In accordance with the objectives, we conducted an experimental study on 40 animals (male rabbits of the Dutch breed), which were divided into 4 groups according to the purpose of the research to study the effect of platelet-rich blood plasma, mucosal gel G32 on periodontal tissues after NRD, and to control groups included intact animals. Animals were removed from the experiment on the 5th and 20th day.
The experimental study revealed changes in the microcirculatory bed in periodontal tissues with the use of NRD, which were characterized by narrowing of arterioles by 1.8 times, dilatation of venules by 1.25 times, damage to periodontal tissues with increased conformational activity of chaperones (both Hsp70 and Hsp90) leading to activation of epidermal growth factor HER2 transmembrane receptor EGFR. These processes lead to activation of vascular endothelial growth factor VEGF and changes in MGMT methylation processes, and activation of proapoptotic proteins p53 and BAX in combination with inhibition of bcl-2 caspase inhibitors lead to the formation of inflammatory-dystrophic lesions.
To solve clinical problems, a comprehensive examination of 113 patients was provided. Age of patients was 18-25 years with inflammatory diseases of periodontal tissues that occurred during orthodontic treatment, and to assess the dynamics of periodontal tissues under the influence of developed treatments, 92 patients were selected for in-depth examination who received orthodontic treatment and were divided into two groups: the main (68 people) and the comparison group (24 people).
The generalization of the results of the clinical examination of patients with NRD in the oral cavity determined an improvement of oral hygiene (according to the Green Vermilion index - from 2.32±0.12 points to 1.18±0.06 points, Silnes-Loe - from 2.35±0.13 points to 1.11±0.05 points), as well as a decrease in periodontal indices: PMA 2.2 times, Svrakov's number 1.6 times and bleeding 1.7 times after completion of treatment with using platelet-enriched plasma, mucosal G32 gel and combinations thereof.
Periodontal protection efficiency when using only mucosal G32 gel at the end of the study was 38.4 %, which indicates a pronounced anti-inflammatory effect of the applied gel. It is noteworthy that when performing PRP-therapy procedures alone and in combination with G32 gel applications was 55.7 % and 58.8 %, respectively.
Clinical studies have shown that the most pronounced signs of periodontal inflammation were in patients who were on orthodontic treatment of NRD for
2-3 years, and the greatest decrease in the numerical values of all studied indices was in patients who were on orthodontic treatment for 1.5-2 years.
A clinical and laboratory study to assess the quantitative and qualitative criteria of non-specific oral protective factors that determine the adaptive processes on the background of orthodontic treatment, found an increase in α-defensin activity by almost 8 times, cathelicidins by 1.2 times, Klotho protein by
1,8-2.2 times in the oral fluid in patients during orthodontic treatment using NRD with simultaneous exposure to periodontal tissues PRP therapy and mucosal gel G32.
Established deficiency of cathelicidin proteins, Klotho, decreased α-defensin activity in oral fluid is consistent with the presence of inflammatory periodontal disease in patients with NRD in the oral cavity and therefore in the presence of etiological risk factors are the markers by which to predict local immunity in the cavity and the development of inflammation in periodontal tissues during orthodontic treatment by NRD.
However, the lowest level of baseline data was found in patients with HCG who had NRD in the oral cavity for 2-3 years, which, in our opinion, is due to the failure of antioxidant defense mechanisms in this group of patients on the background of orthodontic treatment. However, there was an improvement in the state of antioxidant system, which was characterized by an increase in catalase levels in 2 - 2.3 times, after the use of platelet-enriched plasma in combination with mucosal gel G32.
The proposed and developed method of treatment of chronic catarrhal gingivitis in patients with NRD in the oral cavity can improve the results of treatment due to its ability to stimulate the body's own reserves, local regeneration processes in periodontal tissues and is safe to use, has high biological activity. clinical recovery and prevention of complications during orthodontic treatment and normalization of dental status.
