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RUDN University Dentists Recommend Ozone-Based Comprehensive Anti-Inflammatory Therapy

A dentist from RUDN University has implemented a new approach to treat inflammation of the root and peri-root canal tissue. The new comprehensive treatment involves treating inflamed tissue with ozone. When used in complex clinical cases, this approach helps save the patient's teeth. The case was published in the Journal of Clinical, Aesthetic and Research Dentistry.

Both the pulp (the loose connective tissue in the tooth cavity) and the periodontal tissue (the fibers that connect the root of the tooth to the jawbone) become inflamed. If the infection is not localized to the inside or outside of the tooth, but affects both areas at the same time, it will be much more difficult to fully heal the tooth. Such cases are difficult to diagnose, and as a result, they are poorly described in the professional literature, and there are no general recommendations for treatment. Some dentists prefer to treat the inner root canal first, while others recommend treating both the pulp and periodontal tissue at the same time.

A dentist from RUDN University implemented a single protocol for combined endodontic and periodontal treatment.

"Inflammation of the periodontal tissue often leads to tooth loss. In some cases, the lost tooth cannot be replaced with an implant because the consequences of infection worsen the prognosis of the implant. Therefore, in this case, tooth preservation is a more ideal option. results," said Dr. Maria Makeeva, Associate Professor, Department of Conservative Dentistry, RUDN University. Ozone Sterilizer

This new approach was performed in a clinical case of a 44-year-old patient with a right mandibular dog with marked inflammation. Initially, the patient was diagnosed with periodontitis; the teeth were loose and pus was also observed. The first step is a typical periodontitis treatment regimen: giving the patient antibiotics, then instructing the patient to clean their teeth with chlorhexidine. In addition, the dentist performs scaling on the teeth. After that, the patient was observed for six months. Although the bleeding and pus stopped, during an examination, the dentist found tissue damage around the root of the tooth. This process even leads to bone destruction. It was found that a narrow area had an 8mm deep periodontal pocket and that the initial inflammation had metastasized to the inner tissue of the tooth.

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A periodontist and an endodontist worked together to implement a comprehensive treatment approach. Their next step is to remove the dead pulp from the tooth canal. After cleaning, the pipes are dried and treated with ozone for 24 seconds for better disinfection. A week later, the treatment is repeated and the caries are covered with a permanent filling made of a light-cured composite. Ozone therapy is also used to treat periodontal tissue: after cleaning, rinse the periodontal pocket, dry, and treat with ozone for 18 seconds. A recall inspection six months later showed no inflammation of the tooth. The bone tissue recovered gradually, and the periodontal pocket was reduced to 4 mm.

"Inflammation of the pulp and periodontal tissue at the same time is difficult to treat. It can be caused by several types of pathogens at the same time, and these pathogens migrate between tissues, worsening the prognosis. Our experience shows that such infected teeth can be preserved. Yes, but it requires close cooperation between the periodontist and root canalist, as well as the patient's full compliance with oral hygiene recommendations. We should also take into account the possible resistance of bacteria to antibiotics, and therefore the use of additional antibacterial treatments such as ozone, ” added Dr maria Makeeva from RUDN University.

Treatment of peripheral lesions in patients with aggressive periodontitis with ozone gas: a clinical case report and literature

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Abstract: There is an obvious relationship between dental pulp and periodontal tissue. A pulp infection may affect the periodontal tissue and vice versa. Teeth with periodontal disease have a worse prognosis than isolated root canal or periodontal disease. Eradication of root canals and periodontal infections is the key to successful treatment and therefore requires the cooperation of a root canalist and a periodontist. The present case is a 44-year-old man who presented with primary periodontal disease in the right lower canine with secondary root canal disease due to aggressive periodontitis. The clinical attachment loss was 10 mm, and the periodontal pocket had 8 mm light transmittance from the mesial, periapical, and lateral to the root of the tooth and bone. Root canal therapy is performed after periodontal treatment. Periodontal treatment included root scaling and planing, treatment of periodontal pockets with ozone gas, systemic antibiotics, oral hygiene instruction and chlorhexidine rinses. Root canal treatment includes root canal preparation with rotary file, irrigation, ozone root canal treatment and lateral compaction. At the 6-month follow-up, radiographs showed periapical lesions and complete union of the alveolar bone lateral to the root. Treatment of intra-cycle lesions with an interdisciplinary approach provides good clinical outcomes. Ozone therapy has a certain curative effect on intraperipheral lesions in patients with aggressive periodontitis, periodontal pocket narrowing and poor prognosis.