[Method of comprehensive physiotherapy of dental patients after COVID-19]. / Metod kompleksnoi fizioterapii u stomatologicheskikh patsientov posle COVID-19.

Functional gastrointestinal disorders, which had an impact on the dentofacial system (pain, loose teeth and falling out of them) in patients who have had COVID-19, drew the close attention of specialists of different profiles. The pathogenesis of worsening post-COVID edentulism is insufficiently studied, as many issues of adequate therapy remain unsolved, in which the role of non-drug technologies in the treatment of dental patients who have suffered from COVID-19 is extremely high. OBJECTIVE: To describe the mechanism of action and clinical effectiveness of the developed combined physiotherapy method, including the induced technique of piracetam iontophoresis on the frontooccipital technic and acupuncture laser therapy in dental patients with complaints of edentulism progression after COVID-19 on the basis of the analysis of single studies on the post-COVID loss of teeth treatment. MATERIAL AND METHODS: A number of patients equal 120 who complained of tooth loss after COVID-19 during the past 6 months were examined. The following initial and end points were considered: dental bleeding and inflammation scores, vascular and endothelial dysfunction markers - levels of intercellular adhesion molecules and their receptors (SlCAM-1, SVCAM-1, VEGF-A, ET-1) before and after treatment. RESULTS: Negative correlation between VEGF-A (pg/ml) concentration in peripheral blood serum and sVCAM-1 (ng/ml) level in the examined patients (r=0.4830, p<0.05) and strong inverse correlation between slCAM-1 (ng/ml) level and sVCAM-1 (r=0.7696, p<0.01) have been established. More significant effects after application of the combined induced method on the head's structures and laser acupuncture have been noted than after acupuncture laser exposure and after inducing technique separately, namely in the form of dental inflammation score correction by 1.76 times (p<0.001), decrease of bleeding score by 2.6 (p<0.05), decrease of concentration of SVCAM-1 by 1.7 times and SlCAM-1 by 2 times (p<0.001), increase of endothelin level by 1.7 times as well as the initial low VEGF-A (pg/ml) by 1.5 times (p<0.01). CONCLUSION: The developed physiotherapeutic complex, which includes laser acupuncture physiotherapy and induced technique of 5% piracetam iontophoresis, can potentially be considered as a physioprophylactic and therapeutic model of post-COVID edentulism.

[Laser therapy effect on endothelial dysfunction in patients after the surgery for orthognathic disorders]. / Vliyanie lazernoi terapii na endotelial'nuyu disfunktsiyu u bol'nykh, operirovannykh po povodu ortognaticheskoi patologii.

OBJECTIVE: To optimize postoperative rehabilitation by applying low-intensity laser irradiation (LILI) with different wavelengths in the early postoperative period to prevent inflammatory complications. MATERIAL AND METHODS: After radiological examination and ultrasound diagnostics of the periodontal tissue vessels, surgical methods of orthognathic treatment were performed, after completion of which a course of LILI was carried out. The VEGF its receptors (sVEGF-R1; sVEGF-R2) content was measured by enzyme immunoassay using standard reagent kits. The laser therapy using 635 nm laser light was applied directly to the vestibular and oral surfaces of the gingival tissues and in the operation area, changeable by the scanning method, for 1.5 minutes (5 W power); the pulsed infrared laser therapy (PILT) with the 904 nm wavelength (light pulse duration 100 s, power 15 W, 1500 Hz) applied epicutaneously to the operation projective zones (four control points of the upper and lower jaw) through the skin of the cheek, in stable method (1.5 minutes) with a time range between red and infrared wavelength LILI not exceeding 100 s (1.5 minutes). RESULTS: Vascular and endothelial dysfunction after laser irradiation with different wavelengths is better controlled by increasing the microcapillary blood flow (66.7% gain; p<0.05) in arteriolar and 70.3% in venular sections of capillaries (p<0.01), which is associated by vasodilatation: diameter increased by 26.9% compared to that under the influence of red laser radiation (by 13.0%) and infrared laser radiation (by 7.2%); p<0.01). CONCLUSIONS: Early laser therapy using the low-intensity laser irradiation with different wavelengths improves vasoactive processes of hemoregulation in dental tissues associated with the elimination of vasospasm caused by operative stress, activation of arteriolodilatory effects, contributes to the prevention of development of inflammatory complications.