Ilenko N. Pathogenetic basis of primary and secondary prevention of periodontal diseases in HIV-infected patients.

At higher prevalence of periodontal diseases and the trend towards more severe forms of their course with the presence of HIV infection we established a number of changes of homeostasis system of oral cavity. The more severe cases of odontopathology and periodontal diseases were detected in HIV-infected patients with introvertive personality type. A number of cytological and microbiological changes in the oral cavity in HIV-patients were determined that are pointing to the disruption of normal cleansing mechanisms of oral cavity and the growth of Gram "-" microorganisms. The changes in level of concentration of TNF-a, IL-10 and cortisol in the oral liquid of HIV-patients were revealed. Studies of biochemical parameters of the oral liquid in patients with HIV infection showed the changes in intensity of free radical processes and activity of antioxidant systems in persons of the study group. Biophysical changes of the oral liquid with the presence of HIV infection had characteristics of increased viscosity, decreased mineralization potential of the oral liquid and the change in speed of salivation. Taking into account the obtained data and the available information in literature we have developed pathogenetic scheme, reflecting the possible mechanisms of the development of pathological processes in periodontal tissues for the cases with HIV-infection. The well-grounded scheme of complex treatment of inflammatory periodontal diseases was designed and implemented in HIV-patients. The evaluation of the effectiveness of the proposed treatment schemes showed the achievement of remission of inflammatory process in periodontal tissues.