Application of medicinal composition based on tetracycline and ascorbic acid in the treatment of destructive processes in the periapical area

Authors

  • Ірина Петрівна Мазур
  • Наталія Олексіївна Бакшутова
  • С. В. Хлєбас

DOI:

https://doi.org/10.33295/1992-576X-2019-3-12

Keywords:

chronic granulematous periodontitis, destructive processes in the periapical area, drug composition based on tetracycline and ascorbic acid, an increase of treatment efficiency of granulematous periodontitis

Abstract

Background. One of the most important tasks of the dental profession is increasing the effectiveness of treatment of one of the most difficult dental problems – periodontitis. As a result of the toxic effect of microorganisms and their products on the tooth pulp infection of the root canal occurs and this infection can lead to the occurrence of destructive processes in the periapical area that can reduce the non-specific resistance of the organism and violate its immunological status. Qualitative and effective disinfection of the root canal system is one of the main stages of endodontic treatment. Despite the wide range of medicines used for antibacterial treatment of the root canal during the treatment of periodontitis there is no drug that meets all requirements. The situation is complicated by the fact that in recent years antibiotic resistance to many antibacterial agents has been noted. However, as the study showed, tetracycline became an exception – it inhibits the growth of microorganisms. To increase the effectiveness of conservative therapy of the root canal system new effective remedies should be sought.
Objective. To study the efficacy of treatment of patients with chronic granulematous periodontitis with the use of our drug composition based on tetracycline and ascorbic acid, which has antibacterial and anti-inflammatory activity and contributes to the processes of regeneration in periapical tissues.
Materials and Methods. The study was attended by 30 people with chronic granulematous periodontitis with average age of 34.74±6.71 years. Patients were divided into 2 groups. The main group included 15 patients with an average age of 35.53±7.13 years and a control group of 15 patients with an average age of 33.93±6.41 years. All patients underwent clinical examination (review, the definition of paraclinical indices) and X-ray examination (X-ray pattern, the definition of X-ray-morphometric indices: periapical index (PAI) with modification by A.M. Soloviev and area of the periapical defect). Monitoring of the clinical condition and periapical tissues was performed prior to and 6 and 12 months after treatment. Patients of both groups with chronic granulematous periodontitis undergone endodontic intervention in accordance with the protocol of treatment approved by the Ministry of Health of Ukraine. At the stage of instrumental root canal treatment to patients of the main group additionally a medicinal composition based on tetracycline and ascorbic acid developed by us was applied, which acts on the pathogenic microflora of infected root canals and microtubules reducing the number of microorganisms and contributing to reparative processes in the periapical region.
Results. According to the results of clinical and radiological studies high antibacterial and anti-inflammatory efficacy of tetracycline-ascorbic composition in the treatment of patients with chronic granulematous periodontitis have been proved since tetracycline inhibits the growth of pathogenic microorganisms. If the area of destruction among patients of the main group before treatment was 3.60 [3.06, 3.98] mm2 then in 12 months after treatment it decreased to 0.99 [0.84, 1.14] mm2 (p < 0.001). For comparison: in patients from the control group the area of destruction was 3.66 mm2 [2.99; 3.80] and 12 months after treatment – 1.32 mm2 [1.17; 1.42] (p < 0.001). Similarly there was a decrease in the index of PAI in the main group before treatment and 12 months after treatment: from 4.13±0.52 points to 1.47±0.74 points. For comparison: in the control group the index PAI before treatment was 4.07±0.59 points, after 12 months – 1.73±0.59 points (p < 0.001).
Conclusion. The high efficiency of treatment of patients with chronic granulematous periodontitis is confirmed. We received a decrease in the area of destruction and level of RAI in the periapical region. It can be argued that the use of our drug-based composition based on tetracycline and ascorbic acid showing antibacterial and anti-inflammatory effects contributes to the process of regeneration of bone tissue in the region of the apex of the root.
Key words: chronic granulematous periodontitis, destructive processes in the periapical area, drug composition based on tetracycline and ascorbic acid, an increase of treatment efficiency of granulematous periodontitis.

Author Biographies

Ірина Петрівна Мазур

Мазур Ірина Петрівна – д-р мед. наук, професор, президент «Асоціації стоматологів України».
Національна медична академія післядипломної освіти ім. П.Л. Шупика.

Наталія Олексіївна Бакшутова

Бакшутова Наталія Олексіївна – канд. мед. наук,
Національна медична академія післядипломної освіти ім. П.Л. Шупика.

С. В. Хлєбас

С.В. Хлєбас – Національна медична академія післядипломної освіти ім. П.Л. Шупика.

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Published

2019-10-10

Issue

Section

PREVENTIVE DENTISTRY