Microbial Factor, Its Role in the Development and Course of Chronic Periodontitis, Current Research Direction (Literature Review)

The purpose of the study was to analyze the available data about the role of the microbial factor in the development and course of chronic periodontitis at the present stage on the basis of available domestic and foreign specialized literature, to identify unsolved problems and outline directions for further research. Materials and methods. The special literature is analyzed: periodicals for the last 10 years, basic manuals and monographs. We used descriptive method. Results and discussion. A large number of works are devoted to the analysis of the composition and properties of bacterial biofilm of the oral cavity using microscopic, bacteriological and molecular research methods used to assess microbial risk factors for periodontal diseases. At the same time, satisfactory results of conservative treatment of this pathology vary from 61.1% to 93.9%. The situation is aggravated by the fact that apical periodontitis, cystogranulomas and radicular cysts in 65.0% are the cause of severe complications that threaten death. Even outside of exacerbation, the presence of foci of focal infection is accompanied by sensitization of the patient's body and contribute to its generalization. The accumulated experience of research on the etiology and pathogenesis of periodontal diseases over the past decades indicates that the leading role in the formation and development of the inflammatory process of this localization belongs to obligate-anaerobic and microaerophilic facultative-anaerobic microflora. Despite a significant number of studies devoted to this issue, the problem of the effectiveness of endodontic treatment nowadays is far from its final solution, which convinces of the relevance of the research undertaken and its expediency. Conclusion. The results of the analysis of special literature allow us to conclude that the development of new rational complex methods of treatment based on an in-depth analysis of morphological, microbiological, immunological, biochemical, clinical and somatic components is based not only on the need to create effective methods of treatment of chronic periodontitis and the justification of their differentiated use, but also on the need for preventive measures aimed at preventing the development of severe complications of acute odontogenic infection and its generalization. The development of new effective and rational methods for the treatment of chronic periodontitis based on their differentiated use will reduce the number of cases of acute odontogenic infection and its severe complications, which will positively affect the quality of life of patients, increase the rates of specialized medical care and will have a certain socio-economic significance

Evaluation of the preventive care effectiveness in the adults with odontogenic infection given social and hygienic risk factors

Relevance. Odontogenic infection is one of the most important problems of dental science. The variety of anti-inflammatory oral hygiene products determines the need for targeted selection of preventive toothpastes and rinses, balms, foams, elixirs, as well as monitoring and training the algorithm of hygienic measures for a patient with an odontogenic infection. The aim of the study was to study the hygienic status of the adult population for the selection of individual oral hygiene products for odontogenic infection, taking into account social and hygienic factors.Materials and methods. The study examined the prevalence of odontogenic infection in the adult population to determine the need for professional care and dental education. The study involved 198 people without somatic pathology, who were allocated into four groups according to the performed oral care and taking into account the dental status and the intensity of oral microbiota formation in the adult population. The patients were followed-up every week for one month. The study examined the simplified oral hygiene index by GreenVermillion (OHI-S), PMA index and Mühlemann and Son sulcus bleeding index, which allowed calculating the effectiveness of oral care products.Results. The preventive care effectiveness evaluation showed an increase in the cleansing effect in the adult population over the entire study period. The anti-inflammatory effectiveness analysis demonstrated positive changes: by the end of the study, the PMA index was 51.52 ± 3.40% in group 1; it increased by a factor of 3 and amounted to 44.17 ± 2.77% in group 2; 56.51 ± 4.61% – in group 3, 48.95 ± 3.60% – in group 4. The Mühlemann and Son sulcus bleeding index demonstrated the changes in the periodontal tissue condition and amounted to 52.78 ± 3.62% in group 1, 44.11 ± 3.54% in group 2, 54.97 ± 3.98% in group 3, 47.78 ± 2.73% in group 4.Conclusions. The development of oral health promotion measures determines the significance of oral care products for the prevention of odontogenic infection in the adult population, which plays a crucial role in the individual program planning for the main dental disease prevention.

Morphological Features of the Structure of the Root Canals of Premolars and Molars of the Upper Jaw on the Basis of Cone-Beam Computed Tomography

The key issue for dentists of all specialties is the fight against foci of chronic odontogenic infection. Much attention is paid to the introduction of operations that preserve teeth performed at an outpatient surgical appointment, but specialists rarely use them and often remove teeth. The purpose of the study is to determine the morphological features of the structure of the root canals of the premolars and molars of the upper jaw on the basis of cone-beam computed tomography of the jaws, to assess the quality of previously performed endodontic treatment and the frequency of destructive processes in the long-term follow-up. Materials and methods. Anatomical features of the structure of the premolars and molars of the upper jaw were retrospectively studied on the basis of cone-beam computed tomography data in 97 patients aged 26-71 years. 97 teeth (premolars and molars) of the upper jaw were examined in this number of patients. Depending on the belonging to the jaw segments, all the teeth of patients whose anatomical features of the root canals were analyzed, were divided into 4 groups: the first premolars – n=6; the second premolars – n=15; the first molars – n=54; the second molars – n=22. Results and discussion. The study of the morphology of the root canals of the first and second premolars of the upper jaw did not reveal statistically significant differences in the angle of inclination of the root canals, the number of roots and root canals. The analysis of the morphology of the root canals of the first and second molars of the upper jaw also found no significant differences in the angle of inclination of the root canals. At the same time, the share of unsatisfactory endodontic treatment in the analyzed groups of teeth was 82.5%. In addition, destructive bone processes in the periapical region were detected in all molars and premolars of the upper jaw, regardless of the quality of endodontic treatment. Conclusion. Each of the above results as well as all of them together, convincingly demonstrate: 1) insufficient effectiveness of the use of endodontic treatment alone in order to sanitize the foci of chronic odontogenic infection located in the apices of the roots of the molars and premolars of the upper jaw which is largely justified by the features of the anatomical structure of the latter; 2) the need to develop a system of differentiated use of surgical methods of treatment for the rehabilitation of foci of chronic odontogenic infection of the specified localization, taking into account the variant anatomy of the root canals of the premolars and molars of the upper jaw