STRUCTURAL-FUNCTIONAL AND BIOCHEMICAL CHANGES IN PATIENTS WITH STAGE II GENERALIZED PERIODONTITIS UNDER THE INFLUENCE OF COMPLEX TREATMENT

Abstract

Generalized periodontitis is a long-term chronic, recurrent dystrophic-inflammatory condition that eventually leads to the destruction of interdental bone septa, premature tooth loss, and dysfunction of the dentoalveolar system. In recent years, researchers have increasingly focused on the association between generalized periodontitis and osteodeficient conditions. Traditional treatment of generalized periodontitis is primarily aimed at eliminating inflammation by removing local irritants and using antimicrobial, anti-inflammatory, desensitizing, immunomodulatory, and vitamin preparations. However, it is much less frequently supplemented with agents that specifically stimulate metabolic processes in the periodontal tissues. The aim of the study was to evaluate the effectiveness of the proposed therapeutic and preventive measures in patients with stage II generalized periodontitis. Treatment of stage II generalized periodontitis was carried out in 119 patients, including 45 men and 74 women. Among the women, 43 were of reproductive age, and 31 were in the postmenopausal period. To optimize osteogenesis, men in the main group were prescribed the drug “OsteoPro” twice a year. Women of reproductive age received “Calcium D3 Nycomed” and “Osteogenon”, while postmenopausal women were prescribed “OsteoPro” and the estrogen receptor stimulator “Raloxifene”. To determine the effectiveness of the proposed treatment regimen, Fuks’ radiographic index (Rtg-index), densitometry parameters, and bone remodeling markers were analyzed. The results demonstrated that the treatment protocol developed and proposed for managing stage II generalized periodontitis-comprising both local and systemic medications – significantly improved the condition of periodontal tissues in male and female patients of the main groups. On average, stabilization of periodontal tissue condition was achieved in 76.21 % of cases. This positive trend was further confirmed by the reduction of mean index values in both sexes compared with baseline data. The therapy of dystrophic-inflammatory processes in periodontal tissues had a pronounced positive effect on the structural and functional properties of bone tissue, particularly in the mandible. This was confirmed by an average increase in the Rtg-index by 11.07 % and a rise in bone mineral density by 17.21 % compared to baseline values. The proposed treatment regimen also improved bone remodeling markers in the studied patients: in men, blood levels of type I collagen C-terminal telopeptide decreased by 33.93%; in reproductive-age women, urinary deoxypyridinoline levels decreased by 14.44 %; and in postmenopausal women, blood osteocalcin levels increased by 27.78 %. Moreover, the proposed treatment regimen improved the quality of bone remodeling markers in the treated patients. In men, the blood level of type I collagen C-terminal telopeptide decreased by 33.93%, while in reproductive-age women, urinary deoxypyridinoline levels decreased by 14.44 %. In postmenopausal women, blood osteocalcin levels increased by 27.78 %. In contrast, among patients of both sexes treated according to generally accepted standard protocols, periodontal tissue stabilization was achieved in only 31.91 % of cases, with no positive dynamics in clinical and radiographic indices or in functional and laboratory parameters during long-term follow-up. Conclusion: The treatment method we implemented for managing stage II generalized periodontitis in both men and women significantly improved periodontal and hygienic status in the main patient groups. It also substantially corrected the structural and functional properties of bone tissue, as confirmed by radiographic and laboratory investigations.