EFFECTIVENESS OF THERAPEUTIC AND PROPHYLACTIC MEASURES IN THE MANAGEMENT OF GENERALISED PERIODONTITIS OF THE INITIAL AND FIRST DEGREE IN PATIENTS WITH ATHEROSCLEROSIS ACCORDING TO PARACLINICAL STUDIES
Authors: Dankevich-Kharchyshyn I.S. , Pupin T.I. , Bandrivska N.N. 
Published: December 2023

Summary. In recent years, scientists have been paying great attention to the relationship between dental and general somatic health, where, in particular, they express the opinion that periodontitis may play a role as an independent risk factor for the development of vascular atherosclerosis and its clinical manifestations (coronary heart disease, myocardial infarction, stroke).

The aim of the study – to evaluate the effectiveness of the proposed therapeutic and prophylactic measures in the management of generalized periodontitis of the initial I degree in patients with atherosclerosis according to paraclinical indices.

Materials and Methods. The effectiveness of treatment of generalized periodontitis of the initial I degree was evaluated on the basis of the dynamics of hygienic and periodontal indices in 26 patients with atherosclerosis: 15 patients – the main group and 11 patients – the control group. To study the intensity and prevalence of the inflammatory process in the gums, we used a modified method of determining the papillary-marginal-alveolar index by C. Parma. The combined periodontal index proposed by Russel was used to determine the severity of dystrophic-inflammatory changes in periodontal tissues. The loss of epithelial attachment was determined by the method of G.F. Beloklitskaya. The degree of gingival bleeding was determined using the papillary bleeding index (PBI). To determine the degree and nature of bone resorption of the alveolar ridge, the radiological index (Rtg) according to Fush was used. The hygienic condition of the oral cavity was assessed by the Fedorova-Volodkina index. The statistical calculation of the results was performed using Statistica 8.0 (StatSoft, USA) and the statistical functions package of Microsoft Excel 2021.

Results and Discussion. As a result of our studies, it was found that the use of the proposed therapeutic and prophylactic complex for the management of initial I-degree GP contributed to the improvement of the hygienic state of the oral cavity, which was confirmed by a decrease in the index by 47.58 % 6 months after treatment. Improvement in the clinical condition of periodontal tissues in patients of the main group was confirmed by a decrease in the index scores of the indices: PMA, PBI, HEC, p<0,01, PI, p<0,05, against the background of an increase in the Rtg index, p<0,01, relative to the data before treatment. On the basis of the conducted studies, the effectiveness of the use of our proposed treatment and prevention complex, which included a set of individual hygiene measures, local and general pharmacotherapy, adapted for the successful management of initial I degree GP in patients with atherosclerosis, was proved, and was confirmed by the «stabilization» of the pathological process in 80,0% of the treated patients of the main group against 36,36% of the control group, in whom the treatment of initial I degree GP was carried out according to generally accepted methods. The state of periodontal tissues was objectified as «unchanged» in 20,0% of the main group and 36.36% of the treated control group. «Deterioration» of periodontal tissues was diagnosed only in 27,28 % of patients in the control group.

Conclusions. Thus, the use of the proposed therapeutic and prophylactic complex for the management of generalized periodontitis of the initial I degree in patients with atherosclerosis contributed to the improvement of the clinical condition of periodontal soft tissues, which was confirmed by the positive dynamics of hygienic and periodontal indices and was characterized by the «stabilization» of the pathological process in 80,00±5,78 % of the treated patients of the main group against 36,36±7,24 % of the control group.