RU2324452C2 - Method of treatment of patients with chronic and acute peridontitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: tooth cavity is opened, the putrid mass is evacuated, and the canal and apical aperture are broadened. Then, the turunda with ozonised 0.9% saline with ozon concentration 4000-6000 mcg/L is inserted into the root canal. The canal is filled. In addition, the oral cavity irrigation with 1500-2000 mcg/L ozon is performed before tooth processing. The same concentration of ozon solution is used following each stage of processing the tooth canal. And after the treatment, patient use the daily oral bath after each meal, with 1000-1500 mcg/L ozon solution.

EFFECT: treatment efficiency is provided due to dissolution of necrotising mass during irrigation of root canal and improvement of repair process in bone tissue.

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Description

The invention relates to medicine, namely to dentistry, and can be used to treat chronic periodontitis.

The currently used methods of treating pulpitis and periodontitis cannot be considered perfect (V.A. Kozlov, 1979; A.I. Rybakov, 1981). The completeness of filling the tooth canals is 65-68% (V.S. Ivanov et al., 1979). Chronic foci of inflammation in the therapeutic treatment of periodontitis do not disappear immediately after the filling of the canals in the tooth, even if this treatment is complete. In 22% of patients, foci of chronic odontogenic inflammation disappear after 4-6 months, and in 68% only after 1-2 years or more (M.I. Groshikov, 1966).

According to the data of V.V. Mironov (1969), B.C. Ivanov and co-authors (1969), in 51.5% of patients with dental treatment it is possible to eliminate the foci of chronic inflammation. Violation of certain methods and terms of treatment of patients with periodontitis and pulpitis leads to the fact that the foci of open infection turn into closed, non-draining ones and become one of the main sources that cause the body to sensitize to bacteria, toxins and decay products.

The problem of treating patients with chronic apical processes at the apex of the root remains relevant today, despite the emergence of the latest tools for the treatment of this pathology. Pulpitis and periodontitis are the main cause of tooth extraction. As before, 35-40% of teeth are treated for periodontitis, which speaks not only of the inferior treatment of caries and its complications, but also many scientists attribute this disease to a decrease in the general resistance of the body, virulence of microflora, and allergization of the macroorganism. In addition, teeth with destruction elements at the apex of the root become foci of chronic infection. All these problems suggest the search for new methods of treatment that would reduce the risk of complications, would not use expensive medications, including antibiotics, and would shorten the treatment time. Therefore, one of the first places is the question of the effectiveness and economic feasibility of the method of therapeutic effect on periodontal tissues in chronic apical destructive processes.

All of the above factors require a more detailed approach and the development of certain treatment standards, depending on their individual characteristics. Numerous studies have established that the main source of infection with periodontitis is in the root canal, namely in its mouth part. In the future, the infection spreads to the tissues of the periapical region, as a result of which the risk of bacteremic damage to vital organs increases. Even with the full treatment of chronic destructive forms of periodontitis and periodontitis in the acute stage, chronic foci of infection are not immediately eliminated.

A known method for the treatment of chronic periodontitis, based on the use as a drug for the medical treatment of the root canal of lysoamidase with a broad-spectrum antibiotic polymyxin. The method of using these drugs is good because the combination of these drugs enhanced the effect of the enzyme preparation of lysoamidase and allowed to complete the treatment of exacerbation of chronic periodontitis in two visits [Yu.M. Maksimovsky, TD Chirkova, O.R.Sokolova, O.A. Prudnikova] “The need for intracanal use of drugs for endodontic treatment”, New in dentistry, No. 6/2001 (96), p.46.

The disadvantage of this method is an increase in the drug load on the human body and the use of expensive drugs.

The basic principles of the most effective and gentle treatment for periodontitis were developed by the domestic dentist M.I. Groshikov [M.I. Groshikov. Clinic and treatment of periodontitis. Textbook, Moscow - 1971, p. 10], based on previously proposed methods by L.A. Limberg, F.A. Zverzhkhovsky, which consist in thorough and careful mechanical treatment of infected root canals, treatment of the apical site of inflammation until the end of the exudation with subsequent optimal obturation of the canal and restoration of the defect.

The choice of treatment method and material for filling the channel is directly related to the clinical manifestations of the disease. Treatment boils down to the following:

- removal of pulp decay;

- impact on the microflora of the root canal with various medications;

- conducting mechanical expansion of the canal and apical foramen

- effects on the peritoneal tissue with drugs;

- application of physical factors;

- thorough obstruction of the root canal;

- restoration of the defect.

High-quality preparation of the tooth cavity for endodontic measures is carried out according to all the rules of traditional treatment using thorough mechanical and instrumental treatments, removal of decay and, with the preliminary introduction of an antiseptic into the canal, a 2-3% solution of hydrogen peroxide. After the expansion of the canal (EDTA can be used), a cotton wool with an antiseptic is left in the root canal and the tooth is hermetically closed.

At the second visit, the bandage is removed, the canal is re-treated, the apical hole expands and the filling is performed. If the channel is difficult to pass, then a turunda with an antiseptic is left in the canal under the dressing for up to 3 days, if there are no complaints, until clean turunda.

The bandage is removed, in the presence of clean turunda, drug treatment is carried out and the canal is sealed according to the generally accepted technique. To accelerate the reparative processes, a biologically active paste can be removed beyond the apex and then fill the tooth canal.

The absolute indication for treatment in one visit is the presence of a fistulous course. Through it there is an outflow of exudate, therefore filling the canal and removing the material beyond the apical opening of the tooth root is not accompanied by an exacerbation of the inflammatory process.

This method is simple to implement and is applicable with low requirements for the result of treatment. However, a 3% hydrogen peroxide solution is not very effective for use as an independent means for washing the root canals. Hydrogen peroxide is unable to dissolve necrotic tissues and other organic residues, causing irreversible changes in cellular elements. Hydrogen peroxide does not have lytic properties and its antimicrobial effect is very limited. It is ineffective for use as an independent means for washing the root canal, does not have bacteriostatic properties.

The objective of the invention is to increase the effectiveness of treatment, reduce treatment time, reduce the risk of complications.

This object is achieved by the fact that a method for the treatment of patients with chronic forms of periodontitis and periodontitis in the acute stage is proposed, which includes the steps of: opening a tooth cavity and evacuation of putrid masses, expanding the canal and apical opening, introducing an oxygen-containing drug to the root canal on turunda, filling the root canal filling material. As an oxygen-containing medicinal product, an ozonized 0.9% saline solution with different concentrations of ozone is used. Before tooth treatment, irrigation of the oral cavity is carried out at an ozone concentration of 1500-2000 μg / ml. After each stage of treatment of the tooth canal, irrigation with a drug with an ozone concentration of 1500-2000 μg / L is carried out. A drug is injected into the root canal on turunda with an ozone concentration of 4000-6000 μg / ml. After treatment, patients conduct oral baths during the day after each meal with a solution with an ozone concentration of 1000-1500 μg / ml.

The novelty of the method lies in the fact that:

- An ozonized 0.9% saline solution with different concentrations of ozone is used as an oxygen-containing drug. This tool has a stronger bactericidal and bacteriostatic effect and accelerates reparative processes.

- Before tooth treatment, irrigation of the oral cavity is carried out at an ozone concentration of 1500-2000 μg / ml;

- After each stage of processing the tooth canal, irrigation with a drug is carried out, the ozone concentration is 1500-2000 μg / l;

- In the root canal injected about the drug on turunda with an ozone concentration of 4000-6000 μg / l;

- After treatment, patients conduct oral baths during the day after each meal with a solution with an ozone concentration of 1000-1500 μg / ml. This allows for further oxygen to enter the tissues of the oral cavity, which leads to an improvement in the trophism of the oral mucosa, periodontal and tooth tissues, and ultimately improves the regeneration and repair of tooth tissues.

Thus, the set of essential features of the invention allows to obtain a new technical result, namely that when washing the root canal, necrotic tissues and other organic residues are more completely removed, treatment time is reduced by an average of 3 days, reparative processes are intensified, which contribute to the speedy restoration of bone tissues. The use of general ozone therapy before the local one, oral baths during the day after eating and drug irrigation after the stage of processing the canal of the tooth can reduce bacterial contamination of the oral cavity and increase local immunity, which significantly improves the treatment result.

Known methods for the use of ozone:

1) intraarterial administration;

2) rectal administration;

3) enteral administration;

4) intradermal administration;

5) subcutaneous administration;

6) large and small autohemotherapy;

7) intraarticular injection;

8) intramuscular injection;

9) the use of gas, ozonated water and oils.

Emphasizing the pronounced bactericidal effect of ozone on the gram-positive flora of purulent wounds and trophic ulcers, it was noted along with a dynamic decrease in microbial resistance to ozone and an increase in the sensitivity of microorganisms to antibiotics.

The introduction of ozone into the body at certain concentrations is accompanied by a wide range of effects on various organs and systems: the central nervous system, endocrine, respiratory, circulatory, cardiovascular, excretory, humoral, reproductive systems. Ozone has bactericidal, fungicidal, viralolytic, anti-stress, desensitizing and immunomodulating properties [Rilling Z., Viban R. Practical ozone-oxygen therapy. Reference and manual. - Goidelberg, 1985].

Also known is the treatment of periodontitis using medical ozone (MD Bezrukova, Central Research Institute of Hygiene, Moscow, New in Dentistry, No. 4/2001 (94).

This paper presents an analysis of the results of using the IMUDON preparation (Solvey Pharma, France) in patients with typical and atypical forms of inflammatory periodontal diseases, as well as the use of ozone therapy in people with rapidly progressing processes using clinical and laboratory research methods.

In this case, ozonated solutions were used for antibacterial effects, but the main thing was the treatment of periodontal tissue hypoxia.

In our case, the use of an ozonized solution of the proposed concentration allows one to dissolve necrotic masses during washing of the root canals, improves reparative processes in bone tissues, which did not allow one to obtain known methods of using ozone.

Ozone has a bactericidal effect on microorganisms located in the root canal and oral cavity. It does not have a sensitizing effect, has the ability to deep diffusion. Chemically stable ozone remains active during long-term storage, which allows it to be used for oral baths after treatment by patients after eating during the day. The advantage of ozone over hydrogen peroxide lies in the fact that atomic oxygen comes directly from the gaseous medium, therefore, substances that, after the release of atomic oxygen, have further chemical dynamics in the liquid medium do not get into the pathological focus [Kaler GB Physico-chemical mechanisms of interaction of ozone with biological membranes. Author's abstract. dis .... cand. biol. sciences. - Minsk, 1986. - 21 p.]

The proposed method is as follows.

In our work, we used a 0.9% sodium chloride solution for local ozone therapy of patients with chronic periodontitis and periodontitis in the acute stage, the ozonation of which was carried out using the commercially available apparatus for gas ozone therapy "Ozotron" GKTE. 941714. 001 Substation, LLC Research and Production Company METROMED, Omsk, under the guidance of Academician RAMTN Pedder V.V. This device is equipped with special tube nozzles of various lengths and configurations for ease of use. The operating modes of the apparatus: the calculated oxygen concentration at the apparatus outlet is 1 l / min, the maximum supply of ozone-oxygen gas mixture at the apparatus outlet is 10,000 μg / l.

An ozonized 0.9% saline solution was prepared by barbation with an ozone-air mixture for 15-20 minutes, with 250 ml of solution and 20-25 minutes, at 400 ml. In this case, a concentration of 100 ml of physiological saline = 5000-7000 μg / L was obtained. To calculate the time of barbation, in order to achieve the concentrations of ozone in physiological saline necessary for our study, we used the data [E. Durnovo The rationale for the use of ozone in the complex treatment of phlegmon of the face and neck: Dis .... cand. honey. sciences. Nizhny Novgorod 1998; 187]. The time of barbation was chosen taking into account the necessary concentration of ozone in the solution.

Before tooth processing, the oral cavity was irrigated with 0.9% saline solution with an ozone concentration of 1500-2000 μg / L.

Opened the cavity of the tooth. Spent evacuation of putrid masses from the root canal with a pulp extractor. Removal of necrotic tissue and predentin with drill and rasp, with irrigation of a 0.9% ozonized solution (endodontic syringe) with a concentration of 1500-2000 μg / l. Expansion of the apical third of the root canal and giving it a cone shape by files and rimers, with the irrigation of a 0.9% ozonized solution with a concentration of 1500-2000 μg / l. Thorough washing of the root canal with turundas moistened with ozonated 0.9% physiological saline to their purity with a solution concentration of 1500-2000 μg / L. Installation of turunda moistened in a solution with a concentration of 4000-6000 μg / l, installation of a temporary seal.

We remove the temporary filling, in the presence of clean turunda, we carry out drug treatment with 0.9% ozonized physiological saline with a concentration of 1500-2000 μg / l.

The treatment of periodontitis is completed with root canal filling, thereby stopping the passage of microorganisms, microbial toxins and pulp decay products from the root canal to the periodontium.

We continue ozone therapy. Patients conduct oral baths after each meal with a solution with a concentration of 1000-1500 μg / l during the day. This allows for the further supply of oxygen to the tissues of the oral cavity, which leads to an improvement in the trophism of the oral mucosa, periodontal and tooth tissues, and ultimately improves the regeneration and repair of tooth tissues, increases local immunity and resistance of tissues to infection.

We conducted a study in which 90 people aged 30-40 years participated, with chronic apical destructive processes in the apex.

The diagnosis was made on the basis of complaints and objective research methods. As an additional research method, the x-ray method was carried out (intraoral and according to the indications of the orthopantomogram).

The general condition of the patients did not suffer, elevated body temperature was not observed. Complaints consisted in some cases of pain when biting, a feeling of heaviness in the area of the causative tooth, sometimes swelling and discoloration of the tooth. In general, patients did not present complaints, but came to prepare the oral cavity for further prosthetics.

An objective examination revealed a change in the color of the crown of the causative tooth, and often the crown was intact. In people of the older age group who were preparing for prosthetics, the crowns were destroyed, or had large carious cavities. Probing is painless, percussion in some cases was painful. On the alveolar process, in the area of the causative tooth, a fistulous course was found in some patients, sometimes with purulent discharge. Localization of fistulas was different. Most often, they opened at the level of the apex of the root of the causative tooth, from the vestibular surface of the gums, most likely due to the fact that this wall is thinner. Often around the mouth there were growths of bleeding granulations of pink color, and sometimes, instead of a fistula, in some cases scars were observed. From the anamnesis, it turns out that the causative tooth bothers the patient for a long time. At first, the pain was paroxysmal in nature, intensifying with biting and swelling of the gums. With the expiration of purulent contents through the hole in the gum, the pain passed and the general condition improved.

All patients underwent x-ray examination in the form of intraoral images. On radiographs in the bone near the top of the tooth, a site of destruction of bone tissue with uneven and fuzzy contours was noted. In some cases, partial resorption of the root of the tooth was detected. Bone tissue destruction often passed to the alveoli of adjacent teeth.

All patients were advised not to take any medicine and brush their teeth before taking the smears. The material was transported to a bacteriological laboratory for examination in sterile tubes filled with culture medium with a sterile tube. The material was delivered within 20 minutes. The content was taken according to all the rules of the bacteriological research technique. All patients are trained in hygiene skills.

At the time of admission, the Silnes-Loe oral hygiene index (GI) was determined, which was repeated after irrigation of the oral cavity with ozonized 0.9% saline solution with different concentrations of ozone. 1 for a different period after treatment.

Table 1. Oral hygiene index depending on the concentration of ozonized saline Ozone concentration in 0.9% saline solution (μg / L) GI at the time of receipt GI after irrigation of the oral cavity 500 2.74 + -0.04 2.77 + -0.04 1000 1.56 + -0.05 1500 1.68 + -0.06 2000 0.64 + -0.06 2500 0.79 + -0.08

When evaluating the effectiveness of this method, it was found that a significant decrease in the microflora of the oral region occurs at ozone concentrations of 1500, 2000 μg / L 0.9% saline, which indicates a high degree of effectiveness of these concentrations. Therefore, the use of a higher concentration ozonized solution for irrigation of the oral cavity in the treatment of chronic periodontitis and periodontitis in the acute stage does not make sense.

After opening the tooth cavity for the first visit with thin cotton wools on the root needle (everything is sterile, in dry heat cabinets for 1 hour at a temperature of 165-170 degrees or for two hours at a temperature of 155-160 degrees), the contents of the root canal and periapical region were taken. In well-traveled canals, we used ready-made paper turunds. Immediately after taking the sample, the turundas were lowered into the nutrient medium, while the usual bacteriological technique for sowing the burner flame was observed.

To assess the amount of microflora, samples of the contents of the root canal and tissues of the periapical region were taken before treatment and at each subsequent visit, and the material was inoculated with grass on blood agar. On average, during bacteriological examination, in the material before treatment, we examined up to 5 types of various microorganisms in all subjects:

mainly representatives of coccal flora: green streptococcus (mainly in 75% of cases), hemolytic enterococcus, epidermal staphylococcus (100% of cases), Escherichia coli (isolated in 4% of cases), bacteroids.

table 2 Groups Ozone Concentration (μg / L) The composition of the microflora of the root canal Onset time of bactericidal effect (min) twenty 1000 Green streptococcus
E. coli
Bacteroids
Epidermal staphylococcus
Hemolytic enterococcus 15-25 25 2000 Green Streptococcus Bacteroids 10-15 twenty 4000 no microflora growth 5-10 fifteen 6000 no microflora growth 5-10 10 7000 no microflora growth 3-10

The research data show that the optimal result is achieved with an ozone concentration of 4000-6000 μg / l at an exposure time of 5-10 minutes.

Table 3 The microflora of the oral cavity after the procedure “oral bath”, depending on the concentration of ozonized solution. No. p / p Solution characteristics Identified microflora Epidermal staphylococcus Green streptococcus bacteroids E. coli Hemolytic enterococcus one. Boiled water + + + + + 2. Ozonated solution at a concentration of 1000 μg / l + - - + - 3. Ozonated solution at a concentration of 1500 μg / l + - - + - four. Ozonated solution at a concentration of 2000 μg / l + + - - -

The research data shows that the amount of microflora when holding oral baths at home after each meal of 50 ml per one oral bath gives a pronounced bactericidal effect, which consists in reducing the growth of microflora. In addition, as an additional effect, trophism is improved not only in the gum region, but also in the entire oral cavity, which enhances the regenerative processes and gives faster treatment results. The concentration of the solution, giving a good effect of 1000-1500 μg / L.

Clinical and radiological control of the long-term results of the treatment of chronic apical destructive process was carried out in the period from 3 to 18 months.

After 3-6 months, patients after treatment did not show complaints. The teeth were actively involved in the act of chewing, palpation and percussion examination of the changes did not reveal.

In the period from 3-6 months, in patients with chronic periodontitis and periodontitis in the acute stage, 83.7% of patients showed favorable results in the form of an almost complete restoration of the destruction site. And in the period from 12-18 months, these indicators increased by 8.7%.

Example 1. Patient K., 45 years old, complained of darkening of the tooth crown, discomfort, inconsistent aching pain, often noted soreness when biting. History: the tooth has not been previously treated. Hyperemia and swelling of the gingival mucosa of the causative tooth with fistulous passage, with purulent discharge and swelling of granulation tissue, is objectively detected. Percussion of the tooth and palpation of the gums in the area of the projection of the apex of the root are painful. Crowns 11 and 12 are intact. X-ray uneven expansion of the periodontal gap is determined, in the region of the apex of the root, expansion is up to 3 mm.

On treatment, he was diagnosed with chronic granulating periodontitis and treatment was carried out, including trepanation measures, followed by filling of the canals with an osteostimulating paste (“Kalasept”), with the obligatory removal of the paste by the apical hole, and a gutta-peg pin was used as an additional obturator. The treatment was as follows:

- Before tooth treatment, irrigation of the oral cavity is carried out at an ozone concentration of 1500-2000 μg / l,

- After each stage of the processing of the tooth canal, irrigation with a drug is carried out with an ozone concentration of 1500-2000 μg / l,

- Evacuation of putrid masses from the root canal with a pulp extractor.

- Removal of necrotic tissue and predentin with augers and rasps, with irrigation of a 0.9% ozonated solution (endodontic syringe) with a concentration of 1500 μg / l.

- Expansion of the apical third of the root canal and giving it a conical shape with files and rimers, with the irrigation of 0.9% ozonized solution with a concentration of 1500 μg / l.

- Thorough washing of the root canal with turundas moistened with ozonized 0.9% physiological saline to their purity with a solution concentration of 1500 μg / L. Installation of turunda soaked in a solution with a concentration of 4000-6000 μg / l., Installation of a temporary seal. Removal of a temporary filling, in the presence of clean turundum, drug treatment with 0.9% ozonized saline solution of 1500 μg / l .;

- Filling of the root canal, in order to stop the entry of microorganisms, microbial toxins and pulp decay products from the root canal into the periodontium. "CALASEPT" is a sterile application system of calcium hydroxide, for temporary and permanent (in the presence of positive results) filling of channels. Its advantage is coagulation and complete dissolution of necrotic tissues, which is an obstacle to creating a favorable nutrient medium for microorganisms and their further growth. When filling with this drug, the apex of the tooth root is completely closed due to the stimulation of cementoblasts. This process is completed in 8-12 months. For successful treatment, it is necessary to strictly observe the rules of antiseptics.

- Continuation of ozone therapy at home. An oral bath was prescribed after each meal with a solution with a concentration of 1500 μg / l during the day.

After the measures taken, the patient did not complain, the tooth actively takes part in the act of chewing, the mucous membrane is pale pink, without visible changes, the fistulous course healed.

Example 2

Patient K., aged 40, complained of swelling of the face on the left, pain when biting, pain when touching the 21 and 22 teeth, darkening of the crown of the 21 and 22 teeth, feeling of a grown tooth, and fever. History: teeth not previously treated.

Hyperemia and smoothness of the transitional fold in the causative tooth, painful swelling in the projection of the granuloma are objectively revealed. Percussion of the tooth and palpation of the gums in the area of the projection of the apex of the root are sharply painful. Crowns are intact. A clear picture of the destruction of round-shaped bone tissue with a diameter of up to 0.8 cm is determined by X-ray.

On appeal, an exacerbation of chronic granulomatous periodontitis, a cyst from 21 and 22 was diagnosed, and treatment was carried out, including trepanation measures, to obtain purulent contents of the root canal, mechanical and drug treatment of the root canal, followed by filling the canals with osteostimulating paste (“Kalasept”), with obligatory removal of the paste beyond the apical hole, and a gutta-perforated pin was used as an additional obturator. The treatment was as follows:

- Before tooth treatment, irrigation of the oral cavity is performed at an ozone concentration of 1700 μg / L.

- Trepanation and opening of the tooth cavity.

- Evacuation of putrid masses from the root canal with a pulp extractor.

- Removal of necrotic tissue and predentin with augers and rasps, with irrigation of a 0.9% ozonized solution (endodontic syringe) with a concentration of 5000 μg / L.

- Expansion of the apical third of the root canal and giving it a conical shape with files and rimers, with the irrigation of a 0.9% ozonized solution with a concentration of 1,500 μg / L.

- Thorough washing of the root canal with turundas moistened with ozonized 0.9% physiological saline to their purity with a solution concentration of 1500 μg / L. Installation of turunda moistened in a solution with a concentration of 5000 μg / l, installation of a temporary seal.

- Removal of a temporary filling, in the presence of clean turundum, drug treatment with 0.9% ozonized physiological saline with a concentration of 5000 μg / l;

- Filling of the root canal, in order to stop the entry of microorganisms, microbial toxins and pulp decay products from the root canal into the periodontium. "CALASEPT" is a sterile application system of calcium hydroxide, for temporary and permanent (in the presence of positive results) filling of channels. Its advantage is coagulation and complete dissolution of necrotic tissues, which is an obstacle to creating a favorable nutrient medium for microorganisms and their further growth. When filling with this drug, the apex of the tooth root is completely closed due to the stimulation of cementoblasts. This process is completed in 8-12 months. For successful treatment, it is necessary to strictly observe the rules of antiseptics.

- Continuation of ozone therapy at home. An oral bath was prescribed after each meal with a solution with a concentration of 1500 μg / l

After the measures taken, the patient did not complain, the tooth actively takes part in the act of chewing, the mucous membrane is pale pink, without visible changes. After 18 months, we considered an excellent long-term result of treating this pathology to be an increase in favorable results in the absence of complaints and clinical manifestations (pain, swelling, the presence of fistulous passage, preservation of function, lack of growth). Radiologically determined significant reduction in the destruction of the lesion, or the absence of cyst growth. Improving the effectiveness of treatment of destructive forms of periodontitis remains at the moment the most important task.

When evaluating the effectiveness of changes in the tissues of the periapical region, the study of the immediate and long-term results shows that our proposed method using ozonized 0.9% physiological saline with different concentrations in the treatment of chronic periodontitis and periodontitis in the acute stage, provides undoubted advantages in comparison with traditional treatments. As a result, the treatment time was reduced, the time of remission increased, and the number of expensive drugs used, including antibiotics, decreased. The relative ease of use and the reduction in the amount of time allotted to one patient, allowed to increase the number of visits. There are no contraindications to this technique.

The method is practically non-drug, which allows you to abandon expensive medications during the treatment of this group of patients.

Claims (1)

A method of treating patients with chronic forms of periodontitis or periodontitis in the acute stage, comprising the steps of: opening the tooth cavity and evacuation of putrid masses, expanding the canal and apical opening, introducing an oxygen-containing drug into the root canal on the turunda, filling the root canal with filling material, characterized in that an ozonized 0.9% physiological solution with an ozone concentration of 4000-6000 μg / l is introduced into the root canal as a medicine, d, by treating the tooth, the oral cavity is irrigated at an ozone concentration of 1500-2000 μg / L, after each stage of the treatment of the tooth channel, irrigation is carried out with an ozone concentration of 1500-2000 μg / L, and after treatment, patients conduct oral baths during the day after each dose food solution with an ozone concentration of 1000-1500 mcg / l.