Corrective effect of immunological drugs on oral microbiozinosis in patients with chronical apical periodontitis against the background of oral dysbiosis

Relevance. One of the main causes of periodontitis is oral dysbiosis, in which changes in the quantitative and qualitative composition of the microflora occur, the systems of interaction between the microorganism and the microbiota are disturbed, and immunity is reduced. Is to study the comparative anti-disbiotic efcacy of various immunobiological preparations in patients with chronic apical periodontitis against the background of oral dysbiosis.

Materials and methods. The study included 66 patients who were divided into 2 groups: comparisons (n = 34) and main (n = 32). Each group was divided into three subgroups depending on the degree of dysbiosis of the oral cavity according to the method of A.P. Levitsky (2007): determination of the ratio of the relative activities of urease and saliva lysozyme. All patients underwent traditional endodontic treatment and oral hygiene with parallel correction of oral microbiocenosis through the use of a complex of immunomodulatory drugs to patients of the main group.

Results. In chronic apical periodontitis, urease activity was signifcantly increased, and in those examined with grade II-III dysbiosis almost 2 times compared with patients with grade I severity of clinical manifestations. The proposed treatment reduced the activity of urease in patients in all three subgroups of both groups (main and comparison). The results indicate a signifcant decrease in the activity of lysozyme in all patients more than 2 times. Conducted traditional treatment (comparison group) increased activity, but did not lead to a recovery in the rate of healthy individuals. The use of immunomodulatory drugs allowed to increase the level of lysozyme to the indicators of the control group.

Conclusions. The inclusion of immunobiological preparations in the complex therapy of chronic apical periodontitis against the background of oral dysbiosis eliminates the dysbiotic phenomena in the oral cavity and has a therapeutic effect on destructive processes in the periapical tissues that are difcult to treat and often recur.

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