Динаміка параклінічних індексів у результаті комплексного лікування генералізованого пародонтиту у хворих на цукровий діабет І типу з кардіоміопатією

Abstract

The purpose of the study was to trace the dynamics of periodontal indices after comprehensive treatment of generalized periodontitis in patients with type I diabetes mellitus complicated by cardiomyopathy. Materials and methods. Comprehensive treatment and prevention measures were performed in 127 patients with generalized periodontitis on the background of type I diabetes mellitus with cardiomyopathy. The main group, where treatment was carried out with the help of the treatment and prevention scheme developed by us, included 82 people: 25 patients with generalized periodontitis of primary stage – I degree (30.48%); 27 patients with generalized periodontitis of the II degree (32.93%) and 30 – with generalized periodontitis of the III degree (36.59%). The control group, in which the treatment was carried out according to protocol methods, consisted of 45 patients: 14 people with primary stage – generalized periodontitis of the I degree (30.71%), 15 patients with generalized periodontitis of the II degree (33.07%) and 16 patients with generalized periodontitis of the III degree (36.22%). Given the somatic status of the examined patients due to type I diabetes mellitus with cardiomyopathy, clinical visual examination and determination of paraclinical indices were performed 30 days after treatment. The developed algorithm of treatment and prophylactic measures included both local therapy and general appointments. In the control group, the treatment of generalized periodontitis was performed according to conventional methods. Results and discussion. According to the results of the studies, on the 30th day after treatment, in patients of the main group, who were assigned to the developed treatment complex, with generalized periodontitis of the primary stage – I severity, PMA index decreased from 19.00±2.25% before treatment and was 13.17±2.26% after treatment, p >0.05. Periodontal index data in this group of subjects after treatment was 0.42±0.14 points against 0.65±0.12 points before treatment. In patients with generalized periodontitis of the II degree of severity of the main group, on the 30th day after treatment, a decrease in PMA index data was relative to pre-treatment data (28.14±2.70% versus 50.46±2.65%, p <0.01) and periodontal index (1.90±0.30 points versus 2.83±0.44 points, p <0.01). The value of the hygienic index OHI-S in this group of subjects was, after treatment, 2.15±0.71 points against 2.83±0.44 points before treatment, p >0.05. In patients with generalized periodontitis of the II degree of severity of the control group, on the 30th day after treatment, the decrease in PMA indices by 1.2 times and RI – by 1.4 times, p <0.05 with a decrease in the hygienic index by 1.3 times, p >0.05. In patients with generalized periodontitis of the III degree of severity of the main group, on the 30th day after treatment, there was a decrease in the PMA index from 64.42±2.80% before treatment to 35.18±2.70% after treatment, p <0.01. In the studied patients there was a significant decrease in the periodontal index of PI after treatment – up to 2.44±0.10 points against 3.49±0.09 points before treatment, p <0.01. Changes in the hygienic index OHI-S in patients with generalized periodontitis of the III degree of severity were 2.15±0.71 points after treatment against 3.98±1.32 points before treatment, p >0.05. In patients with generalized periodontitis on the background of type I diabetes mellitus of the main group, on average, the PMA index data were by 1.4 times lower, and PI and OHI-S indices were by 1.3 times lower (p1 <0.05, p1 >0.05, respectively) in relation to the average data in patients of the control group. In patients of the main group, the effectiveness of treatment was 42.88% against 18.09% in the control group on the PMA index. Conclusion. As a result of the studies, it can be argued that patients in the main group, where treatment was carried out using our treatment and prevention scheme, significantly improved the condition of periodontal tissues, as evidenced by clinical observations and positive dynamics of paraclinical indices in patients with generalized periodontitis of the control group, where traditional treatment regimens were ineffective