This article presents the etiopathogenetic-based methods of treating patients with chronic generalized inflammatory-destructive periodontal diseases periodontitis, which are mostly multicomponent and are performed in stages. The comprehensive therapy of inflammatory-destructive periodontal diseases should include the identification of common and local endogenous and exogenous parodontopathogenic factors and disease predictors, with the aim of normalizing the microbioprofile in periodontal pockets, providing osteoregeneratory, biostimulating, and normalizing effects on the microhemocirculation, relying on the achievements of genetics and epigenetics, personalized, and meet the requirements of evidence.
Subject. Periodontitis is an inflammatory and destructive process in periodontal tissues, the main etiological factor of which, according to modern concepts, is the microbial invasion of the gingival groove by qualitatively and quantitatively modified microorganisms of cervical plaque. Based on the etiopathogenetic bacterial-vascular mechanisms of the occurrence and progression of inflammatory and destructive periodontal diseases, the use of low-energy (low-intensity) laser exposure was included in all the algorithms for the comprehensive treatment of periodontitis that we studied. Objective: to study the effect of low-intensity laser radiation in combination with local non-steroidal anti-inflammatory drugs on the effectiveness of complex treatment of periodontitis. Methodology. The study involved 120 patients (60 men and 60 women), equally divided into four groups depending on the treatment performed. A randomized controlled trial with discrete longitudinal open observation was conducted. The therapy included the implementation of professional oral hygiene using an ultrasound apparatus, sandblasting, polishing all surfaces of the teeth, a hygiene lesson, recommendations. The methodology of pharmacological treatment was to perform the application of the anti-inflammatory drugs Oralsept and Arkoxia to the periodontal area for 15 minutes with a course of 10 procedures. In the second and fourth groups, low-energy laser exposure was performed using the Optodan apparatus in the second mode for 15 minutes. The course of therapy was 10 procedures. The clinical study was conducted according to generally accepted principles with mandatory x-ray control and an index assessment of the periodontal condition. Results. After a six-month observation period, in the first and third groups, there was a deterioration in both index and hemodynamic digital data, and in the second and fourth indicators remained at a fairly positive level, indicating the effectiveness of the therapy. Conclusions. The use of NLV increases the effectiveness of local exposure to non-steroidal anti-inflammatory drugs "Arkoxia" and "Oralsept" by 16 and 19 % respectively. The positive effect of NLV is maintained throughout the observation period.
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