Endodontic retreatment in the appealability structure of the compulsory medical insurance on the example of the state dental practice

Aim. To assess the need for repeated endodontic treatment and to determine the possible reasons for the repeated revision of the root canals according to the archival material of the state polyclinic in the period 2015-2020.
Materials and methods. Archival data of the registry of the state polyclinic in the period from 2015 to 2020, containing information on repeated endodontic treatment, namely: data on the treatment of patients and the condition of their teeth with apical periodontitis on the admission of CHI, repeated revision of root canals, method and means of mechanical and drug treatment of canals, filling material before and after the revision of root canals, X- rays at all stages of treatment with their description. In accordance with the purpose of the study, descriptive statistics were carried out, the data that were obtained as a result of processing information on the material of the archive of the dental clinic were analyzed and described, absolute frequencies and their proportions were indicated, which are shown in the diagrams, it was done in the Microsoft Excel program.
Results. In 505 teeth (54%), the root canals were obturated with resorcinol - formalin paste, most of the root canals of the teeth - 373 (40%) were sealed at half their length, on sighting radiographs in 80% of cases an expansion of the periodontal gap was revealed, in addition to destructive changes in bone tissue, basically all cases were treated under a temporary calcium- containing paste, 4% of the root canals of the teeth (35) were not obturated with permanent material, due to the absence of patients, 5 teeth (0.5%) underwent surgical treatment. Of all the cases identified, only 1% (10 cases of repeated endodontic treatment) have information about long-term results, which are positive.
Conclusions. Thus, a complex of factors contributes to the occurrence of apical periodontitis, and the selection of one of them, as the main one, will not solve the problem of this complication. Dentists - therapists should focus their attention at each stage of primary and/or repeated endodontic treatment, adherence to the irrigation protocol, mechanical treatment of root canals, high- quality obturation, and most importantly, motivate patients to follow- up visits and control long-term treatment results through computed tomography and control sighting pictures.

1. Antanyan A. A. editor. Effective endodontics. 2nd edition. Medical Information Agency. 2017; 232.

2. Tsarev V. N., Podporin M. S., Ippolitov E. V. Evaluating of the effectiveness of endodontic disinfection of root channels by using scanning electron m icroscopiy of m icrobial biofilms. Bacteriology. 2017; 2(1): 6-13.

3. Chuev V. V., Romanenko A. A., Bondar E. S. Endodontics. Tools, materials and methods: An educational and m ethodological guide. Belgorod: Constanta. 2020; 194.

4. Bazikyan E. A. editor. Endodontics: a tutorial . M. Geotar-Media. 2019;160.

5. Paque F., Boessler C., Zehnder M. Accum ulated hard tissue debris levels in mesial roots of m andibular molars after sequential irrigation steps. International Endodontic Journal. 2011;44(2):148-153.

6. Makedonova Yu. A. editor. A differentiated approach to the choice of an endogerm etic: a tutorial.V olgograd: VolGMU.2016; 228.

7. Chuev V. V., Kuprin P. V., Kuprina M. A. Introduction to endodontics: an educational and m ethodological manual. Belgorod: NRU "BelSU".2018; 190.

8. Borovsky E. V. editor. Clinical endodontics. M. 2006; 123.

9. Maksimovsky Yu. M., Mitronin A. V. Therapeutic dentistry. Cariesology and diseases of the hard tissues of the teeth. Endodontics: a manual to practical classes: a tutorial. M. Geotar-Media. 2021; 480.

10. Zuolu M. L. Endodontic retreatm ent. Sao Paulo: Quintessence. 2016;314.

11. Yarygina L. B. Clinical and functional state of periapical tissues in endodontic treatm ent. M. 2018; 205.

12. Hargreaves K. M. Mitronin A. V. editor. Endodontics. M. Geotar-Media. 2020; 1040.

13. Ricucci D., Huang G. T. J., Lin L. M. Endodontic infections in incom pletely developed teeth. Endodontic Microbiology. 2017; 311-339.

14. Pablo O. V. , Estevez R., Heilborn C. Root anatom y and canal configuration of the perm anent mandibular first molar: clinical im plications and recom mendations. Quintessence International. 2012; 43(1). 15-27.

15. Ricucci D., Siqueira J. Endodontics: Clinical and biological aspects. 2015; 415.

16. Garaza S. N., Zelenskaya A.V., Grishilova E. N. Propaedeutics of dental diseases. Propaedeutics of therapeutic dentistry. Clinical endodontics: instrumental and medical treatment of the root canal: a tutorial. Stavropol: StSMU. 2018; 176.