Sylenko H. Clinical features, diagnosis, and treatment of generalized periodontitis in individuals with secretory immunoglobulin A deficiency

Sylenko H.M. Clinical features, diagnosis, and treatment of generalized periodontitis in individuals with secretory immunoglobulin A deficiency. – Qualification research work on a manuscript basis. The dissertation addresses a pressing issue in contemporary medicine – namely, improving the effectiveness of treatment for patients with generalized periodontitis and secretory immunoglobulin A (sIgA) deficiency. The principal achievement of the study is the clinical and laboratory-based substantiation and optimization of treatment approaches for patients with generalized periodontitis complicated by secretory immunoglobulin A deficiency. The aim of the study: to improve the effectiveness of treatment of generalized periodontitis in individuals with secretory immunoglobulin A deficiency through the clinically substantiated use of an immunomodulatory agent. The results demonstrate that patients with secretory immunoglobulin A deficiency experience a more severe and prolonged disease course, with exacerbations occurring two or more times per year in 12 patients of Subgroup 2 (80.0%), compared with patients with generalized periodontitis and normal sIgA levels in oral fluid. Based on the obtained findings, an algorithm for the treatment of generalized periodontitis in patients with secretory immunoglobulin A deficiency was developed. Treatment was provided to 25 patients divided into two subgroups: Subgroup 1 (n = 10) with normal sIgA levels received therapy according to the protocol approved by the Ministry of Health Care of Ukraine; Subgroup 2 (n = 15) with sIgA deficiency was treated according to the author-developed therapeutic regimen. Comprehensive treatment began with professional oral hygiene, including patient education and monitoring of oral hygiene practices, as well as individualized selection of toothpaste, toothbrushes, and interdental brushes. Antiseptic treatment with 0.12% chlorhexidine bigluconate solution (“Chlorhexidine Denta”) was performed before and after professional cleaning. Patients in the main group were advised to rinse the oral cavity with Stomatophyte solution after each meal for two weeks. Cholisal anti-inflammatory gel was applied to gingival tissues twice daily for five days at home. Direct-acting antioxidants were administered orally (tocopherol acetate 200 mg once daily for one month). Treatment of patients in Subgroup 2 was supplemented with a therapeutic periodontal dressing developed and patented at the Department of Postgraduate Education of Dentists, Poltava State Medical University. Treatment outcomes were evaluated 21 days after therapy, three months after completion of the full treatment course, and at long-term follow-up intervals of 6 and 12 months. The effectiveness of the developed and clinically tested algorithm for comprehensive treatment of generalized periodontitis in patients with secretory immunoglobulin A deficiency was confirmed by clinical, microbiological, and immunological findings.