Abstract

The modern treatment strategy for various forms of generalized periodontitis includes the use of a wide arsenal of drugs, which in turn leads to an excessive drug load on the body, this actualizes the search and use of drugs that have a systemic effect. The aim of the study is to develop and study the effectiveness of the use of systemic enzyme therapy in the treatment of aggressive (rapidly progressing) generalized periodontitis. The work is based on the results of comprehensive clinical and laboratory studies of 61 patients with an aggressive form of generalized periodontitis, without concomitant pathologies (30 main groups and 31 comparison groups). A control group consisted of 20 healthy donor volunteers. We used standard clinical, paraclinical, laboratory diagnostic methods, supplemented by dental volumetric tomography. In patients of both observation groups, standard protocol therapy was used, in the comparison group supplemented pathogenic therapy, and in the main group – multienzyme drug (Wobenzym) and rhBMP-2 injections. A comparative analysis of clinical, paraclinical, and laboratory studies has shown that the use of systemic enzyme therapy supplemented with recombinant morphogenetic protein (rhBMP-2) in patients with aggressive (rapidly progressing) generalized periodontitis is comparable to that of standard polymedicine therapy supplemented with pathogenic therapy, and leads to a faster control (average 13.7±0.7 days) of an active inflammatory and destructive process, normalization of indices of local humoral immunity, cytokine profile, free radical oxidation and antioxidant defense system, achievement of clinical and radiological remission in more than 90% of patients.

Highlights

  • Treatment of aggressive generalized periodontitis using systemic enzyme therapy in combination with osteoinductive medicines

  • The analysis of clinical results showed that in patients of both groups under the influence of medical complexes there was achieved the elimination of inflammatory processes in the periodontium approximately at the same time, this was manifested in the disappearance of complaints of pain and gums bleeding, absence of hyperemia of gingival mucosa tissues, exudate from periodontal pockets, restoring of relief and density of the gingival margin

  • Under their influence a complete elimination of inflammatory phenomena in periodontal tissues was observed in 93.5% of patients in the comparison group on day [14-16] of treatment and in 96.6% of patients in the main group up to [12-14] days

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Summary

Introduction

Treatment of aggressive (rapidly progressing) generalized periodontitis using systemic enzyme therapy in combination with osteoinductive medicines. A comparative analysis of clinical, paraclinical, and laboratory studies has shown that the use of systemic enzyme therapy supplemented with recombinant morphogenetic protein (rhBMP-2) in patients with aggressive (rapidly progressing) generalized periodontitis is comparable to that of standard polymedicine therapy supplemented with pathogenic therapy, and leads to a faster control (average 13.7±0.7 days) of an active inflammatory and destructive process, normalization of indices of local humoral immunity, cytokine profile, free radical oxidation and antioxidant defense system, achievement of clinical and radiological remission in more than 90% of patients. A modern strategy for the treatment of generalized periodontal disease should provide for the correction of the main pathogenetic factors that potentiate the progressive development of destructive manifestations in the gingival and bone structures of the periodontium, among which various pathogens, disorders of local humoral immunity, imbalance of cytokine status, radical lipid oxidation and antioxidant defense system play a leading role [3, 6, 7]

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