Mucogongival Surgery as a Necessary Element of Complex Treatment of Patients with Shallow Vestibule Suffering from Generalized Periodontitis

Shallow oral vestibule and bands of connective tissue in the region of oral vestibule are one of the etiological factors in the development of generalized periodontitis. Today, one of the modern methods of complex treatment of the diseases of periodontal tissue with shallow oral vestibule is the use of surgical correction of pathological structure of oral vestibule. There are a number of mucogingival operations, but not always the use of these techniques of vestibuloplasty gives the desired therapeutic effect. The objective of the research was to improve the efficiency of complex treatment of patients with shallow oral vestibule suffering from generalized periodontitis improving the methods of vestibuloplasty and using the wound healing drug quercetin in the postoperative period. 60 patients with generalized periodontitis and shallow oral vestibule were examined and treated. All patients were divided into 2 groups. Patients of Group I (30 people) underwent vestibuloplasty according to A.I. Hrudyanov (2006). Patients of Group II (30 people) underwent vestibuloplasty developed for this purpose in which a number of technological moments were improved. As an important element of intervention there was the placement and fixation of free mucous grafts taken from the hard palate and inserted into the area of horizontal sections near the premolars using stitches. In the postoperative period the wound healing drug quercetin was prescribed to patients with generalized periodontitis in both groups. The results of research showed that vestibuloplasty with the use of free mucous transplants provided significant improvement of clinical indicators of treatment effectiveness when treating patients with generalized periodontitis and shallow oral vestibule. The most important results of using vestibuloplasty are the restoration of normal depth of oral vestibule, elimination of chronic injury in the region of oral vestibule, normalization of blood supply to the periodontal tissues, restoration of the structure of the mucosa of the periodontal tissues at the cellular level, and normalization of functioning of fibroblasts of the vestibular mucosa. Vestibuloplasty using free mucous grafts and the wound healing drug quercetin in complex treatment of patients with generalized periodontitis and shallow oral vestibule in the postoperative period demonstrated significantly higher treatment efficiency compared to vestibuloplasty where surgical wound was healing by secondary intention according to clinical and laboratory parameters, cytological, morphological features of the vestibular mucosa and radiographic, ultrasound characteristics of jaw bones in the early and late periods after treatment.