INCREASING THE EFFECTIVENESS OF ORTHODONTIC TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS AND PARTIAL DEFECTS AND DEFORMATIONS OF DENTITIONS AT THE STAGE OF PREPARATION FOR DENTAL PROSTHETICS
DOI:
https://doi.org/10.35220/2078-8916-2023-48-2.19Keywords:
dentition defects, dentition deformations, generalized periodontitis, orthodontic treatment, preparation for dental prosthetics, computer tomography, ELISA, platelet-enriched blood plasmaAbstract
Purpose of the study. To carry out a clinical trial of orthodontic treatment of patients with generalized periodontitis and partial defects and deformations of dentitions, added with platelet-rich blood plasma (PRP) therapy, at the stage of preparation for dental prosthetics. Research methods. It was involved 60 patients with generalized periodontitis of the I–II degree of severity, chronic course, aged 32–45 years, equally men and women, who underwent orthodontic treatment with the use of bracket systems. For the patients of the main group, the difference in the treatment was in the additional course of PRP therapy three times (in 1, 6 and 12 months). Each course included three PRP injections with an interval of one week into the transitional fold in projections of premolars of both sides on both jaws. The extensive clinical-laboratory study of patients from both research groups was carried out before and after treatment (in 1.5–2 years), using an index assessment of oral hygiene and periodontal status, and computer tomography data. The ELISA method was used to determine pro-inflammatory cytokines IL-1β, IL-6, TNF-α and anti-inflammatory IL-4 in gingival fluid samples. Scientific novelty. During the orthodontic treatment, the patients of both research groups managed to achieve a significant decrease the hygienic index. However, against the background of the similar state of oral hygiene, the course of the inflammatorydestructive process in the periodontal tissues differed reliably in the research groups. In the patients of the main group, a significant decrease in the intensity of the inflammatory process in the gums was observed within a week after the first PRP injection, while in the comparison group, its inhibition occurred gradually during a month. There were not complications of orthodontic treatment in the both research groups. However, in the patients of the comparison group it was established a further loss of bone mineral density, while in the main group this index was stable. Moreover, in these patients it was a tendency to reduce the depth of periodontal pockets and reduce the loss of epithelial attachment (Р > 0.05). For all patients, after the end of orthodontic treatment, the level of proinflammatory cytokines in the gingival fluid decreased and the level of anti-inflammatory IL-4 increased, however, only in the main group, these changes were significant (Р<0.05). Conclusions. The results of this study proved the effectiveness of the PRP-therapy in patients with generalized periodontitis undergoing orthodontic treatment. This method makes it possible to increase the periodontium stability to excessive loads due to orthodontic forces and to inhibit inflammatory phenomena that cause the development of bone tissue destruction.
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