Preview

Parodontologiya

Advanced search
Vol 25, No 3 (2020)
View or download the full issue PDF (Russian)

RESEARCH

185-188 1595
Abstract

Relevance. SARS-CoV-2 caused the pandemic of the new coronavirus infection (COVID-19) in the world. The virus belongs to the family of RNA-containing coronaviruses and is a representative of the Beta-CoV B line. Epidemiological analysis shows that the disease is transmitted by airborne droplets, airborne dust and contact routes. During dental treatment, patients are face-to-face with the doctor. Coughing, sneezing, salivation and blood may occur when using an ultrasonic or high-speed handpiece. If the patient is infected, then standard protective measures in everyday clinical work are not effective enough to prevent the spread of COVID-19, even if the patients are in an asymptomatic incubation period.

Purpose. A generalization of colleagues ’knowledge and their own practical experience is necessary for the proper organization of the provision of dental care to patients and minimization of the risk of infection in a pandemic of a new coronavirus infection.

Materials and methods. We analyzed the data of colleagues of dentists from different countries, and also presented our own understanding of the issues of dental care during a pandemic of a new coronavirus infection.

Results. In conclusion: the main important steps in the implementation of dental practice are during a pandemic: the doctor's compliance with the recommendations of the Ministry of Health of the Russian Federation on the prevention, diagnosis and treatment of new coronavirus infection (COVID-19); strict observance by the dentist and maxillofacial surgeon of the rules of their own safety; obtaining additional information from the history of possible risk factors for the patient; the correct use of the diagnostic algorithm depending on the pathology of the patient; the use of mainly disposable materials; flawless sterilization and disinfection of materials that are reused; competent aseptic processing of hands and mandatory work with gloves; prudent and proper use of personal protective equipment; disinfection measures; Class B medical waste disposal.

Conclusion. Knowledge of the clinical manifestations of the new coronavirus infection and methods for preventing infection of patients and medical personnel is necessary for each dentist and maxillofacial surgeon to prevent new episodes of spread and provide quality medical care.

190-200 948
Abstract

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.

201-205 773
Abstract

Relevance. The global trend associated with increasing life expectancy leads to an augmentation of the frequency of diseases and conditions associated with the cessation of estrogen production. Hormonal changes in the female body, which lead to changes in the mineral density of bone tissue, microcirculation, and immune status, create prerequisites for the destruction of target organs, including periodontal tissues. The highest prevalence of periodontal pathology is observed against the background of estrogen deficiency, especially during menopause. The multifactorial nature of the Association of pathologies that develop against the background of estrogen deficiency requires further study.

Purpose. Assessment of the contribution of various pathogenetic factors to the progression of oral pathology in women in the period of reproductive aging.

Materials and methods. The paper uses the results obtained during the examination of 73 patients with chronic generalized periodontitis at various stages of menopause with an assessment of the level of reproductive hormones, endothelial dysfunction, major periodontogens, and local immunity.

Results. An increase in the duration of menopause leads to the formation of endothelial dysfunction, increased destruction of periodontal bone tissue, and local immunosuppression.

Conclusion. The progression of periodontal diseases in menopause depends on many factors, including estrogen deficiency, violations of local and general blood supply, immunity disorders and microbial flora.

206-210 547
Abstract

Relevance. The incidence and mortality of oral cavity squamous cell carcinoma (OCSCC) remains a significant level in Russia. In this regard, the search for informative prognostic and predictive markers is very important.

Purpose. To determine the prevalence of DNA of oncogenic viruses in the normal mucosa and OCSCC.

Materials and methods. A prospective study was included 50 healthy volunteers and 116 patients with verified OCSCC. All patients were detected for HSV type I, type II DNA, CMV, EBV, HPV-6.11 types, HPV-16 and HPV-18 types by real-time PCR.

Results. HPV-18 DNA significantly rarer was detected in patients OCSCC vs normal mucosa (HPV-18 was detected 2.8 times less often (p <0.0001)). In OCSCC and normal oral mucosa more frequent were identified DNA HPV-18: as individually – 19 (18.0%) in normal mucosa vs 6 (5.2%) in OCSCC, and in combination with the EBV: 7 (14.0%) (control group) vs 5 (4.3%) (main group), (p = 0,03). Also, significant differences were obtained by analyzing the combination of HPV-18 with CMV, which was detected only in normal mucosa – 2 (4.0%) (p = 0.03).

Conclusion. This analysis suggests that the presence of HPV type 18 DNA in OCSCC can be considered as a favorable prognostic factor. 

211-215 722
Abstract

Relevance. The problem of treating gum recession has become particularly urgent due to the high incidence of the disease, as well as the increased aesthetic requirements of patients.

Purpose. To increase the efficiency of surgical treatment of gum recession by using non-invasive methods of correction of vascular wall endothelial dysfunction in the area of surgery.

Materials and methods. Sixty patients with gingival recession were included. They were randomly allocated in three groups based on the material used and applied methods of treatment: I group – «Mucograft», II group – «Bio-Ost MUCO Plast», III group – «Bio-Ost MUCO Plast» with THF-therapy. Sixty patients with gingival recession were included. They were randomly allocated in three groups based on the material used and applied methods of treatment: I group – «Mucograft», II group – «Bio-Ost MUCO Plast», III group – «Bio-Ost MUCO Plast» with THF-therapy.

Results. The use of THF-therapy at the atmospheric oxygen frequency of 129.0 GHz allows to activate endogenous mechanisms of blood flow normalization in the area of recession, to reduce tissue hypoxia in the preoperative period, to reduce the signs of tissue inflammatory response to traumatic surgery in eliminating recession, to correct the indices of endothelial dysfunction in the preand postoperative period, to improve blood supply to the new tissue, to reduce the wound healing time.

Conclusion. The spongy structure of the collagen matrix «Bio-Ost MUCO Plast» and the effect of THF-therapy at the atmospheric oxygen frequency of 129.0 GHz in the process of the treatment and rehabilitation of patients with gum recession provide improved microcirculation of the emerging tissue due to faster penetration of new vessels into the spongy framework.

217-223 2322
Abstract

Relevance. To successfully relieve the exacerbation of the inflammatory process in the periodontal tissues, it is necessary to resort to the use of systemic antibiotics to destroy the pathogenic microflora, especially in groups of patients with a burdened somatic history or with an aggressive course of periodontitis. The effectiveness of frequently used antibiotics may weaken over time and periodically conduct epidemiological studies of the sensitivity of periodontal pathogens to modern antibacterial drugs and inform specialists about the actualization of the use of these drugs in the complex treatment of periodontal diseases.

Purpose. Analysis of the actual effectiveness of the use of a modern systemic antibacterial drug based on ciprofloxacin and tinidazole to relieve exacerbation of inflammation in the complex treatment of periodontal diseases.

Materials and methods. The study involved 37 patients with signs of exacerbation of inflammation in the periodontal tissues. The range of examination included sequential determination of hygienic (OHI-s, SL) and periodontal (PMA, SBI) indices, probing of periodontal pockets and determination of loss of epithelial attachment (AED), the use of paraclinical examination methods: X-ray (CBCT) and microbiological (bacterial cultivation and subsequent determination of antibacterial sensitivity) studies, as well as Doppler ultrasound of periodontal tissues. To stop the exacerbation of the inflammatory reaction in the periodontal tissues, the patients were prescribed the drug "Cifran ST" according to the standard scheme recommended by the manufacturer under the control of a microbiological examination.

Results. Based on the data of clinical and paraclinical examination methods, there is a high antibacterial efficacy of the drug "Cifran ST" in relation to the studied periodontopathogens and relief of the exacerbation of the inflammatory reaction in the periodontal tissues 5 days after the administration of the drug.

Conclusion. The use of a broad-spectrum antibacterial drug "Cifran ST" helps to reduce inflammation during exacerbation of periodontitis.

225-230 952
Abstract

Relevance. The article describes the use of probiotics in dentistry. This is a possible alternative to antibiotic therapy for major periodontal diseases. The efficacy of the probiotic complex «ASEPTA PARODONTAL®» containing Lactobacillus plantarum, Lactobacillus brevis, vitamin D was studied in the gingivitis treatment.

Purpose. To prove use of the probiotic complex in patients with gingivitis.

Materials and methods. An open comparative study of the use the probiotic complex «ASEPTA PARODONTAL®» for a month was conducted, in which 37 volunteers took part, with an average age of 21.3 ± 1.0 years.

Results. After a month of using the medicine, a decrease in the hygiene index by 38,19 % and the inflammation index PMA by 46,65% were revealed. The decrease of index SBI was 63,47 %, the decrease the level of halitosis on the VAS scale was 66,23%. The biochemical indicators of saliva revealed a decrease in GOT from 22,25 ± 4,06 U/l to 7,36 ± 1,24 U/l, GPT from 14,26 ± 2,61 to 4,67 ± 1,08 U/l, saliva protein level by 70,28% to 0,63 ± 0.10 g/l, a decrease in the integral index of total antioxidant activity from 1,15 ± 0,04 to 0,81 ± 0,05 mmol/l.

Conclusion. The probiotic complex «ASEPTA PARODONTAL®» has anti-inflammatory effect and reduces the level of halitosis. The studied complex normalizes the biochemical parameters of saliva, characterizing the change in the microbiota of the oral cavity.

231-236 804
Abstract

Relevance. Contemporary Desktop scanner provides accuracy up to 5-15 micron according to the manufacturers, whereas the accuracy of intraoral scanners is near 25-30 micron. Foreign researches point out significant deviations, in some cases of more then 165 micro, of actual accuracy of different types of intraoral scanners in case dental arches scanning. Utilisation of such devices for prosthesis production can lead to unacceptable for the prosthodontic standards size of the clearance between prosthesis and its prosthetic bed.

Purpose. Comparative assessment of actual accuracy of open system desktop and intraoral scanners for getting dental models.

Materials and methods. The control model was produced using ExoCAD software and FormLab 3D printer. The model was scanned by 4 intraoral scanning devises (Identica i500, MyCrown Scan, PlanScan and Trios Wireless) and 3 stationary devices (Identica Hybrid, Open Technologies Easy and Open Technologies Neway). The matching of the scanned files and 3D analysis of the reference CAD model with test CAD models was performed in Geometric Control X software. Statistical analysis of the acquired data was performed by IBM SPSS 25.

Results. TRIOS3 Wireless showed the best accuracy among intraoral scanners (82.6 mkm) the worst result in accuracy of the acquired data was for PlanScan (224,4 mkm). Open Technologies Easy was the most accurate among desktop scanners (53.9 mkm) and the least accurate is Open Technologies NeWay (72,48 mkm).

Conclusion. Low accuracy of the intraoral scanning of the whole dental arch does not permit to use it for getting working model in case of production of the long span bridges especially in case of implant supported prosthetics.

238-244 1220
Abstract

Relevance. The development of safe and effective methods and medical products for augmentation of soft tissues in the oral cavity has been the basis for research in experimental and clinical dentistry for more than a year. The widespread use of materials for restoring the volume of soft tissues in surgical dentistry is mainly due to the requirement of patients for aesthetics in visually significant areas of the oral cavity. At the moment, the medical market offers a large number of scaffolds for the restoration of defects in the maxillofacial region, which in turn are made from biological and synthetic raw materials. Collagen matrices occupy an important place among scaffolds. Compared to commonly used inert matrices, the advantages of using combined tissue-engineering constructs with biologically active ingredients have been demonstrated. Associated with this is the growing popularity of implantable medical devices based on the use of extracellular collagen matrix. The extracellular collagen matrix serves as the basis for the growth of cell culture and is an independent matrix that transforms into healthy recipient tissue.

Purpose. An experimentally-clinical research of functional action of collagen matrix in experiment in vivo on animals.

Materials and methods. The study was conducted in the vivarium of the experimental station of the all-Russian research Institute of sheep and goat breeding. Four Mature sheep of the North Caucasian meat-wool breed aged 1.5 to 2 years were used in the in vivo experiment. The body weight of the animals was 35-40 kg. Sheeps were divided into two groups of two individuals. The first group of animals was excluded 3 months after the implantation of collagen matrix samples, the second group was excluded after 6 months. At experiments statement the principle of “divided mouth" was used, where right half of the jaw was of control, and left-hand experienced. After taking the materials from the animals, the degree of biointegration, biodegradation of the samples and vascularization of the newly formed connective tissue in the area of collagen matrix implantation were analyzed.

Results. According to the results of microscopic examination of samples of connective tissue of the inflammatory process was not revealed. Connective tissue in all samples is represented by decorated and unformed connective tissue, a large number of fibrocytes and fibroblasts were found.

Conclusion. The results showed that for soft tissue volume augmentation of the oral mucosa it is effective and safe to use samples from veal, pork collagen and dura mater. Also, experimental samples of collagen matrix showed the same results of biointegration, biodegradation and vascularization as the control ones.

246-250 2704
Abstract

Relevance. The most frequent complication in surgeries of tooth extraction on the upper jaw is perforation of the upper jaw sinus. Plastic surgery is necessary to eliminate the appeared communication. Prior to this, the dentist-surgeon should be sure of absence of chronic polyposes process in the sinus. At present the usual roentgenogram of the paranasal sinus is often proved to be not informative, while taking computer tomography is often not available in many cases either. The biochemical methods of studies of oral fluid is of possible concern in diagnostics of chronic inflammatory processes in the sinus.

Purpose. To study the dynamics of indicators of C-reactive protein and procalcitonin in the mixed saliva of patients with plastic oroantral communication caused by tooth extraction.

Materials and methods. There were studied the indicators of two inflammation markers (C-reactive protein and procalcitonin) in 62 patients of the age from 20 to 45 with oroantral communications. The patients were studied with the help of cone beam computer tomography either and after that they were divided into 2 groups. The first group included patients without x-ray signs of chronic sinus inflammation. The second group was formed by patients with marked signs of chronic inflammation of the maxillary sinus mucosa. There was studied the level of C-reactive protein and procalcitonin in the oral fluid of 23 volunteers (control group). The studies were started 2-3 days after the tooth extraction.

Results. It was determined that before the operation the level of markers was statistically essentially increased in comparison with the control group in all patients with oroantral communications. In the first group C-reactive protein was increased 2,7 times, procalcitonin – 2,4 times. In the second group accordingly 3,1 and 3,3 times. By the 3rd day after the operation the concentration of markers increased more. However in the first group the C-reactive protein increased 3,3 times if compared with the control group and procalcitonin -3,6 times. In the second group – 8,6 and 8,4 times accordingly. By the seventh day after the operation the concentration of the inflammation markers decreased statistically essentially, but while in the 1st group it approached to the norm level, the second group revealed C-reactive protein staying 4,5 times higher than normal and procalcitonin was 4,7 times higher.

Conclusion. The indicators of C-reactive protein and procalcitonin in the oral fluid of patients with oroantral communications are the markers of high sensitivity of the acute inflammation and they can be used either for the verification of the diagnosis or for the monitoring of the disease dynamics in post-operative period.

251-255 740
Abstract

Relevance. A significant group is occupied by risk factors that completely depend directly on the socio-hygienic aspects of the patient's lifestyle.

Purpose. To study the impact of the nature of nutrition and oral hygiene on the dental health of adults in modern conditions. Materials and methods. To identify and assess the risk factors for dental caries, a questionnaire was developed and 121 patients from dental clinics in Kazan were interviewed. A discriminant analysis of a group of risk factors for dental caries was performed. We also conducted a comparative analysis of oral hygiene in 36 people using a manual toothbrush and the new device (toothbrush) for cleaning all surfaces of the teeth.

Results. The majority of the respondents (95,0%) brush their teeth 2 times a day with a cleaning time of 2 minutes (64,5%), and equally use both electric and manual toothbrushes. However, the frequency of brushing does not correspond to the mode and frequency of consumption of foods with easily fermentable carbohydrates in the diet, sugar-containing beverages, which has a direct impact on the occurrence of dental caries and periodontal diseases. The nature of nutrition significantly affects the development of caries of all teeth, except for the incisors of the maxilla. Brushing your teeth with a frequency of less than 2 times a day also contributes to the development of caries (except for premolars and molars of the maxilla). To improve the level of dental health of the population and prevent the development of dental caries and periodontal diseases in adults a new device (toothbrush) for cleaning all surfaces of teeth has been proposed.

Conclusion. The results of the study emphasize the practical importance of analyzing the risk factors for the development of dental caries in the adult population with the possibility of conducting reasonable, targeted correction methods to minimize the risk of further disease progression.

256-262 573
Abstract

Relevance. Chronic inflammation of periodontal tissues in young people.

Purpose. The aim of the work was to study of the effectiveness of the influence of a diode laser on the state of the microbiome of various biotopes of the oral cavity in patients with early manifestations of chronic inflammation.

Materials and methods. 70 patients (66.7%) with chronic gingivitis and periodontitis of mild severity, aged 23–35 years, were examined. A control group was consisted of 35 patients (33.3%) with clinically intact periodontium (CIP). Researchers in this group have the goal of determining critical values (22.9%) and conducting the proposed range of treatment and preventive measures. Clinical and microbiological research methods were used to assess the effectiveness of the proposed treatment and prophylactic complex.

Results. Our results showed high efficiency of the treatment and prophylactic complex in the treatment of early manifestations of chronic inflammation of periodontal tissues. The use of the method of simultaneous processing of the studied biotopes of the oral cavity in the complex of treatment and prophylactic measures has a positive trend. Under the influence of this effect significant elimination of periodontal pathogens of the first order and a decrease in the degree of chronic inflammation (p < 0.05) from the initial data are observed in patients with early manifestations of chronic inflammation in periodontal tissues.

Conclusion. The data obtained on the basis of the study indicate that the developed treatment and oral care are an effective method for correcting the state of the microbiome of the studied biotopes.

REVIEW

180-184 1101
Abstract

Relevance. The life expectancy of people with HIV has increased thanks to the use of specific antiretroviral therapy (ART). Currently, one of the urgent medical problems for this cohort is osteoporosis. Immune reconstitution during ART leads to a sustained inflammatory reaction in the body, the release of cytokines, and activation of osteoclasts. Osteoporosis often causes complications in periodontology and implantology. The significant need of HIV-infected people for these types of dental care and the prevalence of periodontitis, including generalized forms, also determine the importance of this issue.

Purpose. To identify the common links in the pathogenesis of systemic (osteoporosis – hereinafter referred to as OP) and local (jaw bones in periodontitis) osteoresorption, the main methods for the diagnosis, treatment and prevention of OP associated with HIV infection, its effect on the results of implantological treatment of adentia in this population.

Materials and methods. Analysis of publications in scientific periodicals on OP + Periodontal Pathology + HIV/AIDS over the past decade (PubMed, Medline, Elibrary).

Results. The etiology of bone structure disorders is multifactorial: chronic inflammation, direct impact of HIV on osteocytes, effect of ART (viral protease inhibitors) on bone metabolism and remodeling. The planning of specific therapeutic interventions should be individualized and aimed at the key links in the pathogenesis of osteoresorption (osteoprotectors, antiinflammatory agents, bisphosphonates, calcium supplements, vitamin D).

Conclusion. The effectiveness of the bisphosphonate therapy of OP in this cohort and DEXA screening to control the risk of osteoresorption suggest a very likely clinically justified implantation method for the treatment of tooth loss in HIV infection. Topical issues of OP and periodontal pathology in connection with the aging of HIV patients should be considered as related. For them, the planning of specific diagnostic (DEXA, biochemical screening) and therapeutic (remineralizing agents, osteoprotectors, etc.) strategies involving narrowly specialized doctors (endocrinologists, gastroenterologists, etc.) becomes a decisive.



ISSN 1683-3759 (Print)
ISSN 1726-7269 (Online)