Microcirculatory changes in periodontal tissues of patients with periodontitis in the dynamics of physical therapy

Relevance. The prevalence of periodontal diseases among the population of different countries remains at a high level every year. The study of pathogenetic mechanisms of the disease and the search for effective treatment methods for patients with chronic generalized periodontitis remain relevant. Important in the pathogenetic treatment of periodontitis are methods aimed at normalizing hemodynamics in periodontal tissues. Physiotherapeutic methods of treatment are widely used. Today, a large number of modern physiotherapy equipment has appeared on the dental market. However, in the budget health care institutions of the Udmurt Republic, the staffing of routine devices remains quite high.

Purpose. The aim is to study the hemodynamic parameters of periodontal tissues in the dynamics of treatment of patients with chronic generalized periodontitis using routine and innovative methods of physical therapy.

Materials and methods. The study was conducted in 500 patients with chronic generalized periodontitis of moderate severity. Аll the examined patients were divided into 5 groups of 100 people each: in the control group, only professional hygiene was performed using ultrasound and zone – specific scalers; in the first main group, after professional hygiene, a course of physiotherapy was prescribed using a Picasso led laser with a wavelength of 810 nm; the second main group course of physical treatment of periodontitis conducted by the device “ОzoneDTA”; in the first group comparison physiotherapy treatment included the effect on the tissues of the periodontal apparatus “Optodan”, and the second comparison group used darsonvalization unit “Iskra-1”. Professional hygiene was performed once every 3 months, and physical therapy was performed once every 6 months for 12 months of follow-up. The monitoring of clinical indicators was carried out in time: before treatment, 3.6 and 12 months after the start of follow-up. Microcirculation of periodontal tissues during physiotherapy was evaluated by photoplethysmography using the method of Z. M. Segal (1984) with a computer device.

Results. It was found that during physiotherapy treatment, microcirculation in periodontal tissues increases in the nearest time (after a week and 3 months), while maintaining stable hemodynamics for 12 months of follow-up, while in the control group, where physiotherapy was not performed, but professional hygiene was prolonged once every 3 months, improvement of hemodynamics was noted only at the end of the follow-up period-in a year. The most favorable clinical indicators were also observed in the groups where the devices were used during treatment. Аfter 12 months, especially significant differences were observed in the PMA index.

Conclusion. Physiotherapy methods help to increase hemodynamics in periodontal tissues. Modern physiotherapy devices – the Picasso diode laser and the Ozonedta device-have a more intensive effect on the linear systolic blood flow rate.they also significantly increase the anti-inflammatory effect of treatment of chronic generalized periodontitis in patients.

microcirculation, photoplethysmography, physical therapy, instrumental methods, periodontitis

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