PECULIARITIES OF DENTAL TREATMENT OF PATIENTS WITH BACTERIAL VAGINOSIS AND THEIR SEX PARTNERS
Authors: Krutikova A.D. 
Published: December 2020

Patients with bacterial vaginosis are diagnosed with chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases, such as chronic catarrhal gingivitis, periodontitis of initial and first severity.

The aim of the study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners.

Materials and methods. 28 heterosexual couples aged 18-45 years took part in the survey. Clinical dental examination was performed at the time of treatment and 3 months after completion of treatment. Green-Vermilion indices, RMA (in Parma modification), complex periodontal index according to Leus (KPI), Svrakov's number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included: "Fluconazole" 50 mg 1 time per day (7 days), "Clindamycin" 150 mg every 6 hours (5 days), starting from the 3rd day of antibiotics - probiotic "Symbiter acidophilus concentrated "(21 days), Calcium-D3-Nycomed 1 tab. during dinner 30 days. Local treatment included: oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures (7 days), application of "Metrogil-dent" on the gums (7 days), the drug "Lizak" 1 tab. keep in the mouth until complete dissolution every 6 hours (5 days), after the use of "Stomatophyte" and "Metrogil - dent" - application of "Symbiter omega" on the gums in silicone caps at night (21 days).

Results. In women, chronic generalized catarrhal gingivitis was detected in 10.71%, chronic generalized periodontitis of the initial degree in 64.29% and chronic generalized periodontitis of the I degree in 25%. In men who are carriers of pathogens of BV, chronic generalized catarrhal gingivitis was found in 7.14%, chronic generalized periodontitis of the initial degree in 60.71% and chronic generalized periodontitis in grade 32.1. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive objective dynamics of dental status. Thus, after 3 months of clinical and laboratory observations, there were no complaints, the state of oral hygiene improved significantly. If before the treatment the Green-Vermilion index in general in women with BV was 1.323 ± 0.035 points, then after 3 months it was equal to 1.032 ± 0.021. A similar dynamics was determined in men: from the starting index of 1.336 ± 0.041, the Green-Vermilion index decreased to 1.048 ± 0.036. 3 months after treatment, the PMA of patients decreased by 49.03%, in men - by 51.95%, no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant . According to the KPI index, women had a significant difference between baseline and post-treatment outcomes of 1.98 points, while men had a score of 2.01 points. No significant difference was found between the results of groups I and II both before and after treatment. A similar positive dynamics characterizes the indicator - Srakov's number, according to this indicator before treatment and after differences between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. Before treatment and after the detection rate in the oral cavity, Gardnerella vaginalis and Atopobium vaginae did not have a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after treatment in the middle and second groups. Thus, Gardnerella vaginalis was detected less by 67.87% and 61.59%, Atopobium vaginae - by 65.79% and 58.65% in women and men, respectively.

Conclusions. The developed and patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory phenomena, improves oral hygiene, and is suitable for the treatment of women with this comorbidity and for the treatment of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens corresponded to the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who were their sexual partners, which once again confirms the equal effectiveness of treatment for both gender groups.