EVALUATION OF THE CLINICAL EFFECTIVENESS OF THE ELIMINATION OF LOCAL TRAUMATIC FACTORS OF THE ORAL CAVITY DURING THE TREATMENT OF LOCALIZED LESIONS OF THE PERIODONTAL SOFT TISSUES

Abstract

Purpose of the study. Evaluation of the clinical effectiveness of the use of photocomposite restorations of highly destroyed devitalized premolars for the prevention and treatment of localized soft tissue lesions of the periodontium. Research methods. Corporate studies of scientific literature on the pathogenesis, clinical manifestations and treatment of focal periodontal diseases were conducted. With the help of patients who had significantly decayed devitalized premolars, the status of direct photocomposite restorations was studied using the USPHS criteria. The level of preservation of direct restorations performed by the traditional and our proposed method was assessed visually and with tools. The hygienic, gingival, and periodontal index values were determined before treatment, after the restoration of premolars and later. Scientific novelty. According to the results of corporate studies of the scientific literature devoted to the study of the pathogenesis, clinical manifestations, treatment of localized periodontal diseases, it was established that there is no comprehensively analyzed modern scientific data on the condition and treatment of soft periodontal tissues of teeth with a completely destroyed crown part. The study of the condition of photocomposite restorations of a total defect of the hard tissues of the tooth in the long term showed a clear trend of improvement of clinical results in the first group, in which the adhesive preparation was carried out by the proposed method, than in the second group, where the standard approach was applied. The number of photocomposite chips in the long term was the lowest in the first study group compared to the second: on the contact surfaces of the restorations by 14.3%, on the palate – by 14.4%, vestibular – by 16.0%. The results of determining the partial color change of the restorations, the roughness (in the "c" value) of their surface and marginal color were also lower in the first group, respectively, by 16.5%, 16.3% and 20.3%. The study of the indicators of the hygienic, gingival and periodontal index before restorative treatment and after its results revealed a significant improvement in their values compared to the initial data. The value of the Silness-Loe index before treatment was 2.21±0.20 points, two weeks after treatment it decreased to 1.42±0.22 points, and after two months it was 0.82±0.20 points. The value of the PMA index before the start of treatment was 17.66±0.76%, two weeks after the treatment it decreased to 9.88±1.08%, and for two consecutive months it was 2.22±0.26%. The Pi index value before treatment was 1.08±0.16 points, two weeks after treatment it decreased to 0.72±0.04 points, and after two months to 0.12±0.05 points. Conclusions. The results of the conducted scientific studies testify to the effectiveness of the proposed method of restoration of destroyed natural tooth crowns. The study of the state of direct restorations of the total defect of the crown part of the tooth, performed according to the proposed method, showed that the method is not inferior to the known ones, and its use improves the indicators of the USPHS clinical criteria. When applying the proposed restorative treatment, there is a steady positive trend in the values of the Silness-Loe, PMA and Pi indexes, which shows their significant decrease (p <0.001), which confirms the positive therapeutic effect on the soft tissues of the periodontium due to the elimination of local traumatic factors by the restoration of the crown part tooth.