The treatment of chronic granulate periodontitis

Abstract

Introduction: Chronic periodontitis is an inflammation of the apical parodontium mainly infectious etiology, manifested by chronic inflammation of the apical periodontal space and alveolar bone demineralization, more or less extensive, diffuse. Streamlining and improving the methods of treatment of chronic granulate periodontitis is one of the most actual problems of dentistry. Purpose and Objectives: To study the methods of treatment of chronic granulate periodontitis and to choose the best one, choosing tools and materials that will lead to the desired result. Materials and methods: In accordance with the purpose and objectives, conservative treatment was performed on 18 patients with chronic granulating periodontitis. Treatment was carried out in several visits, using a temporary filling material “Diapex” based on calcium hydroxide and iodoform. Results: Optimal type of treatment of this pathology is the endodontic technique while a surgical method is more traumatic for the patient. The endodontic technique includes instrumental removal of necrotic debris from the root canal, antiseptic irrigation and 3Dimensional obturation of edodontic space. The evacuation of disaggregated masses in periodontitis is effectuated by using several steps, part by part, without pressure, under the protection of antiseptic, to not to push the necrotic contents in periapical tissues. Currently the most common root canal irrigation solution is considered sodium hypochlorite. The combination of ultrasonic energy with this antiseptic solution increases its effectiveness. Final filling of root canals can be performed only when the tooth is asymptomatic and his endodontic space can be dried. In other case the temporary obturation is recommended. The most often it is efectuated by the pastes based on calcium hydroxide having the following properties: it has antimicrobial activity, have the ability to remove persistent apical secretions, stimulates the formation of calcified tissue, accelerates the decomposition of necrotized masses. Conclusion: Successful treatment of chronic granulate periodontitis depends on the strict compliance of requirements that need to be respected during each stage separately. The use of sodium hypochlorite in combination with ultrasound and with the drugs based on the calcium hydroxide increases the effectiveness of the treatment of chronic granulate periodontitis.