Surgical treatment of apical chronic periodontitis

Abstract

Introduction. Until nowadays the main cause of dental extractions and of odontogenic inflammatory processes on the maxillo-facial region is the apical chronic periodontitis. More than that, periapical infectious processes are a source of auto- and heterosensibilization of the body, reduce the immune resistance resulting with the loss of work capacity, which becomes an important social problem. It is important to mention that the surgical method of treatment is an alternative one in case of failure of the conservative treatment when the total removal of inflammatory process was impossible. Surgical treatment of periapical lesions has as the main objective the removal of apical and periapical pathological tissues by surgical methods with the preservation of the tooth. Even though the surgical method of treatment is just an alternative one, in case of the failure of conservative methods, we cannot say that it is the most optimal. Along with the removal of the tumor, we obtain a functional reduction of the tooth, the possibility of reinfection, but also the lack of bone tissue, which reduces the resistance of the maxilla bones and also the functional and aesthetic modifications.Aim of the study. The evaluation of the effectiveness of surgical treatment dynamics and the development of diagnostic and therapeutic principles accordingly. Materials and methods. In this study were included 853 of patients treated in the Republican Dental Clinic during one year – 2017, 481 of them were men and 372 women aged from 18 to 70; Out of 853 of patients, 345 were with apical chronic periodontitis, 842 extractions were performed - 247 of the them because of apical chronic periodontitis. Results. After statistical analysis of 345 patients with apical chronic periodontitis, information collected from the observation sheets of the Republican Stomatologic Polyclinic, we noticed an increase of the periapical lesions with the aging. Conclusions. In case of failure of endodontic treatment and the impossibility of the removal of the periapical process using other methods, it was concluded that apical resection is a rational method of treatment that patients easily approve. Surgical treatment methods have satisfactory results, which allows us to keep the tooth in the oral cavity and perform proper function. Nevertheless firstly, we have to opt for a qualitative endodontic treatment before a surgical method. Only after the failure of the endodontic treatment, we can choose a surgical one.