The dissertation thesis was aimed at increasing the efficiency of complex treatment of young patients with periodontal diseases by clinical-experimental substantiation and development of the method of correction of hypoxia on the basis of the use of an ozonetherapy and pharmacological composition. According to the results of experimental studies on cytotoxicity of drugs (in vitro), new pharmacological composition "Cytohexizole" has been substantiated and developed. It consists of Cytoflavin, Chlorhexidine and Metronidazole. The choice of optimal concentrations of drugs, their correlations in the new proposed pharmacological composition and optimal exposure time are substantiated, using which the viability of the cells is more than 75% (р<0,05). Under conditions of cobalt-induced hypoxia, its significant antihypoxic and cytoprotective properties have been established, because the viability of the cells are increases by 18% and 40%, compared to the hypoxia-control (р<0,05), with incubation time of 5 and 10 minutes, respectively. According to the results of experimental studies on laboratory animals (in vivo), complete normalization of metabolic-energy metabolism in periodontal tissues and significant antioxidant properties of composition have been established, because the level of MDA is decreased by 20% (р<0,05), the antioxidant-prooxidant index АРІ is increased by 35% (р<0,05). Based on the study on general toxicity, the absence of a negative effect of components of pharmacological composition "Cytohexizole" on the organism and tissue of the periodontal of laboratory animals was proved. According to the results of clinical-laboratory indicators, the study of features of markers of hypoxia, vascular endothelial dysfunction, prooxidant-antioxidant system, metabolic processes in periodontal tissues and oral liquid of patients with gingivitis and generalized periodontitis was conducted. With the progression of periodontal diseases, we note the deterioration of the clinical and index valuation of periodontal and hygienic statuses: OHI-S is increased by 22% between groups I and II, by 30% between II and III; PMA - by 20% and 30%; PBI - by 30% and 29%, compared between groups (р<0,05), respectively. According to the results of molecular-genetic and biochemical indicators, the level of expression of the HIF1alfa gene is increased by 4.4 times between the I and II groups, and by 4,1 times between the II and III groups; the level of expression of the LDHA gene - by 6,6 times and 1,9 times; the level of MDA - by 30% and 18%; the content of lactate - by 46% and 9%; thus, is decreased the catalase activity - by 13% and 8%; API - by 34% and 22%; the content of pyruvate - by 8% and 23%, compared between groups (р<0,05), respectively. The hypoxia compensation index corresponds to a low level in group I, a very low level - in groups II and III. With the progression of periodontal diseases, according to the molecular-genetic and biochemical indicators the increase of hypoxic and vascular disorders, the imbalance between the prooxidant and the antioxidant systems were established. Also the metabolic disorders were accompanied by a significant predominance of the part of anaerobic pathway of glycolysis. Particularly significant tensions were traced between groups I and II, than between groups II and III. The expediency of using the scheme of correction of hypoxia was substantiated. The scheme provides professional hygiene and a course of ozonotherapy in patients with chronic catarrhal gingivitis, also the course of ozonotherapy and the composition "Cytohexizole"in patients with generalized periodontitis. The high efficiency of the scheme in the nearest and longest terms was proved by the results of research. In patients of the group І the OHI-S, РМА, РВІ, level of expression of the HIF1alfa and LDHA were better by 23%, 25%, 35%, 35% and 26%, compared to the standard treatment method (p<0,05), respectively. In patients of the group ІІ the OHI-S, РМА, РВІ, level of expression of the HIF1alfa and LDHA were better by 17%, 25%, 36%, 47% and 47%, compared to the standard treatment method (p<0,05), respectively. In patients of the group ІІІ the OHI-S, РМА, РВІ, level of expression of the HIF1alfa and LDHA were better by 16%, 31%, 39%, 61% and 73%, compared to the standard treatment method (p<0,05), respectively. The hypoxia compensation index has reached a high level in the main subgroups of all groups, the middle level - in the control subgroups of groups I and II, and the low level - in the control subgroup of group ІІІ. The "stabilization" of the process in the groups I, II and III of the main subgroups was established in 94%, 94%, 88% of patients, as opposed to control subgroups - 71%, 70%, 63%, respectively. Application of the scheme eliminates the manifestation of hypoxia, normalizes the function of the vascular endothelium, improves oxygenation and microcirculation, increases the activity of the antioxidant system, normalizes metabolic and energy processes. This leads to a prolongation of the terms of remission of gingivitis and stabilization of the dystrophic and inflammatory process in the periodontal disease.
