A differentiated approach to treatment of inflammatory periodontal diseases in patients with chronic viral hepatitis

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Currently, in the CIS countries there is an unfavorable epidemic situation for hepatitis B and C, which predominate in the structure of parenteral viral hepatitis [1,3,5]. In terms of the breadth of distribution, degree of morbidity, severity, frequency of development of chronic forms, and economic damage, this type of viral hepatitis ranks among the first in human infectious pathology [6,18]. From 2020 to 2023, a clinical and instrumental study of the condition of periodontal tissues in chronic diffuse liver diseases of viral origin was conducted in 110 patients aged 20–60 years at the Samarkand Regional Dental Clinic. At the first stage, out of 110 participants of the study group, there were 50 patients with mixed infection of viral hepatitis B, group B+C-2. Control group 3 consisted of 25 people with chronic periodontal diseases without chronic viral liver diseases. At the second stage, to further compare the effectiveness of our complex immunocorrective and anti-inflammatory therapy, against the background of a mixed infection of chronic viral hepatitis B, C, and B+C, patients with mild, moderate, and severe chronic general periodontitis were divided into two groups: 1 — control group (39 patients with chronic viral hepatitis who received traditional treatment for chronic general periodontitis); 2 — microbial contamination in the oral cavity of the patients showed that strains of Staphylococcus epidermidis (38.1 %, 33.2 %) and mixed B+C infection in the microflora of the patients with chronic hepatitis B and C were more diverse: Staphylococcus epidermidis (16.6 %), Staphylococcus aureus (13.5 %), Str. salivarius (12.2 %), Staphylococcus saprophyticus (13.4 %), yeast and yeast-like bacteria (21.7 %), and Candida (22.6 %). A study of slgA levels in saliva revealed a significant decrease in these indicators compared to reference values. In a study of local immunity, the level of slgA in saliva decreased to mild — 0.44 g/L, moderate — 0.35 g/L, and severe — 0.28 g/L (usually 0.15–0.54 g/L). The described complex therapy plays an important role in the treatment of periodontitis, along with hygienic measures, helps restore impaired immunological changes, significantly reduces inflammation, participates in the regenerative process of periodontal tissues, and significantly increases the time of remission.