ASSESSMENT OF THE EFFECTIVENESS OF THE TREATMENT OF CHRONIC GENERALIZED PERIODONTITIS USING THE RUSSELL INDEX

Abstract

Abstract. Introduction. Periodontal diseases are among the most common conditions in modern dentistry, affecting a significant portion of the adult population worldwide. Their occurrence results from a complex set of etiological factors, including dental deposits and microbial metabolites, local factors within the oral cavity, and the body’s immune response characteristics. Disruption of the balance between the microbiota and the immune system’s protective mechanisms leads to a chronic inflammatory process with periodic flare-ups, highlighting the importance of systematic monitoring and early preventive measures. The modern approach to treating periodontal disease focuses on eliminating etiological factors, correcting pathogenic mechanisms, and maintaining microbial balance. Specialized indices are used to standardize diagnosis and evaluate treatment effectiveness; these include OHI-S, PMA, and PDI, which quantitatively assess oral hygiene status, inflammation levels, and the extent of periodontal tissue damage. The study aims to evaluate the effectiveness of the proposed drug treatment regimen for patients with chronic generalized periodontitis (CGP) when using a standard antiseptic for rinsing the oral cavity with a solution of “Chlorhexidine” (0,05%) versus “Salviae tincture” (at a dilution of 1 : 40) in combination with the combined drug “Ascorutin”. Methods. We observed the treatment dynamics of 95 patients, 85 of whom were diagnosed with chronic generalized periodontitis at stages I to III, while 10 were diagnosed with it in the initial stage. Control examinations were conducted two and six months after the initial treatment. The patients were divided into seven groups. The first group consisted of patients with chronic generalized periodontitis in the initial stage, who were treated according to a standard regimen without the use of any medication. The second, fourth, and sixth groups included patients with chronic generalized periodontitis at stages I, II, and III, respectively, who received treatment according to a standard regimen that involved rinsing the oral cavity with a “Chlorhexidine” (0.05%) solution. The third, fifth, and seventh groups consisted of patients with chronic generalized periodontitis at stages I, II, and III, respectively. These patients were treated according to a standard regimen that included rinsing the oral cavity with “Salviae tincture” (at a dilution of 1 : 40), combined with oral administration of the drug “Ascorutin”. Statistical analysis of the collected data was carried out using standard methods. Results and Discussion. The study assessed the stage of periodontal tissue damage using the PDI index, modified by Russel, across groups classified by the severity of the disease. The level of oral hygiene before treatment was also evaluated. Two months after starting treatment, it was observed that patients with chronic generalized periodontitis of the 1st stage in the second group, who received standard treatment along with the antiseptic solution “Chlorhexidine” (0.05%), showed a reduction in the PDI index by 43.73%. In contrast, the third group, which underwent standard treatment in conjunction with “Salviae tincture” for oral rinsing and oral administration of the drug “Ascorutin”, experienced a more significant decrease in the PDI index, falling by 57.24%. For patients with chronic generalized periodontitis of the 2nd stage in the fourth group, those treated with the standard regimen and “Chlorhexidine” (0.05%) also saw their PDI index decrease by 41.38%. However, in the fifth group, where patients received standard treatment along with “Salviae tincture” for oral rinsing and oral “Ascorutin”, the PDI index decreased by 54.48%. For patients with stage III chronic generalized periodontitis in the sixth group, treatment with the standard regimen and the antiseptic solution “Chlorhexidine” (0.05%) resulted in a 45.52% decrease in the PDI index value. In the seventh group, patients who received the standard treatment regimen along with the “Salviae tincture” for rinsing the oral cavity, combined with the oral use of “Ascorutin” experienced a 54.40% reduction in the PDI index value after treatment. In the sixth month of clinical studies involving patients with chronic generalized periodontitis of stage I, the second and third groups showed a further decrease in the PDI index values. The second group experienced a reduction of 18.52%, while the third group saw a decline of 4.84%. The mean PDI index values for these groups were 0.66 for the second group and 0.59 for the third group, which indicated that the difference between them was statistically insignificant ( = 0,96). For patients with chronic generalized periodontitis of stage II, the fourth and fifth groups also demonstrated a further decrease in PDI index values, with an 8.84% reduction for the fourth group and a 14.96% decline for the fifth group. The average PDI index values for these groups were 1.41 for the fourth group and 1.08 for the fifth group, showing a statistically significant difference between them ( = 3,30). In the case of patients with stage III chronic generalized periodontitis, the sixth and seventh groups observed a further decrease in PDI index values by 3.29% for the sixth group and 7.52% for the seventh group. The average PDI indices for these groups were 3.53 for the sixth group and 2.83 for (the seventh group, which also indicated a statistically significant difference = 6,61). Thus, it can be concluded that for patients with generalized periodontitis of stage III, treatment with “Salviae tincture” for rinsing the oral cavity, combined with the oral administration of the drug “Ascorutin” leads to a more rapid improvement in the PDI index. Furthermore, the values of this index tend to decrease significantly. Conclusions. Both treatment regimens demonstrated an improvement in the PDI index among patients with chronic generalized periodontitis at stages I–III. The use of a diluted antiseptic solution and “Salviae tincture” for rinsing the oral cavity, in combination with the oral administration of “Ascorutin”, enabled patients with stage I chronic generalized periodontitis to achieve target PDI index values within two months of observation. In contrast, those treated with the standard protocol using “Chlorhexidine” (0.05%) reached these values only after six months. For patients with stage II and III chronic generalized periodontitis, the addition of the “Salviae tincture” for rinsing, along with “Ascorutin” taken orally, resulted in PDI index values that were 10–13% lower after two months and 4–6% lower after six months compared to standard treatment. The effectiveness of this proposed treatment regimen, which incorporates the use of “Salviae tincture” and “Ascorutin” has been clinically validated.