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CNAA / Theses / 2012 / July /

Complex treatment in rehabilitation of patients with chronic marginal periodontitis


Author: Ciobanu Sergiu
Degree:doctor habilitat of medicine
Speciality: 14.00.21 - Stomatology
Year:2012
Scientific consultant: Gheorghe Nicolau
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.21
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 18 July, 2012
Approved by NCAA on the 9 October, 2012

Abstract

Adobe PDF document1.24 Mb / in romanian

Keywords

periodontal disease, chronic marginal periodontitis, gingivitis, periodontal disease, parodontosis, gingival recession, complex treatment, surgical treatment, scaling, addition, guided tissue regeneration, root planning, addition material. Study domain: Stomatology, periodontal disease

Summary

The work divided in 211 typescript pages. The classic division consists of: introduction, 5 chapters, general conclusions recommendations, bibliography from 346 titles, 8 annexes, 175 pages of base text, that include 58 figures, 32 tables, 7 diagram, 2 formulas. The results are published in 49 scientific works, 4 invention brevets were obtained.

Study domain: Stomatology, periodontal disease.

Paper aim: Improvement of dental assistance of patients with periodontal disease (chronic marginal periodontitis) by elaboration of principles of diagnosis and complex treatment.

Objectives of the work: Incidence analysis of periodontal condition in different areas of Republic of Moldova. Estimation of determination and risk factors of patients with CMP in modern vision concept of etiopathogenic periodontal lesions. Morphologic particularities reliefation of marginal periodontitis at patients with CMP. Setting parodontogenic microorganism species incidence in subgingival dental biofilm. Elaboration and argumentation of a new algorithm of complex treatment in patients with CMP with implementation of addition Nano structural material “LitAr”. Comparative osteogenic effect evaluation of some biomaterials used in guided tissue regeneration with the study of bone metabolism markers. Improvement measures elaboration of dental specialized assistance of periodontal compromised patients from Republic of Moldova. Scientific originality and enewement: Periodontal disease epidemiological situations was established, including CMP, in Republic of Moldova during 17 years (1990-2007) and especially in all of the 3 geographical areas during the years 2000-2008. Some periodontal disease indices were determined. As a result of this study, clinical forms of CMP were present in persons under 30-35 years, which denotes a rejuvenation of CMP, followed by a early tooth loss. Pathomorphological changes were studied in CMP. Parodontogenic microorganisms were determined. It was determined, developed and approved the algorithm of complex treatment in rehabilitation of patients with CMP on the basis of initial treatment (conservatory), surgical, including the dental implants, prosthodontics, and maintaining period. A new anti-inflammatory remedy was introduced in the local treatment of CMP (MD 2855 G2). A new method of guided bone regeneration (GTR) was developed and approved, utilizing modern osteogenic biomaterial – nanostructured collagen-apatite – “LitAr”. Evaluation computer method was introduced for dynamic evaluation of alveolar bone density (densitometry) in general, and especially, in the area of regeneration material. New schemes (custom made) of pre and post treatment period were developed and proposed. On the basis of own results and experience of periodontological clinicians at a international level, a new concept of periodontal assistance in Republic of Moldova was initiated, with his aim being the complete rehabilitation of patients with CMP.

Theoretical and applicative significance: Complex treatment scheme proposed by us gives a chance of total function recovery lost due CMP and gives the long term remission state with improvement of general state of periodontal compromised patients organisms. Scientific study results served at development of complex treatment algorithm of periodontal disease. Complex treatment application in patient rehabilitation with chronic marginal periodontitis. Results and conclusions of the actual study may generate new scientific directions researches.

Scientific matter been solved in current thesis. Obtained data evaluation established the MPA frequency in Republic of Moldova and proposed new directions of epidemiologic research, which will give the possibility to elucidate not only the frequency of MPA, but also the clinical forms and the age of the persons being affected. As a result of the present study examination method was introduced for parodontogenic microflora examination by utilizing DNA test, giving a chance for the practioner to prescribe a treatment clearly aimed and individualized. Study results being performed by us gave a new light on elaboration and aprovement of algorithm in the cases of MPA complex treatment, includingly the nanostructural augumentation material LitAr in the guided tissue regeneration technique, wich will contribuit in the normalizing the periodontal assistance.

Scientific results implementation. Present study results were approved as a scientific value and so after were implemented in curative and didactic activity of Therapeutical Stomatology Chair, of USMF “Nicolae Testimitanu”, in activity of clinical stomatology “Parodent Prim” S.R.L., in municipal stomatology clinics, districts, including private stomatology practices. Obtained data are included in practical lessons and courses for students and residents of Stomatology Faulty of USMF “Niolae Testimitanu”, and Recicle Faculty.