Optimization of Preoperative Preparation in Complex Treatment of Generalized Periodontitis

According to WHO periodontal tissues disease occupy a leading position in the structure of dental morbidity Ukraine. Modern approach to the treatment of generalized periodontitis provides comprehensive and targeted treatment based on individual characteristics of periodontal status and somatic condition of the patient. Rational use of various surgical techniques greatly enhances the quality and effectiveness of treatment prolongs the period of disease stabilization and reduces the number of relapses. The success of a method of surgical treatment of generalized periodontitis largely depends on the quality preoperative preparation and appropriate post-operative support. The aim of the study was to increased effectiveness of surgical treatment by GP justification personalized approach to correction of delayed-type hypersensitivity at the stage of preoperative preparation. To solve this problem we used clinical, radiological and immunological methods involving 120 people aged 25-36 years who were diagnosed with generalized periodontitis and II degree, chronic course. The control group consisted of 54 healthy patients of the same age without clinical signs of periodontal pathology. All studies were performed on the stage of preoperative preparation to the standard scrappy operation by direct tissue regeneration using membranes that are resorbed (Periogen, Perio - System). Short-term results of treatment (3 months) was evaluated by the number of complaints of the patient, gingival index and the index of sensitization, the number of lymphocytes and destroyed formed elements. Long-term results evaluated by the number of complaints, the degree of bleeding gums, sensitization indicators index, degree of mobility of the teeth, the presence supracontacts, radiological indicators. Statistical analysis of the results was performed by standard methods of variation statistics. According to a study at the first stage, as a result of reaction inhibition of leukocyte migration in the study group revealed delayed-type hypersensitivity to Streptococcus in 70,8±1,81% of patients, P <0,01; delayed-type hypersensitivity to Staphylococcus in 60,0±5,41% P <0.01; diallergy in the study group was found in 65,0±5,02% P <0.01 . The same pattern was found in the determination of delayed-type hypersensitivity according to skin-reactive test. So, to the antigen Streptococcus she observed in 32,3±4,12% of patients, P <0,01; to the antigen Staphylococcus she observed in 49,2±4,2% of patients, P <0.01; diallergy in 50,0±4,2% of persons P <0.01. In the second phase of the study in the evaluation of specific microbial hyposensitization following immunization with the structure of preoperative preparation it was found that most of the positive treatment outcome (84.2±0.23 %) was observed in patients undergoing immune correcting therapy. The survey results show that the vast majority of patients with generalized periodontitis I-II degree, chronic course, revealed delayed type hypersensitivity to one or two antigens simultaneously Strepto- and Staphylococcus, as well as to the bone antigen. We believe that it is appropriate to include in the list of measures of preoperative preparation for surgery on periodontal tissue specific microbial desensitization followed by immunization.