Buniatian K. Efficiency of using odontotropic material in the treatment of reversible forms of pulpitis of permanent teeth with unformed roots

The aim of the work was to increase the effectiveness of treatment of reversible forms of pulpitis of permanent teeth with unformed roots in children by using odontotropic cements. To solve this goal, clinical, biophysical, experimental, morphological methods of investigation were used. The scientific novelty of the study is to solve the problems of diagnosis, differential diagnosis, treatment of reversible forms of pulpitis and fracture of the tooth root in children. The clinical course of pulpitis of permanent teeth at different stages of development of the root system is quite variable. Anatomico-histological features of the structure of permanent teeth at the stage of unformed root, causes a high viability of the pulp, this is due to the prevalence of reversible forms of pulpitis over irreversible. For the first time, a scale of electrical excitability of the pulp and electrical conductivity of the near-pulp dentin of permanent teeth was developed depending on the age of the child. It was found that the average index o electroexcitability in children aged 6 years is 69,3 μA. At the age of 7 years, the electroexcitability of reversible forms of pulpitis is 63,7 μA, 8 years – 61,5 μA, 9 years – 59,2 μA, 10 years – 57,5 μA, 11 years – 53,9 μA, 12 years – 51,7 μA. The use of TCS cement in the clinic showed a significant decrease of electroexcitability 2 weeks after treatment (17,0 ± 0,8 μA), in 4 weeks it was 16,3 ± 0,8 μA and in 6 weeks – 15,3 ± 0,7 μA, which is 77% lower than the primary data. A significant reduction of electrical conductivity of dentine was established 2 weeks after treatment (by 72%), after 4 weeks - by 76%, and after 6 weeks - by 78% and amounted to 22,1 ± 1,1 μA, which corresponds to the digital data for the average caries of permanent teeth with unformed roots. According to ultrasound Doppler flowmetry, it was found that in children with a fracture of the root there were microcirculation disorders, which were expressed by a decrease in the intensity of hemodynamics in the pathological focus due to suppression of the mechanisms of vascular regulation and, in particular, vasomotor activity. After 30 days after filling the root canal with TCS, normalization of all blood flow parameters was established. Thus, the maximum volume and linear systolic blood flow velocities after the treatment were 0,083 ± 0,0041 ml/s and 2,21 ± 0,11 cm/s. An increase in the intensity of hemodynamics in the pathological focus stimulates healing with the formation of a connective tissue in the fracture line, followed by coating with cement and the formation of fibrous fibers between the root fragments.