Terapija parodontnih apscesa

master's thesis

• Author: Jelena Paljuk
• Mentor: Andrej Aurer (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2004, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Periodontology

Abstract

Parodontni apsces je lokalizirana purulentna upala parodontnih tkiva i nalazi se na trećem mjestu svih hitnih stanja u stomatologiji. Etiološki se uglavnom povezuje s već postojećim parodontnim džepovima, ali uzrok može biti i impakcija stranog tijela i faktori koji se odnose na promjene u morfologiji i integritetu korijena. Dijagnoza mora sagledati sve mogućnosti sličnih stanja. Mikroflora apscesa je kompleksna gdje dominiraju Gstriktni anaerobni štapići. Iako nisu specifični za parodontni apsces, Porphyromonas gingivalis, Prevotella intermedia i Fusobacterium nucleatum su najčešće vrste pronađene u njemu. Zub zahvaćen apscesom ima lošu prognozu i često završava ekstrakcijom. Nažalost nema dovoljno znanstvenih dokaza u literaturi koji bi odredili jedinstveni režim terapije za parodontni apsces. Opisana su 3 terapijska pristupa: drenaža i mehaničko čišćenje, sistemski antibiotici sa ili bez drugih tretmana i parodontološki kirurški zahvati. Lokalizacija apscesa i mogućnost drenaže su osnovni uvjeti za uspješnu terapiju. Antibiotici mogu biti propisani u stanjima općih simptoma ili zbog opasnosti od komplikacija. Njihova uporaba u terapijskom režimu parodontnog apscesa nije jasno definirana. Kontroverzna mišljenja se odnose i na trajanje terapije. Tradicionalno, penicilin se smatra antibiotikom izbora u terapiji parodontnog apscesa, a metronidazol se koristi kod alergije na penicilinske antibiotike. Amoksicilin i klavulonska kiselina i metronidazol se koriste u infekcijama uzrokovanim betalaktamaza producirajućim vrstama. Odgovarajuća mehanička terapija i lokalne antiseptičke irigacije provode se nakon smirivanja akutne faze. Kombinacija incizije i drenaže sa sistemskom uporabom penicilinskih antibiotika se smatra često
uspješnom. Za kroničnu fazu parodontnog apscesa indicirana je operacija režnja gdje je glavni cilj terapije eliminacija zaostalog kamenca i ostvarenje drenaže istovremeno.

Abstract (english)

The periodontal abscess is localised purulent inflammation of the periodontal tissues and it is third most frequent dental emergency. 2 main etiologies should be distinguished: those related to a preexisting periodontal pocket and impactation of foreign objects and factor altering root morphology or root integrity.The diagnosis should take into account the differential diagnostic possibilities described in the dental literature.The microflora related with periodontal abscess is complex, dominated by G- strict anaerobe rods.It does not to be specific, but known periodontal pathogens such as Porphyromonas
gingivalis, Prevotella intermedia and Fusobacterium nucleatum are the most prevalent bacterial species. A tooth suffering from a periodontal abscess has a worse prognosis and is at a higher risk of being lost. The periodontal abscess is the main reason for tooth extraction. 3 therapeutic approaches have been discussed, including: dreinage and debridment, systemic antibiotics with or without other treatments and periodontal surgery procedures.The localisation of the abscess and the possibility of obtaining dreinage are essential consideration for successful treatment. Antibiotics should be prescribed in case of general symptoms or if complications can be suspected. The addition of systemic antibiotics to the treatment is not well defined issue. The duration of the antibiotic therapy is also a matter of discussion. Some authors have recommended shorter antibiotic regimes. Penicillin has traditionally been the drug of choice in the treatment of odontogenic abscesses. Metronidasole are useful in infections involving betalactamase producing strains. Proper mechanical debridment and local antisptic irrigation should be carried out after resolution of the acute inflammatory phase. The combination of incision and dreinage with the systemic administration of penicillins has be considered often succesful.In the treatment of chronic periodontal abscesses, surgical therapy has been indicated with a surgical flaps.The main objective of the therapy is to eliminate the remaining calculus and obtain dreinage at the same time.

• Keywords: parodontitis; parodontni apsces
• Keywords (english): Periodontal Abscess; Periodontitis
• Language: croatian
• URN:NBN: urn:nbn:hr:127:323141
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Closed access
• Created on: 2024-05-21 11:21:41