The results of the conducted research allowed us to develop an algorithm of measures aimed at the prevention and treatment of inflammatory and dystrophic lesions of the periodontium. The complex for the prevention and treatment of generalized periodontitis in patients with metabolic syndrome consisted of several stages, the volume and sequence of which were determined by the clinical manifestations of the disease in each specific case. A mandatory element of the complex was recommendations for lifestyle modification and diet therapy, coordinated with an endocrinologist. The first stage included professional oral hygiene; teaching the rules of oral hygiene followed by monitoring; appointment of an individual oral hygiene regimen. For local therapy, we chose anti-inflammatory mouthwash Lizodent (Ukraine), and for applications - anti-inflammatory gel Abigel (Latus, Ukraine). At the second stage, surgical interventions were performed on periodontal tissues: closed curettage; with PР depth>5 mm, open curettage was performed and PerioChip was inserted into the periodontal pocket, which self-absorbed after 7-10 days, creating a high concentration of chlorhexidine in the gingival fluid.
The general treatment of patients was aimed at increasing the body’s resistance, providing anti-inflammatory effects, normalizing tissue metabolism and removing toxic products from the body. For this purpose, «Succinic acid» (TOV Pharmkom, Ukraine) and «Biotrit-denta» (Ukraine) were prescribed. To normalize the condition of the microcirculatory channel of the periodontal tissues, the combined vitamin preparation «Ascorutin» (Monfarm, Ukraine) was recommended.
Evaluation of the results of treatment in the observation groups was carried out 1 month after the end of the full course of treatment, and in distant terms - after 6 and 12 months.
In the nearest period of observation, 1 month after the treatment of generalized periodontitis, in the main group, the «normalization» of the state of periodontal tissues was noted in 23 patients (57.50±7.91%), in the control group the percentage was significantly lower - 30.00±7 .34%, p<0.01. «Progression» of inflammatory phenomena in the periodontium was recorded only in 4 patients of the main group (10.50±5.29%), but in the control group the number of patients was 4.5 times higher in the nearest period of observation (19 people, 47.50± 7.99%), p>0.05.
After 6 months of observation, «progression» of generalized periodontitis was observed in 3 patients of the main group (10.00±4.80%), and in 25 people of the control group (62.50±7.75%, p<0.01). In the long term, 12 months after treatment, stable remission was observed in 32 patients of the main group (80.00±6.40%) and 7 patients (17.50±6.08%) in the control group, p<0.01 .
The effectiveness of the algorithm developed and tested in the clinic for the prevention and treatment of generalized periodontitis in patients with metabolic syndrome is confirmed by the results of clinical, physicochemical, microbiological and immunological studies.
