Evaluation of the long-term results of the effect of different application adhesive agents in the complex of local treatment of recurrent aphthae of the oral cavity in patients against the background of clinical manifestations of classical and mediated hypersecretory diseases of the gastrointestinal tract

Abstract

The goal of the study is to evaluate the long-term results of local treatment and to identify risk predictors of increased recurrence rate of aphthous stomatitis after treatment in patients against the background of clinical manifestations of classical and mediated hypersecretory diseases of the gastrointestinal tract.
Materials and methods.
Fifty-eight individuals with recurrent aphthous stomatitis (K12.0) against the background of clinical manifestations of classical and mediated hypersecretory diseases of the gastrointestinal tract (GI) have been selected by the method of a monocentric observational uncontrolled prospective study. Poisson regression has been used to identify risk predictors of increased recurrence rate of aphthous stomatitis after treatment.
Results.
The recurrence rate of aphthous stomatitis 2 times a year prevails in patients against the background of manifestations of classical and mediated hypersecretory GI diseases. Among men, clinical manifestations of recurrent oral aphthae with a frequency of once a year have been detected in 56% of cases, twice a year in 33% of cases, and 3 times a year in 11%. In women, these indicators are as follows: once a year — 35%, twice a year — 55%, 3 times a year — 10%. The synergistic effect of the complex possessing a pronounced antiseptic, antimicrobial, antifungal, anti-inflammatory effect due to the adhesive property of Cholisal and diode laser, epithelization and regeneration of the oral mucosa due to the powdered form of platelet autologous plasma in the aggregate had a significant advantage over the well-known treatment, and also influenced the reduction of the recurrence rate. The treatment complex proposed in subgroups with chronic hypersecretory gastritis and duodenitis contributed to the absence of recurrences (p<0.001) as compared to the patients with chronic pancreatitis with hyperacid gastric secretion (p<0.05) during the follow-up period of up to a year. In the clinical subgroups using the well-known method, no effect has been achieved in reducing the recurrence rate during one year of follow-up. The Poisson regression identified risk predictors of increased recurrence rate of aphthous stomatitis within one year of treatment: duration of GI disease (HR=1.259, 95% CI: 1.187—1.338), presence of classic GI disease in a patient as compared to the presence of mediated disease (HR=1.150, 95% CI: 1.083—1.221), the treatment complex proposed as compared to the well-known treatment (HR=0.941, 95% CI: 0.912—0.969).
Conclusion.
In patients with recurrent aphthous stomatitis (K12.0) manifested against the background of classical and mediated hypersecretory diseases of the gastrointestinal tract, the applied three-stage complex of local treatment in conjunction with supportive and antiretroviral therapy contributes to the reduction of the recurrence rate.