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BACKGROUND: Previous studies have shown high clinical efficacy of the course combined use of a low-frequency electrostatic field and low-intensity infrared laser therapy in patients with peri-implantitis. It was shown that the use of these physiotherapeutic factors is accompanied by the development of anti-inflammatory and analgesic effects, increased tissue blood flow in the area of therapeutic exposure, as well as activation of trophic-regenerative processes that determine the degree of osseointegration of implants. However, along with resolving the issue of the current relief of clinical manifestations of peri-implantitis, an important point is the study of the long-term effect of the treatment method used. Evaluation of long-term results makes it possible to determine the duration of the preservation of the therapeutic effect, which makes it possible to determine the optimal parameters of the frequency and frequency of the therapeutic effects. AIMS: Evaluation of complex physiotherapeutic treatment of patients with post-prosthetic inflammatory complications during dental implantation in the long-term period (after 6 and 12 months). MATERIAL AND METHODS: The study was carried out with the participation of 132 patients aged 35 to 57 years with a clinically and radiologically confirmed diagnosis of class I and II peri-implantitis. All patients were divided into 4 groups by the method of simple fixed randomization. The first group (control group, 31 patients) received standard dental treatment, including professional oral hygiene, removal of dental plaque and granulation, and debridement of peri-implant pockets. In the second group (main I, 31 patients), in addition to the standard therapy, a course of laser therapy was carried out using the BTL-4000 physiotherapy apparatus. In the third group (main II, 30 patients), the standard treatment was supplemented with a course of low-frequency electrotherapy. The fourth group (main III, 31 patients), along with standard treatment, received low-frequency electrotherapy in combination with laser therapy. Long-term results were assessed 6 and 12 months after the end of therapy using clinical-functional, biochemical and psychological methods. RESULTS: The course combined use of a laser and a low-frequency electrostatic field as a supplement to the standard treatment protocol for patients with peri-implantitis ensures the maximum preservation of higher indicators characterizing the restoration of the functions of the dentition, aesthetic parameters of the face and an increase in the quality of life of patients in general. CONCLUSION: Taking into account the risk of developing a possible exacerbation of the inflammatory process, as well as the dynamics of the studied clinical and functional parameters in patients with peri-implantitis in the long-term period, it was concluded that it is necessary to conduct repeated courses of combined use of an infrared laser and low-frequency electrostatic therapy in 69 months.
BACKGROUND: Previous studies have shown high clinical efficacy of the course combined use of a low-frequency electrostatic field and low-intensity infrared laser therapy in patients with peri-implantitis. It was shown that the use of these physiotherapeutic factors is accompanied by the development of anti-inflammatory and analgesic effects, increased tissue blood flow in the area of therapeutic exposure, as well as activation of trophic-regenerative processes that determine the degree of osseointegration of implants. However, along with resolving the issue of the current relief of clinical manifestations of peri-implantitis, an important point is the study of the long-term effect of the treatment method used. Evaluation of long-term results makes it possible to determine the duration of the preservation of the therapeutic effect, which makes it possible to determine the optimal parameters of the frequency and frequency of the therapeutic effects. AIMS: Evaluation of complex physiotherapeutic treatment of patients with post-prosthetic inflammatory complications during dental implantation in the long-term period (after 6 and 12 months). MATERIAL AND METHODS: The study was carried out with the participation of 132 patients aged 35 to 57 years with a clinically and radiologically confirmed diagnosis of class I and II peri-implantitis. All patients were divided into 4 groups by the method of simple fixed randomization. The first group (control group, 31 patients) received standard dental treatment, including professional oral hygiene, removal of dental plaque and granulation, and debridement of peri-implant pockets. In the second group (main I, 31 patients), in addition to the standard therapy, a course of laser therapy was carried out using the BTL-4000 physiotherapy apparatus. In the third group (main II, 30 patients), the standard treatment was supplemented with a course of low-frequency electrotherapy. The fourth group (main III, 31 patients), along with standard treatment, received low-frequency electrotherapy in combination with laser therapy. Long-term results were assessed 6 and 12 months after the end of therapy using clinical-functional, biochemical and psychological methods. RESULTS: The course combined use of a laser and a low-frequency electrostatic field as a supplement to the standard treatment protocol for patients with peri-implantitis ensures the maximum preservation of higher indicators characterizing the restoration of the functions of the dentition, aesthetic parameters of the face and an increase in the quality of life of patients in general. CONCLUSION: Taking into account the risk of developing a possible exacerbation of the inflammatory process, as well as the dynamics of the studied clinical and functional parameters in patients with peri-implantitis in the long-term period, it was concluded that it is necessary to conduct repeated courses of combined use of an infrared laser and low-frequency electrostatic therapy in 69 months.
BACKGROUND: The use of dental implants, being the gold standard in the dental rehabilitation of edentulous patients, is often accompanied by the development of inflammatory complications leading to loss of the implant. Common methods in dental practice for the prevention and treatment of peri-implantitis based on local antiseptic and antibacterial drugs and periodic measures of professional oral hygiene are limited and do not contribute to solving the existing problem. AIM: Assessment of the clinical effectiveness and dynamics of the quality of life of patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination. MATERIALS AND METHODS: the study was carried out with the participation of 116 patients with peri-implantitis of classes I and II according to S.A. Jovanovic. All patients were divided into 4 groups using simple fixed randomization. The first group (control; n=28) received standard dental therapy, including professional oral hygiene and local use of antiseptics. In the second group (comparison group 1; n=29), in addition to standard therapy, a course of ozone therapy was performed, for which the peri-implant area was irrigated with ozonated saline solution with an ozone concentration of 2.5–5.5 μg/ml for 15 minutes. In the third group (comparison group 2; n=30), standard treatment was supplemented with a course of MDM therapy. Patients of the fourth group (main group; n=29), along with standard treatment, received complex treatment, including a course of ozone therapy and MDM therapy. The results were assessed after the end of therapy based on the dynamics of dental indices, the osseointegration parameter of the implant and the level of quality of life of the patients. RESULTS: A course of use of various treatment regimens was accompanied by a significant improvement in the clinical and dental status of patients, but the severity of the effect was different in the groups. To a lesser extent, positive changes were identified in the control group. Additional course use of therapeutic physical factors (ozone and MDM therapy) was accompanied by a significant increase in regression of complaints and improvement in objective indicators of dental status. Achieving the maximum positive result was clearly evident in the main group with the complex use of the studied physiotherapeutic factors. The use of the correlation adaptometry method to assess the clinical effectiveness of various treatment regimens for peri-implantitis made it possible to establish that under the influence of the integrated use of ozone and MDM therapy, the most pronounced decrease in mutual correlations between the studied parameters is observed. This indicates an increase in functional reserves and adaptive capabilities of patients in the main group. CONCLUSION: the results obtained convincingly prove the high effectiveness of the complex use of therapeutic physical factors in the implementation of a therapeutic strategy aimed at eliminating inflammatory manifestations in the area of dental implants and improving the quality of life of patients.
BACKGROUND: Significant prevalence of inflammatory complications after dental implantation determines the necessity to search for a more effective solution of this problem with the formation of a comprehensive program of prevention and treatment of peri-implant diseases and its integration into the modern concept of dental rehabilitation. AIM: Study of oxidative stress patterns, level of pro- and anti-inflammatory cytokines in patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination. MATERIALS AND METHODS: The study was carried out with participation of 116 patients with peri-implantitis of I and II classes according to S.A. Jovanovic. By means of simple fixed randomization (based on random numbers generation by computer program) all patients were divided into 4 groups. The first group (control group, n=28) received standard dental therapy, including professional oral hygiene and local application of antiseptic agents. In the second group (comparison group 1, n=29) in addition to the standard therapy the course ozone therapy was carried out, for which the peri-implant zone was irrigated with ozonized physiological solution with ozone concentration 2.5–5.5 mcg/ml for 15 min. In the third group (comparison group 2, n=30) the standard treatment was supplemented with the course application of mesodiencephalic modulation. Patients of the fourth group (main group, n=29) along with the standard treatment received complex treatment including course application of ozone therapy and mesodiencephalic modulation. The results were evaluated after the end of therapy by the dynamics of oxidative stress markers and the content of pro- and anti-inflammatory cytokines. The assessment of clinical efficacy in randomized groups was based on the determination of oral hygiene indexes, papilla bleeding and papillo-marginal-alveolar index, as well as the implant stability coefficient. RESULTS: The use of different therapy schemes caused changes in the patterns of peroxidation metabolism and cytokine status, the intensity of which had different character. In the least degree the corrective activity was revealed in the control group of patients. Supplementation of standard treatment with therapeutic physical factors was accompanied by more pronounced dynamics of the estimated parameters, the direction of which indicated normalization of the lipoperoxidation system and cytokine mechanism of inflammation. Maximum changes of the estimated parameters were revealed in the main group, where the standard therapy was supplemented with a course complex application of mesodiencephalic modulation and ozone therapy. This was manifested in the strengthening of antioxidant activity of enzymes and reduction of the level of lipoperoxidation products to the level of the healthy group, as well as regression of the level of proinflammatory factors against the background of an increase in the level of mediator with anti-inflammatory effect. CONCLUSION: The obtained results convincingly prove the pronounced synergetic interaction observed at course complex application of mesodiencephalic modulation and ozone, characterized by the development of maximum corrective effect aimed at the restoration of pro- and antioxidant equilibrium and reduction of cytokine mechanism activity of inflammation in peri-implant zone. The analysis of the revealed correlations of the biochemical parameters with the index indicators of the dental status of the patients with peri-implantitis allows to consider some indicators of the pro- and antioxidant system and cytokine status as biomarkers determining the prognosis of the treatment efficiency.
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