DIFFERENTIAL DRUG CORRECTION CYTOKINE AND PROSTAGLANDIN CONTENT IN BLOOD AND GINGIVAL FLUID IN GENERALIZED PERIODONTITIS AGAINST THE BACKGROUND OF DIFFERENT RESPONSIVENESS OF THE ORGANIZATION.

OBJECTIVE: The aim is to study the dynamics of prostaglandins and cytokines in the blood and gingival fluid against the background of differential drug correction in patients with generalized periodontitis with different body reactivity. PATIENTS AND METHODS: Materials and methods: 216 people aged 45 between 55 years with a diagnosis of generalized periodontitis of II, III degree of severity, chronic course were examined. Depending on the state of reactivity of the organism, the patients were divided into three groups: the first one consisted of people with normoreaction; the second group included patients with hyperreaction; the third group was made up of people with hyporeaction. The patients underwent patch surgery after the initial therapy. Initially, on the 1st, 2nd, 4th, 6th and 9th day after the operation, the content of prostaglandins (PG) E, E2, F2alpha and cytokines (IL-1ß, IL-6, TNF, IL-4) in the blood and gingival fluid was performed. Patients with impaired body reactivity were treated with the proposed differential drug correction of cytokines and prostaglandins. Statistical processing of the obtained digital data was performed using the computer program Statistica 8.0. RESULTS: Results: The proposed differential drug correction in patients with generalized periodontitis against the background of hyper- and hyporeactivity of the body brings the content of IL-1ß, IL-6, TNF, IL-4 to that of normal body reactivity, which ultimately restores the disturbed balance of pro- and anti-inflammatory cytokines in the blood and gingival fluid. On the 9th day, the content of all proinflammatory cytokines in the main groups was normalized and was commensurate with that of the body's normal response (p>0.05). Differential drug correction led to normalization of the prostaglandin balance index on day 9 after flap surgery (p>0.05), indicating the establishment of a normal balance of eicosanoids in the blood and approximating the values of pro- and anti-inflammatory fractions of prostaglandins to those of normal body reactivity. CONCLUSION: Conclusion: Correction of altered parameters in patients with generalized periodontitis accompanied by impaired (hyper- and hypo-) reactivity of the body with bringing them to values that are typical for normoreactivity is considered to be a condition for optimizing mucosal wound healing after surgery and further stabilization of periodontal tissues.

CLINICAL PECULIARITIES OF WOUND HEALING AFTER SURGICAL TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCOMPANIED BY DIFFERENT TYPES OF REACTIVITY OF THE BODY.

OBJECTIVE: The aim: To study the features of clinical wound healing (intensity and duration of inflammatory reaction) after the indications for patients with generalized periodontitis II, III degrees of severity of patch surgery accompanied by normo-, hyper- and hyporeactivity of the body. PATIENTS AND METHODS: Materials and methods: 216 people aged 45 between 55 years with a diagnosis of generalized periodontitis of II, III degree of severity, chronic course were examined. Depending on the condition of reactivity of the organism, the patients were divided into three groups: the first one consisted of people with normoreaction; the second group included patients with hyperreaction; the third group was made up by people with hyporeaction. The patients after the initial therapy, underwent patch surgery. Initially, on the 2nd, 4th, 6th and 9th day after the operation, the clinical examination of the periodontal tissues (examination, hygienic and periodontal indices) was performed. Statistical processing of the obtained digital data was performed using the computer program Statistica 8.0. RESULTS: Results: Normoreactivity of the body determines the normal time of wound healing after patch surgery, which on the 9th day is characterized by the clinical condition of the gingival mucosa, which corresponds to the concept "healthy" for 98% of patients. In case of hyperreactivity of the organism slowing down of processes of wound healing for 3-4 days in comparison with the time which is typical for normoreactivity with dynamics of the indices which specifies long intensive character of inflammatory reaction in the postoperative period has been observed. In case of hyporeactivity of the body as well as in case of hyperreaction, there was a slowdown in wound healing for 3-4 days compared with normoreactivity with the dynamics of indices that showed slow sluggish nature of the inflammatory reaction in the postoperative period. CONCLUSION: Conclusions: Correction of altered parameters in patients with generalized periodontitis accompanied by impaired (hyper- and hypo-) reactivity of the body with bringing them to values which are typical for normoreactivity is considered to be a condition for optimizing mucosal wound healing after surgery and further stabilization of the periodontal tissues.

ANALYSIS OF THE DYNAMICS OF FUNCTIONAL OCCLUSION INDICATORS IN THE CONSTRUCTION OF OCCLUSION SURFACES OF ORTHOPEDIC STRUCTURES.

OBJECTIVE: The aim: Is to evaluate the effectiveness of the proposed method of constructing occlusal surfaces of orthopedic structures by monitoring the dynamics of functional indicators of occlusion and the functional condition of the masticatory muscles. PATIENTS AND METHODS: Materials and methods: The object of the study was made up by 64 patients with included defects of the dentition of the 3rd class according to Kennedy. Patients were divided into two equal groups - the main group (patients were treated by using the suggested method of construction of occlusal surfaces of orthopedic structures) and control (dentition defects were replaced according to the traditional protocol). RESULTS: Results: The results of evaluating the effectiveness of the proposed method showed that the index of symmetry of the anterior bundles of the temporal muscles dropped by 18.5%, the index of symmetry of the masticatory muscles reduced by 22%, the torque of the mandible reduced by 32%, the index of stabilizing occlusal - by 27%, relative efforts of balance disturbance for more than 10 % regarding the left and right reduced by a factor of 4.4, the rate of opening time was 1.5 times higher than before, the rate of time of opening of the jaws - 1.8 times. CONCLUSION: Conclusions: The use of the suggested method of orthopedic treatment with temporary structures leads to probable changes in the studied functional parameters in comparison with the control group (p <0,05).

Rheological, immunological and microbiological parameter dynamics after dental implantation.

OBJECTIVE: Introduction: It has been proven that the oral hygiene is determined by the quantitative and qualitative composition of the bacterial biofilm, by the local immunity, and the rheological properties of the oral fluid. The aim of this study was to observe the dynamics of these parameters in the short term postoperative period after dental implantation in patients with a different state of periodontal tissues, depending on maintenance therapy. PATIENTS AND METHODS: Materials and methods: 124 healthy people, aged 18 to 34, were examined. Depending on the follow-up maintenance therapy after dental implantation, patients were divided into two equal study groups: patients of the main group received the proposed differentiated maintenance therapy, the volume and multiplicity of which were determined by the initial oral hygiene state; patients of the control group underwent traditional treatment. Patients with healthy periodontium comprised a comparison group. Using the digital drop shape, the viscosity coefficient b2 was determined. Identification of the biofilm's microorganisms was carried out with aerobic and anaerobic cultivation techniques. The presence of immunoglobulin SIgA in the oral liquid was determined by Manchini's radial immunodiffusion method. RESULTS: Results: In the main group, the viscosity coefficient b2 and the content of SIgA immunoglobulin in the oral fluid were significantly higher than in the control group (p <0.05). The proposed maintenance therapy led to the restoration of the species domination of the probiotic microflora, proportional to the healthy periodontium both in the frequency of selection, and the level of insemination. The indicated dynamics of these parameters leads to a probable decrease of the Green-Vermillion HI (p<0,05). CONCLUSION: Conclusions: Proposed maintenance therapy leads to a probable improvement of the oral hygiene state based on Green-Vermillion HI, caused by the normalization of the surfactant properties of the oral liquid, biofilm's ratio of microbial associations, and local oral hygiene.