Patogeneza, dijagnostika i terapija periapikalnih procesa

master's thesis

• Title (english): Etiology, pathogenesis, clinical picture, diagnostics and therapy of periapical processes
• Author: Ivana Alvir
• Mentor: Nada Galić (mentor)
• Committee member: Nada Galić (predsjednik povjerenstva)
• Committee member: Sanja Šegović (član povjerenstva)
• Committee member: Anja Baraba (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Endodontics and Restorative Dentistry); Zagreb
• Defense date and country: 2016-07-01, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Endodonics and Restorative Dentistry

Abstract

Periapikalni procesi, kao vrlo česti patološki nalaz u stomatoloških pacijenata, razlog su brojnih tegoba, a u uznapredovalim slučajevima mogu biti i vrlo opasni. Najčešće nastaju kao posljedica prodora živih i neživih iritansa iz inficiranih korijenskih kanala prema apikalno, pri čemu izazivaju oštećenje tkiva i upalni odgovor. Sam upalni odgovor nije još u potpunosti razjašnjen, no, brojne supstancije se smatraju medijatorima upale. Klinički, periapikalne procese možemo podijeliti na simptomatske i asimptomatske (akutni apikalni parodontitis, kronični apikalni parodontits, sklerozirajući ostitis, akutni apikalni apsces, kronični apikalni apsces). U svrhu postavljanja dijagnoze najčešće se čine anamnestički, klinički i radiološki dijagnostički postupci. Nakon utvrđene dijagnoze, endodontsko liječenje se provodi ručnim ili strojnim tehnikama mehaničkog i kemijskog čišćenja i širenja korijenskih kanala, te punjenja kanala hladnim ili termoplastičnim tehnikama, kako bi se u potpunosti zabrtvio endodontski prostor i spriječila bilo kakva reinfekcija tog područja. Ako je prisutan apsces ili je proces celulitičnog karaktera, potrebna je, uz endodontsku instrumentaciju, incizija i drenaža te primjena odgovarajuće antibiotske terapije. U uznapredovalim slučajevima ponekad je potrebna i hospitalizacija pacijenta. Smatra se da je za procjenu uspjeha cijeljenja periapikalne lezije potrebno oko 6 mjeseci. Cijeljenje može biti u potpunosti (restitutio ad integrum), ožiljkasto ili može izostati. U slučaju neuspjeha endodontskog liječenja, može se raditi ponavljanje tog konzervativnog zahvata ili se, ako nije kontraindicirano, može pristupiti jednom od kirurških postupaka.

Abstract (english)

Periapical processes, often found to be the pathologic result in dental patients, are the cause of many problems, and can be very dangerous in advanced stages. They usually happen when vital and nonvital irritants pass from the infected root canals towards apical, causing damage to the tissue and infection. The infection itself has not been entirely explained yet, but numerous substances are considered to be mediators in the process. Clinical periapical processes can be divided into symptomatic and asymptomatic ones (acute apical periodontitis, chronic apical periodontitis, condensing osteitis, acute apical abscess, chronic apical abscess). In order to make a diagnosis, anamnestic as well as clinical and radiological diagnostic procedures are usually carried out. After making a diagnosis, endodontic therapy is carried out using manual techniques or instruments to mechanically and chemically clean and widen the root canal, and fill it by using cold or warm techniques, in order to completely close the endodontic area and stop any possible reinfection. If abscess is present or the process is of cellulitic character, incision and drenage, as well as adequate antibiotic therapy, are needed besides endodontic instrumentation. In advanced stages hospitalization of the patient is necessary. It is considered that a six month period is needed in order to estimate the success of the healing of the periapical lesion. Healing can be complete (restitutio ad integrum), with a scar or it can not occur, which is considered a failure of the endodontic therapy.This can be caused by numerous reasons. Should the conservative endodontic therapy fail, and there is no contraindication, one of the surgical procedures is carried out.

• Keywords: inficiran korijenski kanal
• Keywords (english): infected tooth root
• Language: croatian
• URN:NBN: urn:nbn:hr:127:042315
• 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: Open access
• Created on: 2016-09-07 10:24:59