DOI:

10.37988/1811-153X_2021_4_42

Efficiency of therapy of inflammatory periodontal pathology in patients with different non-specific adaptive responses of the body

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Authors

  • V.V. Erichev 1, PhD in Medical Sciences, professor of the Dentistry Department at the Faculty of Advanced training and professional retraining
    ORCID ID: 0000-0003-3226-4361
  • T.V. Aksenova 1, PhD in Medical Sciences, associate professor of the Dentistry Department at the Faculty of Advanced training and professional retraining
    ORCID ID: 0000-0003-2921-2982
  • E.S. Ovcharenko 1, PhD in Medical Sciences, associate professor of the Dentistry Department at the Faculty of Advanced training and professional retraining
    ORCID ID: 0000-0002-0132-2517
  • N.P. Bagdasaryan 1, 2, postgraduate at the Dentistry Department;
    ORCID ID: 0000-0002-3427-5411
  • S.V. Melekhov 3, PhD in Medical Sciences, full professor, director
    ORCID ID: 0000-0003-0987-9800
  • S.A. Karapetov 1, assistant at the Dentistry Department at the Faculty of Advanced training and professional retraining
    ORCID ID: 0000-0003-4281-1330
  • 1 Kuban State Medical University, 350063, Krasnodar, Russia
  • 2 Dental Clinic No. 1, 350033, Krasnodar, Russia
  • 3 “Metrostom” Dental Training Center, 350027, Krasnodar, Russia

Abstract

The effectiveness and dynamics of therapy of any pathology depends on the state of the body’s adaptive potential, therefore, this issue requires a detailed and substantiated study. A poorly illuminated direction in the study of the etiology, pathogenesis and prevention of inflammatory periodontal diseases, remains the study of the local and general immune response of the body against the background of favorable and unfavorable nonspecific adaptive reactions of the body. The aim of the study is to evaluate the effectiveness of traditional therapy for inflammatory periodontal diseases in patients with various types of nonspecific adaptive reactions of the body.
Materials and methods.
The study involved 106 patients, including 79 patients with exacerbation of chronic generalized catarrhal gingivitis and exacerbation of chronic generalized periodontitis of moderate severity. The content of the studied cytokines was determined in the papillary blood before treatment and after 3 months of treatment. At the same time, the types of non-specific adaptive reactions of the body were detected. Also, the cytokine balance coefficient was calculated according to the algorithm proposed by the authors. Results: It was revealed the presence in 78% and 94.7% of cases of unfavorable and 22% and 9.7% of cases — favorable types of nonspecific adaptive reactions of the body with exacerbation of chronic generalized catarrhal gingivitis of chronic generalized periodontitis of moderate severity, which is accompanied by an imbalance of cytokines in the blood of the papillary gums. At the same time, there is a significant increase in the level of TNF-α and IL-8, which correlates with the severity of the pathology and low levels of IL-4. In 60% of patients with exacerbation of periodontitis and 80% of patients with exacerbation of gingivitis with unfavorable types of nonspecific adaptive reactions of the body against the background of traditional therapy, there is a significant decrease in the level of IFN-γ by 3 times compared with the results before treatment. In 3 months after the traditional treatment in both groups, there is a positive dynamics of all the studied periodontal indices. The dynamics was directly proportional to the improvement of the clinical status in the oral cavity in 85% of patients against the background of favorable types of nonspecific adaptive reactions of the body. In 20% of patients, clinical symptoms and complaints of bleeding gums, tooth mobility, and the presence of mineralized dental deposits were observed against the background of unfavorable types of nonspecific adaptive reactions of the body.
Conclusion.
Therefore, in 3 months after the treatment, in 20% of patients with inflammatory periodontal diseases against the background of unfavorable types of nonspecific adaptive types of body reactions, the amount of plaque on the proximal surfaces of the teeth increased and the API index increase was determined. As well, clinical symptoms of inflammatory phenomena in the gingivitis are observed, accompanied by an unfavorable increase in the coefficient of cytokine balance, which in the future can lead to the transformation of gingivitis into periodontitis and the chronicity of the inflammatory process. Following our recommendations, it is required that patients with such clinical and immunological parameters should undergo routine dental examinations not 2 times a year, but 3—4 times a year for individual supportive therapy.

Key words:

gingivitis, periodontitis, non-specific adaptive reactions of the body, interferon-gamma, TNF-alpha, IL-8, IL-4

For Citation

[1]
Erichev V.V., Aksenova T.V., Ovcharenko E.S., Bagdasaryan N.P., Melekhov S.V., Karapetov S.A. Efficiency of therapy of inflammatory periodontal pathology in patients with different non-specific adaptive responses of the body. Clinical Dentistry (Russia).  2021; 24 (4): 42—49. DOI: 10.37988/1811-153X_2021_4_42

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Received

June 15, 2021

Accepted

October 18, 2021

Published on

December 1, 2021