Improving medical care in patients with chronic catarrhal gingivitis while using fixed orthodontic appliances

Abstract

Aim. To study the immunostimulating effect of glucosaminyl muramyl dipeptide in the treatment of chronic catarrhal gingivitis in patients undergoing orthodontic treatment using fixed appliances. Methods. The data of clinical and laboratory examination of the oral health status in 54 patients aged 14-24 years with inflammatory periodontal diseases, undergoing orthodontic treatment using fixed appliances were analyzed. The first group included 26 patients in whom glucosaminyl muramyl dipeptide (1 mg sublingual tablets daily for 10 days) was additionally administered. The second group included 28 patients receiving standard treatment. The treatment efficacy estimation was based on subjective assessment, clinical, microbiological and immunological examinations. Results. After 6 weeks of treatment, there was a statistically significant reduction of simplified oral hygiene index (OHI-s) to 0.85±0.03 in patients of the first group, compared to 1.64±0,061 before treatment. Periodontal index (PI) and PMA index values were 0, reflecting good level of hygiene and no inflammation in periodontal tissues. In the second group, the OHI-s was 1.5±0.06, PI 0.71±0.04 and PMA 18±1.046%, reflecting mild gingivitis after the 6 weeks of treatment. Bacteriology showed that the number of colonies in the first group was reduced by 1-2 orders of magnitude on average after 6 weeks of treatment. Patients of the second group showed a significant (p 0.05) increase in the number of bacterial colonies potentially causing the periodontal inflammation. The level of secretory IgA after 6 weeks of combined treatment in the first patients group was 249.5±39.1 mg/ml, whereas in the second patients group it was 182.2±14.9 mg/ml, indicating the immunostimulating activity of the complex treatment administered in patients of the first group. Conclusion. This study shows the effectiveness of glucosaminyl muramyl dipeptide as immunostumulating drug in combined treatment of chronic catarrhal gingivitis in patients with dental braces.