ON THE TOPIC OF ADVISABILITY OF ENDODONTIC TREATMENT OF RETAINED (PERSISTENT) PRIMARY TEETH

Treatment of complicated caries in children and adolescents has a number of features, which is determined by age-related anatomy and the limited functioning time of temporary teeth, as well as the timing of their root resorption. Today, the treatment of pulpitis of preserved temporary (persistent) teeth is of particular clinical interest. Persistent (delayed) teeth are temporary (baby) teeth that are preserved in the dentition after the physiological time of their replacement and are capable of functioning for 10 years or more. In most cases, the presence of retained temporary teeth is due to congenital edentia of permanent teeth, retention or death of their rudiments. There is no data in the literature on the features of the anatomical structure of persistent teeth and recommendations for their endodontic treatment. At the same time, in the treatment of this pathology, the methods of pulpotomy (devital amputation, impregnation method) and pulpectomy (pulp extirpation, vital method) are widely used, followed by obturation of the root canals with resorbable filling materials. Taking into account the above, we conducted a retrospective analysis of 192 orthopantomograms of patients with congenital permanent adentia and the presence of 289 persistent teeth. The anatomical features of the structure of the root canals of persistent teeth have been determined. The results of treatment of 44 preserved temporary teeth with chronic fibrous pulpitis in 27 patients of childhood and adolescence using the method of vital extirpation followed by restoration of the crown parts of the teeth using therapeutic and orthopedic methods are presented. Long-term treatment results up to 60 months were assessed. Meanwhile, the results obtained indicated the absence of signs of root resorption in persistent teeth over a long period of time from the period of their physiological change, as well as the features of the anatomical structure of root canals, similar to that of permanent teeth, and allowing endodontic treatment of preserved teeth using classical for permanent teeth pulpectomy method. The results of clinical observation and X-ray examination in the long term after treatment allow us to conclude that the approach used is highly effective, which reduced the risk of periapical complications and created conditions for the longterm functioning of persistent teeth.

1. Vinogradova T.F. Stomatologiya detskogo vozrasta / T.F. Vinogradova. – M.: Medicina, 1987. – 528 s.

2. Prikaz Ministerstva Zdravoohraneniya Rossijskoj Federacii ot 30.12.2003 № 620 «Ob utverzhdenii protokolov vedeniya detej, stradayushchih stomatologicheskimi zabolevaniyami».

3. Doyle W.A. Formocresol versus calcium hydroxide in pulpotomy / W.A. Doyle, R.E. McDonald, D.F. Mitchell // J. Dent. Child. – 1962. – V. 12. – P. 86 – 97.

4. Fuks A.B. A clinical evaluation of diluted formocresol pulpotomies in primary teeth of school children / A.B. Fuks, E. Bimstein // Pediatr. Dent. – 1981. – V. 3. – P. 321 – 324.

5. Magnusson B. Therapeutic pulpotomies in primary molars with formocresol technique / B. Magnusson // Acta. Odont. Scand. – 1978. – V. 36. – P. 157 – 165.

6. Pruhs R.J. Relationship between formocresol pulpotomy in primary teeth and enamel defects in their permanent successors / R.J. Pruhs, J.A. Olen, P.S. Sharma // J. Am. Dent. Assoc. – 1977. – V. 94. – P. 698 – 700.

7. Rolling I. Morphological and enzyme histochemical observations on the pulp of human primary molars 3 to 5 years after formocresol treatment / I. Rolling, G. Hasselgren, L. Tronstad // Oral. Surg. – 1976. – V. 42. – P. 28 – 58.

8. Schwartz E.A. Formocresol vital pulpotomy on the permanent dentition / E.A. Schwartz // J. Can. Dent. Assoc. – 1980. – V. 46. – P. 570 – 578.

9. Stomatologiya detej i podrostkov / Pod red. R. E. Mak-Donal’da, D. R. Ejveri. Per. s angl. – M.: Med. inform. izd-vo, 2003. – 766 s.

10. Gazhva S.I. Analiz oslozhnenij, voznikayushchih v rezul’tate lecheniya pul’pita molochnyh zubov metodom devital’noj amputacii / S.I. Gazhva, E.S. Pozhitok // Klinicheskaya stomatologiya. – 2009. – № 3. – S. 68 – 71.

11. Kiseleva E.G. Vzaimootnosheniya vrachej i pacientov na detskom stomatologicheskom prieme i puti ih uluchsheniya / E.G. Kiseleva, D.A. Kuz’mina // SPb.: OOO «MEDI izd-vo», 2006. – 48 s.

12. Lechenie i restavraciya molochnyh zubov / M.S. Daggal, M.E. Dzh. Kerzon, S.A. Fejl i dr. – M.: OOO «Medpress-inform», 2006. – 160 s.

13. Ivanov V.S. Vospalenie pul’py zuba / V.S. Ivanov, YU.A. Vinnichenko, E.V. Ivanova. – M.: Med. inform. agentstvo, 2003. – 264 s.

14. Proekt standartov endodonticheskogo lecheniya (STEL) / E.V. Borovskij, A.ZH. Petrikas, A.M. Solov’eva i dr. // Klinicheskaya stomatologiya. – 2003. – № 2. – S. 42 – 44.

15. Sposob klinicheskoj ocenki stepeni iznosa zubnyh plomb. Patent № 2456954, Rossiya: MPK A61S 5/00 / V.G. Galonskij, A.A. Radkevich, A.A. SHushakova, T.V. Kazanceva, M.E. Kazancev, E.S. Surdo, V.O. Tumshevic. Prioritet ot 12.01.2011. Byul. № 21. Opubl. 27.07.2012.