REMOTE RESULTS OF MUСO-GINGIVAL OSTEOPLASTY IN PATIENTS WITH SEVERE FORMS OF GENERALIZED PERIODONTITIS

Abstract

Among all dental diseases, periodontal disease is one of the leading places, taking into account the prevalence of this pathology among the population and its consequences (loss of teeth and dysfunction of the tooth-jaw system). The severity of the disease, frequent relapses and complications lead to a decrease in the quality of life of patients, impaired chewing and speech, significant socio-economic losses. This requires further development of new treatment regimens.

The aim of the study – to develop new approaches to the treatment of patients with severe forms of generalized periodontitis, to prevent in the postoperative period the exposure of the neck teeth and to reduce the height of the alveolar margin, to improve mucogingival osteoplasty and to correct liver function by assigning adequate medical support in the pre and postoperative period.

Materials and Methods. 60 patients with severe forms of chronic generalized periodontitis were operated, depending on the method of treatment, all patients were divided into two groups: 30 patients with generalized periodontitis II-III degree of development with fatty liver hepatosis (group 1) were performed modified muco-gingival osteoplasty with application in the pre and postoperative period of preparation of arginine glutamate and in the postoperative period of the solution of miramistin and methyl uracil ointment with miramistinum. Patients of the group 2 (30 people) without concomitant pathology underwent muco-gingival osteoplasty. The evaluationof the results of the clinical study was carried out according to general-clinical, biochemical, patient surveys.

Results and Discussion. 3 months after the operation there was no significant difference between the patients' state of the groups 1 and 2. 12 months later – 26 patients of group 1 in the area of operated teeth formed a stable tooth-aspartic attachment in the type of circular ligament, with radiological control, islets of oscillation and stabilization of the pathological process were found, and in patients of 2 groups in 4 cases, there were single skinned pockets, the phenomenon of gingivitis. Indicator of RI in remote monitoring period after 12 months gradually decreased. Comparing with the data before surgery, the RI index differed in patients in the group 2 in 1.18 times, and in the group 1 – in 1.20 times in 12 months, respectively. In patients of the group 2, in which, in addition to penetration, we used the local medicines we proposed, the decrease in C-RB was higher and was 9.24 times in 12 months. Even better results were observed in patients in the group 1, and after 12 months, however, it was negligible.

Conclusions. Complex treatment with the preparation of arginine glutamate in patients of the group 1, which contributed to the greatest reduction in the content of oxyproline after 1.6 and 12 months after therapy, 1.42 and 1.38 times, and had little effect on the inhibition of collagen collapse in the tissues of periodontal disease. Our study showed that the greatest influence on the regulation of LF activity in blood serum of patients with HF had a treatment method applied in the group 1. Muco-gingival osteoplasty in the treatment of severe forms of GP in combination with arginine glutamate reduced the activity of CF in serum, especially in patients in the group 1. Data on changes in the activity of transaminases in serum showed that the proposed drug treatment, in combination with the surgical technique, had a significant effect on the regulation of the activity of transaminases in patients with severe forms of GP.