Myhal O. Peculiarities of clinical course, treatment and prevention of generalized periodontitis in patients with chronic rheumatic heart disease

The high prevalence of periodontal disease in patients with chronic rheumatic heart disease was found. In the structure of periodontal disease, the leaders were dystrophic-inflammatory nosologies with advanced severity, which is significantly objectified by index numerical indicators: in CRHD, the average PI was 6.11 ± 0.10 against 4.14 ± 0.19 in somatically healthy individuals (p<0.05). There was a higher incidence of periodontal tissue in younger age groups with a simultaneous increase in the duration of CRHD. This suggests a clear progression of generalized periodontitis, which was diagnosed in all subjects with 10 years of experience in rheumatic disease. The predominance of severe periodontal tissue lesions is evidenced not only by the clinical picture but also by radiological analysis: generalized periodontitis of the II degree of severity was detected in 29.47 ± 1.77% of patients with CRHD against 16.96 ± 2.48% of the comparison group (p<0,01), as well as generalized periodontitis of III degree of severity – in 19.25 ± 1.53% and 13.48 ± 2.26% of the main group and comparison group, respectively. In patients with CHD, the calcium level in the serum was significantly lower than values of the group of comparison: by 4.84% in GP of the initial-I degree (p<0,05), by 8,44% in GP of the II degree 0.01), by 15.72% in GP III degree (p<0.001). Based on the indicators of clinical, biochemical, microbiological, immunological studies, a scheme of treatment and prevention of generalized periodontitis in patients with CRHD was developed. It included a common set of basic therapy measures, accompanied by photoactivated disinfection during removal of local irritants by HELBO systems when irradiated in low power and multiplicity of procedures depending on the periodontal status. The developed scheme of photodynamic therapy in a higher percentage (84.38% vs. 58.06%) led to the normalization of periodontal tissues than in patients of the control group, which contributed to improved oral hygiene, elimination of microbial factors, normalization of periodontal tissues and achieving high clinical results immediately after treatment and in the long term.