RUDN University Dentist Suggested a Comprehensive Ozone-Based Anti-Inflammatory Therapy
Great new article on the use of ozone in dentistry. Ozone dentistry has become more popular as knowledge of the applications for ozone become more wide known and the equipment manufacturers catch up to the industry and provide suitable, reliable equipment to meet the needs of the average dental office.
Read the full original article HERE
A dentist from RUDN University implemented a new approach to treating of inflammation of tissues around dental root and root canal. The new comprehensive therapeutic method includes the treatment of inflamed tissues with ozone. When used in a complex clinical case, the method helped save a patient’s tooth. The case was described in the Clinical, Cosmetic and Investigational Dentistry journal.
Newswise — Both the dental pulp (loose connective tissue in the dental cavity) and the periodontium (fibers that connect the dental root with the bone of the jaw) can get inflamed. If the infection is not localized only on the inside or the outside but affects both areas, it is much more difficult to completely cure a tooth. Such cases are difficult to diagnose, therefore, professional literature contains only a few descriptions of them, and there are no general treatment recommendations. Some dentists prefer to focus on the internal canals first, while others suggest treating the pulp and the periodontium simultaneously. A dentist from RUDN University implemented a single protocol for comprehensive pulp and periodontium treatment.
“Inflammation of periodontal tissues often leads to tooth loss. In some cases, a lost tooth cannot be replaced with an implant, because the consequences of the infection worsen the implantation prognosis. Therefore, keeping the tooth is a more desirable outcome in this scenario,” said Dr.Maria Makeeva, PhD, an Associate Professor at the Department of Conservative Dentistry, RUDN University.
The new approach was carried out in a clinical case of a 44 years old patient with significant inflammation of the right mandibular canine. Initially, the patient was diagnosed with periodontium inflammation; the tooth was loose, and a flow of pus was observed. The first steps were typical for a periodontal inflammation treatment protocol: the patient was administered an antibiotic and then was instructed to rinse the tooth with chlorhexidine. Moreover, the dentist carried out the scaling of the tooth. After that, the patient remained under observation for six months. Although the bleeding and pyorrhea stopped, at one examination the dentist discovered tissue injury around the root of the tooth. The process went so far as to cause bone destruction. It turned out that one narrow area had an 8 mm deep periodontal pocket, and that the initial inflammation transferred to the internal tissues of the tooth.
Working together, a periodontologist and an endodontist implemented a comprehensive treatment approach. Their next step was focused on removing the dead pulp from the dental canals. After cleaning, the canals were dried and treated with ozone for 24 seconds for better disinfection. After a week of dressing, the treatment was repeated, and the cavity was covered with a permanent filling made of a light-cured composite material. Ozonetherapy was used to treat the periodontal tissues too: after cleaning, the periodontal pocket was rinsed, dried, and treated with ozone for 18 seconds. A recall examination in six months showed no inflammation of the tooth. Moreover, the bone tissue was recovering, and the periodontal pocket reduced to 4 mm.
“Simultaneous inflammation of the pulp and periodontium tissues is very difficult to treat. It can be caused by several types of pathogens at the same time that migrate between tissues and worsen the prognosis. Our experience shows that such an infected tooth can be saved, but it requires close collaboration of a periodontologist and an endodontist, as well as a patient’s complete compliance with oral hygiene recommendations. One should also take into consideration possible bacterial resistance to antibiotics and therefore use additional antibacterial treatment, such as ozone,” added Dr.Maria Makeeva from RUDN University.
The original paper can be found HERE. Or, if the link is bad, the paper abstract is listed below:
Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review
Abstract: The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.