Yarov Y. Supportive treatment of patients after dental implantation, depending on the levels hygiene of the oral cavity

The dissertation presents a theoretical generalization and a new solution of the actual scientific and practical task of modern dentistry, that is decreasing the number of complications in the nearest period of postoperative wound healing and in the remote period of implant functioning after dental implantation by substantiating and developing the method of supportive treatment, taking into consideration the hygienic state of the oral cavity. To solve the given tasks, 124 somatically healthy patients (54 men and 70 women) aged between 18 and 34 years were examined, among them: 25 people with intact periodontal disease, 35 patients with chronic catarrhal gingivitis (CCG), 30 patients with generalized periodontitis (GP) of the 1st degree of severity and 34 patients with GP of the 2nd degree. All the patients were performed the operation of dental implantation for medical reasons. Objective assessment of the hygienic state of the oral cavity was carried out by determining the total hygienic index of HI Green-Vermillion. The diagnosis was performed on the basis of the clinical examination data, radiography, periodontal indices according to the International Classification of Diseases ICD-10. Depending on the type of further maintenance therapy, patients were divided into two groups: main (45 people) – the proposed differential supportive therapy was conducted; control (49 people) – the traditional supportive therapy was used. Patients with healthy periodontium (25 people) made up a comparison group. The results of the analysis of the studied parameters indicate the probable differences in the hygienic state of the oral cavity, depending on the severity of the inflammatory and destructive process in the tissues of the periodontal disease. The correlation analysis shows that between the Green-Vermillion HI and the indicators that characterize the condition of periodontal tissues, direct correlation between moderate (bleeding index, average periodontal pockets, Russell periodontal index) and strong (PMA index) is determined. It should be noted that the strongest direct correlation relationship is established between the Green-Vermillion GI and the PMA index (r = 0.601 at p <0.05). Taking into consideration the overwhelming role of the rheological properties of the oral fluid for the hygienic state of the oral cavity, the research of it was performed in patients with different states of periodontal tissue before dental implantation. For the analysis of rheological indicators, the method of dynamic interphase tensiometry was used, which allows us to investigate the surface phenomena occurring in biological fluids of an organism. The results of the comparative analysis of the rheological parameters of the oral fluid in patients with various degrees of severity of the periodontal disease (intact periodontium, chronic catarrhal gingivitis, generalized periodontitis of the 1st and 2nd degree of severity) indicate more profound changes in its surfactant properties in parallel with the progression of the pathological process in tissues of a periodontal disease and, accordingly, with a deterioration of the hygienic state of the oral cavity. The correlation analysis showed the strongest correlation between the Green-Vermillion HI and the viscosity coefficient b2 ( r = 0.705 at p <0.05).