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.
