DYNAMICS OF INDICATORS OF MICROBIOCENOSIS OF THE ORAL CAVITY IN TREATMENT OF PATIENTS WITH COMPLETE REMOVABLE PLATE PROSTHESIS WITH THE USE OF OZONE THERAPY

Abstract

Removable plate prostheses (RPP) belong to the stimuli of combined action and have a direct effect on the oral mucosa, lead to disruption of homeostasis, microbiocenosis of the oral cavity (OC) and various complications; their negative effect is exacerbated by violation of the polymerization regime and increased level of residual monomer (RM).
 Our experimental researches have shown that the use of ozone therapy with Ozone DTA provides antimicrobial effect at the level of 98.8-100%, it has a pronounced bactericidal effect against aerobic and facultative anaerobic microflora of the OP, which may be potential etiological factors of prosthetic stomatitis. Therefore, the aim of our work was to evaluate the impact of ozone therapy on the dynamics of the microbiocenosis of the oral cavity in the treatment of patients with complete removable plate prostheses in clinical settings.
 118 patients were examined and underwent orthopedic treatment with complete RPP.
 There is a significant positive effect of the use of complete RPPs (made of plastic “Ftorax”) with control of the content of RM in their manufacture on the state of microbiocenosis of the mucous membrane of the prosthetic impression area of patients. Combination of these measures with ozone therapy is even more effective, from the standpoint of normalization of the microbiocenosis of the prosthetic impression area. The proposed therapeutic tactics have a preservative effect on the quantitative characteristics of the main resident participants of oral microbiocenoses – α-hemolytic streptococci, while reducing the proportion of stomatococci, epidermal staphylococci, veilonella and diphtheroids in the microbiocenoses of the prosthetic impression area. On the other hand, the combination of RM content control with ozone therapy provides effective elimination from the mucous membrane of the prosthetic impression area of microorganisms with high pathogenic potential.
 Observations of the composition of microbiocenoses of the mucous membrane of the prosthetic impression area of patients showed in the dynamics that the maximum changes are observed 1 month after orthopedic treatment, and they were slightly less severe after 6 months.
 Serious dysbiotic disorders were observed within 1-12 months in patients who used PPPs made of plastic “Ftorax” without control of the content of RM, which is apparently due to the effect of residual monomer on the mucous membrane of the prosthetic impression area. Patients of this group after the treatment with RPP undergo an adaptation period, when on the mucous membrane of the prosthetic impression area the population level of representatives of resident microflora is increased and at the same time the risk of colonization by microflora with high pathogenic potential increases.
 The use of the procedure of control over the content of RM in the process of making RPP from Ftorax plastic shortens the adaptation period, and 6 months after orthopedic treatment there is a steady trend to normalize the qualitative and quantitative composition of microbiocenoses of the mucous membrane of the prosthetic impression area.
 Additional application of the course of ozone therapy helps to eliminate the adverse effects of RPP (made of Ftorax plastic) on the microbiocenosis of the mucous membrane of the prosthetic impression area. This contributes to a significant reduction in the mass colonization of the mucous membrane of the prosthetic impression area by resident and transient representatives of the normal microflora, provides effective elimination of pathogens – β-hemolytic streptococci, Staphylococcus aureus, enterobacteria, and especially yeasts of the genus Candida.