Clinical effectiveness of treating chronic generalised periodontitis in military personnel of the Ukrainian Armed Forces

Abstract

Summary. As a result of the full-scale armed aggression of the russian federation against Ukraine, the issues of maintaining and improving the health, combat capability and efficiency of the military personnel of the Armed Forces of Ukraine are more relevant than ever. A number of scientists have shown that psycho-emotional stress contributes to the development of somatic disorders, including periodontal disease. In their opinion, stress-related diseases are caused by the action of stress factors and affect almost all body systems. Diseases of periodontal tissues can lead to the emergence and development of complications from internal organs and systems that affect the general condition of the body and, most importantly, reduce the combat and work capacity of military personnel. Therefore, strengthening periodontal health is not only an important component of overall health, but also of military personnel readiness, which is part of our country's strategic orientation.

The aim of the study – to evaluate the clinical effectiveness of our proposed treatment complex for the management of chronic generalized periodontitis in patients in the Armed Forces of Ukraine.

Materials and Methods. The treatment of chronic generalized periodontitis of the initial – II degree was carried out in 78 military patients: 46 patients (58,97 %), in whom the GP was managed according to the methodology developed by us (main group) and 32 patients (41,03 %), in whom the treatment of CGP was carried out according to traditional methods. Patients participating in the study were divided into groups depending on their psycho-emotional state: group I – very high stress resistance with a low level of reactive anxiety (there were no dystrophic-inflammatory lesions of periodontal tissues); group II – high stress resistance with a low level of reactive anxiety; group III – threshold level of stress resistance with a moderate level of reactive anxiety; group IV – low stress resistance with a high level of reactive anxiety. To quantify the clinical signs of periodontal tissue damage, the following were determined: papillary marginal-alveolar index (PMA); periodontal index (PI); papillary bleeding index (PBI); the hygienic state of the oral cavity was characterized by the Greene J. Vermillion J index (OHI - S). The effectiveness of the treatment of periodontal tissue diseases was assessed by the following criteria: «stabilization», «clinical well-being», «improvement», «no change» and «deterioration».

Results and Discussion. As a result of the studies, it was found that when using the treatment methodology developed by us for the management of chronic generalized periodontitis of the initial – II degree in patients-soldiers of the main group, «stabilization» of the state of periodontal tissues was achieved in 68,42 % of the treated patients, compared to 12,0 % of the control group, in whom the treatment of CGP was carried out according to traditional methods. The component «clinical well-being» corresponded to the condition of periodontal tissues in (21,05±6,61) % of the treated patients of the main and (16,0±7,33) % of the control group, p>0.05. «Improvement» of the periodontal tissue condition was studied in (7,90±3,37) % of patients in the main and (8,00±3,42) % of patients in the control group, p>0,05. At the same time, the state of periodontal tissues «without changes» was diagnosed only in (2,63±0,59) % of patients in the main group against (36,0±9,60) % of patients in the control group, p<0.01. It was noteworthy that the «deterioration» of periodontal tissues was studied only in patients in the control group – (28.0±8.87) %, p<0.01. At the same time, in this cohort of patients, a reduction in РMA – 26,72 %, РВI – 43,83 %, РI – 26,72 % and OHI-S – 46,98 %, p, p₁<0,01 was achieved.

Conclusions. Thus, the results of clinical trials have convincingly proved the effectiveness of the treatment complex developed by us for the management of chronic generalized periodontitis of the initial – II degree in patients-soldiers of the Armed Forces of Ukraine, which was confirmed by the positive dynamics of paraclinical indices PMA, PI, PBI, OHI-S and «stabilization» of the periodontal tissue condition.