The use of a drug based on extracellular matrix biomimetics as a means of regenerative therapy during resection of the tip of the tooth root

   Introduction. The operation of resection of the tip of the tooth root is one of the main dental–preserving surgical methods of dental treatment with destructive changes in periapical tissues. Despite the high efficiency and other positive aspects, there are some disadvantages of this method of treatment, among which one can single out a long period of healing of periapical tissues, which necessitates the search for remedies that contribute to solving this problem.

   The aim is to study the possibility of using a drug based on extracellular matrix biomimetics as a means of regenerative therapy during resection of the tip of the tooth root, to evaluate its effect on the healing time of periapical tissues and the occurrence of complications.

   Materials and methods. The study involved 42 patients with indications for resection of the tip of the tooth root. The patients were randomly divided into two equal groups (n = 21): the control group, which underwent a traditional operation of resection of the tip of the tooth root, and the study group, which additionally used a drug based on extracellular matrix biomimetics. The timing of complete healing of periapical tissues and the presence of complications (in the form of lack of healing) were assessed using targeted intraoral contact radiography and percussion 6 months after the operation. The collected data were statistically analyzed. The indicators of descriptive statistics included the number of objects, the average value, the mean square deviation (SKO), 95 % confidence interval (CI95 %), median, lower (Q1) and upper (Q3) quartiles, minimum and maximum values. The comparison of the healing time in the study and control groups was carried out using the nonparametric Mann – Whitney criterion for independent groups. The comparison of the groups by the number of complications was carried out using the exact Fisher criterion.

   Results. In the study group, healing occurred on average after 129.9 days. (COE = 8.6 days), DI95 % 126.0–133.8 days, minimum healing period – 117.0 days, maximum – 151.0 days, median – 128.0 days, lower and upper quartiles 124.0 days and 133.0 days accordingly. In the control group, the average healing time was 181.5 days. (COE = 9.0 days), DI95 % 177.4–185.6 days, minimum healing period – 167.0 days, maximum – 199.0 days, median – 181.0 days, lower quartile – 175.0, upper quartile – 188.0 days. A comparison of the groups by healing time using the nonparametric Mann – Whitney criterion for independent samples showed a statistically significant difference (p = 0.00000003). In the study group, healing was faster (on average 129.9 days) than in the control group (on average 181.5 days). A comparison of the groups by the proportion (%) of complications using the exact Fisher criterion showed that there was no statistically significant difference between the groups (p = 0.49). In the study group, healing was in 21 (100 %) patients, in the control group – in 19 (90.5 %), complications were in 2 (9.5 %) patients.

   Conclusion. The results obtained during the study indicate the effectiveness of using the drug based on extracellular matrix biomimetics after resection of the tip of the tooth root: its effect reduces the time for complete healing of periapical tissues and completely prevents the occurrence of complications in the form of lack of healing.

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