Korniienko M. Improvement of surgical treatment of patients with chronic periodontitis and odontogenic cysts of the jaws

The thesis is devoted to optimization of surgical treatment of patients with chronic periapical processes by improvement of surgical techniques and postoperative treatment schemes. The method of cystectomy with plastic closure of the mucous membrane fistula in the region of the alveolar processes of the jaws has been elaborated and implemented into practice. The novelty of the suggested method has been patented. The method of score evaluation of inflammatory response manifestations in complicated forms of chronic periapical processes has been suggested for clinical assessment of oral soft tissue condition in the area of the jaw alveolar processes. Topical medication on the basis of benzydamine hydrochloride has been suggested for treatment at early postoperative period after apicoectomy in complicated forms of chronic periodontitis and radicular cysts in the complex therapy. Influence of the modified scheme of postoperative treatment for pro-oxidant-anti-oxidant balance of the oral cavity, the condition of its nonspecific resistance, peculiarities of regeneration of surgically damaged area has been investigated. The obtained results showed that clinical signs of completion of acute inflammatory reaction were more rapid in patients of the basic group, since they were administered NSAIDs based on benzydamine hydrochloride, which has evident analgesic and anti-exudative properties. In addition, topical application of benzydamine acts as a disinfectant. Its efficiency after topical application is due to its ability of penetration into the epithelial layer and reaching effective concentrations in inflamed tissues. Thus, the suggested method of surgical intervention (apicoectomy or cystectomy) with fistuloplasty and use of NSAIDs on the basis of benzydamine hydrochloride in the treatment of complicated chronic periodontitis of the teeth and odontogenic cysts of the jaws has evident therapeutic and preventive effect including anti-inflammatory influence, and normalization of homeostasis and biocenosis of the oral cavity.