Treatment of acute purulent periodontitis. Purulent periodontitis: does it need treatment? Periodontitis pus

Purulent periodontitis- these are usually the consequences of serous periodontitis. With purulent periodontitis, severe pain occurs. The pain intensifies, becomes throbbing, radiating along the nerve even to the other jaw. Even light pressure on the tooth causes increased pain. The tooth becomes mobile, swelling of the facial tissues is possible. Due to severe infectious inflammation, the lymph nodes become enlarged.

Purulent periodontitis is usually accompanied by a deterioration in general health, a change in the blood picture (leukocytosis, increased ESR), an increase in body temperature is possible, but unless severe complications develop, it is usually low, i.e. subfebrile.

Symptoms of acute purulent periodontitis

A patient with purulent inflammation of the periodontium complains of severe throbbing, increasing pain, which intensifies when touching the tooth and biting on it (due to which the patient does not eat or chews on the other side). The patient cannot indicate the location of the pain; he often notes that half of his head hurts.

The patient is also concerned about poor health - malaise and weakness, increased body temperature and headache.

Objectively: sometimes there is swelling of the soft tissues of the corresponding area, and mouth opening may be limited.

When examining the oral cavity, a discolored causative tooth with a deep carious cavity is determined. Often the tooth is under a crown or filling. During percussion, the patient notes sharp pain, as well as upon palpation of the mucous transitional fold in the area of the roots of the causative tooth. A diseased tooth may be mobile.

The submandibular lymph nodes (submandibular lymphadenitis) very often react to the purulent process in the periodontium. They are painful on palpation, enlarged in size and dense to the touch.

Additional methods for studying purulent periodontitis

X-ray diagnostics
May show slight widening of the periodontal fissure near the root apex, but often no changes can be detected.

Electroodontometry
The current strength at which tooth sensitivity occurs is at least 100-110 µA.

Differential diagnostics

According to the clinical picture, acute purulent periodontitis is similar to other inflammatory diseases of the maxillofacial region, namely: acute serous periodontitis, acute purulent pulpitis, acute purulent periostitis, suppuration of a radicular cyst, odontogenic purulent sinusitis and acute osteomyelitis of the jaws.

With serous periodontitis, the patient can point to the tooth that is bothering him, the reaction of the lymph nodes does not appear, and his health is not disturbed.

With acute purulent pulpitis, there is a different type of pain - the pain is paroxysmal, there are short “light” intervals, while with periodontitis the pain is constant, intensifying when biting.

With purulent periostitis, purulent exudate accumulates in the periosteum, so the characteristic signs of this disease are fluctuation, smoothness of the transitional fold, as well as the presence of infiltration at the level of 2-4 teeth.

The main signs for distinguishing purulent periodontitis from odontogenic sinusitis are congestion and discharge from one half of the nose, headache and general weakness, decreased pneumatization of the sinus on an x-ray.

A suppurating radicular cyst can cause a fan-shaped discrepancy of teeth, bulging of the alveolar process (sometimes with the absence of a bone wall), and it is also characterized by the presence of a rounded focus of destruction of bone tissue more than 1 cm in the area of the root apex.

Acute odontogenic osteomyelitis of the jaws is characterized by severe general disorders (weakness, body temperature about 40C). During the examination, mobility of the causative tooth is detected, and upon percussion, pain is detected not only in the causative tooth, but also in neighboring teeth.

Treatment of purulent periodontitis

The main goal of treatment is the evacuation of purulent contents and infected tissues of the root canal. These tasks can be accomplished by performing endodontic treatment. If the tooth is severely damaged, mobile, and cannot be used for an orthopedic structure, then the only way out is to remove it.

Purulent periodontitis can be considered as a further development of the inflammatory process in the tissues of the apical periodontium, and this form is characterized by the presence of a purulent focus.

In most cases, the purulent process in periodontal tissues is characterized by a violation of the general condition, symptoms of intoxication appear - headache, fever, malaise, weakness, lack of sleep and loss of appetite. A blood test determines accelerated ESR and leukocytosis.

Patients experience severe pain, which over time becomes unbearable. Biting on a tooth, and in some cases any touching it, causes unbearable pain. In this case, painful sensations radiate along the branches of the trigeminal nerve, so the patient cannot accurately indicate the causative tooth. There is a feeling of an “overgrown” tooth.

During an external examination, facial asymmetry may sometimes be noted due to swelling of the soft tissues of the cheek or lip (depending on the number of the causative tooth). However, more often the facial configuration is not changed. The patient's mouth may be half-open, since the closing of the teeth leads to severe pain in the causative tooth.

When palpating the submandibular lymph nodes, they are sore, they are enlarged and compacted.

A causative tooth is found in the oral cavity, which can be:

With a deep carious cavity, discolored.
Destroyed to the level of the gums (root).
Under a filling or crown.

Pressing on a tooth, not to mention percussion, causes severe pain. The mucous membrane in the projection of the causative tooth is swollen, hyperemic, and pain is noted upon palpation.

Despite the characteristic clinical picture, in most cases the doctor refers the patient to an x-ray of the diseased tooth. In acute purulent periodontitis, no periapical changes are detected on the radiograph; the periodontal fissure is slightly widened.

Differential diagnosis

The purulent form of apical periodontitis must be distinguished from:

Acute pulpitis, in which attacks of pain alternate with short pain-free periods. Also, with pulpitis, percussion is painless, and there is no inflammatory reaction of the mucous membrane in the tooth area.
Serous periodontitis, which is not characterized by disturbances in the general condition (fever, weakness, headache). There is also no irradiation of pain to other parts of the maxillofacial area.
Exacerbations of chronic periodontitis, in which x-rays reveal bone changes in the area of the root apexes.
Periostitis of the jaw, which is characterized by significant asymmetry of the face, smoothness of the transitional fold, and the presence of infiltration. It is quite difficult to differentiate incipient periostitis from a purulent process in the periodontium, because a transitional process can often be observed.
Odontogenic sinusitis, in which, in addition to dental symptoms, there will be signs of inflammation in the maxillary sinus - pain and a feeling of fullness in the sinus area, increasing when the head is tilted, discharge from the corresponding half of the nose.

Treatment

The choice of treatment method depends on the functional state of the tooth. Removal is indicated when:

Severe tooth decay (below gum level).
His mobility is grade II-III.
Failure of therapeutic treatment.
Inappropriateness of tooth preservation.

In other cases, endodontic treatment is performed. On the first visit, the tooth cavity is opened, mechanical and antiseptic treatment of the canals is carried out, and the tooth is left open for several days. The patient should rinse the tooth with a saline solution.

On the second visit (when the inflammatory process subsides), the canals are cleaned again and washed with antiseptics, after which they are sealed.

Anesthesia– infiltration, conduction, intraligamentary or intraosseous anesthesia is performed using modern anesthetics. However, sometimes with properly administered anesthesia, the chosen anesthetic and the selected dosage, complete analgesia does not occur.

This may be due to several reasons:

1. The pH in the area of the inflamed tooth is lower, which makes the anesthetic less effective;

2. increased blood circulation in the surrounding tissue promotes rapid removal of the anesthetic from the injection zone, etc.;

3. due to the accumulation of exudate in the periodontal fissure, the diffusion of the anesthetic is impaired.

Or fix the tooth with your fingers.

Preparation carious cavity or removal of an old filling.

The preparation of cavities is carried out in compliance with all stages. All carious dentin should be removed prior to the actual endodontic intervention to avoid iatrogenic (re-)infection of the root canal system;

Providing access to the dental cavity. The task of this stage is to create direct access of the instrument to the tooth cavity and to the mouths of the root canals. It is carried out through a carious cavity in cavities of class 1 according to Black, by removing the carious cavity onto the oral or chewing surface in carious cavities of classes 2-4 according to Black, or by trephination of chewing or oral surfaces in carious cavities of class 5.

Opening of the tooth cavity. The task of this stage is to create wide and convenient access for the instrument to the tooth cavity and to the mouths of the root canals. When opening a tooth cavity, it is necessary to take into account the specific topography of dental cavities depending on their group affiliation and the age of the patient.

When accessing root canals, the following principles must be adhered to:

1. Instruments should not encounter obstacles in the coronal part of the tooth when inserting them into the mouths of the root canals:

2. The pulp chamber overhangs must be removed;

3. The integrity of the bottom of the pulp chamber should not be compromised to maintain the funnel-shaped mouths of the root canals;

Expansion of root canal orifices for unhindered penetration of endodontic instruments into the root canal.

Evacuation of pulp decay from the root canal is carried out in stages (fragmentally), using a pulp extractor or files, starting from the coronal part. A drop of antiseptic is applied to the mouth of the root canal, then the instrument is inserted to 1/3 of the working length of the root canal, rotated 90 degrees and removed. Then, after cleaning the instrument, a drop of antiseptic is applied again and the instrument is inserted into the root canal, but already at 2/3 of its length. Then the instrument is cleaned again, a drop of antiseptic is applied and the instrument is inserted to the full working length of the root canal. Removal of pulp decay should be accompanied by abundant irrigation of the root canals (medicated root canal treatment), most often a 0.5-0.25% sodium hypochlorite solution is recommended for this. Solutions of proteolytic enzymes are used to liquefy the exudate.

There are two different approaches at this stage of treatment. Some authors recommend opening the apical foramen or expanding the apical constriction to create an outflow of exudate from the periapical tissues. The criterion for controlling the opening of the apical foramen is the appearance of exudate in the lumen of the root canal. If exudate is not obtained during the expansion of the apical constriction (duration of inflammation) in the presence of periostitis, at the same visit an incision is made along the transitional fold with subsequent drainage of the wound.

Recently, publications have begun to appear in which the authors have a negative attitude towards the opening of the apical foramen, citing the fact that we thereby destroy the apical constriction and in the future, when filling the root canal, there is a risk of removal of the filling material into the periodontium.

The tooth is left open for several days (usually 2-3).

This ends the first visit. Patients are recommended to take home: thorough rinsing with hypertonic solutions up to 6-8 times a day. Cover the carious cavity with a cotton swab when eating.

Second visit

Be sure to clarify the patient’s complaints, clarify the anamnesis, evaluate the objective status: the condition of the mucous membrane near the causative tooth, percussion data, the presence or absence of exudate in the root canal.

In the absence of complaints and satisfactory general and local condition, they begin instrumental treatment of the root canals using one of the well-known methods (most often the “Crown Down” method), alternating it with medicinal treatment. The optimal treatment result is achieved only with careful mechanical treatment of the root canals with excision of necrotic tissue from the canal walls and creation of a canal configuration acceptable for its complete obturation.

Tooling root canal examination is carried out after determining the working length of the root canal using one of the available methods (tables, x-rays, apex locator, radiovisiography). In this case, treatment is carried out until apical constriction. In order not to injure the periapical tissues with instruments during mechanical processing, it is recommended to set all instruments to the working length of the root canal using a stopper.

Instrumentation of root canals with an open apical foramen requires special attention. Care must be taken to ensure that neither the irrigation solution nor the canal contents enter the periapical tissues and that they are not injured by instruments during mechanical processing.

Further, after the elimination of pain, the absence of exudate from the root canal, with painless percussion of the tooth and palpation of the gums, a number of authors recommend filling the root canals using preparations based on calcium hydroxide at the same second visit. After X-ray control of the root canal filling, an insulating lining and a permanent filling are placed. This approach is more often used in the treatment of single-rooted teeth. In the event of the appearance of periosteal phenomena (that is, an exacerbation of the process - pain when biting), an incision is made along the transitional fold to create an outflow of exudate.

Acute periodontitis occupies a special place in the classification of diseases of periapical tissues. It often affects young people, progresses quickly and leads to early tooth loss. This form was first described about a century ago, and gradually the causes and prevention of the pathology were thoroughly studied. The fact that it still frequently affects people reflects the influence of multiple factors. This requires further study of the possibilities of combating the disease.

Concept and causes of acute periodontitis

Periodontal tissues are located between the bone and the roots of the teeth. They hold the units in the sockets and evenly distribute the chewing load. With periodontal inflammation (acute periodontitis), ligaments rupture and bone tissue is reabsorbed. It is localized at the apex of the tooth root or along the edge of the gum, rarely covering the periodontium completely. In this case, the patient feels the mobility of the tooth and experiences the syndrome of its “enlargement”.

Acute periodontitis in 95% of cases occurs due to the penetration of pathogenic microbes and anaerobic infection into the gums. From there, microorganisms penetrate the dental canal, multiply in the inflamed pulp and move along the root. The causes of acute periodontitis are:

advanced form of caries leading to inflammation of the pulp;
exacerbation of pulpitis;
lack of timely treatment of dental disease;
the initial stage of inflammation of periodontal tissues;
injuries;
poorly sealed canals;
general systemic inflammatory process due to ARVI, influenza, or other infectious lesions;
cyst development;
irrational dental treatment.

Types and symptoms of the disease

Acute periodontitis is a sudden inflammation in the ligament that holds the tooth. The main culprits of the pathology are staphylococci, pneumococci, and anaerobic microorganisms.

Bacteria enter the tooth tissue through the apex or pathologically formed gum pocket. Damage is possible due to inflammation or necrosis of the pulp, when the putrefactive microflora of the tooth finds its way out. Depending on the cause of occurrence, periodontitis is divided into serous and purulent (advanced form of serous periodontitis). Their symptoms and causes differ slightly.

Serous

Serous periodontitis is observed at the beginning of the inflammatory process. It is usually diagnosed in the off-season, when the immune system is weakened. The following forms of acute serous periodontitis are classified by origin:

Medication. Occurs during treatment with highly concentrated medications that cause an allergic or local immunological reaction.
Serous infectious periodontitis. Microorganisms enter the tooth through a canal or periodontal pocket.
Traumatic. A tooth can be damaged by blows, jaw trauma, or playing sports. Acute serous periodontitis is also possible with chronic trauma, which is provoked by an overestimation of the bite height after prosthetics.

According to the location, the marginal and apical forms of acute periodontitis are distinguished. Patients feel severe pain, which intensifies when chewing and brushing in the area of the problem tooth. There is swelling and pain in the problem area. In this case, the general condition of the patient is not disturbed. There is no increase in temperature, fever, lymph nodes remain normal.

Purulent

Purulent periodontitis is characterized by the accumulation of pus in the periodontium. From there, bacterial toxins can easily enter the blood and lead to general intoxication of the body. The inflammatory focus interferes with the normal function of chewing and provokes acute pain at rest. The patient cannot think about anything other than the pain, and if timely treatment is missed, the infection can spread to the internal organs.

Acute purulent periodontitis is always preceded by a serous form. Additional risk factors for the occurrence of pathology are diseases of the gastrointestinal tract, endocrine system, neglect of oral hygiene, and vitamin deficiencies. Purulent periodontitis has the following clinical signs:

Diagnostic methods

The serous form can turn into purulent periodontitis within 2-4 days, so you should not delay your visit to the dentist. When making a diagnosis, the doctor relies on the results of examination, percussion, probing of the tooth canal, and additional studies. Bacteriological and biochemical tests and x-rays are prescribed. Pathology is differentiated from acute pulpitis; the differences between them are shown in the table:

Sign	Periodontitis	Pulpitis
Localization of pain	The patient knows exactly which tooth is causing the pain.	The pain can affect the trigeminal nerve and affect adjacent teeth.
Nature of pain	The tooth hurts when tapping, chewing, or pressing.	The tooth reacts to temperature changes.
X-ray data	There is marked thickening of the root cement, changes in the pattern of bone tissue, and darkening of the periodontium.	The pathological process is noticeable inside the tooth. The roots, bone and periodontal tissues are not subject to changes.
Crown shade	Takes on a grayish tint.	Unaltered.

Acute purulent periodontitis, contrary to popular belief, does not always end with tooth extraction. Its acute forms can be successfully treated if you consult a doctor in a timely manner. In order not to miss the moment, you should not self-medicate and drown out the unpleasant sensations with painkillers. A timely visit to the doctor will help save the tooth and avoid severe complications of acute periodontitis.

Treatment of pathology

Therapy for purulent periodontitis is aimed at removing pus and removing affected tissue. First, the dentist ensures the outflow of the contents, cleans the canals and tooth cavity using a pulp extractor. In difficult cases, based on x-rays, the doctor resorts to the help of a dental surgeon to dissect the gums and drain the cavity.

For sealed root canals, unsealing and cleaning are indicated in order to remove purulent foci. An anaerobic infection can develop in them, a sign of which is the dark contents of the canals with a foul odor. Conventional antiseptics are ineffective in treating it. A suspension of Bactrim, Dioxidin, and nitrofuran preparations is used. The affected areas are treated with antiseptics, and antibiotics, immunomodulators, vitamins and other medications are additionally prescribed.

The final stage of dental intervention for acute periodontitis is the installation of a medical lining on the apex of the root, filling the canals and fixing a temporary and then permanent filling. After inflammation subsides, measures should be taken to prevent relapses. The following methods are used for this:

Applying special wound healing ointments. It is better to take a prescription for acute periodontitis from a doctor and strictly follow the instructions.
Rinse the affected area with a solution of salt and soda. Do the procedure twice a day for 2 weeks, then once a day for two months.
Physiotherapy. Used in the recovery period after treatment of acute periodontitis for the purpose of rapid tissue regeneration.

Removal of a tooth affected by acute periodontitis is rarely resorted to. For example, when the root or gums are severely damaged, and the destruction of the crown excludes the possibility of installing orthodontic structures. In modern dentistry, extirpation is used extremely rarely.

Possible complications

Untimely treatment of acute periodontitis leads to a breakthrough of the canal and the spreading of purulent contents along the gums. Other complications of the pathology include:

Preventive measures

Due to the severity of tissue damage by acute periodontitis, self-treatment is impossible. To avoid complex treatment and surgery, it is important to follow preventive measures.

Among them:

injury prevention;
prevention of chronic diseases;
proper oral hygiene;
healthy lifestyle;
proper nutrition;
timely orthopedic treatment;
regular sanitation of the oral cavity.

When purchasing dental care products for acute periodontitis, you should take into account the opinion of the dentist. The choice depends on the stage of the disease and the characteristics of the medicinal paste, which is used for a short time. Often used:

Lakalut Active;
Splat Active;
President Active;
Lakalut Phytoformula;
Parodontol Active.

Acute periodontitis is an inflammatory disease that affects the tissue located between the apex of the tooth root and the bone. The complex of tissues located here is a ligament that holds the tooth in the alveolar jaw socket. In clinical practice, the acute purulent form of the disease is more common. Other types of periodontitis, which are not accompanied by acute pain, are diagnosed less frequently. Treatment of inflammatory processes of the periodontal ligament is carried out on an outpatient basis, in a dental clinic. The exception is cases of advanced disease, when the pathological process affects not only the root apex area, but also other areas of the jaw. Inflammation can spread to the periosteum, bone, and surrounding teeth.
Acute inflammation of the dental ligament is most often diagnosed in people aged 18–40 years. Chronic processes are observed mainly in elderly patients. The transition from acute to chronic forms occurs when the infection is not treated, as well as when pathogenic bacteria regularly enter the periodontal zone with open dental canals.

Etiology

The development of acute periodontitis is based on the entry of pathogenic or conditionally pathogenic bacteria into the tissues of the periodontal ligament. In 95% of cases, the gates of infection are deep carious lesions of the teeth, leading to the opening of canals. In addition to caries, gates for bacterial penetration can form under the following conditions:

Open jaw injuries;
Presence of periodontal pockets;
Consequences of irrational dental interventions;
The presence of foci of infection in the body, leading to hematogenous or lymphogenous infection. In this case, the gateway of infection is the place where pathogenic bacteria first enter the patient’s body.

Acute periodontitis can have a sterile course. This form of the disease develops with closed injuries to the teeth or jaw. Another cause of sterile inflammation is the entry of chemicals or medications into the periodontal cavity. This is usually the result of a medical error made during dental treatment.

Pathogenesis

During periodontitis, two stages are distinguished: serous and purulent. The serous stage is the body's primary reaction to pathogen entry or chemical irritation. The small areas of irritation that arise quickly increase, capturing new areas of the periodontal space. Small blood vessels present in the inflamed area dilate. Their permeability increases. Infiltration of surrounding tissues with leukocytes and serous exudate occurs.

The transition of serous periodontitis to the purulent stage occurs when waste products of bacteria, remains of dead microflora, and destroyed leukocytes accumulate in the pathological focus. First, multiple small abscesses form in the area of inflammation. Subsequently, they combine to form a single cavity.
If medical care is not provided to the patient at this stage, the pathological process begins to spread. Infiltration of soft tissues by pus occurs, purulent inflammation passes under the periosteum, accompanied by its exfoliation and destruction (purulent periostitis), and soft tissue abscesses can form. The swelling spreads to the patient’s face and neck, impairing the airway.

During the therapeutic treatment of a tooth, as well as during a surgical operation, the following medications are used:

Antiseptics (chlorhexidine, sodium hypochlorite);
Restoring compounds (omegadent, calcept);
Pastes for filling (sealapex, endomethasone);
Local anesthetics (lidocaine, novocaine);
Antidotes used in the treatment of chemical periodontitis (unithiol);
Antiseptics (potassium permanganate, furatsilin).

Pharmacological therapy is actively used in the postoperative period, as well as during the rehabilitation period. After therapeutic intervention, the pharmacological support regimen changes. The patient is prescribed a “lighter” treatment option. To combat the inflammatory process, the following drugs are used:

Antibiotics.	The basis for the treatment of all inflammatory diseases. When prescribing empirically, it is necessary to use broad-spectrum drugs. In dentistry, drugs such as lincomycin, ciprolet, metronidazole, and amoxiclav are more often used.
Painkillers and anti-inflammatory drugs.	The use of drugs that have a predominantly analgesic effect (analgin, ketorol) is justified in cases of severe pain. In the absence of constant excruciating pain, it is recommended to use drugs aimed at relieving inflammation (ibuprufen, paracetamol). It should be remembered that anti-inflammatory drugs also have a weak analgesic effect. Painkillers reduce the intensity of inflammation to one degree or another. Therefore, the combined use of both agents should be avoided.
Antihistamines.	First generation antihistamines (suprastin, tavegil) can be used. These drugs help reduce sensitization of the body and subside the inflammatory process.
Preparations for topical use	Topical preparations are used mainly after surgery, as well as in the period between the first and second visits to the doctor when using a therapeutic approach. In order to disinfect the wound, the mouth of the exposed root canal and the oral cavity as a whole, furatsilin, a weak solution of potassium permanganate, and antibacterial ointments (Metrogil Denta) are used. The use of some folk recipes is allowed as an aid.

Surgery

Acute periodontitis, the therapeutic treatment of which was unsuccessful or was completely absent, leads to the development of a purulent process. The presence of a widespread purulent process affecting the periosteum and deep-lying tissues requires surgical intervention.

The operation to open an abscess for complicated inflammation of the dental ligament is performed on an outpatient basis, under local anesthesia. The surgeon makes an incision along the gum, opening the mucous membrane, muscle layer and periosteum. The periosteum is slightly peeled off, ensuring good drainage of pus. The abscess cavity is washed with antibiotics and drained using sterile rubber gloves.

Complete suturing of the wound is allowed only after the outflow of pus and wound exudate through the drainage has stopped. Until this moment, the wound remains partially open and is covered with a gauze napkin, which prevents bacteria and pieces of food from entering the pathological focus.

Physiotherapy

As physiotherapeutic treatment methods, patients are prescribed UHF and procedures using a helium-ion laser. Physiotherapy allows you to quickly relieve swelling, improve blood circulation in the pathological focus, reduce pain and speed up recovery.

Physiotherapeutic treatment is prescribed to patients from the first days after surgery. In the therapeutic approach to the treatment of periodontitis, the influence of physical factors to accelerate rehabilitation, as a rule, is not used.

Evaluation of results

Treatment of acute periodontitis can be considered complete after a final X-ray examination. Based on its results, the doctor must make a conclusion that the inflammatory process has completely subsided. In this case, some pain in the area of the affected tooth may persist for several weeks. This mainly manifests itself when there is strong pressure on the tooth while eating.

Treatment of the disease that is insufficient in quality or duration leads to the resumption of the pathological process some time after recovery. Therefore, if pain intensifies in the area of an already treated tooth, you should immediately consult a doctor for a follow-up examination and determine the cause of this phenomenon.

Is treatment possible at home?

Treatment of periodontitis at home is impossible, since the source of infection is located in the canals of the tooth, and the source of inflammation is in the periodontal area. Local exposure by rinsing the mouth with antiseptic solutions will not bring results, since medicinal substances simply cannot get into the pathological focus.

The progression of the disease can be delayed with the help of antibiotics. This is a temporary measure to avoid serious complications if an immediate visit to the dentist is not possible. Self-antibiotic therapy cannot be considered as the main method of treatment.

Forecasts

The prognosis for acute periodontitis at any stage is favorable if the necessary treatment is available. If the patient refuses to visit a doctor and the inflammatory process continues to actively spread to surrounding tissues, the prognosis becomes unfavorable in relation to not only health, but also life!

The period of rehabilitation after the intervention depends on the condition of the patient’s body, the stage of the disease, the nature of its course and the type of pathogen that provoked the inflammatory process. With serous uncomplicated periodontitis, the average time required for complete recovery is 7–10 days. Severe purulent forms of the disease may require several months of active rehabilitation.