REMISSION IN THE PROCESS OF DENTAL TREATMENT OF PATIENTS WITH BACTERIAL VAGINOSIS AND THEIR SEXUAL PARTNERS

Abstract

Patients with bacterial vaginosis are diagnosed as having chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases, such as chronic catarrhal gingivitis, mild and moderate periodontitis of initial and first severity. The aim of this study is to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. Materials and methods. 28 heterosexual couples aged from 18 to 45 took part in the survey. Clinical dental examination was performed before the treatment and in 3 months after the completion of treatment. Green-Vermilion indices, RMA (in Parma modification), complex periodontal index according to Leus (KPI), Svrakov's 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" 50 mg once a day (7 days), "Clindamycin" 150 mg every 6 hours (5 days), probiotic "Symbiter acidophilus concentrated" starting from the 3rd day of antibiotics course (21 days), Calcium-D3-Nycomed 1 tab. during dinner (30 days). Local treatment included: oral baths with the drug "Stomatophyte" after morning and evening hygienic procedures (7 days), application of "Metrogil-dent" onto the gums (7 days), the drug "Lizak" 1 tab. kept in the mouth until complete dissolution every 6 hours (5 days), application of "Symbiter omega" onto the gums in silicone caps at night (21 days) after the completion of "Stomatophyte" and "Metrogil-Dent" course. Results. The women demonstrated the following: chronic generalized catarrhal gingivitis was detected in 10.71% of cases, mild chronic generalized periodontitis was found in 64.29% of cases, and chronic generalized periodontitis of I degree was diagnosed in 25% of cases. In men who were carriers of causative agents of bacterial vaginosis, chronic generalized catarrhal gingivitis was found in 7.14% of cases, mild chronic generalized periodontitis was found in 60.71% of cases. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed positive objective dynamic changes in dental status. Thus, in 3 months of clinical and laboratory observations, no complaints were presented, the state of oral hygiene improved significantly. Before the treatment the Green-Vermilion index in general in women with bacterial vaginosis was 1.323 ± 0.035 points, and in 3 months it equalled to 1.032 ± 0.021 points. A similar dynamics was observed in men: from the starting index of 1.336 ± 0.041, the Green-Vermilion index decreased to 1.048 ± 0.036. 3 months after treatment, the PMA of patients dropped by 49.03%, 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 was significant. According to the DFM index, women had a significant difference between baseline and post-treatment outcomes that was 1.98 points, while men had 2.01 points. No significant difference was found between the results of groups I and II before and after the treatment. A similar positive dynamics characterizes the values of Svrakov's number then comparing the values before and after the treatment. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. Before and after the treatment, the detection rate of Gardnerella vaginalis and Atopobium vaginae in oral cavity did not demonstrate a significant difference between the group of men and women, but there was a clear difference between the parameters obtained during the initial examination and in 3 months after the treatment completion. Conclusions. The described treatment mode for patients with bacterial vaginosis contributes to the regression of inflammatory phenomena, improves oral hygiene, and is effective for the treatment of women with this comorbidity and for the treatment of their sexual partners. The dynamic lowering of the percentage of detection of bacterial vaginosis causative agent corresponded to the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who were their sexual partners that confirms the equal effectiveness of treatment for both gender groups.