Article title:
The effectiveness of treatment used for chronic periodontitis, involving antioxidant drugs, in patients with comorbid pathologies.
Authors:
Yu. Ostrovskaya, Yu. L. Osipova, V. M. Morgunova, N. S. Pronina, O. V. Ermakova, Yu. N. Artemenko, L. V. Arinina, T. V. Gerasimova, A. S. Grigorieva, D. A. Domenyuk, T. S. Kochkonyan, O. O. Ivanyuta.
For citation:
Ostrovskaya L.Yu., Osipova Yu.L., Morgunova V.M., Pronina N.S., Ermakova O.V., Artemenko Yu.N., Arinina L.V., Gerasimova T.V., Grigorieva A. S., Domenyuk D.A., Kochkonyan T.S., Ivanyuta O.O. The effectiveness of treatment used for chronic periodontitis, involving antioxidant drugs, in patients with comorbid pathologies.Otorhinolaryngology, Head and Neck Pathology (ORLHNP). 2024; 3 (2): 23-31.
Abstract:
Rationale.Despite the ongoing research and the respectively taken preventive measures, the prevalence of periodontal diseases reveals no tendency towards a decrease. When against a number of somatic diseases (peptic ulcer, diabetes mellitus, etc.), inflammatory and destructive issues affecting periodontium turn even more aggressive, whereas conventional treatment fails to ensure stable long-term remission. Antioxidant drugs, while activating the energy-synthesizing functions of mitochondria, correct disorders in the microcirculation system, as well as they improve the rheological properties of blood, and activate the immune system.
Aim of study.The study was aimed at producing clinical and lab-data based substantiation of employing antioxidant drugs within comprehensive treatment offered to cases of periodontitis where patients feature a comorbid pathology.
Materials and methods.The study methods included a clinical and laboratory examination and treatment of 232 patients aged 18-60 whose diagnoses were K25 and K26, and who suffered from chronic periodontitis. The entire pool of patients was broken randomly into groups depending on the treatment offered for chronic periodontitis. In Group I (117 patients), the treatment was carried out following the StAR Clinical Recommendations, whereas Group II (115 patients) had Mexidol antioxidant drug included into the treatment plan. Both groups were given first-line pharmacotherapeutic support for peptic ulcer disease. The control group were 25 basically healthy individuals.During the study, the oral fluid cytokine content (IL-6, IL-10, IL-12, IL-18), the proliferative activity of gingival epithelial cells (IKi-67, Iapopt, Ibcl-2) were identified, as well as gingival epithelial cells immune-positive to NO-synthase, endothelin-1 and melatonin were detected both prior to and after treatment. The obtained materials were processed with the EXCEL and STATISTICA 6.0 statistical software packages.
Results.The comprehensive treatment of periodontitis employed to deal with cases featuring comorbid pathology, where Mexidol was added to the standard mode, resulted in normalized proliferation and apoptosis in gingival epithelial cells, as well as in positive dynamics in the quantitative density of gingival epithelial cells immune-positive to nitric oxide synthase and melatonin; another beneficial effect observed was concentration of the studied cytokines in the oral fluid that persisted after 2 months. However, there was hyperplasia of gum cells immune-positive to endothelin-1 to be seen in both groups of patients suffering from moderate and severe periodontitis.
Conclusion.Mexidol, introduced into the treatment, allowed bringing down the recurrence rate and maintain periodontitis remission in 90.4% of patients with comorbid pathology.
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