LONG-TERM OUTCOMES OF DENTAL TREATMENT OF PATIENTS WITH BACTERIAL VAGINOSIS AND THEIR SEXUAL PARTNERS

Abstract

Patients with bacterial vaginosis are often diagnosed as having chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases including chronic catarrhal gingivitis, mild and moderate periodontitis. The aim of this study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. The study included 28 heterosexual couples aged 18-45. Clinical dental check-up was performed during the treatment and in 3 months after the treatment completion. Green-Vermilion indices, РMA (in Parma modification), complex periodontal index (CPI) according to Leus, Svrakov's iodine number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included "Fluconazole" in a dose of 50 mg once a day for 7 days, "Clindamycin" in a dose of 150 mg every 6 hours for 5 days, probiotic "Symbiter acidophilus concentrated" was prescribed to be taken starting from the 3rd day of antibiotic therapy for 21 days, and Calcium-D3-Nycomed (1 tab. during dinner for 30 days). Local treatment included oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures for 7 days, "Metrogil-dent" ointment for gum application for 7 days, the chewing drug "Lizak" (1 tab. every 6 hours for 5 days), "Symbiter omega" in silicone caps for gum application overnight following the for 21 days.
 Chronic generalized catarrhal gingivitis was detected in 10.71% of women, mild chronic generalized periodontitis – in 64.29% and moderate chronic generalized periodontitis – in 25% of the women. In men who were carriers of pathogens of bacterial vaginosis, chronic generalized catarrhal gingivitis was found in 7.14% of individuals, mild chronic generalized periodontitis – in 60.71% and moderate chronic generalized periodontitis – in 32 male subjects. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive evidence-based dynamics of dental status. 3 months after clinical and laboratory observations, no complaints were presented and the oral hygiene status improved significantly. Before the treatment, the Green-Vermilion index mean values in women with bacterial vaginosis were 1.323 ± 0.035; by the end of 3 month therapy they equalled to 1.032 ± 0.021. A similar dynamics was seen in the men: from the initial index values of 1.336 ± 0.041, the Green-Vermilion index lowered to 1.048 ± 0.036. By the end of 3 month therapy, the PMA decreased by 49.03% in women and by 51.95% in men; no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant.
 The analysis of the СPI index values demonstrated the women had a significant difference between baseline and post-treatment outcomes of 1.98 scores, while the men had 2.01 scores. No significant difference was found between the findings of groups I and II both before and after the therapy. A similar positive dynamics was confirmed by the Svrakov's iodine number indicator and according to this indicator obtained before and after the therapy, difference between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. The detection Gardnerella vaginalis and Atopobium vaginae in the oral cavity before and after the therapy did not demonstrate a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after the therapy. Gardnerella vaginalis was detected by 67.87% and 61.59% less, Atopobium vaginae – by 65.79% and 58.65% less in the women and men, respectively. This patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory manifestations, improves oral hygiene, and is effective for the treatment of women with this comorbidity and for the therapy of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens reflects the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who are their sexual partners that confirms the effectiveness of the therapy for both gender groups.