Levtushenko M. Pathogenetic substantiation of the use of bacterial lysate for the correction of inflammatory-dystrophic periodontal processes

The dissertation work presents theoretical and experimental substantiations of new scientific approaches to the pathogenetic treatment of gingivitis and periodontitis, which consist in the use of bacterial lysate obtained by mechanical crushing of the local action of MLBL (Lyophilized bacterial lysate obtained by mechanical lysis) against the background of a disturbed state of the antioxidant and immune systems of experimental gingivitis and periodontitis, which leads to the normalization of indicators of these systems and ensures the improvement of all markers of periodontal damage to normal values. It has been proven that by the end of the 90-day period of observing the current of experimental parodontitis, the power of natural compensatory mechanisms had become decompensated. This is manifested by a 3-fold increase in proinflammatory cytokine IL-1β and a 1.7-fold increase in TNF-α, a 1.6-fold decrease in anti-inflammatory cytokine IL-10; and a 2-fold increase in blood CIC concentration, C-reactive protein - 4.4 times local level in gum homogenate tissue of control pathological group of animals. Experimental gingivitis in rats was characterized by the development of local inflammation, as evidenced by an increase in white blood cell count and the imbalance of POL/AOS processes at both the systemic and local levels, as well as an increase in the production of inflammatory cytokines IL-1β and γ-IFN against the background of a constant concentration of anti-inflammatory cytokine IL-4. The powerful corrective effect of the MLBL and LBLCh bacterial lysates on cytokine-type indicators on models of chronic experimental periodontitis has been well established. The normalizing effect is caused by the compensation of bacterial dysbiosis, the restoration of the balance of activity of pro-inflammatory cytokines and the reduction of hyperactivity of immunological markers. The use of bacterial lysates with immunocorrhaging action in experimental modelling of inflammatory and dystrophic processes of parodont completely compensated for the insufficiency of the proper cellular links of non-specific immune resistance. It has been proved that by the end of the 90-day period of experimental parodontitis, a statistically stable course of chronic damage of periodontal tissue was observed in terms of mineral exchange of alkali and acidic phosphatase enzymes of bone tissue membranes of osteoblasts and osteoclasts, which exceeded the intact group by 1.9 times, reflecting the hypoergic state of the chronic inflammation of the periodontium, respectively. The powerful corrective influence of preparations from bacterial lysates MLBL and LBLCh on models of chronic experimental parodontitis and gingivitis is reliably established on the basis of the index of functional condition of bone tissue of the alveolar process. A powerful stimulating influence of the processes of reparative osteoretination in the process of the use of respyrbron during the hypoergic flow of the inflammatory process in the parodont has been established. According to a histological study of parodontic tissues, the use of MLBL in experimental gingivitis prevents the development of experimental hypertrophic gingivitis in 40 per cent of rats, while in other animals it reduces its manifestation. When acute alterative inflammation occurs, MLBL significantly speeds up the healing process compared to non-forested control. MLBL has a positive influence on the clinical course of experimental inflammation of the parodont: it reduces damage from oxidative stress, normalizes the course of the immune non-specific response, the expression of local and general signs of inflammation, which confirms its usefulness in pathogenic therapy of inflammatory diseases of the tissues of the parodont. The results considerably broaden and deepen the current thinking on the development of experimental parodontitis. The relationship between the state of the antioxidant system, immunological protection and the activity of the inflammatory process is determined. The determination of an oxidative stress index has been found to be an informative and highly sensitive criterion of early detection of pathology of parodonts. This method will allow a more complete assessment of the degree of disturbed pro-oxidant-antioxidant state, immunological protection, and progression of inflammatory-antioxidant stateThe dystrophy process of the periodontal tissues and the timely prescription of MLBL bacterial lysate to prevent deeper disorders. For the first time pathogenetically justified is the advisability of using bacterial lysate, which is obtained by mechanical crushing of MLBL in inflammatory diseases of parodont, the effectiveness of which has been experimentally confirmed by the positive influence on the dynamics of reparative processes in periodontal tissue.