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Aim. To evaluate the antimicrobial efficacy of endodontic retreatment of patients with destructive forms of persistent periodontitis using a combined approach to disinfection of the root canal system and a hyaluronic acid medication.Materials and methods. Group № 1 – endodontic retreatment with root canal disinfection by Hypochloran-3; group № 2 – the same, but for root canal disinfection, first "Hypochloran-3" was applied, and then photodynamic therapy using a 662 nm diode laser and a photosensitizer "ELOFIT®"; group № 3 – in addition to the manipulations carried out in group № 2, of the "Revident" medication was injected twice in the projection of the apical part of the causative tooth. Antibacterial efficacy was assessed according to the results of microbiological studies of biological samples taken before and 2 weeks after endodontic retreatment. The identification of microorganism colonies was carried out by mass spectrometry.Results. In patients with destructive forms of persistent periodontitis, both before and after root canals disinfection, Enterococcus faecalis ranked the first in terms of the frequency of detection in biological samples, Candida albicans the second, and Veillonella parvula the third. At the same time, before the treatment of root canals, the predominance (more than 80%) of polymicrobial associations with their participation was shown. After root canal treatment, the number of obtained microorganism isolates in groups 1-3 significantly decreased: by 60.0%, 74.3%, and 76.0%. Against this background, the share of strict anaerobes and microaerophiles in groups 1-3 decreased: by 60.6%, 81.3%, and 78.1%. The share of facultative anaerobes also significantly decreased by 59.7%, 79.7%, and 83.8%.Conclusions. Endodontic retreatment of patients with destructive forms of chronic periodontitis using combined disinfection of root canals both without and in combination with a hyaluronic acid medication is accompanied by a statistically significant reduction in species diversity, associations, and content of periodontal pathogenic microbiota.

Aim. To assess the need for repeated endodontic treatment and to determine the possible reasons for the repeated revision of the root canals according to the archival material of the state polyclinic in the period 2015-2020.Materials and methods. Archival data of the registry of the state polyclinic in the period from 2015 to 2020, containing information on repeated endodontic treatment, namely: data on the treatment of patients and the condition of their teeth with apical periodontitis on the admission of CHI, repeated revision of root canals, method and means of mechanical and drug treatment of canals, filling material before and after the revision of root canals, X- rays at all stages of treatment with their description. In accordance with the purpose of the study, descriptive statistics were carried out, the data that were obtained as a result of processing information on the material of the archive of the dental clinic were analyzed and described, absolute frequencies and their proportions were indicated, which are shown in the diagrams, it was done in the Microsoft Excel program.Results. In 505 teeth (54%), the root canals were obturated with resorcinol - formalin paste, most of the root canals of the teeth - 373 (40%) were sealed at half their length, on sighting radiographs in 80% of cases an expansion of the periodontal gap was revealed, in addition to destructive changes in bone tissue, basically all cases were treated under a temporary calcium- containing paste, 4% of the root canals of the teeth (35) were not obturated with permanent material, due to the absence of patients, 5 teeth (0.5%) underwent surgical treatment. Of all the cases identified, only 1% (10 cases of repeated endodontic treatment) have information about long-term results, which are positive.Conclusions. Thus, a complex of factors contributes to the occurrence of apical periodontitis, and the selection of one of them, as the main one, will not solve the problem of this complication. Dentists - therapists should focus their attention at each stage of primary and/or repeated endodontic treatment, adherence to the irrigation protocol, mechanical treatment of root canals, high- quality obturation, and most importantly, motivate patients to follow- up visits and control long-term treatment results through computed tomography and control sighting pictures.

Aim. Optimization of an endodontic retreatment by performing the following tasks, including the selection of an optimal and safe solvent.Materials and methods. In order to choose the most suitable solvent for the problem, an experiment was conducted with clove, mint, eucalyptus, orange, and grapefruit oils. The surface tension coefficient was measured by the Rebinder apparatus. In order to justify the choice of an effective essential oil, as well as the dissolving ability and the absence of solvent and debris after irrigation with sodium hypochlorite in the root canal, a tube-shaped electron scanning microscopy was performed.Results. Grapefruit oil has the most dissolving activity (p < 0.05). In addition to the solubility of the filler and siller, grapefruit essential oil is able to dissolve the smear layer.Conclusion. Optimization of the endodontic retreatment with root canals previously filled with gutta-percha, is possible using essential oils, however, a grapefruit oil is the most effective.

Continuing pain after root canal treatment, swelling, the occurrence of fistulous, the severity of periapical changes are the indications for repeated endodontic treatment. Mineral trioxide aggregate (MTA) is a reliable bioactive material proposed for widespread use in endodontics, in particular as an obturation material. The article contains a review of the literature on the use of MTA as an intracanal filling material, a comparison of the clinical effectiveness of the methods and principles of its placement, a description of the results of treatment of apical periodontitis. A technique and clinical cases of MTA use in conjunction with thermocompaction of gutta-percha. A new technique combining materials, which can increase positive outlook during the endodontic retreatment.

Perforation teeth are considered the second most important cause of failure of endodontic treatment. The article puts forward a method of repeated endodontic treatment with «Osteoplast» material application for retreatment of chronic destructive forms of periodontitis, complicated with tooth perforation. We have treated 25 people with chronic destructive periodontal disease at the age of 25-35 years of age with a history of endodontic intervention. The efficiency of application of the proposed comprehensive treatment.

Aim. To assess systematically the available scientific evidence about the efficiency and the adverse effects of different solvents dissolving guttapercha.Materials and methods. The study of publications was produced in the electronic databases such as Google Scholar, PubMed during a systematic review of the literature. Included articles contain information about using solvents during endodontic retreatment and their effectiveness and side effects. The publication date criterion was selected from January 2006 to January 2021.Results. 66 articles were viewed during the review. After analyzing the literature for inclusion criteria, the total number of publications has become 13.Conclusions. According to literature data, the frequency of using essential oils (orange oil, grapefruit oil, eucalyptus oil) to dissolve guttapercha in endodontic practice is increasing due to better biocompatibility and lack of cytotoxicity and carcinogenic effects.

Perforation of hard tooth tissues is one of the most common complications of endodontic treatment. According to statistics, perforations account for 9% of the total number of complications in endodontics. The frequently asked question about the preservation or removal of a tooth with a perforation – is a question of a correctly accepted decision with a deep clinical situation analysis and a correctly chosen treatment tactic. On the example of endodontic retreatment of tooth 2.1 chronic apical periodontitis and tooth 2.2 perforation in the middle third of the root, the article details the complications reasons in endodontics, stage-by-stage treatment, results are presented in detail, as well as a number of 3D CT-images confirming the rationality of the chosen tactics.

We studied the duration of ultrasound exposure with the least risk of periodontal damage when removing well cast root inlay made taking into account the anatomical features of root canals. 5 Total successfully completed cases was analyzed. We used standard elongated ultrasonic nozzle to remove dental plaque at the maximum ultrasonic power with constant copious water cooled in the cervical region, for 15 seconds on each side, the results obtained without complications. Coppa crown remover used when a mobility features cast root inlay. After a 10-minute periods of use of ultrasound were 2-minute rest periods. It took 2 to 6 visits without anesthesia for temperature control by the patient. The number of visits depends directly on the number of channels used for fixing pin. The number of visits is inversely related to the statute of limitations, and operating time cast root inlay.

Repeated endodontic treatment is often a contentious issue in the process of making a final decision in the preparation of a comprehensive plan for the treatment of a patient at the dental reception and causes great interest among dentists. For the successful outcome of root canal treatment is important not only knowledge and manual skills of the doctor, but also equipping the workplace with modern materials and technologies. This article describes a clinical case of repeated endodontic treatment of tooth 2.1 and carried out a detailed analysis of his. At the final stage represented the final result after 1 week of treatment. This article will help doctors - dentists acquire additional knowledge needed to effectively address not only repeat, but the primary endodontic treatment.

Were examined 215 patients where were retreated root canals without exacerbation (115) and in acute or acute periapical process (100). After 1, 2, 3 years conducted repeated radiological control of endodontic treatment. In each clinical case were assessed: the state of the periapical tissues at the time of treatment (the original X-ray), the type of sealing mass in the channel, the result of treatment after constant obstruction and after 1, 2, 3 year. It demonstrates that the presence of at least one of these symptoms is an indication for the procedure of root canal retreatment without exacerbation, especially in front of prosthetics.

Background. Inflammatory process in periapical tissues causes tooth extraction in more than 50% of cases. The development of chronic apical periodontitis can be triggered by an intracanal infection in undetected/missed root canal of the mandibular molars. The morphology of mandibular molars is distinguished by additional canals in the mesial root in some cases. Different studies reveal the middle mesial canal in 4.5% to 26% of cases with quite high incidence in youth. The dental therapy has been searching for effective approaches to diagnosis and treatment of chronic periodontitis, enabling the focus of chronic inflammation to be eliminated and the tooth to be saved. Case descriptions. The paper presents clinical cases of patients with destructive changes in bone tissues in the periapical region of the mesial root in mandibular molars. The developing of this pathology is associated with missed anatomy in the mesial root during primary endodontic treatment. The patients underwent clinical examination consisting of basic methods (interview, examination) and additional techniques (intraoral radiography). An additional middle mesial canal in the root of the mandibular molar was identified taking into account the complex morphology of the root system of the tooth and verified by its careful analysis and radiography. The final clinical diagnosis, chronic apical periodontitis (K04.5), was made following the obtained diagnostic results and the ICD-10 classification. Diagnostic examination and endodontic retreatment were performed using a dental operating microscope. Conclusion. An operating dental microscope provides visualization of microscopic anatomotopographical details, promoting the efficiency of diagnosis and treatment of chronic apical periodontitis in mandibular molars. Using dental microscope facilitates systematization of the data obtained during the examination, making a final clinical diagnosis, and development of a reasonable personalized treatment plan focused on detecting an additional middle canal in the mesio-buccal canal of the mandibular molar. Due to the suggested approach, the long-term outcomes of endodontic treatment can be an objective assessed in dynamics, thereby improving the quality of treatment for chronic apical periodontitis in patients.

Poor quality treatment of periodontal inflammation is the cause of tooth extraction. Most of the teeth treated endodontically in the future are subject to retreatment. The success of conservative treatment of apical periodontitis appreciably depends from compliance with the standards of classical endodontics. This article summarizes three clinical cases of endodontic retreatment of destructive forms of apical periodontitis, where noted positive dynamics

This paper presents a complex clinical case of endodontic retreatment of molar with associated defects - metal instrument fracture and two perforations of the canal walls of different localization - in two visits. The process of endodontic treatment is made possible through the use of an operating microscope in dental clinic, which allowed to specify the anatomical structure of root canal, with the help of magnification and increased illumination in order to facilitate the implementation of the basic stages of preparation, sealing, ultrasonic cleaning, extraction of fragmented tools, and finally, a tight sealing the perforations.

In the following clinical situations dismantled everyday cases, require the use of apex locator Proper pixi to determine the length of the root canal. This device has a compact size, can continuously work not only in a dry root canal, but in all environments (solutions of hypochlorite sodium EDTA, various solvents), which is especially important in endodontic retreatment, the need of which occurs in recent years, more and more