A method of treating periodontal disease, complicated by perforation of the bottom of the tooth cavity

 

(57) Abstract:

The invention relates to medicine and can be used for the treatment of periodontal disease, complicated by perforation of the bottom cavity of the tooth. Carry out preparation of carious cavity and root canal treatment and root canal filling, closing the perforations amalgam followed by filling of a tooth crown. Thus, before closing the perforations amalgam produce his one-time processing erbium laser with a wavelength of 2,940 nm, a frequency of 10 Hz and a pulse duration of 250 μs. The method allows for the prevention of complications and save the tooth.

The invention relates to medicine, namely to the dentist, and can be used for the treatment of periodontal disease, complicated by perforation of the bottom cavity of the tooth.

There is a method of closing the perforation amalgam (L. M. Lukinykh, L. C. Shestopalova. Pulpitis (clinic, diagnostics, treatment). Min. Novgorod, 1999, S. 83). Amalgam is not moisture sensitive, hermetically closes the perforation hole and does not change the structure.

Cons: the amalgam impose on infected tissue with preserved pathogenic microflora, which in most cases is aimed at solving problems - prevention of complications, the preservation of the tooth.

These objectives are achieved by preliminary single processing perforation of the bottom of the tooth cavity erbium laser with subsequent closing of the perforations amalgam, that is an amalgam impose on uninfected tissue.

The method is as follows: the patient carious cavity preparation (erection, extension, necrectomy), the opening root canal (if they were sealed), instrumental, medical treatment and sealing or pereplanirovka root canal depending on the clinical situation. Then erbium laser Er:YAG with a wavelength of 2,940 nm, a frequency of 10 Hz and a pulse duration of 250 μs process once punched a hole in the bottom of the tooth cavity, simultaneously coagulated granulation (if any) with the subsequent closure of the defect amalgam. In microbiological crops taken from areas treated with laser, the growth of pathogenic organisms were observed. Erbium laser can be used in the process of ablation (vaporization) and coagulation without burns with minimal impact on adjacent tissue.

Laser Er:YAG processing perforazione complaints of pain in namasivaya, constant aching pain in 46, the presence of a fistula.

Anamnesis: 46 was dauletova 1.5 years ago to prepare for a crown. After filling periodically noted pain in namasivaya, aching pain, the appearance of the fistula with vestibular side in the projection 46, purulent discharge from the fistulous course. Sought dental care. It was recommended deleting 46. Objectively: the crown destroyed more than 46 1/2, tissue thick, slaboaglomerirovannye, canals filled with gutta-percha pins in the bottom of the cavity of the tooth closer to the medial channels perforation filled with granulation tissue. In the perforation hole introduced gutta-percha pin. On the vestibular surface of the gums in the projection of the bifurcation of the roots of the fistula. Percussion is painful.

Treatment: 1 visit

Preparation of carious cavity (erection, extension, necrectomy), the opening root canal, removal of gutta-percha pins, instrumental treatment of the root canals method Step Age, drug treatment sodium hypochlorite; the filling of canals “Pasta Timofeeva for filling root canals” RF Patent №2144348 from 12.04.99. Removal of gutta-percha pins from perfo pulse duration of 250 μs perforations and surrounding tissues. The closure of perforation amalgam. Temporary filling.

2 visits in 2 days

Complaints: poor pain when namasivaya.

Objective: Temporary filling saved, percussion sensitive.

Seal the fistula.

3 visit after 5 days

Complaints: no.

Objective: temporary filling saved. Percussion sensitive.

Closure of the fistula, partial scarring.

4 visit 14 days after the 1st visit.

Complaints: no.

Objective: percussion negative. Scarring of the fistula.

Treatment: replacement of temporary fillings in permanent fixation 46 crown.

Inspection through1/2year: no complaints. According to RB (radiovisiography) restoration of bone structure.

The positive effect from the use of the proposed method lies in the prevention of complications and preservation of the tooth.

A method of treating periodontal disease, complicated by perforation of the bottom cavity of a tooth, consisting in the preparation of cavities and a root canal treatment and root canal filling, closing the perforations amalgam followed by filling of a tooth crown, characterized in that before closing paragraph is 40 nm, a frequency of 10 Hz and a pulse duration of 250 μs.

 

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