CLINICAL AND PATHOGENETIC RATIONALE FOR THE COMBINED USE OF PHOTODYNAMIC THERAPY AND ANTIHYPOXIC AGENTS IN THE SURGICAL MANAGEMENT OF GENERALIZED PERIODONTITIS
DOI:
https://doi.org/10.11603/2311-9624.2026.1.16341Keywords:
generalized periodontitis, photodynamic therapy, antihypoxants, modified flap surgery, periodontal indices, microcirculation, reparative osteogenesis.Abstract
The regeneration of periodontal tissues following surgical intervention for generalized periodontitis remains a significant challenge due to the elevated risk of postoperative complications associated with microcirculatory impairment and oxidative stress. Identifying effective strategies to correct local hypoxia and microbial contamination of the wound bed is a priority for ensuring long-term stabilization of the pathological process. The aim of the study – to enhance the efficacy of surgical treatment in patients with chronic generalized periodontitis II degree by incorporating photodynamic therapy combined with local antihypoxant application into the postoperative rehabilitation protocol. Materials and Methods. Clinical and radiographic examination and treatment were conducted on 33 patients with chronic generalized periodontitis II degree, who underwent modified flap surgery. Patients were randomized into two groups: the study group (n = 21) – received postoperative topical applications of “Actovegin” gel followed by photodynamic therapy sessions; the control group (n = 12) – received conventional pharmacological treatment. Treatment efficacy was evaluated based on the dynamics of periodontal indices (PMA, PBI), clinical attachment loss (CAL), Fuchs’ radiographic index, and the OHI-S hygiene index at intervals of 5–7 days, 1, 3, and 6 months. Statistical analysis was performed using Student’s t-test, with significance set at p < 0.05. Results. It was established that the early postoperative period in the study group was characterized by faster resolution of edema and pain; 80.95 % of patients reported no complaints by days 5–7. At the 6-month follow-up, the study group demonstrated a statistically significant reduction in the PMA index by 75.95 % and a decrease in CAL by 48.98 % compared to baseline values, p < 0.01. In contrast, the reduction of the PMA index in the control group was only 19.36 %. Fuchs’ radiographic index values in the study group increased by a factor of 1.2, indicating stabilization of the alveolar bone tissue. Conclusions. Incorporating photodynamic therapy and antihypoxants into the treatment protocol for Stage II chronic generalized periodontitis optimizes reparative osteogenesis and microcirculation. This approach ensures sustained clinical remission and preservation of periodontal supporting tissues during long-term follow-up.
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