Microcirculation In Periodontal Tissues Research Articles

Optimizing professional oral hygiene tactics with various methods and tools: impact on microcirculation in periodontal tissues

Relevance. While professional oral hygiene (POH) is widely implemented in dental practice, there is a notable lack of comprehensive research on its effects on periodontal tissues. This underscores the need to investigate the impact of various air-polishing systems (APS) on periodontal tissues in specific clinical contexts. Choosing the appropriate active ingredient in mouth rinses for antiseptic treatment during the final stage of professional oral hygiene is critical for dental practitioners, as the active ingredient directly affects microcirculation in periodontal tissues.Materials and methods. A standard dental examination was conducted on 200 patients aged 18 to 25 years. Patients were divided into groups based on the active component of the APS: calcium carbonate, sodium bicarbonate, a mixture of calcium carbonate and sodium bicarbonate, trehalose, or glycine. In the second stage of the study, antiseptic treatment was performed according to the active ingredient in the mouth rinse, using one of the following antiseptics: chlorhexidine (0.20%) with hyaluronic acid; a combination of clove and fennel essential oils, bromelain enzyme, and bifidobacterium lysate; or essential oil-based rinses containing thymol, eucalyptol, menthol, and methyl salicylate. The control group used distilled water. Microcirculation dynamics in the periodontal tissues were monitored throughout the study using ultrasound Doppler flowmetry.Results. An increase in microcirculation parameters in periodontal tissues was observed following professional oral hygiene using various APS components, both with and without ultrasonic treatment. The application of mouth rinses as the final step in antiseptic oral care contributed to the restoration of microcirculation in periodontal tissues within 1 hour of use.Conclusion. The study identified the most effective protocol for mouth rinse application, tailored to the active component of the air-polishing system.

Functional assessment of microcirculation in the injection site tissues when using local anaesthesia

Relevance. In modern dentistry, the primary criteria for successful anaesthesia are the effectiveness and safety of the anaesthetic used. These factors depend on the type of local anaesthetic and the method of its administration in the maxillofacial tissues. Studying the impact of locally anaesthetizing solutions administered by different injection techniques on the periodontal tissues is possible by recording changes in microcirculation using the LDF method.Purpose. To dynamically record the baseline microcirculation indicator in the tissues at the injection site when using various methods and means of local anaesthesia.Materials and methods. The study of changes in the microcirculation of periodontal tissues was conducted among 105 patients: 67 women and 38 men aged 25 to 56 years without periodontal pathology and comorbidities, using injection methods of anaesthesia (infiltration and modified periodontal anaesthesia) with 2% and 4% solutions of articaine with varying concentrations of vasoconstrictor. Changes in the microcirculation index were recorded at the injection site: at the root apex projection during infiltration and in the gingival papilla region during MPA, with an exposure time during LDF registration of 5 minutes. To maintain the fiber optic probe, an individual key made of C-silicone with an additional corrective layer was used for repeat positioning. The most informative indicator of the study was the magnitude of the average blood perfusion flow (M) in the time interval of registration, with its changes reflected in the study results.Results. Analysis of the dynamics of microcirculation indicators in the injection site tissues when using various methods of administering locally anaesthetizing drugs based on 2% and 4% solutions of articaine without vasoconstrictor and with epinephrine at concentrations of 1:200,000 and 1:100,000 allowed the determination of tissue ischemia depth at the injection site and the rate of blood flow restoration after anaesthesia.Conclusion. Changes in microcirculation indicators in the tissues at the injection site of the local anaesthetic depend on the concentration of the local anaesthetic and vasoconstrictor, the method of administration used, and the volume of the drug administered.

Evaluation of the photodynamic effect on the state of microcirculation and oxygenation in periodontal tissues in the treatment of chronic generalized periodontitis

Increasing the effectiveness of treatment of chronic generalized periodontitis using PDT based on clinical and functional substantiation of the effects of a photosensitizer. A clinical and functional study and treatment of moderate chronic generalized periodontitis was carried out in 62 people (26 men and 36 women) aged from 35 to 55 years without a somatic model with an orthognathic occlusion diagnosed according to ICD-10 - K05.3. Of these, 2 groups were divided depending on the type of treatment: Group 1 (main) - patients with moderate chronic generalized periodontitis - 32 people. (17 men and 15 women, average age of the group - 43.2±2.2 years); Group 2 (control) - patients with moderate chronic generalized periodontitis - 30 people. (14 men and 16 women, average age of the group - 44.0±3.3 years). Complex treatment consisted of sanitation of the mouth, removal of dental plaque and curettage of periodontal pockets in group 1, followed by PDT with Revixan gel using a special wired aligner REVIXAN DENTAL LED (16 r). The clinical condition of the periodontium was assessed using the Greene Vermillion Hygienic Index (OHI-S), the Mühlleman Bleeding Index (SBI) modified by Cowell, and the periodontal index PI. To study the state of microcirculation in the gum tissue, the laser Doppler flowmetry (LDF) method was used using the LAKK-M device (NPP «Lazma», Russia). The state of microcirculation was assessed by the microcirculation index (M), which characterizes the level of tissue blood flow; parameter - «σ», which determines the fluctuation of the erythrocyte flow. According to Wavelet analysis of LDF-grams, the shunt index (SH) of blood flow was determined. In the «LDF + spectrometry» mode, oxygenation in periodontal tissues was studied using optical tissue oximetry (OTO), based on the results of which the perfusion saturation index (Sm) and the specific oxygen consumption index (U, %) were determined. According to LDF data, after PDT (group 1), normalization of clinical indices and the level of microcirculation in periodontal tissues was established, which was accompanied by an increase in the level of blood flow (M) and its activity (σ), which persisted after 3 and 6 months. after PDT. The perfusion saturation index (Sm) and specific oxygen consumption (U) increased more significantly after PDT, which persisted after 3 and 6 months. In the control group, the dynamics of indicators was less pronounced. The use of PDT with Revixan gel normalizes the clinical condition of the periodontium, indicators of microhemodynamics and oxygen metabolism.

Эндотелиальная дисфункция и пародонтопатогенная микрофлора: аспекты патогенетической коррекции бактериофагом

INTRODUCTION: Alteration of the expression of intercellular adhesion molecules on the surface of endotheliocytes is associated with disorders of anticoagulant, antiplatelet, fibrinolytic and barrier functions of the endothelium. It results in derangement of microcirculation in periodontal tissues, and, together with adhesive, invasive toxic properties of the main periodontopathogenic bacteria Аggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia, leads to a chronic systemic periodontitis (CSP). AIM: To evaluate pathogenetic aspects of the effect of phagotherapy on the level of secretion of soluble forms of adhesive molecules and on periodontopathogenic microflora. MATERIALS AND METHODS: The study material was the discharge of the dentogingival/periodontal pocket (DG/PP) of patients with intact periodontium and with CSP. The first subgroup with CSP, in addition to therapeutic treatment, received a course of Phagodent bacteriophage applications, the subsecond group received only therapeutic treatment. RESULTS: A high frequency of isolation of periodontal pathogens (92.0%) in patients with CSP was reflected in the detection of P. gingivalis in 81% of cases, T. forsythia in 74% of cases, A. actinomycetemcomitans in 37.0% of cases. On the top of the administered therapy, a statistically significant (6.2 times) decrease in the level of A. actinomycetemcomitans was revealed in subgroup 1 (p = 0.03) and 1.58 times decrease in subgroup 2 (p = 0.045). The content of T. forsythia decreased by 3.9 (p = 0.034) and 2.4 (p = 0.02) times in the respective groups. A significant decrease in the level of T. denticola was detected only in subgroup 1 (p = 0.04). The levels of intercellular adhesion molecules during the therapy decreased in both groups, but most significantly when using a bacteriophage: sICAM-1 decreased 3.2 times in subgroup 1 (p < 0.001) and 2.1 times in subgroup 2 (p < 0.001), sVCAM — 6.4 times (p < 0.001) and 4.6 times (p < 0.001), respectively. The content of sL-selectin and sE-selectin in PP decreased 4.1-times (p < 0.001) and 2.2 times, (p < 0.001), respectively, in individuals receiving bacteriophage and 2.2 times (p < 0.001) and 1.5 times (p < 0.001) in patients with another method of treating CSP. CONCLUSION: The effectiveness of targeted pathogenetic correction using a bacteriophage for the treatment of CSP was confirmed by a decrease in the quantitative content of marker periodontopathogenic microorganisms in the DGP discharge and normalization of the concentration of adhesive molecules, which indicated reduction of the degree of endothelial dysfunction.

КЛИНИКО-РЕНТГЕНОЛОГИЧЕСКИЙ АНАЛИЗ СТРУКТУР ПАРОДОНТА ПРИ АНАТОМО-ФУНКЦИОНАЛЬНЫХ НАРУШЕНИЯХ МУКОГИНГИВАЛЬНОГО КОМПЛЕКСА

Subject. Anatomical and functional disorders of the mucogingival complex.
 Objectives. To evaluate microcirculatory, clinical and radiological changes in periodontal tissues in various variants of mucogingival complex disorders.
 Methodology. The study was conducted at the Department of Therapeutic Dentistry of ASMU. In the course of the study, 80 patients (49 women, 31 men) aged 18 to 35 years were examined with a ratio of dentition close to orthognathic bite in the presence of maximum occlusion. Three groups were formed depending on the anatomical and functional state of the mucogingival complex. In the clinical part of the study, an objective assessment of the condition of periodontal tissues was carried out on the basis of a dental examination with a comprehensive analysis of the periodontal status. The X-ray examination included the analysis and description of cone-beam computed tomograms for patients of clinical groups. To assess microcirculation in periodontal tissues, the method of ultrasonic Dopplerography with functional probe breakdown was used.
 Results. In the studied groups, the level of oral hygiene was characterized as good, and the indicators of hygiene indices did not differ significantly, periodontal indices indicated the absence or minimal degree of inflammation in periodontal tissues. Carrying out a functional tension test made it possible to divide patients into subgroups according to the type of reaction: normal, compensated, subcompensated, decompensated. According to the results of the study of CBCT in the comparison group, pathological changes in the bone tissue of the alveolar process of the studied areas were not recorded, in patients of the first clinical group, in most cases (80.2%), pathological changes in the bone tissue of the alveolar process were not observed, in the rest (19.8%), a low level of alveolar bone was noted. In patients of the second clinical group, the phenomena of osteoporosis and an increase in the distance from the dental enamel-cement border to the edge of the outer cortical plate were recorded.
 Conclusions. X-ray changes in bone tissue most often corresponded to the already existing clinical symptoms of periodontal tissue damage against the background of mucogingival pathology. The predictors of prenosological diagnosis in anatomical and functional disorders of the mucogingival complex were changes in microcirculation indicators.

The use of photodynamic therapy in the complex treatment of chronic generalized moderate periodontitis

Improving the effectiveness of the treatment of chronic generalized periodontitis by photodynamic therapy (PDT) due to clinical and functional validation of the effects of a photosensitizer. A clinical and functional study and treatment of moderate chronic generalized periodontitis was carried out in 60 people (24 males and 36 females) aged 35 to 50 years without somatic pathology with orthognathic bite. The patients were divided into 2 groups depending on the type of treatment: group 1 (main) included 30 patients (17 males and 13 females, mean age of patients was 42.5±3.3 years) who received comprehensive treatment consisting of oral sanitation, removal of dental plaque and curettage of periodontal pockets followed by PDT with 1% Geleophor gel using an AFS Spektr LED emitter with a wavelength of 660 nm and a power of 2.5 W, the course consisted of 4 procedures with exposure time of 7 minutes each; group 2 (control) included 30 patients (11 males and 19 females, mean age of patients was 43.0±2.1 years) undergoing standard treatment followed by protective capping with no active therapeutic agent. The state of microcirculation in tissues was studied by the laser Doppler flowmetry (LDF) using the LAKK-M device (Lazma, Russia). According to LDF data in both groups, it was found that the improvement of microcirculation in periodontal tissues after complex treatment is accompanied by an increase in blood flow and its activity, at that the level of oxygenation and specific oxygen consumption increased more pronounced after PDT, the effect persisted after 6 and 12 months. The use of PDT with LED emitter has a normalizing effect on the state of microcirculation and oxygenation in periodontal tissues.

ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ СИСТЕМЫ МИКРОЦИРКУЛЯТОРНОГО РУСЛА В ТКАНЯХ ПАРОДОНТА У ЛИЦ МОЛОДОГО ВОЗРАСТА ПРИ РАЗЛИЧНЫХ ВИДАХ КУРЕНИЯ

Subject. Tobacco smoking is one of the risk factors of periodontal disease development; therefore, special attention should be paid to this group of patients in periodontal treatment management. Any pathological process in periodontium is directly or indirectly connected with microcirculatory disturbances. Therefore, the correction of these disturbances will promote the normalization of the periodontal morphofunctional status.
 Objectives. To study functional state of the microcirculatory channel system in the periodontal tissues of the young patients with different types of smoking.
 Matodology. Clinical examination of 240 patients was carried out with subsequent division into subgroups depending on the smoking type: smoking cigarettes, electronic cigarettes with liquids, tobacco heating systems and hookah with further division into subgroups depending on the smoking experience: up to 1 year, from 1 to 5 years, more than 5 years. Subsequently indices were determined: simplified index of oral hygiene according to Green–Vermillion (OHI-s, 1964), papillary-marginal-alveolar index (PMA modified by Parma, 1960), bleeding index SBI (Muehlemann modified by Cowell, 1975). For objective assessment of microcirculation in periodontal tissues we used high-frequency ultrasonic Dopplerography device "Minimax-Doppler-K" (LLC "SP-Minimax", St. Petersburg) with subsequent determination of average linear blood flow rate (Vas) and Gosling (PI) and Purcelo (RI) indices. Microcirculatory channel dynamics in periodontal tissues of the studied groups was studied in the state of physiological rest, immediately after smoking, in 15 minutes, in 30 minutes and in 60 minutes. 
 Results. On the basis of the carried out research the distinctive indices of microcirculation in the periodontal tissues before and after different kinds of smoking as well as the functional state of the vascular architectonics were determined. 
 Conclusions. The given research allows to understand at which types of smoking the smallest and the largest changes of microcirculation in periodontal tissues are observed and that also should be taken into account in daily clinical practice when seeing young periodontal patients who smoke.

ПРИМЕНЕНИЕ ЛАЗЕРНОЙ ДОППЛЕРОВСКОЙ ФЛОУМЕТРИИ В ОЦЕНКЕ ЭФФЕКТИВНОСТИ ПРЕДОПЕРАЦИОННОЙ ПОДГОТОВКИ У ДЕТЕЙ К РЕОПЕРАЦИИ ДЕФЕКТА НЕБА ПОСЛЕ УРАНОПЛАСТИКИ

Objectives. The results of the state of microcirculation in the region of the defect of the palate and periodontal mucosa after preoperative preparation in children with congenital cleft palate for the planned reoperation of the defect of the palate are presented.
 Purpose. To monitor the state of microcirculation according to laser Doppler flowmetry and evaluate the effectiveness of preoperative preparation for reoperation of a palate defect in children with congenital cleft palate and a defect after uranoplasty.
 Methodology. The article presents data on the state of microcirculation of periodontal tissues and in the region of the palate defect before and after preoperative preparation for reoperation of the palate defect in 109 children aged 6–12 years with congenital cleft palate and a defect after uranoplasty, which were divided into 4 groups depending on from the methodology used.
 Results. Introduction into the algorithm of preoperative preparation for reoperation of a palate defect in children with congenital cleft palate and a defect after uranoplasty of alternating a course of laser therapy of the periodontal mucosa, mucous membrane in the region of the palate defect from the oral cavity and nasal cavity in combination with ultraphonophoresis with an antibacterial gel based on metronidazole and chlorhexidine, with the subsequent use of a dissociating palatal plate, has a positive effect on the state of microcirculation of periodontal and mucosal tissues in the region of the palate defect, namely, it leads to a decrease in the average perfusion index and an improvement in the intensity of blood flow.
 Conclusions. After monitoring the state of microcirculation of periodontal tissues and in the region of the palate defect in children with congenital cleft palate, deviations from the norm were noted, indicating a weakening of the arteriolar vascular tone and stagnation in the venular link. The use of alternating laser therapy with a diode laser and ultraphonophoresis with an antibacterial gel made it possible to achieve an improvement in microcirculation in a short time, which is the optimal condition for reoperation.

Investigating the impact of coffee consumption and cigarette smoking in the oral cavity and periodontal tissues

Relevance. Modern studies demonstrate that the combination of smoking and coffee drinking adversely affects the whole body, not only the oral mucosa. The study aimed to investigate the impact of coffee consumption and smoking in the oral mucosa and periodontal tissues.Materials and methods. We examined 60 dental patients, mean age of 22.1 ± 0.3 years old. The first group included nonsmoking coffee drinkers, the second – non-coffee-drinkers-smokers, the third – smokers- coffee-drinkers. In all patients, we determined hygiene and periodontal indices: PMA (papillary-marginal-attached) index Parma, Muhlemann sulcus bleeding index (SBI) modified by Cowell, simplified Green-Vermillion Oral Hygiene Index (OHI-s). The study examined microcirculation in periodontal tissues using Doppler ultrasound. We took patients’ blood pressure and heart rate to study salivary flow rate, pH and viscosity according to the Redinova-Pozdeev technique.Results. The combination of coffee consumption and smoking affects the dynamics of the blood flow (BP, HR). The study of periodontal tissue blood supply revealed a significant increase in microcirculation in non-smoking coffee drinkers. Smoking negatively affected periodontal blood supply, namely periodontal circulation decreased, while general circulation parameters increased after smoking. In all studied groups, salivary flow rate increased, and saliva pH and viscosity decreased. The third group exhibited the most significant changes in these parameters.Conclusion. Combined coffee consumption and smoking deter periodontal microcirculation, cause significant adverse changes in the oral fluid, and may take their toll on dental health.

Study of functional state of microcirculatory channel system in periodontal tissues in persons of different age groups

Relevance. The study of age-related features of microcirculation in periodontal tissues, using non-invasive functional research methods, allows us to develop the optimal range of therapeutic measures, as well as form a “personalized therapeutic case”.Purpose. Study of the functional state of the microvasculature in the tissues of the parodont in individuals of various age groups.Materials and methods. A standard dental examination of 80 patients was carried out, the sample of participants was ranked in 4 groups by age: 1 group – 12 years old, 2 group – 15 years old, 3 group – from 16 to 18 years old, 4 group – from 22 to 24 years old. Hygiene and periodontal indices were determined for all patients, such as papillarymarginal-alveolar (PMA) in the Parma modification, the Mulleman bleeding index in the Cowell modification (SBI), and the simplified Green Vermillion index of oral hygiene (OHI–s), caries intensity indicators for a permanent bite (CPI), as well as ultrasound dopplerography of periodontal tissues using the apparatus "Minimax-Doppler-K".Results. When studying microcirculation in periodontal tissues, distinctive characteristics of linear (Vas) and volumetric (Qas) blood flow rates, as well as indicators of pulsation indices (PI) and peripheral resistance (RI) in people of different age groups were recorded.Conclusions. This study confirms the presence of various hemodynamic indicators of periodontal tissues in the studied groups, which is due to structural features of the circulatory system in age periods.

Evaluation of gingival microcirculation in localized periodontitis of traumatic etiology

Relevance. The indispensable study of blood microcirculation of periodontal tissues in patients with localized periodontitis of traumatic etiology (LPTE) alongside with the assessment of the somatic status lets determine the degree of adaptive capacity of the organism. Laser Doppler flowmetry (LDF) allows noninvasively identify preclinical changes in the periodontal blood microcirculation and observe periodontal status at any treatment phase aiming at the confirmation of effectiveness of undertaken measures.Purpose. The objective of this work is to evaluate periodontal blood microcirculation in LPTE for existing latent vascular flow changes and adaptation features.Materials and methods. LDF measurements of periodontal blood microcirculation in 169 patients with mild and medium LPTE, conducted relaxed and with the use of functional cold test, were done.Results. A decrease in the number of functioning capillaries in periodontal tissues (expressed in a decrease of the integral index of microcirculation), a decrease in blood flow variability (σ-standard deviation) and the stress of the functioning of the regulatory blood microcirculation (Cv) were found. Due to outcomes, it was registered that in mild and medium severity LPTE, normal reaction of adaptation detected at 69.6% and 43.4% cases, respectively, in the remaining cases reaction of intense adaptation and unsatisfactory response adaptation (only if the moderate degree of LPTE) were fixed.Conclusion. Latent periodontal vascular flow changes and also adaptation characteristics are closely related with the somatic state of the body, in particular with the presence of cardiovascular disease in a group of patients.

Assessment of peridontal vessels hemodynamics among patients with diabetes mellitus type 1

Relevance. Processes of disturbance of regional hemodynamics, tissue blood flow, insufficiency of transcapillary metabolism and antioxidant system caused by dysfunction of periodontal vascular endothelium among patients with diabetes type 1 directly lead to diabetic microangiopathy accompanied by decrease of level of microcirculation and perfusion of periodontal tissues among patients with absolute insulin insufficiency. The reduction of linear and volumetric blood flow rates in periodontal vessels among patients with type 1 diabetes compared to values obtained by ultrasonic dopplerography in healthy patients can be considered as distinctive features of the manifestation of this systemic disease on microcirculation of periodontal tissues.Purpose. To evaluate the hemodynamics of periodontal vessels among patients with diabetes mellitus type 1 and without diabetes before and after conservative periodontal therapy.Materials and methods. 40 patients at the age 20-30 years were surveyed: 20 patients with diabetes mellitus type 1 and 20 patients without diabetes. All subjects underwent dental examination. To study the state of microcirculation of periodontal tissues patients of both groups underwent high-frequency ultrasound Doppler “Minimax-doppler-k”. Further was conducted professional oral hygiene complex with training in rules of individual oral hygiene. Reexamination was scheduled after 4 weeks. Results. During the conduction have been registered average baseline of the linear (Vam) and volumetric (Qam) blood flow in periodontal vessels in patients with diabetes mellitus type 1 and without diabetes. Average linear (Vam) and volumetric (Qam) blood flow before the conduction of professional oral hygiene complex were considerably lower compared to patients without diabetes. This points reduction of microcirculation and perfusion of periodontal tissues in patients with diabetes mellitus type 1 and without diabetes. Reassessment of blood flow in periodontal tissues in 4 weeks after professional oral hygiene revealed an increase in rate of microcirculation in periodontal tissues among patients with diabetes mellitus type 1 and without diabetes. Conclusion. Our study confirms the theory of hemodynamic impairment and local hemostasis in patients with type 1 diabetes, which is reflected in the appearance of trophic disorders of an inflammatory-dystrophic nature and a decrease in hemodynamic parameters. After conservative periodontal therapy, we revealed positive changes in hemodynamics of periodontal vessels, which was recorded using ultrasound dopplerography. Our results will allow us to select the optimal algorithms for the timely diagnosis, prevention and treatment of dental diseases in patients with type 1 diabetes in future.

Microcirculatory changes in periodontal tissues of patients with periodontitis in the dynamics of physical therapy

Relevance . The prevalence of periodontal diseases among the population of different countries remains at a high level every year. The study of pathogenetic mechanisms of the disease and the search for effective treatment methods for patients with chronic generalized periodontitis remain relevant. Important in the pathogenetic treatment of periodontitis are methods aimed at normalizing hemodynamics in periodontal tissues. Physiotherapeutic methods of treatment are widely used. Today, a large number of modern physiotherapy equipment has appeared on the dental market. However, in the budget health care institutions of the Udmurt Republic, the staffing of routine devices remains quite high. Purpose . The aim is to study the hemodynamic parameters of periodontal tissues in the dynamics of treatment of patients with chronic generalized periodontitis using routine and innovative methods of physical therapy. Materials and methods . The study was conducted in 500 patients with chronic generalized periodontitis of moderate severity. Аll the examined patients were divided into 5 groups of 100 people each: in the control group, only professional hygiene was performed using ultrasound and zone – specific scalers; in the first main group, after professional hygiene, a course of physiotherapy was prescribed using a Picasso led laser with a wavelength of 810 nm; the second main group course of physical treatment of periodontitis conducted by the device “ОzoneDTA”; in the first group comparison physiotherapy treatment included the effect on the tissues of the periodontal apparatus “Optodan”, and the second comparison group used darsonvalization unit “Iskra-1”. Professional hygiene was performed once every 3 months, and physical therapy was performed once every 6 months for 12 months of follow-up. The monitoring of clinical indicators was carried out in time: before treatment, 3.6 and 12 months after the start of follow-up. Microcirculation of periodontal tissues during physiotherapy was evaluated by photoplethysmography using the method of Z. M. Segal (1984) with a computer device. Results . It was found that during physiotherapy treatment, microcirculation in periodontal tissues increases in the nearest time (after a week and 3 months), while maintaining stable hemodynamics for 12 months of follow-up, while in the control group, where physiotherapy was not performed, but professional hygiene was prolonged once every 3 months, improvement of hemodynamics was noted only at the end of the follow-up period-in a year. The most favorable clinical indicators were also observed in the groups where the devices were used during treatment. Аfter 12 months, especially significant differences were observed in the PMA index. Conclusion . Physiotherapy methods help to increase hemodynamics in periodontal tissues. Modern physiotherapy devices – the Picasso diode laser and the Ozonedta device-have a more intensive effect on the linear systolic blood flow rate.they also significantly increase the anti-inflammatory effect of treatment of chronic generalized periodontitis in patients.

Clinical reasoning of application of stem cells in the treatment of gingival recession

The aim of the study is to improve the results of complex treatment of patients with gingival recession on the basis of validation of new, highly effective methods using autologous mesenchymal stem cells. A complex treatment was conducted in 93 patients with an anatomical recession of the gum in combination with dentoalveolar anomalies at the age of 20 to 29 years. Patients were divided into 3 groups depending on the treatment used. All patients underwent periodontological treatment. In the 2nd group, patients underwent periodontological treatment including orthodontic equipment, in the 3rd group, they underwent orthodontic treatment, and a cell transplant based on a mixture of autologous mesenchymal stem cells and sterile bioplastic collagen material “Collost” was used. A comprehensive assessment of the periodontal tissue of the three groups showed that among the patients who received the standard treatment complex, a good condition of the periodontal tissues in 1 to 2 years after treatment was noted only in 16.7 % of the patients of the 1st group. Inclusion of orthodontic treatment made it possible to obtain good results in 25 % of patients in the 2nd group, which is 8 % more than in the 1st group. At the same time, good treatment results were revealed in 94 % of the 3rd group patients, who underwent periodontological and orthodontic treatment using autologous mesenchymal stem cells, which confirms the need for measures aimed to normalize the position of teeth, dentition and bite with the use of small orthodontic long-acting forces, to improve the microcirculation of periodontal tissues, and to restore the contour of marginal dreams. Inclusion of autologous mesenchymal stem cells in the complex treatment of patients with gingival recession is accompanied by a 1.6-fold decrease in the prevalence and gum recession (1.15 mm), and a 2.6-fold increase in the tissue volume, by the stimulation of periodontal microcirculation processes (the capillary periodontal pressure is increased by a factor of 1.1 time and the intensity of periodontic microcirculation is increased by a factor of 3.1 times), as well as by the normalization of the position of teeth, dentition and occlusion, which allowed one to obtain good long-term results in 94 % of patients.

O005: Computer capillaroscopy in the evaluation of microcirculation in periodontal tissues during inflammatory diseases

O005: Computer capillaroscopy in the evaluation of microcirculation in periodontal tissues during inflammatory diseases

Микрогемоциркуляция в тканях пародонта у больных сахарным диабетом

Микрогемоциркуляция в тканях пародонта у больных сахарным диабетом

Microcirculation impairment in periodontal tissues in patients with chronic generalized periodontitis combined with metabolic syndrome

Using the method of laser Doppler flowmetry the study of microcirculation in periodontal tissues in patients with moderate chronic generalized periodontitis and metabolic syndrome was carried out. The analysis of microcirculation values proved not only the reduction of blood flow intensity but also the decreased vasoactivity of microvessels essential to maintain normal microcirculation in periodontal tissues, as it provides active modulation of tissue blood flow and its adaptation to local metabolic needs.

Оценка поведения нелинейной динамической системы микроциркуляторного русла тканей пародонта в фазовом пространстве при диагностике методом лазерной допплеровской флоуметрии

The article presents the assessment the behavior of a nonlinear dynamic system of a micro-vascular channel of periodontal tissues in phase space by laser Doppler flowmetry. For this purpose, 62 patients aged 18-36 years were examined. The control group consisted of 20 healthy individuals without co-morbidities with intact periodontium. The 1st group was 20 patients with chronic catarrhal gingivitis of mild degree; the 2nd group consisted of 22 patients with chronic generalized periodontitis of mild degree. Assessment of the state of a non-linear dynamic system of periodontal tissues was performed by laser Doppler flowmetry, the device LACC-02 (SPE "LAZMA", Russia) and program 2.2.50 (SPE "LAZMA", Russia). Depending on the functional state of the microcirculation in periodontal tissues, phase portraits, reflecting the dynamic state of the nonlinear system were built. The analysis of phase portraits LDF – grams revealed the dysfunctional types characterizing an inflamma-tory process. It can be used in clinical practice as a method of functional monitoring and forecasting in patients after treatment.

Оценка нелинейных динамических процессов и колебательного контура микрогемоциркуляторного русла тканей пародонта методом лазерной допплеровской флоуметрии

The article discusses the assessment of the level of interconnection of non-linear dynamic and oscillatory processes in the microvasculature of periodontal tissues by laser Doppler flowmetry. For this purpose an examination of 62 patients aged 18-36 years was carried out. The control group consisted of 20 healthy indi-viduals without co-morbidities with intact periodontium. The 1st group was 20 patients with chronic catarrhal gingivitis mild; the 2nd group – 22 patients with chronic generalized periodontitis mild. The laser Doppler flow-metry with spectral continuous wavelet analysis of the blood flow oscillations was carried out by the apparatus LACC-02 (SPE "LAZMA", Russia). In the course of the study the authors evaluated the relative vibration ener-gy of E0 flow using spectral analysis of the records of the LDF (program 2.2.509 - SPE "LAZMA", Russia) and normalized nonlinear dynamic parameters of microcirculation of periodontal tissues. This allows to reveal their relationship to the parameters of the oscillatory process, to conduct its analysis, to understand the state of the macroscopic behaviour of the modulating factors, both in normal and in pathological conditions. As result of this study, it was found that the changes of the normalized nonlinear parameters microvasculature of periodontal tissues during the inflammatory process (I and II study group) were characterized by a decrease of the chaotic behavior of the system of microcirculation and its order on the basis of the numerical parameters of randomness (*, D2 N).

Microcirculation in periodontal tissues assessed by computer capillaroscopy in patients with periodontal disease and metabolic disorders

The method of capillaroscopy was used to study microcirculation in periodontal tissues in patients with metabolic syndrome and evaluation of vascular disorders in periodontal disease. In addition to visual assessment of the microcirculation morphometric features of microvessels were obtained: capillary diameter, capillary blood flow velocity, density of capillary network. Computer capillaroscopy thus allowed revealing the structural features of microvessels and their distribution in periodontal tissues.