Резюме. Захворювання пародонта посідають друге місце за частотою і поширеністю після карієсу та залишаються актуальною проблемою у стоматології. Дана патологія виникає унаслідок дії цілого ряду факторів. Особливо часто патологічні процеси в пародонті зустрічаються у пацієнтів із загальносоматичними захворюваннями, зокрема в осіб із хворобами шлунково-кишкового тракту. Проведено порівняльне вивчення видового складу анаеробної мікрофлори пародонтальних кишень у пацієнтів із запально-деструктивними захворюваннями тканин пародонта на тлі Helicobacter pylori – асоційованої патології органів травлення після лікування, яке ми розробили. Мета дослідження – з’ясувати клінічну ефективність місцевої терапії на мікробіоценоз ротової порожнини у пацієнтів із генералізованим пародонтитом на тлі ураження шлунково-кишкового тракту. Матеріали і методи. Видовий склад анаеробних мікроорганізмів у пародонтальних кишенях вивчали у 52 пацієнтів (основна група) з генералізованим пародонтитом, у яких лікування захворювань пародонта проводилось із застосуванням запропонованої місцевої терапії, та 46 пацієнтів (порівняльна група) із ГП І–ІІІ ступенів тяжкості, у яких для лікування уражень тканин пародонта застосовувалась базисна місцева терапія. Детекцію патогенів у ротовій порожнині (вміст пародонтальних кишень) здійснювали методом мультипраймерної полімерно-ланцюгової реакції. Як засіб патогенетичної місцевої фармакотерапії, застосовували у вигляді аплікацій на ясна гель «Холісал». У якості місцевої фізіотерапії хворим на ГП І–ІІІ ступенів тяжкості основної групи проводили озонотерапію за допомогою озоногенератора «OzonyMed». Задля покращення і закріплення ефектів місцевої терапії застосовували полоскання, іригації, гідромасаж мінеральною водою «Моршинська», джерела № 1. Результати досліджень та їх обговорення. У віддалені терміни дослідження (12–18 місяців), незважаючи на незначне збільшення пацієнтів основної групи, у яких в пародонтальних кишенях були ідентифіковані анаеробні види мікроорганізмів, у 2,8 раза зменшилась кількість досліджуваних, у яких об’єктивізувались Helicobacter pylori та Treponema denticola; у 2,5 раза – з Fusobacterium nucleatum та Prevotella intermedia; в 1,7 раза – кількість носіїв Bacteroides forsythus, Porphyromonas gingivalis та Actinobacillus actinomycetemcomitans, (р<0,01). Кількість пацієнтів контрольної групи, де застосовувалась традиційна терапія при лікуванні ГП, у пародонтальних кишенях яких діагностувались анаеробні види мікроорганізмів, повернулась до референтних значень (р>0,05). Висновки. Зменшення кількості пацієнтів із ГП – носіїв анаеробних видів мікроорганізмів, засвідчує адекватність лікувально-профілактичного комплексу для лікування запальних захворювань тканин пародонта, який ми застосували.
The purpose of the study was to evaluate the effectiveness of the proposed treatment based on changes in radiological parameters in patients with destructive forms of apical periodontitis in the long term. Materials and methods. During the study, 185 patients with destructive forms of apical periodontitis were examined and treated. They were divided into 4 groups. Measurements of the size of the lesion in the bone tissue (for lesions of round shape) were performed by the formula: S = πr2; for lesions of elliptical shape: S = π ab, where π = 3.14; r – the radius of the circle; a – the value of the major half-axis of the ellipse; b – the length of the small half-axis of the ellipse. Results and discussion. When evaluating X-rays pictures in the treating group IV, where ("Platelet-Rich Plasma + mp3 OsteoBiol") was used for root canal obturation, after 6 months of observation, in 19 people (40.43%) foci of destruction of the bone tissue of the apical area of 1.5 mm2 and less were visualized. It was characteristic of this group of persons that there was a decrease in their number of bone tissue destruction area in sizes: 1.6 - 20 mm2 – by 1.7 times; 21 - 30 mm2 – by 2.0 times; 31 - 40 mm2 – by 2.5 times; 41 - 51 and more mm2 – by 1.3 times. It should be noted that this trend convincingly demonstrates a significant reduction in bone tissue of the periapical area in patients of group IV, and indicates in favor of the adequacy of the applied therapy using our proposed osteotropic composition. X-ray evaluation of the results of treatment of patients of group IV, in whom for the treatment of destructive forms of apical periodontitis our proposed composition ("Platelet-Rich Plasma + mp3 OsteoBiol") was used, after 12 months of research showed that in 29 patients (61.70%) foci of destruction of the apical area were not visualized; in 14 people (29.79%) the foci of osteoporosis bone tissue in the apical area were 1.5 mm2 or less. At the same time, no lesions ranging in size from 1.6 mm2 to 30 mm2 were identified in the treated group IV. At the same time, we determined a decrease in the number of treated with lesion areas: 31 - 40 mm2 – by 2.0 times; 41 - 50 mm2 – by 3.0 times and 51 mm2 and more – by 1.5 times. After 12 months of follow-up in patients of group IV, Rtg score of bone destruction was 4.27±0.61 points, which was probably higher than in patients of I, II, p, p1 <0,01, and III study groups, p2 <0.05. It was noted that at the areas of destruction of cell tissue of the periapical area from 1.6 mm2 to 30 mm2, Rtg score with a value of 5.0±0.71 points, indicated a complete restoration of bone structure; from 31 mm2 to 50 mm2 – for the reduction of the periapical process more than 1/2 and for the area of 51 mm2 and more – for the reduction of the periapical process from 1/3 to 1/2
The aim of the study was to determine the effectiveness using of osteotropic drugs for the restoration of bone defects. Materials and methods. The model experiment was performing on male Wistar rats. The animals has been simulated a bone defect into which was implanted:"mp3 Osteobiol" (1st experimental group - 14 animals), PRP coated with fibrin glue (2nd experimental group - 13 animals) and PRP + "mp3 Osteobiol" (3rd experimental group - 15 animals). The histological material were staining with hematoxylin-eosin (according to Van – Gizon). Microscopic studies were performing on a Leica MDE optical microscope at a magnification of x 100, x 200. Results. At the 60th day of observation, after implantation of "mp3 OsteoBiol" + PRP, a pronounced growth of fibrous, loose, not quite mature connective tissue was visualized, with the proliferation of giant multinucleated cells, macrophages, osteoblasts and the formation of osteoids. At the end of the experiment (90th day) in the bone regenerates of animals of group III noted the active formation of the newly formed bone lamellar structure, the formation of osteons, the bone marrow canal was filled with bone marrow. Conclusion. According to histological studies, it was found that our proposed composition, containing "mp3 OsteoBiol" and PRP, accelerated the process of bone regeneration, compared with the groups where the above agents were used alone, without inflammation, with the formation of bone, which has mature in nature.
This article presents a comparative analysis of the effectiveness of various treatment approaches, including bone mixture “mp3, Osteobiol, and platelet-enriched plasma, in the therapy of destructive forms of apical periodontitis in the early follow-up. The aim of this work is to investigate the dynamic changes in radiological and densitometric parameters depending on the treatment methods for patients with destructive forms of apical periodontitis in the early follow up period. The study involved 185 patients with destructive forms of apical periodontitis, who were examined and receive the treatment. The subjects were divided into 4 groups. Measurements of the size of the lesion in the bone tissue (for lesions of round shape) were performed by the formula: S = πr2. The area of lesions of elliptical shape was measured by the formula S = π ab, where π = 3.14; r = the radius of the circle; a = the value of the major half-axis of the ellipse; b = the length of the small half-axis of the ellipse. After 3 months of the follow up, the patients of group IV, who received the composition of platelet-rich plasma and osteoplastic material mp3 OsteoBiol, demonstrated an increase in the number of the lesions of the periapical zone sized 1.6-10 mm2 in 1.7 times, while the number of the subjects with foci of bone destruction sized 11–20 mm2 and 21–30 mm2 lowered in 2.8 times and 2.0 times, respectively. In 3 months of the follow up period, the patients of group IV showed the values of Rtg scoring of bone tissues destruction in the apical area with a lesion area of 1.6-20 mm that averaged 2.13±0.10 scores and indicated a reduction of the periapical process by 1/3. The average Rtg score in the patients of group IV (0.92 ± 0.10 points) was significantly higher than in the individuals in groups I and II, p, p 1 <0.01, and was equal to the findings obtained in the individuals of the group III, p2 > 0.05. The relative indicator of bone tissue repair in this follow up was characterized by the minimum values in the individuals of groups I and II: 0.49 ± 0.05 and 0.57 ± 0.06, p <0.05, respectively. In the groups III and IV, the value of the relative indicators of bone tissue repair were significantly higher and scored 4.82 ± 0.54, p, p1 <0.01, and 6.94 ± 0.77, p, p1 <0.01, p2 < 0.05, respectively. At the same time, the average Rtg scoring in patients of group IV was significantly higher than in the participants of groups I and II, and was identical to the values in the subjects of group III. This study has demonstrated the successful outcomes of the treatment of dystrophic forms of apical periodontitis in the early follow up period when applying the composition based on platelet-rich plasma and osteoplastic material "mp3 OsteoBiol".
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.