Abstract
Background. The article has explored the problem of the diagnostics of parodontal tissue destruction and revealed the interrelation between the immunoreactivity level and the intensity of resorptive processes. Such biochemical indices as the concentrations of lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) were used as detectors of destructive disease. Polyoxidonium has been suggested as an immunomodulator, as it promotes faster immune and clinical recovery compared to the conventional treatment regimens. Objectives. To estimate the dynamics of destructive pathology indicators (level of LDH and ALP) in paradontium changes, depending on the immunomodulation, added to the combined treatment regimen of elderly patients with periodontitis. Methods. 2 patient cohorts of 67 elderly persons with chronic generalized periodontitis were examined. The conventional treatment was administered in all patient groups. The patients in the second cohort, along with other medications, received Polyoxidonium. The examination included gingival fluid and venous blood sampling, estimation of LDH and ALP concentration as well as evaluation of periodontium indices (papillary-marginal-alveolar index and gingival bleeding index). Results. The study has revealed the rise of LDH and ALP in gingival fluid and venous blood. The recovery trend was observed in both cohorts, with a more marked dynamics in the second one. The mean values of enzyme concentration in the 2-nd group (since the 14th day) were statistically significant compared to the similar measures in the 1st one. After 3 months follow-up the substantial growth of LDH and ALP concentration was registered in the 1st cohort, whereas the 2nd one still showed the recovery trend. Conclusions. The inclusion of immunomodulator Polyoxidonium into the conventional treatment protocol of periodontitis promotes the effectiveness of the therapeutic intervention, discontinues resorptive processes and stabilizes reparative processes in the paradontium.
Highlights
The article has explored the problem of the diagnostics of parodontal tissue destruction and revealed the interrelation between the immunoreactivity level and the intensity of resorptive processes
The inclusion of immunomodulator Polyoxidonium into the conventional treatment protocol of periodontitis promotes the effectiveness of the therapeutic intervention, discontinues resorptive processes and stabilizes reparative processes in the paradontium
Но вместе с тем подобные сдвиги в иммунологической реактивности пожилого человека далеко не безразличны для состояния его стоматологического здоровья, а значит, требуют коррекции [1, 4, 8, 22, 25]
Summary
The article has explored the problem of the diagnostics of parodontal tissue destruction and revealed the interrelation between the immunoreactivity level and the intensity of resorptive processes. Повышение концентрации указанных ферментов индуцируется факторами иммунной системы (как клеточными, так и гуморальными) и может быть скорректировано иммуномодулирующей терапией, направленной на гармонизацию иммунологической реактивности, что опосредованно повлияет на резорбтивные процессы, нивелируя тканевую деструкцию [5, 8, 24]. Цель исследования — определить динамику показателей тканевой деструкции пародонтального комплекса (уровень ЛДГ и ЩФ) в зависимости от включения этапа иммуномодулирующей терапии в схему комплексного лечения лиц пожилого возраста, страдающих хроническим генерализованным пародонтитом.
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