back to vol. 15, b. 2, 2009

Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312-773X (Online)
Issue: 2009, Volume 15, book 2
Subject Collection: Medicine
Page: 113-118
DOI: 10.5272/jimab.1522009_113
Online date: March 17, 2010,

Angela Gusiyska, E. Dyulgerova.
Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University - Sofia, Bulgaria

Introduction: Typical chronic apical periodontitis is generally accompanied by periapical bone destruction, which is radiographically observed as periapical radiolucency around the apex. Pathological events in apical periodontitis are mainly characterized by bone destruction and this bone destruction is mediated by osteoclasts which are multinuclear cells derived from macrophages. Although bone tissue possesses the capacity for regeneration, there are many pathological situations in which this capacity is not sufficient to stimulate and realize healing processes. The development of biphasic calcium phosphate ceramic  for bone graft is one of the promising biomaterials for better control of the complex processes of bone healing and regeneration.
Materials and Мethods: The subject of this study were seven clinical cases (seven patients - 4 female and 3 male in ages from 22 -53 years) with radiolucency and radiographical evidence of periapical lesions. The result of this treatment was presented in three groups: I) three of root canals were aseptically instrumented to ISO size 60 (# 11, 46, 21), II) two of them – to ISO size 70 (# 11,36), and   III) the third group to ISO size 80 (# 21,22)
Following the ideology of the injectable implant material [37], this study used as, scaffold fine powder particles of biphase calcium phosphate ceramic mixed with saline solution.
Results: The results of this study are presented in the radiographs listed as Fig. 5, 9, 10 preoperatively and Fig. 6, 7, 8, 11, 12, 13 and 14 postoperatively.
The sequence of replacement of radiolucency with a radioopacity in periapex should be considered as one of the characteristics in remodeling of the processes after treatment.
These findings showed that in a lapse of time the healing processes involve immature bone and fibrous connective tissues.
Discussion: Our positive results are insufficient for suggesting any possible mechanisms expanding healing processes of lesions. But having in mind some data from the literature on bone regeneration, molecular and cellular interaction with calcium phosphate ceramics, it should be mentioned that some results have demonstrated that microporosity and surface activity of ceramic is responsible for bone formation
Concluding remarks: The basic aim of this study is to achieve healing and probably bone regeneration in the clinical treatment of apical lesions, using methods of bone regeneration and tissue engineering.
The positive  results of the present pilot study demonstrate: bone remodeling, biomimetic obturation of the translucent apical zone and apical foramen.

Key words: apical periodontitis, bone regeneration, apical obturation.

Page: 113-118; FULL TEXT PDF (313 KB)

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