THE FEATURES OF CHRONIC PERIODONTITIS, COMPLICATED BY FURCATION DEFECTS. CAUSES OF DEFECTS. LITERATURE REVIEW
Abstract and keywords
Abstract (English):
Periodontal tissue diseases remain one of the urgent problems in modern dentistry due to their high prevalence and the number of complications after treatment. The prolonged asymptomatic course of chronic forms of periodontitis causes an increase in destructive processes not only in periodontal tissues and alveolar bone, but also contributes to the resorption of cementum and root dentin, which causes the formation of bone pockets, called furcation defects. Involvement in the pathological process of the zone of divergence of the roots significantly complicates the course of the disease, diagnosis, treatment and prognosis. The complexity of diagnosis, the variability of treatment methods depending on the overall clinical picture and the high percentage of tooth loss when the furcation area is involved in the pathological process determine the relevance of the research topic. Purpose: to study the features of chronic periodontitis complicated by furcation defects and to identify the main causes of these defects. Materials and Methods: the analysis of domestic and foreign publications placed in the eLibrary and PubMed databases was carried out by keywords. Results. The analysis of literature data on the features of chronic periodontitis complicated by furcation defects is carried out, the issues of the etiology of this pathology are considered. Conclusion. It is shown that the treatment of chronic apical periodontitis complicated by furcation defects is one of the important problems of dentistry, which is determined by the significant prevalence of the disease and the incidence of complications after treatment. The most common etiological factor in furcation lesions is microbial invasion, which causes an inflammatory process, the progression of which leads to bone resorption in the area of the furcation arch of the teeth. Also, the etiological factors of periodontal pathogenic genesis, endodontic lesions, fractures, iatrogenic factors, as well as anatomical features contribute to the involvement of furcation.

Keywords:
furcation defects, furcation perforation, furcation periodontitis, apical periodontitis, root canal
References

1. Hernández S.R., Pérez A.R., Baasch A.C., Brisson-Suárez K., Sellera D.P., Ferrari P.H.P., Alberdi J.C., Carreira C.M., Gomes-Azevedo S., Alves F.R.F, Rôças I.N., Siqueira J.F. Management of teeth with dens invaginatus and apical periodontitis: A case series // J Am Dent Assoc. – 2022;153(5):470-478. doi: 10.1016/j.adaj.2021.10.009.

2. Sabeti M., Tayeed H., Kurtzman G., Mashhadi Abbas F., Talebi Ardakani M. Histopathological Investigation of Dental Pulp Reactions Related to Periodontitis // Eur Endod J. – 2021;6(2):164-169. doi: 10.14744/eej.2021.96268.

3. Baochun T., Jianping X., Fuhua Y., Hong H. Clinical comparative study on the efficacy of periodontal endodontic therapy and periodontal treatment alone for advanced periodontitis // Hua Xi Kou Qiang Yi Xue Za Zhi. – 2016;34(6):600-605. doi: 10.7518/hxkq.2016.06.010.

4. Kuratov I.A., Nagaeva M.O., Korneeva M.V., Surkov M.A. Analiz prichin neudach endodonticheskogo lecheniya i udaleniya zubov s diagnozom «hronicheskiy apikal'nyy periodontit». Problemy stomatologii. 2019;15(1):28-32. [I.A. Kuratov, M.O. Nagaeva, M.V. Korneeva, M.A. Surkov. Analysis of the causes of failure of endodontic treatment and extraction of teeth diagnosed with chronic apical periodontitis. Actual problems in dentistry. 2019;15(1):28-32. (In Russ.)]. https://www.elibrary.ru/item.asp?id=37602576

5. Yurovskaya I.A., Pedorec A.P., Pilyaev A.G., Terpigor'eva L.P. Patogistologicheskie proyavleniya v zubah s razlichnym techeniem hronicheskogo periodontita. Actual Questions and Innovations in Science 2. Conference Proceedings (in English, Russian, Turkish, Kazakh languages). Editor-in-Chief Abdullah Soykan. 2019:143-145. [I.A. Yurovskaya, A.P. Pedorec, A.G. Pilyaev, L.P. Terpigor'eva. Pathohistological manifestations in teeth with different course of chronic periodontitis. Actual Questions and Innovations in Science 2. Conference Proceedings (in English, Russian, Turkish, Kazakh languages). Editor-in-Chief Abdullah Soykan. 2019:143-145. (In Russ.)]. https://www.elibrary.ru/item.asp?id=41347432

6. Widbiller M., Knüttel H., Meschi N., Durán-Sindreu Terol F. Effectiveness of endodontic tissue engineering in treatment of apical periodontitis: A systematic review. Int Endod J. 2022 Jun 14. doi: 10.1111/iej.13784.

7. Amaranath B.J., Das N., Gupta I., Gupta R., John B., Devi M.P. Types of bone destruction and its severity in chronic periodontitis patients with tobacco smoking habit using periapical radiographs and transgingival probing: A cross-sectional study // J Indian Soc Periodontol. – 2020;24(1):20-25. doi: 10.4103/jisp.jisp_212_19.

8. Yang H., Zhang M.L., Chen Y., Ding Y. Surface-enhanced raman scattering-based technique for detecting periodontal disease // Journal of Applied Spectroscopy. – 2021;88(6):920-925. doi:10.1007/s10812-022-01298-5

9. Tan B., Sun Q., Xiao J., Zhang L., Yan F. Pulp status of teeth in patients with chronic advanced periodontitis // Int J Clin Exp Pathol. – 2020;13(4):635-641. PMID: 32355511.

10. Jepsen S., Gennai S., Hirschfeld J., Kalemaj Z., Buti J., Graziani F. Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta-analysis of randomized clinical trials // J Clin Periodontol. – 2020;47;22:352-374. doi: 10.1111/jcpe.13238.

11. Alsakr A.M., Creanga A.G., Alqahtani A.S., Gufran K. Accuracy and Reliability of CBCT Compared to Clinical Probing in Detection of Trifurcation Defects: An In Vivo Study // Biomed Res Int. – 2022;2022:5805776. doi: 10.1155/2022/5805776.

12. Akimova M.Yu., Turkina A.Yu., Shelemet'eva G.N Opyt lecheniya razlichnyh form periodontita v odno poseschenie. seriya klinicheskih sluchaev. Endodontiya Today. 2018;2:32-36. [M.Yu. Akimova, A.Yu. Turkina, G.N. Shelemet'eva. Experience in the treatment of various forms of periodontitis in one visit. a series of clinical cases. Endodontiya Today. 2018;2:32-36. (In Russ.)]. doi:10.25636/PMP.2.2018.2.7.

13. Silva R.A.B., Borges A.T.N., Hernandéz-Gatón P., de Queiroz A.M., Arzate H., Romualdo P.C., Nelson-Filho P., Silva L.A.B. Histopathological, histoenzymological, immunohistochemical and immunofluorescence analysis of tissue response to sealing materials after furcation perforation // Int Endod J. – 2019;52(10):1489-1500. doi: 10.1111/iej.13145.

14. Lin J., Huang D., Xu H., Zhan F., Tan X. Macrophages: A communication network linking Porphyromonas gingivalis infection and associated systemic diseases // Front Immunol. – 2022;13:952040. doi: 10.3389/fimmu.2022.952040.

15. Huang H.L., Ma Y.H., Tu C.C., Chang P.C. Radiographic Evaluation of Regeneration Strategies for the Treatment of Advanced Mandibular Furcation Defects: A Retrospective Study // Membranes (Basel). – 2022;12(2):219. doi: 10.3390/membranes12020219.

16. Kornetova I.V., Mitronin A.V., Rabinovich I.M. Sovremennye vozmozhnosti pervichnogo endodonticheskogo lecheniya hronicheskogo apikal'nogo periodontita endoparodontal'nogo proishozhdeniya. Endodontiya Today. 2021;19(4):338-342. [I.V. Kornetova, A.V. Mitronin, I.M. Rabinovich. Modern possibilities of primary endodontic treatment of chronic apical periodontitis of endoperiodontal origin. Endodontiya Today. 2021;19(4):338-342. (In Russ.)]. doi:36377/1683-2981-2021-19-4-338-342

17. Niazi S.A., Bakhsh A. Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review // Medicina (Kaunas). – 2022;58(7):931. doi: 10.3390/medicina58070931.

18. Perminio D.J., Rodrigues D.M., Vianna K.C., Machado A., Lopes R., Barboza E.P. Micro-tomographic analysis of the root trunk and pre-furcation area of the first mandibular molars // Odontology. – 2022;110(1):120-126. doi: 10.1007/s10266-021-00645-w.

19. Singh O., Sinha D.J., Tyagi S.P., Tyagi N. Root resorption: challenge to the endodontist // International Jornal of Dental Research and Oral Sciences. – 2017;2(1):31-41. https://www.researchgate.net/profile/Dakshita-Sinha/publication/317678428_Root_Resorption_Challenge_to_the_Endodontist/links/5948b77c0f7e9b1d9b2341a5/Root-Resorption-Challenge-to-the-Endodontist.pdf

20. Gizatullina E.R., Marshinskaya A.A. Ishod hronicheskogo apikal'nogo periodontita zuba 27. Klinicheskiy sluchay. Endodontiya Today. 2019;17(4):63-66. [E.R. Gizatullina, A.A. Marshinskaya. Outcome of chronic apical periodontitis of tooth 27. Clinical case. Endodontiya Today. 2019;17(4):63-66. (In Russ.)]. doi: 10.36377/1683-2981-2019-17-4-63-66

21. Li X., Liu Y., Yang X., Li C., Song Z. The Oral Microbiota: Community Composition, Influencing Factors, Pathogenesis, and Interventions // Front Microbiol. – 2022;13:895537. doi: 10.3389/fmicb.2022.895537.

22. Tonetti M.S., Greenwell H., Kornman K.S. Staging and grading periodontitis: Framework and proposal new classification and case // J Periodontol. – 2018;89;1:S159-S172. doi: 10.1002/JPER.18-0006.

23. Nazir M.A. Prevalence of periodontal disease, its association with systemic diseases and prevention // Int J Health Sci (Qassim). – 2017;11(2):72-80. PMID: 28539867.

24. Silva B.S., Bueno M.R., Yamamoto-Silva F.P., Gomez R.S., Peters O.A., Estrela C. Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions // Braz Oral Res. – 2017;31:e52. doi: 10.1590/1807-3107BOR-2017.vol31.0052.

25. Connert T., Truckenmüller M., ElAyouti A., Eggmann F., Krastl G., Löst C., Weiger R. Changes in periapical status, quality of root fillings and estimated endodontic treatment need in a similar urban German population 20 years later // Clin Oral Investig. – 2019;23(3):1373-1382. doi: 10.1007/s00784-018-2566-z.

26. Meirinhos J., Martins J., Pereira B., Baruwa A., Ginjeira A. Prevalence of Lateral Radiolucency, Apical Root Resorption and Periapical Lesions in Portuguese Patients: A CBCT Cross-Sectional Study with a Worldwide Overview // Eur Endod J. – 2021;6(1):56-71. doi: 10.14744/eej.2021.29981.

27. Mitronin A.V., Rabinovich I.M., Kornetova I.V. Lechenie pacienta s hronicheskim apikal'nym periodontitom zuba 2.1 pri nalichii perforacii kornya zuba 2.2. Klinicheskiy sluchay. Endodontiya Today. 2018;2:72-77. [A.V. Mitronin, I.M. Rabinovich, I.V. Kornetova. Treatment of a patient with chronic apical periodontitis of tooth 2.1 in the presence of perforation of the root of tooth 2.2. Clinical case. Endodontiya Today. 2018;2:72-77. (In Russ.)]. doi: 10.25636/PMP.2.2018.2.14

28. Kazeko L.A., Benesh Yu.D. Ocenka rezorbcii kostnoy tkani pri razlichnyh formah techeniya periodontita. Aktual'nye voprosy stomatologii. Sbornik III Vserossiyskoy nauchno-prakticheskoy konferencii s mezhdunarodnym uchastiem. Pod redakciey L.M. Zheleznova. 2019:110-112. [L.A. Kazeko, Yu.D. Benesh. Evaluation of bone tissue resorption in various forms of periodontitis. Topical issues of dentistry. Collection of the III All-Russian scientific-practical conference with international participation. Edited by L.M. Zheleznov. 2019:110-112. (In Russ.)]. https://www.elibrary.ru/item.asp?id=41205123

29. Huamán S.D., Brito Aragão M.G., Dias Moreno A.P., Mussolino de Queiroz A., Bezerra da Silva R.A., Garcia de Paula-Silva F.W., Bezerra da Silva L.A. Accuracy of Conventional Periapical Radiography in Diagnosing Furcation Repair after Perforation Treatment // J Endod. – 2020;46(6):827-831. doi: 10.1016/j.joen.2020.03.004.

30. Zhang W., Foss K., Wang B.Y. A retrospective study on molar furcation assessment via clinical detection, intraoral radiography and cone beam computed tomography // BMC Oral Health. – 2018;18(1):75. doi: 10.1186/s12903-018-0544-0.

31. Bolyachin A., Khabadze Z., Mordanov O., Gasbanov M., Teberdiev T. Symptomatic Apical Periodontitis of the Mandibular First Molar with the Accessory Canal in the Furcation Area Mimicking Furcation Perforation // Case Rep Dent. – 2022;2022:6324447. doi: 10.1155/2022/6324447.

32. Gautam S., Galgali S.R., Sheethal H.S., Priya N.S. Pulpal changes associated with advanced periodontal disease: A histopathological study // J Oral Maxillofac Pathol. – 2017;21(1):58-63. doi: 10.4103/0973-029X.203795.

33. Weinberg E.M., Pereda A.E., Khurana S., Lotlikar P.P., Falcon C., Hirschberg C. Incidence of Middle Mesial Canals Based on Distance between Mesial Canal Orifices in Mandibular Molars: A Clinical and Cone-beam Computed Tomographic Analysis // J Endod. – 2020;46(1):40-43. doi: 10.1016/j.joen.2019.10.017.

34. Chiu M.Y., Lin C.Y., Kuo P.Y. The predictive performance of surgical treatment in upper molars with combined bony defect and furcation involvement: a retrospective cohort study // BMC Oral Health. – 2022;22(1):156. doi: 10.1186/s12903-022-02196-0.

35. Suzuki S., Yamada S. Epigenetics in susceptibility, progression, and diagnosis of periodontitis // Jpn Dent Sci Rev. – 2022;58:183-192. doi: 10.1016/j.jdsr.2022.06.001.

36. Sun X., Yang Z., Nie Y., Hou B. Microbial Communities in the Extraradicular and Intraradicular Infections Associated With Persistent Apical Periodontitis // Front Cell Infect Microbiol. – 2022;11:798367. doi: 10.3389/fcimb.2021.798367.

37. Usui M., Onizuka S., Sato T., Kokabu S., Ariyoshi W., Nakashima K. Mechanism of alveolar bone destruction in periodontitis - Periodontal bacteria and inflammation // Jpn Dent Sci Rev. – 2021;57:201-208. doi: 10.1016/j.jdsr.2021.09.005.

38. Sun P., Guo Z., Guo D., Wang J., Wu T., Li T., Liu J., Liu X. The Microbiota Profile Analysis of Combined Periodontal-Endodontic Lesions Using 16S rRNA Next-Generation Sequencing // J Immunol Res. – 2021;2021:2490064. doi: 10.1155/2021/2490064.

39. Nibali L., Krajewski A., Donos N., Völzke H., Pink C., Kocher T., Holtfreter B. The effect of furcation involvement on tooth loss in a population without regular periodontal therapy // J Clin Periodontol. – 2017;44(8):813-821. doi: 10.1111/jcpe.12756.

40. Gonçalves B.C., Costa A.L.F, Correa R., Andere N.M.R.B., Ogawa C.M., Santamaria M.P., de Castro Lopes S.L.P.. Analysis of geometrical tomographic parameters of furcation lesions in periodontitis patients // Heliyon. – 2021;7(1):e06119. doi: 10.1016/j.heliyon.2021.e06119.

41. Rôças I.N., Siqueira J.F. Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis // PLoS One. – 2018;13(1):e0190469. doi: 10.1371/journal.pone.0190469.

42. Glinkin V.V., Klemin V.A., Kondratyuk R.B. Nalichie i lokalizaciya mikroflory v zubah s destruktivnymi formami periodontitov. Universitetskaya klinika. 2020;3(36):52-56. [V.V. Glinkin, V.A. Klemin, R.B. Kondratyuk. The presence and localization of microflora in teeth with destructive forms of periodontitis. University clinic. 2020;3(36):52-56. (In Russ.)]. doi: 10.26435/UC.V0I3(36).526

43. Khijmatgar S., Panda S., Das M., Arbildo-Vega H., Del Fabbro M. Recombinant factors for periodontal intrabony defects: A systematic review and network meta-analysis of preclinical studies // J Tissue Eng Regen Med. – 2021;15(12):1069-1081. doi: 10.1002/term.3250.

44. Caselli E., Fabbri C., D'Accolti M., Soffritti I., Bassi C., Mazzacane S., Franchi M. Defining the oral microbiome by whole-genome sequencing and resistome analysis: the complexity of the healthy picture // BMC Microbiol. – 2020;20(1):120. doi: 10.1186/s12866-020-01801-y.

45. Alsakr A.M., Creanga A.G., Alqahtani A.S., Gufran K. Accuracy and Reliability of CBCT Compared to Clinical Probing in Detection of Trifurcation Defects: An In Vivo Study // Biomed Res Int. – 2022;14;2022:5805776. doi: 10.1155/2022/ 5805776.

46. Sun X., Yang Z., Nie Y., Hou B. Microbial Communities in the Extraradicular and Intraradicular Infections Associated With Persistent Apical Periodontitis // Front Cell Infect Microbiol. – 2022;12;11:798367. doi: 10.3389/fcimb.2021.798367.

47. Dubey S., Saha S.G., Rajkumar B., Dhole T.K. Comparative antimicrobial efficacy of selected root canal irrigants on commonly isolated microorganisms in endodontic infection // Eur J Dent. – 2017;11(1):12-16. doi: 10.4103/ejd.ejd_141_16.

48. Laugisch O., Cosgarea R., Nikou G., Nikolidakis D., Donos N., Salvi G.E., Stavropoulos A., Jepsen S., Sculean A. Histologic evidence of periodontal regeneration in furcation defects: a systematic review // Clin Oral Investig. – 2019;23(7):2861-2906. doi: 10.1007/s00784-019-02964-3.

49. Queiroz L.A., Casarian R.C.V., Daddoub S.M., Tatakis D.N., Enilson A.S., Kumar P.S. Furcation Therapy with Enamel Matrix Derivative: Effects on the Subgingival Microbiome // J Periodontol. – 2017;88(7):617-625. doi: 10.1902 / jop.2017.160542.


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