Assessment of the microbiological picture of the apical granuloma content against the background of treatment with the stromal-vascular fraction of adipose tissue and an osteogenesis stimulator in the experiment

INTRODUCTION. Patients with various forms of periodontitis account for 30–40% of all clinic visitors. Among chronic forms of periodontitis, destructive forms predominate. Among those seeking emergency dental care, patients with acute or exacerbated chronic periodontitis account for 75%. Long-term inflammation of the periodontal tissues is the most common cause of tooth loss and the formation of odontogenic infection foci. The presence of an infection foci poses a risk due to the progressive increase in pathogens and bacteriotoxins in the oral fluid. The quality of treatment outcomes depends on the medicamental and instrumental treatment of the root canals and the complete obturation of the root canal system.

AIM. To study the microflora of the apical granuloma and develop a treatment protocol.

MATERIALS AND METHODS. The study was conducted on 83 rabbits. Clinical, radiographic, and microbiological methods were used in the experiments. The animals were divided into two groups: the main group (n = 43) and the control group (n = 40). The main group received treatment according to the protocol developed by the authors, using a stromal-vascular fraction in combination with an osteogenesis stimulator. The control group received standard therapy, which included endodontic root canal treatment followed by extraapical filling.

RESULTS. Before treatment, high levels of microbial contamination of the apical granuloma were detected in the animals: Gram-positive cocci were 2.8 × 10⁷ CFU/ml, Gram-negative cocci – 1.9 × 10⁷ CFU/ml. After treatment, the main group demonstrated a decrease in the number of Gram-positive and Gram-negative cocci by 0.7 × 10⁶ CFU/ml (p < 0.001). Six and 12 months after therapy, the results remained stable, and a further decrease in the number of pathogenic microorganisms was noted. In the control group, the titers of microbial contamination of the apical granuloma contents decreased by 0.2 × 10⁵ (p < 0.001) after treatment. However, after 6 months, microbial contamination returned to baseline levels. Twelve months after treatment, an increase in contamination by 0.3 × 10⁶ CFU/ml was observed.

CONCLUSION. An analysis of the results of treatment for apical destructive forms of periodontitis using a stromal-vascular fraction and an osteogenesis stimulator under experimental conditions demonstrated high therapeutic efficacy in 99.9% of cases. Furthermore, an evaluation of the treatment protocol proposed by the authors confirmed a reduced incidence of complications and a stable therapeutic effect over a long-term observation period.

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