Dronyk I. Substantiation of the systemic enzyme therapy in a comprehensive treatment of chronic generalized periodontitis

Diseases of the periodontal tissue are the most spread among all the stomatological diseases, and over 90% of the Ukrainian population suffers from it (up to 75% - in Europe). Generalized periodontitis, I-II degree of severity, is a leading one among them. The results of examination and treatment of 68 patients suffering from generalized periodontitis, I-II degree of severity. Anaerobic streptococci and staphylococci in different associations, most often with peptostreptococci or Candida fungi and fusobacteria, sometimes with enterobacteria, were found to take a dominating position in the etiology of purulent process in the periodontal tissue of patients suffering from chronic generalized periodontitis. Undoubtedly, an important role in elimination of bacterial agents belongs to immune response from both humoral and cellular immunity links. In its turn, purulent inflammation is associated with an expressed activation of lymphocytes and macrophages in the focus of inflammation. Biologically active substances are released as a result of cellular activation. Mediators of the intercellular interaction belong to them. Interacting actively with other mechanisms of homeostasis support cytokines participate in the regulation of practically all the protective body reactions determining inflammatory and immune response. A marked deficiency of local secretory immunity, imbalance of the cytokine profile and decrease of the key enzymes in the antioxidant system (superoxide dismutase – 2.07 times lower, and catalase – 1.4 times lower) are a characteristic feature of purulent process pathogenesis in the periodontal tissues. The elaborated and introduced into clinical practical work method of a comprehensive treatment of generalized periodontitis complicated by purulent foci in the periodontal tissues enables to produce an active effect on etiologic and pathogenic parts of the disease and optimize the results of therapy. Under its influence clinical-laboratory rehabilitation is observed within the terms of 5.4±0.2 days quicker, and remission during a year and more is achieved 97.1% of treated individuals. The prognostic value of the availability or absence of anaerobic staphylococci in the periodontal pockets, various content of S IgA and IL-1β in the oral fluid were determined in order to assess clinical course of purulent process in the periodontal tissue and efficacy of its elimination. To assess the quality of treatment administered for the patients with generalized periodontitis complicated by purulent exudate from the periodontal pockets detection of SIgA, IL-1B, FNP- α, IL-4 and superoxide dismutase activity in the oral fluid can be recommended to be determined.