[The assessment of a role of muramyl peptides in the treatment of patients with aggressive form of periodontitis]. / Izuchenie roli kompozitsii muramilpeptidov pri lechenii patsientov s agressivnoi formoi parodontita.

THE AIM OF THE STUDY: Was to determine the effect of the drug based on the composition of muramyl peptides isolated from the cell walls of gram-negative bacteria on the production of α-defensins and the detectability of Porphyromonas gingivalis in patients with an aggressive form of periodontitis. MATERIAL AND METHODS: 60 patients aged 28 to 40 years with an aggressive form of periodontitis were randomized into two equal groups, the main and control. In both groups, patients were removed dental deposits and taught the rules of oral hygiene, followed by three-fold control. In the main group, 200 micrograms of the drug based on the composition of muramyl peptides were additionally administered intramuscularly daily for 7 days. Initially and after 7, 21, 90 days, the level of human neutrophil peptides (hnp1-3) in blood serum and periodontal pockets was determined by the enzyme immunoassay, as well as the presence of P. gingivalis in periodontal pockets by polymerase chain reaction (PCR). RESULTS: In patients of the control group, the concentration of hnp1-3 in periodontal pockets and blood serum did not change significantly during the entire study. The use of PM in the main group caused an increase in the local and systemic levels of hnp1-3, which correlated with a persistent decrease in the detectability of P. gingivalis. CONCLUSION: The drug based on the composition of muramyl peptides of the cell wall of gram-negative bacteria potentiates the eradication of P. gingivalis by stimulating the production of hnp1-3 in patients with an aggressive form of periodontitis.

[Antibacterial effect of a non-specific immunomodulator based on muramilpeptides in chronic periodontitis]. / Antibakterial'nyi effekt immunomodulyatora na osnove kompozitsii muramilpeptidov pri khronicheskom generalizovannom parodontite.

THE AIM OF THE STUDY: Was to investigate the efficacy of immunomodulatory drug based on muramilpeptides for treatment of chronic generalized periodontitis. MATERIALS AND METHODS: The study group comprised 20 patients aged 25 to 64 with severe chronic periodontal disease. Periodontal pockets content was inoculated for specific microbial pathogens before and after treatment. Twenty patients receiving conventional treatment with no muramilpeptides-based agent served as controls. RESULTS: In the main group prolonged suppression of periodontal disease provoking microbiota was seen, while in controls conventional treatment was not sufficiently effective resulting in germs growth relapse at day 21. CONCLUSION: The dynamics of the microbiological landscape of periodontal pockets after treatment proves the necessity for a correction of innate immunity in inflammatory periodontal disease.

[Classification of periodontal and peri-implant tissues diseases (Euro-Perio, 2018). Advantages and inconveniences]. / Klassifikatsiya zabolevanii parodonta i periimplantatnykh tkanei (Evro-Perio, 2018). Dostoinstva i nedostatki.

The article presents the «Classification of periodontal diseases and the state of perimplant tissues¼, adopted at the international Congress Euro-Perio-9 in 2018. The advantages and disadvantages of this systematics in comparison with the previous ones and with the classification currently adopted in the Russian Federation are noted.

[Clinical effectiveness of an immunomodulatory drug based on a muramylpeptide composition in the treatment of patients with chronic generalized periodontitis]. / Klinicheskaya effektivnost' immunomoduliruyushchego preparata na osnove kompozitsii muramilpeptidov pri lechenii patsientov s khronicheskim generalizovannym parodontitom.

THE AIM OF THE STUDY: To assess the efficacy of an immunomodulatory drug based on a muramylpeptide composition in the treatment of patients with chronic generalized periodontitis. MATERIALS AND METHODS: The study comprised 40 patients with chronic generalized periodontitis. In controls the treatment consisted in oral hygiene instructions, professional oral hygiene procedures and root scalling while in main study group the conventional treatment protocol was combined with intramuscular injections of muramylpeptide composition. RESULTS: The study showed significant reduction of inflammatory symptoms in periodontal tissues in muramylpeptide composition group. CONCLUSION: Muramylpeptide composition increases the threshold of tissue protection against constantly present microbial accumulations in periodontal disease patients thus providing opportunity for excluding toxic antimicrobial agents and/or antibiotics (or reducing their dosages).

[Orthodontic treatment of a patient with a thin gingival biotype and malocclusion]. / Ortodonticheskoe lechenie patsientki s tonkim biotipom desny i anomaliiami okkliuzii.

Description of the clinical case of the patient with narrowing and deformation of the dentition of the upper and lower jaw and crowded teeth in the frontal part of the lower jaw in combination with a thin gingival biotype. The combined use of diagnostic methods: colorimetric probe, ultrasonic scanning and cone-beam computed tomography, followed by computer 3D-modeling of the treatment plan made it possible to competently plan and implement orthodontic treatment of the patient without complications from periodontal tissues. Combined application of colorimetric probe, ultrasonic and cone-beam computed tomography methods with digital 3D-modeling of the treatment plan allowed to plan and carry out orthodontic treatment of a patient with a thin gingival biotype without periodontal complications.

[The impact of surgical and conservative treatment of periodontal disease on structural and functional condition of major blood vessels]. / Vliianie khirurgicheskogo i konservativnogo lecheniia patsientov s bolezniami parodonta na strukturno-funktsional'noe sostoianie ikh magistral'nykh sosudov.

The study included 55 patients (24 men and 31 women aged 30-70 years) with chronic periodontal disease and atherosclerosis of brachiocephalic arteries (BCA). Patients in group 1 received only conservative treatment for periodontal disease, while in group 2 both conservative and surgical treatment were performed. The values were evaluated at baseline and 6 months after treatment. Capillaroscopy and laser Doppler flowmetry showed an improvement in periodontal regional vascular network. The level of IL-6 decreased by 3.7 pg/ml and 5.9 pg/ml, C-reactive protein - by 2.0 mg/l and 3.4 mg/l in groups 1 and 2 correspondingly. Dark-field microscopy showed the decrease in the thickness of perfused boundary region by 0.05 mm and 0.28 mm, and the increase of red blood cells filling by 1.2% and 7.8% correspondingly. According to the results of ultrasound scanning of BCA after 6 months the number of atherosclerotic plaques and lumen of the vessels in the area of the plaques has not changed. BCA tone has not changed in group 1 and increased by 1-2% in group 2. Intima-media complex thickness decreased in group 1 by 0.02-0.03 mm, in group 2 - by 0.04 mm. The obtained data prove correlation of vascular status of periodontal and major blood vessels.

[Correlation of chronic periodontal disease and cardiovascular disease]. / Vzaimosvyaz' parodontita i zabolevanii serdechno-sosudistoi sistemy.

The aim of the study was to assess correlative risk of progression of inflammatory periodontal lesions, the development of a systemic inflammatory reaction and cardiovascular diseases. The study involved 89 patients with chronic periodontal disease (CPD) of varying degrees. High cardiovascular disease risk was revealed in 8.8% of patients with moderate and 13.3% of patients with severe periodontal disease. It is proved that an additional factor contributing to the pathogenic relationship between periodontal inflammatory changes and the development of cardiovascular disease is systemic inflammatory response with increased hrC-reactive protein >3.4 mg/l and interleukin-6 to11.0±3.4 mg/l. Changes of blood lipid spectrum with a reduction in apolipoprotein A1 were associated with progression and development of the CPD. Correlations of somatic and dental pathology requires dentists and cardiologists joint efforts to modify common risk factors.

[The impact of periodontal disease treatment on endothelium of sublingual microvessels]. / Vliyanie khirurgicheskogo lecheniya parodontita na sostoyanie endoteliya mikrososudov pod''yazychnoi oblasti.

The intactness degree of glycocalyx and the thickness of endothelium layer in sublingual microvessels was determined by means of darkfield microscopy and GlycoCheck RI software in 35 patients (19 men and 16 women, aged 35 to 65 years) with chronic generalized severe periodontitis before and after anti-inflammatory and surgical treatment. The patients were divided into two groups. The first group recieved only local anti-inflammatory therapy while patients of group 2 underwent surgical intervention on the periodontium in addition to local anti-inflammatory therapy. In both groups the changes of parameters of endothelial glycocalyx (EGC) in the early stages of treatment were not significant. In long terms the changes were not revealed in group 1, but in group 2 6 months after surgical treatment in all patients the decrease in the thickness of the permeable glycocalyx decreased and increase of the volume of red blood cells filling was observed.

[The state of brachiocephalic artery endothelium in individuals with inflammatory periodontal disease and different cardiovascular risks].

The study included 35 patients (19 men and 16 women, aged 35 to 65 years) with chronic generalized severe periodontitis and atherosclerosis of the brachiocephalic artery (BCA). The changes of the BCA tone were evaluated by ultrasonic duplex scanning before and after transient limb ischemia created by endothelium-dependent vasodilation at baseline and at different laps after the anti-inflammatory and surgical treatment. The size of atherosclerotic plaques before and after the treatment was measured. In the early stages of treatment there were no changes of the tone of the brachial artery. The long-term results after conservative treatment also showed no changes but 6 months after surgical treatment in all patients the study showed the improved of the brachial artery tone on average 3-4% and a slight tendency to decrease of the atherosclerotic plaque.

[The choice of coating materials for vestibuloplasty and pre- and postoperative use of pain and sedative medications depending on patient emotional features]. / Vybor pokrovnykh materialov pri provedenii vestibuloplastiki i primenenie obezolivayushchikh sredstv v zavisimosti ot psikhoemotsional'nykh osobennostei patsientov.

The purpose of the message was the comparison of change in the width and quality of keratinized tissue created in the lower vestibuloplasty area. Preliminary results of the case-control study involving 71 patients showed that autotransplantation managed to create the necessary buffer zone with the desired thickness of the mucosa and is particularly justified in cases of «washing board effect¼. However, the method is technically complicated and more expensive and painfull for patients. The use of alternative materials of artificial origin, such as «Mucograft¼ and bloodstatic and desinfecting sponge simplifies the procedure technique thereby reducing operational risk but often does not lead to the formation of a fully keratinized gingiva.

[The relationship between inflammatory periodontal diseases and cardiovascular diseases].

Estimated the relationship between inflammatory periodontal diseases and the risk of developing cardiovascular disease. Installed combined effect of periodontitis and cardiovascular disease.