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The treatment of marginal chronic parodontites using the matrix based on biovitroceramics and collagen


Author: Viorica Chetruş
Degree:doctor of medicine
Speciality: 14.00.21 - Stomatology
Year:2006
Scientific adviser: Gheorghe Nicolau
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 25 January, 2006
Approved by NCAA on the 23 February, 2006

Abstract

Adobe PDF document0.26 Mb / in romanian

Thesis

CZU 616.314.17-008.1-08

Adobe PDF document 2.89 Mb / in romanian
127 pages


Summary

The aim of this paper is the experimental reasoning and clinical application of biovitroceramics PAW1 as an osteoconductive material in the complex treatment of marginal chronic parodontites.

The process of integrating the additional material PAW 1 to limitrophe tissues, stimulating the neogenesis process and the dynamic accumulation of some markers of bony metabolism in tissues and blood have been studied experimentally on rats. The alkaline and acid phosphatases, the 5-nucleotidaze and the non specific esterase have been studied histochemically.

The histologic and histochemical data proved that biovitroceramics PAW 1 has favourable features that contribute actively to the process of regeneration of the damaged bone.

The biochemical blood test demonstrated the increase of alkaline thermosensitive phosphatase of bony nature after 30 days, the utmost result being achieved after 60 days +20% (p<0,05) from the beginning of the experiment.

On the contrary, the activity of the acid bony tartraresistant phosphatase lowers it with 22% in 60 days after the implantation.

30 days after the beginning of the experiment under the influence of the implanted material, the level of the middle molecules (MM) grew with 35% (p<0,05), substances of nucleotide nature (NN) grew with 35% (p<0,05) and also the nitric oxid – with 51% (p<0,05); values of these indices show a tendency of diminuation. The above-mentioned denote that under the influence of the implanted material, the action of osteoreneration enhances.

The clinical part is based on the examination and treatment of a group of 94 patients (62 women and 32 men) with an age ranging from 31 to 60 years with cronic marginal parodontites. Patients were devide in two groups. The test group consisted of 56 patients and the witness one consisted of 38 patients.

The complex treatment was made in both groups, with the exception of the patients from the essential group, that were also subjected to surgical treatment- an operation with a mucoperiosteum flap and the use of addition material PAW1.

The results of clinical investigations denote that the surgical treatment within the framework of the complex treatment of the marginal chronic parodontites and the use of additional material PAW1 show better results (98,1%) than the conservative treatment (71,9%). Meanwhile, patients from the control group have repeated the treatment of parodontites three of four times during two years. The level of the main indices of the bony metabolism in the blood of treated patients with the surgical method of PAW1, the alkaline thermosensitive phosphatase and the osteocalsine have a concentration that is three times higher as compared to the patients treated using conservative methods.