Effect of treatment measures on clinical and laboratory indicators of patients with gingivitis in different course of the inflammatory process in the gums

Abstract

Summary. To study the features of the inflammatory reaction in the gums, providing pathogenetic effects on periodontal tissues in the treatment and prevention scheme included drugs and hygiene products that reduce antigenic effects on periodontal tissues, sensitization, stimulate the body's adaptive mechanisms and regulate local inflammatory response.

The aim of the study – evaluation of the effectiveness of treatment measures for clinical and laboratory parameters of patients with gingivitis with different course of the inflammatory process in the gums.

Materials and Methods. To determine the course of the inflammatory process, the effectiveness of treatment and prevention of exacerbations of chronic catarrhal gingivitis 202 patients with chronic catarrhal gingivitis were taken for dispensary observation. After analysis of anamnestic data and the results of determining the phagocytic activity of leukocytes in the oral fluid of patients were divided into groups: main (102 people) and comparison (100 people); in the middle of the group by type of inflammatory reaction in the gums, patients were divided into hypo-, hyper- and normergic subgroups. All patients received basic therapy in accordance with the Protocol of medical care. In the main group for a month used pathogenetic agents – anti-inflammatory gel with neovitin, recommended hygiene products. In the comparison group for topical treatment used 3 % hydrogen peroxide solution, Holisal gel; for rinsing the mouth (during the first week of treatment) – "Rotokan", therapeutic and prophylactic toothpaste. Examinations and control examinations were performed to determine the hygienic condition of the oral cavity according to the hygienic index Green-Vermillion, GI the prevalence and intensity of the inflammatory process in the gums using Schiller-Pisarev test and PMA index, oral fluid (Ca and P content).

Results and Discussion. After treatment, patients in the main group had a decrease in the PMA index in the hypoergic subgroup by 2.6 times, hyperergic – by 3.5 times and normoergic – by 2.8 times; GI – 1.4 times, 1.4 times and 1.5 times (p <0.05), ONI-S – 3.9, 3.8 and 3.6 times (p <0.05), respectively. Six months later, the PMA index increased in all patients, but remained significantly lower than before treatment. The Schiller-Pisarev test after treatment and after 6 months in the main group was negative, without showing gum color, in the comparsson group after six months the test was from negative to weakly positive. The treatment contributed to an increase in the content of Ca in patients of the main group, and it did not differ significantly from the control indicator. Studies of oral fluid after 0.5 years showed that the content of Ca decreased, but did not reach pre-treatment; in the hypoergic group, this indicator differed significantly from the control indicator. A reduction in the duration of treatment was found – a smaller number of visits in the main group – 3.1, in the comparison group – 3.9 (p <0.05).

Conclusions. The results of clinical and laboratory studies showed that the use of the proposed therapy using neovitin gel contributed to better immediate treatment results: reduction of gingivitis in the PMA index by an average of 2.96 times (in the comparison group 2.16 times); reducing the number of doctor visits by 0.8. The content of Ca and P in different courses of the inflammatory reaction in the gums was lower in patients of the hypoergic subgroup. Topical treatment improved the oral fluid of patients, at the same time, six months after treatment in patients of the hypoergic subgroup, the content of Ca and P decreased, which probably requires the inclusion in the treatment scheme of the general effect on the body to increase reactivity.