The initial stages of the application of «Trapeks-gel» on delayed treatment of destructive forms of periodontitis

The initial stages of the application of «Trapeks-gel» on delayed treatment of destructive forms of periodontitis

E.V.Volodina, Department of Faculty Therapeutical Stomatology MSUMD

Treatment of patients with chronic periodontitis is a complex and important task in modern dentistry. Frequency of periodontal disease at children and adults is not currently have a tendency to decrease. On average, one person has three endodontic teeth [5].

The causes of periodontitis are different, but infectious agents have the major role: traumatic and chemical effects on periodontal [2, 4). The completed root canal treatment is often mistaken for success, while even at technically perfect root canal, a pathological lesion in periapikal tissues persists for a long time, creating a risk of recurrence and complications [1,3].

The inflammation in destructive forms of periodontal disease contributes to the constant antigenic stimulation, which is largely determined by the conservation of detritus in the hearth of the damaged tissue formed in the alteration phase of the inflammatory process. All long flowing inflammatory processes contribute to the overall reduction of immunological reactivity and nonspecific resistance of the body, which increases the risk of inflammatory complications [6, 7).

The main object of the impact in the treatment of chronic apical periodontitis by conservative method is infected root canal with its many ramifications, dentinal tubules, and periodontal tissue in a state of acute or chronic inflammation.

As numerous studies show mechanically it is impossible to clear completely all the internal surfaces of the root canal, efficiently it is handled 70% of the root canal walls passable. Therefore antimicrobials for intracanal application deserve the attention. They must have a high anti-microbial and anti-inflammatory, non-irritating and sensitizing effects, activate the reparative processes in  periapical tissues. However, even a single drug thorough root canal treatment does not guarantee against recurrence. The main disadvantage of antiseptic treatment is the lack of exposure for the complete elimination of pathogens. The optimal thing is an occlusion of the channel and the removal of material at the tip of the tooth root, combining features of suppressing the inflammatory process in the channel and in the periodontal tissues, eliminates pathogens and damaged tissue structures, and stimulates regeneration of newly complete periodontal tissues.

In our work we studied the efficiency of treatment of destructive forms of apical periodontitis using the technology of the delayed filling of the root canal by the Russian drug «Trapeks», R&P Org. POLYSTOM, which has the properties listed above, due to the combination in the structure of substances with anti-inflammatory properties, suppressing oxidative stress and depositing growth factors.
Our study provides data analysis of the results of examination and treatment of 12 patients with chronic destructive forms of periodontitis. The study excluded patients with accompanying medical conditions that lead to a change in the immune status.
Patients were carried out according to traditional methods, adopted in clinical dentistry. Endodontical and pharmacological treatment was carried out according to standard principles. To improve the efficiency of decontamination of the root canal and periodontal tissues technology of deferred root canal filling with breeding of «Trapeks» in the hearth of destruction was used. The length of temporary obturation was 14 — 30 days, followed by a final sealing of the channels.
Clinical efficacy of treatment of chronic periodontitis defined as the percentage of achieved remission. The evaluation was conducted during the second visit in six months. The criterion for the efficiency of the proposed scheme of therapy was the incidence of clinical remission, confirmed by radiographic images.
Analyzing the results of the next treatment of various forms of chronic destructive periodontitis we came to the following conclusions:
— The results of treatment should be regarded as satisfactory;
— Application for a temporary obstruction of channels of «Trapeks» can improve the results of treatment.


1. Garagea N.N., Beloy A.V., Volkov E.A. and other. Clinical and radiological assessment of the immediate filling of root canals with modern endodontic filling materials in the treatment of chronic periodontitis / / In Sat: Act. Questions endodontics. Proceedings CSRIS. — M. ​​- 1990.-P.21-24.
2. Maksimovskiy Y.M., Maksimovskaya L.N., Orekhova L.J. Preventive dentistry / / tutorial. — M: Medicine. 2002. — 640.

  1. Maksimovskiy Y.M. How to measure the success or failure of the planned endodontic treatment.// Clinical Dentistry. -1997. — № 3. — P.4-7.
  2. Nikolaev A.I., Tsepov L.M. Practical preventive dentistry. — St. Petersburg: St. Petersburg Institute of Dentistry. 2001.-309 p..
  3. Petrikas A.J., Zakharova E.L., Obraztsova Y.N. Epidemiological data on the study of endodontic lesions of teeth / / Endodontics today. — 2002.-T2. — № 3-4.-35-37.

6.    Naidorf I.J. Endodontic flareups:    bacteriological    and immunological mechanisms. J. Endod. 11:462. 1985.

7.    Schonfeld S.E., Greening A., Click D., Herles M. Endotoxic activity in periapical lesions. 53:82, 1982.

Применение ТрАпекс геля

The 1st visit, destruction of bone tissue in the top with clear contours 1.5

ТраАпекс гель

The 2nd visit, reducing the degradation of bone tissue, 28 days after temporary sealing by «Trapeks»

Применение ТрАпекс геля

The 3rd visit, half a year after the sealing