Treatment of periodontitis in Kyiv

In endodontics, periodontitis is an inflammation of the tissues near the apex of the tooth root, often associated with infection in the root canals. Treatment of periodontitis in Kyiv begins with diagnosis: the doctor assesses the condition of the tooth and the tissues near the root and selects an appropriate method.

Periodontitis should not be confused with periodontitis—a disease of the tissues that surround and support the tooth. The network of dental clinics DDC (Dobrobut Dental Clinic) conducts endodontic treatment, while tooth-preserving surgeries are considered based on indications.

Symptoms of periodontitis: acute and chronic course

Apical periodontitis can manifest as pain when biting or tapping on the tooth, and sometimes it may occur without pronounced symptoms. The diagnosis is made based on clinical and radiological data.

In chronic cases, a fistula (sinus tract) may form—a pathological pathway for the outflow of inflammatory exudate, and during exacerbations, pain and swelling may intensify. If there is significant pain or swelling, one can seek urgent dental care.

Causes of root inflammation and possible complications

Inflammation near the apex of the root is often associated with pulp necrosis and infection in the root canals. It can also persist or recur in a previously endodontically treated tooth or be related to trauma. Therefore, the treatment of root inflammation begins with diagnosing the cause.

Without appropriate intervention, the focus can persist, increase, or worsen. Antibiotics do not replace local treatment of the source of infection and are prescribed only based on appropriate indications.

Forms of periodontitis: serous, purulent, granulating, granulomatous, fibrous

The terms "serous," "purulent," "granulating," "granulomatous," and "fibrous" appear in traditional classifications, but in themselves, they do not define modern tactics. Treatment is planned based on the clinical diagnosis and the condition of the tooth and the tissues near the root.

The tactic is determined after clinical evaluation. It depends on the nature of the inflammatory process, the condition of the tooth, and the tissues near the root.

Diagnosis: examination, X-ray, CT for evaluating inflammation near the apex of the root

Diagnosis includes history-taking, clinical examination, pulp sensitivity tests, assessment of the response to tapping, and X-ray examination data.

Conservative endodontic treatment of periodontitis

In cases of endodontic origin, work is done with the root canal system if the tooth is restorable and has an acceptable prognosis. Primary canal treatment or repeated endodontic intervention aims to control intra-canal infection and create conditions for healing. This is the primary approach for lesions of the tissues near the apex of the root of endodontic origin.

Canals are mechanically and pharmacologically treated and filled with filling material. In some situations, intracanal medication and temporary filling may be used between visits, but this is not a mandatory stage. Treatment of periodontitis in one visit is possible in certain cases. The number of visits is determined individually.

For more information on the differences between diseases of the pulp and the tissues near the root, visit the pulpitis treatment page.

Surgical methods: resection of the root apex and apical surgery

Surgical methods of treating periodontitis are considered when primary or repeated endodontic therapy is insufficient or impractical, or when there are other indications for a surgical approach. This is not an automatic next step after the detection of a periapical focus.

Apical surgery involves procedures in the area of the root apex. Resection of the root apex may be one of the components of such an intervention, and decisions are made based on the prognosis of the tooth and alternatives.

Features of treating periodontitis in children

Treating periodontitis in permanent teeth in children requires consideration of the stage of root development and the condition of the pulp. For teeth with unformed roots, apexification—creation of an apical barrier—or regenerative endodontic treatment may be considered, which in some cases can promote further root development.

The tactics for primary teeth differ, so a separate evaluation by a dentist is needed for the child, taking into account the type of tooth, its development, and the possibility of restoration.

How treatment of periodontitis is conducted at Dobrobut Dental Clinic

At DDC, during work with root canals, a dental microscope and rubber dam (isolation) are used. If necessary, consultation with a dental surgeon, orthodontist, and other specialists may be involved in the planning.

The cost of periodontitis treatment depends on whether it is primary or repeated work with the canals, their anatomy, the method of restoring the tooth, and any additional interventions.