Tashkent Medical Academy PULPIT to Tashkent Medical Academy PULPIT to THERAPEUTIC STOMATOLOGY THERAPEUTIC STOMATOLOGY

LECTURE 3LECTURE 3FOR STUDENT 4 COURSES 7 FOR STUDENT 4 COURSES 7

SEMESTERS SEMESTERS STOMATOLOGICHESKOGO FACULTYSTOMATOLOGICHESKOGO FACULTY The Subject: Chronic and chronic in stage The Subject: Chronic and chronic in stage

of the intensification of the intensification periodontitisperiodontitis . The . The Clinic, diagnostics and treatment lecturer: Clinic, diagnostics and treatment lecturer:

professor Komilov H.P.professor Komilov H.P.Tashkent 201Tashkent 20133

The Purpose:The Purpose: Acquaint the student with Acquaint the student with chronic forms chronic forms periodontitisperiodontitis .. Their clinic, Their clinic, diagnostics diagnostics and and methodsmethods treatments. treatments.

The Problems: Teach the The Problems: Teach the student to diagnose the chronic student to diagnose the chronic forms an forms an periodontitisperiodontitis , conduct , conduct the differential diagnostics with the differential diagnostics with similar diseases, form the plan of similar diseases, form the plan of the treatment sick with chronic the treatment sick with chronic forms forms periodontitisperiodontitis and methods and methods of the treatment.of the treatment.

Plan:Plan:1. Clinic chronic and chronic in 1. Clinic chronic and chronic in stage of the intensification stage of the intensification periodontitisperiodontitis

2. Diagnostics of the clinical forms 2. Diagnostics of the clinical forms periodontitisperiodontitis

3. Methods of the treatment of the 3. Methods of the treatment of the chronic forms chronic forms periodontitisperiodontitis

Chronic fiber Chronic fiber periodontitisperiodontitis

Chronic fiber Chronic fiber периодонтитпериодонтит

Etiologiya:Etiologiya: 11..AfterAfter treatments treatments pulpitispulpitis 2. transformation2. transformation granulating and granulating and

granulomatousgranulomatous pulpitispulpitis in fiber formin fiber form 3.3.howhow upshot sharp apical upshot sharp apical periodontitisperiodontitis 4. at4. at overloading teethoverloading teeth

PERIVASKULYARNYE INFILITRATY. H 100

LEYKOCITARNAYA INFILITRACIYA. H 200

Early shaping the blood vessels. Newly educated capillaries are labeled asterisk. Early shaping the blood vessels. Newly educated capillaries are labeled asterisk.

The Colouration The Colouration hematoxylinhematoxylin and and eosineosin , uv. 40x10, uv. 40x10

Gistologicheskaya picture Apikalinaya migration epithelium Gistologicheskaya picture Apikalinaya migration epithelium dentogingivaldentogingival of the groove. of the groove.

Infilitraciya Infilitraciya under the epithelialunder the epithelial fabrics hutch to inflammatory reaction with destruction fabrics hutch to inflammatory reaction with destruction

collagencollagen filaments. Gematoksilin-filaments. Gematoksilin-eosineosin , , uv.h20uv.h20

The Zone of the fiber fastening (F) to surfaces of the dentine (D) root The Zone of the fiber fastening (F) to surfaces of the dentine (D) root

teeth without shaping the new cement. Gematoksilin- teeth without shaping the new cement. Gematoksilin- eosineosin (on Caton, (on Caton,

Greenstein 1994)Greenstein 1994)

The Root damaged in normal The Root damaged in normal periodontiumperiodontium : (: (but) - migration epithelium along root surface, but) - migration epithelium along root surface,

apical apical enamel-cement border. enamel-cement border.

Gematoksilin-eosinGematoksilin-eosin, , uv. h10; (b) - an epithelium uv. h10; (b) - an epithelium lines thelines the surface a root and comes to light surface a root and comes to light apical apical

crestcrest alveolar offshoot, showing that new connecting-woven fastening does not meet on surfaces root, alveolar offshoot, showing that new connecting-woven fastening does not meet on surfaces root,

damaged damaged periodontitisperiodontitis though root and is in normal though root and is in normal periodontiumperiodontium Gematoksilin-Gematoksilin-эозин, эозин, uv. uv.

h12.8 (on Poison, Caton 1982)h12.8 (on Poison, Caton 1982)

Chronicn Chronicn granulomatous periodontitisgranulomatous periodontitis

Chronic Chronic granulomatous granulomatous periodontitisperiodontitis

Fiber capsule develops In the field of Fiber capsule develops In the field of tops root,surrounding tops root,surrounding granulationgranulation

fabrics-fabrics-granulomagranuloma

Hroicheskiy granulating Hroicheskiy granulating periodontitisperiodontitis

Chronic granulating Chronic granulating periodontitisperiodontitis

Weak Weak painpain of the sensation-gravity, of the sensation-gravity, DistensionDistension ,,awkwardness,small awkwardness,small sorenesssoreness

under under bitebite on teethon teeth

Granulicionnaya fabricsGranulicionnaya fabrics

Rezorbciya cement and dentineRezorbciya cement and dentine

about apical granulomaabout apical granuloma ::

1. 1. simplesimple 2.2.complex epithelialcomplex epithelial

3. 3. KistogranulemyKistogranulemy

Bone fabrics to jaws is not restored:Bone fabrics to jaws is not restored:

1. 1. channel were filledchannel were filled not completelynot completely 2. 2. The increasedThe increased pressure on teethpressure on teeth 3.Аpical centre of the chronic inflammation 3.Аpical centre of the chronic inflammation

communicates with communicates with periodontalperiodontal by pocketby pocket 4.At cyst if in nearby teeth has occurred 4.At cyst if in nearby teeth has occurred

necrosis of the pulp,but treatment was not necrosis of the pulp,but treatment was not conductedconducted

5. reduction5. reduction general general immunologicalimmunological reactivityreactivity

Using Using hlorfilipthlorfilipt at treatment at treatment

destructivedestructive forms forms periodontitisperiodontitis The Methods of the study:The Methods of the study: Objective and Objective and subjectivesubjective Rentgenology Rentgenology

MikrobiologicheskoeMikrobiologicheskoe

The X-ray 6. D-z: hr. The X-ray 6. D-z: hr.

granulating granulating periodontitisperiodontitis . .

Before treatment. Before treatment.

The X-ray same sick through 1 after treatment крезодентом.

Chronic granulomatous periodontitis 14 teeths.

After depoforeza passed 12 mesyacev. treatments крезодентом

Chronic Chronic granulomatous

periodontitis 46 46 teeths. teeths.

After крезодента passed 9 months.

Conservative-surgical methodsConservative-surgical methods

Resection of the top root Resection of the top root Koronoradikulyarnaya Koronoradikulyarnaya separationseparation

Gemisekciya and amputation root Gemisekciya and amputation root Replantaciya teethReplantaciya teeth

Depoforez hydroxide honeys-calcium can be Depoforez hydroxide honeys-calcium can be used for treatment all gangrenous teeth, used for treatment all gangrenous teeth, including at including at difficult difficult availableavailable , , partly partly obliteratedobliterated and/or powerfully twisted channel and/or powerfully twisted channel teeth, covered crown. The Teeths are after teeth, covered crown. The Teeths are after vital extirpationvital extirpation also possible to cure the also possible to cure the depoforezomdepoforezom , , but after but after devitalizationdevitalization remainder pulps. This method remainder pulps. This method is highlyis highly and and under the other type apical processes such as under the other type apical processes such as radicularradicular of the cyst, of the cyst, osteolysisosteolysis ..

The Designed method The Designed method depoforezadepoforeza possesses possesses beside solving advantage, which is conditioned by beside solving advantage, which is conditioned by using new material: water using new material: water suspensionsuspension hydroxide hydroxide honeys-calcium, possessing exclusive honeys-calcium, possessing exclusive bactericidalbactericidal characteristic. During treatment characteristic. During treatment under the action of electric field from created in under the action of electric field from created in rootroot channel railroad yard above named channel railroad yard above named suspensionsuspension ions HE- and possessing strong ions HE- and possessing strong bactericidalbactericidal action ions action ions hydroxo cupratehydroxo cuprate [[Su(ON)4] get into the whole canal system, Su(ON)4] get into the whole canal system, including secondary and lateral channels, up to including secondary and lateral channels, up to hole. hole.

1. Proteoliz residing in canal system remainder fabric. 1. Proteoliz residing in canal system remainder fabric. Forming herewith sterile Forming herewith sterile oligopeptidesoligopeptides and and myceliummycelium saponification after leaving from canal system are after leaving from canal system are included in processes of the assimilations. included in processes of the assimilations.

2. Destruction all microorganism to account of the taking 2. Destruction all microorganism to account of the taking away of the amino acid sulphur. away of the amino acid sulphur.

3. Vystilanie 3. Vystilanie unfilledunfilled part of the root channel, as well part of the root channel, as well as all as all microtubulesmicrotubules by hydroxide honeys-calcium, which by hydroxide honeys-calcium, which provides long sterility and, besides, provides long sterility and, besides, stimulatesstimulates formation formation bone fabrics in the field of bone fabrics in the field of micro holesmicro holes ..

4. 4. stimulationstimulation activities activities osteoblastsosteoblasts in in periapicalperiapical of of the area as a result the area as a result alkalinizationalkalinization . .

Instrument Original II

The Procedure is executed not in The Procedure is executed not in physiotherapyphysiotherapy cabinet, but in easy chair of cabinet, but in easy chair of the physician. Negative the physician. Negative wire dotwire dot electrode, electrode, bolted in ferrule, carry in channel on bolted in ferrule, carry in channel on depth 4-8 mm. (Since session of the depth 4-8 mm. (Since session of the treatment lasts usually 2-5 minutes, bolt treatment lasts usually 2-5 minutes, bolt the electrode by sticky wax does not the electrode by sticky wax does not follow). The Positive electrode place for follow). The Positive electrode place for cheek.cheek.

Include the instrument and slowly enlarge the current, Include the instrument and slowly enlarge the current, reaching, as a rule, from 1 before 2 mA. The Gross reaching, as a rule, from 1 before 2 mA. The Gross amount electricity, which necessary to process the amount electricity, which necessary to process the channel, forms 15 mA h mines. The Treatment is channel, forms 15 mA h mines. The Treatment is conducted in three sessions usually so given during one conducted in three sessions usually so given during one session amount electricity forms at the average 5 mA h session amount electricity forms at the average 5 mA h

mines. As mines. As tabtab before the following session, which is before the following session, which is conducted through 8-10 days usually, after drainage in conducted through 8-10 days usually, after drainage in channel enter become cool portion of the paste hydroxide channel enter become cool portion of the paste hydroxide honeys-calcium. For time between session of the honeys-calcium. For time between session of the treatment cavity is recommended leave open (or close the treatment cavity is recommended leave open (or close the time seal with done in her hole) to prevent arising the time seal with done in her hole) to prevent arising the

pressure at pressure at outflowoutflow possible else possible else formedformed exudate.exudate.

Rekontaminaciya is practically excluded because of Rekontaminaciya is practically excluded because of powerful disinfecting activity hydroxide honeys-powerful disinfecting activity hydroxide honeys-calcium. After the last procedure entry in channel fill calcium. After the last procedure entry in channel fill атацамитом - атацамитом - a special alkaline cement, contain ions a special alkaline cement, contain ions honeys (the maximum before 1/3 Apical of a part). Is honeys (the maximum before 1/3 Apical of a part). Is

Not required Not required exactingexacting ""full filling the channel". full filling the channel". By means of proposed method possible to cure all By means of proposed method possible to cure all

gangrenous channels, including, gangrenous channels, including, obliteratedobliterated . . Under Under obliterirovaobliterirovate te channel necessary to channel necessary to

produce at least small expansion of the channel in produce at least small expansion of the channel in higher part to contribute hydroxide honeys-calcium.higher part to contribute hydroxide honeys-calcium.

Undertaking Undertaking depoforeza depoforeza can be recommended can be recommended For treatment For treatment osteolysisosteolysis by means of by means of instrument for instrument for depoforezadepoforeza or use galvanic or use galvanic pin pin tumblertumbler element for long element for long depoforezadepoforeza . . The The Methods is described in instructions to Methods is described in instructions to galvanic dowel (the production galvanic dowel (the production "Humanhemi"). "Humanhemi").

LITERATURELITERATURE Summary: 1. Borovsky EV et al "dentistry" .- M. 2002. - 736s. 2. Borovsky EV Barisheva YD, YM Maksimovskiy "Dentistry", Moscow 1998 3. Lutzky IK "Prakticheskeaya dentistry" Minsk: Belarusian Science, 2001. 359. 4. Nikolaev, AI, LM Tsepov "Practical preventive dentistry," Moscow: Inform

MEDpress, 2004. With 548. MORE: 5. Dmitriev, LN etc. "dentistry." -M., 2004. 6.Skorikova L. et al "Propedeutics dental diseases." Rostov n/d..2002 was 7. Lutzky, "Guide to Dentistry", Rostov-N / A: Phoenix, 2002.-544 with. 8. DmitrienkoS.V Krayushkin A., Sapin M.R "Anatomy of human teeth",

Moscow-Nizhny Novgorod: Med.kniga NSMA, 2000. - 196. 9. Leus PA, Goreglyad AA, Chudakov Acting "Diseases of the teeth and mouth,"

Minsk High School. 1998.288s. www.medinfo.homeml.org/E-mail:medinfo. @ mail.admiral.ru www.doctor.ru www. e-stomatology.ru

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