RU2476185C1 - Method of sampling material for bacteriological analysis from root canal and periapical region of tooth in case of chronic apical periodontitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and is intended for identification of microflora in system of root canals and apical region and differential approach to treatment of various forms of periodontitis. Access to root canal of tooth is formed. Length of root canal to apical hole is measured. Sampling of root canal content is performed with paper post No 20. It is placed into test tube with transport sterile medium. After that root, canal is extended to apical hole to size No 25. Opening of apical size to No 25 is performed, instrument length has to be 1.5-2 mm larger than root canal. Sampling of content from periapical region with paper post No 20, whose length is 1.5-2 mm larger than length of root canal. Post is placed into other test tube with the same medium.

EFFECT: method makes it possible to select form of drug treatment and control treatment efficiency due to determination of quantitative and qualitative composition of microflora of root canal and periapical region of tooth.

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Description

The invention relates to medicine, namely to dentistry, is intended to identify microflora in the root canal system and apical region for a differentiated approach to the treatment of various forms of periodontitis.

A known method of sampling gingival fluid, characterized in that the use of absorbent strips of the target wedge-shaped from the dacron plate, which have a thickness of 50-70 μm, a rounded working part with a width of 1.0-1.5 mm and a height of 0.8-1.0 mm and a free end with a width of 10 mm and a height of up to 25 mm, while the target strip is inserted for 3-5 s into the gingival sulcus without effort and without touching its walls and bottom, and the material is taken in the middle, medial and lateral sections of the gingival sulcus in the area of the examined tooth 3-5 hours after brushing , provided that the subject did not eat food in the indicated period of time, using a new target plate each time [patent RU 2342956, 2009].

The closest analogue of the invention is a method for determining the quantitative and qualitative composition of the microflora of the oral cavity in patients with dentoalveolar prostheses, which consists in taking the test material, taking into account the early stages of the wound healing process, in identical sections, segmented, on the 1st, 7th and 12th the day after surgery using a standard swab with circular motion along the entire contact line of the basis with the tissues that limit the operational defect and the entire surface of the obturator [application RU 2009141202, publ. in 2011].

The objective of the invention was the development of a method of collecting material from the root canal and periapical region of the tooth to identify pathogenic microflora in the lesion.

The technical result is the determination of the quantitative and qualitative composition of the microflora of the root canal and the periapical region of the tooth for the choice of drug treatment and monitoring the effectiveness of treatment.

The proposed method is as follows.

Identify the disease in the process of clinical and radiological examination. Form access to the root canals, if necessary, remove the old filling material from the root canals without the use of antiseptic and disinfectants. The length of the root canal is measured using an apex locator to the apical opening, fixing with the K-file size 15 hand-held tool with a silicone lock. The contents from the root canals are taken with a sterile paper pin No. 20 onto the sterile transport medium in the first test tube (Himedia, Hiculture ™ Transport Swabs). Expand the root canal to the apical opening to size No. 25. Then the apical opening is opened with the K-File hand tool to size No. 25, the length of the tool should be 1.5-2 mm longer than the fixed length of the K-file hand tool with size No. 15 (that is, 1.5-2 mm longer than the root canal ) Then carry out the sampling of material from the periapical region with a paper pin No. 20, the length of which is 1.5-2 mm longer than the root canal, to the aforementioned transport medium in the second test tube. Two test tubes with material on a transport medium are sent to a bacteriological laboratory for plating on nutrient media in order to identify microflora of the root canals and the periapical region. After receiving the results, a local treatment is prescribed, including antibacterial drugs, taking into account the results. 10 days after the local drug therapy, a control sampling of the material for bacteriological examination is carried out in order to assess the effectiveness of the drug treatment (excluding the presence of pathogenic flora in the root canals and the periapical region). Endodontic treatment of root canals is carried out according to the generally accepted protocol.

The invention is illustrated by the following clinical example.

Patient K. complained of swelling in the gum area, from the anamnesis - periodically the appearance of the fistulous course in this area. On examination, there is a filling on the occlusal surface of tooth 3.5, tooth percussion is painless, the gum mucosa from the vestibular side in the root projection area is hyperemic, swollen, and painful on palpation.

On targeted radiography: tooth 3.5 was previously treated for complicated caries, the canal was not completely filled, in the periapical region of tooth 3.5 there is a lesion of bone tissue with fuzzy borders, oval in shape.

First visit. Removing the old filling (tooth 3.5), forming endodontic access to the root canals, removing the old filling material from the root canals using K-file endodontic instruments, machining the canal, measuring the length of the root canal using an apex locator to the apical opening , fixing with the K-file tool №15 in size with a silicone clamp. The contents are taken from the root canal with a sterile paper pin No. 20 for bacteriological examination on a sterile transport tube with medium (Himedia, Hiculture ™ Transport Swabs). The expansion of the root canal to the apical foramen to size No. 25.

Then the material was taken from the destruction center. To do this, the apical hole is opened with the K-File hand tool to size No. 25, and the length of the tool should be 1.5-2 mm longer than the root canal; after opening the apical hole, a fence is examined for examination with a sterile paper pin No. 20, the length of which is longer the length of the root canal by 1.5-2 mm, on the aforementioned sterile transport medium (Himedia, Hiculture ™ Transport Swabs).

Two tubes with material on a transport medium were sent to a bacteriological laboratory for inoculation on nutrient media in order to identify microflora of the root canals and the periapical region.

The root canals at the same visit were treated with a 3% sodium hypochlorite solution, temporarily sealed with the Polyoxidonium preparation under a temporary filling. During the bacteriological study, the same type of flora was detected in two test tubes, including: alpha-hemolytic streptococcus, gamma-hemolytic streptococcus, Staphylococcus aureus, micrococcus, lactobacillus, Str. pneumonia. Str. salivarius.

Second visit. Endodontic treatment was carried out, including antibacterial therapy (5% lincomycin solution), alternation with temporary filling of the root canals after 3 days with the Polyoxidonium drug, and the canal treatment was carried out with Krezofen solution.

After 10 days, a second bacteriological study was carried out, pathogenic microflora was not found. The channels are sealed according to the generally accepted technique.

Claims (1)

A method of collecting material for bacteriological research in dental patients, characterized in that they form access to the root canal of the tooth, measure the length of the root canal to the apical opening, take the contents of the root canal with a paper pin No. 20, place it in a test tube with a sterile transport medium, and then expand the root canal to the apical foramen to size No. 25, and then open the apical foramen to No. 25, and the length of the instrument should be greater than the length of the root to Nala 1.5-2 mm, and the contents carried fence periapical paper pin №20, which is greater than the length of the root canal length of 1.5-2 mm, the pin is placed in another tube with the same medium.