSTRICTION, PERIRADICULAR DESTRUCTION OF BONE TISSUE AND RESORPTION Russian patent published in 2024 - IPC A61C5/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to therapeutic dentistry and is intended for use in treating apical periodontitis of single-rooted and multi-rooted teeth burdened by the absence of apical constriction, periradicular destruction of bone tissue and various types of root resorption. Computed tomography of the area of the tooth to be treated is performed. Structural features of its root canal system and surrounding anatomical areas are detected. Anaesthesia and isolation of the working field are performed. Under visual control, removal of mineralized and non-mineralized dental deposits from tooth, filling material, preparation of carious cavity is performed. Tooth cavities are restored by forming lost walls. Parameters of the root canal are determined by measuring its working length, which is fixed on the instrument with a silicone stopper. Root canal is machined to create a ledge at a distance of at least 0.5 mm from the end of the working length of the canal. Drug-induced canal treatment is performed by alternate irrigation with 5.2% sodium hypochlorite, 40% citric acid or 18% etidronic acid with an endodontic needle with side holes at distance of 2 mm less than the working length of the root canal. Irrigation solutions are activated intracanal with an endoactivator. Tooth cavity is closed with a temporary filling. Dental dam, instruments, doctor’s and assistant’s gloves are replaced, antiseptic treatment of potentially significant surfaces is performed, a dental dam is installed, it and the tooth to be treated are antiseptically treated with 3% sodium hypochlorite, and a temporary filling is removed. File corresponding to the diameter of the created ledge is selected. Using the selected file, a gutta-percha point of appropriate size 02 taper is selected. Smeared layer is created on the canal walls by introducing the selected file into it and removing it from the canal by sweeping motions. As a preparatory operation, a gutta-percha point is fitted in the canal with the ledge to produce the effect of the point tip wedging in the ledge. After freeing the root canal, the point is placed in solution of 5.25% sodium hypochlorite and dried on a sterile block; the canal is repeatedly treated with a sodium hypochlorite solution and dried with sterile paper pins. Sealer is added to the canal. Sealer is applied on the gutta-percha point and inserted into the canal and fitted in the created ledge to produce a wedging effect. After verifying the thermafil/guttacore system with the selection of appropriate size 1 mm less than the working length of the root canal, the gutta-percha point is adapted to the wall of the root canal. Thermafil/guttacore obturators are treated with solution of 5.25% sodium hypochlorite, dried on a sterile block, heated in a ThermaPrep furnace and introduced into the canal in a heated state until it stops, thereby performing a three-dimensional obturation of the canal with filling of all undercuts and resorbed areas. Tooth cavity is restored with filling material.

EFFECT: due to reliable fixation of gutta-percha point in root canal, prevention of filling material penetration into periapical tissues beyond limits of truncated working canal of filled tooth, method allows to restore functions of affected tooth after unsuccessful operation of root resection.

1 cl, 20 dwg, 1 ex