THE RESULTS OF THE USE OF SELENIUM IN THE COMPLEX TREATMENT OF PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS
Authors: Gorshkova A.E. 
Published: January 2020

Treatment of chronic generalized periodontitis remains a rather complicated medical problem. The attention of scientists has been recently given to the microelement of selenium, which is a component of selenium-dependent glutathione peroxidase. An important advantage of using of this element is that the regulation of cell membrane lipid peroxidation can be realized by selenium without the involvement of glutathione peroxidase mechanism of peroxide utilization. Selenium-containing drugs have a positive effect on the clinical course of the disease, the process of blood supply to periodontal tissues and the state of antioxidant protection.

Therefore, it is relevant to study the effect of selenium in the complex treatment of periodontal diseases.

The goal of the study is to increase the effectiveness of treatment of patients with chronic generalized periodontitis by selenium preparations.

Research materials and methods. 90 patients with chronic generalized periodontitis between the ages from 27 to 43 years old were examined to solve these problems. Among the examined patients were 47 (52.2%) patients with chronic generalized periodontitis of I grade and there were 43 (47.8%) patients with chronic generalized periodontitis of II grade. The patients were divided into three groups of 30 people.

All patients were examined according to the standard scheme including complaints, life anamnesis information, objective data, and special indices: oral hygiene was performed by the Silness-Loe indices, Stellard, gingivitis severity by the PMA index, blood index clear for H.R. Muhlemann, A.S. Mazor (1958), periodontal index (Russell, 1956), index of need for treatment of periodontal diseases was CPITN.

Results and Discussion. The patients of the first group with chronic generalized periodontitis were treated according to the traditional scheme. Patients of the second group with chronic generalized periodontitis were treated according to a similar algorithm with an additional usage of an oily solution of retinol acetate, topically applied α-tocopherol acetate, ascorbic acid by ultrafonophoresis. Additional mineral complex "Selenium active" was used for the treatment of patients of the third group.

In the first group had a decrease in the Silness-Loe index to 0.74 ± 0.06 (by 63.9%; p <0.001), in the second group had index to 0.61 ± 0.07 (by 69.8%; p <0.001), the most significant changes occurred in patients in the third group, index was to 0.21 ± 0.01 (89.6%; p <0.001).The Stellard index also dropped significantly (p <0.001) in the first group from 2.14 ± 0.09 to 0.79 ± 0.07, in the second group it was from 2.11 ± 0.09 to 0.81 ± 0.04, the third group had index from 2.10 ± 0.09 to 0.60 ± 0.03.

Scale index decreased in patients of the first group to 0.26 ± 0.01 (p <0.001), the second group had 0.24 ± 0.01 (p <0.001), the third group had 0.21 ± 0.01 (p <0.001)).

H.R. Muhleman bleeding index was 1.01 ± 0.06 in the first group, 0.61 ± 1.58 was in the second group and 0.21 ± 0.02 was in the third group after treatment.

The periodontal index showed an improvement in the clinical picture among patients of the first group - 0.99 ± 2.28, the second group had 0.67 ± 0.04, and the most significant changes occurred among patients of the third group - 0.24 ± 0.02.

The index of need for treatment of periodontal diseases was CPITN in the first group; it decreased from 2.45 ± 0.10 to 1.01 ± 0.02, in the second group index was from 2.41 ± 0.10 to 0.75 ± 0.04, in the third group index was from 2.38 ± 0.10 to 0.45 ± 0.04.

The PMA index after treatment in third group of patients decreased from 61.43 ± 1.98 to 18.35 ± 0.49.

Although periodontal tissue improvement occurred in all patients, changes in the third group were more significant, indicating that the proposed regimen was effective.

Conclusions. The inclusion of selenium in the scheme of complex treatment of chronic generalized periodontitis significantly increases the effectiveness of it, which is determined by the improvement of the clinical course of the disease.