Comparative evaluation of changes in the periodontal microbiome in patients with chronic generalized periodontitis after Vector-therapy

Relevance. The development and implementation into wide clinical practice an effective methods for removing subgingival biofilms, which allow qualitatively removing periodontopathogens and preserving the structure of the root surface for the subsequent restoration of the supporting-retaining apparatus of the tooth, is an important aspect in the treatment of chronic generalized periodontitis.

Purpose. To evaluate the effectiveness of removing microbial biofilm in patients with chronic generalized periodontitis using Vector-therapy in comparison with hand-held instruments.

Materials and methods. The study involved 119 patients (68 women and 51 men) in the age of 26-70 years (mean age 47.0 ± 12.5 years) with chronic generalized periodontitis of moderate and severe degree. The patients were divided into 3 groups depending on the method of root surface treatment (Curettes, Vector Paro, combined Curette Vector Paro treatment). Patients of all groups was evaluated such parameters, as BOP, PD / HPA, CAL / RFP and radiological parameters. For microbiological examination, real-time PCR was used with the sampling of the contents of the periodontal pocket before treatment for 10 days and 6 weeks. The dynamics of clinical indicators, frequency of occurrence, absolute, and the participation of key periodontal pathogenic microorganisms (A. actinomycetemcomitans, P. Gingivalis, P. intermedia, T. forsythia, T. denticola) and Candida albicans from the total bacterial mass of the contents of the periodontal pocket were assessed. The results were processed statistically using the Statistica software.

Results. When comparing the groups with each other, a statistically significant relationship was found for a decrease in PB in group 2 (Vector) and group 3 (Curettes Vector Paro) in group 1 (Curettes), an inverse correlation between the level of bleeding (BOR) at a follow-up of 10 days (rs -0.463, p < 0.001) and 6 weeks (rs -0.342, p-value 0.025) and by the method of removing subgingival dental plaque. Statistically significant changes in the frequency of occurrence, number and proportion of periodontal pathogenic microorganisms in the groups were found in the dynamics of observation, indicating changes in the structure of the subgingival microbiome.

Conclusion. The inclusion of Vector therapy in conservative treatment significantly accelerates the timing of inflammation in the periodontal tissues and leads to some significant shifts in the structure of the subgingival microbiome.

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