The effectiveness of post-prosthetic rehabilitation measures with the use of platelet autoplasm in patients with periodontal diseases and disorders of carbohydrate metabolism

Abstract

Periodontal diseases and disorders of carbohydrate metabolism are comorbid conditions that aggravate each other. There are a number of practical recommendations aimed at preserving the positive results achieved by a dentist as a result of oral sanitation, periodontal and prosthetic treatment. However, they do not fully take into account the features of examination, treatment and rehabilitation of patients suffering from periodontal diseases for a long time, but denying the presence of somatic diseases.The purpose of the study. To evaluate the effectiveness of a complex of post-prosthetic rehabilitation measures using PRP therapy in patients with periodontal diseases and disorders of carbohydrate metabolism.Material and methods. In the period from 2016 to 2021, 441 patients aged 35-55 years who applied to a dental clinic were examined. All patients suffered from chronic generalized periodontitis (CGP), but denied the presence of somatic pathology. As a result of an additional examination in somatic medical organizations (CFOs), 205 patients suffering from CGP were found to have cardiometabolic disorders (impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension). Prosthetic treatment was performed in 195 patients who were stratified into two groups. Group 1 (120 people) included patients who underwent correction of identified metabolic disorders, group 2 (75 people) – persons who refused further observation by a clinician. By randomization, subgroups were formed in each group: patients of subgroups 1a and 2a received standard post-prosthetic rehabilitation (professional oral hygiene, periodontal treatment), patients of subgroups 1b and 2b additionally underwent local immunocorrection with platelet-enriched autoplasm – PRP (Platelet-rich plasma) therapy. The article presents the results of post-prosthetic rehabilitation of patients with CGP according to clinical (PMA, PI, BOP, OHI-S indices) and immunological (IL-10, IL-8, IL-1ß, TNF-α, sIg A, LDH in oral fluid) indicators obtained after oral sanitation, rehabilitation course, after 3 and 6 months of follow-up.Conclusions. The team approach of dentists and clinicians and the use of periodontal PRP therapy can improve the effectiveness of post-prosthetic rehabilitation measures in periodontal patients with identified comorbid somatic pathology.