Integrated Approach to the Diagnosis and Treatment of Endo-Periodontal Lesions

Abstract

The purpose of the study was to increase the effectiveness of diagnosis and treatment of patients with endo-periodontal lesions. Materials and methods. The study was conducted from 2019 to 2022 on the basis of the Department of Therapeutic Dentistry of the Azerbaijan Medical University. 41 patients with endo-periodontal lesions who were not burdened with somatic pathology with combined endodontic and periodontal lesions were examined. Radiation diagnostic methods, in particular orthopantomography and intraoral targeted radiographs, were carried out in both groups and in all patients in these groups before the start of therapeutic measures and 6 and 12 months after their completion. The selected groups of patients were practically comparable in gender and age composition (p>0.05). All persons with the same diagnosis, depending on the therapeutic method or treatment algorithm, were divided into two groups: I – with the diagnosis of endo-periodontal lesions – 20 patients of the main group, who, along with standard treatment, were additionally treated with decontamination of root canal and laser curettage with a dental diode laser (Picasso Life); II – with a diagnosis of endo-periodontal lesions – 21 patients of the control group. Root canal treatment: mechanical expansion with endodontic instruments, antiseptic treatment with 3% sodium hypochlorite solution, 17% EDTA solution. To remove dental deposits in the control group, scaling, curettage with Gracie curettes were performed, and an ultrasound device "Piezon Master 600" ™ EMS was used. Cleaning and polishing of the teeth surface was carried out with an abrasive paste. Patients of the main group were additionally treated with a diode laser. Patients of the control group did not undergo such a procedure. Results and discussion. According to the results of the behavioral study, the values of the hygienic index, the gingivitis index and the periapical index before the start of the course of basic therapy for endo-periodontal complications were comparable in both study groups. In terms of follow-up, statistically significant differences were clearly expressed 12 months after treatment. The high frequency of occurrence of combined periodontal and endodontic tissue diseases in male and female individuals, as well as the increase in their prevalence with age, certain difficulties in the diagnosis and treatment of endo-periodontal lesions, causes constant and increased interest in this problem. The results of the index evaluation showed pronounced anti-inflammatory and stimulating bone tissue repair properties of laser therapy. Conclusion. The method of treatment of endo-periodontal complications with the use of a diode laser made it possible to significantly reduce the focus of destruction of bone tissue in the periapical region; contributed to improving oral hygiene and the condition of periodontal tissues. The high efficiency of the proposed combined method of endo-periodontal lesions treatment allows us to recommend it for wide application in practical dentistry