Optimisation of the composition of safe dental gel with IL-1β antagonist for the treatment of inflammatory periodontal diseases

In this article the review of foreign and domestic literary sources, which are devoted to the actual problem of modern dentistry – the treatment of inflammatory diseases of periodontal tissues: gingivitis and periodontitis are presented. The complex approach to their treatment involves the appointment of a significant amount of pharmacotherapeutic drugs. Therapeutic failures and iatrogenic complications have led to the fact that today the interests of doctors and population to medicinal products significantly increased. The purpose of the study is to analyze the data of scientific literature on the use of plant-based medicinal products for the treatment of periodontal inflammatory diseases over the past 10 years. Materials and methods. Comprehensive and systematic analysis of literature. Review and discussion. The analysis of information sources on the use of plant-based medicinal products in dentistry both independently and in the composition of medical and prophylactic means has established that the modern assortment of plant-based preparations in the pharmaceutical market of Ukraine to a certain extent is limited. The emergence of new plant-based species that have been tested in conditions of experimental pathology and require an evidence-based clinical base is noted. The composition of plant-based preparations used for the treatment of inflammatory periodontal diseases include vitamins, biologically active substances, glycosides, alkaloids, in connection with a wide range of action: antiseptic, anti-inflammatory, regenerating, hemostatic, antioxidative. The data on plant-based preparations that are most often used such as chamomile extracts, calendula, hypericum, plantain, kalanchoe, aloe, eucalyptus, milfoil, nettle, calamus and plant-based species are summarized. The medicinal agents considered are mainly recommended for local treatment of periodontal diseases in the form of dental care means, mouth rinse, gel, chewing gum, herbal liquer. It is known that the complex treatment of periodontal diseases includes a general influence on the body. The properties of green tea with its wide range of actions are investigated. With antioxidant properties, it can be a healthy alternative for controlling destructive changes in periodontal diseases. Attention is drawn to the proposed unique natural complex “Resverazin” due to a wide range of pharmacological action, low toxicity and relative safety. The drug produces antioxidant, anti-inflammatory, immune stimulating, vasodilative, neuroprotective action. Conclusion. Based on the literature analysis, it can be concluded that the accumulated experimental and clinical data on the therapeutic properties of plants prove perspective of their use in the complex treatment of inflammatory periodontal diseases. Future studies are mandatory for further confirmation of the effectiveness of these medicinal plants

American Academy of Periodontology Statement on the Efficacy of Lasers in the Non‐Surgical Treatment of Inflammatory Periodontal Disease

A comparative assessment of the antamicrobial properties of the gel herbal preparation Abigel was made; the comparison group consisted of Fitoron and President-gel with chlorhesidine. The studies were carried out using standard test cultures of gram-positive and gram-negative bacteria belonging to different taxonomic groups: Staphylococcus aureus ATCC 25923, Esсherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Bacillus subtilis ATCC6633, Proteus vulgaris ATCC 4636. The antifungal effect of the sample was investigated on the reference strain Candida albicans ATCC 885-653 (4, 5, 6). Also used clinical museum strains (Staphylococcus epidermidis, Enterococcus faecalis, Haemophillus influenzae, Streptococcus pyogenes, Streptococcusmutans, Neisseria sp). President gel with chlorhexidine, Fitoron and Abigel gel have pronounced anti-microbial properties in relation to the investigated test cultures of microorganisms. Abigel is an effective method of vibor in the conservative treatment of inflammatory periodontal diseases. The method of treatment and prevention of inflammatory periodontal diseases with the use of Abigel is quite effective and justified in complex treatment, and as an independent method.

Dental pathology is represented by a wide range of diseases of hard and soft tissues of these organs, various types of injuries, anomalies of shape, number, location, periodontitis. Inflammatory periodontal diseases are one of the most common human diseases, which lead to significant socio-economic losses and reduced quality of life. At the beginning of the XXI century, prevention and treatment of inflammatory periodontal diseases remains an urgent problem of medicine. The high frequency of periodontal lesions is largely due to the peculiarities of its structure and function, general human health, the constant influence of microorganisms, among which the dominant role is played by opportunistic and pathogenic bacteria. The microflora in inflammatory periodontal diseases differs from the microflora of the oral cavity of a healthy person by the presence of peculiar symbiotic associations with a specific dominant species of the pathogen. The main element of the modern protocol of medical care for periodontal disease is the systemic or local use of antimicrobials. Modern antibiotics and chemotherapeutics used in dental practice for the treatment of CPD, totally affect all parts of the biocenosis of the oral cavity and lead to its undesirable changes. In addition, even a short-term positive effect of the use of these drugs can be combined with a selective increase in the resistance of pathogens to antibacterial drugs, which generally reduces the expected effectiveness of traditional therapy. Inflammatory periodontal diseases, prospects of their treatment by classical methods and with the use of modern medical technologies were studied in the work. For the objectification of the study used archival materials and their own work over the past 15 years. The purpose of the study: to identify promising areas of integrated use of traditional and innovative treatments for inflammatory periodontal disease. The subject of the study was to clarify the issues of antibacterial, antifungal activity of hop products, the rate of formation of resistance in microorganisms, the adequacy of physical, physicochemical properties of gel compositions. Particular attention was paid to the use of antibacterial properties of gel compositions based on hop products. It is established that the use of antibiotics and chemotherapeutics in modern medical practice for the treatment of inflammatory periodontal diseases has a number of significant limitations due to the short duration of their therapeutic effect, negative impact on human microbiocenosis and the formation of acquired resistance of pathogenic microflora to widely used drugs. The results of previous studies have demonstrated the prospects of herbal medicines, namely, created on the basis of hop products for the prevention and treatment of diseases of microbial origin. It was found that the antibacterial and antifungal action of gel preparations of optimal composition with EHV 0.5% significantly exceeds the specified indicators of such known and currently used drugs. Therefore, it is clear the scientific and practical meaning of the use in protocols for the treatment of inflammatory periodontal diseases (as drugs for local therapy) phytomedicine based on hop herbal substance. Thus, a clear prospect of using new compositions of drugs with high antibacterial properties based on plant raw materials (including hops) for the treatment and prevention of periodontal disease. Solving this problem is a timely and socially appropriate fact.

The aim is to study the effect of photodynamic therapy as an additional method of treatment of inflammatory periodontal diseases on a clinical example. Research objectives. To develop and apply a protocol for the treatment of periodontal patients using photodynamic therapy in combination with traditional methods of treatment in a clinical study. Evaluate the results of the treatment, compare the results with the literature data. Materials and methods. The study involved 50 patients diagnosed with K05.1 Chronic gingivitis of moderate severity. The patients were divided into 2 groups: the study group and the control group. The study group, unlike the control group, received photodynamic therapy in addition to the standard treatment of chronic gingivitis. The evaluation of treatment results was carried out using the papillary-marginal-alveolar index (PMA) modified by C. Parma (1960). The results obtained during the study were statistically analyzed. Descriptive statistics methods were used, the Student’s t-test was calculated, as well as the nonparametric Mann—Whitney test for independent groups. Results and discussion. During the comparison of the groups before the start of periodontal treatment, there was no statistically significant difference between the groups: the study and control groups did not differ from each other before the treatment. However, after periodontal treatment, the values of statistical criteria showed a statistically significant difference: in the study group, after therapeutic measures, a greater degree of reduction in the average papillary-marginal-alveolar index was revealed than in the control group. Conclusion. The developed protocol of photodynamic therapy demonstrates high efficiency in reducing the level of inflammation (reduction of the PMA index by 36.84% in the group using photodynamic therapy (p<0.05)) in periodontal tissues due to the elimination of pathogenic microflora. Treatment using photodynamic therapy contributes to a more significant reduction in the average PMA index than in the control group by 10.88% (p<0.05). The use of photodynamic therapy opens up new horizons in the treatment of periodontal patients. The results of the study are consistent with the data obtained by a number of authors. In all the presented works, there was a significant decrease in the PMA index (p<0.05, p<0.05, p=0.0001) in groups of patients undergoing combined treatment, including traditional treatment of inflammatory periodontal diseases and photodynamic therapy, which also emphasizes the effectiveness of photodynamic therapy in the treatment of inflammatory periodontal diseases.

Relevance: the presence of somatic disease is often the main and aggravating factor in development of chronic generalized periodontitis. Treatment of inflammatory periodontal diseases begins with mechanical removal of dental calculus and biofilm on a surface of the teeth. For this purpose along with traditional manual tools are applied sonic ultrasonic, and vibrascalers. Atraumatic and high efficiency of professional oral hygiene complex are extremely important for the treatment of periodontal disease in patients with diabetes. Purpose – to study the effectiveness of professional oral hygiene with use of the Vector apparatus in patients with type 1 diabetes. Materials and methods: this article presents study results of the effectiveness of the Vector ultrasound device use as part of therapeutic and preventive measures complex among 3 patients in different ages with generalized periodontitis and type 1 diabetes mellitus. We conducted a dental and X-ray examination and microbiological analysis of periodontal space contents. All patients underwent professional oral hygiene and Vector-therapy. Results were evaluated after 1 month. Results: using the example of 3 clinical cases, the effectiveness of professional oral hygiene complex was presented. After 4 weeks there were observed the reduction of patients complaints for bleeding gums when brushing teeth, improving hygienic and periodontal indices, reducing the composition and number of periodontal pathogens. Conclusion: treatment of inflammatory periodontal diseases using the Vector system is recommended as an early prevention of the development of a more severe periodontitis, as well as the most benign and minimally invasive treatment for periodontal diseases due to its high effectiveness.

Subject: Inflammatory periodontal diseases are one of the most common dental diseases in the world. To ensure successful treatment and a stable period of remission, it is necessary to take into account the etiopathogenesis of the disease. One of the main roles in the development of inflammatory periodontal diseases is played by the immune response of the body to the action of periodontal-pathogenic micro-organisms.
 Objective ― to study the current literature indicates about the role of immunological processes in the development of inflammatory periodontal diseases, as well as the possibility of their correction
 Material and methodologies: Data from the scientific literature on the etiopathogenesis of inflammatory periodontal diseases was used in the study. To achieve this objective the databases of the Tyumen State Medical University Library, electronic libraries (eLibrary, Cyberleninka, PubMed, Googl.Scholar), official sites of scientific publications were used.
 Results: the review of the literature presents information on the immunological processes developing in inflammatory periodontal diseases. The role of cellular and humoral elements in pathogenesis, the role of pro and anti-inflammatory cytokines in the chronization of the inflammatory process is described. The possibilities of local immunological correction in the treatment of inflammatory periodontal diseases are considered.
 Conclusions: The concept of cytokine development of inflammatory periodontal diseases has been formed and substantiated in modern scientific literature. The evaluation of the cytokine profile of the oral and gingival fluid allows to establish the activity and severity of the disease. The established immunological and molecular genetic mechanisms of the development of inflammatory periodontal diseases associated with the influence of cytokines make it possible to adjust the complex treatment of inflammatory periodontal diseases, determine the direction of personalized therapy of patient, determine the effectiveness of the treatment and the prognosis of the disease.

48 Anti-inflammatory and bactericidal action of LED medolight device at treatment of dental diseases

Microbiological stability of medicines is an integral part of their quality, therefore, at the stage of pharmaceutical development, the issues of ensuring microbiological purity should be considered. To this end, various chemicals are added to the composition of semisolid medicines that actively inhibit the growth of microorganisms that enter the pharmaceutical system during production and reuse. Insufficient amount of a preservative can lead to the adaptation of microorganisms, and excess- to increase the toxicity of the drug. In the development of the composition of the anti-allergic action gel containing dimethindene maleate and dexpanthenol in order to select a preservative and its concentration, the following antimicrobial substances have been chosen: phenoxyethanol, benzalkonium chloride, methylparahydroxybenzoate (nipagin, E218), propylparahydroxybenzoate (nipasol, E216) and potassium sorbate (E202). The purpose of this work is to evaluate the effectiveness of these antimicrobial preservatives in the composition of the gel under study. For microbiological studies 5 samples have been developed: N 1 – gel + phenoxyethanol 0.75%; N 2 – gel + benzalkonium chloride 0.015%; N 3 – gel + nipagin 0.15% + nipasol 0.05%; N 4 – gel + potassium sorbate 0.2%; N 5 – gel without preservatives added. The research used the method for evaluating the effectiveness of antimicrobial preservatives given in SPU 2.0 (Section 5.1.3). As a result of the experiment, it has been determined that the sample of gel without preservative does not meet the requirements of SPU and proved the need to add antimicrobial preservatives to the composition of the developed gel. The results of the study for samples with preservatives phenoxyethanol 0.75%, benzalkonium chloride 0.015%, nipagin 0.15% + nipasol 0.05% completely meet the requirements of SPU on the indicator «antimicrobial effectiveness of preservatives» for medicinal products for external use. An experimental study of the sample with a potassium sorbate 0.2% preservative showed that it did not fully meet the requirements of the above article of SPU. Among the samples that meet the requirements of SPU, the highest antimicrobial efficacy against strains of Staphylococcus aureus ATCC 6538, Pseudomonas aeruginosa ATCC 9027, Candida albicans ATCC 885-653, Aspergillus brasiliensis ATSC 16404 has shown a sample of 0.75% phenoxyethanol preservative (N 1). Therefore, for further microbiological studies, samples of gels with phenoxyethanol concentrations of 0.5%, 0.75% and 1.0% were prepared and the antimicrobial efficacy of these samples has been studied. Based on experimental studies, it has been found that 0.75% is the optimal concentration of phenoxyethanol in the composition of gel containing dimethidene maleate and dexpanthenol. Thus, a complex of studies has been conducted to prove the antimicrobial effectiveness of the phenoxyethanol preservative and its concentration.

BACKGROUND: Periodontal diseases are one of the most common in dentistry. Along with the complications of caries, periodontitis is one of the causes of tooth loss. In the etiology of this disease, the leading role is played by the microbial factor, as well as microcirculatory disorders in periodontal tissues. The complex mechanism of periodontitis development involves a comprehensive treatment approach aimed at different links in the pathogenesis of the development of this disease. Among the numerous physical factors used in the treatment of periodontal diseases, ultraphonophoresis, which combines the effects of ultrasound and a medicinal substance, is not widely used. The study of the effectiveness of the use of Metrogil Denta gel ultraphonophoresis in the treatment of inflammatory periodontal diseases is of considerable scientific and practical interest.
 AIM: This study aimed to investigate the effect of ultraphonophoresis of gel on the clinical course of chronic generalized periodontitis of moderate severity.
 MATERIALS AND METHODS: Sixty patients (aged 3162) with chronic generalized periodontitis of moderate severity were examined and treated. In the main group (n=30), treatment included high-frequency ultrasound and antibacterial preparation of Metrogyl Denta gel applied to the periodontal tissue (ultraphonophoresis of Metrogyl Denta gel). In the control group (n=30 patients), Metrogyl Denta gel was injected into the periodontal tissue.
 RESULTS: Application of Metrogyl Denta gel for moderate periodontitis did not improve local blood circulation. Six months after treatment, nearly half of the examined patients showed signs of inflammation, which was accompanied by a worsening of periodontal index (PI), SchillerPisarev tests results, and rheography finding. Twelve months after treatment, 63% of the patients developed complications.
 CONCLUSIONS: There was further deterioration in the clinical and functional parameters. After ultraphonophoresis of Metrogyl Denta gel, there was a decrease in the readings of the SchillerPisarev test, PI, and normalization of the qualitative and quantitative indicators of the rheoparodontogram, which indicated a decrease in inflammation and activation of local blood circulation in the periodontium. In the long term after treatment, despite the increase in hygiene index, the relative stability of clinical and functional parameters was maintained. Even a year after treatment, the level of indicators did not reach the level obtained before treatment.

Periodontitis is the most common inflammatory disease that leads to the destruction of the supporting tissues of the tooth. Therapeutic treatments aimed at reducing the effects of matrix metalloproteinases (MMPs) may be an effective adjunct to the treatment of periodontitis. The review examines the role of proteolytic enzyme inhibitors in the treatment of inflammatory periodontal diseases. General information about the ability of tetracyclines to inhibit MMPs is discussed. The purpose of the study was to examine the use of MMP inhibitors as a treatment for periodontal disease. Material and research methods. A scientific review of studies was carried out in Russian and English using information portals and platforms eLIBRARY.ru, Web of Science, PubMed and Scopus. The search was carried out using the following keywords: matrix metalloproteinases; oral diseases; tissue inhibitors of metalloproteinases. Of the 55 initially identified articles, after the initial analysis, 19 publications devoted to the study of MMP inhibitors associated with periodontal diseases were selected. Results of the study. Analysis of the literature allows us to conclude that the elimination of local irritants of periodontal tissues, the use of a therapeutic and prophylactic complex of measures using MMP inhibitors will have an advantage over traditional methods of treatment, will contribute to longer remission and prevent the progression of the inflammatory process in periodontal tissues, positively influence its course and reduce treatment time. The use of metalloproteinase inhibitors is an effective therapeutic strategy in the treatment of periodontal diseases. Conclusions. The therapeutic potential of metalloproteinase inhibitors may help prevent tissue damage in inflammatory periodontal diseases.

The article presents an overview of the use of photodynamic therapy in modern dentistry based on the literature sources. Various types of photosensitizers are presented, the action of which has a good effect on the course of the process in periodontal pockets. The conclusion is made about the vantages of using this method in the treatment of inflammatory periodontal diseases, as well as the effect of photodynamic therapy on the periodontal microbiota, which has a positive effect on the treatment of patients.

Dentists are always in quest of new methods for the treatment of periodontal diseases, and photodynamic therapy (PDT) is considered one of the most effective methods. A significant improvement in the clinical pic-ture was obtained in all patients throughout the control period of observation of the patients as a result of the treatment with the use of PDT. According to the data from research study it can be said that photodynamic therapy is an effective and gentle method of antibacterial treatment of inflammatory periodontal diseases, which can be effectively used to prevent exacerbations of chronic inflammatory periodontal diseases, to achieve a long-term positive effect and to refuse, in some cases, from surgical methods of treatment. There is a signifi-cant increase in the duration of remission of the disease, improvement of microcirculatory blood circulation in per-iodontal tissues and a small microbial contamination of periodontal pockets of patients treated with photodynam-ic therapy in the long term compared with groups of pa-tients treated with only antiseptic and antibacterial drugs.

Relevance.Numerous epidemiological studies have found a high degree of association between DM and periodontal disease, and periodontal disease has even been proposed as a sixth complication of DM. It has also been demonstrated that this relationship is bidirectional, with periodontitis exerting an effect on DM. These fndings have diagnostic and therapeutic implications. Thus, the high prevalence of periodontal disease in DM indicates the need to evaluate glucose levels in periodontal patients. Conversely, intervention studies have demonstrated that the treatment of periodontal disease improves the glycemic control of DM patients. To alert health professionals about the risk that periodontitis represents for the onset or exacerbation of complications in individuals with type 2 diabetes mellitus (DM) and to emphasize that the mechanical treatment of periodontal disease and reestablishment of oral health are essential for the metabolic control of these patients.Materials and methods.A review of the literature on the topic of 30 sources from them 5 domestic and 25 foreign data.Some researchers demonstrate the Periodontal screening must be part of the overall clinical examination of patients with diabetes and, if diagnosed, periodontal disease must be treated appropriately to avoid or exacerbate diabetes complications besides improving glycemic control in these individuals.Results:In the postoperative period during the frst three days, patients of both groups had moderate soft tissue edema, slight flap hyperemia and palpation pain.Conclusions.Increased knowledge of dentists, endocrinologists and the public is required to improve early diagnosis of diabetes, adequate management, prevention and treatment of dental diseases in patients with DM.

Diagnosis of the level of halitosis (bad breath) is very important, because this may indicate pathology gastrointestinal tract, upper respiratory tract, endocrine system. The most common cause of its occurrence is oral disease. Objective. To determine the effectiveness of the treatment of periodontal disease, halitosis accompanied by a galimetr apparatus. Materials and Methods. The study involved 118 people with periodontal disease of varying severity, accompanied by periodontitis. In the study group underwent a comprehensive treatment of periodontal disease, accompanied by halitosis, with the inclusion of probiotic complex. The control group consisted of 58 people with periodontitis, accompanied by halitosis, did not receive the probiotic complex. Periodontal status was determined by Silness-Loe index Myullemana index, measuring the depth of periodontal pockets. halitosis level determined by galimetr apparatus. The data were processed using statistical methods. Results. After treatment in both groups showed improvement in the patient's mouth and a statistically significant change in the indicators characterizing it. The average depth of the periodontal pocket of the first group ofpatients has decreased by 2 mm (or 40%) patients of the second group of reduction was 1.9 mm (or 42.2%). After 6 weeks of treatment of halitosis level significantly decreased in both groups. In the first group to 67.7 (6.4 times), the second group - to 157.8 (2.8 times). Level halitosis patients in group 6 weeks after treatment was significantly lower than the patients of the second group of halitosis. The level of halitosis patients of the first group is 2.3 times lower than that of the second group ofpatients, demonstrating the effectiveness of the treatment. Conclusions. The use of probiotic complex in treatment of inflammatory periodontal diseases, accompanied by halitosis increases the efficiency of traditional therapy. A galimetr is a necessary tool to measure and evaluate the level of halitosis.